Journal Article

DZNE-2026-00312

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Baseline Cerebral Small Vessel Disease Predicting Long-Term Cognitive Decline in Transient Ischemic Attack Patients.

Roesen, P. ; Temuulen, U. ; Rios, A. S. ; Ganeshan, R. ; Braemswig, T. B. ; Khalil, A. ; Villringer, K. ; Ihl, T. ; Ali, H. F. ; Gebert, P. ; Grittner, U. ; Ahmadi, M. ; Puy, L. ; Cordonnier, C. ; Endres, M.DZNE* ; Audebert, H. J. ; Kufner, A.

2026
Wiley-Blackwell Oxford [u.a.]

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Please use a persistent id in citations: doi:10.1111/ene.70578

Abstract: Cerebral small vessel disease (CSVD) is a common incidental MRI finding in patients with transient ischemic attack (TIA) and stroke and has been linked to cognitive decline. This study investigated the prevalence of CSVD imaging biomarkers in TIA patients and their association with cognitive performance over 3 years.We included 246 TIA patients from the INSPiRE-TMS study (ClinicalTrials.gov: NCT01586702). CSVD was assessed on baseline 3 T MRI using a composite score (0-4) including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (PVS). Cognitive performance was evaluated using the Montreal Cognitive Assessment (MoCA) at baseline and annually for 3 years.At least one CSVD imaging biomarker was present in 58.5% of patients. Lacunes (36.6%) were the most common, followed by PVS (28.1%), WMH (19.5%), and CMBs (17.9%). Higher CSVD-score was independently associated with greater cognitive decline over 3 years (β = -0.52, 95% CI -0.95- -0.08, p = 0.020), along with older age (β = -0.08, 95% CI -0.13 to -0.03, p = 0.001). CMB burden was the strongest predictive component of the CSVD-score (β = 0.42, 95% CI -0.63 to -0.22, p < 0.001). CSVD-score was particularly associated with decline in the memory domain (adjusted β of -0.18, 95% CI -0.32 to -0.04, p = 0.015).CSVD imaging markers are present in over half of TIA patients and are independently associated with cognitive decline up to 3 years, with the strongest effect on memory. Whether the presence of CMBs is the strongest predictive imaging biomarker of cognitive decline in TIA patients requires confirmation in further studies.

Keyword(s): Humans (MeSH) ; Ischemic Attack, Transient: complications (MeSH) ; Ischemic Attack, Transient: diagnostic imaging (MeSH) ; Ischemic Attack, Transient: epidemiology (MeSH) ; Cerebral Small Vessel Diseases: diagnostic imaging (MeSH) ; Cerebral Small Vessel Diseases: epidemiology (MeSH) ; Cerebral Small Vessel Diseases: complications (MeSH) ; Male (MeSH) ; Female (MeSH) ; Aged (MeSH) ; Cognitive Dysfunction: etiology (MeSH) ; Cognitive Dysfunction: diagnostic imaging (MeSH) ; Cognitive Dysfunction: epidemiology (MeSH) ; Middle Aged (MeSH) ; Magnetic Resonance Imaging (MeSH) ; cerebral small vessel disease ; cerebrovascular risk factors ; cognitive impairment ; magnetic resonance imaging ; transient ischemic attack

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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