Background: Neuropsychological deficits after lacunar infarction, such as amnesia and memory loss, have been reported occasionally. Hypometabolism and hypoperfusion are squelae of ischemia, and can have detrimental effects on cognitive functioning Objective: To investigate the changes in cognitive functions and neurometabolites in patients with lacunar infarctions and the relation between 1H-MRS results and cognitive deficit found by psychometric testing. Methods: This study included 30 patients with symptomatic lacunar infarction (18 males (60%) and 12 females (40%) with a mean age of 59.13±9.518 y) and 12 age and sex matched controls. They were subjected to clinical evaluation, complete laboratory testing, and a battery of neuropsychological testing, MRI and 1 H-MRS studies. Results: Patients had significantly lower scores of all psychometric tests, higher lactate/cr and lower NAA/cr and choline/cr in comparison to controls (p<0.05). Patients with multiple lesions had significantly lower scores of PWAT, digit span, Bender and vocabulary and higher lactate (p<0.05). Females and obese patients had significantly lower scores of psychometric tests. Lactate was significantly higher in males, smokers, obese and patients with multiple lesions (p<0.05). Hypertension severity and smoking index significantly correlated with psychometric results. Age, HTN degree and duration, degree of spasticity and muscle power as well as psychometric results is correlated with 1H-MRS results (p<0.05). Conclusion: Despite that lacunar infarctions are small however, the neurometabolic changes with its effect on cognition extends far beyond the infarction area. Psychometric and neurometabolic changes correlated with the presence and severity of risk factors. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 1-10)
Correspondence to Amany M. Rabah, Department of neurology, Cairo University, Egypt.
Tel: +02 0122421045 E-mail: amanyrabah@hotmail.com