Lacunar infarction aggravates the cognitive deficit in the elderly with white matter lesion

Cerebral white matter lesion (WML) and lacunar infarction (LI) were primary causes of cognitive deficit. Our study aimed to investigate the correlation between LI and cognitive deficit in the elderly with WML. A total of 118 participants (96 WML patients and 22 controls) were consecutively enrolled according to neuroimaging diagnosis of magnetic resonance imaging for this retrospective study. Neuroimaging evaluation and cognitive function assessment were analyzed. Compared with the controls, moderate and severe WML groups had significantly lower scores of Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). Most cognitive domains of MOCA scores decreased, corresponding to the severity of WMLs. While there was no significant difference in score of MMSE between deep WML (DWML) and periventricular WML (PVL) groups, the scores of visuospatial/executive and naming function domains of MOCA appeared to be low in the DWML group. The scores of MMSE and MOCA were higher in only WMLs (WML−) group than WMLs combined with LIs (WML+) group, except for the naming cognitive domain. Moreover, LIs were independently correlated with the cognitive deficit in the elderly with WMLs. In the elderly with WMLs, the presence of LIs is associated with further aggravation of cognitive deficit.