Multiple Hypointense Vessels are Associated with Cognitive Impairment in Patients with Single Subcortical Infarction

We aimed to explore the relationship between multiple hypointense vessels and cognitive function in patients with single subcortical infarction (SSI) and the role of SSI with different etiological mechanisms in the above relationship. Multiple hypointense vessels were measured by the number of deep medullary veins (DMVs), DMVs score, and cortical veins (CVs) score. The Montreal Cognitive Assessment (MoCA), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) were assessed to evaluate cognitive function. SSI was dichotomized as branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI by whole-brain vessel-wall magnetic resonance imaging. We included a total of 103 acute SSI patients. After adjustments were made for related risk factors of cognitive function, the SSI patients with higher DMVs score were more likely to have longer STT-B (P = 0.001) and smaller STT-B-1 min (P = 0.014), and the SSI patients with higher CVs score were more likely to have shorter STT-A (P = 0.049). In subgroup analysis, we found that the negative relationship between DMVs scores and cognitive function and the positive relationship between CVs scores and cognitive function were significantly stronger in BAD patients. We provided valuable insights into the associations between DMVs, CVs, and multi-domain cognitive impairment in SSI patients, which underscored the necessity to further study the dynamic alterations of venules and their specific influence on post-stroke cognitive impairment.