Stroke Patients with SVD Cognition Study

Consecutive patients with SVD were recruited to the St George's Cognition and Neuroimaging in Stroke (SCANS) study from stroke services in three hospitals covering a geographically contiguous area of South London (St George's Hospital, King's College Hospital and St Thomas's Hospital). SVD was defined as a clinical lacunar stroke syndrome [16] (link) with an anatomically appropriate lacunar infarct on MRI, as well as confluent leukoaraiosis (Fazekas grade 2 or more) on MRI [17] (link). All patients were fluent in English to allow neuropsychological testing. Exclusion criteria were: any cause of stroke other than SVD including extra or intracranial arterial vessel stenosis >50%; any cardioembolic source; cortical infarcts; subcortical infarcts >1.5 cm in diameter as these (striatocapsular type infarcts) are often due to embolism; other major central neurological system disorders; major psychiatric disorders (except depression); any cause for white matter disease other than SVD. Individuals with contraindications to MRI including claustrophobia were excluded.
The study was granted ethical approved by Wandsworth REC. 180 patients were screened of whom 137 volunteered to participate and gave written informed consent. 121 of the 137 SVD patients completed the protocol. Of non-completers, 6 withdrew due to the length of the neuropsychology examination, 2 could not complete MRI, 6 became unwell between consenting and testing, and 2 were found to meet exclusion criteria after consent, 1 due to narcolepsy and 1 due to schizophrenia.
All cognitive testing and MRI was performed at least 3 months post-stroke to minimise acute effects of stroke on cognition.