Both hypoperfusion and structural impairment associates with cognitive decline in HR-NICE patients

Motivation: Patients with high-risk non-disabling ischemic cerebrovascular events (HR-NICE) are recommended as the key population for stroke prevention. However, the functional impairment and underlying neural mechanisms are rarely investigated in this cohort. Goal(s): We attempt to confirm the neural and cognitive impairment and explain the mechanism of cognitive impairment in aspects of both hypoperfusion and cortical abnormality in HR-NICE patients. Approach: Cerebral blood flow, grey matter volume and asymmetry were calculated based on MR perfusion and anatomical data. Results: Hypoperfusion and cortical abnormality are significant in HR-NICE patients, these neural impairments are robustly correlated with cognitive decline. Impact: Our study confirmed the existence of early neural damage in HR-NICE patients, which is reflected in multiple aspects of hypoperfusion, grey matter atrophy and decreased asymmetry. These abnormalities collectively contribute to cognitive decline, especially in patients with left involvement.