Neuroimaging changes, particularly structural changes in the medial temporal lobe and hippocampus, have been described in those with mild cognitive impairments (MCI), especially in patients who progress to develop Alzheimer’s disease (AD). However, imaging changes in those with mild cognitive impairments presumed due to vascular disease have not been well defined and predictors of subsequent declined are not known. We aimed to determine MRI correlations of mild cognitive deficits in non-demented stroke survivors. Detailed neuropsychological assessment (attention and working memory) were undertaken in 50 stroke survivors >75 (38 with Ageing Associated Cognitive Decline-AACD), and 15 age matched controls. A 1.5T GE MRI scanner was used. Standardized visual ratings were undertaken of white matter hyperintensities (WMH). Grey matter volumes were assessed using voxel-based morphometery. Associations were identified between processing speed and executive function and the severity of WMH in key areas. In addition, atrophy in the fronto-subcortical circuits was associated with AACD. In conclusion we found that attentional and executive impairments in post-stroke patients were underpinned by WMH in fronto-striato-thalamo-frontal circuits. Frontal atrophy was identified as a novel substrate of cognitive impairment in non-demented stroke patients. These changes appear distinct from those described in “degenerative” type MCI.
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