Influence of cerebral small vessel disease on functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes

Objective

To estimate the effect of the total cerebral small vessel disease score in the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.

Methods

A comparative study was used to review the initial cerebral infarction cases of patients with type 2 diabetes undergoing cranial MRI during 2016–2019, follow up their recovery for 3 months, and count the events of cerebral infarction recurrence within 24 months. MRI with lacunes, enlarged perivascular space (EPVS), cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) were defined as cerebral small vessel disease (CSVD). Chi-square tests, t-tests, rank-sum tests, and Logistic regression were used for the statistical analysis.

Results

A total of 208 patients were included in the analyses. Mean age was 65.2 ± 11.8 years, and 62% were men. The distribution of the total SVD score from 0 to 4 was 26.9%, 23.6%, 26.4%, 16.3%, and 6.7%. Multivariate Logistic regression showed that the cumulative CSVD score was independently associated with poor outcome 3 months after cerebral infarction (OR:2.193, 95% CI:1.673–2.875) and recurrence within 2 years (OR:2.715, 95% CI: 1.363–2.979). Lacunes, CMBs, WMHs but not EPVS were associated with the modified Rankin Scale (mRS) scores at 3 months after cerebral infarction, Lacunes was associated with recurrence within 2 years. However, the impact of each CSVD marker on functional outcome and stroke recurrence was smaller than that of the total CSVD score.

Conclusion

Cumulative CSVD burden exert important influences on the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.