Abstract:

Objective

To explore the characteristics of global cognitive function and domain-specific cognitive test performance in patients with asymptomatic posterior cerebral artery atherosclerotic stenosis (aPCAS).

Methods

A total of 19 patients diagnosed with aPCAS (stenosis ＞50%) at the Neurology Department of Peking Union Medical College Hospital between February 2021 and July 2024 were enrolled, along with 53 age-, sex-, and education-matched control subjects.Linear regression models were used to compare Z-scores across cognitive domains (including memory, attention, executive function, visuospatial ability, language, and calculation) and cognitive test results [including the mini-mental state examination (MMSE), Montreal cognitive assessment(MoCA), and domain-specific subtests] between the two groups, with demographic variables statistically adjusted.P-values were corrected using the Bonferroni method.

Results

Compared to the control group, the aPCAS group exhibited significantly lower MoCA scores [(23.11±4.25) vs(26.47±3.03), β=-3.46, 95% CI: -4.88 to -2.03, P＜0.001], as well as reduced Z-scores in the memory[(-0.94±0.73) vs (-0.27±0.73), β=-0.67, 95% CI:-1.07 to -0.28, P=0.001], language [(-0.09±0.88) vs(0.83±0.85), β=-0.91, 95% CI: -1.37 to -0.46, P＜0.001], and calculation [(-0.82±0.91) vs (0.02±0.92),β=-0.84, 95% CI: -1.34 to -0.33, P=0.001].

Conclusion

Despite the absence of stroke episodes,aPCAS patients demonstrate cognitive impairment even with mild cortical atrophy and low white matter hyperintensity burden, indicating that they should be considered a high-risk population for dementia.

Key words: Asymptomatic posterior cerebral artery atherosclerotic stenosis, Cognition, Vascular cognitive impairment