Vascular Mild Cognitive Impairment Research Articles

Hippocampal subfield volumetry in patients with subcortical vascular mild cognitive impairment.

Memory impairment is a typical characteristic of patients with subcortical vascular mild cognitive impairment (svMCI) or with amnestic mild cognitive impairment (aMCI). The hippocampus, which plays an important role in the consolidation of information from short-term memory to long-term memory, is a heterogeneous structure that consists of several anatomically and functionally distinct subfields. However, whether distinct hippocampal subfields are differentially and selectively affected by svMCI pathology and whether these abnormal changes in hippocampal subfields are different between svMCI and aMCI patients are largely unknown. A total of 26 svMCI patients, 26 aMCI patients and 26 healthy controls matched according to age, gender and years of education were enrolled in this study. We utilized an automated hippocampal subfield segmentation method provided by FreeSurfer to estimate the volume of several hippocampal subfields, including the cornu ammonis (CA) areas, the dentate gyrus (DG), the subiculum and the presubiculum. Compared with controls, the left subiculum and presubiculum and the right CA4/DG displayed significant atrophy in patients with svMCI. Interestingly, we also found significant differences in the volume of the right CA1 between the svMCI and aMCI groups. Taken together, our results reveal region-specific vulnerability of hippocampal subfields to svMCI pathology and identify distinct hippocampal subfield atrophy patterns between svMCI and aMCI patients.

The Difference of Verbal Fluency Task Performance between Alzheimer’s Disease and Subcortical Vascular Dementia: CREDOS (Clinical Research Center for Dementia of South Korea) Study

Background: The verbal fluency test consists of two separate tests of semantic fluency and phonemic fluency. The performance patterns of these tests differ with the type of dementia. We studied the patterns of verbal fluency between Alzheimer's disease (AD) and subcortical vascular dementia (SVaD), and assessed the clinical utility of these tests. Methods: The 1,475 selected participants comprised 73 normal control sub jects, 673 patients with amnestic mild cognitive impairment (aMCI), 535 AD patients, 42 patients with subcortical vascular mild cognitive impairment (svMCI), and 152 SVaD patients. We analyzed the z-score for the total number of animal items as a semantic fluency index and the z-score of the phonemic total score as a phonemic fluency index. Results: The performance of semantic fluency was lower than that of phonemic fluency in all groups. The SVaD group showed the worst scores and abnormal performances on both tests, while the AD group presented abnormal performance only for semantic fluency. Dividing the patients with dementia according to severity revealed a different pattern between AD and SVaD for the clinical dementia rating (CDR) stage of 0.5. The performance of the AD group declined gradually with CDR. However, the SVaD group performed very poorly in both tests even for very mild dementia (CDR stage of 0.5). The aMCI and svMCI groups exhibited similar performance patterns. Conclusions: The pattern of semantic and phonemic fluency was not clinically useful at the MCI stage, but it could be helpful in differentiating AD and SVaD in the early stage of dementia. J Korean Neurol Assoc 34(1):14-22, 2016

Left Temporal Neuronal Hyperexitability as a Predictor of Mild Cognitive Impairment: Clinical and Neurophysiological Study

Introduction: Mild cognitive impairment (MCI) usually is the early stage of dementia which is defined as decreasing in mental abilities such cognition, memory, and speech not too severe to interfere daily activities. MCI diagnosis is rather hard and usually assumed as normal consequences of aging. Diagnosis is usually performed through a combination of extensive testing and eliminations of other possible causes. “Seizures” or neuronal hyperexitability in the temporal lobe, transiently impair cognition and steadily damage hippocampal circuitry, leading to progressive memory loss. Objective: The objective of this study was demonstrated that EEG pattern abnormalities in the left temporal in healthy subjects, are an early sign of progressive cognitive impairment. Material and methods: This was an clinical and neurophysiology observational study in healthy adults patients with EEG pattern characterized by slow activity in left temporal region. This study lasted three years in total, being divided into two phases: recruitment (for an entire year) and follow-up after 1 year. Admission criteria were checked. The follow-up consisted of neuropsychological assessment with Mini Mental State Examination (MMSE) and MRI scan. Our analysis was based on pooled of patients from neurophysiology department in Italy from February 2010 to July 2013. The EEG activity was recorded continuously from 19 electrodes positioned according to the 10–20 International system. Results: One hundred forty patients were recruited and one hundred thirty completed the 24-month study. Of the ten patients who did not complete the study. In case group we had 60 subjects, 15 males and 45 females with sharp slow-wave in left temporal region on EEG. In control group we had 70 subjects, 30 males and 40 females with normal EEG. 57 patients (Case) and 33 patients (Controls) showed a mild cognitive impairment (MMSE ≥ 23 adjusted for age and education). 49 patients (Case) and 21 patients (Controls) with deep lacunar infarcts or subcortical white matter alterations on MRI scan. Analysis performed according to methods proposed by Koch showed that pattern EEG of slow waves significantly correlated with both variables MCI (P<0.0001) and vascular alterations (P<0.0001). Discussion: In our sample, pattern EEG was predictive for vascular abnormalities and MCI more than 50% after a few years. Conclusion: In summary, typical geographic alterations in left temporal region are “indicators” or “markers” of early cognitive impairment and may be used as prevention strategies. EEG may be considered a useful tool for early diagnosis of MCI. Further translational exploration of these issues in animals and/or humans studies over the coming years will determine new therapeutic approaches directed at selectively suppressing aberrant network excitability in the temporal lobe.

Τhe pattern of relations between cognitive control and Theory of Mind in older adults having vascular risk factors and older adults with Mild Cognitive Impairment: are there any differences?

Τhe pattern of relations between cognitive control and Theory of Mind in older adults having vascular risk factors and older adults with Mild Cognitive Impairment: are there any differences?

A Comparison of the Deterioration Characteristics in Verbal Fluency between Amnestic Mild Cognitive Impairment and Vascular Mild Cognitive Impairment

ë°°ê²½ 및 ëª©ì : 본 연구는 구어 ìœ ì°½ì„±ì´ 기억성 ê²½ë„ì¸ì§€ìž¥ì• (amMCI)와 혈관성 ê²½ë„ì¸ì§€ìž¥ì• (VaMCI)에서 어떻게 ì €í•˜ë˜ëŠ”ì§€ë¥¼ ë°ížˆê³ ê·¸ ì €í•˜ 양상이 의미 ìœ ì°½ì„±ê³¼ 음소 ìœ ì°½ì„±ì— 있어 차이가 있는지를 ì•Œì•„ë³´ê³ ìž 수행되었다. 방법: ì •ìƒë ¸ì¸ 34ëª , amMCI 72ëª , VaMCI 70ëª , ì•Œì¸ í•˜ì´ë¨¸í˜• 치매(DAT) 36ëª ë° 혈관치매(VaD) 39ëª ì´ 연구에 참여하였다. ê²½ë„ì¸ì§€ìž¥ì• ì§‘ë‹¨ë“¤ì€ CDR-SBì ìˆ˜ 2.0을 기준으로 초기(E)와 후기(L)로 다시 ë¶„ë¥˜ë˜ì—ˆê³ , ëª¨ë“ ì—°êµ¬ëŒ€ìƒìžë“¤ì—ê²Œ 의미 ìœ ì°½ì„±(동물) 검사와 음소 ìœ ì°½ì„±(ㄱ, 㠇, ã ) 검사를 실시하였다. ê²°ê³¼: 의미 ìœ ì°½ì„±ì€ amMCI의 경우에는 초기부터 DAT까지 ì ì§„ì ìœ¼ë¡œ 계속 ì €í•˜ëœ 반면, VaMCI의 경우에는 초기에는 ìœ ì§€ë˜ë‹¤ê°€ 후기에 ì €í•˜ë˜ì–´ VaD까지 ìœ ì§€ë˜ëŠ” 양상을 보였다. 음소 ìœ ì°½ì„±ì€ amMCI의 경우에는 초기에 ì €í•˜ë˜ì–´ DAT까지 ìœ ì§€ë˜ì—ˆê³ , VaMCI의 경우에는 초기부터 VaD까지 ì ì§„ì ìœ¼ë¡œ 계속 ì €í•˜ë˜ëŠ” 양상을 보였다. ë ¼ì˜ 및 ê²°ë¡ : 연구 결과는 amMCI와 VaMCI가 의미 ìœ ì°½ì„±ê³¼ 음소 ìœ ì°½ì„±ì— 있어 각각 서로 다른 퇴행 속도와 양상을 ì§€ë‹ˆê³ ìžˆìŒì„ 시사한다. Keywords: 구어 ìœ ì°½ì„±, 의미 ìœ ì°½ì„±, 음소 ìœ ì°½ì„±, ê²½ë„ì¸ì§€ìž¥ì• , 기억성 ê²½ë„ì¸ì§€ìž¥ì• , 혈관성 경도인지장ì•

Postural instability detected by stabiloplatform examination in the patients with vascular mild cognitive impairment and Parkinson's disease patients with mild cognitive impairment

Postural instability detected by stabiloplatform examination in the patients with vascular mild cognitive impairment and Parkinson's disease patients with mild cognitive impairment

Neuroimaging criteria and cognitive performance in vascular mild cognitive impairment: A systematic review.

The recognition of Cerebrovascular Disease (CVD) at earlier clinical stages may favor the control of vascular risk factors and prevention of dementia. However, operational criteria for symptomatic phases at non-dementia stages are often difficult, as the current criteria normally require the evidence of extensive subcortical disease.ObjectiveTo identify the neuroimaging profile of Vascular Mild Cognitive Impairment (VaMCI), the impact of those aspects over cognition and the neuropsychological tests that distinguished VaMCI from other groups.MethodsSearches were performed in Scopus, ISI and PsycINFO, using the following key terms: "vascular mild cognitive impairment" OR "vascular cognitive impairment no dementia" OR "vascular cognitive impairment not demented" OR "subcortical mild cognitive impairment".ResultsOf 249 papers, 20 studies were selected. Ten of those included only patients with severe White Matter Hyperintensities (WMH), whereas 10 others admitted subjects with moderate-to-severe WMH. Both groups showed poor performances in Executive Function (EF) tasks in comparison to normal controls and other diagnostic groups. Among EF tests, those assessing "complex" EF abilities consistently distinguished VaMCI from other groups, regardless of the severity of WMH. VaMCI subjects with severe or moderate-to-severe WMH showed cognitive deficits in comparison with other groups. "Complex" EF tests were the most useful in differentiating those patients from the other groups.ConclusionThe occurrence of VaMCI may be associated with the presence of CVD at moderate levels; the detection of vascular damage at earlier stages may allow the adoption of therapeutic actions with significant effect-sizes.

Impact of Bilingualism on Cognitive Outcome After Stroke.

Bilingualism has been associated with slower cognitive aging and a later onset of dementia. In this study, we aimed to determine whether bilingualism also influences cognitive outcome after stroke. We examined 608 patients with ischemic stroke from a large stroke registry and studied the role of bilingualism in predicting poststroke cognitive impairment in the absence of dementia. A larger proportion of bilinguals had normal cognition compared with monolinguals (40.5% versus 19.6%; P<0.0001), whereas the reverse was noted in patients with cognitive impairment, including vascular dementia and vascular mild cognitive impairment (monolinguals 77.7% versus bilinguals 49.0%; P<0.0009). There were no differences in the frequency of aphasia (monolinguals 11.8% versus bilinguals 10.5%; P=0.354). Bilingualism was found to be an independent predictor of poststroke cognitive impairment. Our results suggest that bilingualism leads to a better cognitive outcome after stroke, possibly by enhancing cognitive reserve.

White matter microstructural damage and depressive symptoms in patients with mild cognitive impairment and cerebral small vessel disease: the VMCI-Tuscany Study.

Disruption of cortical-subcortical circuits related to small vessel disease (SVD) may predispose to depression in the elderly. We aimed to determine the independent association between white matter (WM) microstructural damage, evaluated with diffusion tensor imaging (DTI), and depressive symptoms in a cohort of elderly subjects with mild cognitive impairment (MCI) and SVD. The vascular mild cognitive impairment (VMCI)-Tuscany Study is an observational multicentric longitudinal study that enrolled patients with MCI and moderate to severe degrees of WM hyperintensities on MRI. Lacunar infarcts, cortical atrophy, medial temporal lobe atrophy, microbleeds, and DTI-derived indices (mean diffusivity, MD and fractional anisotropy, FA) were evaluated on baseline MRI. Geriatric Depression Scale (GDS) (score 0-15) was used to assess depressive symptoms. An extensive neuropsychological battery, Instrumental Activities of Daily Living scale, and the Short Physical Performance Battery were used for cognitive, functional, and motor assessments, respectively. Seventy-six patients (mean age: 75.1 ± 6.8 years) were included. Univariate analyses showed a significant association between GDS score and both DTI-derived indices (MD: r = 0.307, p = 0.007; FA: r = -0.245; p = 0.033). The association remained significant after adjustment for age, WM hyperintensities severity, global cognitive, functional and motor performances, and antidepressant therapy (MD: r = 0.361, p = 0.002; FA: r = -0.277; p = 0.021). These results outline the presence of an association between WM microstructural damage and depressive symptoms in MCI patients with SVD. This relationship does not seem to be mediated by disability, cognitive, and motor impairment, thus supporting the vascular depression hypothesis.

Regional Gray Matter Atrophy in Vascular Mild Cognitive Impairment

The aim of this study was to explore the neuroanatomical bases of vascular mild cognitive impairment (VaMCI) with respect to attention/executive function, memory, language, and visuospatial function. We used voxel-based morphometric analysis to identify brain regions that significantly differed in terms of gray matter volumes (GMVs) between 43 patients with VaMCI and 55 healthy controls. Then, we compared the individual GMVs of the selected regions with the neuropsychological profiles of the VaMCI patients. The delayed recall component of the Rey-Osterrieth Complex Figure Test (CFT) (74.4%), the Symbol Digit Modalities Test (74.4%), the Boston Naming Test (51.2%), and the CFT-copy (81.4%) shared the highest incidence of impairment in the 4 cognitive domains, respectively. Compared with controls, patients with VaMCI exhibited significantly reduced GMVs. This effect was mainly present in the frontal regions, including the bilateral dorsolateral prefrontal cortex (DLPFC), the orbital portion of the superior frontal gyrus (SFG), and the left supplemental motor area, and was also observed in the bilateral posterior cingulated cortex (PCC). GMVs were significantly correlated with performance in the Trail Making Test, part B, in the bilateral DLPFC and PCC, the clock drawing test in the right orbital portion of the SFG, and CFT-delayed recall in the right PCC. These results, from the perspective of brain morphology, uniquely explored the specific cerebral structural changes of VaMCI, thus providing a deeper understanding of the pathophysiology of the disease.

Disrupted topological organization of resting-state functional brain network in subcortical vascular mild cognitive impairment.

Neuroimaging studies have demonstrated both structural and functional abnormalities in widespread brain regions in patients with subcortical vascular mild cognitive impairment (svMCI). However, whether and how these changes alter functional brain network organization remains largely unknown. We recruited 21 patients with svMCI and 26 healthy control (HC) subjects who underwent resting-state functional magnetic resonance imaging scans. Graph theory-based network analyses were used to investigate alterations in the topological organization of functional brain networks. Compared with the HC individuals, the patients with svMCI showed disrupted global network topology with significantly increased path length and modularity. Modular structure was also impaired in the svMCI patients with a notable rearrangement of the executive control module, where the parietal regions were split out and grouped as a separate module. The svMCI patients also revealed deficits in the intra- and/or intermodule connectivity of several brain regions. Specifically, the within-module degree was decreased in the middle cingulate gyrus while it was increased in the left anterior insula, medial prefrontal cortex and cuneus. Additionally, increased intermodule connectivity was observed in the inferior and superior parietal gyrus, which was associated with worse cognitive performance in the svMCI patients. Together, our results indicate that svMCI patients exhibit dysregulation of the topological organization of functional brain networks, which has important implications for understanding the pathophysiological mechanism of svMCI.

Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

Background Vascular mild cognitive impairment (VaMCI) is the prodromal syndrome of vascular dementia (VaD) and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI. Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS) in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ) studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA)/American Stroke Association (ASA) in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ) described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ) described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) was being good consistency with other neuropsychological assessment tools. Conclusions The neuropsychological features of VaMCI have guiding significance for diagnosis. VASCOG diagnostic criteria for VaMCI is practical in clinical practice, and 5-minute protocol is suitable for clinical rapid screening of VaMCI. DOI: 10.3969/j.issn.1672-6731.2015.07.007

Development and Clinical Validity of a Mild Vascular Cognitive Impairment Assessment Tool for Korean Stroke Patients

The present study was conducted to develop a mild vascular cognitive impairment (MVCI) assessment tool for patients with stroke and to examine its validity, reliability, and clinical adequacy. Items of this tool were developed based on previously verified cognitive assessment tools. Face, content, and criterion (concurrent) validities, optimal cut-off score for differentiation of MVCI and normal cognitive function, clinical adequacy, internal consistency, and inter-rater reliability of the assessment tool were determined in 60 stroke patients at a university hospital located in Incheon, South Korea. The devised MVCI assessment tool contains 20 items which were designed to assess seven cognitive domains: orientation, memory, language, attention, reasoning/abstraction, visuospatial perception, and executive function/problem solving. Content, face, and construct validities were well supported. Clinical adequacy testing revealed that the overall probability of correctly discriminating MVCI using the MVCI assessment tool for stroke was 90.0%, which was statistically significant. Furthermore, a score of 23 was found to be the optimal cut-off score for MVCI. Internal consistency and inter-rater reliability were also well supported. The findings of this study indicate that the developed MVCI assessment tool for stroke could serve as a clinically useful tool for detecting MVCI and for properly assessing degree of cognitive impairment in stroke patients.

The effect of aerobic exercise on fall risk reduction among older adults with mild vascular cognitive impairment

The effect of aerobic exercise on fall risk reduction among older adults with mild vascular cognitive impairment

Impact of vascular mild cognitive impairment on functional dependency in mexican elderly

Impact of vascular mild cognitive impairment on functional dependency in mexican elderly

The effect of education on cognition and cortical thickness in pure vascular mild cognitive impairment and dementia of the subcortical type

The effect of education on cognition and cortical thickness in pure vascular mild cognitive impairment and dementia of the subcortical type

PP.34.06

Objective: Cognitive impairment is associated with compliance issues and worse outcomes in patients with chronic diseases. Most guidelines recommend using the Mini Mental State Examination (MMSE) to screen for cognitive impairment in older hypertensive patients. The aim of this study was to compare the yield of the MMSE and of the Montreal Cognitive Assessment (MoCA), a screening test known to be more sensitive for vascular dementia and mild cognitive impairment (TCL), in older outpatients at high cardiovascular risk. Design and method: Independently living patients over 65 who were prescribed a treatment for cardiovascular prevention and followed-up by their general practitioner were recruited in a health center. Each patient was randomly assigned to undergo either the MMSE or the MoCA. A MMSE score < 27 (or 24 if high school was not completed) or MoCA score < 26 (25 if high school was not completed) was considered as indicating cognitive impairment. The physician judgement regarding the cognitive ability of each patient was recorded, blind to test results. Results: Patients randomized to the MMSE (n = 55) were similar to those randomized to the MoCA (n = 56, Table). Assessment lasted a little more than 10 min with both tests (Table). There were 22 (40%) screen positive patients with the MMSE and 38 (68%) with the MoCA (p < 0.004 for the difference). Physicians’ judgements predicted a positive MMSE with 97% specificity but only 9% sensitivity, a positive MoCA with 94% specificity but only 16% sensitivity.Conclusions: Cognitive impairment is very frequent in patients over 65 years treated for cardiovascular prevention in primary care, and largely unrecognized by physicians despite its wide ranging consequences including therapeutic non-compliance. Screening guidelines should promote use of the MoCA rather than the MMSE in these patients, since it is able to better detect vascular dementia and mild cognitive impairment with a similar screening time.

Diagnosis of vascular cognitive impairment and its main categories

ObjectiveA review of current criteria for the diagnosis of categories related with vascular cognitive impairment, in particular the nomenclature, diagnostic criteria, and differential clinical–radiological findings. DevelopmentThe criteria for the diagnosis of vascular cognitive impairment have evolved, but available criteria were designed basically for differentiating between vascular dementia and dementia due to Alzheimer disease, and for research purposes. Nevertheless, in clinical practice precise elements are required for: (1) Clinical diagnosis of dementia and mild cognitive impairment; (2) Clinical and neuroimaging criteria for identification of the various cerebrovascular lesions associated with cognitive dysfunction, and (3) A formulation of the aetiogenic–pathogenic relationship between cognitive impairment and cerebrovascular lesions. For this reason, a review was carried out on the diagnostic elements of vascular cognitive impairment categories, classification, and their most relevant characteristics. It highlights the characteristic for the diagnosis of multi-infarction dementia, strategic single infarct dementia, small vessel disease with dementia, mixed dementia, and vascular mild cognitive impairment. ConclusionsStandardisation is required, by a multidisciplinary expert team, as regards nomenclature and criteria for the diagnosis of the full spectrum associated with vascular cognitive impairment and especially for vascular dementia and its categories.

Abstract 48: Factors Associated With Motor Performance in Patients With Mild Cognitive Impairment and Cerebral Small Vessel Disease: Data From the VMCI-Tuscany study

Background and purpose: Neuroimaging correlates of cerebral small vessel disease (SVD) are frequently detected in elderly subjects and are clinically associated with cognitive and gait dysfunction. Our aim was to evaluate clinical and neuroimaging factors associated with motor performance in a cohort of patients with mild cognitive impairment (MCI) and cerebral small vessel disease (SVD). Methods: the VMCI Tuscany Study is an ongoing, longitudinal, multicenter, observational study aimed at investigating predictors of transition from vascular MCI to dementia. Inclusion criteria were: 1) MCI (Winblad et al. criteria), and 2) evidence on MRI of moderate to severe degrees of white matter hyperintensities [(WMH), modified Fazekas scale]. Centralized visual assessment also included: number of lacunar infarcts, microbleeds, cortical atrophy, and medial temporal lobe atrophy on MRI. All patients underwent clinical and functional evaluation. Quantitative tests of gait and balance included the Short Physical Performance Battery (SPPB; range: 0 [poor] to 12 [normal]). Results: Out of the 145 patients enrolled (mean age 74.6±6.7, 55% males, 52% with severe WMH), mean SPPB score was 8.5±2.5, and Montreal Cognitive Assessment test (MoCA) 20.0±4.9. MoCA significantly correlated with SPPB (Spearman coefficient 0.204, p=0.014). The association also remained significant in the multivariate linear regression model (standardized coefficient 0.111, p=0.009), entering MoCA together with age, and neuroimaging variables. Among these latter, global atrophy retained a significant association (standardized coefficient -0.273, p=0.002). Conclusion: in our cohort of MCI patients with moderate to severe WMH, motor performance was associated with cognitive performance. Among MRI features, cortical atrophy seem to have a primary role, in line with the recent view that regards cortical atrophy as one of the neuroimaging correlates of SVD. Study funded by Tuscany Region.

Changes of serum cystatin C levels in patients with vascular cognitive impairment after acute stroke

Objective To explore changes and clinical significances of serum cystatin (Cys) C levels in patients with vascular cognitive impairment (VCI) after acute stroke, in order to provide evidence for early diagnosis and treatment of patients with VCI. Methods From December 2012 to December 2013, a total of 120 cases of acute stroke patients who were treated in Department of Neurology and Neurosurgery, Dongying People's Hospital were included in this study, as study group. According to whether the patients complicated VCI or not after stroke, study group were divided into VCI subgroup (n=60) and non-VCI subgroup (n=60). And at the same period, a total of 60 cases of elderly health examination who were over 50 years old and without complaints of cognitive dysfunction were included in control group (n=60). Systematic evaluations of VCI patients' cognitive function were evaluated by mini-mental state examination (MMSE) scale, and severity of VCI was divided according to results of MMSE score. Levels of serum Cys C in three group were detected with immunoturbidimetry by automatic biochemical analyzer, and relationship between serum Cys C levels and VCI severity was analyzed. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Dongying People's Hospital. Informed consent was obtained from all participants. Results There were no significant differences in gender, age, years of education, high blood pressure, diabetes and other socio-demographic data among VCI subgroup, non-VCI subgroup and control group (P>0.05). Level of serum Cys C in VCI subgroup was (1.68±0.46) mg/L, which was higher than (0.88±0.42) mg/L of non-VCI subgroup and (0.83±0.32) mg/L of control group, and difference among three group was statistically significant (F=12.99, P<0.05). In VCI subgroup, there was statistical difference of levels of serum Cys C in patients with different VCI degrees (F=7.98, P<0.05). There were 19 cases of severe VCI patients with MMSE score ≤13 whose serum levels of Cys C were (1.92±0.36) mg/L. There were 23 cases of moderate VCI patients with MMSE score of ≥14-20 whose serum levels of Cys C were (1.33±0.41) mg/L. There were 18 cases of mild VCI patients with MMSE score of ≥21-24 whose levels of Cys C were (1.09±0.28) mg/L. There was statistical difference among above three groups (F=7.98, P<0.05). The higher levels of serum Cys C in VCI patients after acute stroke were, the more serious the degree of their VCI. The results of bivariate Spearmen correlation coefficient analysis showed that there was a negative correlation between levels of Cys C and MMSE scores in VCI patients (r=-0.421, P=0.039). Conclusions Levels of Cys C in VCI patients after acute stroke were related to their development of VCI. Levels of serum Cys C could be one of biomarkers in peripheral blood as an early diagnosis of VCI, to provide biological evidence for early diagnosis and treatment of VCI. Key words: Stroke; Cognition disorders; Diagnosis; Cystatin C