Objective To explore the characteristics of cognitive function in the patients with different
locations of lesions and severity degrees of white matter lesions (WMLs).
Methods A total of 179 WMLs cases and 97 normal brain magnetic resonance imaging (MRI)
control cases were included prospectively and demographic information was collected. According
to the locations of lesions, WMLs were classified into 3 subgroups: subcortical white matter lesions
(SWML), periventricular lesions (PVL) group and mixed legions group. Fazekas visual ratings were
administered to evaluate the severity of WMLs. Montreal Cognitive Assessment Scale (MoCA) was
used to evaluate the cognitive function differences among different locations of lesions and severity
degrees of WMLs. According to MoCA, WMLs group can be divided into subgroups WMLs
cognitive impairment (116 cases) and the WMLs cognitively normal group (63 cases). The analysis
of risk factors for cognitive impairment of patients with WMLs was performed and discussed.
Results Total MoCA scores (P ﹤0.001), visual space execution ability (P ﹤0.001), named (P =0.019),
language (P =0.005), abstract understanding (P =0.003) and delayed memory (P ﹤0.001) of WMLs
group was significantly lower than those of control groups, respectively. The higher Fazekas
classification, the significantly lower MoCA scores and the scores of all items (P ﹤0.05). Compared
with control group, the MoCA scores (all P ﹤0.001), visual space execution ability (P ﹤0.001),
language (P =0.006, 0.022, 0.008), abstract understanding (P =0.003, 0.011, 0.016) and delayedmemory (all P ﹤0.001) of PVL group, the SWML group and mixed group had significant statistical
differences. WMLs subgroup analysis showed that the high level of education was a protection
factor for cognitive impairment WMLs.
Conclusion High education is the protection factor for cognitive impairment in WMLs patients.
The visual space execution ability, delayed memory are more obviously impaired in WMLs patients.
The higher severity level of WMLs lesions, the more distinct decrease of the cognitive function.
SWML WMLs, PVL WMLs and mixed groups have severe damage in the visual space and
execution ability, language, abstract understanding, and delayed memory.
