Objective To investigate the relevant influencing factors of cognitive impairment in patients with isolated thalamic infarction treated with nimergoline combined with Xingnaojing.Methods A retrospective analysis was conducted on the clinical data of 120 patients with cerebral infarction admitted to the Department of Neurology,Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2020 to December 2022.All patients received treatment with nimergoline combined with Xingnaojing.The incidence of cognitive impairment was statistically analyzed,and relevant data was organized and analyzed.Multiple logistic regression analysis was used to identify the relevant influencing factors leading to cognitive impairment.Results The incidence of cognitive impairment in patients with isolated thalamic infarction was 37.50%.Univariate analysis showed that the proportion of cognitive impairment patients aged≥60 years,hyperhomocysteinemia (Hcy),severe stenosis or occlusion of posterior circulation large vessels,and medial thalamic infarction were higher than those in non cognitive impairment patients,the differences were statistically significant (P＜0.05).There were no significant differences in gender,hypertension,diabetes,hyperlipidemia,stroke history,hyperuricemia,smoking and drinking among patients with cognitive impairment and non-cognitive impairment (P＞0.05).Multivariate logistic regression analysis showed severe stenosis or occlusion of posterior circulation large vessels (β=0.513,OR=1.670,95%CI: 1.318-2.117),hyperhomocysteinemia (β=0.679,OR=1.972,95%CI: 1.247-3.119) and medial thalamic infarction (β=0.427,OR=1.533,95%CI:1.245-1.887)were the main influencing factors for cognitive impairment in patients with isolated thalamic infarction (P＜0.05).Conclusion Severe stenosis or occlusion of large blood vessels in the posterior circulation,medial thalamic infarction,and high Hcy are important factors leading to cognitive impairment after isolated thalamic infarction.During clinical treatment,it is necessary to closely monitor changes in various indicators and improve the condition through rational medication and dietary regulation.