Cortical cerebral microinfarcts on 3T MRI
- 11 October 2016
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 87 (15), 1583-1590
- https://doi.org/10.1212/wnl.0000000000003110
Abstract
Objective: We examined the risk factors of cortical cerebral microinfarcts (CMIs) on 3T MRI and their association with cognitive impairment. Methods: Participants (aged 60 years and older) from the multiethnic Epidemiology of Dementia In Singapore Study underwent detailed neuropsychological testing and 3T brain MRI. Cortical CMIs were graded using a previously validated protocol. Cognitive impairment was categorized into cognitive impairment, no dementia (CIND)-mild, CIND-moderate, and dementia. Cognitive function was summarized as composite and domain-specific z scores. Results: Among 861 participants, 54 (6.3%) had ≥1 cortical CMI. In multivariate-adjusted models, the risk factors of cortical CMIs were increasing age, Malay ethnicity, hypertension, diabetes, history of stroke, and markers of both large (cortical infarcts and intracranial stenosis) and small (lacunar infarcts, white matter hyperintensities, cerebral microbleeds) vessel disease. Presence of cortical CMIs was associated with CIND-moderate (odds ratio: 3.12; 95% confidence interval [CI]: 1.18–8.58), dementia (odds ratio: 16.92; 95% CI: 3.37–85.05), and poorer cognitive function (mean difference in composite z score: −0.42; 95% CI: −0.62 to −0.21). Additional adjustments for vascular risk factors and other MRI markers did not alter these associations. Conclusions: Cortical CMIs are a novel MRI marker of cerebrovascular disease and are independently associated with cognitive impairment and dementia. These findings provide new insights into the burden of cerebrovascular disease in cognitive impairment. Future research is needed to establish the additional etiologic and prognostic significance of cortical CMIs.Keywords
This publication has 30 references indexed in Scilit:
- Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegenerationThe Lancet Neurology, 2013
- Cerebral microinfarcts: the invisible lesionsThe Lancet Neurology, 2012
- Cerebral Microinfarcts: A Systematic Review of Neuropathological StudiesJournal of Cerebral Blood Flow & Metabolism, 2012
- Characteristics of MR Infarcts Associated with Dementia and Cognitive Function in the ElderlyNeuroepidemiology, 2011
- Ecology of the Aging Human BrainArchives of Neurology, 2011
- Microinfarct Pathology, Dementia, and Cognitive SystemsStroke, 2011
- Blood Pressure and Brain Injury in Older Adults: Findings from a Community‐Based Autopsy StudyJournal of the American Geriatrics Society, 2009
- Associations Between Microinfarcts and Other Macroscopic Vascular Findings on Neuropathologic Examination in 2 DatabasesAlzheimer Disease & Associated Disorders, 2009
- Different Patterns of Cerebral Injury in Dementia With or Without DiabetesArchives of Neurology, 2009
- Effect of infarcts on dementia in the Baltimore longitudinal study of agingAnnals of Neurology, 2008