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Updated: May 5, 2026

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Silent brain infarcts impact on cognitive function in atrial fibrillation
Michael Kühne1,2, Philipp Krisai1,2, Michael Coslovsky2,3
1Cardiology/Electrophysiology Division, Department of Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031 Basel, Switzerland.
New brain infarcts, often silent, were found in 5.5% of atrial fibrillation patients over two years. Both overt and silent infarcts negatively impacted cognitive function, highlighting the importance of monitoring brain health in AF patients.
Area of Science:
- Neurology
- Cardiology
- Neuroimaging
Background:
- Atrial fibrillation (AF) is linked to an increased risk of stroke and cognitive impairment.
- Brain lesions, including infarcts and white matter changes, are common in AF patients.
- The impact of clinically overt versus silent brain lesions on cognitive function in AF requires further investigation.
Purpose of the Study:
- To investigate the association between clinically overt and silent brain lesions and cognitive function in patients with atrial fibrillation.
- To quantify the incidence of new brain lesions in AF patients over a two-year period.
- To compare the cognitive decline associated with different types of brain lesions.
Main Methods:
- A prospective, multicentre cohort study (Swiss-AF) enrolled 1227 AF patients.
- Standardized brain magnetic resonance imaging (MRI) was performed at baseline and after 2 years.
- New small non-cortical infarcts (SNCIs), large non-cortical or cortical infarcts (LNCCIs), white matter lesions (WML), and microbleeds (Mb) were quantified. Cognition was assessed using validated tests.
Main Results:
- 5.5% of AF patients developed new brain infarcts (SNCI/LNCCI) over 2 years.
- The majority of new infarcts were clinically silent (88.2% occurred in anticoagulated patients).
- Patients with new brain infarcts showed a significantly larger decline in cognitive function compared to those without new infarcts.
Conclusions:
- New brain infarcts are common in AF patients and often clinically silent.
- Both overt and silent brain infarcts have a similar, negative impact on cognitive decline.
- These findings underscore the importance of neuroimaging and cognitive monitoring in AF management.
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