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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Evolution of cortical cerebral microinfarcts on 3T MRI: risk factors and clinical relevance
Jiannan Huang1, Christopher Chen2,3, Wei Ying Tan1
1Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Introduction:
Cortical cerebral microinfarcts (CMIs) are associated with cognitive dysfunction and dementia, while their evolution on sequential magnetic resonance imaging (MRI) remains unclear.
Methods:
The study enrolled 490 patients (72.5 ± 7.9 years) from a memory-clinic cohort, with 5-year follow-up. Cortical CMIs were graded at baseline and year 2 to identify incident lesions and other evolutionary patterns. Cognitive function was assessed annually. Clinical events, including dementia, stroke, and mortality, were recorded with time to event.
Results:
Forty-one (8.4%) patients showed incident cortical CMIs at year 2. Additionally, 12 had CMIs becoming invisible, and six showed CMIs incorporated into new large infarctions. Baseline cortical CMIs and large cortical infarcts showed the strongest association with incident CMIs. Incident cortical CMIs were associated with cognitive decline, white matter hyperintensity progression, and incident dementia, independent of prevalent lesions.
Discussion:
Cortical CMI evolution may reflect dynamic changes in brain vascular pathology and represent a potential target for interventions aimed at preserving cognitive function.
Insights
New cortical cerebral microinfarcts (CMIs) appear in 8.4% of patients over two years and are linked to cognitive decline and dementia risk. Their evolution offers insights into brain vascular health.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Dementia Research
Background:
- Cortical cerebral microinfarcts (CMIs) are linked to cognitive impairment and dementia.
- The longitudinal evolution of CMIs on serial MRI is not well understood.
Purpose of the Study:
- To investigate the evolution of cortical CMIs over five years using serial MRI.
- To determine the association of CMI evolution with cognitive function and clinical outcomes.
Main Methods:
- A cohort of 490 memory clinic patients underwent annual cognitive assessments and MRI at baseline and year 2.
- Cortical CMIs were evaluated for incidence, resolution, and incorporation into larger infarcts.
- Clinical events (dementia, stroke, mortality) were recorded.
Main Results:
- Incident cortical CMIs were observed in 8.4% of patients by year 2.
- CMIs resolved in 12 patients, and six showed incorporation into larger infarcts.
- Incident CMIs correlated with cognitive decline, white matter hyperintensity progression, and incident dementia.
Conclusions:
- Cortical CMI evolution indicates dynamic brain vascular pathology.
- Tracking CMI changes may help identify individuals at risk for cognitive decline.
- Cortical CMIs represent a potential therapeutic target for preserving cognitive function.
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