Affiliations: [a] Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| [b] Department of Neurology, J.P.K. Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| [c] Department of Geriatrics, University Medical Center Utrecht, Utrecht, The Netherlands
Correspondence:
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Correspondence to: Doeschka A. Ferro, Department of Neurology G03.232, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Tel.: +31 88 7571420; Fax: +31 30 2542100; E-mail: d.a.ferro@umcutrecht.nl.
Abstract: Background:Cerebral microinfarcts (CMIs) are small ischemic lesions that are a common neuropathological finding in patients with stroke or dementia. CMIs in the cortex can now be detected in vivo on 3 Tesla MRI. Objective:To determine the occurrence of CMIs and associated clinical features in patients with possible vascular cognitive impairment (VCI). Method:182 memory-clinic patients (mean age 71.4±10.6, 55% male) with vascular injury on brain MRI (i.e., possible VCI) underwent a standardized work-up including 3 Tesla MRI and cognitive assessment. A control group consisted of 70 cognitively normal subjects (mean age 70.6±4.7, 60% male). Cortical CMIs and other neuroimaging markers of vascular brain injury were rated according to established criteria. Result:Occurrence of CMIs was higher (20%) in patients compared to controls (10%). Among patients, the presence of CMIs was associated with male sex, history of stroke, infarcts, and white matter hyperintensities. CMI presence was also associated with a diagnosis of vascular dementia and reduced performance in multiple cognitive domains. Conclusion:CMIs on 3 Tesla MRI are common in patients with possible VCI and co-occur with imaging markers of small and large vessel disease, likely reflecting a heterogeneous etiology. CMIs are associated with worse cognitive performance, independent of other markers of vascular brain injury.
Keywords: Cerebral small vessel disease, cerebrovascular disease, dementia, infarct, magnetic resonance imaging, neuropsychological test
