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. 2018 Oct;49(10):2330-2336.
doi: 10.1161/STROKEAHA.118.022280.

Cerebral Cortical Microinfarcts on Magnetic Resonance Imaging and Their Association With Cognition in Cerebral Amyloid Angiopathy

Li Xiong  1 , Susanne J van Veluw  1 , Narimene Bounemia  1 , Andreas Charidimou  1 , Marco Pasi  1 , Gregoire Boulouis  2 , Yael D Reijmer  3 , Anne-Katrin Giese  1 , Sigurros Davidsdottir  4 , Panagiotis Fotiadis  1 , Raffaella Valenti  5 , Grace Riley  1 , Kristin Schwab  1 , Edip M Gurol  1 , Alessandro Biffi  1 , Steven M Greenberg  1 , Anand Viswanathan  1
Affiliations

Cerebral Cortical Microinfarcts on Magnetic Resonance Imaging and Their Association With Cognition in Cerebral Amyloid Angiopathy

Li Xiong et al. Stroke. 2018 Oct.

Abstract

Background and Purpose- We aimed to explore the association between presence of cerebral cortical microinfarcts (CMIs) on magnetic resonance imaging and other small-vessel disease neuroimaging biomarkers in cerebral amyloid angiopathy (CAA) and to analyze the role of CMIs on individual cognitive domains and dementia conversion. Methods- Participants were recruited from an ongoing longitudinal research cohort of eligible CAA patients between March 2006 and October 2016. A total of 102 cases were included in the analysis that assessed the relationship of cortical CMIs to CAA neuroimaging markers. Ninety-five subjects had neuropsychological tests conducted within 1 month of magnetic resonance imaging scanning. Seventy-five nondemented CAA patients had cognitive evaluation data available during follow-up. Results- Among 102 patients enrolled, 40 patients had CMIs (39%) on magnetic resonance imaging. CMIs were uniformly distributed throughout the cortex without regional predilection ( P=0.971). The presence of CMIs was associated with lower total brain volume (odds ratio, 0.85; 95% CI, 0.74-0.98; P=0.025) and presence of cortical superficial siderosis (odds ratio, 2.66; 95% CI, 1.10-6.39; P=0.029). In 95 subjects with neuropsychological tests, presence of CMIs was associated with impaired executive function (β, -0.23; 95% CI, -0.44 to -0.02; P=0.036) and processing speed (β, -0.24; 95% CI, -0.45 to -0.04; P=0.020). Patients with CMIs had a higher cumulative dementia incidence compared with patients without CMIs ( P=0.043), whereas only baseline total brain volume (hazard ratio, 0.76; 95% CI, 0.62-0.92; P=0.006) independently predicted dementia conversion. Conclusions- Magnetic resonance imaging-detected CMIs in CAA correlated with greater overall disease burden. The presence of CMIs was associated with worse cognitive performance, whereas only total brain atrophy independently predicted dementia conversion.

Keywords: cerebral amyloid angiopathy; dementia; incidence; magnetic resonance imaging; microinfarct.

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Figures

Figure 1.
Figure 1.
Microinfarcts are represented by white dots.
See this image and copyright information in PMC

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