Authors: Rashid Ghaznawi, Maarten H. T. Zwartbol, Jeroen de Bresser, Hugo J. Kuijf, Jeroen Hendrikse, Mirjam I. Geerlings
Published: 2020-12-07
DOI: 10.1002/alz.041960
Source: Full article
AbstractBackgroundHistopathological studies suggest that microinfarcts in the deep gray matter are associated with ante‐mortem cognitive impairment, however in vivo data on subcortical microinfarcts are lacking. We examined the association of microinfarcts in the deep gray matter on 7T MRI with vascular risk factors, MRI markers of cerebrovascular disease and cognitive functioning in patients with a history of arterial disease.MethodWithin the SMART‐MR study, 213 patients (68 ± 8 years) had risk factor assessment, a 7T and 1.5T brain MRI, and cognitive examination. Microinfarcts in the deep gray matter on 7T MRI were defined as lesions ≤4 mm. Regression models were used to examine the age‐adjusted associations between risk factors, MRI markers and presence of microinfarcts in the deep gray matter. Cognitive function was summarized as composite and domain‐specific z‐scores.ResultA total of 47 microinfarcts were found in 28 patients (13%). Older age, history of stroke, hypertension and intima‐media thickness were significantly associated with microinfarcts. On 1.5T MRI, cerebellar infarcts (RR = 2.75, 95% CI: 1.42 ‐ 5.33), lacunes in the white (RR = 3.28, 95% CI: 3.28 ‐ 6.04) and deep gray matter (RR = 3.06, 95% CI: 1.75 ‐ 5.35) were associated with microinfarcts, and on 7T MRI cortical microinfarcts (RR = 2.33, 95% CI: 1.32 ‐ 4.13). Microinfarcts were also associated with poorer global cognitive functioning (mean difference in global z‐score between patients with multiple microinfarcts vs. none = ‐0.97, 95% CI: ‐1.66 to ‐0.28, p = 0.006) and across all cognitive domains, independent of age, education level and number of infarcts ≥5 mm in the deep gray matter.ConclusionMicroinfarcts in the deep gray matter on 7T MRI were associated with MRI markers of small and large vessel disease and worse cognitive functioning. These findings suggest that microinfarcts in the deep gray matter represent a novel imaging marker of vascular brain injury.