Cerebral microinfarcts revisited: Detection, causes, and clinical relevance

Huang, Jiannan; Biessels, Geert-Jan; Leeuw, Frank‐Erik de; Ii, Yuichiro; Skoog, Ingmar; Mok, Vincent; Chen, Christopher; Hilal, Saima

doi:10.1177/17474930231187979

Cited by 9 publications

(7 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…36 One of the pathways by which arteriolosclerosis may contribute to dementia is via small microinfarcts in the aging brain. 37 In a pathway analysis of the neuropathological features that mediate the association of age with dementia in the ROSMAP cohort, about 30% of the association was related to vascular pathways. 38 Most studies have shown that the contribution of SVD to cognitive impairment is additive, rather than synergistic, with that of AD pathology (amyloid and tangles).…”

Section: Vcid Epidemiologymentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Small Vessel Disease, Hypertension, and Vascular Contributions to Cognitive Impairment and Dementia

Hainsworth,

Markus,

Schneider

2024

Hypertension

View full text Add to dashboard Cite

Hypertension-associated cerebral small vessel disease is a common finding in older people. Strongly associated with age and hypertension, small vessel disease is found at autopsy in over 50% of people aged ≥65 years, with a spectrum of clinical manifestations. It is the main cause of lacunar stroke and a major source of vascular contributions to cognitive impairment and dementia. The brain areas affected are subcortical and periventricular white matter and deep gray nuclei. Neuropathological sequelae are diffuse white matter lesions (seen as white matter hyperintensities on T2-weighted magnetic resonance imaging), small ischemic foci (lacunes or microinfarcts), and less commonly, subcortical microhemorrhages. The most common form of cerebral small vessel disease is concentric, fibrotic thickening of small penetrating arteries (up to 300 microns outer diameter) termed arteriolosclerosis. Less common forms are small artery atheroma and lipohyalinosis (the lesions described by C. Miller Fisher adjacent to lacunes). Other microvascular lesions that are not reviewed here include cerebral amyloid angiopathy and venous collagenosis. Here, we review the epidemiology, neuropathology, clinical management, genetics, preclinical models, and pathogenesis of hypertensive small vessel disease. Knowledge gaps include initiating factors, molecular pathogenesis, relationships between arterial pathology and tissue damage, possible reversibility, pharmacological targets, and molecular biomarkers. Progress is anticipated from multicell transcriptomic and proteomic profiling, novel experimental models and further target-finding and interventional clinical studies.

show abstract

Section: Vcid Epidemiologymentioning

confidence: 99%

Section: Epidemiology Of Svd and Vcidmentioning

confidence: 99%

Cerebral Small Vessel Disease, Hypertension, and Vascular Contributions to Cognitive Impairment and Dementia

Hainsworth,

Markus,

Schneider

2024

Hypertension

View full text Add to dashboard Cite

show abstract

“… 155 – 157 In vascular dementia, gross examination of the brain may reveal overt lesions, microinfarcts, or damage to blood vessels, and microscopic evaluation may detect accumulation of lipids or blood clots. 158 , 159 Other postmortem signs of vascular disease include white matter atrophy and calcification of arteries. 43 , 160 , 161 …”

Section: Results Of the Reviewed Studiesmentioning

confidence: 99%

Alcohol Use Disorder and Dementia: A Review

Zahr

2024

ARCR

View full text Add to dashboard Cite

PURPOSE By 2040, 21.6% of Americans will be over age 65, and the population of those older than age 85 is estimated to reach 14.4 million. Although not causative, older age is a risk factor for dementia: every 5 years beyond age 65, the risk doubles; approximately one-third of those older than age 85 are diagnosed with dementia. As current alcohol consumption among older adults is significantly higher compared to previous generations, a pressing question is whether drinking alcohol increases the risk for Alzheimer’s disease or other forms of dementia. SEARCH METHODS Databases explored included PubMed, Web of Science, and ScienceDirect. To accomplish this narrative review on the effects of alcohol consumption on dementia risk, the literature covered included clinical diagnoses, epidemiology, neuropsychology, postmortem pathology, neuroimaging and other biomarkers, and translational studies. Searches conducted between January 12 and August 1, 2023, included the following terms and combinations: “aging,” “alcoholism,” “alcohol use disorder (AUD),” “brain,” “CNS,” “dementia,” “Wernicke,” “Korsakoff,” “Alzheimer,” “vascular,” “frontotemporal,” “Lewy body,” “clinical,” “diagnosis,” “epidemiology,” “pathology,” “autopsy,” “postmortem,” “histology,” “cognitive,” “motor,” “neuropsychological,” “magnetic resonance,” “imaging,” “PET,” “ligand,” “degeneration,” “atrophy,” “translational,” “rodent,” “rat,” “mouse,” “model,” “amyloid,” “neurofibrillary tangles,” “α-synuclein,” or “presenilin.” When relevant, “species” (i.e., “humans” or “other animals”) was selected as an additional filter. Review articles were avoided when possible. SEARCH RESULTS The two terms “alcoholism” and “aging” retrieved about 1,350 papers; adding phrases—for example, “postmortem” or “magnetic resonance”—limited the number to fewer than 100 papers. Using the traditional term, “alcoholism” with “dementia” resulted in 876 citations, but using the currently accepted term “alcohol use disorder (AUD)” with “dementia” produced only 87 papers. Similarly, whereas the terms “Alzheimer’s” and “alcoholism” yielded 318 results, “Alzheimer’s” and “alcohol use disorder (AUD)” returned only 40 citations. As pertinent postmortem pathology papers were published in the 1950s and recent animal models of Alzheimer’s disease were created in the early 2000s, articles referenced span the years 1957 to 2024. In total, more than 5,000 articles were considered; about 400 are herein referenced. DISCUSSION AND CONCLUSIONS Chronic alcohol misuse accelerates brain aging and contributes to cognitive impairments, including those in the mnemonic domain. The consensus among studies from multiple disciplines, however, is that alcohol misuse can increase the risk for dementia, but not necessarily Alzheimer’s disease. Key issues to consider include the reversibility of brain damage following abstinence from chronic alcohol misuse compared to the degenerative and progressive course of ...

show abstract

“…In an excellent review in this month’s IJS, Huang and colleagues provide an update on their detection, prevalence, and association with symptoms. 24 They describe how CMIs are small ischemic lesions invisible to the naked eye at brain autopsy, while the larger ones (0.5–4 mm in diameter) can be visualized on MRI. They can be detected both on diffusion-weighted imaging (DWI) as incidental small DWI-positive lesions, and on structural MRI for those confined to the cortex and in the chronic phase.…”

mentioning

confidence: 99%

How genetics is impacting on stroke, thrombolysis for central retinal artery occlusion, and cerebral microinfarcts

Markus

2024

International Journal of Stroke

View full text Add to dashboard Cite

Cerebral microinfarcts revisited: Detection, causes, and clinical relevance

Cited by 9 publications

References 75 publications

Cerebral Small Vessel Disease, Hypertension, and Vascular Contributions to Cognitive Impairment and Dementia

Cerebral Small Vessel Disease, Hypertension, and Vascular Contributions to Cognitive Impairment and Dementia

Alcohol Use Disorder and Dementia: A Review

How genetics is impacting on stroke, thrombolysis for central retinal artery occlusion, and cerebral microinfarcts

Contact Info

Product

Resources

About