Cortical Microinfarcts Detected by 3-Tesla Magnetic Resonance Imaging

Ishikawa, Hidehiro; Yuichiro,; Shindo, Akihiro; Tabei, Ken-ichi; Umino, Maki; Ito, Ai; Matsuura, Keita; Taniguchi, Akira; Matsuyama, Hirofumi; Niwa, Atsushi; Ogura, Toru; Yoshimaru, Kimiko; Satoh, Masayuki; Maeda, Masayuki; Tomimoto, Hidekazu

doi:10.1161/strokeaha.119.028202

Cited by 18 publications

(17 citation statements)

References 14 publications

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“…11 CMIs are caused by different pathological backgrounds, including CAA, arteriosclerosis and microembolism 12 ; however, neuroradiological findings obtained using 3 Tesla (3T) MRI may enable distinction between CMIs related to CAA and those due to microembolisms. 13 Figure 1 Representative MRI findings of cerebral small vessel disease. The arrows show lobar cerebral microbleeds on SWI sequences.…”

Section: Introductionmentioning

confidence: 99%

Investigation of hypertensive arteriopathy-related and cerebral amyloid angiopathy-related small vessel disease scores in patients from a memory clinic: a prospective single-centre study

et al. 2021

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ObjectiveThe severity of cerebral small vessel disease (SVD) is assessed through neuroimaging findings, including hypertensive arteriopathy (HA)-SVD and cerebral amyloid angiopathy (CAA)-SVD. HA-SVD and CAA-SVD have been collectively estimated as total scores: the HA-SVD and CAA-SVD scores, respectively. Previous reports suggest that HA-SVD scores are associated with cognitive function; however, the relationship between CAA-SVD scores and cognitive function remains unclear. Therefore, we examined the association between CAA-SVD scores and cognitive function. Furthermore, we developed a modified CAA-SVD score considering cortical microinfarcts and posterior dominant white matter hyperintensities, which are imaging findings of CAA, and examined the association between these scores and cognitive function in the same patient group.DesignProspective study.SettingSingle centre study from a memory clinic.ParticipantsSubjects were diagnosed with mild cognitive impairment (MCI) or mild dementia in our memory clinic between February 2017 and July 2019 and underwent clinical dementia rating scale and brain MRI assessment. A total of 42 patients (aged 75.3±9.12 years) were registered prospectively.Primary and secondary outcome measuresWe evaluated intellectual function, memory, frontal lobe function and constructional ability. Furthermore, the relationship between each score and cognitive function was examined.ResultsThe CAA-SVD score showed significant associations with cognitive function (R2=0.63, p=0.016), but the HA-SVD score did not (R2=0.41, p=0.35). The modified CAA-SVD score was also significantly associated with cognitive function (R2=0.65, p=0.008).ConclusionCognitive function is associated with the CAA-SVD score, and more efficiently with the modified CAA-SVD score, in memory clinic patients. Although we have not validated the weighting of the modified CAA-SVD score, these scores can be a predictor of cognitive deterioration in patients with MCI and mild dementia.

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Section: Introductionmentioning

confidence: 99%

Investigation of hypertensive arteriopathy-related and cerebral amyloid angiopathy-related small vessel disease scores in patients from a memory clinic: a prospective single-centre study

et al. 2021

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“…CAA and cerebral embolisms can cause CMIs. CMIs from patients with CAAs (G-I) showed that all lesions were localized within cortical structures, with a size of <5 mm (Ishikawa et al, 2020). CMIs caused by embolisms involved subcortical areas, and the size of the lesions was ≥5 mm (Ishikawa et al, 2020).…”

Section: Neuroimaging Of Cerebral Small Vessel Disease (Figure 2)mentioning

confidence: 99%

“…CMIs from patients with CAAs (G-I) showed that all lesions were localized within cortical structures, with a size of <5 mm (Ishikawa et al, 2020). CMIs caused by embolisms involved subcortical areas, and the size of the lesions was ≥5 mm (Ishikawa et al, 2020). system activation (Matsuo et al, 2018), the details of this possible relationship remain unclear.…”

Section: Neuroimaging Of Cerebral Small Vessel Disease (Figure 2)mentioning

confidence: 99%

“…Histopathological studies have demonstrated neuroradiological and pathological correlations (Niwa et al, 2017;Ishikawa et al, 2018). A recent study using 3T-MRI has shown that it may be possible to distinguish between CMIs due to CAA and those due to microembolism (Ishikawa et al, 2020). They say that CMIs in CAA patients are localized within the cortex, predominantly in the occipital lobe, smaller <5 mm in diameter, with fewer than three lesions (Ishikawa et al, 2020).…”

Section: Neuroimaging Of Cerebral Small Vessel Disease (Figure 2)mentioning

confidence: 99%

“…A recent study using 3T-MRI has shown that it may be possible to distinguish between CMIs due to CAA and those due to microembolism (Ishikawa et al, 2020). They say that CMIs in CAA patients are localized within the cortex, predominantly in the occipital lobe, smaller <5 mm in diameter, with fewer than three lesions (Ishikawa et al, 2020). On the other hand, CMIs resulting from microembolisms may involve the cortico-subcortical junction, are predominantly distributed in the frontal or parietal lobes, larger (≥5 mm) in diameter with multiple lesions, typically at least three (Ishikawa et al, 2020).…”

Section: Neuroimaging Of Cerebral Small Vessel Disease (Figure 2)mentioning

confidence: 99%

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Clinical Features and Experimental Models of Cerebral Small Vessel Disease

Shindo

Ishikawa

Yuichiro

et al. 2020

Front. Aging Neurosci.

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Cerebral small vessel disease (SVD) refers to a group of disease conditions affecting the cerebral small vessels, which include the small arteries, arterioles, capillaries, and postcapillary venules in the brain. SVD is the primary cause of vascular cognitive impairment and gait disturbances in aged people. There are several types of SVD, though arteriolosclerosis, which is mainly associated with hypertension, aging, and diabetes mellitus, and cerebral amyloid angiopathy (CAA) comprise most SVD cases. The pathology of arteriolosclerosis-induced SVD is characterized by fibrinoid necrosis and lipohyalinosis, while CAA-associated SVD is characterized by progressive deposition of amyloid beta (Aβ) protein in the cerebral vessels. Brain magnetic resonance imaging (MRI) has been used for examination of SVD lesions; typical lesions are characterized by white matter hyperintensity, lacunar infarcts, enlargement of perivascular spaces (EPVS), microbleeds, cortical superficial siderosis (cSS), and cortical microinfarcts. The microvascular changes that occur in the small vessels are difficult to identify clearly; however, these consequent image findings can represent the SVD. There are two main strategies for prevention and treatment of SVD, i.e., pharmacotherapy and lifestyle modification. In this review, we discuss clinical features of SVD, experimental models replicating SVD, and treatments to further understand the pathological and clinical features of SVD.

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