Cortical microinfarcts in patients with multiple lobar microbleeds on 3 T MRI

Yuichiro,; Maeda, Masayuki; Ishikawa, Hidehiro; Ito, Ai; Matsuo, Kimiko; Umino, Maki; Shindo, Akihiro; Kida, Hirotaka; Satoh, Masayuki; Niwa, Atsushi; Taniguchi, Akira; Tomimoto, Hidekazu

doi:10.1007/s00415-019-09350-9

Cited by 16 publications

(15 citation statements)

References 46 publications

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“…We followed the MRI protocol by Ii et al 28 Briefly, MRI studies were performed with a 3T MRI unit (Achieva, Philips Medical System, Best, the Netherlands) using an 8-channel or 32-channel phased-array head coil. We used T1-weighted and T2-weighted images and threedimensional (3D)-fluid attenuated inversion recovery (FLAIR) images for the evaluation of WMH, lacunar infarcts and PVS.…”

Section: Mri Protocolmentioning

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: Mri Protocolmentioning

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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“…A retrospective hospital‐based study showed a strong association between CMIs at autopsy and higher number of lobar CMBs on ante‐mortem MRI in autopsy‐confirmed CAA [37]. Two previous studies using in vivo 3T MRI, including our own, found an association between presence of CMI and cSS [9,12]. However, CSO‐PVS and CAA‐SVD scores were not evaluated in these two studies.…”

Section: Discussionmentioning

confidence: 95%

“…Although the pathogenesis of CMIs is heterogeneous, cerebral amyloid angiopathy (CAA) and cerebral microembolism are one of the major causes [2]. The in vivo detection of CMIs on 3‐Tesla (3‐T) magnetic resonance imaging (MRI) was first reported in 2013 [3]; since then, several studies using 3T MRI have been reported in both hospital and population‐cohort settings [4–12]. In addition, a radiologic score that evaluates the characteristics of CMIs on 3T MRI to differentiate CMIs attributable to CAA (CMI‐CAA score) from CMIs attributable to microembolism (CMI‐ME score) has recently been proposed [13].…”

Section: Introductionmentioning

confidence: 99%

Association between cortical microinfarcts and total small vessel disease burden in cerebral amyloid angiopathy on 3‐Tesla magnetic resonance imaging

Yuichiro

Ishikawa

Shindo

et al. 2020

Euro J of Neurology

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Background and purpose Cortical microinfarcts (CMIs) are frequently found in the brains of patients with advanced cerebral amyloid angiopathy (CAA) at autopsy. The small vessel disease (SVD) score for CAA (i.e., the CAA‐SVD score) has been proposed to evaluate the severity of CAA‐associated vasculopathic changes by a combination of magnetic resonance imaging (MRI) markers. The aim of this study was to examine the association between total CAA‐SVD score and features of CMIs on in vivo 3‐Tesla MRI. Methods Eighty patients with probable CAA were retrospectively analyzed. Lobar cerebral microbleeds, cortical superficial siderosis, enlargement of perivascular space in the centrum semiovale and white matter hyperintensity were collectively assessed, and the total CAA‐SVD score was calculated. The presence of CMI was also examined. Results Of the 80 patients, 13 (16.25%) had CMIs. CMIs were detected more frequently in the parietal and occipital lobes. A positive correlation was found between total CAA‐SVD score and prevalence of CMI (ρ = 0.943; p = 0.005). Total CAA‐SVD score was significantly higher in patients with CMIs than in those without (p = 0.009). In a multivariable logistic regression analysis, the presence of CMIs was significantly associated with total CAA‐SVD score (odds ratio 2.318 [95% confidence interval 1.228–4.376]; p = 0.01, per each additional point). Conclusions The presence of CMIs with a high CAA‐SVD score could be an indicator of more severe amyloid‐associated vasculopathic changes in patients with probable CAA.

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“…Representative images of SVD typically show white matter hyperintensities (WMH) in MRI, as well as lacunar infarcts, and cerebral MBs (Pantoni, 2010). Moreover, enlargement of perivascular spaces (EPVS), cSS, convexity subarachnoid hemorrhages, and cortical microinfarcts (CMIs) are also indicators of SVD (van Veluw et al, 2017;Wilson et al, 2017;Raposo et al, 2018;Ii et al, 2013Ii et al, , 2019Wardlaw et al, 2019).…”

Section: Types Of Cerebral Small Vessel Diseasementioning

confidence: 99%

“…Moreover, lobar MBs and CMIs are often observed in severe CAA cases, and these lesions are typically associated with cognitive impairments (van Veluw et al, 2016). Other types of SVD include inherited or genetic SVD (Type 3), inflammatory and immunologically mediated SVD (Type 4), SVD caused by venous collagenosis (Type 5), and SVD related to other causes (Type 6; Ii et al, 2019). CADASIL and Fabry disease are well-known causes of inherited or genetic SVD.…”

Section: Types Of Cerebral Small Vessel Diseasementioning

confidence: 99%

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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Cortical microinfarcts in patients with multiple lobar microbleeds on 3 T MRI

Cited by 16 publications

References 46 publications

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

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

Association between cortical microinfarcts and total small vessel disease burden in cerebral amyloid angiopathy on 3‐Tesla magnetic resonance imaging

Clinical Features and Experimental Models of Cerebral Small Vessel Disease

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