Antemortem MRI findings associated with microinfarcts at autopsy

Mekala R. Raman, Gregory M. Preboske, Scott A. Przybelski, Jeffrey L. Gunter, Matthew L. Senjem, Prashanthi Vemuri, Matthew C. Murphy, Melissa E. Murray, Bradley F. Boeve, David S. Knopman, Ronald C. Petersen, Joseph E. Parisi, Dennis W. Dickson, Clifford R. Jack, Kejal Kantarci

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objective: To determine antemortem MRI findings associated with microinfarcts at autopsy. Methods: Patients with microinfarcts (n = 22) and patients without microinfarcts (n = 44) who underwent antemortem MRI were identified from a dementia clinic-based, population-based, and community clinic-based autopsy cohort. The microinfarct and no-microinfarct groups were matched on age at MRI, age at death, sex, APOE status, Mini-Mental State Examination score, and pathologic diagnosis of Alzheimer disease. Brain infarcts were assessed on fluid-attenuated inversion recovery (FLAIR) MRI. White matter hyperintensities on FLAIR MRI and hippocampal volumes on T1-weighted MRI were quantified using automated methods. A subset of subjects with microinfarcts (n = 15) and a matched group of subjects without microinfarcts (n = 15) had serial T1-weighted MRIs and were included in an analysis of global and regional brain atrophy rates using automated methods. Results: The presence of cortical (p = 0.03) and subcortical (p = 0.02) infarcts on antemortem MRI was associated with presence of microinfarcts at autopsy. Higher numbers of cortical (p = 0.05) and subcortical (p = 0.03) infarcts on antemortem MRI were also associated with presence of microinfarcts. Presence of microinfarcts was not associated with white matter hyperintensities and cross-sectional hippocampal volume on antemortem MRI. Whole-brain and regional precuneus, motor, and somatosensory atrophy rates were higher in subjects with microinfarcts compared to subjects without microinfarcts. Conclusions: Microinfarcts increase brain atrophy rates independent of Alzheimer disease pathology. Association between microinfarct pathology and macroinfarcts on MRI suggests either common risk factors or a shared pathophysiology and potentially common preventive targets.

Original languageEnglish (US)
Pages (from-to)1951-1958
Number of pages8
JournalNeurology
Volume82
Issue number22
DOIs
StatePublished - Jun 3 2014

ASJC Scopus subject areas

  • Clinical Neurology

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