TY - JOUR
T1 - Study of Symptomatic vs. Silent Brain Infarctions on MRI in Elderly Subjects
AU - Raghavan, Sheelakumari
AU - Graff-Radford, Jonathan
AU - Scharf, Eugene
AU - Przybelski, Scott A.
AU - Lesnick, Timothy G.
AU - Gregg, Brian
AU - Schwarz, Christopher G.
AU - Gunter, Jeffrey L.
AU - Zuk, Samantha M.
AU - Rabinstein, Alejandro
AU - Mielke, Michelle M.
AU - Petersen, Ronald C.
AU - Knopman, David S.
AU - Kantarci, Kejal
AU - Jack, Clifford R.
AU - Vemuri, Prashanthi
N1 - Publisher Copyright:
© Copyright © 2021 Raghavan, Graff-Radford, Scharf, Przybelski, Lesnick, Gregg, Schwarz, Gunter, Zuk, Rabinstein, Mielke, Petersen, Knopman, Kantarci, Jack and Vemuri.
PY - 2021/2/17
Y1 - 2021/2/17
N2 - Brain infarctions are closely associated with future risk of stroke and dementia. Our goal was to report (i) frequency and characteristics that differentiate symptomatic vs. silent brain infarctions (SBI) on MRI and (ii) frequency and location by vascular distribution (location of stroke by major vascular territories) in a population based sample. From Mayo Clinic Study of Aging, 347 participants (≥50 years) with infarcts detected on their first MRI were included. Infarct information was identified visually on a FLAIR MRI image and a vascular territory atlas was registered to the FLAIR image data in order to identify the arterial territory of infarction. We identified the subset with a clinical history of stroke based on medical chart review and used a logistic regression to evaluate the risk factors associated with greater probability of a symptomatic stroke vs. SBI. We found that 14% of all individuals with infarctions had a history of symptomatic stroke (Silent: n = 300, symptomatic: n = 47). Factors associated with a symptomatic vs. SBI were size which had an odds ratio of 3.07 (p < 0.001), greater frequency of hypertension (odds ratio of 4.12, p = 0.025) and alcohol history (odds ratio of 4.58, p = 0.012). The frequency of infarcts was greater in right hemisphere compared to the left for SBI. This was primarily driven by middle cerebral artery (MCA) infarcts (right = 60%, left = 40%, p = 0.005). While left hemisphere strokes are more common for symptomatic carotid disease and in clinical trials, right hemispheric infarcts may be more frequent in the SBI group.
AB - Brain infarctions are closely associated with future risk of stroke and dementia. Our goal was to report (i) frequency and characteristics that differentiate symptomatic vs. silent brain infarctions (SBI) on MRI and (ii) frequency and location by vascular distribution (location of stroke by major vascular territories) in a population based sample. From Mayo Clinic Study of Aging, 347 participants (≥50 years) with infarcts detected on their first MRI were included. Infarct information was identified visually on a FLAIR MRI image and a vascular territory atlas was registered to the FLAIR image data in order to identify the arterial territory of infarction. We identified the subset with a clinical history of stroke based on medical chart review and used a logistic regression to evaluate the risk factors associated with greater probability of a symptomatic stroke vs. SBI. We found that 14% of all individuals with infarctions had a history of symptomatic stroke (Silent: n = 300, symptomatic: n = 47). Factors associated with a symptomatic vs. SBI were size which had an odds ratio of 3.07 (p < 0.001), greater frequency of hypertension (odds ratio of 4.12, p = 0.025) and alcohol history (odds ratio of 4.58, p = 0.012). The frequency of infarcts was greater in right hemisphere compared to the left for SBI. This was primarily driven by middle cerebral artery (MCA) infarcts (right = 60%, left = 40%, p = 0.005). While left hemisphere strokes are more common for symptomatic carotid disease and in clinical trials, right hemispheric infarcts may be more frequent in the SBI group.
KW - clinical stroke
KW - laterality
KW - middle cerebral artery
KW - silent brain infarction
KW - vascular distribution
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U2 - 10.3389/fneur.2021.615024
DO - 10.3389/fneur.2021.615024
M3 - Article
AN - SCOPUS:85101980080
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 615024
ER -