Cortical microinfarcts in memory clinic patients are associated with reduced cerebral perfusion


Cortical microinfarcts in memory clinic patients are associated with reduced cerebral perfusion

Ferro, D.; Mutsaerts, H.; Hilal, S.; Kuijf, H.; Petersen, E.; Petr, J.; van Veluw, S.; Venketasubramanian, N.; Biessels, G.; Chen, C.

Background: Cerebral cortical microinfarcts (CMIs) are small ischemic lesions visible on autopsy and structural MRI. As CMIs occur/are observed more frequently in the cortical watershed areas, we hypothesize that hypoperfusion plays a role in their development. We investigated whether CMI presence is associated with decreased cerebral perfusion using arterial spin labeling (ASL).
Methods: We have analyzed 180 memory clinic patients (mean age 72 ± 9y, 51% male, 72% CMIs present ) with pCASL acquired at 3T MRI (PLD=xx ms, labeling duration=xx ms). Cerebral blood flow (CBF) was quantified (in ml/100g/min) and mean CBF and spatial coefficient of variation (CoV, quantitative proxy of transit time, expressed as SD of the CBF/mean CBF) was calculated in gray matter in each vascular territory. Vascular artefacts were observed in 33 patients due to prolonged transit time, and these were excluded from the CBF but not CoV analysis. CMIs were rated according to previously established criteria.
Results: In this cohort, CMIs presence was associated with a higher burden of cerebrovascular disease (Table 1). Patients with CMIs had lower CBF and a higher spatial CoV in the anterior circulatory territory, indicating a decreased perfusion and a delayed transit time (Table 1, Figure 1). The total number of CMIs was correlated to a lower CBF and a higher spatial CoV (p<.02). A sub-analysis in patients with unilateral CMI presence revealed no significant inter-hemisphere differences in CBF (n=27, .56 ±.7 ml/100g/min) or in CoV (n=36, .05 ±.25).
Conclusion: This is the first study to demonstrate that CMIs presence is associated with reduced global cerebral perfusion. Further research should identify at which level of the vascular tree the cause of hypoperfusion originates.

  • Contribution to proceedings
    VasCog 2018 - The 9th International Conference of The International Society of Vascular Behavioural and Congnitive Disorders, 14.11.2018, Hong-Kong, China
  • Lecture (Conference)
    VasCog 2018 - The 9th International Conference of The International Society of Vascular Behavioural and Congnitive Disorders, 14.11.2018, Hong-Kong, China

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Publ.-Id: 28284