TY - JOUR
T1 - Microinfarcts in the Deep Gray Matter on 7T MRI
T2 - Risk Factors, MRI Correlates, and Relation to Cognitive Functioning-The SMART-MR Study
AU - Ghaznawi, R.
AU - Zwartbol, M. H. T.
AU - de Bresser, J.
AU - Kuijf, H. J.
AU - Vincken, K. L.
AU - Rissanen, I.
AU - Hendrikse, J.
AU - Geerlings, Mirjam I.
AU - Asselbergs, F. W.
AU - Nathoe, H. M.
AU - de Borst, G. J.
AU - Bots, M. L.
AU - Geerlings, M. I.
AU - Emmelot, M. H.
AU - de Jong, P. A.
AU - Leiner, T.
AU - Lely, A. T.
AU - van der Kaaij, N. P.
AU - Kappelle, L. J.
AU - Ruigrok, Y.
AU - Verhaar, M. C.
AU - the UCC-SMART-Study Group
AU - Visseren, F. L. J.
AU - Westerink, J.
N1 - Funding Information: Funding for this article was received as part of a grant from the Netherlands Organization for Scientific Research-Medical Sciences (project No. 904-65-095) and the European Research Council under the European Union's Horizon 2020/ERC grant agreement No. 637024 and No. 66681 (SVDs@target). Publisher Copyright: © 2022 American Society of Neuroradiology. All rights reserved.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - BACKGROUND AND PURPOSE: The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning. MATERIALS AND METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, 213 patients (mean age, 68 [SD, 8] years) had a risk-factor assessment, 7T and 1.5T brain MR imaging, and a cognitive examination. Microinfarcts on 7T MR imaging were defined as lesions of,5 mm. Regression models were used to examine the age-adjusted associations among risk factors, MR imaging markers, and microinfarcts. Cognitive function was summarized as composite and domain-specific z scores. RESULTS: A total of 47 microinfarcts were found in 28 patients (13%), most commonly in the thalamus. Older age, history of stroke, hypertension, and intima-media thickness were associated with microinfarcts. On 1.5T MR imaging, cerebellar infarcts (relative risk ¼ 2.75; 95% CI, 1.4-5.33) and lacunes in the white (relative risk ¼ 3.28; 95% CI, 3.28-6.04) and deep gray matter (relative risk = 3.06; 95% CI, 1.75-5.35) were associated with microinfarcts, and on 7T MR imaging cortical microinfarcts (relative risk = 2.33; 95% CI, 1.32-4.13). Microinfarcts were also associated with poorer global cognitive functioning (mean difference in the global z score between patients with multiple microinfarcts versus none = -0.97; 95% CI, -1.66 to -0.28, P = .006) and across all cognitive domains. CONCLUSIONS: Microinfarcts in the deep gray matter on 7T MR imaging were associated with worse cognitive functioning and risk factors and MR imaging markers of small-vessel and large-vessel disease. Our findings suggest that microinfarcts in the deep gray matter may represent a novel imaging marker of vascular brain injury.
AB - BACKGROUND AND PURPOSE: The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning. MATERIALS AND METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, 213 patients (mean age, 68 [SD, 8] years) had a risk-factor assessment, 7T and 1.5T brain MR imaging, and a cognitive examination. Microinfarcts on 7T MR imaging were defined as lesions of,5 mm. Regression models were used to examine the age-adjusted associations among risk factors, MR imaging markers, and microinfarcts. Cognitive function was summarized as composite and domain-specific z scores. RESULTS: A total of 47 microinfarcts were found in 28 patients (13%), most commonly in the thalamus. Older age, history of stroke, hypertension, and intima-media thickness were associated with microinfarcts. On 1.5T MR imaging, cerebellar infarcts (relative risk ¼ 2.75; 95% CI, 1.4-5.33) and lacunes in the white (relative risk ¼ 3.28; 95% CI, 3.28-6.04) and deep gray matter (relative risk = 3.06; 95% CI, 1.75-5.35) were associated with microinfarcts, and on 7T MR imaging cortical microinfarcts (relative risk = 2.33; 95% CI, 1.32-4.13). Microinfarcts were also associated with poorer global cognitive functioning (mean difference in the global z score between patients with multiple microinfarcts versus none = -0.97; 95% CI, -1.66 to -0.28, P = .006) and across all cognitive domains. CONCLUSIONS: Microinfarcts in the deep gray matter on 7T MR imaging were associated with worse cognitive functioning and risk factors and MR imaging markers of small-vessel and large-vessel disease. Our findings suggest that microinfarcts in the deep gray matter may represent a novel imaging marker of vascular brain injury.
UR - http://www.scopus.com/inward/record.url?scp=85131772503&partnerID=8YFLogxK
U2 - https://doi.org/10.3174/ajnr.A7512
DO - https://doi.org/10.3174/ajnr.A7512
M3 - Article
C2 - 35618425
SN - 0195-6108
VL - 43
SP - 829
EP - 836
JO - American journal of neuroradiology
JF - American journal of neuroradiology
IS - 6
ER -