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

Abstract Background The study was performed to identify the association between total magnetic resonance imaging burden of small vessel disease and occurrence of post-stroke dysphagia in patients with a single recent small subcortical infarct. Methods All patients with a magnetic resonance imaging-confirmed single recent small subcortical infarct underwent the water-swallowing test and volume-viscosity swallow test within the first 24 hours following admission to assess swallowing. Demographic and clinical data were extracted from our stroke database. Based on brain magnetic resonance imaging, we independently rated the presence of cerebral microbleeds, lacunes, white matter hyperintensities and enlarged perivascular spaces. The presence of each small vessel disease feature was summed in the total small vessel disease burden, ranging from 0–4. Results In total, 308 patients with a single recent small subcortical infarct were enrolled. Overall, 54 (17.5%) were diagnosed with post-stroke dysphagia. The risk factors related to post-stroke dysphagia included the following: older age, National Institute of Health Stroke Scale, higher C-reactive protein levels and higher fibrinogen levels. Based on multiple logistic regression, two variables with the most significant associations, namely, National Institute of Health Stroke Scale and total small vessel disease burden, were combined with age, gender, history of hypertension, C-reactive protein level and fibrinogen level. Conclusions Dysphagia in patients with a single recent small subcortical infarct resulted from severe small vascular disease, which was associated with systemic inflammation. This information might provide a new anti-inflammatory treatment for post-stroke dysphagia in the future.

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Striped occipital cortex and intragyral hemorrhage: Novel magnetic resonance imaging markers for cerebral amyloid angiopathy

International Journal of Stroke ◽

10.1177/1747493021991961 ◽

2021 ◽

pp. 174749302199196

Author(s):

EA Koemans ◽

S Voigt ◽

I Rasing ◽

WMT Jolink ◽

TW van Harten ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Cerebral Amyloid Angiopathy ◽

Small Vessel Disease ◽

Occipital Cortex ◽

7 Tesla ◽

Amyloid Angiopathy ◽

Resonance Imaging ◽

Imaging Markers ◽

Cerebral Amyloid

Background and aim To investigate whether a striped occipital cortex and intragyral hemorrhage, two markers recently detected on ultra-high-field 7-tesla-magnetic resonance imaging in hereditary cerebral amyloid angiopathy (CAA), also occur in sporadic CAA (sCAA) or non-sCAA intracerebral hemorrhage (ICH). Methods We performed 7-tesla-magnetic resonance imaging in patients with probable sCAA and patients with non-sCAA-ICH. Striped occipital cortex (linear hypointense stripes perpendicular to the cortex) and intragyral hemorrhage (hemorrhage restricted to the juxtacortical white matter of one gyrus) were scored on T2*-weighted magnetic resonance imaging. We assessed the association between the markers, other CAA-magnetic resonance imaging markers and clinical features. Results We included 33 patients with sCAA (median age 70 years) and 29 patients with non-sCAA-ICH (median age 58 years). Striped occipital cortex was detected in one (3%) patient with severe sCAA. Five intragyral hemorrhages were found in four (12%) sCAA patients. The markers were absent in the non-sCAA-ICH group. Patients with intragyral hemorrhages had more lobar ICHs (median count 6.5 vs. 1.0), lobar microbleeds (median count >50 vs. 15), and lower median cognitive scores (Mini Mental State Exam: 20 vs. 28, Montreal Cognitive Assessment: 18 vs. 24) compared with patients with sCAA without intragyral hemorrhage. In 12 (36%) patients, sCAA diagnosis was changed to mixed-type small vessel disease due to deep bleeds previously unobserved on lower field-magnetic resonance imaging. Conclusion Whereas a striped occipital cortex is rare in sCAA, 12% of patients with sCAA have intragyral hemorrhages. Intragyral hemorrhages seem to be related to advanced disease and their absence in patients with non-sCAA-ICH could suggest specificity for CAA.

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Total small vessel disease burden and brain network efficiency in cerebral amyloid angiopathy

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.09.015 ◽

2017 ◽

Vol 382 ◽

pp. 10-12 ◽

Cited By ~ 8

Author(s):

Raffaella Valenti ◽

Yael D. Reijmer ◽

Andreas Charidimou ◽

Gregoire Boulouis ◽

Sergi Ramirez Martinez ◽

...

Keyword(s):

Cerebral Amyloid Angiopathy ◽

Disease Burden ◽

Small Vessel Disease ◽

Brain Network ◽

Small Vessel ◽

Amyloid Angiopathy ◽

Network Efficiency ◽

Vessel Disease ◽

Cerebral Amyloid

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Interhemispheric distribution of amyloid and small vessel disease burden in cerebral amyloid angiopathy‐related intracerebral hemorrhage

European Journal of Neurology ◽

10.1111/ene.14301 ◽

2020 ◽

Vol 27 (8) ◽

pp. 1664-1671

Author(s):

M. Planton ◽

J. Pariente ◽

F. Nemmi ◽

J‐F. Albucher ◽

L. Calviere ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Cerebral Amyloid Angiopathy ◽

Disease Burden ◽

Small Vessel Disease ◽

Small Vessel ◽

Amyloid Angiopathy ◽

Vessel Disease ◽

Cerebral Amyloid

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Neuropathology of Vascular Brain Health: Insights From Ex Vivo Magnetic Resonance Imaging–Histopathology Studies in Cerebral Small Vessel Disease

Stroke ◽

10.1161/strokeaha.121.032608 ◽

2022 ◽

Author(s):

Susanne J. van Veluw ◽

Konstantinos Arfanakis ◽

Julie A. Schneider

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Human Brain ◽

Small Vessel Disease ◽

Ex Vivo ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Amyloid Angiopathy ◽

Resonance Imaging ◽

Vessel Disease

Sporadic cerebral small vessel disease (SVD) is a major contributor to vascular cognitive impairment and dementia in the aging human brain. On neuropathology, sporadic SVD is characterized by abnormalities to the small vessels of the brain predominantly in the form of cerebral amyloid angiopathy and arteriolosclerosis. These pathologies frequently coexist with Alzheimer disease changes, such as plaques and tangles, in a single brain. Conversely, during life, magnetic resonance imaging (MRI) only captures the larger manifestations of SVD in the form of parenchymal brain abnormalities. There appears to be a major knowledge gap regarding the underlying neuropathology of individual MRI-detectable SVD abnormalities. Ex vivo MRI in postmortem human brain tissue is a powerful tool to bridge this gap. This review summarizes current insights into the histopathologic correlations of MRI manifestations of SVD, their underlying cause, presumed pathophysiology, and associated secondary tissue injury. Moreover, we discuss the advantages and limitations of ex vivo MRI-guided histopathologic investigations and make recommendations for future studies.

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CORRELATION BETWEEN TOTAL SMALL VESSEL DISEASE BURDEN ON MRI AND IMPAIRMENTS IN STRUCTURAL BRAIN NETWORKS IN PATIENTS WITH CEREBRAL AMYLOID ANGIOPATHY

10.26226/morressier.58e389b2d462b8029238514b ◽

2017 ◽

Author(s):

Raffaella Valenti

Keyword(s):

Cerebral Amyloid Angiopathy ◽

Disease Burden ◽

Small Vessel Disease ◽

Brain Networks ◽

Small Vessel ◽

Amyloid Angiopathy ◽

Vessel Disease ◽

Cerebral Amyloid ◽

Structural Brain

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Total magnetic resonance imaging of cerebral small vessel disease burden predicts dysphagia in patients with a single recent small subcortical infarct

BMC Neurology ◽

10.1186/s12883-021-02518-9 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Lulu Zhang ◽

Xiang Tang ◽

Yidan Li ◽

Juehua Zhu ◽

Dongxue Ding ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Disease Burden ◽

Small Vessel Disease ◽

Small Vessel ◽

Resonance Imaging ◽

Post Stroke ◽

Reactive Protein ◽

Vessel Disease ◽

Scale Scores

Abstract Background This study was performed to identify the association between the total magnetic resonance imaging burden of small vessel disease and the occurrence of post-stroke dysphagia in patients with a single recent small subcortical infarct (RSSI). Methods We retrospectively identified all patients with a magnetic resonance imaging-confirmed single RSSI. The water-swallowing test and volume-viscosity swallow test were performed within the first 24 h following admission to assess swallowing. Demographic and clinical data were extracted from our stroke database. Based on brain magnetic resonance imaging, we independently rated the presence of cerebral microbleeds, lacunes, white matter hyperintensities and enlarged perivascular spaces. The presence of each small vessel disease feature was summed to determine the total small vessel disease burden, ranging from 0 to 4. Results In total, 308 patients with a single RSSI were enrolled. Overall, 54 (17.5%) were diagnosed with post-stroke dysphagia. The risk factors related to post-stroke dysphagia included the following: older age, higher National Institute of Health Stroke Scale scores, higher C-reactive protein level and higher fibrinogen level. Based on multiple logistic regression, National Institute of Health Stroke Scale scores and total small vessel disease burden were independent risk factors of post-stroke dysphagia in patients with a single RSSI, after adjusting for age, gender, history of hypertension, C-reactive protein level and fibrinogen level. Conclusions Dysphagia in patients with a single RSSI was associated with a more severe total small vessel disease burden as reflected by MRI. Total MRI of cerebral small vessel disease burden may predict dysphagia in these patients. Furthermore, more severe total small vessel disease burden was associated with systemic inflammation.

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Post-Mortem 7.0-Tesla Magnetic Resonance Imaging of the Hippocampus in Progressive Supranuclear Palsy with and without Cerebral Amyloid Angiopathy

NeuroSci ◽

10.3390/neurosci1020011 ◽

2020 ◽

Vol 1 (2) ◽

pp. 115-120

Author(s):

Jacques De Reuck ◽

Florent Auger ◽

Nicolas Durieux ◽

Claude-Alain Maurage ◽

Vincent Deramecourt ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Progressive Supranuclear Palsy ◽

Cerebral Amyloid Angiopathy ◽

Amyloid Angiopathy ◽

Post Mortem ◽

Resonance Imaging ◽

Cerebral Amyloid ◽

Magnetic Resonance Imaging Mri ◽

Neuropathological Examination

Introduction and Purpose: Cerebral amyloid angiopathy (CAA) can be observed in patients with progressive supranuclear palsy (PSP), though to a lesser degree than in Alzheimer’s disease. The present post-mortem 7.0-tesla magnetic resonance imaging (MRI) evaluates whether CAA has an influence on the degree of hippocampal atrophy (HA) and on the incidence of associated micro-infarcts (HMIs) and cortical micro-bleeds (HMBs). Material and Methods: Eight brains with PSP-CAA were compared to 20 PSP brains without CAA. In addition to the neuropathological examination, the hippocampus was evaluated on the most representative coronal section with T2 and T2*-weighted MRI sequences. The average degree of HA was determined in both groups. The incidence of HMIs and HMBs was also compared as well as the frequency of cortical micro-infarcts (CoMIs) and cortical micro-bleeds (CoMBs) in the hemispheric neocortex. Results: The neuropathological examination showed a higher incidence of lacunar infarcts in the PSP-CAA brains compared to the PSP ones. With magnetic resonance imaging (MRI), the severity of HA and the incidence of HMIs and HMBs was similar between both groups. Additionally, the frequency of CoMIs and CoMBs in the neocortex was comparable. Conclusions: The association of CAA in PSP brains has no influence on the degree of HA and on the incidence of the small cerebrovascular lesions in the hippocampus as well as in the neocortex.

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