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Lancet Neurol. 2017 Sep;16(9):730-740. doi: 10.1016/S1474-4422(17)30196-5. Epub 2017 Jul 14.

Detection, risk factors, and functional consequences of cerebral microinfarcts.

Author information

1
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
2
Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
3
Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
4
Memory Ageing and Cognition Centre, National University Health System, Singapore.
5
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
6
Centre for Clinical Brain Sciences and Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
7
Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
8
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: g.j.biessels@umcutrecht.nl.

Abstract

Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that is independent of Alzheimer's disease pathology or larger infarcts (ie, lacunar infarcts, and large cortical and non-lacunar subcortical infarcts). Substantial progress has been made with regard to understanding risk factors and functional consequences of cerebral microinfarcts, partly driven by new in-vivo detection methods and the development of animal models that closely mimic multiple aspects of cerebral microinfarcts in human beings. Evidence from these advances suggests that cerebral microinfarcts can be manifestations of both small vessel and large vessel disease, that cerebral microinfarcts are independently associated with cognitive impairment, and that these lesions are likely to cause damage to brain structure and function that extends beyond their actual lesion boundaries. Criteria for the identification of cerebral microinfarcts with in-vivo MRI are provided to support further studies of the association between these lesions and cerebrovascular disease and dementia.

PMID:
28716371
PMCID:
PMC5861500
DOI:
10.1016/S1474-4422(17)30196-5
[Indexed for MEDLINE]
Free PMC Article

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