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Lacune infarct or silent infarction

J Matthijs Biesbroek, Nick A Weaver, Geert Jan Biessels
Cerebral small vessel disease (SVD) is an important cause of cognitive impairment. Important MRI manifestations of SVD include white matter hyperintensities (WMH) and lacunes. This narrative review addresses the role of anatomical lesion location in the impact of SVD on cognition, integrating findings from early autopsy studies with emerging findings from recent studies with advanced image analysis techniques. Early autopsy and imaging studies of small case series indicate that single lacunar infarcts in, for example the thalamus, caudate nucleus or internal capsule can cause marked cognitive impairment...
April 25, 2017: Clinical Science (1979-)
Yanan Zhu, Yuek Ling Chai, Saima Hilal, M Kamran Ikram, Narayanaswamy Venketasubramanian, Boon-Seng Wong, Christopher P Chen, Mitchell K P Lai
INTRODUCTION: Neuroinflammation and cerebrovascular disease (CeVD) have been implicated in cognitive impairment and Alzheimer's disease (AD). The present study aimed to examine serum inflammatory markers in preclinical stages of dementia and in AD, as well as to investigate their associations with concomitant CeVD. METHODS: We performed a cross-sectional case-control study including 96 AD, 140 cognitively impaired no dementia (CIND), and 79 noncognitively impaired participants...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Maria Del C Valdés Hernández, Xinyi Qiu, Xin Wang, Stewart Wiseman, Eleni Sakka, Lucy C Maconick, Fergus Doubal, Cathie L M Sudlow, Joanna M Wardlaw
BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces...
January 2017: Brain and Behavior
Yifeng Ling, François De Guio, Marco Duering, Eric Jouvent, Dominique Hervé, Ophélia Godin, Martin Dichgans, Hugues Chabriat
BACKGROUND AND PURPOSE: Previous studies in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy showed that accumulation of lacunes strongly relate to clinical severity. However, the potential predictors of incident lacunes and their clinical consequences over a short time frame have not been investigated. This study aimed to determine the predictors and clinical impact of such lesions in a large cohort of patients. METHODS: Two hundred and six NOTCH3 mutation carriers (mean age, 49...
February 2017: Stroke; a Journal of Cerebral Circulation
Hiroko H Dodge, Jian Zhu, Randy Woltjer, Peter T Nelson, David A Bennett, Nigel J Cairns, David W Fardo, Jeffrey A Kaye, Deniz-Erten Lyons, Nora Mattek, Julie A Schneider, Lisa C Silbert, Chengjie Xiong, Lei Yu, Frederick A Schmitt, Richard J Kryscio, Erin L Abner
INTRODUCTION: The presence of cerebrovascular pathology may increase the risk of clinical diagnosis of Alzheimer's disease (AD). METHODS: We examined excess risk of incident clinical diagnosis of AD (probable and possible AD) posed by the presence of lacunes and large infarcts beyond AD pathology using data from the Statistical Modeling of Aging and Risk of Transition study, a consortium of longitudinal cohort studies with more than 2000 autopsies. We created six mutually exclusive pathology patterns combining three levels of AD pathology (low, moderate, or high AD pathology) and two levels of vascular pathology (without lacunes and large infarcts or with lacunes and/or large infarcts)...
December 23, 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Simrin Sennik, Tom A Schweizer, Corinne E Fischer, David G Munoz
BACKGROUND: Neuropsychiatric symptoms are common manifestations of Alzheimer's disease (AD). A number of studies have targeted psychosis, i.e., hallucinations and delusions in AD, but few have assessed agitation/aggression in AD. OBJECTIVE: To investigate the risk factors and pathological substrates associated with presence [A(+)] and absence [A(-)] of agitation/aggression (A) in autopsy-confirmed AD. METHODS: Data was collected from the UDS data as of 2015 on the NACC database...
2017: Journal of Alzheimer's Disease: JAD
Laurens Jl De Cocker, Arjen Lindenholz, Jaco Jm Zwanenburg, Anja G van der Kolk, Maarten Zwartbol, Peter R Luijten, Jeroen Hendrikse
Stroke and related cerebrovascular diseases are a major cause of mortality and disability. Even at standard-field-strengths (1.5T), MRI is by far the most sensitive imaging technique to detect acute brain infarctions and to characterize incidental cerebrovascular lesions, such as white matter hyperintensities, lacunes and microbleeds. Arterial time-of-flight (TOF) MR angiography (MRA) can depict luminal narrowing or occlusion of the major brain feeding arteries, and this without the need for contrast administration...
November 18, 2016: NeuroImage
Eric Jouvent, Edouard Duchesnay, Foued Hadj-Selem, François De Guio, Jean-François Mangin, Dominique Hervé, Marco Duering, Stefan Ropele, Reinhold Schmidt, Martin Dichgans, Hugues Chabriat
OBJECTIVE: To obtain simple models predicting disease evolution at 3 years for a given patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). METHODS: Based on data obtained in a prospective study of 236 patients, we built and validated models predicting, at the individual level, 3-year changes in Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS), Trail Making Test version B (TMTB), and modified Rankin Scale (mRS)...
October 25, 2016: Neurology
Yuek Ling Chai, Saima Hilal, Jenny P C Chong, Yan Xia Ng, Oi Wah Liew, Xin Xu, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian, A Mark Richards, Mitchell K P Lai, Christopher P Chen
Vascular pathology plays an important role in the development of cognitive decline and dementia. In this context, growth differentiation factor-15 (GDF-15) has been suggested to be a biomarker due to its regulatory roles in inflammatory and trophic responses during tissue injury. However, limited data exist on the associations of GDF-15 with either cerebrovascular disease (CeVD) burden or the spectrum of cognitive impairment. Therefore, we aimed to study peripheral levels of GDF-15 incognitive impairment no dementia (CIND) or Alzheimer disease (AD) subjects assessed for CeVD using a case-control cohort design, with cases recruited from memory clinics and controls from memory clinics and the community...
August 2016: Medicine (Baltimore)
Xiangliang Chen, Lihui Duan, Yunfei Han, Ling Tian, Qiliang Dai, Shang Wang, Ying Lin, Yunyun Xiong, Xinfeng Liu
BACKGROUND: Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. METHODS: We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI...
July 26, 2016: BMC Neurology
Shanshan Duan, Shan Zhang, Liang Li, Chuancheng Ren, Juan Xie
BACKGROUND AND PURPOSE: Small deep brain infarcts are often caused by two different vascular pathologies: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). In this study, we compare the clinical characteristics of BAD and LD and investigate the role of C-reactive protein (CRP), homocysteine (Hcy), and carotid artery intima-media thickness (IMT) in the prognosis of patients with BAD and LD. METHODS: Of 262 adult patients with small deep infarcts, 104 were considered BAD and 158 were considered LD...
April 2017: International Journal of Neuroscience
Benno Gesierich, Edouard Duchesnay, Eric Jouvent, Hugues Chabriat, Reinhold Schmidt, Jean-Francois Mangin, Marco Duering, Martin Dichgans
BACKGROUND AND PURPOSE: Lacunes are a major manifestation of cerebral small vessel disease. Although still debated, the morphological features of lacunes may offer mechanistic insights. We systematically analyzed the shape of incident lacunes in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, a genetically defined small vessel disease. METHODS: A total of 88 incident lacunes from 57 patients were segmented from 3-dimensional T1 magnetic resonance images and 3 dimensionally reconstructed...
May 2016: Stroke; a Journal of Cerebral Circulation
Laura K Wilson, Lesly A Pearce, Antonio Arauz, David C Anderson, Jorge Tapia, Carlos Bazan, Oscar R Benavente, Thalia S Field
BACKGROUND: Pontine infarcts are common and often attributed to small vessel disease ("small deep infarcts") or basilar branch atherosclerosis ("wedge shaped"). A well-described morphological differentiation using magnetic resonance images has not been reported. Furthermore, whether risk factors and outcomes differ by morphology, or whether infarct morphology should guide secondary prevention strategy, is not well characterized. METHODS: All participants in the Secondary Prevention of Small Subcortical Strokes Study with magnetic resonance imaging -proven pontine infarcts were included...
June 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Eric Jouvent, Zhong Yi Sun, François De Guio, Edouard Duchesnay, Marco Duering, Stefan Ropele, Martin Dichgans, Jean-François Mangin, Hugues Chabriat
BACKGROUND AND PURPOSE: Both brain and cognitive reserves modulate the clinical impact of chronic brain diseases. Whether a motor reserve also modulates the relationships between stroke and disability is unknown. We aimed to determine whether the shape of the central sulcus, a marker of the development of underlying motor connections, is independently associated with disability in patients with a positive history of small subcortical ischemic stroke. METHODS: Shapes of central sulci were reconstructed from high-resolution magnetic resonance imaging and ordered without supervision according to a validated algorithm in 166 patients with a positive history of small subcortical ischemic stroke caused by CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy), a severe monogenic cerebral small vessel disease affecting young patients...
April 2016: Stroke; a Journal of Cerebral Circulation
Breda Cullen, Fiona C Moreton, Michael S Stringer, Rajeev Krishnadas, Dheeraj Kalladka, Maria R López-González, Celestine Santosh, Christian Schwarzbauer, Keith W Muir
Cognitive impairment is an inevitable feature of cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), affecting executive function, attention and processing speed from an early stage. Impairment is associated with structural markers such as lacunes, but associations with functional connectivity have not yet been reported. Twenty-two adults with genetically-confirmed CADASIL (11 male; aged 49.8 ± 11.2 years) underwent functional magnetic resonance imaging at rest...
May 2016: Journal of Cerebral Blood Flow and Metabolism
Eda Kiliç Çoban, Sedat Gez, Batuhan Kara, Aysun Soysal
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity characterized by epileptic seizures, headaches, altered mental status and focal neurological signs. Hypertension is the second most common condition associated with PRES. The 50-year-old-male patient with, right-sided hemiparesis and speech disturbances admitted to our clinic. His blood pressure at the emergency service was 220/140 mmHg. A left putaminal hematoma was seen in his CT and MRI. In his brain MRI, FLAIR and T2 -weighted sequences showed bilateral symmetric diffuse hyperintensities in the brain stem, basal ganglia, and occipital, parietal, frontal, and temporal lobes...
November 30, 2015: Ideggyógyászati Szemle
Erin L Abner, Peter T Nelson, Richard J Kryscio, Frederick A Schmitt, David W Fardo, Randall L Woltjer, Nigel J Cairns, Lei Yu, Hiroko H Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L Tyas, David A Bennett, Julie A Schneider, Zoe Arvanitakis
INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood. METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression. RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1...
August 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Maria Del C Valdés Hernández, Paul A Armitage, Michael J Thrippleton, Francesca Chappell, Elaine Sandeman, Susana Muñoz Maniega, Kirsten Shuler, Joanna M Wardlaw
RATIONALE: Cerebral small vessel disease (SVD) is common in ageing and patients with dementia and stroke. Its manifestations on magnetic resonance imaging (MRI) include white matter hyperintensities, lacunes, microbleeds, perivascular spaces, small subcortical infarcts, and brain atrophy. Many studies focus only on one of these manifestations. A protocol for the differential assessment of all these features is, therefore, needed. AIMS: To identify ways of quantifying imaging markers in research of patients with SVD and operationalize the recommendations from the STandards for ReportIng Vascular changes on nEuroimaging guidelines...
December 2015: Brain and Behavior
Yong Bum Kim, Kwang-Yeol Park, Pil-Wook Chung, Jeong-Min Kim, Heui-Soo Moon, Young Chul Youn
OBJECTIVE: The aim of this study was to determine the association of brachial-ankle pulse wave velocity (baPWV) with both acute and chronic cerebral small vessel disease (SVD). METHODS: We identified 1282 consecutive patients with acute ischemic stroke or transient ischemic attack. Neuroimaging correlates of chronic lacunes, white matter hyperintensity (WMH), and cerebral microbleed (CMB) were assessed using MR images. Combined SVD score was defined as the number of presence of SVD markers including chronic lacunes, WMH, deep CMB, and acute lacunar infarction...
February 2016: Atherosclerosis
Xiaoyu Zhang, Lingling Ding, Junliang Yuan, Wei Qin, Wenli Hu
BACKGROUND: White matter hyperintensities (WMH) predict incident strokes and new lacunes; moreover, WMH may also affect infarct locations. Our aim in this study was to examine the spatial relationship between WMH and acute lacunar infarction. METHODS: Five hundred and ninety patients with acute lacunar infarction in supratentorial region were included. Four situations between infarction and WMH were assessed by axial and coronal MRI: no contact (Grade 0), contact without overlap (Grade Ia), partial overlap (Grade Ib), and complete overlap (Grade II) with preexisting WMH...
2015: European Neurology
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