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P4‐201: Cortical Microinfarcts and Regional Gray Matter Loss on Antemortem MRI
Author(s) -
Raman Mekala R.,
Reichard Ross R.,
Przybelski Scott A.,
Lesnick Timothy G.,
Murray Melissa E.,
Schwarz Christopher G.,
Boeve Bradley F.,
Knopman David S.,
Petersen Ronald C.,
Parisi Joseph E.,
Dickson Dennis W.,
Jack Clifford R.,
Kantarci Kejal
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.2294
Subject(s) - atrophy , medicine , pathology , population , autopsy , hippocampus , alzheimer's disease , disease , environmental health
Background: Microinfarcts are common in older adults. Presence of microinfarcts has been associated with increased risk of dementia and with higher rates of gray matter atrophy over time. The purpose of this study was to investigate regional associations between antemortem gray matter atrophy on MRI and microinfarct burden identified postmortem on histology. Methods:Participants (n1⁄421) were consecutively identified from community, memory disorders clinic, and population-based cohorts and had antemortem 3T MRI and microinfarcts at autopsy. Eight cortical regions routinely sampled for diagnosis of Alzheimer’s disease were analyzed for location and density of microinfarcts. Density of neurofibrillary tangles of tau (NFT) was measured with immunohistochemistry and digital microscopy methods. Microinfarct and NFT pathologies were compared in linear regression models for contribution to gray matter volume on MRI in the regions with the highest prevalence of microinfarcts. Results: Of the eight cortical regions sampled, microinfarcts most often occurred in the midfrontal gyrus (MFG) (6 of the 21 subjects) and in the posterior hippocampus (6 of the 21 subjects). In neither the hippocampus (p1⁄40.47) nor the MFG (p1⁄40.78) was there an association between volume and microinfarct presence. In contrast there was an association between greater NFT density and smaller hippocampal volume (p1⁄40.04), though (because of low NFT burden), there was no association in MFG between NFT and smaller volumes (p1⁄40.23). Conclusions: In these patients, the microinfarcts most commonly occurred in a cortical watershed zone (MFG) as well as in the posterior hippocampus. We also confirmed the established association between increased NFT pathology and smaller hippocampal volumes, but the effects of microinfarcts on macroscopic measures of gray matter volume were not statistically significant.