Small cortical infarcts: prevalence, determinants, and cognitive correlates in the general population

I (Yolanda) Riba-Llena; Marcel Koek; Ben Verhaaren; Henri Vrooman; Aad van der Lugt; Bert Hofman; Arfan Ikram; Meike Vernooij

doi:10.1111/ijs.12543

Small cortical infarcts: prevalence, determinants, and cognitive correlates in the general population

I (Yolanda) Riba-Llena, Marcel Koek, Ben Verhaaren, Henri Vrooman, Aad van der Lugt, Bert Hofman, Arfan Ikram, Meike Vernooij

Research output: Contribution to journal › Article › Academic

12 Citations (Scopus)

Abstract

BackgroundCortical brain infarcts are defined as infarcts involving cortical gray matter, but may differ considerably in size. It is unknown whether small cortical infarcts have a similar clinical phenotype as larger counterparts. We investigated prevalence, determinants, and cognitive correlates of small cortical infarcts in the general population and compared these with large cortical infarcts and lacunar infarcts. MethodsFour thousand nine hundred five nondemented individuals (age 63951099) from a population-based study were included. Infarcts were rated on magnetic resonance imaging and participants were classified according to mean infarct diameter into small (15mm in largest diameter) or large (>15mm) cortical infarcts, lacunar infarcts, or a combination of subtypes. Spatial distribution maps were created for manually labeled small and large infarcts. Participants underwent cognitive testing. Analyses were performed using multinomial regression and analysis of covariance. ResultsThree hundred eighty-one (78%) persons had any infarct on magnetic resonance imaging, among whom 54 with small (11%) and 77 (16%) with large cortical infarcts. Small cortical infarcts were mainly localized in external watershed areas, whereas large cortical infarcts were localized primarily in large arterial territories. Age (odds ratio=106; 95% confidence interval=102, 109), male gender (198; 101, 392), and smoking (255; 106, 614) were determinants of small cortical infarcts. Participants with these infarcts had worse scores in delayed memory, processing speed, and attention tests than persons without infarcts, even after adjustment for cardiovascular risk factors. ConclusionsIn the elderly, small cortical infarcts appear as frequent as large infarcts but in different localization. Our results suggest that small cortical infarcts share cardiovascular risk factors and cognitive correlates with large cortical, but also with lacunar infarcts.

Original language	Undefined/Unknown
Pages (from-to)	18-24
Number of pages	7
Journal	International Journal of Stroke
Volume	10
DOIs	https://doi.org/10.1111/ijs.12543
Publication status	Published - 2015

Research programs

EMC COEUR-09
EMC NIHES-01-64-01
EMC NIHES-03-30-01
EMC NIHES-03-30-02
EMC NIHES-03-30-03

Access to Document

10.1111/ijs.12543

http://hdl.handle.net/1765/87165

Cite this

@article{2abff362744c4f5280cef1ba1a669547,

title = "Small cortical infarcts: prevalence, determinants, and cognitive correlates in the general population",

abstract = "BackgroundCortical brain infarcts are defined as infarcts involving cortical gray matter, but may differ considerably in size. It is unknown whether small cortical infarcts have a similar clinical phenotype as larger counterparts. We investigated prevalence, determinants, and cognitive correlates of small cortical infarcts in the general population and compared these with large cortical infarcts and lacunar infarcts. MethodsFour thousand nine hundred five nondemented individuals (age 63951099) from a population-based study were included. Infarcts were rated on magnetic resonance imaging and participants were classified according to mean infarct diameter into small (15mm in largest diameter) or large (>15mm) cortical infarcts, lacunar infarcts, or a combination of subtypes. Spatial distribution maps were created for manually labeled small and large infarcts. Participants underwent cognitive testing. Analyses were performed using multinomial regression and analysis of covariance. ResultsThree hundred eighty-one (78%) persons had any infarct on magnetic resonance imaging, among whom 54 with small (11%) and 77 (16%) with large cortical infarcts. Small cortical infarcts were mainly localized in external watershed areas, whereas large cortical infarcts were localized primarily in large arterial territories. Age (odds ratio=106; 95% confidence interval=102, 109), male gender (198; 101, 392), and smoking (255; 106, 614) were determinants of small cortical infarcts. Participants with these infarcts had worse scores in delayed memory, processing speed, and attention tests than persons without infarcts, even after adjustment for cardiovascular risk factors. ConclusionsIn the elderly, small cortical infarcts appear as frequent as large infarcts but in different localization. Our results suggest that small cortical infarcts share cardiovascular risk factors and cognitive correlates with large cortical, but also with lacunar infarcts.",

author = "Riba-Llena, {I (Yolanda)} and Marcel Koek and Ben Verhaaren and Henri Vrooman and {van der Lugt}, Aad and Bert Hofman and Arfan Ikram and Meike Vernooij",

year = "2015",

doi = "10.1111/ijs.12543",

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T1 - Small cortical infarcts: prevalence, determinants, and cognitive correlates in the general population

AU - Riba-Llena, I (Yolanda)

AU - Koek, Marcel

AU - Verhaaren, Ben

AU - Vrooman, Henri

AU - van der Lugt, Aad

AU - Hofman, Bert

AU - Ikram, Arfan

AU - Vernooij, Meike

PY - 2015

Y1 - 2015

N2 - BackgroundCortical brain infarcts are defined as infarcts involving cortical gray matter, but may differ considerably in size. It is unknown whether small cortical infarcts have a similar clinical phenotype as larger counterparts. We investigated prevalence, determinants, and cognitive correlates of small cortical infarcts in the general population and compared these with large cortical infarcts and lacunar infarcts. MethodsFour thousand nine hundred five nondemented individuals (age 63951099) from a population-based study were included. Infarcts were rated on magnetic resonance imaging and participants were classified according to mean infarct diameter into small (15mm in largest diameter) or large (>15mm) cortical infarcts, lacunar infarcts, or a combination of subtypes. Spatial distribution maps were created for manually labeled small and large infarcts. Participants underwent cognitive testing. Analyses were performed using multinomial regression and analysis of covariance. ResultsThree hundred eighty-one (78%) persons had any infarct on magnetic resonance imaging, among whom 54 with small (11%) and 77 (16%) with large cortical infarcts. Small cortical infarcts were mainly localized in external watershed areas, whereas large cortical infarcts were localized primarily in large arterial territories. Age (odds ratio=106; 95% confidence interval=102, 109), male gender (198; 101, 392), and smoking (255; 106, 614) were determinants of small cortical infarcts. Participants with these infarcts had worse scores in delayed memory, processing speed, and attention tests than persons without infarcts, even after adjustment for cardiovascular risk factors. ConclusionsIn the elderly, small cortical infarcts appear as frequent as large infarcts but in different localization. Our results suggest that small cortical infarcts share cardiovascular risk factors and cognitive correlates with large cortical, but also with lacunar infarcts.

AB - BackgroundCortical brain infarcts are defined as infarcts involving cortical gray matter, but may differ considerably in size. It is unknown whether small cortical infarcts have a similar clinical phenotype as larger counterparts. We investigated prevalence, determinants, and cognitive correlates of small cortical infarcts in the general population and compared these with large cortical infarcts and lacunar infarcts. MethodsFour thousand nine hundred five nondemented individuals (age 63951099) from a population-based study were included. Infarcts were rated on magnetic resonance imaging and participants were classified according to mean infarct diameter into small (15mm in largest diameter) or large (>15mm) cortical infarcts, lacunar infarcts, or a combination of subtypes. Spatial distribution maps were created for manually labeled small and large infarcts. Participants underwent cognitive testing. Analyses were performed using multinomial regression and analysis of covariance. ResultsThree hundred eighty-one (78%) persons had any infarct on magnetic resonance imaging, among whom 54 with small (11%) and 77 (16%) with large cortical infarcts. Small cortical infarcts were mainly localized in external watershed areas, whereas large cortical infarcts were localized primarily in large arterial territories. Age (odds ratio=106; 95% confidence interval=102, 109), male gender (198; 101, 392), and smoking (255; 106, 614) were determinants of small cortical infarcts. Participants with these infarcts had worse scores in delayed memory, processing speed, and attention tests than persons without infarcts, even after adjustment for cardiovascular risk factors. ConclusionsIn the elderly, small cortical infarcts appear as frequent as large infarcts but in different localization. Our results suggest that small cortical infarcts share cardiovascular risk factors and cognitive correlates with large cortical, but also with lacunar infarcts.

U2 - 10.1111/ijs.12543

DO - 10.1111/ijs.12543

M3 - Article

C2 - 26043763

SN - 1747-4930

VL - 10

SP - 18

EP - 24

JO - International Journal of Stroke

JF - International Journal of Stroke

ER -