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low CMI burden regions was arbitrarily set at > 5 CMIs (For a histogram of the CMI numbers per AAL region, see Supplementary Figure 1). The AAL regions with a relatively high number of CMI were defined as high CMI burden regions, other AAL regions were defined as low CMI burden regions. The number of CMIs within each AAL region was determined to assess whether CMIs predominantly occurred in specific brain regions.
The automated anatomic labeling (AAL) template ( 29) was used as overlay on this sample-averaged CMI map. Cortical CMI Spatial MappingĬortical CMI locations from all patients were registered to Montreal Neurological Institute (MNI) space. Alternative mechanisms, such as focal disturbances in cortical structure and functioning, may better explain CMI associated cognitive impairment.Ĭerebral microinfarcts (CMIs) are small ( 0.95) agreement, details regarding the intra- and interrater reliability were published previously ( 4). Nevertheless, WM connections projecting to these regions were not disproportionally impaired in patients with compared to patients without cortical CMIs.
WM connectivity in the whole brain and WM voxels directly underneath the cortical surface did not differ between patients with and without cortical CMIs.Ĭonclusion:Cortical CMIs displayed a strong local clustering in highly interconnected frontal, pre- and postcentral brain regions. In these high CMI burden regions, presence of cortical CMIs was not associated with WM connectivity after correction for conventional neuroimaging markers of vascular injury. More than 70% of the cortical CMIs were located in the superior frontal, middle frontal, and pre- and postcentral brain regions (covering 16% of the cortical surface). Results:30 patients (18%) had at least 1 cortical CMI.
WM connectivity and integrity were compared between patients with and without cortical CMIs for the whole brain and regions with a high CMI burden. Diffusion imaging-based tractography was used to reconstruct WM connections and voxel based analysis (VBA) to assess integrity of WM directly below the cortex. Cortical CMIs were rated according to established criteria and their spatial location was marked. All underwent 3 tesla MRI, including a diffusion MRI and cognitive testing. Methods:164 memory clinic patients with vascular brain injury with a mean age of 72 ± 11 years (54% male) were included. We investigated in memory clinic patients whether cortical CMIs are clustered in specific brain regions and if presence of cortical CMIs is associated with reduced white matter (WM) connectivity in tracts projecting to these regions. CMIs might affect cognitive performance through disruption of cerebral networks.