Cortical microinfarcts in adults with Down syndrome assessed with 3T-MRI
Aranha, Mateus Rozalem; Montal, Victor; van den Brink, Hilde; Pegueroles, Jordi; Carmona-Iragui, Maria; Videla, Laura; Maure Blesa, Lucia; Benejam, Bessy; Arranz, Javier; Valldeneu, Sílvia; Barroeta, Isabel; Fernández, Susana; Ribas, Laia; Alcolea, Daniel; González-Ortiz, Sofía; Bargalló, Núria; Biessels, Geert Jan; Blesa, Rafael; Lleó, Alberto; Coutinho, Artur Martins; Leite, Cláudia Costa; Bejanin, Alexandre; Fortea, Juan
(2024) Alzheimer's & Dementia, volume 20, issue 6, pp. 3906 - 3917
(Article)
Abstract
BACKGROUND: Cortical microinfarcts (CMI) were attributed to cerebrovascular disease and cerebral amyloid angiopathy (CAA). CAA is frequent in Down syndrome (DS) while hypertension is rare, yet no studies have assessed CMI in DS. METHODS: We included 195 adults with DS, 63 with symptomatic sporadic Alzheimer's disease (AD), and 106 controls
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with 3T magnetic resonance imaging. We assessed CMI prevalence in each group and CMI association with age, AD clinical continuum, vascular risk factors, vascular neuroimaging findings, amyloid/tau/neurodegeneration biomarkers, and cognition in DS. RESULTS: CMI prevalence was 11.8% in DS, 4.7% in controls, and 17.5% in sporadic AD. In DS, CMI increased in prevalence with age and the AD clinical continuum, was clustered in the parietal lobes, and was associated with lacunes and cortico-subcortical infarcts, but not hemorrhagic lesions. DISCUSSION: In DS, CMI are posteriorly distributed and related to ischemic but not hemorrhagic findings suggesting they might be associated with a specific ischemic CAA phenotype. Highlights: This is the first study to assess cortical microinfarcts (assessed with 3T magnetic resonance imaging) in adults with Down syndrome (DS). We studied the prevalence of cortical microinfarcts in DS and its relationship with age, the Alzheimer's disease (AD) clinical continuum, vascular risk factors, vascular neuroimaging findings, amyloid/tau/neurodegeneration biomarkers, and cognition. The prevalence of cortical microinfarcts was 11.8% in DS and increased with age and along the AD clinical continuum. Cortical microinfarcts were clustered in the parietal lobes, and were associated with lacunes and cortico-subcortical infarcts, but not hemorrhagic lesions. In DS, cortical microinfarcts are posteriorly distributed and related to ischemic but not hemorrhagic findings suggesting they might be associated with a specific ischemic phenotype of cerebral amyloid angiopathy.
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Keywords: Alzheimer's disease, cerebral amyloid angiopathy, cerebral microbleeds, cortical microinfarcts, Down syndrome, magnetic resonance imaging, neuroimaging, small vessel diseases, Clinical Neurology, Geriatrics and Gerontology, Psychiatry and Mental health, Cellular and Molecular Neuroscience, Health Policy, Developmental Neuroscience, Epidemiology, Journal Article
ISSN: 1552-5260
Publisher: John Wiley & Sons Inc.
Note: Publisher Copyright: © 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.
(Peer reviewed)