Association Between Silent Brain Infarcts and Cognitive Function: A Systematic Review and Meta-Analysis

Lei, Chunyan; Deng, Qionghua; Li, Haijiang; Zhong, Lianmei

doi:10.1016/j.jstrokecerebrovasdis.2019.03.036

Cited by 38 publications

(22 citation statements)

References 21 publications

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“…White matter hyperintensities along with perivascular space widening, brain atrophy, and lacunar infarctions are neuroradiological manifestations of CVSD and are histopathologically correlated with axonal loss, focal myelinolysis, reactive astrocytosis, and vessel wall hyalinosis. Clinical implications include increased risk of stroke, cognitive dysfunction, dementia, gait instability, and depression [14,15]. Typically, changes increase with the aging process; however, their onset and progression can be exacerbated by comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND (Prospective Urban and Rural Epidemiological) cohort study

et al. 2021

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IntroductionChanges typical for cerebral small vessel disease (i.a. white matter hyperintensities – WMHs) are often found accidentally in neuroimaging studies. Although asymptomatic, this condition increases the risk of future ischaemic incidents and neurodegenerative disorders. Sleep apnoea is a recognised risk factor for vascular diseases. The aim of our study was to assess the prevalence of, and association between, obstructive sleep apnea (OSA) and cerebral small vessel disease in the studied population.Material and methodsTwo hundred and seven patients (participants of Prospective Urban Rural Epidemiology Study) took part in our study. The study group consisted of 31 patients with OSA (11 women and 20 men). Nine of them were diagnosed with mild OSA, nine with moderate OSA, and 13 with severe OSA. The control group consisted of 176 patients (133 women and 43 men) who scored 0–2 points in the STOP-BANG questionnaire. All patients underwent brain magnetic resonance imaging. We evaluated the occurrence and severity of WMHs.ResultsSignificantly higher incidence of WMHs was found in the study group compared to controls. In univariate analyses, age was a significant predictor of periventricular white matter changes. For subcortical area, age and waist-to-hip ratio were significant predictors.ConclusionsSignificantly higher incidence of WMHs in the studied group suggests that patients with OSA may have a higher risk of neurodegeneration.

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND (Prospective Urban and Rural Epidemiological) cohort study

et al. 2021

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“…Patients with silent brain infarction may have cognitive de cits and the risk of developing dementia is doubled. Also, it was determined that the risk of recurrent stroke in elderly patients with lesions due to free brain infarction increased three times [2,8].…”

Section: Introductionmentioning

confidence: 99%

“…Silent brain infarcts (SBIs) have been de ned as ischemic lesions that are common in patients without a history of stroke, especially in the elderly and some other populations at risk [1,2]. SBI is widely used to identify cerebral infarctions seen on magnetic resonance imaging (MRI) without neurological signs or a history of transient ischemic attacks [3].…”

Section: Introductionmentioning

confidence: 99%

Effect of Methylenetetrahydrofolate Reductase (MTHFR) gene mutations and oxidative stress in silent brain infarction

Koşar¹,

Tepebaşı²,

Şengeze³

et al. 2021

Preprint

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Ischemic infarctions occur under the influence of genetic and environmental factors. In our study, the role of ischemia-modified albumin and thiol balance, which are new markers in determining oxidative damage together with MTHFR gene mutations and homocysteine levels, in the development of SBI was investigated. White matter lesions in the magnetic resonance imaging (MRI) results of the patients were evaluated according to the Fazekas scale and divided into groups (Grade 0, 1, 2, and 3). Homocysteine, folate, B12, IMA, total thiol, and native thiol were measured by biochemical methods. The mutations in MTHFR genes were investigated by the RT-PCR method. According to our results, a significant difference was found between the groups in age, homocysteine, folate, IMA, total thiol, and native thiol parameters (p<0.05). When we compared the groups in terms of genotypes of the C677T gene, we found a significant difference in TT genotype between grades 0/3 and 1/3 (p<0.05). We determined that homocysteine and IMA levels increased and folate levels decreased in CC/TT and CT/TT genotypes in the C677T gene (p<0.05). Considering our results, the observation of homocysteine and IMA changes at the genotype level of the MTHFR C677T gene and between the groups, and the deterioration of thiol balance between the groups suggested that these markers can be used in the diagnosis of silent brain infarction.

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“…Current circumstances are plagued by over-treatment and over-diagnosis, which may increase potential anxiety and economic burden for the patient [ 5 ]. However, remaining unnoticed leads to a blindness of the risk of subsequent stroke and dementia [ 4 , 6 ]. Although it is recommended that prevention strategies [ 3 ] adhere to guidelines of the American Heart Association/American Stroke Association [ 7 ], these guidelines appear to lack specialized strategies for high-risk patients.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive model for predicting future ischemic strokes in patients with silent lacunar infarction using radiomics

Meng

Dong

et al. 2020

BMC Med Imaging

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Background This study aimed to investigate integrating radiomics with clinical factors in cranial computed tomography (CT) to predict ischemic strokes in patients with silent lacunar infarction (SLI). Methods Radiomic features were extracted from baseline cranial CT images of patients with SLI. A least absolute shrinkage and selection operator (LASSO)–Cox regression analysis was used to select significant prognostic factors based on Model C with clinical factors, Model R with radiomic features, and Model CR with both factors. The Kaplan–Meier method was used to compare stroke-free survival probabilities. A nomogram and a calibration curve were used for further evaluation. Results Radiomic signature ( p < 0.01), age ( p = 0.09), dyslipidemia ( p = 0.03), and multiple infarctions ( p = 0.02) were independently associated with future ischemic strokes. Model CR had the best accuracy with 6-, 12-, and 18-month areas under the curve of 0.84, 0.81, and 0.79 for the training cohort and 0.79, 0.88, and 0.75 for the validation cohort, respectively. Patients with a Model CR score < 0.17 had higher probabilities of stroke-free survival. The prognostic nomogram and calibration curves of the training and validation cohorts showed acceptable discrimination and calibration capabilities (concordance index [95% confidence interval]: 0.7864 [0.70–0.86]; 0.7140 [0.59–0.83], respectively). Conclusions Radiomic analysis based on baseline CT images may provide a novel approach for predicting future ischemic strokes in patients with SLI. Older patients and those with dyslipidemia or multiple infarctions are at higher risk for ischemic stroke and require close monitoring and intensive intervention.

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Association Between Silent Brain Infarcts and Cognitive Function: A Systematic Review and Meta-Analysis

Cited by 38 publications

References 21 publications

Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND (Prospective Urban and Rural Epidemiological) cohort study

Magnetic resonance white matter changes in patients with obstructive sleep apnoea. The subset of the PURE-MIND (Prospective Urban and Rural Epidemiological) cohort study

Effect of Methylenetetrahydrofolate Reductase (MTHFR) gene mutations and oxidative stress in silent brain infarction

Noninvasive model for predicting future ischemic strokes in patients with silent lacunar infarction using radiomics

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