title: Estimating cerebral microinfarct burden from autopsy samples.
abstract: OBJECTIVE
  To estimate whole-brain microinfarct burden from microinfarct counts in routine postmortem examination.
  
  
  METHODS
  We developed a simple mathematical method to estimate the total number of cerebral microinfarcts from counts obtained in the small amount of tissue routinely examined in brain autopsies. We derived estimates of total microinfarct burden from autopsy brain specimens from 648 older participants in 2 community-based clinical-pathologic cohort studies of aging and dementia.
  
  
  RESULTS
  Our results indicate that observing 1 or 2 microinfarcts in 9 routine neuropathologic specimens implies a maximum-likelihood estimate of 552 or 1,104 microinfarcts throughout the brain. Similar estimates were obtained when validating in larger sampled brain volumes.
  
  
  CONCLUSIONS
  The substantial whole-brain burden of cerebral microinfarcts suggested by even a few microinfarcts on routine pathologic sampling suggests a potential mechanism by which these lesions could cause neurologic dysfunction in individuals with small-vessel disease. The estimation framework developed here may generalize to clinicopathologic correlations of other imaging-negative micropathologies.
authors.affiliation: Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.
authors.forename: M Brandon
authors.initials: MB
authors.lastname: Westover
authors.forename: Matt T
authors.initials: MT
authors.lastname: Bianchi
authors.forename: Chunhui
authors.initials: C
authors.lastname: Yang
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schneider
authors.forename: Steven M
authors.initials: SM
authors.lastname: Greenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D020520:Brain Infarction / Q000150:complications*; D015331:Cohort Studies; D003704:Dementia / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011336:Probability; D012111:Residence Characteristics