title: Increased number of microinfarcts in Alzheimer disease at 7-T MR imaging.
abstract: OBJECTIVE
  To assess the prevalence and number of cortical microinfarcts in patients with Alzheimer disease (AD) by using a 7-T magnetic resonance (MR) imaging system, to assess the independent association of cortical microinfarcts with cognitive dysfunction, and to investigate potential confounding effects of the coexisting presence of cerebral amyloid angiopathy (CAA).
  
  
  METHODS
  The local institutional review board approved this study. In all cases, informed consent was obtained. High-spatial-resolution fluid-attenuated inversion recovery and T2*-weighted images were acquired in 14 AD patients and 18 control subjects to assess the presence of microinfarcts and microbleeds. Presence of CAA was assessed according to the Boston criteria. Image analysis was performed independently by two reviewers. Mann-Whitney U test was performed to assess differences in number of microinfarcts between groups. Negative binomial regression models were used to assess the association between diagnosis of AD and diagnosis of CAA and number of microinfarcts, between diagnosis of AD and number of microbleeds and number of microinfarcts, and between cognitive function and number of microinfarcts, all corrected for age and sex.
  
  
  RESULTS
  Interobserver agreement was excellent for detecting microinfarcts (κ = 0.91) (P < .001). Patients with AD demonstrated higher number (P = .005) of microinfarcts (mean, 7.2) compared with control subjects (mean, 1.8). Negative binomial regression models showed an independent association between AD and number of microinfarcts (P = .006) and a trend for CAA and microinfarcts (P = .052). A negative correlation was found between cognitive function and the number of microinfarcts (P = .009).
  
  
  CONCLUSIONS
  Patients with AD show more microinfarcts than do control subjects, the number of microinfarcts correlates with global cognitive performance, and the presence of microinfarcts was mainly AD rather than CAA related.
authors.affiliation: From the C.J. Gorter Center for High-Field-Strength MRI (S.v.R., A.M.v.O., M.J.V., A.G.W., M.A.v.B., J.v.d.G.), Department of Radiology (S.v.R., A.M.v.O., M.J.V., A.G.W., M.A.v.B., J.v.d.G.), and Department of Gerontology and Geriatrics (G.J.B.), Leiden University Medical Center, PO Box 9600, C3-Q, 2300 RC Leiden, the Netherlands; Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands (J.D.C.G., W.M.v.d.F., P.S.); Departments of Radiology (F.B.) and Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Department of Gerontology and Geriatrics, Bronovo Hospital, Den Haag, the Netherlands (G.J.B.).
authors.forename: Sanneke
authors.initials: S
authors.lastname: van Rooden
authors.forename: Jeroen D C
authors.initials: JD
authors.lastname: Goos
authors.forename: Annemarieke M
authors.initials: AM
authors.lastname: van Opstal
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Versluis
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Webb
authors.forename: Gerard Jan
authors.initials: GJ
authors.lastname: Blauw
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D016022:Case-Control Studies; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000453:epidemiology; D003072:Cognition Disorders / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015995:Prevalence