title: Are acute infarcts the cause of leukoaraiosis? Brain mapping for 16 consecutive weeks.
abstract: Neuroimaging of older adults commonly reveals abnormality (leukoaraiosis) in the cerebral white matter. Studies have established that extensive leukoaraiosis predicts dementia and disability, but the pathogenesis of leukoaraiosis remains unclear. We recruited 5 patients with leukoaraiosis and performed magnetic resonance mapping of the brain for 16 consecutive weeks. We observed tiny lesions arising de novo in the cerebral white matter. These lesions were clinically silent. They had the signature features of acute ischemic stroke. With time, the characteristics of these lesions approached those of pre-existing leukoaraiosis. Together, these findings suggest that tiny silent acute infarcts are a cause of leukoaraiosis.
authors.affiliation: Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Conklin
authors.forename: Frank L
authors.initials: FL
authors.lastname: Silver
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Mandell
mesh_terms: D000208:Acute Disease; D000368:Aged; D001931:Brain Mapping / Q000639:trends*; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D049292:Leukoaraiosis / Q000175:diagnosis* / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors