MRI Findings as Surrogate Markers for Brain Microinfarcts

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 Interview with:
Kejal Kantarci, M.D. M.S.
Professor of Radiology
Division of Neuroradiology
Mayo Clinic, Rochester, MN 55905

MedicalResearch: What are the main findings of the study?

Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones.

MedicalResearch: Were any of the findings unexpected?

Dr. Kantarci: An unexpected finding was the absence of a relationship between white matter hyperintensities and microinfarcts. We were expecting a relationship as both are associated with small vessel ischemic disease.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Kantarci: Presence of macroinfarcts on MRI suggest the presence of microinfarcts, but not all cases with microinfarcts have macroinfarcts on MRI. Microinfarcts on MRI are associated with atrophy independent of Alzheimer’s disease which is an important consideration when using volumetric MRI as an outcome measure in clinical trials.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Kantarci: I think there is an ongoing need for imaging markers of microinfarcts. Our study suggests that MRI findings may be valuable surrogates for the presence of microinfarcts and their impact on the brain.

Antemortem MRI findings associated with microinfarcts at autopsy
Mekala R. Raman, BS, Gregory M. Preboske, MS, Scott A. Przybelski, BS, Jeffrey L. Gunter, PhD, Matthew L. Senjem, MS, Prashanthi Vemuri, PhD, Matthew C. Murphy, PhD, Melissa E. Murray, PhD, Bradley F. Boeve, MD, David S. Knopman, MD, Ronald C. Petersen, MD, PhD, Joseph E. Parisi, MD, Dennis W. Dickson, MD, Clifford R. Jack Jr, MD and Kejal Kantarci, MD, MS
Published online before print May 2, 2014, doi: 10.1212/WNL.0000000000000471 Neurology