Cortical microinfarcts in adults with Down syndrome assessed with 3T‐MRI

• Published in: Alzheimer's & dementia Vol. 20; no. 6; pp. 3906 - 3917
• Main Authors: Aranha, Mateus Rozalem, Montal, Victor, den Brink, Hilde, Pegueroles, Jordi, Carmona‐Iragui, Maria, Videla, Laura, Maure Blesa, Lucia, Benejam, Bessy, Arranz, Javier, Valldeneu, Sílvia, Barroeta, Isabel, Fernández, Susana, Ribas, Laia, Alcolea, Daniel, González‐Ortiz, Sofía, Bargalló, Núria, Biessels, Geert Jan, Blesa, Rafael, Lleó, Alberto, Coutinho, Artur Martins, Leite, Cláudia Costa, Bejanin, Alexandre, Fortea, Juan
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01.06.2024
• Subjects: Alzheimer's disease; cerebral amyloid angiopathy; cerebral microbleeds; cortical microinfarcts; Down syndrome; magnetic resonance imaging; neuroimaging; small vessel diseases; magnetic resonance imaging; cerebral amyloid angiopathy; small vessel diseases; cortical microinfarcts; cerebral microbleeds; Down syndrome; Alzheimer's disease; neuroimaging
• ISSN: 1552-5260; 1552-5279; 1552-5279
• DOI: 10.1002/alz.13797

BACKGROUND Cortical microinfarcts (CMI) were attributed to cerebrovascular disease and cerebral amyloid angiopathy (CAA). CAA is frequent in Down syndrome (DS) while hypertension is rare, yet no studies have assessed CMI in DS. METHODS We included 195 adults with DS, 63 with symptomatic sporadic Alzheimer's disease (AD), and 106 controls with 3T magnetic resonance imaging. We assessed CMI prevalence in each group and CMI association with age, AD clinical continuum, vascular risk factors, vascular neuroimaging findings, amyloid/tau/neurodegeneration biomarkers, and cognition in DS. RESULTS CMI prevalence was 11.8% in DS, 4.7% in controls, and 17.5% in sporadic AD. In DS, CMI increased in prevalence with age and the AD clinical continuum, was clustered in the parietal lobes, and was associated with lacunes and cortico‐subcortical infarcts, but not hemorrhagic lesions. DISCUSSION In DS, CMI are posteriorly distributed and related to ischemic but not hemorrhagic findings suggesting they might be associated with a specific ischemic CAA phenotype. Highlights This is the first study to assess cortical microinfarcts (assessed with 3T magnetic resonance imaging) in adults with Down syndrome (DS). We studied the prevalence of cortical microinfarcts in DS and its relationship with age, the Alzheimer's disease (AD) clinical continuum, vascular risk factors, vascular neuroimaging findings, amyloid/tau/neurodegeneration biomarkers, and cognition. The prevalence of cortical microinfarcts was 11.8% in DS and increased with age and along the AD clinical continuum. Cortical microinfarcts were clustered in the parietal lobes, and were associated with lacunes and cortico‐subcortical infarcts, but not hemorrhagic lesions. In DS, cortical microinfarcts are posteriorly distributed and related to ischemic but not hemorrhagic findings suggesting they might be associated with a specific ischemic phenotype of cerebral amyloid angiopathy.