Relationship between inferior frontal sulcal hyperintensities on brain MRI, ageing and cerebral small vessel disease

• Published in: Neurobiology of aging Vol. 106; pp. 130 - 138
• Main Authors: Zhang, Jun-Fang, Lim, Hwee Fang, Chappell, Francesca M., Clancy, Una, Wiseman, Stewart, Valdés-Hernández, Maria C., Garcia, Daniela Jaime, Bastin, Mark E., Doubal, Fergus N., Hewins, Will, Cox, Simon R., Maniega, Susana Muñoz, Thrippleton, Michael, Stringer, Michael, Jardine, Charlotte, McIntyre, Donna, Barclay, Gayle, Hamilton, Iona, Kesseler, Lucy, Murphy, Madeleine, Perri, Carol Di, Wu, Yun-Cheng, Wardlaw, Joanna M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2021
• Subjects: Adult; Aging - pathology; Cerebral small vessel disease; Cerebral Small Vessel Diseases - pathology; Cerebrospinal Fluid - diagnostic imaging; Cerebrospinal Fluid - metabolism; Cohort Studies; Female; Fluid-attenuated inversion recovery; Glymphatic system; Humans; Independent Living; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; Neuroimaging - methods; Perivascular spaces; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - pathology; Risk Factors; Stroke - cerebrospinal fluid; Stroke - diagnostic imaging; Stroke - pathology; Glymphatic system; Fluid-attenuated inversion recovery; Magnetic resonance imaging; Perivascular spaces; Cerebral small vessel disease
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2021.06.013

•Raised signal in CSF on FLAIR may indicate raised CSF protein or debris.•Inferior frontal sulcal hyperintensities (IFSH) were associated with ageing.•IFSH were associated with PVS score in centrum semiovale in stroke patients. Raised signal in cerebrospinal fluid (CSF) on fluid-attenuated inversion recovery (FLAIR) may indicate raised CSF protein or debris and is seen in inferior frontal sulci on routine MRI. To explore its clinical relevance, we assessed the association of inferior frontal sulcal hyperintensities (IFSH) on FLAIR with demographics, risk factors, and small vessel disease markers in three cohorts (healthy volunteers, n=44; mild stroke patients, n=105; older community-dwelling participants from Lothian birth cohort 1936, n=101). We collected detailed clinical data, scanned all subjects on the same 3T MRI scanner and 3-dimensional FLAIR sequence and developed a scale to rate IFSH. In adjusted analyses, the IFSH score increased with age (per 10-year increase; OR 1.69; 95% CI, 1.42-2.02), and perivascular spaces score in centrum semiovale in stroke patients (OR 1.73; 95% CI, 1.13-2.69). Since glymphatic CSF clearance declines with age and drains partially via the cribriform plate to the nasal lymphatics, IFSH on 3T MRI may be a non-invasive biomarker of altered CSF clearance and justifies further research in larger, more diverse samples.