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Abstract Details

Antemortem MRI Findings Associated with Microinfarcts at Autopsy
Cerebrovascular Disease and Interventional Neurology
S49 - (-)
007
After Alzheimer's disease, microinfarcts are the second most common pathology identified at autopsy and are associated with cognitive impairment and dementia in the elderly. These microscopic lesions are not visible on conventional antemortem MRI. Conversely, macroscopic lesions associated with cerebrovascular disease are visible on antemortem T2-weighted or Fluid Attenuated Inversion Recovery (FLAIR) MRI.
Patients (n=18) with one or more microinfarcts at autopsy who underwent MRI up to three years before death were 2:1 propensity matched with patients with no microinfarcts (n=36) on age, sex, education and pathologic diagnosis. White matter hyperintensity (WMH) volumes were calculated from FLAIR images using a semi-automated segmentation algorithm referencing to total white matter volume. Macroscopic cortical and subcortical infarctions were visually assessed on FLAIR MRI. Rates of whole brain atrophy and ventricular volume change on antemortem longitudinal MRI were calculated using the boundary shift integral method on T1-weighted scans at least two years apart.
Presence and number of subcortical (p=0.03) and cortical infarctions (p=0.02) on antemortem MRI were associated with presence of microinfarcts postmortem. Patients with microinfarcts showed a trend (p=0.09) of greater rates of whole brain atrophy as compared to patients with no microinfarcts at autopsy. Total fractional WMH (p=0.18) and ventricular volume increase (p=0.27) were not significantly greater in patients with microinfarcts compared to patients with no microinfarcts.
Presence and number of cortical and subcortical infarctions on MRI are associated with presence of microinfarcts at autopsy. This data suggests that similar vascular disease mechanisms are responsible for the cortical and subcortical infarctions identified on antemortem MRI and microinfarcts identified at autopsy.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
Scott Przybelski Scott Przybelski has nothing to disclose.
Jeffery Gunter (Mayo Clinic and Foundation) The institution of Jeffery Gunter has received research support from NIH. Jeffery Gunter has received intellectual property interests from a discovery or technology relating to health care.
Edward Fox, MD, PhD, FAAN Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GW Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Fox has received research support from Biogen. The institution of Dr. Fox has received research support from Genentech. The institution of Dr. Fox has received research support from Celgene - BMS. The institution of Dr. Fox has received research support from Chugai. The institution of Dr. Fox has received research support from Novartis. The institution of Dr. Fox has received research support from EMD-Serono. The institution of Dr. Fox has received research support from TG Therapeutics. The institution of Dr. Fox has received research support from AbbVie. The institution of Dr. Fox has received research support from Sanofi Genzyme. The institution of Dr. Fox has received research support from AbbVie.
Matthew Senjem (Mayo Clinic) Matthew Senjem has received stock or an ownership interest from Align Technology, Inc.. Matthew Senjem has received stock or an ownership interest from Inovio Biomedical Corp.. Matthew Senjem has received stock or an ownership interest from Johnson & Johnson. Matthew Senjem has received stock or an ownership interest from Mesa Laboratories, Inc.. Matthew Senjem has received stock or an ownership interest from Nvidia Inc.. Matthew Senjem has received stock or an ownership interest from LHC Group, Inc.. Matthew Senjem has received stock or an ownership interest from Natus Medical Incorporated. Matthew Senjem has received stock or an ownership interest from Varex Imaging Corporation. Matthew Senjem has received personal compensation in the range of $100,000-$499,999 for serving as a IT Technical Specialist II with Mayo Clinic.
No disclosure on file
Melissa Murray, PhD (Mayo Clinic) Dr. Murray has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Avid Radiopharmaceuticals. The institution of Dr. Murray has received research support from National Institute on Aging. The institution of Dr. Murray has received research support from Alzheimer's Association. The institution of Dr. Murray has received research support from Chan Zuckerberg Initiative.
Bradley F. Boeve, MD, FAAN (Mayo Clinic) Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
David S. Knopman, MD, FAAN (Mayo Clinic) Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH.
Ronald C. Petersen, MD, PhD, FAAN (Mayo Clinic) Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co.. Dr. Petersen has received personal compensation in the range of $0-$499 for serving as a Consultant for Eisai, Inc.. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has a non-compensated relationship as a Board of Directors with American Brain Foundation that is relevant to AAN interests or activities.
Joseph E. Parisi, MD (Mayo Clinic) Dr. Parisi has nothing to disclose.
Dennis W. Dickson, MD (Mayo Clinic) Dr. Dickson has nothing to disclose.
Clifford R. Jack, Jr., MD (Mayo Clinic) The institution of Dr. Jack has received research support from NIH. The institution of Dr. Jack has received research support from Alexander Family Alzheimer's Disease Research Professorship of the Mayo Clinic.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF.