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Cerebral atherosclerosis is associated with cystic infarcts and microinfarcts but not Alzheimer pathologic changes.
Stroke. 2013 Oct; 44(10):2835-41.S

Abstract

BACKGROUND AND PURPOSE

Some studies have reported associations between intracranial atherosclerosis and Alzheimer disease pathology. We aimed to correlate severity of cerebral atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy with neurofibrillary tangles, neuritic plaques, and cerebral infarcts.

METHODS

This autopsy study (n=163) was drawn from a longitudinal study of subcortical ischemic vascular disease, Alzheimer disease, and normal aging. Multivariable logistic regression models were used to test associations among the 3 forms of cerebrovascular disease and the presence of ischemic and neurodegenerative brain lesions. Apolipoprotein E genotype was included as a covariate in these multivariable models.

RESULTS

Cerebral atherosclerosis was positively associated with microinfarcts (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2-4.4) and cystic infarcts (OR, 2.0; 95% CI, 1.0-4.2) but not Alzheimer disease pathology. Arteriolosclerosis showed a positive correlation with lacunar infarcts (OR, 2.0; 95% CI, 1.0-4.2) but not Alzheimer disease pathology. Cerebral amyloid angiopathy was inversely associated with lacunar infarcts (OR, 0.6; 95% CI, 0.41-1.1), but positively associated with Braak and Braak stage (OR, 1.5; 95% CI, 1.1-2.1) and Consortium to Establish a Registry for Alzheimer Disease plaque score (OR, 1.5; 95% CI, 1.1-2.2).

CONCLUSIONS

Microinfarcts, which have been correlated with severity of cognitive impairment, were most strongly associated with atherosclerosis. Possible pathogenetic mechanisms include artery-to-artery emboli, especially microemboli that may include atheroemboli or platelet-fibrin emboli. Arteriolosclerosis was positively, whereas cerebral amyloid angiopathy was negatively correlated with lacunar infarcts, which might prove helpful in clinical differentiation of arteriolosclerotic from cerebral amyloid angiopathy-related vascular brain injury.

Authors+Show Affiliations

From the Department of Neurology (L.Z., C.Z., H.C.C.), and Department of Preventive Medicine (W.J.M.), Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Neurology, University of California Los Angeles, Los Angeles, CA (H.V.V.); and Department of Neurology, University of California Davis, Sacramento, CA (W.G.E.).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23887837

Citation

Zheng, Ling, et al. "Cerebral Atherosclerosis Is Associated With Cystic Infarcts and Microinfarcts but Not Alzheimer Pathologic Changes." Stroke, vol. 44, no. 10, 2013, pp. 2835-41.
Zheng L, Vinters HV, Mack WJ, et al. Cerebral atherosclerosis is associated with cystic infarcts and microinfarcts but not Alzheimer pathologic changes. Stroke. 2013;44(10):2835-41.
Zheng, L., Vinters, H. V., Mack, W. J., Zarow, C., Ellis, W. G., & Chui, H. C. (2013). Cerebral atherosclerosis is associated with cystic infarcts and microinfarcts but not Alzheimer pathologic changes. Stroke, 44(10), 2835-41. https://doi.org/10.1161/STROKEAHA.113.001945
Zheng L, et al. Cerebral Atherosclerosis Is Associated With Cystic Infarcts and Microinfarcts but Not Alzheimer Pathologic Changes. Stroke. 2013;44(10):2835-41. PubMed PMID: 23887837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebral atherosclerosis is associated with cystic infarcts and microinfarcts but not Alzheimer pathologic changes. AU - Zheng,Ling, AU - Vinters,Harry V, AU - Mack,Wendy J, AU - Zarow,Chris, AU - Ellis,William G, AU - Chui,Helena C, Y1 - 2013/07/25/ PY - 2013/7/27/entrez PY - 2013/7/28/pubmed PY - 2013/12/16/medline KW - Alzheimer KW - atherosclerosis KW - infarction KW - microinfarct SP - 2835 EP - 41 JF - Stroke JO - Stroke VL - 44 IS - 10 N2 - BACKGROUND AND PURPOSE: Some studies have reported associations between intracranial atherosclerosis and Alzheimer disease pathology. We aimed to correlate severity of cerebral atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy with neurofibrillary tangles, neuritic plaques, and cerebral infarcts. METHODS: This autopsy study (n=163) was drawn from a longitudinal study of subcortical ischemic vascular disease, Alzheimer disease, and normal aging. Multivariable logistic regression models were used to test associations among the 3 forms of cerebrovascular disease and the presence of ischemic and neurodegenerative brain lesions. Apolipoprotein E genotype was included as a covariate in these multivariable models. RESULTS: Cerebral atherosclerosis was positively associated with microinfarcts (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2-4.4) and cystic infarcts (OR, 2.0; 95% CI, 1.0-4.2) but not Alzheimer disease pathology. Arteriolosclerosis showed a positive correlation with lacunar infarcts (OR, 2.0; 95% CI, 1.0-4.2) but not Alzheimer disease pathology. Cerebral amyloid angiopathy was inversely associated with lacunar infarcts (OR, 0.6; 95% CI, 0.41-1.1), but positively associated with Braak and Braak stage (OR, 1.5; 95% CI, 1.1-2.1) and Consortium to Establish a Registry for Alzheimer Disease plaque score (OR, 1.5; 95% CI, 1.1-2.2). CONCLUSIONS: Microinfarcts, which have been correlated with severity of cognitive impairment, were most strongly associated with atherosclerosis. Possible pathogenetic mechanisms include artery-to-artery emboli, especially microemboli that may include atheroemboli or platelet-fibrin emboli. Arteriolosclerosis was positively, whereas cerebral amyloid angiopathy was negatively correlated with lacunar infarcts, which might prove helpful in clinical differentiation of arteriolosclerotic from cerebral amyloid angiopathy-related vascular brain injury. SN - 1524-4628 UR - https://www.unboundmedicine.com/medline/citation/23887837/Cerebral_atherosclerosis_is_associated_with_cystic_infarcts_and_microinfarcts_but_not_Alzheimer_pathologic_changes_ L2 - http://www.ahajournals.org/doi/full/10.1161/STROKEAHA.113.001945?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -