24 Jun 21. Featured Paper

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

Link to paper on Neurobiology of Aging

Authors

Jun-Fang Zhang, Hwee Fang Lim, Francesca M. Chappell, Una Clancy, Stewart Wiseman, Maria C. Valdés-Hernández, Daniela Jaime Garcia, Mark E. Bastin, Fergus N. Doubal, Will Hewins, Simon R. Cox, Susana Muñoz Maniega, Michael Thrippleton, Michael Stringer, Charlotte Jardine, Donna McIntyre, Gayle Barclay, Iona Hamilton, Lucy Kesseler, Madeleine Murphy, Carol Di Perri, Yun-Cheng Wu, Joanna M. Wardlaw

Abstract

Raised signal in cerebrospinal fluid (CSF) on fluid-attenuated inversion recovery (FLAIR) may indicate raised CSF protein or debris & 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, & 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 & 3-dimensional FLAIR sequence & 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), & 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 & drains partially via the cribriform plate to the nasal lymphatics, IFSH on 3T MRI may be a non-invasive biomarker of altered CSF clearance & justifies further research in larger, more diverse samples.

Keywords

• Cerebral small vessel disease
• Fluid-attenuated inversion recovery
• Glymphatic system
• Magnetic resonance imaging
• Perivascular spaces