{"id":3334,"date":"2026-04-13T02:10:03","date_gmt":"2026-04-13T02:10:03","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/medphc\/?p=3334"},"modified":"2026-04-13T02:10:03","modified_gmt":"2026-04-13T02:10:03","slug":"synergistic-effect-between-cortical-cerebral-microinfarcts-and-brain-atrophy-on-cognitive-decline","status":"publish","type":"post","link":"https:\/\/medicine.nus.edu.sg\/medphc\/publications\/synergistic-effect-between-cortical-cerebral-microinfarcts-and-brain-atrophy-on-cognitive-decline\/","title":{"rendered":"Synergistic effect between cortical cerebral microinfarcts and brain atrophy on cognitive decline"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3335\" src=\"https:\/\/medicine.nus.edu.sg\/medphc\/wp-content\/uploads\/sites\/33\/2026\/04\/20251104-SH-300x169.jpg\" alt=\"\" width=\"850\" height=\"479\" srcset=\"https:\/\/medicine.nus.edu.sg\/medphc\/wp-content\/uploads\/sites\/33\/2026\/04\/20251104-SH-300x169.jpg 300w, https:\/\/medicine.nus.edu.sg\/medphc\/wp-content\/uploads\/sites\/33\/2026\/04\/20251104-SH-1024x576.jpg 1024w, https:\/\/medicine.nus.edu.sg\/medphc\/wp-content\/uploads\/sites\/33\/2026\/04\/20251104-SH-768x432.jpg 768w, https:\/\/medicine.nus.edu.sg\/medphc\/wp-content\/uploads\/sites\/33\/2026\/04\/20251104-SH.jpg 1280w\" sizes=\"auto, (max-width: 850px) 100vw, 850px\" \/><\/p>\n<h2 id=\"539090112\" class=\"abstract-title js-splitscreen-abstract-title\">Abstract<\/h2>\n<p class=\"chapter-para\">Cortical cerebral microinfarcts are associated with brain atrophy in cross-sectional studies, with further investigation using longitudinal datasets being warranted. Moreover, little is known about their combined impact on cognition. This study aimed to establish the association between cortical cerebral microinfarcts and brain volume loss over time and explore whether they synergistically contribute to cognitive decline.<\/p>\n<p class=\"chapter-para\">A total of 475 patients, aged 72.7 \u00b1 7.9 years, were enrolled from a memory clinic cohort, who underwent neuroimaging and neuropsychological assessments at least twice over 5 years. Cortical cerebral microinfarcts and other cerebrovascular disease were assessed using 3-T MRI. Brain volumes were calculated semi-automatically using FreeSurfer. Cognitive function was assessed using a neuropsychological test battery including six domains. Linear mixed-effect models were utilized to examine the association between cortical cerebral microinfarcts and brain volume loss and their interaction on cognitive decline. Estimated marginal means were derived to plot global cognitive trajectories.<\/p>\n<p class=\"chapter-para\">Cortical cerebral microinfarcts were associated with a greater decrease over 2 years in total brain volume [<em>\u03b2<\/em> = \u22121.94 (\u22123.07, \u22120.82) at Year 2, <em>P<\/em>-interaction with time &lt; 0.001], grey matter volume [<em>\u03b2<\/em> = \u22121.00 (\u22121.69, \u22120.30) at Year 2, <em>P<\/em>-interaction = 0.002] and white matter volume [<em>\u03b2<\/em> = \u22120.95 (\u22121.54, \u22120.35) at Year 2, <em>P<\/em>-interaction &lt; 0.001]. Brain volume loss was more pronounced in patients with multiple microinfarcts. Patients with high brain volume loss and cortical cerebral microinfarcts, particularly multiple microinfarcts, exhibited significantly lower global cognitive scores [single microinfarct: <em>\u03b2<\/em> = \u22121.83 (\u22122.68, \u22120.97) at Year 5, <em>P<\/em>-interaction with time &lt; 0.001; multiple microinfarcts: <em>\u03b2<\/em> = \u22123.13 (\u22124.21, \u22122.05) at Year 5, <em>P<\/em>-interaction &lt; 0.001]. The synergistic effects were more significant in the domains of executive function, memory, language and visuospatial function. Global cognitive trajectories revealed greater cognitive decline in patients with high brain volume loss and single or multiple microinfarcts, with the latter showing the steepest slope.<\/p>\n<p class=\"chapter-para\">This study established a longitudinal association between cortical cerebral microinfarcts and brain atrophy progression, with higher microinfarct burden associated with more pronounced brain volume loss. Furthermore, cortical cerebral microinfarcts and brain atrophy showed synergistic effects on cognitive decline. These findings highlight the importance of investigating the role of mixed pathologies in the development of cognitive impairment and dementia in future research.<\/p>\n<p>Full Article:\u00a0<a href=\"https:\/\/academic.oup.com\/brain\/article\/148\/11\/3924\/8232732\">https:\/\/academic.oup.com\/brain\/article\/148\/11\/3924\/8232732<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Abstract Cortical cerebral microinfarcts are associated with brain atrophy in cross-sectional studies, with further investigation using longitudinal datasets being warranted. Moreover, little is known about their combined impact on cognition. This study aimed to establish the association between cortical cerebral microinfarcts and brain volume loss over time and explore whether they synergistically contribute to cognitive [&hellip;]<\/p>\n","protected":false},"author":9345,"featured_media":3335,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[5],"tags":[],"class_list":["post-3334","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publications"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Synergistic effect between cortical cerebral microinfarcts and brain atrophy on cognitive decline - Pharmacology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/medphc\/publications\/synergistic-effect-between-cortical-cerebral-microinfarcts-and-brain-atrophy-on-cognitive-decline\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Synergistic effect between cortical cerebral microinfarcts and brain atrophy on cognitive decline - Pharmacology\" \/>\n<meta property=\"og:description\" content=\"Abstract Cortical cerebral microinfarcts are associated with brain atrophy in cross-sectional studies, with further investigation using longitudinal datasets being warranted. 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