Cerebral microinfarcts affect brain structural network topology in cognitively impaired patients

Liwen Zhang, Geert Jan Biessels, Saima Hilal, Joanna Su Xian Chong, Siwei Liu, Hee Youn Shim, Xin Xu, Eddie Jun Yi Chong, Zi Xuen Wong, Yng Miin Loke, Narayanaswamy Venketasubramanian, Tan Boon Yeow, Christopher Li-Hsian Chen, Juan Helen Zhou

Research output: Contribution to journalArticleAcademicpeer-review


Cerebral microinfarcts (CMIs), a novel cerebrovascular marker, are prevalent in Alzheimer’s disease (AD) and associated with cognitive impairment. Nonetheless, the underlying mechanism of how CMIs influence cognition remains uncertain. We hypothesized that cortical-CMIs disrupted structural connectivity in the higher-order cognitive networks, leading to cognitive impairment. We analyzed diffusion-MRI data of 92 AD (26 with cortical-CMIs) and 110 cognitive impairment no dementia patients (CIND, 28 with cortical-CMIs). We compared structural network topology between groups with and without cortical-CMIs in AD/CIND, and tested whether structural connectivity mediated the association between cortical-CMIs and cognition. Cortical-CMIs correlated with impaired structural network topology (i.e. lower efficiency/degree centrality in the executive control/dorsal attention networks in CIND, and lower clustering coefficient in the default mode/dorsal attention networks in AD), which mediated the association of cortical-CMIs with visuoconstruction dysfunction. Our findings provide the first in vivo human evidence that cortical-CMIs impair cognition in elderly via disrupting structural connectivity.

Original languageEnglish
Pages (from-to)105-115
Number of pages11
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number1
Early online date27 Jan 2020
Publication statusPublished - Jan 2021


  • Alzheimer’s disease
  • cognitive impairment
  • cognitive impairment no dementia
  • cortical cerebral microinfarcts
  • structural network topology


Dive into the research topics of 'Cerebral microinfarcts affect brain structural network topology in cognitively impaired patients'. Together they form a unique fingerprint.

Cite this