A Japanese study suggested that vulnerable carotid plaque increases the risk of cortical cerebral microinfarcts (CMIs) and subsequent cognitive impairment. The study included 89 patients with >30% carotid stenosis on ultrasound. CMIs were identified in 26 patients (29%). Adjusted for age and sex, CMIs were associated with intraplaque hemorrhage, lacunar infarcts, and cortical infarcts (rate ratio, 1.95, 1.54 and 3.22, respectively). These associations were also observed in asymptomatic patients (n=64). Of 81 patients with unilateral carotid stenosis, the prevalence and number of CMIs were significantly higher in the hemisphere ipsilateral to the carotid stenosis than in the contralateral hemisphere. The presence of CMIs was associated with poor cognitive function. CMIs play an important role in vascular cognitive impairment and dementia. The findings suggest that carotid atherosclerosis could be a potential therapeutic target for cognitive impairment. Source: https://www.ahajournals.org/
