Spatial and temporal effects of cortical cerebral microinfarcts on the cortical and subcortical regions in cerebral small vessel disease

This is the first study to comprehensively assess both spatial (cortical and subcortical) and temporal effects of microstructural changes associated with cortical microinfarcts (CMIs) in cerebral small vessel disease using quantitative multi-modal MRI. We employed multiple advanced imaging measures, including cortical thickness, R1 (1/T1) mapping, and neurite densitivity index (NDI) derived from neurite orientation dispersion and density imaging (NODDI) modeling to sensitively detect tissue microstructural alterations. We found that old CMIs were associated with pronounced subcortical microstructural injury along white matter tracts but showed minimal cortical involvement, whereas recent CMIs presented localized and transient changes.