Prevalence and determinants of subclinical brain infarction: The Northern Manhattan Study

S. Prabhakaran, C. B. Wright, M. Yoshita, R. Delapaz, T. Brown, Charles DeCarli, R. L. Sacco

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


Objective: Risk factors for subclinical brain infarcts (SBI) have not been well studied, especially in Hispanic and black populations who may be at higher risk for vascular disease. We examined the prevalence and determinants of SBI in a multiethnic community cohort. Methods: The Northern Manhattan Study (NOMAS) includes 892 stroke-free participants who underwent brain MRI. Baseline demographic and vascular risk factor data were collected. The presence of SBI was determined from the size, location, and imaging characteristics of the lesion based on fluid attenuated inversion recovery (FLAIR) T1 and T2, and proton density MRI sequences. We calculated the prevalence of SBI and cross-sectional associations with sociodemo-graphic and vascular risk factors, using logistic regression to adjust for relevant covariates. Results: Among 892 subjects (mean age 71.3 years), 158 (17.7%) had SBI (13.5% had 1 lesion, 4.3% had >1 lesion). Of the total 216 infarcts, most were small (<1 cm, 82.4%) and subcortica (82.9%). SBI prevalence increased with age (<65: 9.7%; 65 to 75: 16.4%; >75: 26.1%), was ncreased among men (21.3% vs 15.2% in women), and was increased among blacks (24.0% vs 18.1% in whites and 15.8% in Hispanics). The presence of SBI was independently associated with older age (per year: OR 1.06, 95% CI 1.04 to 1.09), male sex (OR 1.79, 95% CI 1.22 to 2.61), and hypertension (OR 2.08, 95% CI 1.35 to 3.22) adjusting for age, sex, race-ethnicity, and vascular risk factors. A significant interaction (p = 0.002) between race and age was observed such that younger black subjects had greater odds of having SBI. Conclusions: SBI were detected in nearly 18% of subjects in a multiethnic community-based cohort. Age, male sex, and hypertension were independently associated with SBI. Subclinica cerebral infarcts are more prevalent than symptomatic infarcts and may increase the true public health burden of stroke. Neurology® 2008;70:425-430

Original languageEnglish (US)
Pages (from-to)425-430
Number of pages6
Issue number6
StatePublished - Feb 5 2008

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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