Relationship between inferior frontal sulcal hyperintensities on brain MRI, ageing and cerebral small vessel disease

Jun-fang Zhang, Hwee Fang Lim, Francesca M. Chappell, Una Clancy, Stewart Wiseman, Maria C. Valdés-hernández, Daniela Jaime Garcia, Mark E. Bastin, Fergus N. Doubal, Will Hewins, Simon R. Cox, Susana Muñoz Maniega, Michael Thrippleton, Michael Stringer, Charlotte Jardine, Donna Mcintyre, Gayle Barclay, Iona Hamilton, Lucy Kesseler, Madeleine MurphyCarol Di Perri, Yun-cheng Wu, Joanna M. Wardlaw

Research output: Contribution to journalArticlepeer-review


Raised signal in cerebrospinal fluid (CSF) on fluid-attenuated inversion recovery (FLAIR) may indicate raised CSF protein or debris and is seen in inferior frontal sulci on routine MRI. To explore its clinical relevance, we assessed the association of inferior frontal sulcal hyperintensities (IFSH) on FLAIR with demographics, risk factors, and small vessel disease markers in three cohorts (healthy volunteers, n=44; mild stroke patients, n=105; older community-dwelling participants from Lothian birth cohort 1936, n=101). We collected detailed clinical data, scanned all subjects on the same 3T MRI scanner and 3-dimensional FLAIR sequence and developed a scale to rate IFSH. In adjusted analyses, the IFSH score increased with age (per 10-year increase; OR 1.69; 95% CI, 1.42-2.02), and perivascular spaces score in centrum semiovale in stroke patients (OR 1.73; 95% CI, 1.13-2.69). Since glymphatic CSF clearance declines with age and drains partially via the cribriform plate to the nasal lymphatics, IFSH on 3T MRI may be a non-invasive biomarker of altered CSF clearance and justifies further research in larger, more diverse samples.
Original languageEnglish
Pages (from-to)130-138
JournalNeurobiology of Aging
Publication statusPublished - 21 Jun 2021


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