SynthesisStroke2016
Silent Brain Infarction and Risk of Future Stroke: A Systematic Review and Meta-Analysis.
5 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph
Synthesis in Stroke, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 118 papers, 10 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
118citing papers in PubMed, 10 pooled it
13.3field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Antiplatelet Therapy in Secondary Prevention for Patient With Silent Brain Infarction
Detecting the Vulnerable Carotid Plaque: "The Carotid Artery Multi-modality Imaging Prognostic (CAMP) Study" - Implications for Stroke and Cognitive Decline Prediction in Asymptomatic Carotid Artery Disease
Advanced Cardiac Imaging To Predict Embolic Stroke On Brain MRI: A Pilot Study
Comparison of Anti-coagulation and Anti-Platelet Therapies for Intracranial Vascular Atherostenosis- Magnetic Resonance Imaging
Silent Brain Infarcts in Spontaneous Intracerebral Hemorrhage as a Prognostic Biomarker for Vascular Contributions to Cognitive Impairment and Dementia (VCID)
Who cites it
118 citing papers in PubMed, 10 syntheses or guidelines pooled it, 220 citations in OpenAlex.
- Retinal imaging for the assessment of stroke risk: a systematic review.Journal of neurology · 2024Pooled it
- Antiplatelet therapy and outcomes after aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis.Clinical neurology and neurosurgery · 2023Pooled it
- Quality appraisal for systematic literature reviews of health state utility values: a descriptive analysis.BMC medical research methodology · 2022Pooled it
- Prevalence and incidence of stroke, white matter hyperintensities, and silent brain infarcts in patients with chronic heart failure: A systematic review, meta-analysis, and meta-regression.Frontiers in cardiovascular medicine · 2022Pooled it
- Health Utility Weighting of the Modified Rankin Scale: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Clinical Significance of Magnetic Resonance Imaging Markers of Vascular Brain Injury: A Systematic Review and Meta-analysis.JAMA neurology · 2019Pooled it
- Association between Carotid Plaque Features on CTA and Cerebrovascular Ischemia: A Systematic Review and Meta-Analysis.AJNR. American journal of neuroradiology · 2017Pooled it
- The Association between Carotid Artery Atherosclerosis and Silent Brain Infarction: A Systematic Review and Meta-analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2017Pooled it
- Restarting Anticoagulant Therapy After Intracranial Hemorrhage: A Systematic Review and Meta-Analysis.Stroke · 2017Pooled it
- Gadolinium Enhancement in Intracranial Atherosclerotic Plaque and Ischemic Stroke: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2016 · on this mapPooled it
- Late-Life Vascular Risk Score in Association With Postmortem Cerebrovascular Disease Brain Pathologies.Stroke · 2021Trial
- Trial
- Vessel wall MRI predictors of postprocedural new ischemic brain lesions after endovascular treatment for basilar artery stenosis.Quantitative imaging in medicine and surgery · 2026Article
- GLP-1, GIP, and Glucagon Receptor Agonism at the Obesity-Neurodegeneration Interface: A Narrative Review.International journal of molecular sciences · 2026Review
- Association Between Predicted 10-Year Atherosclerotic Cardiovascular Disease Risk and Magnetic Resonance Imaging-Defined Covert Brain Infarction.Journal of stroke · 2026Article
- Review
- Opportunistic Cardiovascular Risk Assessment Using Routine Head CT in the Emergency Department.Journal of the American College of Cardiology · 2026Article
- Observational
- Impact of sedentary behavior and physical activity on stroke risk in a cohort of patients with silent brain infarction.Scientific reports · 2026Article
- The Role of Brain Structure in Explaining Physical Functioning in Male Veterans With Impaired Kidney Function.Journal of the American Geriatrics Society · 2026Article
58 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Ajay GuptaFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.). ajg9004@med.cornell.edu.
Ashley E GiambroneFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Gino GialdiniFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Caitlin FinnFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Diana DelgadoFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Jose GutierrezFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Clinton WrightFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Alexa S BeiserFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Sudha SeshadriFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Ankur PandyaFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Hooman KamelFrom the Department of Radiology (A.G., C.F.), Feil Family Brain and Mind Research Institute (A.G., G.G., H.K.), Department of Healthcare Policy and Research (A.E.G.), Samuel J. Wood Library and C.V. Starr Biomedical Information Center (D.D.), Department of Neurology (H.K.), Weill Cornell Medical College, New York, NY; Department of Neurology, Columbia University Medical Center, New York, NY (J.G.); Department of Neurology, University of Miami Miller School of Medicine, FL (C.W.); Department of Biostatistics, Boston University School of Public Health, MA (A.S.B.); Department of Neurology, Boston University School of Medicine, MA (S.S.); and Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA (A.P.).
Boston University · USColumbia University Irving Medical Center · USUniversity of Miami · US
Funding
UC Davis Alzheimer's Disease Core CenterP30AG010129 · NIA · UNIVERSITY OF CALIFORNIA DAVIS · PI DECARLI, CHARLES · 1991 to 2020
$28.3MPRECURSORS OF STROKE INCIDENCE AND PROGNOSISR01NS017950 · NINDS · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI Hugo Javier Aparicio, Jose Rafael Romero · 1985 to 2026
$22.9MSTROKE INCIDENCE AND RISK FACTORS IN A TRI-ETHNIC REGIONR01NS029993 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ELKIND, MITCHELL S, SACCO, RALPH L. · 1993 to 2019
$19.2MEPIDEMIOLOGY OF DEMENTIA IN THE FRAMINGHAM STUDYR01AG008122 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI AU, RHODA, SESHADRI, SUDHA · 1989 to 2015
$14.4MStroke Incidence and Risk Factors in a Tri-Ethnic RegionR37NS029993 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ELKIND, MITCHELL S, SACCO, RALPH L. · 2008 to 2014
$12.1MAtrial Fibrillation Precursors May Be Novel Stroke Risk FactorsK23NS082367 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI KAMEL, HOOMAN · 2013 to 2017
$937kVascular Determinants of Dementia and Cognitive Decline in a Tri-Ethnic RegionR56NS029993 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI ELKIND, MITCHELL S, RUNDEK, TATJANA · 2021 to 2021
$537kNIA NIH HHS P30 AG010129NIA NIH HHS R01 AG008122NINDS NIH HHS K23 NS082367NINDS NIH HHS R01 NS017950NINDS NIH HHS R01 NS029993NINDS NIH HHS R37 NS029993NINDS NIH HHS R56 NS029993
Abstract
background and purposeSilent brain infarction (SBI) on magnetic resonance imaging has been proposed as a subclinical risk marker for future symptomatic stroke. We performed a systematic review and meta-analysis to summarize the association between magnetic resonance imaging-defined SBI and future stroke risk.
methodsWe searched the medical literature to identify cohort studies involving adults with SBI detected by magnetic resonance imaging who were subsequently followed up for incident clinically defined stroke. Study data and quality assessment were recorded in duplicate with disagreements in data extraction resolved by a third reader. Strength association between magnetic resonance imaging-detected SBI and future symptomatic stroke was measured by an hazard ratio.
resultsThe meta-analysis included 13 studies (14 764 subjects) with a mean follow-up ranging from 25.7 to 174 months. SBI predicted the occurrence of stroke with a random effects crude relative risk of 2.94 (95% confidence interval, 2.24-3.86, P<0.001; Q=39.65, P<0.001). In the 8 studies of 10 427 subjects providing hazard ratio adjusted for cardiovascular risk factors, SBI was an independent predictor of incident stroke (hazard ratio, 2.08 [95% confidence interval, 1.69-2.56; P<0.001]; Q=8.99; P=0.25). In a subgroup analysis pooling 9483 stroke-free individuals from large population-based studies, SBI was present in ≈18% of participants and remained a strong predictor of future stroke (hazard ratio, 2.06 [95% confidence interval, 1.64-2.59]; P<0.01).
conclusionsSBI is present in ≈1 in 5 stroke-free older adults and is associated with a 2-fold increased risk of future stroke. Future studies of in-depth stroke risk evaluations and intensive prevention measures are warranted in patients with clinically unrecognized radiologically evident brain infarctions.
Indexed as
Brain InfarctionForecastingHumansObservational Studies as TopicRisk FactorsStrokebrain infarctioninfarctionmagnetic resonance imagingrisk factorsstroke
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Registered trials
NCT03318744ClinicalTrials.gov
NCT04679727ClinicalTrials.gov
NCT04769310ClinicalTrials.gov
NCT05907629ClinicalTrials.gov
NCT06836141ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.