Evidence map›Paper›PMID 39821913›Full record

ArticleAnnals of neurology2025

Clinical Relevance of 'Cap' and 'Track' Development after Recent Small Subcortical Infarct.

Yajun Cheng, Carmen Arteaga-Reyes, Una Clancy, Daniela Jaime Garcia, Maria Del C Valdés Hernández, Michael J Thrippleton, Michael S Stringer, Gordon W Blair, Stewart Wiseman, Francesca M Chappell and 14 more

Abstract read
In one paragraph

Article in Annals of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Yajun ChengDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.ORCID 0000-0002-5227-9811
Carmen Arteaga-ReyesCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Una ClancyCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Daniela Jaime GarciaCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Maria Del C Valdés HernándezCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Michael J ThrippletonCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Michael S StringerCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3811-4439
Gordon W BlairCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Stewart WisemanCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Francesca M ChappellCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Junfang ZhangDepartment of Neurology & Institute of Neurology, Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaodi LiuDivision of Neurology, Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Angela C C JochemsCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Susana Muñoz ManiegaCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Eleni SakkaCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Mark E BastinCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Rosalind BrownCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Caroline M J LoosDepartment of Neurology, Antwerp University Hospital and Research Group on Translational NeuroSciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Stephen D J MakinCentre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Inverness, UK.
Ming LiuDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Bo WuDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, China.
Fergus N DoubalCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
Joanna M WardlawCentre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-9812-6642
MSS‐2, MSS‐3 and the INVESTIGATE‐SVDs Study Group

Funding

Anne Rowling Regenerative Neurology ClinicBiotechnology and Biological Sciences Research Council, and the Economic and Social Research Council BB/W008793/1British Heart Foundation Edinburgh Centre for Research Excellence RE/18/5/34216Chief Scientist Office CAF/18/08Chinese Government Scholarship CSC202006240281Dunhill Trust R380R/1114Edinburgh and Lothians Health Foundation 2012/17European Union Horizon 2020 666881Fondation Leducq Network for the Study of Perivascular Spaces in Small Vessel Disease 16 CVD 05Medical Research Council UKDRI-4002Mexican Council of Humanities Science and Technology 2021-00000701EXTF-00234Muir Maxwell Research FundNational Key Research and Development Program of China 2023YFC2506603NHS Lothian Research and Development OfficeNHS Research ScotlandPostdoctor Research Fund of West China Hospital, Sichuan University 2024HXBH041Stroke Association Garfield Weston Foundation TSALECT2015/04Stroke Association Postdoctoral Fellowship SA PDF 23\100007Stroke Association 'Small Vessel Disease-Spotlight on Symptoms (SVD-SOS)' SAPG 19n100068The Row Fogo Charitable Trust Centre for Research into Aging and the Brain AD.ROW4.35The Row Fogo Charitable Trust Centre for Research into Aging and the Brain BRO-D.FID3668413TSA Wiseman Stroke Association Postdoctoral Fellowship (SA PDF 18\100026) TSA StrUniversity of Edinburgh College of Medicine and Veterinary MedicineWellcome Trust
6 · The paper itself

Abstract

objectiveAfter a recent small subcortical infarct (RSSI), some patients develop perilesional or remote hyperintensities ('caps/tracks') to the index infarct on T2/FLAIR MRI. However, their clinical relevance remains unclear. We investigated the clinicoradiological correlates of 'caps/tracks', and their impact on long-term outcomes following RSSI.

methodsWe identified participants with lacunar stroke and MRI-confirmed RSSI from 3 prospective studies. At baseline, we collected risk factors, RSSI characteristics, small vessel disease (SVD) features, and microstructural integrity on diffusion imaging. Over 1-year, we repeated MRI and recorded 'caps/tracks' blinded to other data. We evaluated predictors of 'caps/tracks', and their association with 1-year functional (modified Rankin Scale score ≥2), mobility (Timed Up-and-Go), cognitive outcomes (Montreal Cognitive Assessment [MoCA] score <26), and recurrent cerebrovascular events (stroke/transient ischemic attack/incident infarct) using multivariable regression.

resultsAmong 185 participants, 93 (50.3%) developed 'caps/tracks' first detected at median 198 days after stroke. 'Caps/tracks' were independently predicted by baseline factors: larger RSSI, RSSI located in white matter, higher SVD score, and higher mean diffusivity in normal-appearing white matter (odds ratio [OR] [95% confidence interval {CI}], 1.15 [1.07-1.25], 6.01 [2.80-13.57], 1.77 [1.31-2.44], 1.42 [1.01-2.03]). At 1 year, 'cap/track' formation was associated with worse functional outcome (OR: 3.17, 95% CI: 1.28-8.22), slower gait speed (β: 0.13, 95% CI: 0.01-0.25), and recurrent cerebrovascular events (hazard ratio [HR]: 2.05, 95% CI: 1.05-4.02), but not with cognitive impairment.

interpretation'Caps/tracks' after RSSI are associated with worse clinical outcomes, and may reflect vulnerability to progressive SVD-related injury. Reducing 'caps/tracks' may offer early efficacy markers in trials aiming to improve outcome after lacunar stroke. ANN NEUROL 2025;97:942-955.

Indexed as

Cerebral InfarctionStroke, LacunarAgedAged, 80 and overClinical RelevanceFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesRisk Factors

Identifiers

PMID39821913
PMCPMC12010063

What OpenQuestion holds

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Registered trials

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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.