Evidence map›Paper›PMID 42475254›Full record

ArticleCerebrovascular diseases (Basel, Switzerland)2026

Covert Embolic Brain Infarcts, Remote Cortical Thinning, and Cognitive Impairment in Atrial Fibrillation: An Analysis of the Swiss-AF Cohort.

Tim Sinnecker, Stefanie Aeschbacher, Anne Springer, Michael Coslovsky, Juerg Beer, Giorgio Moschovitis, Urs Fischer, Nicolas Rodondi, David Conen, Philipp Krisai and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cerebrovascular diseases (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Tim SinneckerDepartment of Neurology, University Hospital Basel, Basel, Switzerland, tim.sinnecker@usb.ch.
Stefanie AeschbacherCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Anne SpringerCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Michael CoslovskyCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Juerg BeerDepartment of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zurich, Zurich, Switzerland.
Giorgio MoschovitisDivision of Cardiology, Ente Ospedaliero Cantonale (EOC), Cardiocentro Ticino Institute, Regional Hospital of Lugano, Lugano, Switzerland.
Urs FischerDepartment of Neurology, Bern University Hospital, Inselspital, Bern, Switzerland.
Nicolas RodondiDepartment of General Internal Medicine, Bern University Hospital, Inselspital, Bern, Switzerland.
David ConenPopulation Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Philipp KrisaiCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Michael KühneCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Stefan OsswaldCardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Leo H BonatiDepartment of Neurology, University Hospital Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients with atrial fibrillation (AF) exhibit a notable prevalence of both (covert) brain infarcts and white matter hyperintensities (WMHs). They face an elevated risk of cognitive decline and dementia, yet the pathogenesis remains largely unknown. Here, we aimed to investigate a potential relationship between lesion location of embolic brain infarcts or WMHs and (i) remote cortical volume using a tract-based analysis, as well as (ii) global cognitive function using voxel-based lesion-symptom mapping.

methodsThis is a cross-sectional analysis from a prospective, multicenter cohort study of unselected patients with AF (Swiss-AF) enrolling 1,716 patients with eligible MRI data (mean age 73 ± 8 years, 27% women, 90% anticoagulated). We assessed the association of brain lesions including embolic brain infarcts and WMHs in specific white matter tracts with remote cortical volume by using LASSO regression. In addition, voxel-based lesion-symptom mapping was deployed to assess the effect of WMH location in relationship to embolic brain infarcts on cognitive function.

resultsWe observed WMH in 1,699 of 1,716 (99%) and embolic brain infarcts in 395 of 1,716 (23%) patients. The presence of embolic infarcts within most fiber tracts (mean, IQR: 55, 8-66 cm3) accounted for more variability in remote cortical volumes than WMH regional volume (mean, IQR: 366, 63-657 cm3) despite their lower volume. In addition, while the presence of WMH was initially associated with cognitive function across most brain regions (61.8% of voxels with significant association), when adjusting models for the presence of embolic infarcts, only a minor fraction of WMH remained significantly associated with cognitive function (23.6% of voxels).

conclusionsAmong patients with AF, (covert) embolic brain infarcts and WMHs are associated with remote cortical atrophy and with lower cognitive performance. The disruption of brain networks through embolic infarcts seems to contribute to cognitive impairment in patients with AF.

Indexed as

Atrial fibrillationCognitive impairmentCortical thinningCovert brain infarcts

Identifiers

PMID42475254
PMCPMC13506151

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.