Focal cortical thinning is caused by remote subcortical infarcts: spooky action at a distance.

In this issue of Neurology®, Duering et al.(1) present compelling proof-of-principle evidence that small subcortical infarcts have remote consequences on gray matter volume. Using MRI scans acquired before and after an incident subcortical infarct, they were able to show that the appearance of a new subcortical infarct was associated with cortical thinning in connected brain regions.