Arterial Stiffness Is Associated With Basal Ganglia Enlarged Perivascular Spaces and Cerebral Small Vessel Disease Load

Riba‐Llena, Iolanda; Jiménez-Baladó, Joan; Castañé, Xavier; Girona, Anna; López-Rueda, Antonio; Mundet, Xavier; Jarca, Carmen Ioana; Álvarez-Sabín, José; Montaner, Joan; Delgado, Pilar

doi:10.1161/strokeaha.118.020163

Cited by 71 publications

(65 citation statements)

References 9 publications

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“…IMT and plaque were thought to reflect the pathological changes of carotid atherosclerosis, while baPWV and ABI suggested large artery stiffness. In this study, our findings revealed that baPWV was positively associated with four CSVD markers and total disease burden, which was in accordance with previous studies 24 , 39 ) , while others had significant associations with some CSVD markers. Therefore, we considered that baPWV may be clinically more useful in discriminating the presence of small vessel diseases.…”

Section: Discussionsupporting

confidence: 93%

Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population

Zhang

Jiang

Wang

et al. 2020

JAT

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Aims : We aimed to examine the associations of four extracranial artery indicators with cerebral small vessel disease (CSVD) and its total burden. Methods: A total of 904 individuals aged 55–65 years old were included from the Taizhou Imaging Study. CSVD markers, including lacunes (LAC), white matter hyperintensities (WMH), cerebral microbleeds (CMB), and perivascular spaces (PVS), were rated based on brain magnetic resonance imaging. We also measured extracranial artery indices, including the brachial-ankle pulse wave velocity (baPWV), the ankle-brachial index, the carotid intima-media thickness (IMT), and carotid plaque. Linear and binary logistic regressions were adopted to test the associations among these four artery indicators and each CSVD marker when appropriate. Additionally, ordinal and multinomial logistic regressions were performed to assess the relationships between artery indicators and total CSVD score (range from 0–4 points). Results: A total of 443 (49.0%) participants were found to have at least one of the CSVD markers, including 172 (19.0%) with WMH, 184 (20.4%) with LAC, 147 (16.3%) with CMB, and 226 (25.0%) with PVS. Increased baPWV was significantly associated with each CSVD marker, increasing carotid IMT was associated with LAC and PVS, and the presence of carotid plaque was associated with WMH volume and PVS. Moreover, per SD increment of baPWV (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.11–1.50) and the presence of carotid plaque (OR: 1.42, 95% CI: 1.05–1.92) were significantly associated with greater total CSVD scores. Conclusion : Increased baPWV and the presence of carotid plaque appear to be associated with total CSVD burden in rural regions in China.

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Section: Discussionsupporting

confidence: 93%

Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population

Zhang

Jiang

Wang

et al. 2020

JAT

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“…The cause of dilated perivascular spaces is still under debate. They have been associated with other vascular risk factors for CSVD, such as elevated blood pressure (Klarenbeek et al, 2013; Yakushiji et al, 2014; Yao et al, 2014; Gutierrez et al, 2015) and large-vessel abnormalities (Gutierrez et al, 2013; Riba-Llena et al, 2018), however these results are not consistent in the literature (Bouvy et al, 2016). Thus although perivascular spaces seem to share similar risk factors as other measures of CSVD, more research is warranted.…”

Section: Perivascular Spacesmentioning

confidence: 90%

Neuroimaging of Cerebral Small Vessel Disease and Age-Related Cognitive Changes

Caunca

León-Benedetti

Latour

et al. 2019

Front. Aging Neurosci.

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Subclinical cerebrovascular disease is frequently identified in neuroimaging studies and is thought to play a role in the pathogenesis of cognitive disorders. Identifying the etiologies of different types of lesions may help investigators differentiate between age-related and pathological cerebrovascular damage in cognitive aging. In this review article, we aim to describe the epidemiology and etiology of various brain magnetic resonance imaging (MRI) measures of vascular damage in cognitively normal, older adult populations. We focus here on population-based prospective cohort studies of cognitively unimpaired older adults, as well as discuss the heterogeneity of MRI findings and their relationships with cognition. This review article emphasizes the need for a better understanding of subclinical cerebrovascular disease in cognitively normal populations, in order to more effectively identify and prevent cognitive decline in our rapidly aging population.

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“…Finally, the association between BGPVS and ICH might be mediated by a shared underlying mechanism. For example, arterial stiffening has recently been associated with BGPVS 22 , adjusted for major vascular risk factors, and also with deep ICH cross-sectionally and new CMB formation prospectively 23,24 . By reducing damping of the cardiac impulse and increasing transmission of pulsatile force to small cerebral arteries 25 ,…”

Section: Discussionmentioning

confidence: 99%

Association of enlarged perivascular spaces and anticoagulant-related intracranial hemorrhage

et al. 2020

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ObjectiveTo investigate whether enlarged perivascular spaces within the basal ganglia or deep cerebral white matter are risk factors for intracranial hemorrhage in patients taking oral anticoagulants (OAC), independent of established clinical and radiological risk factors, we conducted a post hoc analysis of CROMIS-2 (AF), a prospective inception cohort study.MethodsPatients with atrial fibrillation and recent TIA or ischaemic stroke underwent standardised MR imaging prior to starting OAC. We rated basal ganglia (BGPVS) and centrum semiovale (CSOPVS) perivascular spaces, cerebral microbleeds (CMBs), white matter hyperintensities and lacunes. We dichotomized the PVS rating using a threshold of >10 PVS in the relevant region of either cerebral hemisphere. The primary outcome was symptomatic intracranial hemorrhage (sICH). We identified risk factors for sICH using Cox regression.Results1386 participants with available clinical and imaging variables were followed up for a mean of 2.34 years. 14 sICH occurred (11 intracerebral). In univariable analysis, diabetes, CMB presence, lacune presence and >10 BGPVS, but not CSOPVS, were associated with sICH. In a multivariable model incorporating all variables with significant associations in univariable analysis, >10 BGPVS (HR 8.96, 95% CI 2.41 – 33.4, p = 0.001) and diabetes (HR 3.91, 95% CI 1.34 – 11.4) remained significant risk factors for sICH.ConclusionEnlarged BGPVS might be a novel risk factor for OAC-related ICH. The strength of this association and potential use in predicting ICH in clinical practice should be investigated in larger cohorts.

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Arterial Stiffness Is Associated With Basal Ganglia Enlarged Perivascular Spaces and Cerebral Small Vessel Disease Load

Abstract: We found that, in a cohort of hypertensive individuals, the arterial stiffness is associated with the total load of the cSVD, especially with lacunes and basal ganglia EPVS.

Cited by 71 publications

References 9 publications

Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population

Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population

Neuroimaging of Cerebral Small Vessel Disease and Age-Related Cognitive Changes

Association of enlarged perivascular spaces and anticoagulant-related intracranial hemorrhage

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