Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Du, Houwei; Chen, Chao; Ye, Chengbin; Lin, Feifei; Wu, Jin; Xia, Pincang; Chen, Ronghua; Wu, Sangru; Yuan, Qilin; Chen, Hongbin; Xiao, Yingchun; Liu, Nan

doi:10.3389/fneur.2020.00293

Cited by 8 publications

(7 citation statements)

References 39 publications

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“…For instance, basal ganglia ePVS are independently related to nonimaging measures of arterial stiffness, 17,18 hypertensive arteriopathy, 19,40 and atherosclerosis. 41 Localization of such findings to the basal ganglia may be in part a result of an increased susceptibility to the early effects of cSVD in the perforating arterioles that supply the basal ganglia. 4,42 Our results further suggest that rates of ePVS development may differ as a function of brain region.…”

Section: Discussionmentioning

confidence: 99%

Association of Baseline Cerebrovascular Reactivity and Longitudinal Development of Enlarged Perivascular Spaces in the Basal Ganglia

Libecap,

Bauer,

Zachariou

et al. 2023

Stroke

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BACKGROUND: Increasing evidence suggests that enlarged perivascular spaces (ePVS) are associated with cognitive dysfunction in aging. However, the pathogenesis of ePVS remains unknown. Here, we tested the possibility that baseline cerebrovascular dysfunction, as measured by a magnetic resonance imaging measure of cerebrovascular reactivity, contributes to the later development of ePVS. METHODS: Fifty cognitively unimpaired, older adults (31 women; age range, 60–84 years) underwent magnetic resonance imaging scanning at baseline and follow-up separated by ≈2.5 years. ePVS were counted in the basal ganglia, centrum semiovale, midbrain, and hippocampus. Cerebrovascular reactivity, an index of the vasodilatory capacity of cerebral small vessels, was assessed using carbon dioxide inhalation while acquiring blood oxygen level-dependent magnetic resonance images. RESULTS: Low baseline cerebrovascular reactivity values in the basal ganglia were associated with increased follow-up ePVS counts in the basal ganglia after controlling for age, sex, and baseline ePVS values (estimate [SE]=−3.18 [0.96]; P =0.002; [95% CI, −5.11 to −1.24]). This effect remained significant after accounting for self-reported risk factors of cerebral small vessel disease (estimate [SE]=−3.10 [1.00]; P =0.003; [CI, −5.11 to −1.09]) and neuroimaging markers of cerebral small vessel disease (estimate [SE]=−2.72 [0.99]; P =0.009; [CI, −4.71 to −0.73]). CONCLUSIONS: Our results demonstrate that low baseline cerebrovascular reactivity is a risk factor for later development of ePVS.

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Section: Discussionmentioning

confidence: 99%

Association of Baseline Cerebrovascular Reactivity and Longitudinal Development of Enlarged Perivascular Spaces in the Basal Ganglia

Libecap,

Bauer,

Zachariou

et al. 2023

Stroke

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“…Standardized parameters for the MRI sequences are as follows: T1WI sequence: repetition time (TR), 1,990 ms; echo time (TE), 8.7 ms, field of view (FOV), 230 × 217 mm 2 ; T2WI sequence: TR, 4,700 ms; TE, 109 ms; FOV, 230 × 217 mm 2 ; fluid-attenuated inversion recovery (FLAIR) sequence: TR, 9,000 ms; TE, 95 ms; FOV, 230 × 217 mm 2 ; diffusion-weighted imaging (DWI) sequence: TR, 3,570 ms; TE, 67 ms; FOV, 235 × 235 mm 2 . We determined well-established baseline imaging cSVD markers according to the previously published method ( Wardlaw et al, 2013 ; Capuana et al, 2020 ; Du et al, 2020a ). Lacunes of presumed vascular origin were round or oval, located in the subcortex, similar to the signal of cerebrospinal fluid between 3 and 15 mm in diameter at fluid-attenuated inversion recovery (T2-FLAIR) and usually with low intensity of central cerebrospinal fluid and high-intensity margin around it ( Wardlaw et al, 2013 ).…”

Section: Methodsmentioning

confidence: 99%

“…CMBs were a round or oval low-signal intensity focus of cerebral parenchyma on T2-weighted gradient-recalled echo (T2*-GRE) or susceptibility-weighted imaging (SWI) with a diameter of 2–10 mm ( Wardlaw et al, 2013 ; Capuana et al, 2020 ). Enlarged perivascular spaces at basal ganglia (BG-EPVS) and centrum semiovale (CSO-EPVS) were defined on T2-weighted using a validated five-point ordinal scale as follows: 0 = no EPVS, 1 = 1–10 EPVS, 2 = 11–20 EPVS, 3 = 21–40 EPVS, and 4 = > 40 EPVS ( Wardlaw et al, 2013 ; Du et al, 2020a ). We graded WMH in periventricular and deep white matter on T2-FLAIR sequences according to the Fazekas criteria ( Staals et al, 2014 ).…”

Section: Methodsmentioning

confidence: 99%

Total Cerebral Small Vessel Disease Score and Cerebral Bleeding Risk in Patients With Acute Stroke Treated With Intravenous Thrombolysis

Lei

et al. 2022

Front. Aging Neurosci.

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ObjectiveThe aim of this study was to investigate the association of total cerebral small vessel disease (cSVD) score with the risk of intracerebral hemorrhage (ICH) in patients with acute ischemic stroke who received intravenous thrombolysis (IVT) using recombinant tissue-plasminogen activator (rt-PA).MethodsWe retrospectively reviewed clinical data from two stroke registries of patients with acute ischemic stroke treated with IVT. We assessed the baseline magnetic resonance (MR) visible cSVD markers and total cSVD score (ranging from 0 to 4) between patients with and without ICH after IVT. Logistic regression analysis was used to determine the association of total cSVD score with the risk of ICH after IVT, adjusted for cofounders selected by least absolute shrinkage and selection operator (LASSO). We additionally performed an E-value analysis to fully explain away a specific exposure-outcome association. Receiver operating characteristic (ROC) curve analysis was used to quantify the predictive potential of the total cSVD score for any ICH after IVT.ResultsAmong 271 eligible patients, 55 (20.3%) patients experienced any ICH, 16 (5.9%) patients experienced a symptomatic ICH (sICH), and 5 (1.85%) patients had remote intracranial parenchymal hemorrhage (rPH). Logistic regression analysis showed that the risk of any ICH increased with increasing cSVD score [per unit increase, adjusted odds ratio (OR) 2.03, 95% CI 1.22–3.41, P = 0.007]. Sensitivity analyses using E-value revealed that it would need moderately robust unobserved confounding to render the exposure-outcome (cSVD-any ICH) association null. ROC analysis showed that compared with the National Institutes of Health Stroke Scale (NIHSS) score alone, a combination of cSVD and NIHSS score had a larger area under the curve for any ICH (0.811, 95% CI 0.756–0.866 vs. 0.784, 95% CI 0.723–0.846, P = 0.0004).ConclusionThe total cSVD score is associated with an increased risk of any ICH after IVT and improves prediction for any ICH compared with NIHSS alone.

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“…5 Recently, studies have shown that chronic SVD burden exists in ischemic stroke patients with LAD, especially ICAS. 6,7 Only a few studies have evaluated the relationship between different SVD imaging markers and the degree of ICAS. 8,9 Although the imaging markers of SVD, such as WMH, PVS, CMB, and chronic lacunes, are correlated to some extent, they might have different etiologies.…”

mentioning

confidence: 99%

“…According to the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE) criteria, the imaging markers of SVD usually include white matter hyperintensity (WMH), perivascular space (PVS), chronic lacunes, cerebral microbleeds (CMBs), recent small subcortical infarcts, and brain atrophy 5 . Recently, studies have shown that chronic SVD burden exists in ischemic stroke patients with LAD, especially ICAS 6,7 . Only a few studies have evaluated the relationship between different SVD imaging markers and the degree of ICAS 8,9 …”

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confidence: 99%

Severity of Intracranial Large Artery Disease Correlates With Cerebral Small Vessel Disease

Wang

Lyu

Zhang

et al. 2021

Magnetic Resonance Imaging

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Background Small vessel disease (SVD) shares common vascular risk factors with large artery disease (LAD). However, little is known about the relationship between intracranial artery stenosis and SVD burden. Purpose To investigate whether SVD burden correlates with severity of intracranial LAD. Study Type Retrospective. Population Five hundred and sixteen patients with LAD of arterial circulation were enrolled from one hospital, including 384 males (59 ± 11 years) and 132 females (60 ± 12 years). Field Strength/Sequence 3 T. T1‐weighted fast spin echo (T1W FSE), T2W FSE, T2 fluid attenuated inversion recovery, diffusion‐weighted imaging, susceptibility‐weight imaging, and time‐of‐flight magnetic resonance angiography. Assessment The LAD was divided into mild stenosis (<30%), moderate stenosis (30%–69%), and severe stenosis (≥70%). The Standard for Reporting Vascular Changes on Neuroimaging criteria was used to rate the SVD burden according to the level of white matter hyperintensity (WMH), perivascular space (PVS), cerebral microbleed (CMB), and lacunes. Statistical Tests Lilliefors test, ANOVA, chi‐squared test, Mann–Whitney U test, Wilcoxon signed rank test, Bonferroni test, Spearman's correlation, logistic regression, and Cohen's kappa test. Results The grade scores for centrum semiovale PVS (CS‐PVS) were positively correlated with the degree of stenosis (R = 0.413), whereas the presence of severe basal ganglia PVS (BG‐PVS) was associated with CMB (R = 0.508), lacunes (R = 0.365), and severe WMH (R = 0.478). In multivariate analysis, severe CS‐PVS (adjusted odds ratio [aOR], 3.1; 95% confidence interval [CI], 1.9–4.8) and lacunes (aOR, 2.1; 95% CI, 1.3–3.4) were associated with severe stenosis of LAD. In addition, CS‐PVS was related to severe stenosis in a dose‐dependent manner: when CS‐PVS score was 3 and 4, the aORs of severe stenosis were 1.9 and 7.7, respectively. Data Conclusion The severity of LAD in anterior circulation is associated with SVD burden, which suggests that different SVD burden may be used for risk stratification in LAD. Evidence Level 3 Technical Efficacy Stage 3

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Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Cited by 8 publications

References 39 publications

Association of Baseline Cerebrovascular Reactivity and Longitudinal Development of Enlarged Perivascular Spaces in the Basal Ganglia

Association of Baseline Cerebrovascular Reactivity and Longitudinal Development of Enlarged Perivascular Spaces in the Basal Ganglia

Total Cerebral Small Vessel Disease Score and Cerebral Bleeding Risk in Patients With Acute Stroke Treated With Intravenous Thrombolysis

Severity of Intracranial Large Artery Disease Correlates With Cerebral Small Vessel Disease

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