Intracranial arteriosclerosis is related to cerebral small vessel disease: a prospective cohort study

Vinke, Elisabeth J.; Yilmaz, Pınar; Toorn, Janine E. van der; Fakhry, Rahman; Frenzen, Kate; Dubost, Florian; Licher, Silvan; Bruijne, Marleen de; Kavousi, Maryam; Ikram, M. Arfan; Vernooij, Meike W.; Bos, Daniel

doi:10.1016/j.neurobiolaging.2021.04.005

Cited by 7 publications

(9 citation statements)

References 33 publications

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“…In some cases, these may be related to B-ASC directly. A recent study found that intracranial arteriosclerosis was significantly associated with PVS (38). The pathological changes of intracranial arteriosclerosis are similar to B-ASC, which may be correlated with EPVS.…”

Section: Discussionmentioning

confidence: 87%

The Triglyceride Glucose Index Is a Risk Factor for Enlarged Perivascular Space

et al. 2022

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The triglyceride glucose (TyG) index is considered a simple surrogate marker for insulin resistance and has been associated with cerebrovascular diseases. However, limited information is available regarding its association with the subclinical cerebral small vessel disease (CSVD). Here, we investigated the association of TyG index with the burden and distribution of enlarged perivascular space (EPVS) in the non-diabetic population. The data of 531 non-diabetic patients from 2017 to 2020 were assessed. Participants were grouped according to the burden of EPVS. TyG index was calculated using the log scale of fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2. The association of TyG index with EPVS burden and distribution was evaluated. In the multivariable logistic regression analysis, the TyG index was associated with moderate to severe EPVS [odds ratio (OR): 2.077; 95% CI = 1.268–3.403]. The TyG index was significantly associated with an increased risk of moderate to severe EPVS in subgroups of age <65 years, male, diastolic blood pressure (DBP) <90 mmHg, low-density lipoprotein cholesterol (LDL-C) ≥2.85 mmol/L, serum homocysteine <10 μmol/L, and estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m2, as well as those without smoking. Further analysis of EPVS distribution, the TyG index was found to be associated with moderate to severe EPVS in the centrum semiovale (CSO), not in the basal ganglia (BG). Conclusively, the TyG index was independently and positively associated with moderate to severe CSO EPVS. TyG index may serve as an independent risk factor for CSVD in clinical practice.

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Section: Discussionmentioning

confidence: 87%

The Triglyceride Glucose Index Is a Risk Factor for Enlarged Perivascular Space

et al. 2022

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“…Although calcifications were more common among the cognitively impaired, we observed high rates of intracranial vascular calcification in both cases and controls. Tsimane rates of calcification of 95.7% in internal carotid and 98.2% in vertebral arteries can be compared to 79.0% intracranial carotid artery calcification and 16.9% vertebrobasilar artery calcification in a population‐based European sample ≥60 years of age 49 . Although intracranial vascular calcification was correlated with CAC, the high prevalence of intracranial vascular calcification contrasts with the very low prevalence of CAC found in these populations 15 .…”

Section: Discussionmentioning

confidence: 96%

“…15,[18][19][20][21] In contrast, indigenous populations with high rates of dementia do not practice a subsistence lifestyle and are prone to these other conditions. 4 Furthermore, we were struck by an unusual phenotype in demen- 49 Although intracranial vascular calcification was correlated with CAC, the high prevalence of intracranial vascular calcification contrasts with the very low prevalence of CAC found in these populations. 15 Currently, the pathogenic mechanism leading to the observed medial arterial calcification is not known.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of dementia and mild cognitive impairment in indigenous Bolivian forager‐horticulturalists

Gatz

Mack

Chui

et al. 2022

Alzheimer's & Dementia

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Introduction:We evaluated the prevalence of dementia and mild cognitive impairment (MCI) in indigenous Tsimane and Moseten, who lead a subsistence lifestyle. Methods: Participants from population-based samples ≥ 60 years of age (n = 623) were assessed using adapted versions of the Modified Mini-Mental State Examination, informant interview, longitudinal cognitive testing and brain computed tomography (CT) scans. Results: Tsimane exhibited five cases of dementia (among n = 435; crude prevalence = 1.2%, 95% confidence interval [CI]: 0.4, 2.7); Moseten exhibited one case (among n = 169; crude prevalence = 0.6%, 95% CI: 0.0, 3.2), all age ≥ 80 years.Age-standardized MCI prevalence was 7.7% (95% CI: 5.2, 10.3) in Tsimane and 9.8% (95% CI: 4.9, 14.6) in Moseten. Cognitive impairment was associated with visuospatial impairments, parkinsonian symptoms, and vascular calcification in the basal ganglia. Discussion:The prevalence of dementia in this cohort is among the lowest in the world.Widespread intracranial medial arterial calcifications suggest a previously unrecognized, non-Alzheimer's disease (AD) dementia phenotype.

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“… 1 Indeed, optimal blood pressure (BP) control reduces the progression of white matter hyperintensities 3 , 4 and intracranial carotid artery calcification (ICAC)—a marker of cerebral arteriosclerosis—has been associated with white matter hyperintensities, lacunes, and cerebral microbleeds. 5 …”

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confidence: 99%

“…1 Indeed, optimal blood pressure (BP) control reduces the progression of white matter hyperintensities 3,4 and intracranial carotid artery calcification (ICAC)-a marker of cerebral arteriosclerosis-has been associated with white matter hyperintensities, lacunes, and cerebral microbleeds. 5 Although high BP and ICAC are independently related to CSVD of presumed vascular origin, they are also strongly correlated and therefore, might interplay in the process of leading to CSVD. Between the 2 risk factors, the study of ICAC offers a more clear understanding from the etiological perspective.…”

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confidence: 99%

Intracranial Carotid Arteriosclerosis Mediates the Association Between Blood Pressure and Cerebral Small Vessel Disease

et al. 2023

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BACKGROUND: Intracranial arteriosclerosis could explain the association between blood pressure (BP) and cerebral small vessel disease (CSVD). Therefore, we tested whether intracranial carotid artery calcification (ICAC) mediates the association between BP and CSVD and determined pathophysiological mechanisms based on ICAC subtypes. METHODS: One thousand four hundred fifty-eight stroke-free participants from the Rotterdam Study (mean age, 68 years; 52% women) underwent nonenhanced computed tomography scans to quantify ICAC volume (mm 3 ) between 2003 and 2015. ICAC was categorized into intimal and internal elastic lamina calcifications. CSVD included white matter hyperintensities volume, the presence of lacunes, and cerebral microbleeds visualized on magnetic resonance imaging. Office BP included systolic BP, diastolic BP, pulse pressure, and mean arterial pressure. Mediation analysis included a 2-way decomposition to determine the direct association between BP and CSVD and the indirect or mediated effect (negative or positive mediations expressed in %) of ICAC volume on such association. BP and log-ICAC were correlated and were also associated with CSVD. RESULTS: In all participants, total log-ICAC volume mediated the association of diastolic BP (−14.5%) and pulse pressure (16.5%) with log-white matter hyperintensities. Internal elastic lamina log-ICAC volume mediated −19.5% of the association between diastolic BP and log-white matter hyperintensities; intimal log-ICAC volume did not mediate associations. For lacunes, total and internal elastic lamina log-ICAC volume mediated the association of diastolic BP (−40% and −45.8%) and pulse pressure (26.9% and 18.2%). We did not observe mediations for cerebral microbleeds. CONCLUSIONS: Intracranial arteriosclerosis mediates the association between BP and CSVD. Internal elastic lamina calcification, considered a proxy of arterial stiffness, is the leading mechanism explaining the link between BP and CSVD.

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Intracranial arteriosclerosis is related to cerebral small vessel disease: a prospective cohort study

Cited by 7 publications

References 33 publications

The Triglyceride Glucose Index Is a Risk Factor for Enlarged Perivascular Space

The Triglyceride Glucose Index Is a Risk Factor for Enlarged Perivascular Space

Prevalence of dementia and mild cognitive impairment in indigenous Bolivian forager‐horticulturalists

Intracranial Carotid Arteriosclerosis Mediates the Association Between Blood Pressure and Cerebral Small Vessel Disease

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