scholarly journals Microvessel stenosis, enlarged perivascular spaces, and fibrinogen deposition are associated with ischemic periventricular white matter hyperintensities

2021 ◽  
Author(s):  
Austyn D. Roseborough ◽  
Berk Rasheed ◽  
Youngkyung Jung ◽  
Kevin Nishimura ◽  
William Pinsky ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Periventricular White Matter ◽  
Perivascular Spaces ◽  
Fibrinogen Deposition

scholarly journals Association between Perivascular Spaces and Progression of White Matter Hyperintensities in Lacunar Stroke Patients

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0137323 ◽  
Author(s):  
Caroline M. J. Loos ◽  
Pim Klarenbeek ◽  
Robert J. van Oostenbrugge ◽  
Julie Staals
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Perivascular Spaces ◽  
Lacunar Stroke ◽  
Stroke Patients

scholarly journals Collateral Recruitment Is Impaired by Cerebral Small Vessel Disease

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1404-1410 ◽  
Author(s):  
Michelle P. Lin ◽  
Thomas G. Brott ◽  
David S. Liebeskind ◽  
James F. Meschia ◽  
Kevin Sam ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Cerebral Microbleeds ◽  
Large Vessel ◽  
Small Vessel ◽  
Perivascular Spaces ◽  
Vessel Disease ◽  
Poor Recruitment

Background and Purpose— Cerebral small vessel disease (SVD) is associated with increased stroke risk and poor stroke outcomes. We aimed to evaluate whether chronic SVD burden is associated with poor recruitment of collaterals in large-vessel occlusive stroke. Methods— Consecutive patients with middle cerebral artery or internal carotid artery occlusion presenting within 6 hours after stroke symptom onset who underwent thrombectomy from 2012 to 2017 were included. The prespecified primary outcome was poor collateral flow, which was assessed on baseline computed tomographic angiography (poor, ≤50% filling; good, >50% filling). Markers of chronic SVD on brain magnetic resonance imaging were rated for the extent of white matter hyperintensities, enlarged perivascular spaces, chronic lacunar infarctions and cerebral microbleeds using the Standards for Reporting Vascular Changes on Neuroimaging criteria. Severity of SVD was quantified by adding the presence of each SVD feature, with a total possible score of 0 to 4; each SVD type was also evaluated separately. Multivariable logistic regression analyses were performed to evaluate the relationships between SVD and poor collaterals, with adjustment for potential confounders. Results— Of the 100 eligible patients, the mean age was 65±16 years, median National Institutes of Health Stroke Scale score was 15, and 68% had any SVD. Poor collaterals were observed in 46%, and those with SVD were more likely to have poor collaterals than patients without SVD (aOR, 1.9 [95% CI, 1.1–3.2]). Of the SVD types, poor collaterals were significantly associated with white matter hyperintensities (aOR, 2.9 per Fazekas increment [95% CI, 1.6–5.3]) but not with enlarged perivascular spaces (adjusted odds ratio [aOR], 1.3 [95% CI, 0.4–4.0]), lacunae (aOR, 2.1 [95% CI, 0.6–7.1]), or cerebral microbleeds (aOR, 2.1 [95% CI, 0.6–7.8]). Having a greater number of different SVD markers was associated with a higher odds of poor collaterals (crude trend P <0.001; adjusted P =0.056). There was a dose-dependent relationship between white matter hyperintensity burden and poor collaterals: adjusted odds of poor collaterals were 1.5, 3.0, and 9.7 across Fazekas scores of 1 to 3 ( P trend=0.015). No patient with an SVD score of 4 had good collaterals. Conclusions— Chronic cerebral SVD is associated with poor recruitment of collaterals in large vessel occlusive stroke. A prospective study to elucidate the potential mechanism of how SVD may impair the recruitment of collaterals is ongoing.

Abstract MP057: Subclinical Cerebrovascular Disease is Associated with Worsening Gait and Balance in an Elderly Multi-Ethnic Population: The Northern Manhattan Study (NOMAS)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Joshua Z Willey ◽  
Yeseon Park Moon ◽  
Janet DeRosa ◽  
Erin Kulick ◽  
Sandino Cespedes ◽  
...  
Keyword(s):  
White Matter ◽  
Cerebrovascular Disease ◽  
White Matter Hyperintensities ◽  
Physical Aging ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
The Elderly ◽  
Brain Regions ◽  
Periventricular White Matter ◽  
Age Related

Introduction: Age-related decline in gait and balance is a contributor to morbidity in the elderly. Subclinical cerebrovascular disease, seen on magnetic resonance imaging (MRI) as white matter hyperintensities (WMH) and silent brain infarcts (SBI), is associated with impaired mobility. Less is known about the association of WMH in specific brain regions and mobility impairment. We hypothesized that anterior WMH volume would be associated with lower scores on the Short Physical Performance Battery (SPPB), a well-validated mobility scale associated with falls and mortality in the elderly. Methods: Participants in the Northern Manhattan Study MRI cohort had the SPPB measured a median of 5 years after enrollment. The SPPB has three domains with a maximum total score of 12: gait speed, chair stands, standing balance. Volumetric distributions for WMH volume across 14 brain regions (brainstem, cerebellum, and bilateral frontal, occipital, temporal, and parietal lobes, and bilateral anterior and posterior periventricular white matter) were determined separately for each hemisphere by combining bimodal image intensity distribution and atlas based methods. Multi-variable linear regression was performed to examine the association between SBI and total and regional (frontal, parietal, occipital, temporal, anterior, posterior, and brainstem) head size-corrected WMH volumes, with the total SPPB score; models were adjusted for cardiovascular disease risk factors, osteo-arthritis, and grip strength. Results: Among 668 stroke-free participants with the SPPB available, mean age at the time of assessment was 74 ±9 years, 37% were male and 70% Hispanic; the mean SPPB score was 8.2 ± 2.9, interquartile range 7-10. Mean total WMHV was 0.55±0.75cc, mean anterior WMH volume 0.18±0.24cc, and 12% of participants had SBI. In multi-variable models, total WMHV was associated with a lower SPPB (beta = -0.3 per SD of logWMH, p=0.004), while SBI was not (beta= -0.12, p=0.7). For regional WMH volumes, only greater anterior periventricular WMHV was associated with SPPB (beta= -0.29 per SD, p=0.009). Conclusions: White matter hyperintensities, especially in the anterior cerebral regions, are associated with a lower SPPB. Prevention of subclinical cerebrovascular disease is a potential target to prevent physical aging in the elderly.

scholarly journals White Matter Hyperintensities and Their Association With Suicidally in Major Affective Disorders: A Meta-Analysis of Magnetic Resonance Imaging Studies

CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 375-381 ◽  
Author(s):  
Maria Conceição Grangeon ◽  
Camila Seixas ◽  
Lucas C. Quarantini ◽  
Angela Miranda-Scippa ◽  
Maurizio Pompili ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Meta Analysis ◽  
Periventricular White Matter ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
History Of ◽  
Bipolar Patients

ABSTRACTIntroduction: Individuals who have deep and periventricular white matter hyperintensities may have a higher risk for suicidal behavior. There are mixed results in the literature regarding whether unipolar or bipolar patients who have attempted suicide have more deep white matter hyperintensities (DWMH) or periventricular hyperintensities (PVH) relative to those who have no history of suicide attempts.Methods: A meta-analysis of studies examining white matter hyperintensities (WMH) in mood disorder patients with and without a history of suicide attempts was performed.Results: Four studies, including a total of 173 patients who attempted suicide and 183 who did not attempt suicide, were included. A significantly higher number of attempters were found to have WMH than non-attempters. Unipolar depressed patients who had attempted suicide had 1.9 times more DWMH and 2.1 times more PVH than those who did not. Bipolar patients who had attempted suicide had 5.4 times more PVH than those who had not. Taken together, unipolar and bipolar patients who had attempted suicide had 2.8 times more DWMH and 4.5 times more PVH than those who had never attempted suicide.

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