Sex and cerebral small vessel disease‐specific longitudinal trajectories of amyloid, tau, and neurodegeneration

BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589

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Lenticulostriate artery combined with neuroimaging markers of cerebral small vessel disease differentiate the pathogenesis of recent subcortical infarction

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x21992622 ◽

2021 ◽

pp. 0271678X2199262

Author(s):

Shuai Jiang ◽

Tian Cao ◽

Yuying Yan ◽

Tang Yang ◽

Ye Yuan ◽

...

Keyword(s):

Magnetic Resonance ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vessel Disease ◽

Branch Atheromatous Disease ◽

Lenticulostriate Artery ◽

Subcortical Infarction

Recent subcortical infarction (RSI) in the lenticulostriate artery (LSA) territory with a non-stenotic middle cerebral artery is a heterogeneous entity. We aimed to investigate the role of LSA combined with neuroimaging markers of cerebral small vessel disease (CSVD) in differentiating the pathogenic subtypes of RSI by whole-brain vessel-wall magnetic resonance imaging (WB-VWI). Fifty-two RSI patients without relevant middle cerebral artery (MCA) stenosis on magnetic resonance angiography were prospectively enrolled. RSI was dichotomized as branch atheromatous disease (BAD; a culprit plaque located adjacent to the LSA origin) (n = 34) and CSVD-related lacunar infarction (CSVD-related LI; without plaque or plaque located distal to the LSA origin) (n = 18). Logistic regression analysis showed lacunes (odds ratio [OR] 9.68, 95% confidence interval [CI] 1.71–54.72; P = 0.010) and smaller number of LSA branches (OR 0.59, 95% CI 0.36–0.96; P = 0.034) were associated with of BAD, whereas severe deep white matter hyperintensities (DWMH) (OR 0.11, 95% CI 0.02–0.71; P = 0.021) was associated with CSVD-related LI. In conclusion, the LSA branches combined with lacunes and severe DWMH may delineate subtypes of SSI. The WB-VWI technique could be a credible tool for delineating the heterogeneous entity of SSI in the LSA territory.

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Genotype–phenotype correlations of heterozygous HTRA1-related cerebral small vessel disease: case report and systematic review

Neurogenetics ◽

10.1007/s10048-021-00646-5 ◽

2021 ◽

Author(s):

Haohan Zhang ◽

Xiaoming Qin ◽

Yingying Shi ◽

Xinya Gao ◽

Fengyu Wang ◽

...

Keyword(s):

Systematic Review ◽

Case Report ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vessel Disease ◽

Disease Case

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Total Cerebral Small Vessel Disease Score and Anthropometric Indices: A Population-Based Study in Older Adults of Amerindian Ancestry

European Neurology ◽

10.1159/000517915 ◽

2021 ◽

pp. 1-4

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera

Keyword(s):

Older Adults ◽

Small Vessel Disease ◽

Brain Magnetic Resonance Imaging ◽

Population Based ◽

Cerebral Small Vessel Disease ◽

The Body ◽

Small Vessel ◽

Population Based Study ◽

Vessel Disease ◽

Ordinal Logistic Regression Model

A total of 590 older adults of Amerindian ancestry living in rural Ecuador received anthropometric measurements and a brain magnetic resonance imaging to estimate the total cerebral small vessel disease (cSVD) score. A fully adjusted ordinal logistic regression model, with categories of the total cSVD score as the dependent variable, disclosed significant associations between the waist circumference, the waist-to-hip, and the waist-to-height ratios – but not the body mass index (BMI) – and the cSVD burden. Indices of abdominal obesity may better correlate with severity of cSVD than the BMI in Amerindians. Phenotypic characteristics of this population may account for these results.

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Small Blood Vessel Disease in the Brain Theme Issue Overlapping protein accumulation profiles of CADASIL and CAA: Is there a common mechanism driving cerebral small vessel disease?

American Journal Of Pathology ◽

10.1016/j.ajpath.2020.11.015 ◽

2020 ◽

Author(s):

Kelly Z. Young ◽

Gang Xu ◽

Simon G. Keep ◽

Jimo Borjigin ◽

Michael M. Wang

Keyword(s):

Blood Vessel ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Common Mechanism ◽

Protein Accumulation ◽

Theme Issue ◽

Small Blood Vessel ◽

Vessel Disease ◽

The Brain

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Higher Cerebral Small Vessel Disease Burden in Patients with White Matter Recent Small Subcortical Infarcts

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2021.105824 ◽

2021 ◽

Vol 30 (7) ◽

pp. 105824

Author(s):

Salvatore Rudilosso ◽

Luis Mena ◽

Diana Esteller ◽

Marta Olivera ◽

Juan José Mengual ◽

...

Keyword(s):

White Matter ◽

Disease Burden ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vessel Disease

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Cerebral Small Vessel Disease

International Journal of Molecular Sciences ◽

10.3390/ijms21249729 ◽

2020 ◽

Vol 21 (24) ◽

pp. 9729

Author(s):

Jakub Litak ◽

Marek Mazurek ◽

Bartłomiej Kulesza ◽

Paweł Szmygin ◽

Joanna Litak ◽

...

Keyword(s):

Small Vessel Disease ◽

Current Knowledge ◽

Cerebral Small Vessel Disease ◽

Cerebral Vessels ◽

Small Vessel ◽

Epithelial Layer ◽

Small Arteries ◽

Vessel Disease ◽

The Impact ◽

Cerebral Small Vessel Diseases

Cerebral small vessel disease (CSVD) represents a cluster of various vascular disorders with different pathological backgrounds. The advanced vasculature net of cerebral vessels, including small arteries, capillaries, arterioles and venules, is usually affected. Processes of oxidation underlie the pathology of CSVD, promoting the degenerative status of the epithelial layer. There are several classifications of cerebral small vessel diseases; some of them include diseases such as Binswanger’s disease, leukoaraiosis, cerebral microbleeds (CMBs) and lacunar strokes. This paper presents the characteristics of CSVD and the impact of the current knowledge of this topic on the diagnosis and treatment of patients.

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