Risk factor profile of cerebral small vessel disease and its subtypes

AbstractSevere acute respiratory syndrome corona virus-2 (SARS-CoV-2) due to novel coronavirus disease 2019 (COVID-19) has affected the global society in numerous unprecedented ways, with considerable morbidity and mortality. Both direct and indirect consequences from COVID-19 infection are recognized to give rise to cardio- and cerebrovascular complications. Despite current limited knowledge on COVID-19 pathogenesis, inflammation, endothelial dysfunction, and coagulopathy appear to play critical roles in COVID-19-associated cerebrovascular disease (CVD). One of the major subtypes of CVD is cerebral small vessel disease (CSVD) which represents a spectrum of pathological processes of various etiologies affecting the brain microcirculation that can trigger subsequent neuroinflammation and neurodegeneration. Prevalent with aging, CSVD is a recognized risk factor for stroke, vascular dementia, and Alzheimer’s disease. In the background of COVID-19 infection, the heightened cellular activations from inflammations and oxidative stress may result in elevated levels of microthrombogenic extracellular-derived circulating microparticles (MPs). Consequently, MPs could act as pro-coagulant risk factor that may serve as microthrombi for the vulnerable microcirculation in the brain leading to CSVD manifestations. This review aims to appraise the accumulating body of evidence on the plausible impact of COVID-19 infection on the formation of microthrombogenic MPs that could lead to microthrombosis in CSVD manifestations, including occult CSVD which may last well beyond the pandemic era.

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Cerebral small-vessel disease : vascular risk factor profiles, clinical manifestations, and disease progression in stroke

10.26481/dis.19971219mz ◽

1997 ◽

Author(s):

M.S.G. van Zagten

Keyword(s):

Risk Factor ◽

Disease Progression ◽

Small Vessel Disease ◽

Clinical Manifestations ◽

Vascular Risk Factor ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vascular Risk ◽

Vessel Disease

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Microalbuminuria is a risk factor for cerebral small vessel disease in community-based elderly subjects

Journal of the Neurological Sciences ◽

10.1016/j.jns.2007.01.066 ◽

2007 ◽

Vol 255 (1-2) ◽

pp. 27-34 ◽

Cited By ~ 73

Author(s):

Manabu Wada ◽

Hikaru Nagasawa ◽

Keiji Kurita ◽

Shingo Koyama ◽

Shigeki Arawaka ◽

...

Keyword(s):

Risk Factor ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Elderly Subjects ◽

Community Based ◽

Vessel Disease

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Sex differences in Cerebral Small Vessel Disease: a systematic review and meta-analysis

10.1101/2021.03.04.21252853 ◽

2021 ◽

Cited By ~ 1

Author(s):

Lorena Jiménez-Sánchez ◽

Olivia K. L. Hamilton ◽

Una Clancy ◽

Ellen V. Backhouse ◽

Catriona R. Stewart ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Risk Factor ◽

Small Vessel Disease ◽

Sex Ratios ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Community Based ◽

Vessel Disease ◽

Male To Female

AbstractBackgroundCerebral small vessel disease (SVD) is an important cause of acute ischemic stroke and vascular dementia. Several studies recruiting more males than females have reported sex differences regarding SVD incidence and severity, but it is unclear whether this reflects underlying sex-specific mechanisms or recruitment bias. This work aimed to systematically review and meta-analyze potential sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution and severity of SVD features.MethodsFull text of 228 studies from four databases of recent systematic reviews on SVD and an independent search of MEDLINE were evaluated against inclusion and exclusion criteria (registered protocol: CRD42020193995). Data from participants with clinical or non-clinical presentations of SVD with radiological evidence of SVD were extracted. Sex ratios of total participants or SVD groups were calculated and differences in sex ratios across time, countries, SVD severity and risk factors for SVD were explored.ResultsAmongst 123 relevant studies (n = 36,910 participants) including 53 community-based, 67 hospital-based and 3 mixed studies, more males were recruited in hospital-based than in community-based studies (M:F = 1.16 (0.70) vs M:F = 0.79 (0.35), respectively; p <0.001). More males had moderate to severe SVD (M:F = 1.08 (0.81) vs M:F = 0.82 (0.47) in healthy to mild SVD; p <0.001), especially in stroke presentations where M:F was 1.67 (0.53). M:F of recent research (2015-2020) did not differ from that published pre-2015 and no geographical trends were apparent. There were insufficient sex-stratified data to explore M:F and risk factors for SVD.ConclusionsOur results highlight differences in male-to-female ratios in SVD that may reflect sex-specific variability in risk factor exposures, study participation, clinical recognition, genuine SVD severity, or clinical presentation and have important clinical and translational implications.

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