Abstract WMP59: White Matter Hyperintensities Play a Pivotal Role in Progression of Cerebral Small Vessel Disease: A 7-Year Chinese Urban Community Study

Objective: To explore the role of WMH in progression of CSVD in an urban community in China over a period of 7 years, and to investigate associations between WMH volume (baseline & progression) and cognitive impairment. Methods: CSVD markers and neuropsychological tests at baseline and follow-up of 191 participants of the Shanghai Aging Study (SAS) were assessed. WMH volume were assessed by automatic segmentation based on U-net model. Lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces (ePVS) were rated manually. SVD score was rated as the total burden of CSVD markers. We performed multivariate linear regression and binominal logistic regression. We plotted progression of markers by baseline WMH volume in tertile. Results: Participants with higher baseline WMH volume developed more progression of WMH volume, increased risk of incident lacunes, incident CMBs, and ePVS progression. Mean change of WMH volume over 7 years was 4.27mL (0.62mL/y) for all participants, 3.21mL for participants with 1st tertile WMH volume at baseline, 4.19mL for those with 2nd tertile WMH, and 5.43mL for those with 3rd tertile WMH. Incident lacunes and incident CMBs were predominantly seen in participants with 2nd and 3rd tertile WMH. WMH (baseline & progression) were associated with decline of executive function. Conclusions: WMH play a pivotal role in progression of cerebral small vessel disease and are associated with decline of executive function in a Chinese urban community study over a period of 7 years.

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The INECO Frontal Screening for the Evaluation of Executive Dysfunction in Cerebral Small Vessel Disease: Evidence from Quantitative MRI in a CADASIL Cohort from Colombia

Journal of the International Neuropsychological Society ◽

10.1017/s1355617720000533 ◽

2020 ◽

Vol 26 (10) ◽

pp. 1006-1018 ◽

Cited By ~ 1

Author(s):

Dorothee Schoemaker ◽

Yesica Zuluaga ◽

Anand Viswanathan ◽

Markus Shrimer ◽

Heirangi Torrico-Teave ◽

...

Keyword(s):

Executive Function ◽

Screening Tool ◽

Small Vessel Disease ◽

Characteristic Curve ◽

Executive Dysfunction ◽

Cerebral Small Vessel Disease ◽

Quantitative Mri ◽

Small Vessel ◽

Perivascular Spaces ◽

Vessel Disease

AbstractObjectives:Executive dysfunction is a predominant cognitive symptom in cerebral small vessel disease (SVD). The Institute of Cognitive Neurology Frontal Screening (IFS) is a well-validated screening tool allowing the rapid assessment of multiple components of executive function in Spanish-speaking individuals. In this study, we examined performance on the IFS in subjects with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), an inherited condition leading to the early onset of SVD. We further explored associations between performance on the IFS and magnetic resonance imaging (MRI) markers of SVD.Methods:We recruited 24 asymptomatic CADASIL subjects and 23 noncarriers from Colombia. All subjects underwent a research MRI and a neuropsychological evaluation, including the IFS. Structural MRI markers of SVD were quantified in each subject, together with an SVD Sum Score representing the overall burden of cerebrovascular alterations. General linear model, correlation, and receiver operating characteristic curve analyses were used to explore group differences on the IFS and relationships with MRI markers of SVD.Results:CADASIL subjects had a significantly reduced performance on the IFS Total Score. Performance on the IFS correlated with all quantified markers of SVD, except for brain atrophy and perivascular spaces enlargement. Finally, while the IFS Total Score was not able to accurately discriminate between carriers and noncarriers, it showed adequate sensitivity and specificity in detecting the presence of multiple MRI markers of SVD.Conclusions:These results suggest that the IFS may be a useful screening tool to assess executive function and disease severity in the context of SVD.

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White matter hyperintensities associated with progression of cerebral small vessel disease: a 7-year Chinese urban community study

Aging ◽

10.18632/aging.103154 ◽

2020 ◽

Vol 12 (9) ◽

pp. 8506-8522

Author(s):

Yiwei Xia ◽

Yi Shen ◽

Yi Wang ◽

Lumeng Yang ◽

Yiqing Wang ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Small Vessel Disease ◽

Urban Community ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Community Study ◽

Vessel Disease

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Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes

Stroke and Vascular Neurology ◽

10.1136/svn-2019-000305 ◽

2020 ◽

Vol 5 (2) ◽

pp. 128-137

Author(s):

Huimin Chen ◽

Yuesong Pan ◽

Lixia Zong ◽

Jing Jing ◽

Xia Meng ◽

...

Keyword(s):

Regression Models ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Arterial Stenosis ◽

Small Vessel ◽

Minor Stroke ◽

Bleeding Events ◽

Stroke Outcomes ◽

Vessel Disease ◽

Increased Risk

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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Circulating biologic markers of endothelial dysfunction in cerebral small vessel disease: A review

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2015.116 ◽

2015 ◽

Vol 36 (1) ◽

pp. 72-94 ◽

Cited By ~ 98

Author(s):

Anna Poggesi ◽

Marco Pasi ◽

Francesca Pescini ◽

Leonardo Pantoni ◽

Domenico Inzitari

Keyword(s):

Endothelial Dysfunction ◽

Endothelial Function ◽

Small Vessel Disease ◽

Brain Magnetic Resonance Imaging ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Perivascular Spaces ◽

Vessel Disease ◽

Brain Changes

The term cerebral small vessel disease (SVD) refers to a group of pathologic processes with various etiologies that affect small arteries, arterioles, venules, and capillaries of the brain. Magnetic resonance imaging (MRI) correlates of SVD are lacunes, recent small subcortical infarcts, white-matter hyperintensities, enlarged perivascular spaces, microbleeds, and brain atrophy. Endothelial dysfunction is thought to have a role in the mechanisms leading to SVD-related brain changes, and the study of endothelial dysfunction has been proposed as an important step for a better comprehension of cerebral SVD. Among available methods to assess endothelial function in vivo, measurement of molecules of endothelial origin in peripheral blood is currently receiving selective attention. These molecules include products of endothelial cells that change when the endothelium is activated, as well as molecules that reflect endothelial damage and repair. This review examines the main molecular factors involved in both endothelial function and dysfunction, and the evidence linking endothelial dysfunction with cerebral SVD, and gives an overview of clinical studies that have investigated the possible association between endothelial circulating biomarkers and SVD-related brain changes.

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Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Brain ◽

10.1093/brain/awh553 ◽

2005 ◽

Vol 128 (9) ◽

pp. 2034-2041 ◽

Cited By ~ 420

Author(s):

Niels D. Prins ◽

Ewoud J. van Dijk ◽

Tom den Heijer ◽

Sarah E. Vermeer ◽

Jellemer Jolles ◽

...

Keyword(s):

Information Processing ◽

Executive Function ◽

Processing Speed ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Information Processing Speed ◽

Vessel Disease

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Beyond attention, executive function & memory—Re‐socializing cerebral small vessel disease

Alzheimer s & Dementia ◽

10.1002/alz.12391 ◽

2021 ◽

Author(s):

Matthias L. Schroeter

Keyword(s):

Executive Function ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vessel Disease

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Abstract P332: Cerebral Small Vessel Disease Score in CADASIL: Relationships to Cognitive Dysfunctions

Stroke ◽

10.1161/str.52.suppl_1.p332 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Dorothee Schoemaker ◽

Yesica Zuluaga ◽

Lina Velilla ◽

Carolina Ospina ◽

Francisco Lopera ◽

...

Keyword(s):

Small Vessel Disease ◽

Structural Mri ◽

Vascular Cognitive Impairment ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

White Matter Hyperintensity ◽

Perivascular Spaces ◽

Cerebrovascular Injury ◽

Vessel Disease ◽

History Of

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral small vessel disease (cSVD) linked to NOTCH3 mutations and leading to the early onset of stroke and vascular cognitive impairment. Neuroimaging features of CADASIL include extensive white matter hyperintensity, lacunes, cerebral microbleeds and enlarged perivascular spaces. Researchers from the Rotterdam study recently proposed a MRI-based cSVD Score reflecting the overall burden of cerebrovascular injury (Yilmaz et al., 2018). Here, we explored the relevance of this cSVD Score in distinguishing CADASIL subjects from non-carriers and its relationships to cognition. We evaluated 26 NOTCH3 mutation carriers and 25 non-carriers from large Colombian families. Of the CADASIL subjects, 4 had previous strokes (symptomatic) and 22 had no history of strokes (asymptomatic). All subjects underwent a 3T MRI and a neuropsychological evaluation. Structural MRI markers of cSVD, as well as the cSVD Score, were quantified in each subject following established protocols. Demographic, cognitive and neuroimaging features across groups are presented in Table 1. The cSVD Score significantly differed between groups, after adjusting for age (Figure 1-A). In CADASIL subjects, the cSVD Score was negatively related to performance in Memory, Processing Speed, Executive Function, after accounting for age and education (Figure 1-B). These results suggest that the cSVD Score could be a useful marker of disease severity in CADASIL. Longitudinal studies are now needed to determine if this score allows predicting clinical outcomes in CADASIL, such as stroke or dementia.

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Total Cerebral Small Vessel Disease Burden on MRI Correlates With Cognitive Impairment in Outpatients With Amnestic Disorders

Frontiers in Neurology ◽

10.3389/fneur.2021.747115 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yangyi Fan ◽

Yicheng Xu ◽

Ming Shen ◽

Huailian Guo ◽

Zhaoxu Zhang

Keyword(s):

Linear Regression ◽

Regression Model ◽

Linear Regression Model ◽

Small Vessel Disease ◽

Multiple Linear Regression Model ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Perivascular Spaces ◽

Vessel Disease ◽

Moca Score

Objectives: The main markers of cerebral small vessel disease (cSVD) on MRI may be entered into a scoring system, with the total score representing the overall burden of cSVD. An association between total cSVD score and cognitive dysfunction has been reported in several cohorts. The present study aimed to investigate this association in outpatients with amnestic disorders.Materials and Methods: Outpatients with amnestic complaints in a memory clinic (n = 289) were recruited retrospectively. All the patients had undergone clinical and cognitive evaluation at first presentation. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) scale. The total cSVD score was based on the following markers on MRI: lacune; white matter hyperintensities, microbleed, and enlarged perivascular spaces. The association between total cSVD score and MoCA score was tested via Spearman's analysis and a linear regression model.Results: Among the 289 patients, rates for 0–4 cSVD markers respectively ranged from 30.4 to 2.8%. A multiple linear regression model revealed an inverse correlation between the total cSVD score and MoCA score. The association remained significant after adjusting for gender, age, education, levels of medial temporal lobe atrophy, and classical vascular risk factors [β = −0.729, 95% CI (−1.244, −0.213); P = 0.006]. When individual markers were individually analyzed after adjusting for the same factors, only microbleed associated with MoCA score [β = −3.007, 95% CI (−4.533, −1.480), P < 0.001].Conclusions: A significant association was demonstrated between total cSVD score and cognitive performance in the outpatients with amnestic disorders.

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