Abstract MP42: Arterial Spin Labeling Imaging Assessment of Cerebrovascular Reactivity in Hypertensive Small Vessel Disease

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Hsin-Hsi C Tsai ◽  
Bo-Ching Lee ◽  
Abel Po-Hao Huang ◽  
Li-Kai Tsai ◽  
Ya-Fang Chen ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Arterial Spin Labeling ◽  
Small Vessel Disease ◽  
Vascular Dysfunction ◽  
Spin Labeling ◽  
Cerebrovascular Reactivity ◽  
Small Vessel ◽  
Disease Score ◽  
Temporal Lobes ◽  
Vessel Disease

Objective: Cerebrovascular reactivity (CVR) represents the phenomenon that cerebral vessels dilate or constrict in response to vasoactive stimuli, and CVR impairment may contribute to the brain injury caused by cerebral small vessel disease (SVD). We aim to determine the CVR in hypertensive intracerebral hemorrhage (ICH) and to identify its vascular dysfunction. Methods: 21 patients with spontaneous hypertensive ICH (strictly deep or mixed deep and lobar hemorrhages, mean age 62.5 ± 11.3 years) and 10 control subjects (mean age 66.1 ± 6.0) were enrolled for CVR measurement. Each participant received a brain MRI study, and CVR was calculated as cerebral blood flow (CBF) change using arterial spin labeling (ASL) sequence at baseline and 10 minutes after intravenous dipyridamole injection (0.57mg/Kg). Traditional MRI markers for SVD including cerebral microbleed, white matter hyperintensity, lacune and MRI-visible enlarged perivascular space were also evaluated to determine the total small vessel disease score. Results: Hypertensive ICH patients showed reduced CVR in the basal ganglia (CBF change 22.4 ± 22.7% vs. 41.7 ± 18.3, p=0.026), the frontal (15.1 ± 11.9 vs. 26.6 ± 9.9, p=0.013) and the temporal lobes (14.7 ± 11.1 vs. 26.2 ± 10.0, p=0.010) compared to control subjects (Figure). These differences remained significant in multivariable models after adjusting for age, sex, hypertension, diabetes, and hyperlipidemia. Within ICH groups, the CBF change in basal ganglia was significantly correlated with total small vessel disease score (R=-0.58, p=0.006), but not with individual MRI markers. Conclusion: Patients with advanced HTN-SVD demonstrated impaired vasoconstriction after dipyridamole challenge in basal ganglia, frontal and temporal lobes. Our findings provide safe approaches for whole brain CVR mapping in small vessel disease, and identify the potential physiological basis of vascular dysfunction in HTN-SVD.

scholarly journals Arterial Spin Labeling Imaging Assessment of Cerebrovascular Reactivity in Hypertensive Small Vessel Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Bo-Ching Lee ◽  
Hsin-Hsi Tsai ◽  
Abel Po-Hao Huang ◽  
Yen-Ling Lo ◽  
Li-Kai Tsai ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Arterial Spin Labeling ◽  
Small Vessel Disease ◽  
Vascular Dysfunction ◽  
Spin Labeling ◽  
Cerebrovascular Reactivity ◽  
Small Vessel ◽  
Disease Score ◽  
Vessel Disease ◽  
Control Subjects

Objective: Cerebrovascular reactivity (CVR) represents the phenomenon where cerebral vessels dilate or constrict in response to vasoactive stimuli. CVR impairment may contribute to brain injury due to cerebral small vessel disease (SVD). We aimed to determine the CVR in hypertensive intracerebral hemorrhage (ICH) and to identify its vascular dysfunction.Methods: A total of 21 patients with spontaneous hypertensive ICH (strictly deep or mixed deep and lobar hemorrhages, mean age 62.5 ± 11.3 years) and 10 control subjects (mean age 66.1 ± 6.0 years) were enrolled for CVR measurement at least 3 months after the symptomatic ICH event. Each participant underwent a brain MRI study, and CVR was calculated as the cerebral blood flow (CBF) reduction using arterial spin labeling (ASL) between baseline and 10 min after an intravenous dipyridamole injection (0.57 mg/kg). Traditional MRI markers for SVD were also evaluated, including cerebral microbleed, white matter hyperintensity, lacune, and MRI-visible enlarged perivascular space, which were used to determine the total small vessel disease score.Results: Compared to control subjects, hypertensive ICH patients showed reduced CVR in the basal ganglia (CBF reduction 22.4 ± 22.7% vs. 41.7 ± 18.3, p = 0.026), the frontal lobe (15.1 ± 11.9 vs. 26.6 ± 9.9, p = 0.013), and the temporal lobe (14.7 ± 11.1 vs. 26.2 ± 10.0, p = 0.010). These differences remained significant in multivariable models after adjusting for age and sex. Within ICH groups, the CBF reduction in the basal ganglia was significantly correlated with the total small vessel disease score (R = 0.58, p = 0.006), but not with individual MRI markers.Conclusion: Patients with advanced hypertensive SVD demonstrated impaired vasoconstriction after dipyridamole challenge in the basal ganglia and the frontal and temporal lobes. Our findings provide safe approaches for whole-brain CVR mapping in SVD and identify a potential physiological basis for vascular dysfunction in hypertensive SVD.

scholarly journals Arterial Stiffness Is Associated With Basal Ganglia Enlarged Perivascular Spaces and Cerebral Small Vessel Disease Load

Stroke ◽  
2018 ◽  
Vol 49 (5) ◽  
pp. 1279-1281 ◽  
Author(s):  
Iolanda Riba-Llena ◽  
Joan Jiménez-Balado ◽  
Xavier Castañé ◽  
Anna Girona ◽  
Antonio López-Rueda ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Arterial Stiffness ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Perivascular Spaces ◽  
Vessel Disease

Abstract TMP111: Prediction of Cognitive Impairment after Intracerebral Hemorrhage using MRI Small Vessel Disease Score

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Marco Pasi ◽  
Lansing Sugita ◽  
Li Xiong ◽  
Andreas Charidimou ◽  
Gregoire Boulouis ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Intracerebral Hemorrhage ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Disease Score ◽  
Vessel Disease

scholarly journals P4-078: REPRESENTATION OF BLOOD FLOW IN PERFORATING BASAL GANGLIA ARTERIES OF PATIENTS WITH CEREBRAL SMALL VESSEL DISEASE (CSVD) AT 7 TESLA MRI

2019 ◽  
Vol 15 ◽  
pp. P1304-P1304
Author(s):  
Valentina Perosa ◽  
Emrah Düzel ◽  
Tine Arts ◽  
Stefanie Schreiber ◽  
Anne Assmann ◽  
...  
Keyword(s):  
Blood Flow ◽  
Basal Ganglia ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
7 Tesla ◽  
Vessel Disease ◽  
7 Tesla Mri

scholarly journals Cerebrovascular reactivity measurement in cerebral small vessel disease: Rationale and reproducibility of a protocol for MRI acquisition and image processing

2017 ◽  
Vol 13 (2) ◽  
pp. 195-206 ◽  
Author(s):  
Michael J Thrippleton ◽  
Yulu Shi ◽  
Gordon Blair ◽  
Iona Hamilton ◽  
Gordon Waiter ◽  
...  
Keyword(s):  
White Matter ◽  
Grey Matter ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Cerebrovascular Reactivity ◽  
Small Vessel ◽  
Minor Stroke ◽  
Reactivity Measurement ◽  
Vessel Disease ◽  
History Of

Background Impaired autoregulation may contribute to the pathogenesis of cerebral small vessel disease. Reliable protocols for measuring microvascular reactivity are required to test this hypothesis and for providing secondary endpoints in clinical trials. Aims To develop and assess a protocol for acquisition and processing of cerebrovascular reactivity by MRI, in subcortical tissue of patients with small vessel disease and minor stroke. Methods We recruited 15 healthy volunteers, testing paradigms using 1- and 3-min 6% CO2 challenges with repeat scanning, and 15 patients with history of minor stroke. We developed a protocol to measure cerebrovascular reactivity and delay times, assessing tolerability and reproducibility in grey and white matter areas. Results The 3-min paradigm yielded more reproducible data than the 1-min paradigm (CV respectively: 7.9–15.4% and 11.7–70.2% for cerebrovascular reactivity in grey matter), and was less reproducible in white matter (16.1–24.4% and 27.5–141.0%). Tolerability was similar for the two paradigms, but mean cerebrovascular reactivity and cerebrovascular reactivity delay were significantly higher for the 3-min paradigm in most regions. Patient tolerability was high with no evidence of greater failure rate (1/15 patients vs. 2/15 volunteers withdrew at the first visit). Grey matter cerebrovascular reactivity was lower in patients than in volunteers (0.110–0.234 vs. 0.172–0.313%/mmHg; p < 0.05 in 6/8 regions), as was the white matter cerebrovascular reactivity delay (16.2–43.9 vs. 31.1–47.9 s; p < 0.05 in 4/8 regions). Conclusions An effective and well-tolerated protocol for measurement of cerebrovascular reactivity was developed for use in ongoing and future trials to investigate small vessel disease pathophysiology and to measure treatment effects.

scholarly journals Microalbuminuria and the Combination of MRI Markers of Cerebral Small Vessel Disease

2016 ◽  
Vol 42 (1-2) ◽  
pp. 66-72 ◽  
Author(s):  
Andrea Vilar-Bergua ◽  
Iolanda Riba-Llena ◽  
Natalia Ramos ◽  
Xavier Mundet ◽  
Eugenia Espinel ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Basal Ganglia ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Perivascular Spaces ◽  
Vessel Disease

Background: Kidney function has been related to the presence of individual markers of cerebral small vessel disease (CSVD), as lacunes, white matter hyperintensities (WMH) or microbleeds. We aimed at studying the relationship of kidney dysfunction with the combination of several markers of CSVD. Methods: Subjects are those included in the ISSYS cohort (Investigating Silent Strokes in hypertensives: a magnetic resonance imaging study). A scale ranging from 0 to 4 points was applied based on the presence (one point each) of lacunes, deep microbleeds, moderate to extensive basal ganglia enlarged perivascular spaces (EPVS), and periventricular or deep WMH. We determined the creatinine-based glomerular filtration rate and the urinary albumin-to-creatinine ratio (UACR) as markers of kidney function and studied their association with the scale of CSVD in univariate and ordinal logistic regression analyses. Results: Among the 975 patients included, 28.2% presented one or more CSVD markers, being the most prevalent marker (either alone or in combination) basal ganglia EPVS. The UACR was elevated at increasing the scores of the CSVD scale and remained as independent predictor of the combination of markers (common OR per natural log unit increase in UACR: 1.23, 1.07-1.41) after controlling per age, gender, cardiovascular risk, antihypertensive treatment and hypertension duration. In contrast, no associations were found between the CSVD scores and the creatinine-based estimated glomerular filtration rate. Conclusions: A significant proportion of stroke-free hypertensives present at least one imaging marker of CSVD. UACR but not creatinine-based glomerular filtration rate is associated with the combination of markers of CSVD.

scholarly journals Total Small Vessel Disease Score in Neurologically Healthy Japanese Adults in the Kashima Scan Study

2018 ◽  
Vol 57 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Yusuke Yakushiji ◽  
Andreas Charidimou ◽  
Tomoyuki Noguchi ◽  
Masashi Nishihara ◽  
Makoto Eriguchi ◽  
...  
Keyword(s):  
Small Vessel Disease ◽  
Small Vessel ◽  
Disease Score ◽  
Vessel Disease ◽  
Japanese Adults
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