Cerebral Small Vessel Disease Burden Is Associated with Motor Performance of Lower and Upper Extremities in Community-Dwelling Populations

Some degree of ischemic injury to white matter tracts occurs naturally with age and is visible on magnetic resonance imaging as focal or confluent white matter hyperintensities (WMHs). Its relationship to cognition, however, remains unclear. To explore this, community-dwelling adults between the ages 55-80 years old completed structural imaging, neuropsychological testing, and questionnaires to provide objective measures and subjective experience of executive functioning. Volumetric lesion burden derived from structural MRI identified those with significant WMH burden (~10 cubic cm). Half of those recruited met this criterion and were designated as the cerebral small vessel disease (CSVD) group. Subjective complaints but not objective test scores differentiated adults with and without CSVD. Hierarchical clustering revealed two CSVD subgroups that differentiated those with impaired versus preserved executive function relative to controls. Overall these results provide some explanation for behavioural heterogeneity often observed in studies of age-related white matter changes. They also support the use of questionnaires to assess subjective complaints that may be able to detect subtle effects of pathology not evident on standardized cognitive scores.

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Cerebral Small Vessel Disease Burden and All-Cause Mortality: Mayo Clinic Florida Familial Cerebrovascular Diseases Registry

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2019.07.001 ◽

2019 ◽

Vol 28 (12) ◽

pp. 104285 ◽

Cited By ~ 1

Author(s):

Eric D. Goldstein ◽

Mohammed K. Badi ◽

Tasneem F. Hasan ◽

Elizabeth R. Lesser ◽

David O. Hodge ◽

...

Keyword(s):

Mayo Clinic ◽

Disease Burden ◽

Small Vessel Disease ◽

Cerebrovascular Diseases ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Vessel Disease ◽

All Cause Mortality

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The relation between total cerebral small vessel disease burden and gait impairment in patients with minor stroke

International Journal of Stroke ◽

10.1177/1747493017730780 ◽

2017 ◽

Vol 13 (5) ◽

pp. 518-524 ◽

Cited By ~ 10

Author(s):

Caroline MJ Loos ◽

Caroline McHutchison ◽

Vera Cvoro ◽

Stephen DJ Makin ◽

Julie Staals ◽

...

Keyword(s):

Disease Burden ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Minor Stroke ◽

Lacunar Stroke ◽

Gait Impairment ◽

Vessel Disease ◽

Stroke Impact Scale ◽

Impact Scale

Background and aims Individual MRI markers of cerebral small vessel disease are associated with gait impairment. The impact of total cerebral small vessel disease-related brain damage, expressed by a cerebral small vessel disease MRI burden score, on mobility after stroke, has not been considered, although this score gives a better representation of the overall effect of cerebral small vessel disease on the brain. We determined if the total cerebral small vessel disease burden is associated with gait impairment three years after minor stroke. Methods In total, 200 patients with minor lacunar or non-lacunar stroke (NIHSS ≤ 7) underwent a brain MRI at presentation. Presence of lacunes, white matter hyperintensities, cerebral microbleeds, and perivascular spaces were summed in a total cerebral small vessel disease MRI burden score (range 0–4). Gait disturbances, measured by timed-up-and-go test and self-reported stroke impact scale mobility domain were assessed three years after stroke. We tested associations adjusted for key variables by linear regression analysis. Results Total cerebral small vessel disease burden was not associated with gait impairment after minor stroke in all patients, nor in lacunar stroke patients ( n = 87). In non-lacunar stroke patients ( n = 113), total cerebral small vessel disease burden was associated with lower stroke impact scale mobility domain scores, independent of age, vascular risk factors, and stroke severity (unstandardized B −4.61; 95% CI −8.42; −0.79, p < 0.05). Conclusion Patients with non-lacunar stroke and a higher total cerebral small vessel disease burden have more subjective mobility impairment three years after stroke. The total cerebral small vessel disease MRI burden score is a possible marker to identify patients at risk for subjective gait impairment. These findings should be confirmed in larger studies.

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Association of cerebral small vessel disease burden with brain structure and cognitive and vascular risk trajectories in mid-to-late life

10.1101/2021.04.13.21255391 ◽

2021 ◽

Author(s):

Michelle G Jansen ◽

Ludovica Griffanti ◽

Clare E Mackay ◽

Melis Anatürk ◽

Luca Melazzini ◽

...

Keyword(s):

Brain Structure ◽

Small Vessel Disease ◽

Late Life ◽

Cognitive Status ◽

Cerebral Small Vessel Disease ◽

Community Dwelling ◽

Small Vessel ◽

Vascular Risk ◽

Linear Mixed Effects ◽

Vessel Disease

We characterize the associations of total cerebral small vessel disease (SVD) burden with brain structure, trajectories of vascular risk factors, and cognitive functions in mid-to-late life. Participants were 623 community-dwelling adults from the Whitehall II Imaging Sub-study with multi-modal MRI (mean age 69.96 SD=5.18, 79% men). We used linear mixed-effects models to investigate associations of SVD burden with up to 25-year retrospective trajectories of vascular risk and cognitive performance. General linear modelling was used to investigate concurrent associations with grey matter (GM) density and white matter (WM) microstructure, and whether these associations were modified by cognitive status (Montreal Cognitive Assessment, MoCA). Severe SVD burden in older age was associated with higher mean arterial pressure throughout midlife (β=3.36, 95% CI [0.42—6.30]), and faster 25-year cognitive decline in letter fluency (β=-0.07, 95% CI [-0.13—-0.01]), and verbal reasoning (β=-0.05, 95% CI [-0.11—-0.001]). Moreover, SVD burden was related to lower GM volumes in 9.7% of total GM, and widespread WM microstructural decline (FWE-corrected p<0.05). The latter association was most pronounced in individuals with cognitive impairments on MoCA (F3,608=2.14, p=0.007). These findings highlight the importance of managing midlife vascular health to preserve brain structure and cognitive function in old age.

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Cerebral small vessel disease is associated with gait disturbance among community-dwelling elderly individuals: the Taizhou imaging study

Aging ◽

10.18632/aging.102779 ◽

2020 ◽

Vol 12 (3) ◽

pp. 2814-2824 ◽

Cited By ~ 3

Author(s):

Peixi Li ◽

Yingzhe Wang ◽

Yanfeng Jiang ◽

Kexun Zhang ◽

Qi Yang ◽

...

Keyword(s):

Small Vessel Disease ◽

Imaging Study ◽

Cerebral Small Vessel Disease ◽

Community Dwelling ◽

Gait Disturbance ◽

Small Vessel ◽

Elderly Individuals ◽

Vessel Disease

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Disrupted Rest-Activity Rhythms and Cerebral Small Vessel Disease Pathology in Older Adults

Stroke ◽

10.1161/strokeaha.120.030870 ◽

2021 ◽

Author(s):

Rosa Sommer ◽

Lei Yu ◽

Julie A. Schneider ◽

David A. Bennett ◽

Aron S. Buchman ◽

...

Keyword(s):

Older Adults ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Community Dwelling ◽

Small Vessel ◽

Activity Rhythms ◽

Logistic Regression Models ◽

Vessel Disease ◽

Lower Amplitude ◽

Rest Activity

Background and Purpose: The pathogenesis of cerebral small vessel disease remains incompletely understood. The relationship between circadian rhythm disturbances and histopathologic measures of cerebral small vessel disease has not been studied. We hypothesized that disrupted circadian rest-activity rhythms would be associated with a higher burden of cerebral small vessel disease pathology. Methods: We studied 561 community-dwelling older adults (mean age at death, 91.2, 27.4% male) from the Rush Memory and Aging Project. We used actigraphy to quantify several measures of 24-hour rest-activity rhythmicity, including interdaily stability, intradaily variability, and amplitude, and used ordinal logistic regression models to relate these measures to the severity of cerebral arteriolosclerosis, atherosclerosis, macroinfarcts, and microinfarcts, assessed at autopsy. Results: Lower interdaily stability was associated with a higher burden of arteriolosclerosis, higher intradaily variability was associated with a higher burden of atherosclerosis and subcortical infarcts, and lower amplitude was associated with a higher burden of arteriosclerosis, atherosclerosis and subcortical macroinfarcts. Moreover, the associations between interdaily stability and arteriolosclerosis and intradaily variability and subcortical infarcts were independent of cardiovascular risk factors, sleep fragmentation, and medical comorbidities. Conclusions: Disrupted rest-activity rhythms are associated with a greater burden of cerebral small vessel disease in older adults.

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