scholarly journals Risk factors for small-vessel disease revealed by magnetic resonance imaging of the brain.

Nosotchu ◽  
1996 ◽  
Vol 18 (1) ◽  
pp. 10-18
Author(s):  
Tatsuo Kohriyama ◽  
Shinya Yamaguchi ◽  
Eiji Tanaka ◽  
Yasuhiro Yamamura ◽  
Shigenobu Nakamura
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Vessel Disease ◽  
The Brain

scholarly journals Rationale and design of a longitudinal study of cerebral small vessel diseases, clinical and imaging outcomes in patients presenting with mild ischaemic stroke: Mild Stroke Study 3

2020 ◽  
pp. 239698732092961
Author(s):  
Una Clancy ◽  
Daniela Jaime Garcia ◽  
Michael S Stringer ◽  
Michael J Thrippleton ◽  
Maria C Valdés-Hernández ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Risk Factors ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Brain Magnetic Resonance Imaging ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Vessel Disease ◽  
Stroke Study ◽  
Mild Stroke

Background Cerebral small vessel disease is a major cause of dementia and stroke, visible on brain magnetic resonance imaging. Recent data suggest that small vessel disease lesions may be dynamic, damage extends into normal-appearing brain and microvascular dysfunctions include abnormal blood–brain barrier leakage, vasoreactivity and pulsatility, but much remains unknown regarding underlying pathophysiology, symptoms, clinical features and risk factors of small vessel disease. Patients and Methods: The Mild Stroke Study 3 is a prospective observational cohort study to identify risk factors for and clinical implications of small vessel disease progression and regression among up to 300 adults with non-disabling stroke. We perform detailed serial clinical, cognitive, lifestyle, physiological, retinal and brain magnetic resonance imaging assessments over one year; we assess cerebrovascular reactivity, blood flow, pulsatility and blood–brain barrier leakage on magnetic resonance imaging at baseline; we follow up to four years by post and phone. The study is registered ISRCTN 12113543. Summary Factors which influence direction and rate of change of small vessel disease lesions are poorly understood. We investigate the role of small vessel dysfunction using advanced serial neuroimaging in a deeply phenotyped cohort to increase understanding of the natural history of small vessel disease, identify those at highest risk of early disease progression or regression and uncover novel targets for small vessel disease prevention and therapy.

Abstract 01: Retinal Microvascular Signs and White Matter MRI Findings: The Atherosclerosis Risk in Communities Neurocognitive Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jennifer A Deal ◽  
Melinda C Power ◽  
Karen Bandeen-Roche ◽  
Michael Griswold ◽  
David Knopman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Fundus Photography ◽  
Resonance Imaging ◽  
Lacunar Infarcts ◽  
Vessel Disease ◽  
Arteriolar Narrowing

Introduction: Cerebrovascular small vessel disease, seen on brain imaging as lacunes and white matter hyperintensities (WMH), is a substrate for dementia in older adults. Diffusion tensor imaging (DTI) is thought to provide early signs of loss of white matter (WM) integrity due to microvascular disease and predicts WM hyperintensity volume. Retinal fundus photography provides surrogate measures of cerebral microvasculature. No studies have quantified the long-term association between retinal signs and DTI measures. Hypothesis: Microvascular retinal signs measured in midlife are associated with small vessel disease measured on brain magnetic resonance imaging (MRI) 18 years later, including reduced WM microstructural integrity (lower fractional anisotrophy [FA] and greater mean diffusivity [MD] by DTI), greater WM hyperintensity volume and greater lacune prevalence. Methods: In a biracial prospective cohort study, retinal signs were measured using fundus photography (1993-1995) with 3-T magnetic resonance imaging conducted in 2011-13. Multivariable-adjusted linear regression was used to quantify the relationships of retinal signs with WM measures. Prevalence of lacunar infarcts by retinal sign status was estimated using log binomial regression. Analyses were adjusted for age [linear and quadratic terms], education, sex, race, intracranial volume, body mass index, smoking, diabetes, hypertension, and ≥1 APOE ε4 alleles. Results: In 1829 men and women (60% [N=1100] female, 27% [N=489] black race, aged 50-72 years when retinal signs were measured), a binary measure comprised of two retinal signs suggestive of arteriolar damage due to hypertension (focal arteriolar narrowing and/or arteriovenous nicking) was associated with worse (lower) FA (standardized β=-0.19, 95% confidence interval [CI]=-0.35, -0.02), worse (higher) MD (β=0.15, 95% CI=0.00, 0.30), greater WM hyperintensity volume (β=0.15, 95% CI=0.01, 0.30), and greater prevalence of lacunes (prevalence ratio=1.33, 95% CI: 0.99, 1.80). Generalized arteriolar narrowing, measured as the central retinal arteriolar equivalent (CRAE, narrowest quartile vs. widest three quartiles) was associated with worse FA (β=-0.13, 95% CI=-0.24, -0.01) and worse MD (β=0.12, 95% CI=0.01, 0.23). Results did not differ by sex, race, hypertension status or APOE ε4 genotype. No associations were found for retinopathy, but only 56 participants had retinopathy. Conclusions: Consistent with prior work, and as expected based on a common underlying pathology, retinal signs predicted WM disease and lacunar infarcts 18 years later. Novel to this study, we found that retinal signs related to arteriolar damage also predicted loss of white matter microvascular integrity measured using DTI.

scholarly journals Magnetic resonance imaging manifestations of cerebral small vessel disease

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lei Zhao ◽  
Allan Lee ◽  
Yu-Hua Fan ◽  
Vincent C.T. Mok ◽  
Lin Shi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Vessel Disease

scholarly journals Total Magnetic Resonance Imaging of Cerebral Small Vessel Disease Burden Predicts Dysphagia in Patients with a Single Recent Small Subcortical Infarct

2021 ◽  
Author(s):  
Lulu Zhang ◽  
Xiang Tang ◽  
Yidan Li ◽  
Juehua Zhu ◽  
Dongxue Ding ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Burden ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Post Stroke ◽  
Reactive Protein ◽  
Vessel Disease ◽  
Subcortical Infarct

Abstract Background The study was performed to identify the association between total magnetic resonance imaging burden of small vessel disease and occurrence of post-stroke dysphagia in patients with a single recent small subcortical infarct. Methods All patients with a magnetic resonance imaging-confirmed single recent small subcortical infarct underwent the water-swallowing test and volume-viscosity swallow test within the first 24 hours following admission to assess swallowing. Demographic and clinical data were extracted from our stroke database. Based on brain magnetic resonance imaging, we independently rated the presence of cerebral microbleeds, lacunes, white matter hyperintensities and enlarged perivascular spaces. The presence of each small vessel disease feature was summed in the total small vessel disease burden, ranging from 0–4. Results In total, 308 patients with a single recent small subcortical infarct were enrolled. Overall, 54 (17.5%) were diagnosed with post-stroke dysphagia. The risk factors related to post-stroke dysphagia included the following: older age, National Institute of Health Stroke Scale, higher C-reactive protein levels and higher fibrinogen levels. Based on multiple logistic regression, two variables with the most significant associations, namely, National Institute of Health Stroke Scale and total small vessel disease burden, were combined with age, gender, history of hypertension, C-reactive protein level and fibrinogen level. Conclusions Dysphagia in patients with a single recent small subcortical infarct resulted from severe small vascular disease, which was associated with systemic inflammation. This information might provide a new anti-inflammatory treatment for post-stroke dysphagia in the future.

scholarly journals Cysteine-Altering NOTCH3 Variants Are a Risk Factor for Stroke in the Elderly Population

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3562-3569 ◽  
Author(s):  
Remco J. Hack ◽  
Julie W. Rutten ◽  
Thomas N. Person ◽  
Jiang Li ◽  
Ayesha Khan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Elderly Population ◽  
Autosomal Dominant ◽  
Small Vessel Disease ◽  
Brain Magnetic Resonance Imaging ◽  
The Elderly ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Vessel Disease

Background and Purpose: Cysteine altering NOTCH3 variants, which have previously been exclusively associated with the rare hereditary small vessel disease cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, have a population frequency of 1:300 worldwide. Using a large population database, and taking genotype as a starting point, we aimed to determine whether individuals harboring a NOTCH3 cysteine altering variant have a higher load of small vessel disease markers on brain magnetic resonance imaging than controls, as well as a higher risk of stroke and cognitive impairment. Methods: A cross-sectional study using integrated clinical, neuroimaging, and whole-exome sequencing data of 92 456 participants from the Geisinger DiscovEHR initiative cohort. The case group consisted of individuals harboring a NOTCH3 cysteine altering variant (n=118). The control group consisted of randomly selected age- and sex-matched individuals who did not have any nonsynonymous variants in NOTCH3 (n=184). Medical records including brain magnetic resonance imagings were evaluated for clinical and neuroimaging findings associated with small vessel disease. Group comparisons were done using Fisher exact test and ordinal logistic regression models. Risk of stroke was assessed using Cox regression. Results: Of the 118 cases, 39.0% were men, mean age 58.1±16.9 years; 12.6% had a history of stroke, compared with 4.9% of controls. The risk of stroke was significantly increased after age 65 years (hazard ratio, 6.0 [95% CI, 1.4–26.3]). Dementia, mild cognitive impairment, migraine with aura and depression were equally prevalent in cases and controls. Twenty-nine cases (25%) and 45 controls (24%) had an available brain magnetic resonance imaging. After age 65 years, cases had a higher white matter lesion burden and more lacunes. A severe small vessel disease phenotype compatible with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy was rarely seen. Conclusions: Cysteine altering NOTCH3 variants are an important contributor to the risk of stroke, lacunes, and white matter hyperintensities in the elderly population.

scholarly journals Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging

Stroke ◽  
2015 ◽  
Vol 46 (11) ◽  
pp. 3131-3136 ◽  
Author(s):  
Jennifer L. Dearborn ◽  
Andrea L.C. Schneider ◽  
A. Richey Sharrett ◽  
Thomas H. Mosley ◽  
Daniel C. Bezerra ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Insulin Resistance ◽  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Resonance Imaging ◽  
Vessel Disease
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