BACKGROUND AND PURPOSE: Increased blood-brain barrier (BBB) permeability occurs in cerebral small vessel disease. It is not known if BBB changes predate progression of small vessel disease. METHODS: We followed-up patients with nondisabling lacunar or cortical stroke and BBB permeability magnetic resonance imaging after their original stroke. Approximately 3 years later, we assessed functional outcome (Oxford Handicap Score, poor outcome defined as 3-6), recurrent neurological events, and white matter hyperintensity (WMH) progression on magnetic resonance imaging. RESULTS: Among 70 patients with mean age of 68 (SD ± 11) years, median time to clinical follow-up was 39 months (interquartile range, 30-45) and median Oxford Handicap Score was 2 (interquartile range, 1-3); poor functional outcome was associated with higher baseline WMH score (P<0.001) and increased basal ganglia BBB permeability (P=0.046). Among 48 patients with follow-up magnetic resonance imaging, WMH progression at follow-up was associated with baseline WMH (ANCOVA P<0.0001) and age (ANCOVA P=0.032). CONCLUSIONS: Further long-term studies to evaluate the role of BBB dysfunction in progression of small vessel disease are required in studies that are large enough to account for key prognostic influences such as baseline WMH and age.
BACKGROUND AND PURPOSE: Increased blood-brain barrier (BBB) permeability occurs in cerebral small vessel disease. It is not known if BBB changes predate progression of small vessel disease. METHODS: We followed-up patients with nondisabling lacunar or cortical stroke and BBB permeability magnetic resonance imaging after their original stroke. Approximately 3 years later, we assessed functional outcome (Oxford Handicap Score, poor outcome defined as 3-6), recurrent neurological events, and white matter hyperintensity (WMH) progression on magnetic resonance imaging. RESULTS: Among 70 patients with mean age of 68 (SD ± 11) years, median time to clinical follow-up was 39 months (interquartile range, 30-45) and median Oxford Handicap Score was 2 (interquartile range, 1-3); poor functional outcome was associated with higher baseline WMH score (P<0.001) and increased basal ganglia BBB permeability (P=0.046). Among 48 patients with follow-up magnetic resonance imaging, WMH progression at follow-up was associated with baseline WMH (ANCOVA P<0.0001) and age (ANCOVA P=0.032). CONCLUSIONS: Further long-term studies to evaluate the role of BBB dysfunction in progression of small vessel disease are required in studies that are large enough to account for key prognostic influences such as baseline WMH and age.
Authors: Beverly G Windham; Michael E Griswold; Dean Shibata; Alan Penman; Diane J Catellier; Thomas H Mosley Journal: Stroke Date: 2012-03-01 Impact factor: 7.914
Authors: Maria del C Valdés Hernández; Karen J Ferguson; Francesca M Chappell; Joanna M Wardlaw Journal: Eur Radiol Date: 2010-02-16 Impact factor: 5.315
Authors: N D Prins; E C W van Straaten; E J van Dijk; M Simoni; R A van Schijndel; H A Vrooman; P J Koudstaal; P Scheltens; M M B Breteler; F Barkhof Journal: Neurology Date: 2004-05-11 Impact factor: 9.910
Authors: Paul A Armitage; Andrew J Farrall; Trevor K Carpenter; Fergus N Doubal; Joanna M Wardlaw Journal: Magn Reson Imaging Date: 2010-10-27 Impact factor: 2.546
Authors: Adam M Staffaroni; Fanny M Elahi; Dana McDermott; Kacey Marton; Elissaios Karageorgiou; Simone Sacco; Matteo Paoletti; Eduardo Caverzasi; Christopher P Hess; Howard J Rosen; Michael D Geschwind Journal: Semin Neurol Date: 2017-12-05 Impact factor: 3.420
Authors: Natalia S Rost; Pedro Cougo; Svetlana Lorenzano; Hua Li; Lisa Cloonan; Mark Jrj Bouts; Arne Lauer; Mark R Etherton; Hasan H Karadeli; Patricia L Musolino; William A Copen; Ken Arai; Eng H Lo; Steve K Feske; Karen L Furie; Ona Wu Journal: J Cereb Blood Flow Metab Date: 2017-05-08 Impact factor: 6.200
Authors: Rosalind Brown; Helene Benveniste; Sandra E Black; Serge Charpak; Martin Dichgans; Anne Joutel; Maiken Nedergaard; Kenneth J Smith; Berislav V Zlokovic; Joanna M Wardlaw Journal: Cardiovasc Res Date: 2018-09-01 Impact factor: 10.787