Nagaendran Kandiah1, Orlanda Goh2, Elijah Mak2, Maznah Marmin3, Amanda Ng2. 1. Department of Neurology, National Neuroscience Institute, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore. Electronic address: Nagaendran_Kandiah@nni.com.sg. 2. Department of Neurology, National Neuroscience Institute, Singapore. 3. Case Management Unit, Tan Tock Seng Hospital, Singapore.
Abstract
BACKGROUND: We sought to study the association between carotid stenosis and white-matter hyperintensity (WMH) among patients without intracranial large-vessel stenosis. METHODS: This was a prospective study of patients with acute lacunar infarcts without concomitant intracranial large-vessel stenosis having undergone carotid ultrasonography. WMH was quantified using the modified Fazekas scale. Patients were grouped into quartiles based on the degree of carotid stenosis. The association among carotid stenosis, vascular risk factors, and WMH were modeled using logistic regression analysis. RESULTS: In all, 100 patients with a mean age of 56.2 ± 11.7 years were studied. The quartile with the greatest carotid stenosis had a mean internal/common carotid artery peak systolic velocity ratio of 2.36. Total WMH was 4.64 in the highest quartile and 2.52 in the lowest quartile of carotid stenosis. Periventricular (pv)-WMH was significantly greater between the highest and lowest quartiles (2.80 versus 1.28, P = .025). No significant difference was observed for deep subcortical WMH (1.84 versus 1.24, P = .281). With increasing carotid stenosis, increase in both ipsilateral and contralateral pv-WMH was observed. When patients with significant carotid stenosis were compared to those without significant carotid stenosis, pv-WMH was significantly higher in the group with significant stenosis even after correcting for age and comorbid vascular risk factors (odds ratio 1.24; confidence interval 1.0-1.54). CONCLUSIONS: Carotid stenosis is an important risk factor for WMH. Volumes of pv-WMH significantly increase with higher grades of carotid stenosis.
BACKGROUND: We sought to study the association between carotid stenosis and white-matter hyperintensity (WMH) among patients without intracranial large-vessel stenosis. METHODS: This was a prospective study of patients with acute lacunar infarcts without concomitant intracranial large-vessel stenosis having undergone carotid ultrasonography. WMH was quantified using the modified Fazekas scale. Patients were grouped into quartiles based on the degree of carotid stenosis. The association among carotid stenosis, vascular risk factors, and WMH were modeled using logistic regression analysis. RESULTS: In all, 100 patients with a mean age of 56.2 ± 11.7 years were studied. The quartile with the greatest carotid stenosis had a mean internal/common carotid artery peak systolic velocity ratio of 2.36. Total WMH was 4.64 in the highest quartile and 2.52 in the lowest quartile of carotid stenosis. Periventricular (pv)-WMH was significantly greater between the highest and lowest quartiles (2.80 versus 1.28, P = .025). No significant difference was observed for deep subcortical WMH (1.84 versus 1.24, P = .281). With increasing carotid stenosis, increase in both ipsilateral and contralateral pv-WMH was observed. When patients with significant carotid stenosis were compared to those without significant carotid stenosis, pv-WMH was significantly higher in the group with significant stenosis even after correcting for age and comorbid vascular risk factors (odds ratio 1.24; confidence interval 1.0-1.54). CONCLUSIONS:Carotid stenosis is an important risk factor for WMH. Volumes of pv-WMH significantly increase with higher grades of carotid stenosis.
Authors: Perminder S Sachdev; Jessica W Lo; John D Crawford; Lisa Mellon; Anne Hickey; David Williams; Régis Bordet; Anne-Marie Mendyk; Patrick Gelé; Dominique Deplanque; Hee-Joon Bae; Jae-Sung Lim; Amy Brodtmann; Emilio Werden; Toby Cumming; Sebastian Köhler; Frans R J Verhey; Yan-Hong Dong; Hui Hui Tan; Christopher Chen; Xu Xin; Raj N Kalaria; Louise M Allan; Rufus O Akinyemi; Adesola Ogunniyi; Aleksandra Klimkowicz-Mrowiec; Martin Dichgans; Frank A Wollenweber; Vera Zietemann; Michael Hoffmann; David W Desmond; Thomas Linden; Christian Blomstrand; Björn Fagerberg; Ingmar Skoog; Olivier Godefroy; Mélanie Barbay; Martine Roussel; Byung-Chul Lee; Kyung-Ho Yu; Joanna Wardlaw; Stephen J Makin; Fergus N Doubal; Francesca M Chappell; Velandai K Srikanth; Amanda G Thrift; Geoffrey A Donnan; Nagaendran Kandiah; Russell J Chander; Xuling Lin; Charlotte Cordonnier; Solene Moulin; Costanza Rossi; Behnam Sabayan; David J Stott; J Wouter Jukema; Susanna Melkas; Hanna Jokinen; Timo Erkinjuntti; Vincent C T Mok; Adrian Wong; Bonnie Y K Lam; Didier Leys; Hilde Hénon; Stéphanie Bombois; Darren M Lipnicki; Nicole A Kochan Journal: Alzheimers Dement (Amst) Date: 2016-11-18
Authors: Sara E Berman; Xiao Wang; Carol C Mitchell; Bornali Kundu; Daren C Jackson; Stephanie M Wilbrand; Tomy Varghese; Bruce P Hermann; Howard A Rowley; Sterling C Johnson; Robert J Dempsey Journal: Neuroimage Clin Date: 2015-08-22 Impact factor: 4.881