BACKGROUND AND PURPOSE: White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small-vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain. METHODS: A cross-sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d-WMHs, n = 560) and periventricular WMHs (p-WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290). RESULTS: The ICAS group showed a higher d-WMH/p-WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P < 0.001 for all). Patients with a greater number of ICAS were more likely to have higher scores of d-WMH/p-WMH (P < 0.001 for all). Patients with higher scores of d-WMH/p-WMH had a higher incidence of ICAS (P < 0.001 for all), but not of ECAS or NCAS. In multivariable analysis, a dose-response relationship was observed between the extent of ICAS versus WMHs. Compared with one ICAS lesion, for d-WMHs the odds ratio (OR) = 2.61 [95% confidence interval (CI) 0.95-7.20] for two ICAS lesions and OR = 3.37 (1.10-10.32) for ≥3 ICAS lesions; whilst for p-WMHs (score ≥2) OR = 1.70 (95% CI 0.96-2.98) for two ICAS lesions and OR = 2.02 (1.15-3.55) for ≥3 ICAS lesions. CONCLUSION: ICAS is independently associated with progressively greater WMH burden. The association of ICAS with WMH severity appears to be stronger than that of ECAS/NCAS in the Korean (Asian) stroke population.
BACKGROUND AND PURPOSE: White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small-vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain. METHODS: A cross-sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d-WMHs, n = 560) and periventricular WMHs (p-WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290). RESULTS: The ICAS group showed a higher d-WMH/p-WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P < 0.001 for all). Patients with a greater number of ICAS were more likely to have higher scores of d-WMH/p-WMH (P < 0.001 for all). Patients with higher scores of d-WMH/p-WMH had a higher incidence of ICAS (P < 0.001 for all), but not of ECAS or NCAS. In multivariable analysis, a dose-response relationship was observed between the extent of ICAS versus WMHs. Compared with one ICAS lesion, for d-WMHs the odds ratio (OR) = 2.61 [95% confidence interval (CI) 0.95-7.20] for two ICAS lesions and OR = 3.37 (1.10-10.32) for ≥3 ICAS lesions; whilst for p-WMHs (score ≥2) OR = 1.70 (95% CI 0.96-2.98) for two ICAS lesions and OR = 2.02 (1.15-3.55) for ≥3 ICAS lesions. CONCLUSION: ICAS is independently associated with progressively greater WMH burden. The association of ICAS with WMH severity appears to be stronger than that of ECAS/NCAS in the Korean (Asian) stroke population.
Authors: Adam de Havenon; Chelsea Meyer; J Scott McNally; Matthew Alexander; Lee Chung Journal: Curr Atheroscler Rep Date: 2019-07-27 Impact factor: 5.113
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Authors: Hui Fang; Xinyi Leng; Yuehua Pu; Xinying Zou; Yuesong Pan; Bo Song; Yannie O Y Soo; Thomas W H Leung; Chunxue Wang; Xingquan Zhao; Yilong Wang; Yongjun Wang; Ka Sing Wong; Liping Liu; Yuming Xu Journal: Front Neurol Date: 2020-04-15 Impact factor: 4.003
Authors: Maarten Ht Zwartbol; Anja G van der Kolk; Hugo J Kuijf; Theo D Witkamp; Rashid Ghaznawi; Jeroen Hendrikse; Mirjam I Geerlings Journal: J Cereb Blood Flow Metab Date: 2020-10-06 Impact factor: 6.200