Large-vessel correlates of cerebral small-vessel disease

Department of Neurology (M.B., F.P.), André Mignot Hospital, University of Versailles, St-Quentin-en-Yvelines
Neurology (Impact Factor: 8.29). 01/2013; 80(7). DOI: 10.1212/WNL.0b013e318281ccc2
Source: PubMed


Our aim was to investigate the relationship of carotid structure and function with MRI markers of cerebral ischemic small-vessel disease.

The study comprised 1,800 participants (aged 72.5 ± 4.1 years, 59.4% women) from the 3C-Dijon Study, a population-based, prospective cohort study, who had undergone quantitative brain MRI and carotid ultrasound. We used multivariable logistic and linear regression adjusted for age, sex, and vascular risk factors.

Presence of carotid plaque and increasing carotid lumen diameter (but not common carotid artery intima-media thickness) were associated with higher prevalence of lacunar infarcts: odds ratio (OR) = 1.60 (95% confidence interval [CI]: 1.09-2.35), p = 0.02 and OR = 1.24 (95% CI: 1.02-1.50), p = 0.03 (by SD increase). Carotid plaque was also associated with large white matter hyperintensity volume (WMHV) (age-specific top quartile of WMHV distribution): OR = 1.32 (95% CI: 1.04-1.67), p = 0.02, independently of vascular risk factors. Increasing Young elastic modulus and higher circumferential wall stress, reflecting augmented carotid stiffness, were associated with increasing WMHV (effect estimate [β] ± standard error: 0.0003 ± 0.0001, p = 0.024; β ± standard error: 0.005 ± 0.002, p = 0.008). Large WMHV was also associated with increasing Young elastic modulus (OR = 1.22 [95% CI: 1.04-1.42], p = 0.01) and with decreasing distensibility coefficient (OR = 0.83 [95% CI: 0.69-0.99], p = 0.04), independently of vascular risk factors. Associations of carotid lumen diameter with lacunar infarcts and of carotid stiffness markers with WMHV were independent of carotid plaque.

In addition to and independently of carotid plaque, increasing carotid lumen diameter and markers of carotid stiffness were associated with increasing prevalence of lacunar infarcts and increasing WMHV, respectively.

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Available from: Bernard Mazoyer, May 26, 2014
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    • "To our knowledge, there is only one study that has already reported increased carotid arterial stiffness in a relatively old population of ILA patients (Brisset et al. 2013). Because age is an important risk factor for arterial stiffness as well as for ILA (Benetos et al. 2002; Lee and Oh 2010; Pantoni 2010) it would be wise to study younger patients and compare them to a control group without ILA matched with respect to risk factors. "
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