Cerebral White Matter Lesions Are Associated With the Risk of Stroke But Not With Other Vascular Events The 3-City Dijon Study

INSERM Unit 708, Paris, France.
Stroke (Impact Factor: 5.72). 06/2009; 40(7):2327-31. DOI: 10.1161/STROKEAHA.109.548222
Source: PubMed


White matter lesions (WMLs) have been shown to be associated with the risk of stroke in previous studies but little is known about the prediction of other vascular events. We evaluated the risk of stroke and other vascular events according to WML volume in a large population-based sample. We also studied WML volume by type (deep or periventricular) in relation to these events.
The 3-City Study is a population-based prospective cohort of people aged >or=65 years followed up for, on average, 4.9 years. Among them, 1643 participants free of prevalent vascular events had quantitative measurements of WML volume at baseline using a fully automatic method. The risks of incident major vascular events according to WML volume were evaluated using Cox proportional hazards models.
The risk of incident stroke significantly increased with increasing baseline WML volume and was multiplied by 5 for those in the highest quartile of WML volume. Nonstroke vascular events' incidence was not associated with WML volumes, whatever their type.
WMLs are an independent predictor of stroke in the elderly. This association is specific because WMLs are not associated with the risk of other vascular events.

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    • "Previously, LA is only considered as a common brain neuroimaging phenomenon that is associated with the risk of cognitive decline, incident stroke, gait disturbance and falls, and dementia ( Garde et al., 2005 ; Ross et al., 2005 ; Au et al., 2006 ; Bokura et al., 2006 ; O ' Sullivan, 2008 ; Buyck et al., 2009 ; Debette and Markus, 2010 ). Pathologically , LA is predominantly considered to represent incomplete ischemia, with the following common pathological characterizations: widespread perivascular rarefaction of myelin, patchy demyelination, partial loss of axons and oligodendroglial cells, mild reactive astrocytic gliosis, and sparsely distributed macrophages as well as disruption of ependyma ( Brun and Englund, 1986 ; Babikian and Ropper, 1987 ; Fazekas et al., 1998 ; Pantoni, 2002 ; Kim et al., 2008 ; Schmidt et al., 2011 ). "
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