Longitudinal Relationship Between Cerebral Small-Vessel Disease and Cerebral Blood Flow The Second Manifestations of Arterial Disease-Magnetic Resonance Study

Pieternella H. van der Veen, Majon Muller, Koen L. Vincken, J Hendrikse, Willem P. T. M. Mali, Yolanda van der Graaf, Mirjam I. Geerlings*,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and Purpose-Cerebral small-vessel disease and cerebral blood flow (CBF) are interrelated. However, the direction of the relationship is unknown, and longitudinal studies are scarce. We investigated the longitudinal relationship between CBF and white matter hyperintensities (WMHs) and lacunes, as representatives of cerebral small-vessel disease, in patients with manifest arterial disease.

Methods-Within the Second Manifestations of Arterial Disease-Magnetic Resonance (SMART-MR) study, 1.5T brain magnetic resonance imaging, including an MR angiography, was obtained at baseline and after on approximate to 3.9 years of follow-up in 575 patients with manifest arterial disease (mean age, 57 +/- 10 years). Longitudinal associations of WMHs and lacunes with parenchymal CBF (pCBF; per 100-mL brain volume) were estimated using regression analyses, adjusted for age, sex, follow-up time, and baseline brain measures.

Results-Baseline pCBF was not associated with progression of WMHs and lacunes over time. However, periventricular and deep WMHs at baseline were associated with decline in pCBF; mean (95% confidence interval) decline in pCBF per % intracranial volume increase in periventricular and deep WMH volume was -0.70 (-1.40 to -0.00) and -1.01 (-1.64 to -0.38) mL/min per 100-mL brain volume, respectively. These associations were partly explained by cardiovascular risk factors but remained significant for deep WMHs (mean decline [95% confidence interval] in pCBF per % intracranial volume increase in deep WMH volume was -0.92 [-1.56 to -0.28] mL/min per 100-mL brain volume). Lacunes were not associated with change in pCBF.

Conclusions-In patients with manifest arterial disease, baseline periventricular and deep WMH volumes were associated with decline in pCBF over time, but baseline pCBF was not associated with progression of WMHs and lacunes over time.

Original languageEnglish
Pages (from-to)1233-1238
Number of pages6
JournalStroke
Volume46
Issue number5
DOIs
Publication statusPublished - May 2015

Keywords

  • atherosclerosis
  • cerebral small vessel disease
  • magnetic resonance imaging
  • WHITE-MATTER HYPERINTENSITIES
  • CEREBROVASCULAR REACTIVITY
  • COGNITIVE PERFORMANCE
  • AMYLOID ANGIOPATHY
  • OXYGEN-METABOLISM
  • SMART-MR
  • BRAIN
  • LESIONS
  • PERFUSION
  • CIRCULATION

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