TY - JOUR
T1 - Longitudinal Relationship Between Cerebral Small-Vessel Disease and Cerebral Blood Flow The Second Manifestations of Arterial Disease-Magnetic Resonance Study
AU - van der Veen, Pieternella H.
AU - Muller, Majon
AU - Vincken, Koen L.
AU - Hendrikse, J
AU - Mali, Willem P. T. M.
AU - van der Graaf, Yolanda
AU - Geerlings, Mirjam I.
AU - Doevendans, PAFM
PY - 2015/5
Y1 - 2015/5
N2 - 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.
AB - 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.
KW - atherosclerosis
KW - cerebral small vessel disease
KW - magnetic resonance imaging
KW - WHITE-MATTER HYPERINTENSITIES
KW - CEREBROVASCULAR REACTIVITY
KW - COGNITIVE PERFORMANCE
KW - AMYLOID ANGIOPATHY
KW - OXYGEN-METABOLISM
KW - SMART-MR
KW - BRAIN
KW - LESIONS
KW - PERFUSION
KW - CIRCULATION
U2 - 10.1161/STROKEAHA.114.008030
DO - 10.1161/STROKEAHA.114.008030
M3 - Article
C2 - 25804924
SN - 0039-2499
VL - 46
SP - 1233
EP - 1238
JO - Stroke
JF - Stroke
IS - 5
ER -