TY - JOUR
T1 - The association between lacunes and white matter hyperintensity features on MRI
T2 - The SMART-MR study
AU - Ghaznawi, Rashid
AU - Geerlings, Mirjam I
AU - Jaarsma-Coes, Myriam G
AU - Zwartbol, Maarten Ht
AU - Kuijf, Hugo J
AU - van der Graaf, Yolanda
AU - Witkamp, Theo D
AU - Hendrikse, Jeroen
AU - de Bresser, Jeroen
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this paper was received as part of a grant from the Netherlands Organization for Scientific Research-Medical Sciences (NWO-MW: project no. 904-65-095). This funding source had no role in the design, data collection, data analyses and data interpretation of the study or writing of the report. We also gratefully acknowledge the funding from the European Research Council under the European Union’s Horizon 2020 Programme (H2020)/ERC grant agreement nos.°637024 and 66681 (SVDs@target).
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Lacunes and white matter hyperintensities (WMHs) are features of cerebral small vessel disease (CSVD) that are associated with poor functional outcomes. However, how the two are related remains unclear. In this study, we examined the association between lacunes and several WMH features in patients with a history of vascular disease. A total of 999 patients (mean age 59 ± 10 years) with a 1.5 T brain magnetic resonance imaging (MRI) scan were included from the SMART-MR study. Lacunes were scored visually and WMH features (volume, subtype and shape) were automatically determined. Analyses consisted of linear and Poisson regression adjusted for age, sex, and total intracranial volume (ICV). Patients with lacunes (n = 188; 19%) had greater total (B = 1.03, 95% CI: 0.86 to 1.21), periventricular/confluent (B = 1.08, 95% CI: 0.89 to 1.27), and deep (B = 0.71, 95% CI: 0.44 to 0.97) natural log-transformed WMH volumes than patients without lacunes. Patients with lacunes had an increased risk of confluent type WMHs (RR = 2.41, 95% CI: 1.98 to 2.92) and deep WMHs (RR = 1.41, 95% CI: 1.22 to 1.62) and had a more irregular shape of confluent WMHs than patients without lacunes, independent of total WMH volume. In conclusion, we found that lacunes on MRI were associated with WMH features that correspond to more severe small vessel changes, mortality, and poor functional outcomes.
AB - Lacunes and white matter hyperintensities (WMHs) are features of cerebral small vessel disease (CSVD) that are associated with poor functional outcomes. However, how the two are related remains unclear. In this study, we examined the association between lacunes and several WMH features in patients with a history of vascular disease. A total of 999 patients (mean age 59 ± 10 years) with a 1.5 T brain magnetic resonance imaging (MRI) scan were included from the SMART-MR study. Lacunes were scored visually and WMH features (volume, subtype and shape) were automatically determined. Analyses consisted of linear and Poisson regression adjusted for age, sex, and total intracranial volume (ICV). Patients with lacunes (n = 188; 19%) had greater total (B = 1.03, 95% CI: 0.86 to 1.21), periventricular/confluent (B = 1.08, 95% CI: 0.89 to 1.27), and deep (B = 0.71, 95% CI: 0.44 to 0.97) natural log-transformed WMH volumes than patients without lacunes. Patients with lacunes had an increased risk of confluent type WMHs (RR = 2.41, 95% CI: 1.98 to 2.92) and deep WMHs (RR = 1.41, 95% CI: 1.22 to 1.62) and had a more irregular shape of confluent WMHs than patients without lacunes, independent of total WMH volume. In conclusion, we found that lacunes on MRI were associated with WMH features that correspond to more severe small vessel changes, mortality, and poor functional outcomes.
KW - magnetic resonance imaging
KW - cerebrovascular disease
KW - lacunes
KW - Small vessel disease
KW - white matter hyperintensities
UR - http://www.scopus.com/inward/record.url?scp=85060512062&partnerID=8YFLogxK
U2 - 10.1177/0271678X18800463
DO - 10.1177/0271678X18800463
M3 - Article
C2 - 30204039
SN - 0271-678X
VL - 39
SP - 2486
EP - 2496
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 12
ER -