Cerebrovascular Reactivity in Patients With Small Vessel Disease: A Cross-Sectional Study.


Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
Nov 2023
Historique:
medline: 1 11 2023
pubmed: 10 10 2023
entrez: 10 10 2023
Statut: ppublish

Résumé

Cerebrovascular reactivity (CVR) is inversely related to white matter hyperintensity severity, a marker of cerebral small vessel disease (SVD). Less is known about the relationship between CVR and other SVD imaging features or cognition. We aimed to investigate these cross-sectional relationships. Between 2018 and 2021 in Edinburgh, we recruited patients presenting with lacunar or cortical ischemic stroke, whom we characterized for SVD features. We measured CVR in subcortical gray matter, normal-appearing white matter, and white matter hyperintensity using 3T magnetic resonance imaging. We assessed cognition using Montreal Cognitive Assessment. Statistical analyses included linear regression models with CVR as outcome, adjusted for age, sex, and vascular risk factors. We reported regression coefficients with 95% CIs. Of 208 patients, 182 had processable CVR data sets (median age, 68.2 years; 68% men). Although the strength of association depended on tissue type, lower CVR in normal-appearing tissues and white matter hyperintensity was associated with larger white matter hyperintensity volume (B Lower CVR in patients with SVD was related to more severe SVD burden and worse cognition in this cross-sectional analysis. Longitudinal analysis will help determine whether lower CVR predicts worsening SVD severity or vice versa. URL: https://www.isrctn.com; Unique identifier: ISRCTN12113543.

Sections du résumé

BACKGROUND BACKGROUND
Cerebrovascular reactivity (CVR) is inversely related to white matter hyperintensity severity, a marker of cerebral small vessel disease (SVD). Less is known about the relationship between CVR and other SVD imaging features or cognition. We aimed to investigate these cross-sectional relationships.
METHODS METHODS
Between 2018 and 2021 in Edinburgh, we recruited patients presenting with lacunar or cortical ischemic stroke, whom we characterized for SVD features. We measured CVR in subcortical gray matter, normal-appearing white matter, and white matter hyperintensity using 3T magnetic resonance imaging. We assessed cognition using Montreal Cognitive Assessment. Statistical analyses included linear regression models with CVR as outcome, adjusted for age, sex, and vascular risk factors. We reported regression coefficients with 95% CIs.
RESULTS RESULTS
Of 208 patients, 182 had processable CVR data sets (median age, 68.2 years; 68% men). Although the strength of association depended on tissue type, lower CVR in normal-appearing tissues and white matter hyperintensity was associated with larger white matter hyperintensity volume (B
CONCLUSIONS CONCLUSIONS
Lower CVR in patients with SVD was related to more severe SVD burden and worse cognition in this cross-sectional analysis. Longitudinal analysis will help determine whether lower CVR predicts worsening SVD severity or vice versa.
REGISTRATION BACKGROUND
URL: https://www.isrctn.com; Unique identifier: ISRCTN12113543.

Identifiants

pubmed: 37814956
doi: 10.1161/STROKEAHA.123.042656
pmc: PMC10589433
mid: EMS188308
doi:

Banques de données

ClinicalTrials.gov
['ISRCTN12113543']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2776-2784

Subventions

Organisme : Alzheimer's Society
ID : 486
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 108890
Pays : United Kingdom
Organisme : The Dunhill Medical Trust
ID : R380R/1114
Pays : United Kingdom
Organisme : Chief Scientist Office
ID : CAF/18/08
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 104916
Pays : United Kingdom

Auteurs

Emilie Sleight (E)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Michael S Stringer (MS)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Una Clancy (U)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Carmen Arteaga (C)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Daniela Jaime Garcia (D)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Will Hewins (W)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Angela C C Jochems (ACC)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Olivia K L Hamilton (OKL)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Cameron Manning (C)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Alasdair G Morgan (AG)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Rachel Locherty (R)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Yajun Cheng (Y)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
Department of Neurology, West China Hospital of Sichuan University, Chengdu (Y.C.).

Xiaodi Liu (X)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
Department of Medicine, University of Hong Kong (X.L.).

Junfang Zhang (J)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, China (J.Z.).

Iona Hamilton (I)

Edinburgh Imaging Facility RIE (I.H., C.J., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Charlotte Jardine (C)

Edinburgh Imaging Facility RIE (I.H., C.J., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Rosalind Brown (R)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Eleni Sakka (E)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Agniete Kampaite (A)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Stewart Wiseman (S)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Maria C Valdés-Hernández (MC)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Francesca M Chappell (FM)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Fergus N Doubal (FN)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Ian Marshall (I)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Michael J Thrippleton (MJ)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
Edinburgh Imaging Facility RIE (I.H., C.J., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

Joanna M Wardlaw (JM)

Centre for Clinical Brain Sciences (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
UK Dementia Research Institute (E. Sleight, M.S.S., U.C., C.A., D.J.G., W.H., A.C.C.J., O.K.L.H., C.M., A.G.M., R.L., Y.C., X.L., J.Z., R.B., E. Sakka, A.K., S.W., M.C.V.-H., F.M.C., F.N.D., I.M., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.
Edinburgh Imaging Facility RIE (I.H., C.J., M.J.T., J.M.W.), University of Edinburgh, United Kingdom.

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