How often does white matter hyperintensity volume regress in cerebral small vessel disease?
How often does white matter hyperintensity volume regress in cerebral small vessel disease?
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脑小血管疾病中白色物质高信号体积消退的频率如何？
DOI：
10.1177/17474930231169132
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发表时间：
2023-10
影响因子：
6.7
通讯作者：
Markus, Hugh S.
中科院分区：
文献类型：
--
作者：
Brown, Robin B.;Tozer, Daniel J.;Egle, Marco;Tuladhar, Anil M.;de Leeuw, Frank-Erik;Markus, Hugh S.
有研究表明，白质高强度病变（WMHs）通常会随着时间的推移而进展，但也会消退，这可能与良好的认知表现有关。我们确定了脑血管疾病（SVD）患者WMH退化的患病率，并检查了哪些人口统计学、临床和放射学标志物与这种退化相关。在三个有症状的SVD队列中，我们使用半自动病变标记方法在多个时间点量化WMH体积；2例患有中度至重度症状性SVD （SCANS观察组和PRESERVE介入性试验的对照组），1例患有轻度至中度SVD （RUN DMC观察组）。采用混合效应有序逻辑回归模型检验哪些因素预测被试出现WMH回归。scan中没有参与者（0/98），PRESERVE中6/42 (14.3%)，RUN DMC中6/276（2.2%）出现WMH回归。在多变量分析中，只有较低的脑白质体积（OR: 0.36, 95% CI: 0.23-0.56）和较好的白质微结构完整性（OR: 1.55, 95% CI: 1.07-2.24）可以预测参与者分类为回归因子与稳定因子或进展因子。当使用盲法标准化评估方法时，只有一小部分参与者在三个队列中表现出WMH回归。出现退化的受试者在基线时的疾病影像标记较轻。我们的研究结果表明，病变消退在SVD中并不常见，不太可能是影响临床试验中使用WMH量化结果的主要因素。
It has been suggested that white matter hyperintensity lesions (WMHs), which typically progress over time, can also regress, and that this might be associated with favorable cognitive performance. We determined the prevalence of WMH regression in patients with cerebral small vessel disease (SVD) and examined which demographic, clinical, and radiological markers were associated with this regression. We used semi-automated lesion marking methods to quantify WMH volume at multiple timepoints in three cohorts with symptomatic SVD; two with moderate-to-severe symptomatic SVD (the SCANS observational cohort and the control arm of the PRESERVE interventional trial) and one with mild-to-moderate SVD (the RUN DMC observational cohort). Mixed-effects ordered logistic regression models were used to test which factors predicted participants to show WMH regression. No participants (0/98) in SCANS, 6/42 (14.3%) participants in PRESERVE, and 6/276 (2.2%) in RUN DMC showed WMH regression. On multivariate analysis, only lower WMH volume (OR: 0.36, 95% CI: 0.23–0.56) and better white matter microstructural integrity assessed by fractional anisotropy using diffusion tensor imaging (OR: 1.55, 95% CI: 1.07–2.24) predicted participant classification as regressor versus stable or progressor. Only a small proportion of participants demonstrated WMH regression across the three cohorts, when a blinded standardized assessment method was used. Subjects who showed regression had less severe imaging markers of disease at baseline. Our results show that lesion regression is uncommon in SVD and unlikely to be a major factor affecting the use of WMH quantification as an outcome for clinical trials.
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影响因子：
8.2
作者：
Cho AH;Kim HR;Kim W;Yang DW
通讯作者：
Yang DW
DOI：
10.1042/cs20170146
发表时间：
2017-06-01
期刊：
Clinical science (London, England : 1979)
影响因子：
--
作者：
Croall ID;Lohner V;Moynihan B;Khan U;Hassan A;O'Brien JT;Morris RG;Tozer DJ;Cambridge VC;Harkness K;Werring DJ;Blamire AM;Ford GA;Barrick TR;Markus HS
通讯作者：
Markus HS
评估他汀类药物治疗缓解 75 岁以下人群脑小血管疾病进展的有效性
影响因子：
4.1
作者：
Guo, Yuqi;Li, Yunpeng;Liu, Zhendong
通讯作者：
Liu, Zhendong
影响因子：
9.9
作者：
Jochems, Angela C. C.;Arteaga, Carmen;Chappell, Francesca;Ritakari, Tuula;Hooley, Monique;Doubal, Fergus;Maniega, Susana Munoz;Wardlaw, Joanna M.
通讯作者：
Wardlaw, Joanna M.
影响因子：
6
作者：
Firbank, Michael J.;Wiseman, Rebecca M.;Ford, Gary A.
通讯作者：
Ford, Gary A.