MRI-visible perivascular spaces: relationship to cognition and small vessel disease MRI markers in ischaemic stroke and TIA.
MRI-visible perivascular spaces: relationship to cognition and small vessel disease MRI markers in ischaemic stroke and TIA.
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DOI：
10.1136/jnnp-2013-305815
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发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Werring DJ
中科院分区：
文献类型：
--
作者：
Hurford R;Charidimou A;Fox Z;Cipolotti L;Jager R;Werring DJ
MRI可见的血管周围间隙（PVS）是脑小血管疾病的潜在神经影像学标志，但其功能意义和机制尚不清楚。我们在一个缺血性卒中/短暂性脑缺血发作（TIA）转诊的患者队列中研究了PVS与认知功能障碍以及其他小血管疾病的MRI标志物之间的相关性。数据收集自前瞻性观察数据库。进行了标准化的详细神经心理学测试。使用T2加权MRI上经验证的视觉评定量表对PVS严重程度进行分类;使用经验证的量表评估白色高信号（WMH）、脑微出血（CMB）和腔隙。我们纳入了246例患者（45.1%为女性，平均年龄62岁）。 任何脑区的PVS严重程度等级与任何认知领域的损害之间均无显著相关性。在多变量分析中，WMH和高血压（而不是年龄）与基底节PVS严重程度独立相关（OR：1.27; p<0.0001和OR：4.89; p=0.013）。基底节PVS严重程度的增加与腔隙性卒中亚型相关（p<0.0001）。年龄和高血压（而不是WMH或腔隙性卒中亚型）与半卵圆中心PVS严重程度独立相关（OR：1.19; p=0.013和OR：3.71; p=0.007）。PVS与缺血性卒中或TIA患者的认知功能障碍无独立相关性。与临床-放射学因素的相关性与PVS反映脑小血管疾病的假设一致;基底节和半卵圆中心PVS的不同相关性可能表明根据PVS解剖分布的不同基础小血管动脉病，但这需要进一步研究。
MRI-visible perivascular spaces (PVS) are potential neuroimaging markers of cerebral small vessel disease, but their functional significance and mechanisms remain uncertain. We investigated the association between PVS and cognitive impairment, and other MRI markers of small vessel disease, in a patient cohort of ischaemic stroke/transient ischaemic attack (TIA) referrals. Data were collected from a prospective observational database. Standardised detailed neuropsychological testing was performed. A validated visual rating scale on T2-weighted MRI was used to categorise PVS severity; validated scales were used to assess white matter hyperintensities (WMH), cerebral microbleeds (CMB) and lacunes. We included 246 patients (45.1% female, mean age 62 years). No significant association between PVS severity grade in any brain region and impairment in any cognitive domain was identified. In multivariable analysis, WMH and hypertension (but not age) were independently associated with basal ganglia PVS severity (OR: 1.27; p<0.0001 and OR: 4.89; p=0.013, respectively). Increasing PVS severity in the basal ganglia was associated with lacunar stroke subtype (p<0.0001). Age and hypertension (but not WMH or lacunar stroke subtype) were independently associated with centrum semiovale PVS severity (OR: 1.19; p=0.013 and OR: 3.71; p=0.007, respectively). PVS do not have an independent association with cognitive impairment in patients with ischaemic stroke or TIA. The associations with clinical-radiological factors are consistent with the hypothesis that PVS reflect cerebral small vessel disease; the different associations for basal ganglia and centrum semiovale PVS might indicate different underlying small vessel arteriopathies according to PVS anatomical distribution, but this requires further study.
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影响因子：
8.3
作者：
Doubal, Fergus N.;MacLullich, Alasdair M. J.;Wardlaw, Joanna M.
通讯作者：
Wardlaw, Joanna M.
影响因子：
4
作者：
Zhu, Yi-Cheng;Dufouil, Carole;Tzourio, Christophe
通讯作者：
Tzourio, Christophe
影响因子：
14.5
作者：
Werring, DJ;Frazer, DW;Jäger, HR
通讯作者：
Jäger, HR
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DOI：
10.1136/jnnp-2012-304434
发表时间：
2013-06
期刊：
Journal of neurology, neurosurgery, and psychiatry
影响因子：
--
作者：
Charidimou A;Meegahage R;Fox Z;Peeters A;Vandermeeren Y;Laloux P;Baron JC;Jäger HR;Werring DJ
通讯作者：
Werring DJ
影响因子：
11
作者：
MacLullich, AMJ;Wardlaw, JM;Deary, IJ
通讯作者：
Deary, IJ