Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities
Background and purpose White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small‐vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed confli...
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| Veröffentlicht in: | European journal of neurology 2015-01, Vol.22 (1), p.44-e3 |
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| creator | Park, J.-H. Kwon, H.-M. Lee, J. Kim, D.-S. Ovbiagele, B. |
| description | Background and purpose
White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small‐vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain.
Methods
A cross‐sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d‐WMHs, n = 560) and periventricular WMHs (p‐WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290).
Results
The ICAS group showed a higher d‐WMH/p‐WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P |
| doi_str_mv | 10.1111/ene.12431 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1647020976</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1637568399</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4941-d14fb13cdf33dd9036adf5efc7d2d6f3001e0ecaa8cdb43d0d84c1959a9fae813</originalsourceid><addsrcrecordid>eNqNkc1qGzEUhUVpaH7aRV-gDHSTLCbRHWlGo2Uwzh8mXbQlpRshS1dY6XjGkeQ4fvvIcZJFoBAtJIG-c-DqI-Qr0GPI6wR7PIaKM_hA9oA3bQmMwcd8ZzWUNVDYJfsx3lJKK1HRT2S34gIqAWKPmNMYB-N18kNfDK7wfQraBN173RU6zTAM0XR5T94UMWE_RB-LlU-zIuI9Bp_Wm9hq5hMWc50ShmK2XuSHPsPRJ4_xM9lxuov45fk8IL_Pxr9GF-Xkx_nl6HRSGi45lBa4mwIz1jFmraSs0dbV6IywlW0coxSQotG6NXbKmaW25QZkLbV0GltgB-Rw27sIw90SY1JzHw12ne5xWEYFDRe0olI070CZqJuWSZnR72_Q22EZ-jzIhqqZpK3YUEdbyuQPiwGdWgQ_12GtgKqNJJUlqSdJmf323LicztG-ki9WMnCyBVa-w_X_m9T4evxSWW4TPjt6eE3o8E81Io-ibq7P1c-bswm_-gvqD3sEFoGssA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1635390879</pqid></control><display><type>article</type><title>Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Park, J.-H. ; Kwon, H.-M. ; Lee, J. ; Kim, D.-S. ; Ovbiagele, B.</creator><creatorcontrib>Park, J.-H. ; Kwon, H.-M. ; Lee, J. ; Kim, D.-S. ; Ovbiagele, B.</creatorcontrib><description>Background and purpose
White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small‐vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain.
Methods
A cross‐sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d‐WMHs, n = 560) and periventricular WMHs (p‐WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290).
Results
The ICAS group showed a higher d‐WMH/p‐WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P < 0.001 for all). Patients with a greater number of ICAS were more likely to have higher scores of d‐WMH/p‐WMH (P < 0.001 for all). Patients with higher scores of d‐WMH/p‐WMH had a higher incidence of ICAS (P < 0.001 for all), but not of ECAS or NCAS. In multivariable analysis, a dose−response relationship was observed between the extent of ICAS versus WMHs. Compared with one ICAS lesion, for d‐WMHs the odds ratio (OR) = 2.61 [95% confidence interval (CI) 0.95–7.20] for two ICAS lesions and OR = 3.37 (1.10–10.32) for ≥3 ICAS lesions; whilst for p‐WMHs (score ≥2) OR = 1.70 (95% CI 0.96–2.98) for two ICAS lesions and OR = 2.02 (1.15–3.55) for ≥3 ICAS lesions.
Conclusion
ICAS is independently associated with progressively greater WMH burden. The association of ICAS with WMH severity appears to be stronger than that of ECAS/NCAS in the Korean (Asian) stroke population.
Click here to view the accompanying paper in this issue.</description><identifier>ISSN: 1351-5101</identifier><identifier>EISSN: 1468-1331</identifier><identifier>DOI: 10.1111/ene.12431</identifier><identifier>PMID: 24712717</identifier><identifier>CODEN: EJNEFL</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Brain Ischemia - pathology ; Comorbidity ; Confidence intervals ; Constriction, Pathologic - epidemiology ; Constriction, Pathologic - pathology ; Cross-Sectional Studies ; Female ; Humans ; Intracranial Arteriosclerosis - epidemiology ; Intracranial Arteriosclerosis - pathology ; intracranial stenosis ; Leukoencephalopathies - epidemiology ; Leukoencephalopathies - pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Severity of Illness Index ; Stroke - pathology ; white matter hyperintensities</subject><ispartof>European journal of neurology, 2015-01, Vol.22 (1), p.44-e3</ispartof><rights>2014 The Author(s) European Journal of Neurology © 2014 EAN</rights><rights>2014 The Author(s) European Journal of Neurology © 2014 EAN.</rights><rights>European Journal of Neurology © 2015 European Academy of Neurology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4941-d14fb13cdf33dd9036adf5efc7d2d6f3001e0ecaa8cdb43d0d84c1959a9fae813</citedby><cites>FETCH-LOGICAL-c4941-d14fb13cdf33dd9036adf5efc7d2d6f3001e0ecaa8cdb43d0d84c1959a9fae813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fene.12431$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fene.12431$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24712717$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, J.-H.</creatorcontrib><creatorcontrib>Kwon, H.-M.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><creatorcontrib>Kim, D.-S.</creatorcontrib><creatorcontrib>Ovbiagele, B.</creatorcontrib><title>Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities</title><title>European journal of neurology</title><addtitle>Eur J Neurol</addtitle><description>Background and purpose
White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small‐vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain.
Methods
A cross‐sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d‐WMHs, n = 560) and periventricular WMHs (p‐WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290).
Results
The ICAS group showed a higher d‐WMH/p‐WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P < 0.001 for all). Patients with a greater number of ICAS were more likely to have higher scores of d‐WMH/p‐WMH (P < 0.001 for all). Patients with higher scores of d‐WMH/p‐WMH had a higher incidence of ICAS (P < 0.001 for all), but not of ECAS or NCAS. In multivariable analysis, a dose−response relationship was observed between the extent of ICAS versus WMHs. Compared with one ICAS lesion, for d‐WMHs the odds ratio (OR) = 2.61 [95% confidence interval (CI) 0.95–7.20] for two ICAS lesions and OR = 3.37 (1.10–10.32) for ≥3 ICAS lesions; whilst for p‐WMHs (score ≥2) OR = 1.70 (95% CI 0.96–2.98) for two ICAS lesions and OR = 2.02 (1.15–3.55) for ≥3 ICAS lesions.
Conclusion
ICAS is independently associated with progressively greater WMH burden. The association of ICAS with WMH severity appears to be stronger than that of ECAS/NCAS in the Korean (Asian) stroke population.
Click here to view the accompanying paper in this issue.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain Ischemia - pathology</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Constriction, Pathologic - epidemiology</subject><subject>Constriction, Pathologic - pathology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Intracranial Arteriosclerosis - epidemiology</subject><subject>Intracranial Arteriosclerosis - pathology</subject><subject>intracranial stenosis</subject><subject>Leukoencephalopathies - epidemiology</subject><subject>Leukoencephalopathies - pathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Severity of Illness Index</subject><subject>Stroke - pathology</subject><subject>white matter hyperintensities</subject><issn>1351-5101</issn><issn>1468-1331</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1qGzEUhUVpaH7aRV-gDHSTLCbRHWlGo2Uwzh8mXbQlpRshS1dY6XjGkeQ4fvvIcZJFoBAtJIG-c-DqI-Qr0GPI6wR7PIaKM_hA9oA3bQmMwcd8ZzWUNVDYJfsx3lJKK1HRT2S34gIqAWKPmNMYB-N18kNfDK7wfQraBN173RU6zTAM0XR5T94UMWE_RB-LlU-zIuI9Bp_Wm9hq5hMWc50ShmK2XuSHPsPRJ4_xM9lxuov45fk8IL_Pxr9GF-Xkx_nl6HRSGi45lBa4mwIz1jFmraSs0dbV6IywlW0coxSQotG6NXbKmaW25QZkLbV0GltgB-Rw27sIw90SY1JzHw12ne5xWEYFDRe0olI070CZqJuWSZnR72_Q22EZ-jzIhqqZpK3YUEdbyuQPiwGdWgQ_12GtgKqNJJUlqSdJmf323LicztG-ki9WMnCyBVa-w_X_m9T4evxSWW4TPjt6eE3o8E81Io-ibq7P1c-bswm_-gvqD3sEFoGssA</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Park, J.-H.</creator><creator>Kwon, H.-M.</creator><creator>Lee, J.</creator><creator>Kim, D.-S.</creator><creator>Ovbiagele, B.</creator><general>Blackwell Publishing Ltd</general><general>John Wiley & Sons, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201501</creationdate><title>Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities</title><author>Park, J.-H. ; Kwon, H.-M. ; Lee, J. ; Kim, D.-S. ; Ovbiagele, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4941-d14fb13cdf33dd9036adf5efc7d2d6f3001e0ecaa8cdb43d0d84c1959a9fae813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain Ischemia - pathology</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Constriction, Pathologic - epidemiology</topic><topic>Constriction, Pathologic - pathology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Intracranial Arteriosclerosis - epidemiology</topic><topic>Intracranial Arteriosclerosis - pathology</topic><topic>intracranial stenosis</topic><topic>Leukoencephalopathies - epidemiology</topic><topic>Leukoencephalopathies - pathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Severity of Illness Index</topic><topic>Stroke - pathology</topic><topic>white matter hyperintensities</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, J.-H.</creatorcontrib><creatorcontrib>Kwon, H.-M.</creatorcontrib><creatorcontrib>Lee, J.</creatorcontrib><creatorcontrib>Kim, D.-S.</creatorcontrib><creatorcontrib>Ovbiagele, B.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, J.-H.</au><au>Kwon, H.-M.</au><au>Lee, J.</au><au>Kim, D.-S.</au><au>Ovbiagele, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities</atitle><jtitle>European journal of neurology</jtitle><addtitle>Eur J Neurol</addtitle><date>2015-01</date><risdate>2015</risdate><volume>22</volume><issue>1</issue><spage>44</spage><epage>e3</epage><pages>44-e3</pages><issn>1351-5101</issn><eissn>1468-1331</eissn><coden>EJNEFL</coden><abstract>Background and purpose
White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) have been linked to small‐vessel disease, but the precise pathogenesis underlying WMHs remains unclear. Studies about an association of WMHs with extracranial atherosclerotic stenosis (ECAS) showed conflicting results and the relationship of WMHs with intracranial atherosclerotic stenosis (ICAS) is uncertain.
Methods
A cross‐sectional study of 679 consecutive Korean patients with acute ischaemic stroke (mean age 67.8 ± 12.6; 395 males) who underwent brain MRI/MR angiography was conducted. Severity of deep WMHs (d‐WMHs, n = 560) and periventricular WMHs (p‐WMHs, n = 590) was rated separately and compared across three groups: ICAS (n = 318), ECAS (n = 71) and no cerebral atherosclerotic stenosis (NCAS) (n = 290).
Results
The ICAS group showed a higher d‐WMH/p‐WMH score (1.62 ± 0.85/1.65 ± 0.79) than both the ECAS (1.25 ± 0.87/1.23 ± 0.78) and NCAS (1.19 ± 0.92/1.24 ± 0.81) groups (P < 0.001 for all). Patients with a greater number of ICAS were more likely to have higher scores of d‐WMH/p‐WMH (P < 0.001 for all). Patients with higher scores of d‐WMH/p‐WMH had a higher incidence of ICAS (P < 0.001 for all), but not of ECAS or NCAS. In multivariable analysis, a dose−response relationship was observed between the extent of ICAS versus WMHs. Compared with one ICAS lesion, for d‐WMHs the odds ratio (OR) = 2.61 [95% confidence interval (CI) 0.95–7.20] for two ICAS lesions and OR = 3.37 (1.10–10.32) for ≥3 ICAS lesions; whilst for p‐WMHs (score ≥2) OR = 1.70 (95% CI 0.96–2.98) for two ICAS lesions and OR = 2.02 (1.15–3.55) for ≥3 ICAS lesions.
Conclusion
ICAS is independently associated with progressively greater WMH burden. The association of ICAS with WMH severity appears to be stronger than that of ECAS/NCAS in the Korean (Asian) stroke population.
Click here to view the accompanying paper in this issue.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24712717</pmid><doi>10.1111/ene.12431</doi><tpages>10</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Brain Ischemia - pathology Comorbidity Confidence intervals Constriction, Pathologic - epidemiology Constriction, Pathologic - pathology Cross-Sectional Studies Female Humans Intracranial Arteriosclerosis - epidemiology Intracranial Arteriosclerosis - pathology intracranial stenosis Leukoencephalopathies - epidemiology Leukoencephalopathies - pathology Magnetic Resonance Imaging Male Middle Aged NMR Nuclear magnetic resonance Severity of Illness Index Stroke - pathology white matter hyperintensities |
| title | Association of intracranial atherosclerotic stenosis with severity of white matter hyperintensities |
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