Association of Vascular Properties With the Brain White Matter Hyperintensity in Middle‐Aged Population

Abstract

Background The periventricular white matter is more sensitive to the systemic hemodynamic alterations than the deep white matter because of differences in its vascular structure and systemic circulation relationship. We hypothesize that periventricular white matter hyperintensity (PVWMH) volume shows greater association than deep white matter hyperintensity (DWMH) volume with vascular properties (VPs) reflecting arterial stiffness and cardiovascular remodeling, indicators of the systemic circulation. Methods and Results A total of 426 participants (age, 59.0±6.1 years; 57.5% women; and 39.7% Black race) in the Genetic Study of Atherosclerosis Risk who were aged ≥50 years and had brain magnetic resonance imaging were studied. VPs included pulse pressure, hypertensive response to exercise, diastolic brachial artery diameter, diastolic common carotid artery diameter, common carotid artery distensibility coefficient, and left ventricular function. The relative associations of VPs with PVWMH and DWMH as multiple measures within the same individual were determined using multilevel linear models. We also determined if age modified the differences in VPs associations with PVWMH and DWMH. Our findings indicated that, within the same subject, PVWMH volume had greater association than DWMH volume with pulse pressure ( P =0.002), hypertensive response to exercise ( P =0.04), diastolic brachial artery diameter ( P =0.012), and diastolic common carotid artery diameter ( P =0.04), independent of age and cardiovascular risk factors. The differences of PVWMH versus DWMH associations with VPs did not differ at any age threshold. Conclusions We show, for the first time, that PVWMH has greater association than DWMH, independent of age, with vascular measurements of arterial stiffness and cardiovascular remodeling suggesting that changes in the systemic circulation affect the PVWMH and DWMH differently.

Associations of Cerebrovascular Regulation and Arterial Stiffness With Cerebral Small Vessel Disease: A Systematic Review and Meta‐Analysis

“… 21 , 118 , 119 , 120 , 121 , 123 , 124 , 125 , 126 , 127 , 128 , 130 , 131 , 132 , 133 , 134 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 147 , 148 , 150 , 151 , 152 , 153 , 154 , 156 , 157 , 158 , 160 , 161 , 163 , 165 , 166 , 167 , 169 , 171 , 172 , 173 , 176 , 177 , 178 , 179 , 182 , 183 , 185 , 186 …”

Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities

“…[169][170][171][172] A few studies have also investigated the relationships between arterial stiffness and the LA subtypes classified on the basis of PVWMH and DWMH, but their results were inconsistent. [173][174][175][176] Two of these studies reported that PWV was statistically significantly associated with both LA subtypes. 173,174 However, two other studies found significantly different associations between arterial stiffness and PVWMH and DWMH 175,176 -in one study, arterial stiffness was associated with PVWMH but not DWMH, 175 whereas in the other, PVWMH had a higher correlation with arterial stiffness than DWMH.…”

“…[173][174][175][176] Two of these studies reported that PWV was statistically significantly associated with both LA subtypes. 173,174 However, two other studies found significantly different associations between arterial stiffness and PVWMH and DWMH 175,176 -in one study, arterial stiffness was associated with PVWMH but not DWMH, 175 whereas in the other, PVWMH had a higher correlation with arterial stiffness than DWMH. 176 Although the differences between the associations between arterial stiffness and PVWMH versus DWMH need to be clarified, these findings strong-ly suggest that arterial stiffness is associated with LA incidence and severity.…”

“…Except in one study, which found no association between pulse wave velocity (PWV), considered as the gold standard for measuring arterial stiffness, and cerebral SVD markers [ 168 ], most studies have shown that increased arterial stiffness is significantly associated with increased WMH prevalence or volume [ 169 - 172 ]. A few studies have also investigated the relationships between arterial stiffness and the LA subtypes classified on the basis of PVWMH and DWMH, but their results were inconsistent [ 173 - 176 ]. Two of these studies reported that PWV was statistically significantly associated with both LA subtypes [ 173 , 174 ].…”

Central arterial stiffness, brain white matter hyperintensity and total brain volume across the adult lifespan

“…Consequently, cfPWV assesses an integrated stiffness of different segments of the aorta [19]. Alternatively, carotid arterial stiffness is determined by the changes of the lumen diameter and the arterial pulse pressure at the common carotid artery (CCA) [20], which is a regional arterial stiffness measure close to the brain, thus likely to be more relevant to assess the effects of central arterial stiffening on the brain [12,17,21,22]. In this regard, previous studies have reported that cfPWV and carotid arterial stiffness measured with ultrasonography may reflect different arterial wall properties in healthy adults [23].…”