Cerebral Small Vessel Disease: Neuroimaging Features, Biochemical Markers, Influencing Factors, Pathological Mechanism and Treatment

Ren, Beida; Tan, Lei; Song, Yu; Li, Danxi; Xue, Bin; Lai, Xinxing; Gao, Ying

doi:10.3389/fneur.2022.843953

Cited by 19 publications

(7 citation statements)

References 105 publications

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“…When the BBB is compromised, harmful substances, inflammatory molecules, and immune cells can more easily enter the brain. This, in turn, can trigger and worsen neuroinflammation and tissue damage, potentially contributing to the progression of ischemic injury [23,26]. Based on our findings, clinicians can use initial neuroimaging findings to identify markers of CSVD burden and select patients for EVT.…”

Section: Discussionmentioning

confidence: 81%

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Effect of Cerebral Small Vessel Disease Burden on Infarct Growth Rate and Stroke Outcomes in Large Vessel Occlusion Stroke Receiving Endovascular Treatment

Sohn,

Kim,

Kim

et al. 2023

Biomedicines

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This study aimed to investigate the association between cerebral small vessel disease (CSVD) burden and infarct growth rate (IGR) in patients with large vessel occlusion (LVO) stroke who underwent endovascular treatment (EVT). A retrospective analysis was conducted on a cohort of 495 patients with anterior circulation stroke who received EVT. CSVD burden was assessed using a CSVD score based on neuroimaging features. IGR was calculated from diffusion-weighted imaging (DWI) lesion volumes divided by the time from stroke onset to imaging. Clinical outcomes included stroke progression and functional outcomes at 3 months. Multivariate analyses were performed to assess the relationship between CSVD burden, IGR, and clinical outcomes. The fast IGR group had a higher proportion of high CSVD scores than the slow IGR group (24.4% vs. 0.8%, p < 0.001). High CSVD burden was significantly associated with a faster IGR (odds ratio [95% confidence interval], 26.26 [6.26–110.14], p < 0.001) after adjusting for confounding factors. High CSVD burden also independently predicted stroke progression and poor functional outcomes. This study highlights a significant relationship between CSVD burden and IGR in LVO stroke patients undergoing EVT. High CSVD burden was associated with faster infarct growth and worse clinical outcomes.

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Section: Discussionmentioning

confidence: 81%

“…These microvascular changes associated with CSVD may lead to impaired cerebral blood flow and altered perfusion [24]. CSVD has been associated with increased permeability of the BBB [25,26]. When the BBB is compromised, harmful substances, inflammatory molecules, and immune cells can more easily enter the brain.…”

Section: Discussionmentioning

confidence: 99%

Effect of Cerebral Small Vessel Disease Burden on Infarct Growth Rate and Stroke Outcomes in Large Vessel Occlusion Stroke Receiving Endovascular Treatment

Sohn,

Kim,

Kim

et al. 2023

Biomedicines

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“…Various single CSVD imaging features exert different effects on the pathophysiologic basis of cerebrovascular diseases, and each features generally coexist and influence each other. 18 The overall CSVD burden is highly reflective of the general condition of CSVD and thus has gained more attention in some relevant studies. 19 Multiple previous studies proved that high total CSVD score was independently prognostic for poor prognosis of patients receiving IVT.…”

Section: Discussionmentioning

confidence: 99%

Overall cerebral small vessel disease burden is associated with outcome of acute ischemic stroke after mechanical thrombectomy

et al. 2022

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Objectives To investigate the association between the overall cerebral small vessel disease (CSVD) burden and the therapeutic outcome of mechanical thrombectomy (MT) in patients with acute anterior circulation large-vessel occlusion stroke. Materials and Methods Data of patients who achieved successful revascularization after MT for acute anterior circulation large-vessel occlusion stroke in the Ningbo Medical Center Lihuili Hospital between April 2017 and January 2022 were retrospectively analyzed. The overall CSVD burden was evaluated by total CSVD score based on MRI images. According to the 90-day modified Rankin Scale (mRS) score, the participants were divided into the Good outcome group (mRS score 0–2) and Poor outcome group (mRS score 3–6). Multivariate Logistic regression was applied to assess the relationship between the overal CSVD burdern and 90-day outcome. Results In total, 145 eligible patients were included and classified into the Good outcome group (n = 77, 62.3% males, mean age: 64.92 ± 13.67 years) and Poor outcome group (n = 68, 50% males, mean age: 69.76 ± 10.88 years). Symptomatic intracranial hemorrhage (OR = 2.788, 95%CI: 1.143–8.745, P = 0.048), poor preoperative collateral status (OR = 3.619, 95%CI: 1.670–7.844, P = 0.001), and high total CSVD score (score 2: OR = 3.800, 95%CI: 1.173 = 12.311, P = 0.026; score 3: OR = 7.529, 95%CI: 1.555–36.460, P = 0.012) were independently prognostic for poor 90-day outcome in patients receiving MT. Conclusion This study identified that the overall CSVD burden was independently associated with the prognosis of patients receiving MT for acute anterior circulation large-vessel occlusion stroke.

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“…Currently, it is thought that CSVD is a dynamic disorder of whole brain function and that abnormal neurovascular unit (NVU) function plays an important role in the pathogenesis [6]. CSVD can cause a series of clinical symptoms, and CSVD is arguably the most prevalent mechanism contributing to cognitive dysfunction, which is characterized mainly by decreases in executive function, information processing speed, and attention function [7]. Small vessel disease (SVD) is considered to be the leading cause of ischemic stroke and the second most common cause of dementia, second only to Alzheimer's disease, with CSVD accounting for approximately 20% of all strokes, including 25% of ischemic strokes and 45% of vascular dementia cases [8].…”

Section: Introductionmentioning

confidence: 99%

Alterations in Dynamic Functional Connectivity in Patients with Cerebral Small Vessel Disease

Chen

Zhu

et al. 2023

Transl. Stroke Res.

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Cerebral small vessel disease (CSVD) is a common disease that seriously endangers people’s health, and is easily overlooked by both patients and clinicians due to its near-silent onset. Dynamic functional connectivity (DFC) is a new concept focusing on the dynamic features and patterns of brain networks that represents a powerful tool for gaining novel insight into neurological diseases. To assess alterations in DFC in CSVD patients, and the correlation of DFC with cognitive function. We enrolled 35 CSVD patients and 31 normal control subjects (NC). Resting-state functional MRI (rs-fMRI) with a sliding-window approach and k-means clustering based on independent component analysis (ICA) was used to evaluate DFC. The temporal properties of fractional windows and the mean dwell time in each state, as well as the number of transitions between each pair of DFC states, were calculated. Additionally, we assessed the functional connectivity (FC) strength of the dynamic states and the associations of altered neuroimaging measures with cognitive performance. A dynamic analysis of all included subjects suggested four distinct functional connectivity states. Compared with the NC group, the CSVD group had more fractional windows and longer mean dwell times in state 4 characterized by sparse FC both inter-network and intra-networks. Additionally, the CSVD group had a reduced number of windows and shorter mean dwell times compared to the NC group in state 3 characterized by highly positive FC between the somatomotor and visual networks, and negative FC in the basal ganglia and somatomotor and visual networks. The number of transitions between state 2 and state 3 and between state 3 and state 4 was significantly reduced in the CSVD group compared to the NC group. Moreover, there was a significant difference in the FC strength between the two groups, and the altered temporal properties of DFC were significantly related to cognitive performance. Our study indicated that CSVD is characterized by altered temporal properties in DFC that may be sensitive neuroimaging biomarkers for early disease identification. Further study of DFC alterations could help us to better understand the progressive dysfunction of networks in CSVD patients.

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Cerebral Small Vessel Disease: Neuroimaging Features, Biochemical Markers, Influencing Factors, Pathological Mechanism and Treatment

Cited by 19 publications

References 105 publications

Effect of Cerebral Small Vessel Disease Burden on Infarct Growth Rate and Stroke Outcomes in Large Vessel Occlusion Stroke Receiving Endovascular Treatment

Effect of Cerebral Small Vessel Disease Burden on Infarct Growth Rate and Stroke Outcomes in Large Vessel Occlusion Stroke Receiving Endovascular Treatment

Overall cerebral small vessel disease burden is associated with outcome of acute ischemic stroke after mechanical thrombectomy

Alterations in Dynamic Functional Connectivity in Patients with Cerebral Small Vessel Disease

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