Classification of white matter lesions and characteristics of small vessel disease markers

Park, Kyung‐Il; Jung, Keun‐Hwa; Lee, Eung‐Joon; Lee, Woojin; Hwang, Seol Ah; Kim, Young Ho; Salat, David H.

doi:10.1007/s00330-022-09070-1

Cited by 2 publications

(7 citation statements)

References 31 publications

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“…Based on the MRI features, Park and colleagues classified CSVD into three distinct classes: multiple, small, deep WMHs with a low burden of lacunes and CMBs (class I); large periventricular WMHs with a high burden of lacunes and CMBs (class II); and limited juxtaventricular WMHs lacking lacunes and CMBs (class III). The authors found that class II was associated with older age, diabetes, and higher neutrophil‐to‐lymphocyte ratio (NLR); while, class I was related to smoking and higher uric acid levels 42 . However, because of the limitation of cross‐sectional design, the outcomes of each class are unclear.…”

Section: Resultsmentioning

confidence: 99%

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Plasma inflammatory biomarkers in cerebral small vessel disease: A review

et al. 2022

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Cerebral small vessel disease (CSVD) is a group of pathological processes affecting small arteries, arterioles, capillaries, and small veins of the brain. It is one of the most common subtypes of cerebrovascular diseases, especially highly prevalent in elderly populations, and is associated with stroke occurrence and recurrence, cognitive impairment, gait disorders, psychological disturbance, and dysuria. Its diagnosis mainly depends on MRI, characterized by recent small subcortical infarcts, lacunes, white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVS), cerebral microbleeds (CMBs), and brain atrophy. While the pathophysiological processes of CSVD are not fully understood at present, inflammation is noticed as playing an important role. Herein, we aimed to review the relationship between plasma inflammatory biomarkers and the MRI features of CSVD, to provide background for further research.

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Section: Resultsmentioning

confidence: 99%

“…The authors found that class II was associated with older age, diabetes, and higher neutrophil-tolymphocyte ratio (NLR); while, class I was related to smoking and higher uric acid levels. 42 However, because of the limitation of crosssectional design, the outcomes of each class are unclear.…”

Section: Imaging Features Of Csvdmentioning

confidence: 99%

Plasma inflammatory biomarkers in cerebral small vessel disease: A review

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…On the other hand, the insignificant association between MMD and subcortical WMH volume might be because of other complex mechanisms, such as glymphatic dysfunction, that contribute to subcortical WMH development besides reduced perfusion. 11,15,16 Other commonly reported neurologic complications of MMD include cognitive impairment. 26 Previous studies suggested that chronic ischemia-induced reduction in white matter integrity may result in cognitive decline in patients with MMD.…”

Section: Discussionmentioning

confidence: 99%

“…The residual of fit was determined as the difference between the actual and anticipated values for the patient's age in each linear regression model. 16 Age-detrended WMH volume was log-transformed for analysis. The periventricular-to-subcortical ratio was calculated as (1 + age-detrended periventricular WMH volume)/(1 + age-detrended subcortical WMH volume) to assess the topologic preference of WMH lesions and to address the collinearity between periventricular and subcortical WMHs (r = 0.472; p < 0.001).…”

Section: Methodsmentioning

confidence: 99%

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Characteristics and Clinical Implication of White Matter Lesions in Patients With Adult Moyamoya Disease

et al. 2023

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Background and ObjectivesWhite matter hyperintensities (WMH) are reportedly increased in moyamoya disease (MMD); however, their clinical importance is not well-established owing to their pathophysiological heterogeneity by distribution. This study aimed to evaluate the burden and pattern of WMH and its clinical implications in the MMD trajectory.MethodsAdult MMD patients without significant structural lesions were 1:1 propensity score-matched with healthy controls for sex and vascular risk factors. The total, periventricular, and subcortical WMH volumes were segmented and quantified fully automatically. WMH volumes were detrended by age and compared between the two groups. MMD severity based on Suzuki stage and future ischemic events were assessed for their association with WMH volumes.ResultsA total of 161 pairs of patients with MMD and controls were analyzed. MMD significantly correlated with increased total WMH volume (B [standard error], 0.126 [0.030]; p<0.001), periventricular WMH volume (0.114 [0.027]; p<0.001), and periventricular-to-subcortical ratio (0.090 [0.034]; p=0.009). In the MMD subgroup (n=187), advanced MMD had an independent positive association with the total WMH volume (0.120 [0.035]; p<0.001), periventricular WMH volume (0.110 [0.031]; p<0.001), and periventricular-to-subcortical ratio (0.139 [0.038]; p<0.001). Periventricular WMH volume (adjusted hazard ratio [95% confidence interval], 5.12 [1.26–20.79]) and periventricular-to-subcortical ratio (3.80 [1.51–9.56]) were associated with future ischemic events in medically followed-up MMD patients. However, no demonstrable association was found between subcortical WMH volume and MMD, MMD severity, or future ischemic events.DiscussionPeriventricular WMH, but not subcortical WMH, may represent the main pathophysiology of MMD. Periventricular WMH may be used as a marker for ischemic vulnerability in patients with MMD.

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Classification of white matter lesions and characteristics of small vessel disease markers

Cited by 2 publications

References 31 publications

Plasma inflammatory biomarkers in cerebral small vessel disease: A review

Plasma inflammatory biomarkers in cerebral small vessel disease: A review

Characteristics and Clinical Implication of White Matter Lesions in Patients With Adult Moyamoya Disease

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