Intracranial artery calcifications: Risk factors and association with cardiovascular disease and cognitive function

Golüke, Nienke M.S.; Brouwer, Eric; Jonghe, Annemarieke de; Claus, J. J.; Staekenborg, Salka S.; Emmelot-Vonk, Mariëlle H.; Jong, Pim A. de; Koek, Huiberdina L.

doi:10.1016/j.neurad.2020.08.001

Cited by 19 publications

(19 citation statements)

References 20 publications

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“…However, the link between IAC and type of dementia or cognitive disorder turned uncertain after adjustment for age and gender. Similar findings were reported in the severity of mixed dementia, which was identified as “not associated” with IAC after additional adjustment for cardiovascular risk ( 61 ). The correlation of IAC to cognitive dysfunction remained unclear.…”

Section: Clinical Relevance Of Iacsupporting

confidence: 80%

“…Although intimal calcification and medial calcification share mutual risk factors, such as age and higher pulse pressure ( 39 , 60 , 61 ), there are some differences in other traditional risk factors ( Table 2 ). After differentiating into different IAC patterns (intimal and medial), male gender and smoking were found to be independently associated with intimal calcification, while aging and diabetes mellitus were more related to medial calcification ( 60 , 64 ).…”

Section: Clinical Relevance Of Iacmentioning

confidence: 99%

“…The association between cognitive disorder and IAC has been studied in recent years. A cross-sectional study with 1992 recruited patients who were diagnosed with different types of cognitive dysfunction ( 107 ) revealed a high incidence (about 95%) of intracranial internal carotid artery calcification ( 61 ). Cognitive impairment had been observed among patients diagnosed with IAC and concurrent conditions, such as chronic hypoparathyroidism ( 108 ) and hemodialysis ( 109 ) that could directly result in irregular serum calcium.…”

Section: Clinical Relevance Of Iacmentioning

confidence: 99%

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Histology-Verified Intracranial Artery Calcification and Its Clinical Relevance With Cerebrovascular Disease

Yang

Chen

2022

Front. Neurol.

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Intracranial artery calcification (IAC) was regarded as a proxy for intracranial atherosclerosis (ICAS). IAC could be easily detected on routine computer tomography (CT), which was neglected by clinicians in the previous years. The evolution of advanced imaging technologies, especially vessel wall scanning using high resolution-magnetic resonance imaging (HR-MRI), has aroused the interest of researchers to further explore the characteristics and clinical impacts of IAC. Recent histological evidence acquired from the human cerebral artery specimens demonstrated that IAC could mainly involve two layers: the intima and the media. Accumulating evidence from histological and clinical imaging studies verified that intimal calcification is more associated with ICAS, while medial calcification, especially the internal elastic lamina, contributes to arterial stiffness rather than ICAS. Considering the highly improved abilities of novel imaging technologies in differentiating intimal and medial calcification within the large intracranial arteries, this review aimed to describe the histological and imaging features of two types of IAC, as well as the risk factors, the hemodynamic influences, and other clinical impacts of IAC occurring in intimal or media layers.

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Section: Clinical Relevance Of Iacsupporting

confidence: 80%

Section: Clinical Relevance Of Iacmentioning

confidence: 99%

Section: Clinical Relevance Of Iacmentioning

confidence: 99%

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Histology-Verified Intracranial Artery Calcification and Its Clinical Relevance With Cerebrovascular Disease

Yang

Chen

2022

Front. Neurol.

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“…Hunt et al also found that 52 out of the 142 patients who had a TIA or stroke, 65% (n = 34) did not have any carotid plaque calcification, while 35% (n = 18) had a calcified plaque (P < 0.042) [ 21 ]. In contrast, Golüke et al found that intimal and medial intracranial carotid artery calcifications were significantly associated with stroke [adjusted odds ratio (OR) 1.84, 1.88, and 2.88, respectively], and the severity of calcification in both intimal and medial layers also had significant associations with stroke and myocardial infarction [ 29 ]. Furthermore, a Korean study involving 445 patients determined that higher carotid siphon calcification scores were associated with higher rates of lacunar infarction [ 5 , 30 ].…”

Section: Reviewmentioning

confidence: 99%

“…Several studies correlated carotid artery calcifications and cardiovascular disease. Dominant intimal calcifications were significantly associated with myocardial infarction (adjusted OR 2.27 and 4.45, respectively) [ 29 ]. Patients with carotid plaques composed of large sheets of calcium were more likely to have coronary artery disease (P < 0.0333) [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

Carotid Artery Calcification: What We Know So Far

Ahmed¹,

McPherson²,

Abruzzo³

et al. 2021

Cureus

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Carotid artery calcification (CAC) is a well-known marker of atherosclerosis and is linked to a high rate of morbidity and mortality. CAC is divided into two types: intimal and medial calcifications, each with its own set of risk factors. Vascular calcification is now understood to be an active, enzymatically regulated process involving dystrophic calcification and endothelial dysfunction at an early stage. This causes a pathogenic inflammatory response, resulting in calcium phosphate deposition in the form of microcalcifications, which causes plaque formation, ultimately becoming unstable with sequelae of complications. If the inflammation goes away, hydroxyapatite crystal formation takes over, resulting in macro-calcifications that help to keep the plaque stable. As CAC can be asymptomatic, it is critical to identify it early using diagnostic imaging.The carotid artery calcification score is calculated using computed tomography angiography (CTA), which is a confirmatory test that enables the examination of plaque composition and computation of the carotid artery calcification score. Magnetic resonance angiography (MRA), which is sensitive as CTA, duplex ultrasound (DUS), positron emission tomography, and computed tomography (PET-CT) imaging with (18) F-Sodium Fluoride, and Optical Coherence Tomography (OCT) are some of the other diagnostic imaging modalities used. The current therapeutic method starts with the best medical care and is advised for all CAC patients. Carotid endarterectomy and carotid stenting are two treatment options that have mixed results in terms of effectiveness and safety. When patient age and anatomy, operator expertise, and surgical risk are all considered, the agreement is that both techniques are equally beneficial.

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Intracranial arteriosclerosis and the risk of dementia: A population‐based cohort study

van den Beukel,

Wolters,

Siebert

et al. 2023

Alzheimer's & Dementia

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BACKGROUNDThe impact of intracranial arteriosclerosis on dementia remains largely unclear.METHODSIn 2339 stroke‐free and dementia‐free participants (52.2% women, mean age 69.5 years) from the general population, we assessed intracranial carotid artery calcification (ICAC) and vertebrobasilar artery calcification (VBAC) as proxy for arteriosclerosis. Associations with dementia were assessed using Cox models. In addition, indirect effects through cerebral small vessel disease (cSVD) and subcortical brain structure volumes were assessed using causal mediation analyses.RESULTSDuring a median of 13.4 years (25th–75th percentiles 9.9–14.5) of follow‐up, 282 participants developed dementia. Both ICAC presence (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.00–2.32]) and volume (HR per standard deviation: 1.19, 95% CI: 1.01–1.40) increased dementia risk. For VBAC, severe calcifications increased dementia risk (HR for third vs first volume tertile: 1.89, 95% CI: 1.00–3.59). These effects were mediated partly through increased cSVD (percentage mediated for ICAC: 13% and VBAC: 24%).DISCUSSIONIntracranial arteriosclerosis increases the risk of dementia.

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Intracranial artery calcifications: Risk factors and association with cardiovascular disease and cognitive function

Cited by 19 publications

References 20 publications

Histology-Verified Intracranial Artery Calcification and Its Clinical Relevance With Cerebrovascular Disease

Histology-Verified Intracranial Artery Calcification and Its Clinical Relevance With Cerebrovascular Disease

Carotid Artery Calcification: What We Know So Far

Intracranial arteriosclerosis and the risk of dementia: A population‐based cohort study

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