Pandemic of the aging society — sporadic cerebral small vessel disease

Lau, Amy Hing‐Ling; Ip, Bonaventure; Ko, Ho; Lam, Bonnie Yin Ka; Shi, Lin; Ma, Karen Ka Yan; Au, Lisa; Soo, Yannie; Leung, Thomas Wai Hong; Wong, Adrian; Mok, Vincent Chung Tong

doi:10.1097/cm9.0000000000001320

Cited by 8 publications

(7 citation statements)

References 93 publications

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“…As a part of system for drainage of waste metabolites in the brain, PVS influence the pathogenesis of common cerebrovascular, neuroinflammatory, and neurodegenerative disorders. [17,18] The association of PVS and vascular dementia was detected. [19] In addition, some studies confirmed that oxidative stress [20] and inflammatory [21,22] played a key role in stroke and vascular dementia, and it provided a direction to explore the mechanism of PVS.…”

Section: Discussionmentioning

confidence: 99%

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

Huang,

Hou,

Wang

et al. 2023

Chinese Medical Journal

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Background: In the clinic, practitioners encounter many patients with an abnormal pattern of dense punctate magnetic resonance imaging (MRI) signal in the basal ganglia, a phenomenon known as "cheese sign". This sign is reported as common in cerebrovascular diseases, dementia, and old age. Recently, cheese sign has been speculated to consist of dense perivascular space (PVS). This study aimed to assess the lesion types of cheese sign and analyze the correlation between this sign and vascular disease risk factors. Methods: A total of 812 patients from Peking Union Medical College Hospital (PUMCH) dementia cohort were enrolled. We analyzed the relationship between cheese sign and vascular risk. For assessing cheese sign and defining its degree, the abnormal punctate signals were classified into basal ganglia hyperintensity (BGH), PVS, lacunae/infarctions and microbleeds, and counted separately. Each type of lesion was rated on a four-level scale, and then the sum was calculated; this total was defined as the cheese sign score. Fazekas and Age-Related White Matter Changes (ARWMC) scores were used to evaluate the paraventricular, deep, and subcortical gray/white matter hyperintensities. Results: A total of 118 patients (14.5%) in this dementia cohort were found to have cheese sign. Age (odds ratio [OR]: 1.090, 95% confidence interval [CI]: 1.064–1.120, P <0.001), hypertension (OR: 1.828, 95% CI: 1.123–2.983, P = 0.014), and stroke (OR: 1.901, 95% CI: 1.092–3.259, P = 0.025) were risk factors for cheese sign. There was no significant relationship between diabetes, hyperlipidemia, and cheese sign. The main components of cheese sign were BGH, PVS, and lacunae/infarction. The proportion of PVS increased with cheese sign severity. Conclusions: The risk factors for cheese sign were hypertension, age, and stroke. Cheese sign consists of BGH, PVS, and lacunae/infarction.

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Section: Discussionmentioning

confidence: 99%

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

Huang,

Hou,

Wang

et al. 2023

Chinese Medical Journal

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“…In recent years, quantification of white matter hyperintensity (WMH) volumes on T2 fluid-attenuated inversion recovery (FLAIR) images has shed light on the contribution of CSVD to age-related cognitive decline 38 . While the exact etiology of WMH is still debated, potential pathogenic mechanisms include hypoxic events which are thought to cause small vessel ischemic episodes leading to cerebral white matter damage and leukoaraiosis 39,40 .…”

Section: Introductionmentioning

confidence: 99%

Cerebrovascular pathology mediates associations between hypoxemia during rapid eye movement sleep and medial temporal lobe structure and function in older adults

Berisha,

Rizvi,

Chappel-Farley

et al. 2024

Preprint

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Obstructive sleep apnea (OSA) is common in older adults and is associated with medial temporal lobe (MTL) degeneration and memory decline in aging and Alzheimer's disease (AD). However, the underlying mechanisms linking OSA to MTL degeneration and impaired memory remains unclear. By combining magnetic resonance imaging (MRI) assessments of cerebrovascular pathology and MTL structure with clinical polysomnography and assessment of overnight emotional memory retention in older adults at risk for AD, cerebrovascular pathology in fronto-parietal brain regions was shown to statistically mediate the relationship between OSA-related hypoxemia, particularly during rapid eye movement (REM) sleep, and entorhinal cortical thickness. Reduced entorhinal cortical thickness was, in turn, associated with impaired overnight retention in mnemonic discrimination ability across emotional valences for high similarity lures. These findings identify cerebrovascular pathology as a contributing mechanism linking hypoxemia to MTL degeneration and impaired sleep-dependent memory in older adults.

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“…Cerebral small vessel disease (CSVD), in its prevalent sporadic form, refers to a syndrome of clinical and neuroimaging findings in ageing populations that is frequently related to vascular risk factors and onset of neurological impairments including stroke, dementia, parkinsonism, gait problems, and mood disturbances[ 1 , 2 ]. Sporadic CSVD pathologies are often heterogeneous, as evidenced by neuroimaging findings such as lacunes, white matter hyperintensities and enlarged perivascular spaces on T2-weighted magnetic resonance imaging (MRI)[ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects

Safri¹,

Nassir²,

Iman³

et al. 2022

WJCC

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Cerebral small vessel disease (CSVD) is a leading cause of age-related microvascular cognitive decline, resulting in significant morbidity and decreased quality of life. Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging (MRI), key questions on CSVD remain elusive. Enhanced relationships and reliable lesion studies, such as white matter tractography using diffusion-based MRI (dMRI) are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD. Diffusion tensor imaging (DTI) and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage. However, due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting, interpreting the findings remain contentious, especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use. In this minireview, we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD, even for subclinical CSVD in at-risk individuals.

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Pandemic of the aging society — sporadic cerebral small vessel disease

Cited by 8 publications

References 93 publications

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

Cerebrovascular pathology mediates associations between hypoxemia during rapid eye movement sleep and medial temporal lobe structure and function in older adults

Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects

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