Pathogenesis and research progress in leukoaraiosis

Sun, Lingqi; Lin, Hui; Li, Yang; Chen, Xian; Liu, Rong; Ma, Jianmin

doi:10.3389/fnhum.2022.902731

Cited by 10 publications

(8 citation statements)

References 158 publications

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“…Cumulative evidence demonstrated that WMLs was associated with an increased risk of symptomatic stroke, cognitive impairment, and death. 25,26 In our study, we found that 44.9% of patients who suffered an ischemic stroke present with moderate-severe WMLs. These results broadly agree with the findings of previous studies.…”

Section: Discussionmentioning

confidence: 52%

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Zhao,

Xu,

et al. 2023

JIR

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High-mobility group box-1 (HMGB1) is a useful biomarker for disease severity stratification and prognosis prediction. We aim to explore whether the circulating HMGB1 concentrations are associated with the white matter lesions (WMLs) burden in stroke patients. Methods: Between 2022 June and December 2022, patients with acute ischemic stroke were prospectively enrolled. HMGB1 levels were measured by an enzyme-linked immunosorbent assay after admission for all patients. The WMLs severity was assessed by the Fazekas scale. We dichotomized patients into those with moderate-severe WMLs (Fazekas score 3-6) versus those with none-mild WMLs (Fazekas score 0-2). Furthermore, based on the severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs), patients were categorized as none-mild (Fazekas score 0-1) or moderate-severe (Fazekas score 2-3). Results: A total of 287 participants (mean age: 64.9 years; 157 male) were analyzed. The median serum HMGB1 levels were 7.3 ng/mL (interquartile, 4.3 ng/mL-12.3 ng/mL). After adjustment for potential confounders, elevated HMGB1 levels were associated with the presence of moderate-severe WMLs (first quartile vs fourth quartile, odds ratio [OR], 4.101; 95% confidence interval [CI], 1.948-8.633; P = 0.001) and moderate-severe PWMLs (first quartile vs fourth quartile, OR, 9.181; 95% CI, 4.078-20.671; P = 0.001). Similar results were found when the HMGB1 levels were analyzed as a continuous variable. Conclusion:This study demonstrated that increased HMGB1 levels were associated with the severity of WMLs, mainly in the periventricular region.

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Section: Discussionmentioning

confidence: 52%

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Zhao,

Xu,

et al. 2023

JIR

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“…Unfortunately, neuroimaging findings regarding the presence of microbleeds or white matter hyperintensities were not available for analysis in our study. Yet, the correlation of b‐SICH and r‐SICH with age may be partly interpreted through the prism that the prevalence of both microbleeds and leukoaraiosis consistently increase with age [34–36]. Furthermore, with regard to previous ischaemic lesions, a history of previous stroke or TIA was indeed more frequent in patients with r‐SICH compared to l‐SICH.…”

Section: Discussionmentioning

confidence: 99%

Predictors of functional outcome after symptomatic intracranial hemorrhage complicating intravenous thrombolysis: results from the SITS‐ISTR

Tsivgoulis

Palaiodimou

Stefanou

et al. 2023

Euro J of Neurology

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Background and purposeSeveral risk factors of symptomatic intracerebral hemorrhage (SICH) following intravenous thrombolysis for acute ischaemic stroke have been established. However, potential predictors of good functional outcome post‐SICH have been less studied.MethodsPatient data registered in the Safe Implementation of Treatment in Stroke—International Stroke Thrombolysis Register (SITS‐ISTR) from 2005 to 2021 were used. Acute ischaemic stroke patients who developed post intravenous thrombolysis SICH according to the SITS Monitoring Study definition were analyzed to identify predictors of functional outcomes.ResultsA total of 1679 patients with reported SICH were included, out of which only 2.8% achieved good functional outcome (modified Rankin Scale scores of 0–2), whilst 80.9% died at 3 months. Higher baseline National Institutes of Health Stroke Scale (NIHSS) score and 24‐h ΔNIHSS score were independently associated with a lower likelihood of achieving both good and excellent functional outcomes at 3 months. Baseline NIHSS and hematoma location (presence of both SICHs, defined as remote and local SICH concurrently; n = 478) were predictors of early mortality within 24 h. Independent predictors of 3‐month mortality were age, baseline NIHSS, 24‐h ΔNIHSS, admission serum glucose values and hematoma location (both SICHs). Age, baseline NIHSS score, 24‐h ΔNIHSS, hyperlipidemia, prior stroke/transient ischaemic attack, antiplatelet treatment, diastolic blood pressure at admission, glucose values on admission and SICH location (both SICHs) were associated with reduced disability at 3 months (≥1‐point reduction across all modified Rankin Scale scores). Patients with remote SICH (n = 219) and local SICH (n = 964) had comparable clinical outcomes, both before and after propensity score matching.ConclusionsSymptomatic intracerebral hemorrhage presents an alarmingly high prevalence of adverse clinical outcomes, with no difference in clinical outcomes between remote and local SICH.

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“…Similarly, a previous study found patients with transient ischemic attack within 3 days of onset show an increase in choline ( Bisschops et al, 2002 ). Ischemia or hypometabolism are also potential pathogenic mechanisms for LA ( Sun et al, 2022 ). In the subgroup analysis, the level of tCho showed no significant increase in mild WMHs subgroup patients compared to healthy controls, which suggests that mild cerebral white matter hyperintensities do not cause changes in the level of tCho until the disease has progressed to a certain level.…”

Section: Discussionmentioning

confidence: 99%

Reduced GABA concentration in patients with white matter hyperintensities

Wang,

Miao

et al. 2023

Front. Neurosci.

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To investigate potential alterations of white matter hyperintensities (WMHs) on J-edited MR spectroscopy (MRS) measures of the primary inhibitory neurotransmitter γ-aminobutyric acid (GABA). Twenty-four WMHs patients and 20 healthy controls (HCs) were recruited to undergo magnetic resonance spectroscopy (MRS) scan at 3T from voxels in left centrum semiovale white matter, using the MEGA point resolved spectroscopy (MEGA-PRESS) technique with the MATLAB-based Gannet tool to estimate GABA+ co-edited macromolecule (GABA+) levels and using Tarquin software to estimate levels of glutamate + glutamine (Glx), total N-acetylaspartate (tNAA), total choline (tCho), and total creatine (tCr). Independent t-tests or Mann-Whitney U-tests were used to test group differences between WMHs and HCs. Additionally, WMHs patients were divided into mild and moderate-severe WMHs subgroup according to the Fazekas scale. Analysis of variance (ANOVA) and post-hoc tests were used among WMHs subgroups and HCs. We found there was a significant reduction in GABA+ levels (p = 0.018) in WMHs patients compared with healthy controls. In subgroup analyses, there was also a significant reduction of GABA+ levels in moderate-severe WMHs subgroup (p = 0.037) and mild WMHs subgroup (p = 0.047) when compared to HCs. Besides, the moderate-severe WMHs subgroup had significantly higher levels of tCho compared with healthy controls (p = 0.019). In conclusion, reduced GABA+ levels in WMHs patients and elevated tCho levels in moderate-severe WMHs were observed when compared with HCs. These results demonstrate that abnormalities of the GABAergic system and choline metabolism may contribute to the pathogenesis of WMHs.

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Pathogenesis and research progress in leukoaraiosis

Cited by 10 publications

References 158 publications

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Predictors of functional outcome after symptomatic intracranial hemorrhage complicating intravenous thrombolysis: results from the SITS‐ISTR

Reduced GABA concentration in patients with white matter hyperintensities

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