Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries

Hilal, Saima; Mok, Vincent; Youn, Young Chul; Wong, Adrian; Ikram, M. Kamran; Chen, Christopher

doi:10.1136/jnnp-2016-315324

Cited by 187 publications

(160 citation statements)

References 25 publications

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“…This result may be unexpected since vascular risk factors (a predictor of WMSA) [40,41] are exclusion criteria in ADNI. However, previous studies showed that WMSA burden increases with older age [41,42], and ADNI patients are older than KIDS patients in our study, which could explain our nding of higher WMSA in ADNI. This nding aligns with the recent conceptual framework of biological subtypes of AD [5], i.e., older patients had higher WMSA burden, they more frequently had an A + T + N + pro le, and included a higher proportion of typical and limbic-predominant AD cases.…”

Section: Discussioncontrasting

confidence: 63%

“…Although using different methods for WMSA could induce some noise in our analysis, we recently showed that both methods are strongly associated with each other [27]. Further, by classifying the output from both methods into high and low WMSA burden, we used a rougher measure that is less in uenced by differences between the two methods and has greater clinical applicability [42].…”

Section: Limitationsmentioning

confidence: 99%

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Atrophy subtypes and the ATN classification scheme in Alzheimer’s disease

Cedrés

Ekman

Poulakis

et al. 2020

Preprint

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BACKGROUND We investigated the association between atrophy subtypes of Alzheimer’s disease (AD), the ATN classification scheme, and key demographic and clinical factors, in two cohorts with different source characteristics (a highly selective research-oriented cohort, ADNI; and a naturalistic heterogeneous clinically-oriented cohort, Karolinska Imaging Dementia Study (KIDS). METHODS A total of 382 AD patients were included. Factorial analysis of mixed data was used to investigate associations between AD subtype based on brain atrophy patterns, ATN profiles based on cerebrospinal fluid biomarkers, and age, sex, Mini Mental State Examination (MMSE), cerebrovascular disease (CVD) (burden of white matter signal abnormalities, WMSA), and APOE genotype. RESULTS Older patients with high WMSA burden, belonging to the typical AD subtype, and showing A + T + N + or A + T + N- profiles clustered together and were mainly from ADNI. Younger patients with low WMSA burden, limbic-predominant or minimal atrophy AD subtypes, and A + T-N- or A + T-N + profiles, clustered together and were mainly from KIDS. APOE ε4 carriers more frequently showed the A + T-N- and A + T + N- profiles. CONCLUSIONS Our findings align with the recent framework for biological subtypes of AD: the combination of risk factors, protective factors, and brain pathologies determines belonging of AD patients to distinct subtypes.

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Section: Discussioncontrasting

confidence: 63%

Section: Limitationsmentioning

confidence: 99%

Atrophy subtypes and the ATN classification scheme in Alzheimer’s disease

Cedrés

Ekman

Poulakis

et al. 2020

Preprint

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“…Ни для кого не секрет, что АГосновной фактор риска хронической ишемии головного мозга и сосудистых когнитивных нарушений. По разным данным, поражение головного мозга, не вызванное инсультом, встречается у 70-95% пациентов с АГ в зависимости от возраста, пола и критериев включения [27,28]. Вследствие поражения головного мозга на фоне гипертонической болезни формируются нарушения когнитивных функций [29].…”

Section: причины коморбидности хронической боли и артериальной гипертunclassified

Comorbidity of Hypertension and Chronic Pain Syndrome

Grinyuk¹,

Vv²

2019

EPh

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The paper discusses the reasons of frequent comorbidity of hypertension and chronic pain syndrome. The pathogenesis of both conditions includes dysfunction of same anatomical structures of the central nervous system. According some observation, chronic pain syndrome significantly increases the risk of hypertension. The conditions share common risk factors like old age, decrease of physical activity, obesity, etc. Both conditions are accompanied by the increase in concentration of the factors of systemic inflammation of blood, cognitive impairment and depression. The paper presents case report of the patient with the association of hypertension and chronic pain syndrome.

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“…To date, SVD has been recognized to be the second commonest cause of dementia, gait disturbances, affective disorders and late-onset depression [5]. SVD is becoming a major public health issue in Asian countries especially in China [6].…”

Section: Introductionmentioning

confidence: 99%

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

Shan

et al. 2019

BMC Neurol

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Background The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China. Methods We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12–20 ng/ml) and sufficiency (> 20 ng/ml). Results Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls ( P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level ( P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD ( OR 0.772, 95% CI 0.691–0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006–15.683) and 1.077 (95% CI : 0.338–3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398–39.540) and 1.108 (95% CI 0.232–5.280), respectively ( P interaction = 0.001). Conclusion We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

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Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries

Abstract: Elderly Asians have a high burden of SVD which was associated with cognitive dysfunction. This suggests that SVD markers should be a potential target for treatment in clinical trials so as to delay progression of cerebrovascular disease and potentially cognitive decline.

Cited by 187 publications

References 25 publications

Atrophy subtypes and the ATN classification scheme in Alzheimer’s disease

Atrophy subtypes and the ATN classification scheme in Alzheimer’s disease

Comorbidity of Hypertension and Chronic Pain Syndrome

The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China

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