Enlarged perivascular spaces and cognitive impairment after stroke and transient ischemic attack

被引:133
作者
Arba, Francesco [1 ,2 ]
Quinn, Terence J. [3 ]
Hankey, Graeme J. [4 ]
Lees, Kennedy R. [5 ]
Wardlaw, Joanna M. [6 ]
Ali, Myzoon [2 ]
Inzitari, Domenico [1 ]
机构
[1] Univ Florence, Neurofarba Dept, Largo Brambilla 3, I-50134 Florence, Italy
[2] Queen Elizabeth Univ Hosp Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland
[3] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland
[4] Univ Western Australia, Harry Perkins Inst Med Res, Sch Med & Pharmacol, QEII Med Ctr, Perth, WA, Australia
[5] Univ Glasgow, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland
[6] Univ Edinburgh, Div Neuroimaging Sci JMW, Edinburgh, Midlothian, Scotland
关键词
Perivascular spaces; small vessel disease; stroke; transient ischemic attack; cognitive impairment; SMALL VESSEL DISEASE; VIRCHOW-ROBIN SPACES; BLOOD-PRESSURE; MRI MARKERS; AGREEMENT; DIAGNOSIS; DEMENTIA;
D O I
10.1177/1747493016666091
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background Previous studies suggested that enlarged perivascular spaces are neuroimaging markers of cerebral small vessel disease. However, it is not clear whether enlarged perivascular spaces are associated with cognitive impairment. We aimed to determine the cross-sectional relationship between enlarged perivascular spaces and small vessel disease, and to investigate the relationship between enlarged perivascular spaces and subsequent cognitive impairment in patients with recent cerebral ischemic event. Methods Anonymized data were accessed from the virtual international stroke trial archive. We rated number of lacunes, white matter hyperintensities, brain atrophy, and enlarged perivascular spaces with validated scales on magnetic resonance brain images after the index stroke. We defined cognitive impairment as a mini mental state examination score of 26, recorded at one year post stroke. We examined the associations between enlarged perivascular spaces and clinical and imaging markers of small vessel disease at presentation and clinical evidence of cognitive impairment at one year using linear and logistic regression models. Results We analyzed data on 430 patients with mean (SD) age 64.7 (+/- 12.7) years, 276 (64%) males. In linear regression analysis, age (=0.24; p<0.001), hypertension (=0.09; p=0.025), and deep white matter hyperintensities (=0.31; p<0.001) were associated with enlarged perivascular spaces. In logistic regression analysis, basal ganglia enlarged perivascular spaces were independently associated with cognitive impairment at one year after adjusting for clinical confounders (OR=1.72, 95% CI=1.22-2.42) and for clinical and imaging confounders (OR=1.54; 95% CI=1.03-2.31). Conclusions Our data show that in patients with ischemic cerebral events, enlarged perivascular spaces are cross-sectionally associated with age, hypertension, and white matter hyperintensities and suggest that enlarged perivascular spaces in the basal ganglia are associated with cognitive impairment after one year.
引用
收藏
页码:47 / 56
页数:10
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