Large-vessel correlates of cerebral small-vessel disease
Neurology. 2013-01-23; 80(7): 662-669
Lire sur PubMed
1. Neurology. 2013 Feb 12;80(7):662-9. doi: 10.1212/WNL.0b013e318281ccc2. Epub 2013
Large-vessel correlates of cerebral small-vessel disease.
Brisset M(1), Boutouyrie P, Pico F, Zhu Y, Zureik M, Schilling S, Dufouil C,
Mazoyer B, Laurent S, Tzourio C, Debette S.
(1)Inserm U708, Neuroepidemiology, Paris, France.
OBJECTIVE: Our aim was to investigate the relationship of carotid structure and
function with MRI markers of cerebral ischemic small-vessel disease.
METHODS: The study comprised 1,800 participants (aged 72.5 ± 4.1 years, 59.4%
women) from the 3C-Dijon Study, a population-based, prospective cohort study, who
had undergone quantitative brain MRI and carotid ultrasound. We used
multivariable logistic and linear regression adjusted for age, sex, and vascular
RESULTS: Presence of carotid plaque and increasing carotid lumen diameter (but
not common carotid artery intima-media thickness) were associated with higher
prevalence of lacunar infarcts: odds ratio (OR) = 1.60 (95% confidence interval
[CI]: 1.09-2.35), p = 0.02 and OR = 1.24 (95% CI: 1.02-1.50), p = 0.03 (by SD
increase). Carotid plaque was also associated with large white matter
hyperintensity volume (WMHV) (age-specific top quartile of WMHV distribution): OR
= 1.32 (95% CI: 1.04-1.67), p = 0.02, independently of vascular risk factors.
Increasing Young elastic modulus and higher circumferential wall stress,
reflecting augmented carotid stiffness, were associated with increasing WMHV
(effect estimate [β] ± standard error: 0.0003 ± 0.0001, p = 0.024; β ± standard
error: 0.005 ± 0.002, p = 0.008). Large WMHV was also associated with increasing
Young elastic modulus (OR = 1.22 [95% CI: 1.04-1.42], p = 0.01) and with
decreasing distensibility coefficient (OR = 0.83 [95% CI: 0.69-0.99], p = 0.04),
independently of vascular risk factors. Associations of carotid lumen diameter
with lacunar infarcts and of carotid stiffness markers with WMHV were independent
of carotid plaque.
CONCLUSIONS: In addition to and independently of carotid plaque, increasing
carotid lumen diameter and markers of carotid stiffness were associated with
increasing prevalence of lacunar infarcts and increasing WMHV, respectively.
PMID: 23345633 [Indexed for MEDLINE]