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Endothelial Function, Inflammation, Thrombosis, and Basal Ganglia Perivascular Spaces in Patients with Stroke.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2016 Dec; Vol. 25 (12), pp. 2925-2931. Date of Electronic Publication: 2016 Aug 27. - Publication Year :
- 2016
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Abstract
- Background and Objective: Recent studies suggest perivascular spaces are a marker of small vessel disease, blood-brain barrier permeability, and inflammation, but little is known about their risk factors and associations with peripheral blood markers.<br />Materials and Methods: In prospectively recruited patients with recent minor ischemic stroke, we investigated the influence of age, sex, hypertension, diabetes, and smoking on the severity of perivascular spaces in the basal ganglia seen on T2-weighted magnetic resonance imaging. We assessed plasma markers of endothelial function (von Willebrand factor, intracellular adhesion molecule-1), inflammation (interleukin-6, tumor necrosis factor-alpha, C-reactive protein), and thrombosis (fibrinogen, prothrombin fragments 1 + 2, thrombin-antithrombin complex, tissue plasminogen activator, D-dimer). We used a validated semi-automated method to measure basal ganglia perivascular spaces count and volume. We tested uni- and multivariable associations between blood markers and basal ganglia perivascular spaces count and volume.<br />Findings: In 100 patients (median age: 67 years, range: 37-92), on adjusted analysis, basal ganglia perivascular spaces count was associated with age (r = .117, P = .003) and hypertension (r = 2.225, P = .013). On multivariable linear regression, adjusted for age, sex, hypertension, smoking and diabetes, reduced von Willebrand factor was associated with increased basal ganglia perivascular spaces count (r = -.025, P = .032).<br />Conclusion: The association of increased basal ganglia perivascular spaces count with reduced von Willebrand factor is novel. As von Willebrand factor may promote cerebral endothelial integrity, insufficient von Willebrand factor is consistent with dysfunctional cerebral endothelium and increased basal ganglia perivascular spaces in cerebral small vessel disease. Quantitative perivascular spaces measurement may increase sensitivity to detect cerebral endothelial dysfunction.<br /> (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Basal Ganglia diagnostic imaging
Biomarkers blood
Brain Ischemia blood
Brain Ischemia diagnostic imaging
Brain Ischemia physiopathology
Cerebral Arteries diagnostic imaging
Cerebral Arteries physiopathology
Cerebral Small Vessel Diseases blood
Cerebral Small Vessel Diseases diagnostic imaging
Cerebral Small Vessel Diseases physiopathology
Diffusion Magnetic Resonance Imaging
Down-Regulation
Endothelium, Vascular diagnostic imaging
Endothelium, Vascular physiopathology
Female
Humans
Inflammation Mediators blood
Intracranial Thrombosis blood
Intracranial Thrombosis diagnostic imaging
Intracranial Thrombosis physiopathology
Linear Models
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
Risk Factors
Stroke blood
Stroke diagnostic imaging
Stroke physiopathology
Basal Ganglia blood supply
Brain Ischemia etiology
Cerebral Arteries metabolism
Cerebral Small Vessel Diseases complications
Endothelium, Vascular metabolism
Intracranial Thrombosis complications
Stroke etiology
von Willebrand Factor metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 25
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 27576214
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.08.007