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Arterial, Venous, and Cerebrospinal Fluid Flow and Pulsatility in Stroke-Related Cerebral Small Vessel Disease: A Longitudinal Analysis

Title: Arterial, Venous, and Cerebrospinal Fluid Flow and Pulsatility in Stroke-Related Cerebral Small Vessel Disease: A Longitudinal Analysis
Authors: Morgan, Alasdair G.; Thrippleton, Michael J.; Stringer, Michael S.; Chappell, Francesca M.; Valdés-Hernández, Maria C.; Wiseman, Stewart; Ballerini, Lucia; Brown, Rosalind; Cheng, Yajun; Liu, Xiaodi; Zhang, Junfang; Sakka, Eleni; Jamie Garcia, Daniela; Sleight, Emilie; Manning, Cameron; Coello, Roberto D.; Job, Dominic; Jochems, Angela; Arteaga Reyes, Carmen; Clancy, Una; Marshall, Ian; Doubal, Fergus N.; Wardlaw, Joanna M.
Source: Stroke ; volume 56, issue 9, page 2450-2463 ; ISSN 0039-2499 1524-4628
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2025
Description: BACKGROUND: Cerebral small vessel disease (SVD) causes up to 45% of dementias and 25% of ischemic strokes, but the understanding of vascular pathophysiology is limited. We aimed to investigate the contribution of pulsatility of intracranial arteries, veins, and cerebrospinal fluid (CSF) and cerebral blood flow to long-term imaging and clinical outcomes in SVD. METHODS: We prospectively recruited participants in Edinburgh/Lothian, Scotland, with lacunar or nonlacunar ischemic stroke (modified Rankin Scale score ≤2, as controls) and assessed medical and brain magnetic resonance imaging characteristics at baseline and 1 year (2018–2022). We used phase-contrast magnetic resonance imaging to measure flow and pulsatility in major cerebral vessels and CSF to investigate independent associations with baseline white matter hyperintensity (WMH) and perivascular space (PVS) volumes and their progression, as well as with recurrent stroke, functional, and cognitive outcomes at 1 year. We applied linear, logistic, and ordinal regression models in our analysis. RESULTS: We recruited 210 participants; 205 (66.8% male; aged 66.4±11.1 years) had useable data. In covariate-adjusted analyses, higher baseline arterial pulsatility was associated with larger volumes of baseline WMH (B=0.26 [95% CI, 0.08–0.44]; P =0.01) and basal ganglia PVS (B=0.12 [95% CI, 0.04–0.20]; P
Document Type: article in journal/newspaper
Language: English
DOI: 10.1161/strokeaha.124.049103
DOI: 10.1161/STROKEAHA.124.049103
Availability: https://doi.org/10.1161/strokeaha.124.049103; https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.124.049103
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.11CC299D
Database: BASE