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Cerebral arterial pulsatility is associated with features of small vessel disease in patients with acute stroke and TIA: a 4D flow MRI study
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper. Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap.ORCID-id: 0000-0001-6331-4283
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Umeå universitet, Medicinska fakulteten, Umeå centrum för funktionell hjärnavbildning (UFBI).ORCID-id: 0000-0001-6784-1945
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap.ORCID-id: 0000-0001-6451-1940
2019 (engelsk)Inngår i: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

Cerebral small vessel disease (SVD) is a major cause of stroke and cognitive impairment. However, the underlying mechanisms behind SVD are still poorly understood. High cerebral arterial pulsatility has been suggested as a possible cause of SVD. In population studies, arterial pulsatility has been linked to white matter hyperintensities (WMH), cerebral atrophy, and cognitive impairment, all features of SVD. In stroke, pulsatility data are scarce and contradictory. The aim of this study was to investigate the relationship between arterial pulsatility and SVD in stroke patients. With a cross-sectional design, 89 patients with acute ischemic stroke or TIA were examined with MRI. A neuropsychological assessment was performed 1 year later. Using 4D flow MRI, pulsatile indices (PI) were calculated for the internal carotid artery (ICA) and middle cerebral artery (M1, M3). Flow volume pulsatility (FVP), a measure corresponding to the cyclic expansion of the arterial tree, was calculated for the same locations. These parameters were assessed for associations with WMH volume, brain volume and cognitive function. ICA-FVP was associated with WMH volume (β = 1.67, 95% CI: [0.1, 3.24], p = 0.037). M1-PI and M1-FVP were associated with decreasing cognitive function (β = - 4.4, 95% CI: [- 7.7, - 1.1], p = 0.009 and β = - 13.15, 95% CI: [- 24.26, - 2.04], p = 0.02 respectively). In summary, this supports an association between arterial pulsatility and SVD in stroke patients, and provides a potential target for further research and preventative treatment. FVP may become a useful biomarker for assessing pulsatile stress with PCMRI and 4D flow MRI.

sted, utgiver, år, opplag, sider
2019.
Emneord [en]
4D flow MRI, Pulsatile index, Pulsatility, Small vessel disease, White matter hyperintensities
HSV kategori
Forskningsprogram
neurologi
Identifikatorer
URN: urn:nbn:se:umu:diva-167287DOI: 10.1007/s00415-019-09620-6PubMedID: 31728712OAI: oai:DiVA.org:umu-167287DiVA, id: diva2:1385691
Forskningsfinansiär
Swedish Research Council, 2015-05616Swedish Research Council, 2017-04949Swedish Heart Lung Foundation, 20110383Swedish Heart Lung Foundation, 20140592The Swedish Brain FoundationTilgjengelig fra: 2020-01-15 Laget: 2020-01-15 Sist oppdatert: 2020-01-17bibliografisk kontrollert

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Birnefeld, JohanWåhlin, AndersEklund, AndersMalm, Jan

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