Chuang Shao-Yuan, Wang Pei-Ning, Chen Liang-Kung, Chou Kun-Hsien, Chung Chih-Ping, Chen Chen-Huan, Mitchell Gary F, Pan Wen-Harn, Cheng Hao-Min
Institute of Population Health Science, National Health Research Institute, Miaoli, Taiwan.
Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
Transl Stroke Res. 2021 Apr;12(2):248-258. doi: 10.1007/s12975-020-00836-7. Epub 2020 Aug 1.
Cerebral small vessel disease (CSVD) is a common finding on brain magnetic resonance imaging (MRI). We previously demonstrated that high blood pressure (BP) and low carotid flow velocity were associated with cerebrovascular disease. However, their associations with brain volume and CSVD remain to be determined. A total of 721 adults (≥ 50 years) from the community-based I-Lan Longitudinal Aging Study were included. Flow velocities at the common (CCA) and internal carotid artery (ICA), including peak systolic velocity (PSV) and end-diastolic velocity (EDV), were measured with Doppler ultrasound. We further detected the presence of CSVD including lacune, microbleed, and white matter hyperintensity (WMH) on brain MRI, which were used to construct a combined CSVD score. General linear regression and logistic regression analysis were exploited to evaluate the association between carotid flow velocity, BP, brain volume, and CSVD. The mean of white matter, gray matter, and WMH volume were 422.2 cm, 546.9 cm, and 2.61 cm, respectively. The proportion of lacune and microbleed were 11.1% and 14.2%, respectively. The CSVD score were negatively associated with gray (r = - 0.121, p < .01) and white matter volume (r = 0.058, p = 0.12), but positively associated with systolic BP (beta = 1.02, p = 0.0017). EDV at common carotid artery associated positively with white matter volume (beta = 1.013, p = 0.0064) and negatively predicted the presence CSVD (odds ratio [OR] = 0.93, p = 0.0023). In the ordinal logistic regression analysis adjusting for age, sex, total intracranial volume education, low-density lipoprotein cholesterol, and fasting glucose, compared with hypertensive subjects with low EDV, normotensive subjects with low, middle, and high EDV had an odds ratio of 0.656 (0.327-1.318), 0.429 (0.261-0.705), and 0.272 (0.147-0.502) for CSVD score, respectively. High SBP and low carotid flow velocities were independently associated with brain volume and CSVD. These associations may be involved in the pathophysiology of cognitive function decline.
脑小血管病（CSVD）是脑磁共振成像（MRI）中常见的表现。我们之前证明高血压（BP）和低颈动脉血流速度与脑血管疾病有关。然而，它们与脑容量和CSVD的关联仍有待确定。纳入了来自宜兰纵向老龄化社区研究的721名成年人（≥50岁）。使用多普勒超声测量颈总动脉（CCA）和颈内动脉（ICA）的血流速度，包括收缩期峰值速度（PSV）和舒张末期速度（EDV）。我们进一步在脑MRI上检测CSVD的存在，包括腔隙、微出血和白质高信号（WMH），并用于构建综合CSVD评分。采用一般线性回归和逻辑回归分析来评估颈动脉血流速度、BP、脑容量和CSVD之间的关联。白质、灰质和WMH体积的平均值分别为422.2cm³、546.9cm³和2.61cm³。腔隙和微出血的比例分别为11.1%和14.2%。CSVD评分与灰质（r = -0.121，p < 0.01）和白质体积（r = 0.058，p = 0.12）呈负相关，但与收缩压呈正相关（β = 1.02，p = 0.0017）。颈总动脉的EDV与白质体积呈正相关（β = 1.013，p = 0.0064），并对CSVD的存在呈负向预测（比值比[OR] = 0.93，p = 0.0023）。在调整年龄、性别、总颅内体积、教育程度、低密度脂蛋白胆固醇和空腹血糖的有序逻辑回归分析中，与低EDV的高血压受试者相比，低、中和高EDV的血压正常受试者的CSVD评分比值比分别为0.656（0.327 - 1.318）、0.429（0.261 - 0.705）和0.272（0.147 - 0.502）。高收缩压和低颈动脉血流速度与脑容量和CSVD独立相关。这些关联可能参与了认知功能下降的病理生理过程。
