Xu Yun, Song Yifan, Tang Tieqi, Jia Weili, Xu Huijuan, Li Yu, Guo Yu, Wang Xiaorui, Liu Ruihong
Department of Ultrasonography, Electric Power Teaching Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Electric Power Teaching Hospital, Capital Medical University, Beijing, China.
Cerebrovasc Dis Extra. 2025;15(1):93-101. doi: 10.1159/000543355. Epub 2025 Jan 2.
The recently proposed cerebral small vessel disease (CSVD) score system may help capture the overall burden of CSVD. This study aimed to investigate the associations between carotid artery ultrasound features and the burden score and cognitive performance of CSVD patients.
This is a cross-sectional analysis of an ongoing prospective study. From May 2019 to October 2023, 287 patients with at least one neuroimaging marker of CSVD were recruited and underwent carotid ultrasound examination, brain magnetic resonance imaging (MRI) scans, and neuropsychological assessment. Carotid artery properties, including carotid plaque, intima-media thickness (IMT), β stiffness index (β-index), Peterson's elastic modulus (PEM), and pulse wave velocity-β (PWV-β), were calculated. The CSVD score was graded according to MRI evaluation. Participants were classified as having cognitive impairment (CI) or normal cognitive function (NCF) according to Montreal Cognitive Assessment (MoCA) scale.
A total of 209 eligible patients were included in the final analysis. A significant difference was revealed regarding the CSVD score between CI and NCF participants (p < 0.001). After adjusted for covariates, increased IMT (OR = 1.11, 95% CI: 1.04-1.37, p = 0.030) and PWV-β (OR = 1.24, 95% CI: 1.09-1.51, p = 0.006) were both associated with the presence of CI. IMT and PWV-β were also associated with worse performance on attention and processing speed (IMT: β = -0.13, p = 0.011; PWV-β: β = -0.21, p = 0.011), and executive function (IMT: β = -0.20, p = 0.024; PWV-β: β = -0.33, p = 0.008). Additionally, PEM was negatively associated with executive function (β = -0.20, p = 0.009). Furthermore, binary logistic regression indicated that IMT (OR = 1.45, 95% CI: 1.18-2.01, p = 0.006), β-index (OR = 1.30, 95% CI: 1.10-1.64, p = 0.008) and PWV-β (OR = 1.23, 95% CI: 1.01-1.89, p = 0.047) were independently related to a moderate to severe CSVD burden score.
Carotid artery atherosclerosis and stiffness are associated with the burden score and cognitive performance of CSVD patients. Noninvasive ultrasound parameters of the carotid artery are capable of discriminating high-risk individuals with CSVD.
最近提出的脑小血管病（CSVD）评分系统可能有助于评估CSVD的总体负担。本研究旨在探讨颈动脉超声特征与CSVD患者负担评分及认知表现之间的关联。
这是一项正在进行的前瞻性研究的横断面分析。2019年5月至2023年10月，招募了287例至少有一项CSVD神经影像学标志物的患者，他们接受了颈动脉超声检查、脑磁共振成像（MRI）扫描和神经心理学评估。计算颈动脉特性，包括颈动脉斑块、内膜中层厚度（IMT）、β硬度指数（β指数）、彼得森弹性模量（PEM）和脉搏波速度-β（PWV-β）。根据MRI评估对CSVD评分进行分级。根据蒙特利尔认知评估（MoCA）量表，将参与者分为有认知障碍（CI）或正常认知功能（NCF）。
最终分析纳入了209例符合条件的患者。CI和NCF参与者之间的CSVD评分存在显著差异（p<0.001）。在调整协变量后，IMT增加（OR=1.11，95%CI：1.04-1.37，p=0.030）和PWV-β增加（OR=1.24，95%CI：1.09-1.51，p=0.006）均与CI的存在相关。IMT和PWV-β也与注意力和处理速度较差的表现相关（IMT：β=-0.13，p=0.011；PWV-β：β=-0.21，p=0.011），以及执行功能（IMT：β=-0.20，p=0.024；PWV-β：β=-0.33，p=0.008）。此外，PEM与执行功能呈负相关（β=-0.20，p=0.009）。此外，二元逻辑回归表明，IMT（OR=
