Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease
Abstract Background Basilar artery branch atheromatous disease (BABAD), in which basilar artery atheroma occludes penetrating arteries at their origin, is a common etiology of posterior circulation stroke (PCS). It is currently unknown whether white matter hyperintensity(WMH), a marker of small vess...
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doaj-f9b469fcdb354b019357e02518e8c5c82020-11-25T00:21:37ZengBMCBMC Neurology1471-23772017-07-011711610.1186/s12883-017-0918-yGreater periventricular white matter hyperintensity severity in basilar artery branch atheromatous diseasePo-Chen Lin0Feng-Chi Chang1Hui-Chi Huang2Jui-Yao Tsai3Yung-Yang Lin4Chih-Ping Chung5Department of Neurology, Taipei Veterans General HospitalNational Yang Ming UniversityDepartment of Neurology, Taipei Veterans General HospitalDepartment of Neurology, Taipei Veterans General HospitalDepartment of Neurology, Taipei Veterans General HospitalDepartment of Neurology, Taipei Veterans General HospitalAbstract Background Basilar artery branch atheromatous disease (BABAD), in which basilar artery atheroma occludes penetrating arteries at their origin, is a common etiology of posterior circulation stroke (PCS). It is currently unknown whether white matter hyperintensity(WMH), a marker of small vessel disease(SVD), is associated with BABAD. Methods The present study analyzed data from patients with PCS who were enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and February 28, 2014. WMH severity was rated using the Scheltens scale. We used multivariate analyses to: (1) compare the severity of WMH between patients with BABAD, patients with large-artery > 50% atherosclerotic stenosis-related PCS(LAA), and non-stroke subjects(NS); and (2) evaluate the relationship between WMH severity and the 3-month prognosis of patients with BABAD. Results The study pool included 151 BABAD, 97 LAA, and 78 non-stroke patients. Multivariate analyses adjusting for age, sex, and vascular risk factors showed that compared to patients with LAA [Odds ratio(OR) = 0.51, p = 0.037] and NS (OR = 0.40, p = 0.004), patients with BABAD (OR = 1) had greater WMH severity (score ≥ 50th percentile) in periventricular, but not subcortical, regions. Moreover, greater periventricular WMH severity predicted poor 3-month functional outcomes (modified Rankin Scale > 3) with an OR of 3.21 (p = 0.028) in BABAD patients. Conclusions We are the first to show a significant association between WMH and BABAD that is independent of vascular risk factors and atherosclerotic large-artery disease. Our results suggest that small vessel abnormalities other than lipohyalinosis may be involved in BABAD pathophysiology. A future management strategy should include both large and small vessel protection.http://link.springer.com/article/10.1186/s12883-017-0918-yWhite matter hyperintensityBranch atheromatous diseasePosterior circulation ischemic strokeBasilar artery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Po-Chen Lin Feng-Chi Chang Hui-Chi Huang Jui-Yao Tsai Yung-Yang Lin Chih-Ping Chung |
spellingShingle |
Po-Chen Lin Feng-Chi Chang Hui-Chi Huang Jui-Yao Tsai Yung-Yang Lin Chih-Ping Chung Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease BMC Neurology White matter hyperintensity Branch atheromatous disease Posterior circulation ischemic stroke Basilar artery |
author_facet |
Po-Chen Lin Feng-Chi Chang Hui-Chi Huang Jui-Yao Tsai Yung-Yang Lin Chih-Ping Chung |
author_sort |
Po-Chen Lin |
title |
Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
title_short |
Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
title_full |
Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
title_fullStr |
Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
title_full_unstemmed |
Greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
title_sort |
greater periventricular white matter hyperintensity severity in basilar artery branch atheromatous disease |
publisher |
BMC |
series |
BMC Neurology |
issn |
1471-2377 |
publishDate |
2017-07-01 |
description |
Abstract Background Basilar artery branch atheromatous disease (BABAD), in which basilar artery atheroma occludes penetrating arteries at their origin, is a common etiology of posterior circulation stroke (PCS). It is currently unknown whether white matter hyperintensity(WMH), a marker of small vessel disease(SVD), is associated with BABAD. Methods The present study analyzed data from patients with PCS who were enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and February 28, 2014. WMH severity was rated using the Scheltens scale. We used multivariate analyses to: (1) compare the severity of WMH between patients with BABAD, patients with large-artery > 50% atherosclerotic stenosis-related PCS(LAA), and non-stroke subjects(NS); and (2) evaluate the relationship between WMH severity and the 3-month prognosis of patients with BABAD. Results The study pool included 151 BABAD, 97 LAA, and 78 non-stroke patients. Multivariate analyses adjusting for age, sex, and vascular risk factors showed that compared to patients with LAA [Odds ratio(OR) = 0.51, p = 0.037] and NS (OR = 0.40, p = 0.004), patients with BABAD (OR = 1) had greater WMH severity (score ≥ 50th percentile) in periventricular, but not subcortical, regions. Moreover, greater periventricular WMH severity predicted poor 3-month functional outcomes (modified Rankin Scale > 3) with an OR of 3.21 (p = 0.028) in BABAD patients. Conclusions We are the first to show a significant association between WMH and BABAD that is independent of vascular risk factors and atherosclerotic large-artery disease. Our results suggest that small vessel abnormalities other than lipohyalinosis may be involved in BABAD pathophysiology. A future management strategy should include both large and small vessel protection. |
topic |
White matter hyperintensity Branch atheromatous disease Posterior circulation ischemic stroke Basilar artery |
url |
http://link.springer.com/article/10.1186/s12883-017-0918-y |
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