In:
Annals of Neurology, Wiley, Vol. 92, No. 5 ( 2022-11), p. 871-881
Abstract:
High cerebral arterial pulsatility index (PI), white matter lesions (WMLs), enlarged perivascular spaces (PVSs), and lacunar infarcts are common findings in the elderly population, and considered indicators of small vessel disease (SVD). Here, we investigate the potential temporal ordering among these variables, with emphasis on determining whether high PI is an early or delayed manifestation of SVD. Methods In a population‐based cohort, 4D flow MRI data for cerebral arterial pulsatility was collected for 159 participants at baseline (age 64–68), and for 122 participants at follow‐up 5 years later. Structural MRI was used for WML and PVS segmentation, and lacune identification. Linear mixed‐effects (LME) models were used to model longitudinal changes testing for pairwise associations, and latent change score (LCS) models to model multiple relationships among variables simultaneously. Results Longitudinal 5‐year increases were found for WML, PVS, and PI. Cerebral arterial PI at baseline did not predict changes in WML or PVS volume. However, WML and PVS volume at baseline predicted 5‐year increases in PI. This was shown for PI increases in relation to baseline WML and PVS volumes using LME models (R 0.24; p 〈 0.02 and R 0.23; p 〈 0.03, respectively) and LCS models ( = 0.28; p = 0.015 and = 0.28; p = 0.009, respectively). Lacunes at baseline were unrelated to PI. Interpretation In healthy older adults, indicators of SVD are related in a lead–lag fashion, in which the expression of WML and PVS precedes increases in cerebral arterial PI. Hence, we propose that elevated PI is a relatively late manifestation, rather than a risk factor, for cerebral SVD. ANN NEUROL 2022;92:871–881
Type of Medium:
Online Resource
ISSN:
0364-5134
,
1531-8249
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2037912-2
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