Risk factors analysis according to regional distribution of white matter hyperintensities in a stroke cohort


Por: Medrano-Martorell, S, Capellades, J, Jimenez-Conde, J, Gonzalez-Ortiz, S, Vilas-Gonzalez, M, Rodriguez-Campello, A, Ois, A, Cuadrado-Godia, E, Avellaneda, C, Fernandez, I, Merino-Pena, E, Roquer, J, Marti-Fabregas, J, Giralt-Steinhauer, E

Publicada: 1 ene 2022 Ahead of Print: 1 jun 2021
Resumen:
Objectives The spectrum of distribution of white matter hyperintensities (WMH) may reflect different functional, histopathological, and etiological features. We examined the relationships between cerebrovascular risk factors (CVRF) and different patterns of WMH in MRI using a qualitative visual scale in ischemic stroke (IS) patients. Methods We assembled clinical data and imaging findings from patients of two independent cohorts with recent IS. MRI scans were evaluated using a modified visual scale from Fazekas, Wahlund, and Van Swieten. WMH distributions were analyzed separately in periventricular (PV-WMH) and deep (D-WMH) white matter, basal ganglia (BG-WMH), and brainstem (B-WMH). Presence of confluence of PV-WMH and D-WMH and anterior-versus-posterior WMH predominance were also evaluated. Statistical analysis was performed with SPSS software. Results We included 618 patients, with a mean age of 72 years (standard deviation [SD] 11 years). The most frequent WMH pattern was D-WMH (73%). In a multivariable analysis, hypertension was associated with PV-WMH (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.29-2.50, p = 0.001) and BG-WMH (OR 2.13, 95% CI 1.19-3.83, p = 0.012). Diabetes mellitus was significantly related to PV-WMH (OR 1.69, 95% CI 1.24-2.30, p = 0.001), D-WMH (OR 1.46, 95% CI 1.07-1.49, p = 0.017), and confluence patterns of D-WMH and PV-WMH (OR 1.62, 95% CI 1.07-2.47, p = 0.024). Hyperlipidemia was found to be independently related to brainstem distribution (OR 1.70, 95% CI 1.08-2.69, p = 0.022). Conclusions Different CVRF profiles were significantly related to specific WMH spatial distribution patterns in a large IS cohort.

Filiaciones:
Medrano-Martorell, S:
 Hosp Clin Barcelona, Dept Neuroradiol, Villarroel 170, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Med, Dept Neuroradiol, Barcelona, Spain

Capellades, J:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Med, Dept Neuroradiol, Barcelona, Spain

Jimenez-Conde, J:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Gonzalez-Ortiz, S:
 Hosp Clin Barcelona, Dept Neuroradiol, Villarroel 170, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Med, Dept Neuroradiol, Barcelona, Spain

Vilas-Gonzalez, M:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Med, Dept Neuroradiol, Barcelona, Spain

Rodriguez-Campello, A:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Ois, A:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Cuadrado-Godia, E:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Avellaneda, C:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Fernandez, I:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Merino-Pena, E:
 Univ Autonoma Barcelona UAB, Dept Neuroradiol, Hosp Santa Creu & St Pau, Barcelona, Spain

Roquer, J:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain

Marti-Fabregas, J:
 Univ Autonoma Barcelona UAB, Dept Neurol, Hosp Santa Creu & St Pau, Barcelona, Spain

Giralt-Steinhauer, E:
 Univ Autonoma Barcelona UAB, Hosp del Mar, Dept Neurol, Barcelona, Spain

 Univ Autonoma Barcelona UAB, Neurovasc Res Grp, IMIM Inst Hosp Mar Invest Med, Barcelona, Spain

 Univ Pompeu Fabra UPF, DCEXS, Barcelona, Spain
ISSN: 09387994
Editorial
SPRINGER, 233 SPRING ST, NEW YORK, NY 10013 USA, Alemania
Tipo de documento: Article
Volumen: 32 Número: 1
Páginas: 272-280
WOS Id: 000660336800003
ID de PubMed: 34117555
imagen Open Access

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