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Objective:To investigate the association of white matter hyperintensities (WMHs) with long-term stroke recurrence in patients with recent subcortical small infarcts (RSSIs).Methods:Consecutive patients admitted to the Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University between January 2019 and August 2022 and met the clinical and imaging manifestations of RSSIs were collected. The demographic characteristics, baseline clinical data, and MRI features were collected. Using stroke recurrence as the endpoint event, the recurrence time was recorded, and Cox regression model was used to analyze relevant factors affecting stroke recurrence in patients with RSSIs.Results:A total of 202 patients were enrolled, including 138 males (68.3%), aged 67.9±10.5 years. Seventy-seven patients (38.1%) were mild WMHs, 64 (31.7%) were moderate WMHs, and 61 (30.2%) were severe WMHs. There were statistically significant differences in age, history of stroke, hypertension, hyperlipidemia, total cholesterol, infarct thickness, and infarct distribution among different WMHs severity groups (all P<0.05). The median follow-up time was 40.5 months (interquartile range, 27.7-49.0 months), and a total of 55 patients (27.2%) had stroke recurrence (ischemic stroke 54, occipital hemorrhage 1). Recurrence rates of stroke in the mild, moderate, and severe WMHs groups were 18.2%, 31.3%, and 34.4%, respectively. Cox regression analysis showed that WMHs were an independent risk factor for stroke recurrence (compared to the mild group, the risk ratio of the severe group was 2.225, 95% confidence interval was 1.116-4.436; P=0.023). Conclusion:The risk of long-term stroke recurrence in patients with RSSI is associated with the severity of WMHs.
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In recent years, the incidence of cerebral small vessel disease (CSVD) has been increasing with the aging of the population, and the cognitive impairment caused by it has brought huge burden to patients and their families. As a novel inflammatory biomarker, lipoprotein-associated phospholipase A 2 (Lp-PLA 2) directly participates in the pathogenesis of cognitive impairment in patients with CSVD by regulating circulatory vascular injury and neuroinflammation, and is expected to become a predictive indicator and therapeutic target for CSVD.
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Objective:To investigate the correlation between serum ischemia modified albumin (IMA) and calmodulin (CaM) expression levels and neurological impairment in patients with cerebral small vessel disease.Methods:The clinical data of 140 patients with cerebral small vessel disease (CSVD) who received treatment at The Third People Hospital in Liaocheng between April 2020 and December 2021 were retrospectively analyzed. On admission, serum levels of CaM and IMA were measured using an enzyme-linked immunosorbent assay and an albumin-cobalt binding test. Patients' neurological function was evaluated using the National Institutes of Health Stroke Scale (NIHSS). Patients' transient cerebral ischemia, urinary incontinence, and gait disturbance were evaluated using the National Institute of Neurological Disorders and Stroke Scale. Patients' cognitive function was evaluated using the Montreal Cognitive Assessment scale. The influential factors of serum IMA and CaM expression levels in patients with CSVD were analyzed. The factors that affect the severity of neuological imairment in patients with CSVD and their correlation with serum IMA and CaM expression levels were analyzed.Results:The gender, age, presence or absence of gait disorders, and presence or absence of urinary incontinence of patients were not correlated with serum IMA and CaM levels (all P > 0.05). The serum levels of IMA [(38.5 ± 5.3) × 103U/L, (38.5 ± 4.7) × 103U/L, (39.0 ± 4.4) × 103U/L] and CaM [(190.4 ± 34.5) μg/L, (191.2 ± 26.7) μg/L, (199.7 ± 24.8) μg/L] in patients with cognitive impairment, dizziness and vertigo, and transient cerebral ischemia were significantly higher than those in patients with normal cognitive function, patients without dizziness and vertigo, or patients without transient cerebral ischemia [(27.3 ± 4.4) × 103U/L, (21.0 ± 3.8) × 103U/L, (20.5 ± 5.1) × 103U/L, (180.6 ± 29.6) μg/L, (179.5 ± 28.6) μg/L, (168.6 ± 32.4) μg/L, t = 14.10, 24.36, 22.50, all P < 0.05]. There were significant differences in cognitive impairment (38/16/9), dizziness and vertigo (39/16/8), transient cerebral hemorrhage (35/16/9), NIHSS score [(3.6 ± 0.8) points, (7.5 ± 0.9) points, (16.2 ± 3.2) points], CaM levels [(125.3 ± 20.5) μg/L, (185.5 ± 23.6) μg/L, (237.9 ± 54.3) μg/L], and IMA levels [(21.2 ± 3.5)] × 103 U/L, [(38.5 ± 4.3) × 103 U/L, (74.9 ± 5.4) × 103 U/L] among patients with mild, moderate, and severe neurological impairment ( t = 32.87, 11.28, 12.42, 34.59, 151.73, 147.84, all P < 0.05). The results of multivariate analysis indicated that cognitive impairment ( OR = 1.578, 95% CI: 1.043-2.386), transient cerebral ischemia ( OR = 2.396, 95% CI: 1.156-4.969), dizziness and vertigo ( OR = 1.906, 95% CI: 1.086-3.345), NIHSS score ( OR = 2.171, 95% CI: 1.162-4.056), CaM level ( OR = 2.022, 95% CI: 1.268-3.224), and increased IMA levels ( OR = 2.090, 95% CI: 1.313-3.325) were independent influential factors for worsened neurological impairment (all P < 0.05). The serum levels of IMA and CaM in patients with CSVD were significantly positively correlated with the severity of neurological impairment ( r = 5.45, 8.33, both P < 0.05). Conclusion:The elevated serum levels of IMA and CaM in patients with CSVD serve as independent risk factors for neurological impairment, and these levels are positively correlated with the severity of neurological impairment.
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White matter hyperintensities(WMH)is prevalent in the elderly population and is associated with stroke,cognition,gait instability,and neuropsychiatric symptoms.WMH burden usually increases with the growth of age.However,in recent years,there are researches found that WMH is actually dynamic variable.During the development,part of the WMH may regress,accompanied by the slowdown of brain atrophy and cognitive improvement.While,its mechanism,influencing factors and clinical significance remains unclear,and the effective treatment to reverse WMH is not clear.The article reviewed the current studies on the regression of WMH,aiming to provide reference for clinicians to actively perform intervention in the WMH related factors,promote their reversal in the early stage and improve the brain health of patients.
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Objective To explore the correlation between the total burden of cerebral small vessel disease and poor prognosis of branch atheromatous disease(BAD)in elderly patients.Methods A total of 114 BAD patients admitted to Shanghai Eighth People's Hospital between January 2021 and March 2023 were enrolled,and according to mRS score at 90 d after onset,they were divided into a good prognosis group(mRS score ≤2,67 cases)and a poor prognosis group(mRS score>2,47 cases).The clinical and imaging characteristics were analyzed,and the relationship between total cerebral small vessel disease burden and clinical prognosis of BAD was investigated using lo-gistic regression analysis.ROC curve analysis was used to determine the threshold of the total cere-bral small vessel disease burden for predicting adverse outcomes and to evaluate its sensitivity and specificity.Results The good prognosis group had younger age,smaller proportion of diabetes,lower SBP,NIHSS score at admission and white matter hyperintensities,and reduced ratio of cerebral microbleeds than the poor prognosis group(P<0.05,P<0.01).Statistical difference was observed in the total cerebral small vessel disease burden between the two groups(P<0.01).Binary logistic regression analysis showed that the total cerebral small vessel disease burden score and NIHSS score at admission were independent predicators of poor prognosis in BAD patients(OR=3.350,95%CI:1.439-7.798,P=0.005;OR=2.814,95%CI:1.586-4.993,P=0.001).ROC curve analysis indicated that the total cerebral small vessel disease burden had a cut-off val-ue of 1.5,and the sensitivity and specificity for predicting poor prognosis was 63.8%and 86.6%,respectively,for BAD patients.Conclusion The total cerebral small vessel disease burden is an in-dependent predictor for poor prognosis of BAD patients.
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Objective To investigate the relationship between cerebral atrophy and total burden of cerebral small vessel disease in patients with recent small subcortical infarct(RSSI).Methods A total of 194 elderly RSSI patients admitted to Department of Neurology of Changzhou Second People's Hospital Affiliated to Nanjing Medical University from September 2021 to November 2022 were recruited in this study.All patients completed cranial MRI examination and were divid-ed into a non-mild group 1(97 cases)and a moderate to severe group 1(97 cases)based on the to-tal burden of cerebral small vessel diseases(CSVD)imaging.Visual assessment scale was used to assess the severity of brain atrophy in the whole brain and various regions of the brain.According to the global cortical atrophy scale(GCA)score,all patients were divided into a non-mild group 2(88 cases)and a moderate to severe group 2(106 cases).Brain atrophy in various regions,medial temporal lobe atrophy(MTA)score,frontal temporal lobe atrophy(FTA)score,and posterior cortical atrophy(PA)score were evaluated.Their general clinical and imaging data were collected,multivariate logistic regression analysis was employed to analyze the relationship between GCA score and total burden of CSVD imaging in RSSI patients,and Spearman correlation analysis was further adopted to explore the correlation of GCA score and different parts of brain atrophy with total burden of CSVD imaging.Results When compared with the non-mild group 1,the moderate to severe group 1 had significantly larger proportions of having GCA score of 2-3 points,PA score of 2-3 points,MTA score of 2-4 points and FTA score of 2-4 points(P<0.01).The ra-tio of having 2-4 points in total imaging burden score of CSVD was obviously higher in the mod-erate to severe group 2 than the non-mild group 2(P<0.01).Multivariate logistic regression anal-ysis showed that age and total burden of CSVD imaging were independent risk factors for brain atrophy in RSSI patients(OR=1.184,95%CI:1.099-1.276,P=0.000;OR=3.537,95%CI:1.664-7.518,P=0.001).Spearman correlation analysis revealed that the total burden score of CSVD imaging was positively correlated with GCA,MTA,FTA and PA scores in RSSI patients(r=0.518,r=0.382,r=0.471,r=0.388,P=0.000).Conclusion The total burden of CSVD is an independent risk factor for GCA in elderly RSSI patients.The more serious the total burden of CSVD is,the higher the grade of GCA is.The total burden of CSVD is related to the whole brain and brain atrophy in other different regions of the brain.
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Objective To explore the influencing factors of over active bladder(OAB)in patients with cerebral small vessel disease(CSVD)and its correlation with CSVD imaging markers.Meth-ods A total of 163 elderly CSVD patients admitted in our hospital from January 2021 to Decem-ber 2022 were enrolled and divided into OAB group(37 cases)and non-OAB group(126 cases)based on the results of OAB rating scale.Mini-mental State Examination(MMSE)score,Fazekas scale score,and total CSVD burden score were recorded and compared between the two groups.Results The OAB group had older age,higher urinary frequency,larger proportions of nocturia,urgency,and urge incontinence ratio,increased Fazekas score,periventricular white matter hyper-intensity(PWMH)score and deep white matter hyperintensity(DWMH)score,and elevated total CSVD burden score and lower MMSE score than the non-OAB group(P<0.05,P<0.01).PWMH score and DWMH score were risk factors for the occurrence of OAB(P<0.01).The OAB score was positively correlated with Fazekas score,PWMH score,and DWMH score in the CSVD patients(r=0.533,P=0.001;r=0.462,P=0.004;r=0.398,P=0.015).The occurrence of urgency urinary incontinence was positively correlated with Fazekas score and PWMH score in the CSVD patients(r=0.352,P=0.033;r=0.346,P=0.036).Conclusion PWMH and DWMH are risk factors for OAB occurrence in CSVD patients.
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Objective:To investigate the correlation between paroxysmal slow-wave events (PSWEs) and cerebral small vessel disease (CSVD) and CSVD-related cognitive impairment.Methods:Patients with CSVD visited Weihai Municipal Hospital from March 2021 to April 2022 were included, and sex- and age-matched healthy controls were recruited for cross-sectional analysis. The patients with CSVD were further divided into cognitive impairment group and non-cognitive impairment group. The self-developed Python script was used to detect the PSWE parameters in electroencephalogram records. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function. Multivariate logistic regression analysis was used to determine whether PWSE parameters were the independent related factors of CSVD and CSVD-related cognitive impairment. Multiple linear regression analysis was used to determine the correlation between the PSWE parameters and overall cognitive function (MoCA total score) in patients with CSVD. Results:A total of 76 patients with CSVD (including 41 patients with cognitive impairment and 35 patients without cognitive impairment) and 45 healthy controls were included. Compared with the healthy control group, PWSEs in the F3 (left frontal area) and O1 (left occipital area) regions of the CSVD group occurred more frequently and lasted longer (all P<0.05). Multivariate logistic regression analysis showed that the frequency (odds ratio [ OR] 1.080, 95% confidence interval [ CI] 1.023-1.140; P=0.005) and duration ( OR 1.006, 95% CI 1.001-1.011; P=0.023) of PWSEs in the left frontal area, as well as the frequency ( OR 1.052, 95% CI 1.010-1.095; P=0.014) and duration ( OR 1.003, 95% CI 1.000-1.006; P=0.028) of PWSEs in the left occipital region were the independent related factors for CSVD. The frequency ( OR 1.106, 95% CI 1.033-1.183; P=0.004) and duration ( OR1.010, 95% CI 1.003-1.017; P=0.004) of PWSEs in the left frontal area were the independent risk factors for cognitive impairment in patients with CSVD. Multiple linear regression analysis showed that the frequency ( β= –0.242, P=0.045) and duration ( β= –0.235, P=0.046) of PWSEs in the left frontal region were negatively correlated with the overall cognitive function score in patients with CSVD. Conclusions:The frequency and duration of PSWEs in some brain regions of patients with CSVD increase, and there is an independent correlation between PSWEs and cognitive impairment, suggesting that the damage of blood-brain barrier may participate in the pathogenesis of cognitive impairment in patients with CSVD.
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Gut microbiota is involved in maintaining intestinal homeostasis. The bidirectional communication between intestinal flora and brain can also be conducted through the neuro-immune-endocrine network, namely, the "microbiota-gut-brain axis". A number of studies have shown that the "microbiota-gut-brain axis" disorder plays an important role in the occurrence, development and prognosis of some cerebrovascular diseases, such as cerebral small vessel disease and stroke. This article introduces the latest research progress of the relationship between gut microbiota and cerebrovascular diseases, so as to provide more ideas and options for the treatment of cerebrovascular diseases.
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Cerebral small vessel disease (CSVD) is an important cause of ischemic stroke and vascular dementia, which brings heavy burden to families and society. The prevention and treatment of CSVD has always been a research hotspot, but its pathogenesis is still not completely clear. This article reviews the pathogenesis of CSVD, including chronic cerebral hypoperfusion, blood-brain barrier dysfunction, vascular endothelial dysfunction, interstitial fluid reflux disorder, inflammatory response, and genetic factors, in order to provide more sufficient theoretical basis for early intervention and treatment of CSVD.
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Cerebral small vessel disease (CSVD) is a group of pathological, imaging and clinical syndromes involving small cerebral vessels with different causes. The incidence rate of CSVD increases with age and is the most important cause of vascular cognitive impairment. Different diffusion imaging techniques can quantify white matter microstructure damage by revealing the diffusion movement of water molecules in specific brain tissues, explore the basis and biophysical mechanisms of tissue change, and have important value for the mechanism research, early diagnosis, progression risk, and therapeutic evaluation of cognitive impairment related to CSVD. This article reviews the research progress of diffusion magnetic resonance imaging in CSVD related cognitive impairment.
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Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.
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Optical coherence tomography-based angiography (OCTA) is a novel non-invasive technique for quantitatively evaluating retinal microvascular perfusion. Due to the similar embryonic origin, anatomical characteristics, and physiological characteristics of the retina and cerebral small vessels, changes in retinal microvasculature may provide a new perspective for studying the mechanisms of cerebral small vessel diseases. This article summarizes the application of OCTA in cerebrovascular diseases, aiming to evaluate whether OCTA can become an effective tool for early prediction of the occurrence of cerebrovascular disease and monitoring disease changes.
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Spontaneous intracerebral hemorrhage (ICH) is the second common subtype of stroke, characterized by high morbidity, mortality, and disability. Cerebral small vessel disease (CSVD) refers to a series of clinic, imaging, and pathological syndromes caused by various causes that affect small arteries, arterioles, capillaries, and small venules in the brain. In recent years, there has been increasing research on the correlation between CSVD and ICH recurrence and outcomes. This article mainly reviews the relationship between CSVD imaging markers and ICH, in order to have a deeper understanding of ICH.
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Cerebral small vessel disease (CSVD) is one of the main causes of cognitive impairment and decreased the quality of daily life in the elderly. Researches have shown that CSVD is closely associated with autonomic nervous function. Patients with CSVD may be accompanied by cardiovascular, endocrine, gastrointestinal, urination, sleep disorders and other autonomic dysfunction.
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Dementia is one of the age-related diseases with the fastest increase in incidence. With the increasingly severe aging problem of the population, it further exacerbates the demand and burden of the healthcare system. Red blood cell distribution width (RDW) is an easily obtainable blood routine indicator that reflects the variability of red blood cell size. As an early marker of dementia risk, researches have shown an association between white matter hyperintensities (WMHs) and RDW. This article reviews the relationship between RDW and WMHs.
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Objective:To investigate the clinical value of high-frequency ultrasound combined with virtual touch tissue imaging and quantification in the assessment of limb muscle tension after stroke in patients.Methods:A total of 31 patients with stroke who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to May 2022 and 41 healthy controls who concurrently underwent physical examination in the same hospital were included in this study. Before rehabilitation treatment, the shear wave velocity of the main muscle groups of the limbs was measured using virtual touch tissue imaging and quantification in all participants. The shear wave velocity of the main muscle groups was compared between the affected and healthy sides of patients between two sides of patients. The patient's muscle tension was evaluated using the modified Ashworth Scale. The shear wave velocity of the affected muscle groups in patients was correlated with the modified Ashworth Scale score.Results:There were no significant differences in the shear wave velocities of the main muscle groups of upper (biceps, flexor digitorum sublimis, flexor digitorum profundus) and lower [medial head of the gastrocnemius muscle, lateral head of the gastrocnemius muscle] limbs between the left [(2.46 ± 0.26) m/s, (2.81 ± 0.50) m/s, (2.96 ± 0.31) m/s, (2.49 ± 0.44) m/s, (2.21 ± 0.20) m/s] and right [(2.42 ± 0.29) m/s, (2.80 ± 0.47) m/s, (3.02 ± 0.36) m/s, (2.54 ± 0.37) m/s, (2.18 ± 0.17) m/s] sides in healthy controls ( t = 0.78, 0.04, 0.83, 0.58, 1.15, P = 0.435, 0.967, 0.405, 0.558, 0.216). The shear wave velocities of the main muscle groups of upper [flexor digitorum sublimis (3.74 ± 0.67) m/s, flexor digitorum profundus (3.64 ± 0.60) m/s), biceps (3.63 ± 0.64) m/s] and lower [medial head of the gastrocnemius muscle (3.28 ± 0.61) m/s, lateral head of the gastrocnemius muscle (2.90 ± 0.37) m/s] limbs on the affected side in patients with stroke were significantly higher than (2.56 ± 0.40) m/s, (2.67 ± 0.38) m/s, (2.78 ± 0.41) m/s, (2.30 ± 0.21) m/s, (2.25 ± 0.23) m/s on the healthy side ( t = 11.81, 8.21, 8.75, 8.91, 10.43, all P < 0.001). The shear wave velocities of the main muscle groups of the upper (flexor digitorum sublimis, flexor digitorum profundus, and biceps) and lower (medial head of the gastrocnemius muscle and lateral head of the gastrocnemius muscle) limbs were positively correlated with the modified Ashworth Scale score ( r = 0.77, 0.70, 0.72, 0.74, 0.78, P = 0.007, 0.029, 0.021, 0.016, 0.001). Conclusion:Monitoring the shear wave velocities of the main muscle groups of the upper and lower limbs using high-frequency ultrasound combined with virtual touch tissue imaging and quantification can effectively reflect the change in limb muscle tension of patients with stroke, which is highly valuable for evaluating rehabilitation efficacy and prognosis in patients with stroke.
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Cerebral microbleed (CMB) is a type of cerebral small vessel disease (CSVD). Recently studies have found that there is a certain relationship between CMB and cognitive impairment. This article mainly reviews the etiology of CMB, the relationship between CMB and cognitive impairment, CMB and cognitive disorders and the possible mechanism of CMB-related cognitive impairment, in order to improve the understanding of cognitive impairment caused by CMB.
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Cerebral small vessel disease (CSVD) is a series of clinical, imaging, and pathological syndromes resulting from various etiologies affecting small arteries (microarteries, capillaries, microvenules, and small veins in the brain). The diagnosis of CSVD is based on imaging presentations, but the high cost and bleeding risk of cranial imaging methods make the diagnosis of rare CSVD more difficult. Retinal vessels are the only vasculature visible in vivo and share anatomical and embryological features with small brain vessels. Retinal vascular abnormalities have been shown to exist in rare CSVD such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cerebral amyloid angiopathy (CAA) and moyamoya disease (MMD). Retinal vascular examination may provide new ideas for the study of rare CSVD.
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Objective:To investigate the relationship between the overall burden score of cerebral small vessel disease (CSVD) and sudden sensorineural hearing loss (SSNHL) and its severity.Methods:Patients with SSNHL admitted to Zhengzhou People’s Hospital from January 2019 to June 2022 were used as the case group, and age- and gender-matched patients with tension headache or benign positional vertigo were used as the control group. MRI was used to evaluate the phenotype of CSVD, including white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), enlarged perivascular spaces (EPVS), and lacune of presumed vascular origin, and then the total burden score of CSVD was calculated. Multivariate logistic regression analysis was used to determine the independent factors of SSNHL. Ordinal logistic regression analysis was used to investigate the relationship between the overall burden of CSVD and the severity of hearing loss in patients with SSNHL. Results:A total of 86 patients with SSNHL and 90 age- and gender-matched controls were included. There were statistically significant differences in triglycerides, high-density lipoprotein cholesterol, fasting blood glucose levels, WMHs overall score classification, periventricular WMHs score classification, deep WMHs score classification, CMBs, moderate to severe EPVS, CSVD overall burden score and classification between the two groups (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for high-density lipoprotein cholesterol, fasting blood glucose ≥6.1 mmol/L (odds ratio [ OR] 2.149, 95% confidence interval [ CI] 1.042-4.432; P=0.038), triglycerides ≥1.7 mmol/L ( OR 7.012, 95% CI 2.962-16.597; P=0.000), CSVD overall burden score >1 (compared to 0 point, 2 points: OR 4.095, 95% CI 1.364-12.291, P=0.012; 3 points: OR 5.776, 95% CI 1.888-17.614, P=0.002; 4 points: OR 7.900, 95% CI 2.526-24.706; P=0.000) were significantly independently correlated with SSNHL. Ordinal logistic regression analysis showed that after adjusting for age and fasting blood glucose, the flat decline type hearing loss ( OR 1.276, 95% CI 1.131-1.618; P=0.044) and total deafness type hearing loss ( OR 1.029, 95% CI 1.002-1.058; P=0.038), and the overall burden of CSVD being moderate ( OR 1.318, 95% CI 1.036-1.677; P=0.025) and severe ( OR 2.330, 95% CI 1.232-4.406; P=0.009) were significantly independent associated with the degree of hearing loss in patients with SSNHL. Conclusion:The CSVD total burden score of moderate to severe degree is independently associated with SSNHL and the degree of hearing loss.