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Clinical Associations and Prognostic Value of MRI-Visible Perivascular Spaces in Patients With Ischemic Stroke or TIA: A Pooled Analysis
Best, Jonathan G; Ambler, Gareth; Wilson, Duncan; Du, Houwei; Lee, Keon-Joo; Lim, Jae-Sung; Teo, Kay Cheong; Mak, Henry; Kim, Young Dae; Song, Tae-Jin; Selcuk Demirelli, Derya; Nishihara, Masashi; Yoshikawa, Masaaki; Kubacka, Marta; Zietz, Annaelle; Al-Shahi Salman, Rustam; Jäger, Hans Rolf; Lip, Gregory Y H; Panos, Leonidas; Goeldlin, Martina B; Slater, Lee-Anne; Karayiannis, Christopher Charles; Phan, Thanh G; Bellut, Maximilian; Abrigo, Jill; Cheng, Cyrus; Leung, Thomas W; Chu, Winnie; Chappell, Francesca; Makin, Stephen D J; van Dam-Nolen, Dianne H K; Kooi, M Eline; Köhler, Sebastian; Staals, Julie; Kuchcinski, Grégory; Bordet, Régis; Dubost, Florian; Wardlaw, Joanna M; Soo, Yannie O Y; Fluri, Felix; Srikanth, Velandai K; Jung, Simon; Peters, Nils; Hara, Hideo; Yakushiji, Yusuke; Necioglu Orken, Dilek; Heo, Ji-Hoe; Lau, Gary Kui Kai; Bae, Hee-Joon; Werring, David J.
Affiliation
  • Best JG; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Ambler G; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Wilson D; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Du H; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Lee KJ; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Lim JS; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Teo KC; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Mak H; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Kim YD; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Song TJ; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Selcuk Demirelli D; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Nishihara M; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Yoshikawa M; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Kubacka M; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Zietz A; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Al-Shahi Salman R; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Jäger HR; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Lip GYH; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Panos L; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Goeldlin MB; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Slater LA; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Karayiannis CC; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Phan TG; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Bellut M; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Abrigo J; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Cheng C; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Leung TW; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Chu W; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Chappell F; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Makin SDJ; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • van Dam-Nolen DHK; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Kooi ME; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Köhler S; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Staals J; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Kuchcinski G; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Bordet R; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Dubost F; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Wardlaw JM; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Soo YOY; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Fluri F; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Srikanth VK; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Jung S; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Peters N; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Hara H; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Yakushiji Y; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Necioglu Orken D; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Heo JH; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Lau GKK; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Bae HJ; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
  • Werring DJ; From the UCL Stroke Research Centre (J.G.B., D.W., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London; Department of Statistical Science (G.A.), University College London, United Kingdom; Stroke Researc
Neurology ; 102(1): e207795, 2024 01 09.
Article in En | MEDLINE | ID: mdl-38165371
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Visible perivascular spaces are an MRI marker of cerebral small vessel disease and might predict future stroke. However, results from existing studies vary. We aimed to clarify this through a large collaborative multicenter analysis.

METHODS:

We pooled individual patient data from a consortium of prospective cohort studies. Participants had recent ischemic stroke or transient ischemic attack (TIA), underwent baseline MRI, and were followed up for ischemic stroke and symptomatic intracranial hemorrhage (ICH). Perivascular spaces in the basal ganglia (BGPVS) and perivascular spaces in the centrum semiovale (CSOPVS) were rated locally using a validated visual scale. We investigated clinical and radiologic associations cross-sectionally using multinomial logistic regression and prospective associations with ischemic stroke and ICH using Cox regression.

RESULTS:

We included 7,778 participants (mean age 70.6 years; 42.7% female) from 16 studies, followed up for a median of 1.44 years. Eighty ICH and 424 ischemic strokes occurred. BGPVS were associated with increasing age, hypertension, previous ischemic stroke, previous ICH, lacunes, cerebral microbleeds, and white matter hyperintensities. CSOPVS showed consistently weaker associations. Prospectively, after adjusting for potential confounders including cerebral microbleeds, increasing BGPVS burden was independently associated with future ischemic stroke (versus 0-10 BGPVS, 11-20 BGPVS HR 1.19, 95% CI 0.93-1.53; 21+ BGPVS HR 1.50, 95% CI 1.10-2.06; p = 0.040). Higher BGPVS burden was associated with increased ICH risk in univariable analysis, but not in adjusted analyses. CSOPVS were not significantly associated with either outcome.

DISCUSSION:

In patients with ischemic stroke or TIA, increasing BGPVS burden is associated with more severe cerebral small vessel disease and higher ischemic stroke risk. Neither BGPVS nor CSOPVS were independently associated with future ICH.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ischemic Attack, Transient / Stroke / Cerebral Small Vessel Diseases / Ischemic Stroke Type of study: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Language: En Journal: Neurology Year: 2024 Document type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Ischemic Attack, Transient / Stroke / Cerebral Small Vessel Diseases / Ischemic Stroke Type of study: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Language: En Journal: Neurology Year: 2024 Document type: Article