Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study

Background: Cerebral pulsatility is thought to reflect arterial stiffness and downstream microvascular resistance. Although previous studies indicated cerebral pulsatility might closely relate to development of cerebral small vessel disease (SVD), yet evidence remain controversial and longitudinal d...

Full description

Bibliographic Details
Main Authors: Weiyi Zhong, Yiwei Xia, Yunqing Ying, Yi Wang, Lumeng Yang, Xiaoniu Liang, Qianhua Zhao, Jianjun Wu, Zonghui Liang, Xiaoxiao Wang, Xin Cheng, Ding Ding, Qiang Dong
Format: Article
Language:English
Published: SAGE Publishing 2024-02-01
Series:Therapeutic Advances in Neurological Disorders
Online Access:https://doi.org/10.1177/17562864241227304
_version_ 1797304909299712000
author Weiyi Zhong
Yiwei Xia
Yunqing Ying
Yi Wang
Lumeng Yang
Xiaoniu Liang
Qianhua Zhao
Jianjun Wu
Zonghui Liang
Xiaoxiao Wang
Xin Cheng
Ding Ding
Qiang Dong
author_facet Weiyi Zhong
Yiwei Xia
Yunqing Ying
Yi Wang
Lumeng Yang
Xiaoniu Liang
Qianhua Zhao
Jianjun Wu
Zonghui Liang
Xiaoxiao Wang
Xin Cheng
Ding Ding
Qiang Dong
author_sort Weiyi Zhong
collection DOAJ
description Background: Cerebral pulsatility is thought to reflect arterial stiffness and downstream microvascular resistance. Although previous studies indicated cerebral pulsatility might closely relate to development of cerebral small vessel disease (SVD), yet evidence remain controversial and longitudinal data are rare. Objective: We aimed to explore relationships of cerebral pulsatility with severity and progression of various SVD imaging markers among the community-dwelling elderly. Design: A longitudinal cohort study. Methods: As part of the prospective community-based Shanghai Aging Study cohort, dementia- and stroke-free elderly were recruited for baseline assessment of cerebral pulsatility and SVD severity during 2010–2011 and traced for SVD progression during 2016–2017. Cerebral pulsatility was quantified for both anterior and posterior circulation with transcranial Doppler ultrasound. SVD imaging markers were measured with brain magnetic resonance imaging (MRI) including white matter hyperintensities (WMHs), enlarged perivascular spaces (ePVS), lacunes, and microbleeds. The cross-sectional and longitudinal relationships between cerebral pulsatility and SVD were analyzed by univariable and multivariable regression models. Results: Totally, 188 eligible subjects were included at baseline and out of them, 100 (53.19%) returned for a 7-year follow-up. At baseline, increased pulsatility of posterior circulation was independently associated with more periventricular WMH (PWMH) and ePVS in basal ganglia (BG-ePVS) but not with other SVD markers. Longitudinally, higher posterior pulsatility predicted greater PWMH progression in participants with hypertension (β = 2.694, standard error [SE] = 1.112, p  = 0.020), whereas pulsatility of anterior circulation was shown to prevent BG-ePVS progression among followed-up elderly (β = −6.737, SE = 2.685, p  = 0.012). However, no significant relationship was found between cerebral pulsatility and burden of lacunes or cerebral microbleeds. Conclusion: Higher pulsatility of posterior circulation could worsen PWMH progression, especially for participants with hypertension. But for development of ePVS, increased cerebral pulsatility could play a compensatory role among several healthy elderly. The distinct relationships between cerebral pulsatility and various SVD markers emphasized the importance of individualized SVD management.
first_indexed 2024-03-08T00:17:14Z
format Article
id doaj.art-971456b80e8747539ae4b57714561496
institution Directory Open Access Journal
issn 1756-2864
language English
last_indexed 2024-03-08T00:17:14Z
publishDate 2024-02-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Neurological Disorders
spelling doaj.art-971456b80e8747539ae4b577145614962024-02-17T02:04:11ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28642024-02-011710.1177/17562864241227304Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based studyWeiyi ZhongYiwei XiaYunqing YingYi WangLumeng YangXiaoniu LiangQianhua ZhaoJianjun WuZonghui LiangXiaoxiao WangXin ChengDing DingQiang DongBackground: Cerebral pulsatility is thought to reflect arterial stiffness and downstream microvascular resistance. Although previous studies indicated cerebral pulsatility might closely relate to development of cerebral small vessel disease (SVD), yet evidence remain controversial and longitudinal data are rare. Objective: We aimed to explore relationships of cerebral pulsatility with severity and progression of various SVD imaging markers among the community-dwelling elderly. Design: A longitudinal cohort study. Methods: As part of the prospective community-based Shanghai Aging Study cohort, dementia- and stroke-free elderly were recruited for baseline assessment of cerebral pulsatility and SVD severity during 2010–2011 and traced for SVD progression during 2016–2017. Cerebral pulsatility was quantified for both anterior and posterior circulation with transcranial Doppler ultrasound. SVD imaging markers were measured with brain magnetic resonance imaging (MRI) including white matter hyperintensities (WMHs), enlarged perivascular spaces (ePVS), lacunes, and microbleeds. The cross-sectional and longitudinal relationships between cerebral pulsatility and SVD were analyzed by univariable and multivariable regression models. Results: Totally, 188 eligible subjects were included at baseline and out of them, 100 (53.19%) returned for a 7-year follow-up. At baseline, increased pulsatility of posterior circulation was independently associated with more periventricular WMH (PWMH) and ePVS in basal ganglia (BG-ePVS) but not with other SVD markers. Longitudinally, higher posterior pulsatility predicted greater PWMH progression in participants with hypertension (β = 2.694, standard error [SE] = 1.112, p  = 0.020), whereas pulsatility of anterior circulation was shown to prevent BG-ePVS progression among followed-up elderly (β = −6.737, SE = 2.685, p  = 0.012). However, no significant relationship was found between cerebral pulsatility and burden of lacunes or cerebral microbleeds. Conclusion: Higher pulsatility of posterior circulation could worsen PWMH progression, especially for participants with hypertension. But for development of ePVS, increased cerebral pulsatility could play a compensatory role among several healthy elderly. The distinct relationships between cerebral pulsatility and various SVD markers emphasized the importance of individualized SVD management.https://doi.org/10.1177/17562864241227304
spellingShingle Weiyi Zhong
Yiwei Xia
Yunqing Ying
Yi Wang
Lumeng Yang
Xiaoniu Liang
Qianhua Zhao
Jianjun Wu
Zonghui Liang
Xiaoxiao Wang
Xin Cheng
Ding Ding
Qiang Dong
Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
Therapeutic Advances in Neurological Disorders
title Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
title_full Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
title_fullStr Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
title_full_unstemmed Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
title_short Cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease: a longitudinal community-based study
title_sort cerebral pulsatility in relation with various imaging markers of cerebral small vessel disease a longitudinal community based study
url https://doi.org/10.1177/17562864241227304
work_keys_str_mv AT weiyizhong cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT yiweixia cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT yunqingying cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT yiwang cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT lumengyang cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT xiaoniuliang cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT qianhuazhao cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT jianjunwu cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT zonghuiliang cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT xiaoxiaowang cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT xincheng cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT dingding cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy
AT qiangdong cerebralpulsatilityinrelationwithvariousimagingmarkersofcerebralsmallvesseldiseasealongitudinalcommunitybasedstudy