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Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke

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Abstract

Cerebral microvascular angiopathy (MVA) is associated with clinical vascular risk factors and is characterised by histological changes, including thickening of the walls of arterial vessels and dilatation of the Virchow-Robin spaces (VRS). We have previously described two novel biomarkers of MVA based on magnetic resonance imaging (MRI), VRS dilatation and abnormalities in the transfer of systolic arterial pulsation to the ventricular CSF, which occur as a result of decreased cerebral arterial compliance. These are associated with vascular dementia and treatment-resistant late onset depression. We studied a group of normal subjects at risk of cerebrovascular disease to determine if these biomarkers are present in patients who have no evidence of symptomatic vascular disease. We studied 31 subjects, 16 with three or more vascular risk factors and 15 with one or less significant risk factors. We measured arterial blood flow and CSF flow in the cerebral aqueduct, white matter lesion load, and the distribution and number of VRS. There were significant differences in CSF pulsatility and in VRS in the basal ganglia between the two groups, but no differences in white matter lesion load. We conclude that asymptomatic subjects at risk of stroke have MRI evidence of MVA before white matter lesions become apparent.

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Notes

  1. Leng GC, Fowkes FG (1992): The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose questionnaire for use in epidemiological surveys. J Clin Epidemiol 10:1101–9

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Acknowledgements

This study was funded by the Sir Jules Thorn Charitable Trust. PT, AJ, MS and NR are funded by the University of Manchester. We acknowledge the support of the Translational Imaging Unit staff, particularly Dr Lloyd Gregory and Mr Barry Whitnall.

Conflict of interest statement

None declared.

Author information

Authors and Affiliations

  1. Clinical Neurosciences Group, Greater Manchester Neuroscience Centre, Salford Royal Foundation Trust, Salford, M6 8HD, UK

    Johann Selvarajah, Sharon Hulme, Rachel Georgiou & Pippa Tyrrell

  2. Imaging Science and Biomedical Engineering, School of Medicine, University of Manchester, Manchester, M13 9PT, UK

    Marietta Scott, Stavros Stivaros & Alan Jackson

  3. Faculty of Life Sciences, Smith Building, University of Manchester, Manchester, M14, UK

    Nancy Rothwell

  4. Wolfson Molecular Imaging Centre, 27 Palatine Road, Manchester, England, M20 3LJ, UK

    Alan Jackson

Authors
  1. Johann Selvarajah
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  2. Marietta Scott
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  3. Stavros Stivaros
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  4. Sharon Hulme
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  5. Rachel Georgiou
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  6. Nancy Rothwell
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  7. Pippa Tyrrell
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  8. Alan Jackson
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Correspondence to Alan Jackson.

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Selvarajah, J., Scott, M., Stivaros, S. et al. Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke. Eur Radiol 19, 1011–1018 (2009). https://doi.org/10.1007/s00330-008-1202-8

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  • DOI: https://doi.org/10.1007/s00330-008-1202-8

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