Endothelial function, inflammation, thrombosis, and basal ganglia perivascular spaces in patients with stroke

Wang, X., Chappell, F. M., Valdes Hernandez, M., Lowe, G., Rumley, A., Shuler, K., Doubal, F. and Wardlaw, J. M. (2016) Endothelial function, inflammation, thrombosis, and basal ganglia perivascular spaces in patients with stroke. Journal of Stroke and Cerebrovascular Diseases, 25(12), pp. 2925-2931. (doi: 10.1016/j.jstrokecerebrovasdis.2016.08.007) (PMID:27576214) (PMCID:PMC5176093)

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Abstract

Background and Objective: Recent studies suggest perivascular spaces are a marker of small vessel disease, blood–brain barrier permeability, and inflammation, but little is known about their risk factors and associations with peripheral blood markers. Materials and Methods: In prospectively recruited patients with recent minor ischemic stroke, we investigated the influence of age, sex, hypertension, diabetes, and smoking on the severity of perivascular spaces in the basal ganglia seen on T2- weighted magnetic resonance imaging. We assessed plasma markers of endothelial function (von Willebrand factor, intracellular adhesion molecule-1), inflammation (interleukin-6, tumor necrosis factor-alpha, C-reactive protein), and thrombosis (fi- brinogen, prothrombin fragments 1 + 2, thrombin–antithrombin complex, tissue plasminogen activator, D-dimer). We used a validated semi-automated method to measure basal ganglia perivascular spaces count and volume. We tested uniand multivariable associations between blood markers and basal ganglia perivascular spaces count and volume. Findings: In 100 patients (median age: 67 years, range: 37-92), on adjusted analysis, basal ganglia perivascular spaces count was associated with age (r = .117, P = .003) and hypertension (r = 2.225, P = .013). On multivariable linear regression, adjusted for age, sex, hypertension, smoking and diabetes, reduced von Willebrand factor was associated with increased basal ganglia perivascular spaces count (r = −.025, P = .032). Conclusion: The association of increased basal ganglia perivascular spaces count with reduced von Willebrand factor is novel. As von Willebrand factor may promote cerebral endothelial integrity, insufficient von Willebrand factor is consistent with dysfunctional cerebral endothelium and increased basal ganglia perivascular spaces in cerebral small vessel disease. Quantitative perivascular spaces measurement may increase sensitivity to detect cerebral endothelial dysfunction.

Item Type:Articles
Additional Information:Funding: Chief Scientist Office of the Scottish Executive (CZB/4/281), the Wellcome Trust (075611), Row Fogo Charitable Trust, and the China Scholarships Council/ University of Edinburgh Scholarships (SC005336) scheme (XW).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Rumley, Dr Ann and Lowe, Professor Gordon
Authors: Wang, X., Chappell, F. M., Valdes Hernandez, M., Lowe, G., Rumley, A., Shuler, K., Doubal, F., and Wardlaw, J. M.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Stroke and Cerebrovascular Diseases
Publisher:Elsevier
ISSN:1052-3057
ISSN (Online):1532-8511
Published Online:27 August 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Journal of Stroke and Cerebrovascular Diseases 25(12): 2925-2931
Publisher Policy:Reproduced under a Creative Commons License

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