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ORIGINAL ARTICLE
Ann Clin Neurophysiol. 2018; 20(2): 79-84.
Published online July 31, 2018.
doi: https://doi.org/10.14253/acn.2018.20.2.79
Pulsatility of middle cerebral arteries is better correlated with white matter hyperintensities than aortic stiffening
Sang-Hwa Lee1, Yerim Kim2, Yeongbae Lee3, and Ju-Hun Lee2
1Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
2Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
3Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
Corresponding Author: Ju-Hun Lee ,Tel: +82-2-2224-2206, Fax: +82-2-2224-2114, Email: leejuhun@hallym.or.kr
Received May 13, 2018   Revised: June 2, 2018    Accepted June 7, 2018
ABSTRACT
Background: Pulsatility of cerebral arteries and aortic stiffness have been associated with white matter hyperintensities (WMH). We explored which is better correlated with the severity of WMH in a population with acute lacunar infarct.
Methods: We included patients with acute small subcortical infarcts who underwent transcranial Doppler (TCD) and brachial ankle pulse wave velocity (baPWV). Exclusion criteria were any stenosis or occlusion on major cerebral arteries on magnetic resonance angiography; poor temporal insonation windows; ankle brachial index < 0.9; and atrial fibrillation. We assessed the performance of the pulsatility index of bilateral middle cerebral arteries (PI-MCA) and baPWV for predicting moderate-to-severe WMH, defined as an Age Related White Matter Changes score > 5, and then sought to find independent predictors using binary logistic regression analysis.
Results: Eighty-three patients (56 males, mean age 61.5 ± 11.4) participated in the study. Univariate analysis showed old age and high PI-MCA were significantly correlated with moderate-to-severe WMH. However, baPWV was not associated with the severity of WMH. Multivariate analysis revealed old age (odds ratio per 1-year increase, 1.068; p = 0.044) and upper tertile of PI-MCA (odds ratio, 5.138; p = 0.049) were independently associated with moderate-to-severe WMH. Receiver-operating characteristics showed PI-MCA differentiated those with and without moderate-to-severe WMH with an area under the curve of 0.719.
Conclusions: PI-MCA derived from TCD was better correlated with the severity of WMH than baPWV in a population with lacunar infarction. Pulsatility of cerebral arteries may better predict cerebral small vessel disease than the aortic stiffness index.
Key words: Pulsatility index; Aortic stiffness; Transcranial Doppler ultrasonography
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