Enlarged perivascular spaces as a marker of underlying arteriopathy in intracerebral haemorrhage: a multicentre MRI cohort study
Identifieur interne : 000054 ( France/Analysis ); précédent : 000053; suivant : 000055Enlarged perivascular spaces as a marker of underlying arteriopathy in intracerebral haemorrhage: a multicentre MRI cohort study
Auteurs : Andreas Charidimou [Royaume-Uni] ; Rukshan Meegahage [Royaume-Uni] ; Zoe Fox [Royaume-Uni] ; Andre Peeters [Belgique] ; Yves Vandermeeren [Belgique] ; Patrice Laloux [Belgique] ; Jean-Claude Baron [Royaume-Uni, France] ; Hans Rolf J Ger [Royaume-Uni] ; David J. Werring [Royaume-Uni]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2013-06.
Abstract
Background and purpose Small vessel disease (mainly hypertensive arteriopathy and cerebral amyloid angiopathy (CAA)) is an important cause of spontaneous intracerebral haemorrhage (ICH), a devastating and still poorly understood stroke type. Enlarged perivascular spaces (EPVS) are a promising neuroimaging marker of small vessel disease. Based on the underlying arteriopathy distributions, we hypothesised that severe centrum semiovale EPVS are more common in lobar ICH attributed to CAA than other ICH. We evaluated EPVS prevalence, severity and distribution, and their clinical–radiological associations. Methods Retrospective multicentre cohort study of 121 ICH patients. Clinical information was obtained using standardised forms. Basal ganglia and centrum semiovale EPVS on T2-weighted MRI (graded 0–4 (>40 EPVS)), white-matter changes, cerebral microbleeds (CMBs) and lacunes were rated using validated scales. Results Patients with probable or possible CAA (n=76) had a higher prevalence of severe (>40) centrum semiovale EPVS compared with other ICH patients (35.5% vs 17.8%; p=0.041). In logistic regression age (OR: 1.43; 95% CI 1.01 to 2.02; p=0.045), deep CMBs (OR: 3.27; 95% CI 1.27 to 8.45; p=0.014) and mean white-matter changes score (OR: 1.29; 95% CI 1.17 to 1.43; p<0.0001) were independently associated with increased basal ganglia EPVS severity; only age was associated with increased centrum semiovale EPVS severity (OR: 1.50; 95% CI 1.08 to 2.10; p=0.017). Conclusions EPVS are common in ICH. Different mechanisms may account for EPVS according to their anatomical distribution. Severe centrum semiovale EPVS may be secondary to, and indicative of, CAA with value as a new neuroimaging marker. By contrast, basal ganglia EPVS severity is associated with markers of hypertensive arteriopathy.
Url:
DOI: 10.1136/jnnp-2012-304434
Affiliations:
- Belgique, France, Royaume-Uni
- Angleterre, Angleterre de l'Est, Grand Londres, Région de Bruxelles-Capitale
- Bruxelles, Cambridge, Londres, Paris
- Université catholique de Louvain, Université de Cambridge
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cohort study</title><author><name sortKey="Charidimou, Andreas" sort="Charidimou, Andreas" uniqKey="Charidimou A" first="Andreas" last="Charidimou">Andreas Charidimou</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Stroke Research Group, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Meegahage, Rukshan" sort="Meegahage, Rukshan" uniqKey="Meegahage R" first="Rukshan" last="Meegahage">Rukshan Meegahage</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Stroke Research Group, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London</wicri:regionArea><placeName><settlement 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sort="Peeters, Andre" uniqKey="Peeters A" first="Andre" last="Peeters">Andre Peeters</name><affiliation wicri:level="3"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Neurology, Cliniques Universitaires UCL Saint Luc, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Vandermeeren, Yves" sort="Vandermeeren, Yves" uniqKey="Vandermeeren Y" first="Yves" last="Vandermeeren">Yves Vandermeeren</name><affiliation wicri:level="4"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Neurology, CHU Mont-Godinne, Université Catholique de Louvain, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Neuroscience, Université Catholique de Louvain, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Laloux, Patrice" sort="Laloux, Patrice" uniqKey="Laloux P" first="Patrice" last="Laloux">Patrice Laloux</name><affiliation wicri:level="4"><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Neurology, CHU Mont-Godinne, Université Catholique de Louvain, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Neuroscience, Université Catholique de Louvain, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Baron, Jean Claude" sort="Baron, Jean Claude" uniqKey="Baron J" first="Jean-Claude" last="Baron">Jean-Claude Baron</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge</wicri:regionArea><orgName type="university">Université de Cambridge</orgName><placeName><settlement type="city">Cambridge</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Angleterre de l'Est</region></placeName></affiliation><affiliation wicri:level="1"><country 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3BG</wicri:noRegion></affiliation></author><author><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J" last="Werring">David J. 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Enlarged perivascular spaces (EPVS) are a promising neuroimaging marker of small vessel disease. Based on the underlying arteriopathy distributions, we hypothesised that severe centrum semiovale EPVS are more common in lobar ICH attributed to CAA than other ICH. We evaluated EPVS prevalence, severity and distribution, and their clinical–radiological associations. Methods Retrospective multicentre cohort study of 121 ICH patients. Clinical information was obtained using standardised forms. Basal ganglia and centrum semiovale EPVS on T2-weighted MRI (graded 0–4 (>40 EPVS)), white-matter changes, cerebral microbleeds (CMBs) and lacunes were rated using validated scales. Results Patients with probable or possible CAA (n=76) had a higher prevalence of severe (>40) centrum semiovale EPVS compared with other ICH patients (35.5% vs 17.8%; p=0.041). In logistic regression age (OR: 1.43; 95% CI 1.01 to 2.02; p=0.045), deep CMBs (OR: 3.27; 95% CI 1.27 to 8.45; p=0.014) and mean white-matter changes score (OR: 1.29; 95% CI 1.17 to 1.43; p<0.0001) were independently associated with increased basal ganglia EPVS severity; only age was associated with increased centrum semiovale EPVS severity (OR: 1.50; 95% CI 1.08 to 2.10; p=0.017). Conclusions EPVS are common in ICH. Different mechanisms may account for EPVS according to their anatomical distribution. Severe centrum semiovale EPVS may be secondary to, and indicative of, CAA with value as a new neuroimaging marker. By contrast, basal ganglia EPVS severity is associated with markers of hypertensive arteriopathy.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>France</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Angleterre de l'Est</li><li>Grand Londres</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Bruxelles</li><li>Cambridge</li><li>Londres</li><li>Paris</li></settlement><orgName><li>Université catholique de Louvain</li><li>Université de Cambridge</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Charidimou, Andreas" sort="Charidimou, Andreas" uniqKey="Charidimou A" first="Andreas" last="Charidimou">Andreas Charidimou</name></region><name sortKey="Baron, Jean Claude" sort="Baron, Jean Claude" uniqKey="Baron J" first="Jean-Claude" last="Baron">Jean-Claude Baron</name><name sortKey="Fox, Zoe" sort="Fox, Zoe" uniqKey="Fox Z" first="Zoe" last="Fox">Zoe Fox</name><name sortKey="Fox, Zoe" sort="Fox, Zoe" uniqKey="Fox Z" first="Zoe" last="Fox">Zoe Fox</name><name sortKey="J Ger, Hans Rolf" sort="J Ger, Hans Rolf" uniqKey="J Ger H" first="Hans Rolf" last="J Ger">Hans Rolf J Ger</name><name sortKey="J Ger, Hans Rolf" sort="J Ger, Hans Rolf" uniqKey="J Ger H" first="Hans Rolf" last="J Ger">Hans Rolf J Ger</name><name sortKey="Meegahage, Rukshan" sort="Meegahage, Rukshan" uniqKey="Meegahage R" first="Rukshan" last="Meegahage">Rukshan Meegahage</name><name sortKey="Werring, David J" sort="Werring, David J" uniqKey="Werring D" first="David J" last="Werring">David J. Werring</name></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Peeters, Andre" sort="Peeters, Andre" uniqKey="Peeters A" first="Andre" last="Peeters">Andre Peeters</name></region><name sortKey="Laloux, Patrice" sort="Laloux, Patrice" uniqKey="Laloux P" first="Patrice" last="Laloux">Patrice Laloux</name><name sortKey="Laloux, Patrice" sort="Laloux, Patrice" uniqKey="Laloux P" first="Patrice" last="Laloux">Patrice Laloux</name><name sortKey="Vandermeeren, Yves" sort="Vandermeeren, Yves" uniqKey="Vandermeeren Y" first="Yves" last="Vandermeeren">Yves Vandermeeren</name><name sortKey="Vandermeeren, Yves" sort="Vandermeeren, Yves" uniqKey="Vandermeeren Y" first="Yves" last="Vandermeeren">Yves Vandermeeren</name></country><country name="France"><noRegion><name sortKey="Baron, Jean Claude" sort="Baron, Jean Claude" uniqKey="Baron J" first="Jean-Claude" last="Baron">Jean-Claude Baron</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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