Короткий опис (реферат):
Cerebral small vessel disease (CSVD) is a heterogeneous group of disorders which affect
small perforating vessels of the brain. Clinically CSVD manifest with various constellations
of symptoms, like cognitive, functional, affective as well as lacunar stroke or intracerebral
hemorrhage. It is responsible for 25 % of all strokes and are the second contributor to
dementia after Alzheimer's disease. The gold standard for CSVD diagnostic is neuroimaging.
The main key features are white matter hyperintensity (WMH), lacunes, enlarged perivascular
spaces (EPVS), brain atrophy. Brain atrophy have been recognized to play a synergistic
role in both cerebrovascular and neurodegenerative disorders occurring in the aging
brain. It reflects a final common pathway for pathological processes, which progress in
time. CSVD progression results in gradual decrease of brain volume, which is seen as
changes of ventricles size and cortical sulci span of the brain. But not much is known about
its extent, correlates and consequences. The aim of the research is to investigate whether
brain morphometric changes correlate with CSVD features. In this study, we included 129
CSVD patients and 165 non-CSVD controls, both with acute stroke. All participants underwent neuroimaging assessment with magnetic resonance imaging (MRI) and computed
tomography (CT). We used both univariate and multivariate regression analysis, as well as
correlation analysis to identify differences in brain morphometric parameters between
groups. Multivariable regression analysis, adjusted for age and sex, revealed significant
impact of Evans index (OR 1.09, 95 %; CI 1.01-1.16, p=0.018), the third ventricle index (OR
1.42, 95 %; CI 1.21-1.67, p<0.001), Schaltenbrand and N?rnberger index (OR 1.42, 95 %;
CI 1.21-1.67, p<0.001), the fourth ventricle index (OR 1.31, 95 %; CI 1.13-1.51, p<0,001),
bicaudate index (OR 1.19, 95 %; CI 1.10-1.30, p<0.001), cella media index (Schiersmann's
index) (OR 0.55, 95 %; CI 0.42-0.72, p<0.001), Huckman number (OR 1.05, 95 %; CI 1.02-
1.08, p<0.001), width of the longitudinal cerebral fissure in the anterior part of the frontal
lobes (OR 1.46, 95 %; CI 1.22-1.75, p<0.001), width of the left insular cistern (OR 1.24, 95
%; CI 1.11-1.39, p<0.001), width of the right insular cistern (OR 1.31, 95 %; CI 1.17-1.46,
p<0.001), width of the right and left insular cisterns in sum (OR 1.17, 95 %; CI 1.10-1.25,
p<0.001), width of the cerebral fissure in the area of the skull vault (OR 1.49, 95 %; CI 1.21-
1.84, p<0.001) on the CSVD presence. Width of the longitudinal cerebral fissure in the
anterior part of the frontal lobes in CSVD was 6.13±1.56 mm vs 5.10±1.38 mm in non-
CSVD, p<0.001 and width of the right and left insular cisterns in sum in CSVD was 16.98±4.60 mm vs 13.41±4.16 mm in non-CSVD, p<0.001. Width of the cerebral fissure in the area of the skull vault (parietal cortex) was also greater in CSVD patients: 5.04±1.85 mm vs 4.12±1.29 mm, p<0.001. Thus, all ventricular and cortical indices were increased in the
group of patients with CSVD. Our results indicate that morphometric indicators of the brain
are closely related to CSVD and can be useful for predicting the consequences of a stroke
and ascertaining the decline of cognitive functions.
