title: Potential surrogate markers of cerebral microvascular angiopathy in asymptomatic subjects at risk of stroke.
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.
authors.affiliation: Clinical Neurosciences Group, Greater Manchester Neuroscience Centre, Salford Royal Foundation Trust, Salford, UK.
authors.forename: Johann
authors.initials: J
authors.lastname: Selvarajah
authors.forename: Marietta
authors.initials: M
authors.lastname: Scott
authors.forename: Stavros
authors.initials: S
authors.lastname: Stivaros
authors.forename: Sharon
authors.initials: S
authors.lastname: Hulme
authors.forename: Rachel
authors.initials: R
authors.lastname: Georgiou
authors.forename: Nancy
authors.initials: N
authors.lastname: Rothwell
authors.forename: Pippa
authors.initials: P
authors.lastname: Tyrrell
authors.forename: Alan
authors.initials: A
authors.lastname: Jackson
mesh_terms: D000368:Aged; D015415:Biomarkers; D002536:Cerebral Arteries / Q000473:pathology; D015140:Dementia, Vascular / Q000150:complications / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008858:Microscopy, Phase-Contrast; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000473:pathology; D014652:Vascular Diseases / Q000175:diagnosis* / Q000628:therapy
chemical_list: D015415:Biomarkers