title: Sublingual microvascular changes in patients with cerebral small vessel disease.
abstract: OBJECTIVE
  It is unknown whether changes in cerebral small vessel disease (SVD) are limited to the brain or part of a generalized vascular disorder.
  
  
  METHODS
  We examined the sublingual microcirculation of 10 healthy controls, 10 patients with large vessel disease, and 8 with SVD, with side-stream dark field imaging. We analyzed 146 video fragments masked to the origin of the videos. Imaging software measured the functional capillary density per tissue surface unit. We scored the percentage of blood vessels with abnormal flow (abnormal flow index) and the presence of extravascular erythrocyte material as presumed evidence of past microbleeds or obliterated vessels.
  
  
  RESULTS
  Functional capillary density differed between the 3 groups (SVD, large vessel disease, and controls; means, 14.8, 17.0, and 16.1 mm/mm2; P=0.01). Abnormal flow was more frequent in SVD patients compared with large vessel disease patients and controls (medians, 10.5%, 6.1%, 5.5%; P=0.04). Extravascular erythrocyte material was almost exclusively present in patients with SVD (P=0.004).
  
  
  CONCLUSIONS
  We found evidence of pathological changes in the sublingual microcirculation in patients with cerebral small vessel disease, which suggests that cerebral SVD is part of a generalized vascular disorder.
authors.affiliation: Amsterdam Medical Centre, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Khalilzada
authors.forename: Kemal
authors.initials: K
authors.lastname: Dogan
authors.forename: Can
authors.initials: C
authors.lastname: Ince
authors.forename: Jan
authors.initials: J
authors.lastname: Stam
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply; D002196:Capillaries; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D004912:Erythrocytes / Q000166:cytology; D006801:Humans; D008833:Microcirculation; D018715:Microscopy, Video / Q000379:methods; D008875:Middle Aged; D009060:Mouth Floor / Q000098:blood supply / Q000503:physiopathology*; D012984:Software; D020521:Stroke / Q000175:diagnosis* / Q000503:physiopathology*