Large-vessel correlates of cerebral small-vessel disease.
OBJECTIVE
Our aim was to investigate the relationship of carotid structure and function with MRI markers of cerebral ischemic small-vessel disease.


METHODS
The study comprised 1,800 participants (aged 72.5 ± 4.1 years, 59.4% women) from the 3C-Dijon Study, a population-based, prospective cohort study, who had undergone quantitative brain MRI and carotid ultrasound. We used multivariable logistic and linear regression adjusted for age, sex, and vascular risk factors.


RESULTS
Presence of carotid plaque and increasing carotid lumen diameter (but not common carotid artery intima-media thickness) were associated with higher prevalence of lacunar infarcts: odds ratio (OR) = 1.60 (95% confidence interval [CI]: 1.09-2.35), p = 0.02 and OR = 1.24 (95% CI: 1.02-1.50), p = 0.03 (by SD increase). Carotid plaque was also associated with large white matter hyperintensity volume (WMHV) (age-specific top quartile of WMHV distribution): OR = 1.32 (95% CI: 1.04-1.67), p = 0.02, independently of vascular risk factors. Increasing Young elastic modulus and higher circumferential wall stress, reflecting augmented carotid stiffness, were associated with increasing WMHV (effect estimate [β] ± standard error: 0.0003 ± 0.0001, p = 0.024; β ± standard error: 0.005 ± 0.002, p = 0.008). Large WMHV was also associated with increasing Young elastic modulus (OR = 1.22 [95% CI: 1.04-1.42], p = 0.01) and with decreasing distensibility coefficient (OR = 0.83 [95% CI: 0.69-0.99], p = 0.04), independently of vascular risk factors. Associations of carotid lumen diameter with lacunar infarcts and of carotid stiffness markers with WMHV were independent of carotid plaque.


CONCLUSIONS
In addition to and independently of carotid plaque, increasing carotid lumen diameter and markers of carotid stiffness were associated with increasing prevalence of lacunar infarcts and increasing WMHV, respectively.
Inserm U708, Neuroepidemiology, Paris, France.
Marion
M
Brisset
Pierre
P
Boutouyrie
Fernando
F
Pico
Yicheng
Y
Zhu
Mahmoud
M
Zureik
Sabrina
S
Schilling
Carole
C
Dufouil
Bernard
B
Mazoyer
Stéphane
S
Laurent
Christophe
C
Tzourio
Stéphanie
S
Debette
D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D018672:Community Health Planning; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors