title: Vascular risk factors and clinical progression in spinocerebellar ataxias.
abstract: BACKGROUND
  The contributions of vascular risk factors to spinocerebellar ataxia (SCA) are not known.
  
  
  METHODS
  We studied 319 participants with SCA 1, 2, 3, and 6 and repeatedly measured clinical severity using the Scale for Assessment and Rating of Ataxia (SARA) for 2 years. Vascular risk factors were summarized by CHA2DS2-VASc scores as the vascular risk factor index. We employed regression models to study the effects of vascular risk factors on ataxia onset and progression after adjusting for age, sex, and pathological CAG repeats. Our secondary analyses took hyperlipidemia into account.
  
  
  RESULTS
  Nearly 60% of SCA participants were at low vascular risks with CHA2DS2-VASc = 0, and 31% scored 2 or greater. Higher CHA2DS2-VASc scores were not associated with either earlier onset or faster progression of ataxia. These findings were not altered after accounting for hyperlipidemia.
  
  
  CONCLUSIONS
  Vascular risks are not common in SCAs and are not associated with earlier onset or faster ataxia progression.
authors.affiliation: Department of Neurology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
authors.forename: Raymond Y
authors.initials: RY
authors.lastname: Lo
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Karla P
authors.initials: KP
authors.lastname: Figueroa
authors.affiliation: Department of Neurology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Pulst
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Chi-Ying
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Department of Neurology, University of California, Los Angeles, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Perlman
authors.affiliation: Department of Neurology, Emory University, Atlanta, GA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Wilmot
authors.affiliation: Department of Neurology, University of Chicago, Chicago, IL, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Gomez
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Schmahmann
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Paulson
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Vikram G
authors.initials: VG
authors.lastname: Shakkottai
authors.affiliation: Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Ying
authors.affiliation: Department of Neurology, University of South Florida, Tampa, FL, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Zesiewicz
authors.affiliation: Department of Neurology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Khalaf
authors.initials: K
authors.lastname: Bushara
authors.affiliation: Department of Neurology, University of California, San Francisco, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Geschwind
authors.affiliation: Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Guangbin
authors.initials: G
authors.lastname: Xia
authors.affiliation: Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Subramony
authors.affiliation: Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ashizawa
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Sheng-Han
authors.initials: SH
authors.lastname: Kuo
keywords: Hypertension; hyperlipidemia; neurodegeneration; spinocerebellar ataxias; vascular