title: Increased arterial pulsatility and progression of single subcortical infarction.
abstract: OBJECTIVE
  We investigated the association of clinical, laboratory, sonographic and imaging parameters, in the progression of single subcortical infarctions.
  
  
  METHODS
  Consecutive 169 patients with lacunar (n = 89) and striatocapsular infarctions (n = 80) in the middle cerebral artery (MCA) territory with nonstenotic MCAs were recruited and examined for stroke progression. The pulsatility index (PI) was measured by transcranial Doppler from ipsilateral M1.
  
  
  RESULTS
  The striatocapsular infarction group exhibited more stroke progression. The patients with progressive lacunar infarctions had more diabetes, higher HbA1c levels, and higher initial National Institutes of Health Stroke Scale (NIHSS) scores, and the patients with progressive striatocapsular infarctions had more hypertension, higher cholesterol levels, and higher NIHSS scores. The MCA PI was higher in the lacunar infarction patients with progression (0.99 ± 0.19 vs. 0.90 ± 0.14, p = 0.048), while the striatocapsular infarction patients did not differ according to progression. From a multivariate analysis, higher MCA PI were independently associated with lacunar infarction progression (by 0.1 increase, OR 1.51; 95 % CI 1.06-2.15; p = 0.024).
  
  
  CONCLUSIONS
  Higher pulsatility was associated with progression in lacunar infarction. PI measured by transcranial Doppler sonography might reflect downstream arterial resistance and vascular/paravascular perfusion status and be a possible indicator of stroke progression.
  
  
  CONCLUSIONS
  • Higher pulsatility index was observed in progression group of lacunar infarction patients. • Higher pulsatility index seemed to be associated with progression in lacunar infarction patients. • Differences in the factors associated with stroke progression suggest different underlying pathophysiologies.
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Keon-Joo
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea. jungkh@gmail.com.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea. jungkh@gmail.com.
authors.forename: Keun-Hwa
authors.initials: KH
authors.lastname: Jung
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Chan-Young
authors.initials: CY
authors.lastname: Park
authors.affiliation: Department of Neurology, Chung-Ang University Medical Center, College of Medicine, Chung-Ang University, Seoul, South Korea.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Manho
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.|Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Neurology, The Armed Forces Capital Hospital, Seongnam, South Korea.
authors.forename: Jae-Kyu
authors.initials: JK
authors.lastname: Roh
mesh_terms: D002544:Cerebral Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000503:physiopathology; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D059409:Stroke, Lacunar / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
keywords: Cerebral infarction; Disease progression; Doppler transcranial ultrasound; Infarction, lacunar; Stroke