Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study
Background: Carotid artery stenosis could contribute to gradual loss of brain function through chronic hypoxia and ischemia. Methods: We included consecutive participants of the population-based Rotterdam Study with unilateral ≥50 % stenosis at the carotid artery bifurcation on time-of-flight caroti...
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Elsevier
2025-01-01
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| Series: | Cerebral Circulation - Cognition and Behavior |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666245025000157 |
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| author | Frank J. Wolters Meike W. Vernooij Gennady V. Roshchupkin M․Arfan Ikram Maryam Kavousi Peter J. Koudstaal Aad van der Lugt Daniel Bos |
| author_facet | Frank J. Wolters Meike W. Vernooij Gennady V. Roshchupkin M․Arfan Ikram Maryam Kavousi Peter J. Koudstaal Aad van der Lugt Daniel Bos |
| author_sort | Frank J. Wolters |
| collection | DOAJ |
| description | Background: Carotid artery stenosis could contribute to gradual loss of brain function through chronic hypoxia and ischemia. Methods: We included consecutive participants of the population-based Rotterdam Study with unilateral ≥50 % stenosis at the carotid artery bifurcation on time-of-flight carotid MR angiography, and compared between hemispheres the presence of ischemic lesions, tissue volumes, and white matter integrity on structural brain MRI. Results: Among 50 participants (mean age 76 years, 50 % women), flow was lower in the affected carotid artery than on the unaffected side (160mL/min versus 202mL/min; flow reduction [95 %CI] per 1 % increase in stenosis: 1.7 mL/min [1.0–2.5]). Twelve individuals had radiographic evidence of cortical infarction, of whom 8 had cortical microinfarcts, all on the side of the stenosis (P = 0.001). Downstream of the stenotic artery, parenchymal volume was lower than in the contralateral hemisphere (mean difference: -2.7 mL [-4.9;-0.4]), similar for grey and white matter. Differences were most profound in the frontoparietal lobes, and increased with severity of stenosis to roughly 5 mL in individuals with ≥70 % stenosis. White matter hyperintensity volume and microstructural integrity did not differ between hemispheres. Conclusions: Carotid artery stenosis is associated with downstream presence of cortical microinfarcts as well as lower parenchymal tissue volume. |
| format | Article |
| id | doaj-art-0b4987f1bfde4ffc9a34b2ca3d16e597 |
| institution | Kabale University |
| issn | 2666-2450 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cerebral Circulation - Cognition and Behavior |
| spelling | doaj-art-0b4987f1bfde4ffc9a34b2ca3d16e5972025-08-20T03:58:21ZengElsevierCerebral Circulation - Cognition and Behavior2666-24502025-01-01910039110.1016/j.cccb.2025.100391Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam StudyFrank J. Wolters0Meike W. Vernooij1Gennady V. Roshchupkin2M․Arfan Ikram3Maryam Kavousi4Peter J. Koudstaal5Aad van der Lugt6Daniel Bos7Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands; Corresponding author at: Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam, the Netherlands.Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Medical Informatics, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, the NetherlandsBackground: Carotid artery stenosis could contribute to gradual loss of brain function through chronic hypoxia and ischemia. Methods: We included consecutive participants of the population-based Rotterdam Study with unilateral ≥50 % stenosis at the carotid artery bifurcation on time-of-flight carotid MR angiography, and compared between hemispheres the presence of ischemic lesions, tissue volumes, and white matter integrity on structural brain MRI. Results: Among 50 participants (mean age 76 years, 50 % women), flow was lower in the affected carotid artery than on the unaffected side (160mL/min versus 202mL/min; flow reduction [95 %CI] per 1 % increase in stenosis: 1.7 mL/min [1.0–2.5]). Twelve individuals had radiographic evidence of cortical infarction, of whom 8 had cortical microinfarcts, all on the side of the stenosis (P = 0.001). Downstream of the stenotic artery, parenchymal volume was lower than in the contralateral hemisphere (mean difference: -2.7 mL [-4.9;-0.4]), similar for grey and white matter. Differences were most profound in the frontoparietal lobes, and increased with severity of stenosis to roughly 5 mL in individuals with ≥70 % stenosis. White matter hyperintensity volume and microstructural integrity did not differ between hemispheres. Conclusions: Carotid artery stenosis is associated with downstream presence of cortical microinfarcts as well as lower parenchymal tissue volume.http://www.sciencedirect.com/science/article/pii/S2666245025000157Carotid artery stenosisCerebral blood flowCortical microinfarctsNeurodegenerationCerebral small-vessel disease |
| spellingShingle | Frank J. Wolters Meike W. Vernooij Gennady V. Roshchupkin M․Arfan Ikram Maryam Kavousi Peter J. Koudstaal Aad van der Lugt Daniel Bos Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study Cerebral Circulation - Cognition and Behavior Carotid artery stenosis Cerebral blood flow Cortical microinfarcts Neurodegeneration Cerebral small-vessel disease |
| title | Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study |
| title_full | Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study |
| title_fullStr | Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study |
| title_full_unstemmed | Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study |
| title_short | Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study |
| title_sort | effect of carotid artery stenosis on cortical microinfarcts white matter integrity and brain volume an interhemispheric comparison within the population based rotterdam study |
| topic | Carotid artery stenosis Cerebral blood flow Cortical microinfarcts Neurodegeneration Cerebral small-vessel disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666245025000157 |
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