Susceptibility-weighted imaging and transcranial Doppler ultrasound in patients with cerebral small vessel disease
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ORIGINAL ARTICLE
Susceptibility-weighted imaging and transcranial Doppler ultrasound in patients with cerebral small vessel disease Petrenko Mykola 1 & Natalia Svyrydova 1 & Yevgen Trufanov 1 Received: 18 December 2019 / Accepted: 13 April 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Introduction Cerebral small vessel disease (SVD) is a common accompaniment to aging. Magnetic resonance imaging (MRI) features of SVD include lacunar infarcts (LI) and white matter hyperintensity (WMH). Brain iron deposition is also a known marker of SVD that is associated with cognitive impairment and can be detected with susceptibility-weighted imaging (SWI) MRI technique. According to recent studies, the pulsation of cerebral blood flow can be one of the main factors of the development of pathological brain changes in elderly patients. The objective of this study was to investigate the relationship between the brain iron deposition, cerebral blood flow pulsation, and cognitive impairment in patients with SVD. Materials and methods For the study, 97 patients with diagnosed SVD were selected. The patients were divided into two groups based on the Montreal Cognitive Assessment (MoCA) test scores. All patients underwent MRI in the SWI sequence. Pulsatility index (PI) and resistivity index (RI) were recorded from the middle cerebral artery bilaterally using transcranial Doppler (TCD). Results The linear regression model showed that the pulsatility index (PI) and resistivity index (RI) were associated with cognitive impairment and brain iron deposition in basal ganglia. The most significant association was found between left globus pallidus severe hypointensity voxels count and left middle cerebral artery (MCA) RI (p = 0.009). Conclusion The results of the study provide information that TCD indicators may be associated with brain iron deposition and cognitive decline in patients with SVD. Our findings suggest that both brain iron deposition and cerebral hemodynamics abnormalities may play an important role in the pathophysiological mechanisms of SVD. Keywords Small vessel disease . Brain iron deposition . Transcranial Doppler . Cognitive decline
Introduction Hypertension and cerebral atherosclerosis can often result in a cerebral small vessel disease (SVD). SVD is a common Highlights 1. Brain iron deposition is a marker of cerebral small vessel disease. 2. Basal ganglia hypointensity at SWI MRI is associated with cognitive decline. 3. TCD parameters are associated with basal ganglia SWI MRI hypointensity. 4. Cognitive status of elderly patients is associated with TCD parameters. * Petrenko Mykola [email protected] Natalia Svyrydova [email protected] 1
Department of Neurology and Reflexotherapy, P.L. Shupyk National Medical Academy of Postgraduate Education, 9 Dorohozhytska Str, Kyiv 04112, Ukraine
accompaniment to aging and is associated with increased risk of cognitive decline. The most common neuroimaging markers of SVD that can be seen on MRI include lacunar infarcts (LI) and white matter hyper
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