C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study

Area of Science:

• Neurology
• Cardiovascular Medicine
• Immunology

Background:

• Cerebral small-vessel disease, manifesting as white matter lesions and lacunar infarcts, is common in the elderly and linked to stroke and dementia risk.
• The role of inflammatory processes in cerebral small-vessel disease remains unclear, unlike their established role in atherosclerosis.

Purpose of the Study:

• To investigate the association between C-reactive protein (CRP) levels, a marker of inflammation, and the presence and progression of white matter lesions and lacunar infarcts.

Main Methods:

• The study analyzed data from 1033 participants (aged 60-90) in the Rotterdam Scan Study, who underwent baseline and follow-up MRI scans.
• Multivariate regression models were used to assess associations between CRP levels and markers of small-vessel disease, adjusting for cardiovascular risk factors and carotid atherosclerosis.

Main Results:

• Elevated CRP levels were significantly associated with the presence and progression of white matter lesions, particularly marked progression.
• Higher CRP levels also showed a tendency towards more prevalent and incident lacunar infarcts.

Conclusions:

• Inflammatory processes, as indicated by CRP levels, may contribute to the pathogenesis of cerebral small-vessel disease.
• Specifically, inflammation appears to play a role in the development of white matter lesions.