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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
C-reactive protein and cerebral small-vessel disease: the Rotterdam Scan Study
E J van Dijk1, N D Prins, S E Vermeer
1Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, 3000DR Rotterdam, The Netherlands.
Background:
Inflammatory processes are involved in the development and consequences of atherosclerosis. Whether these processes are also involved in cerebral small-vessel disease is unknown. Cerebral white matter lesions and lacunar brain infarcts are caused by small-vessel disease and are commonly observed on MRI scans in elderly people. These lesions are associated with an increased risk of stroke and dementia. We assessed whether higher C-reactive protein (CRP) levels were related to white matter lesion and lacunar infarcts.
Methods And Results:
We based our study on 1033 participants of the population-based Rotterdam Scan Study for whom complete data on CRP levels were available and who underwent brain MRI scanning. Subjects were 60 to 90 years of age and free of dementia at baseline. Six hundred thirty-six subjects had a second MRI scan on average 3.3 years later. We used multivariate regression models to assess the associations between CRP levels and markers of small-vessel disease. Higher CRP levels were associated with presence and progression of white matter lesions, particularly with marked lesion progression (ORs for highest versus lowest quartile of CRP 3.1 [95% CI 1.3 to 7.2] and 2.5 [95% CI 1.1 to 5.6] for periventricular and subcortical white matter lesion progression, respectively). These associations persisted after adjustment for cardiovascular risk factors and carotid atherosclerosis. Persons with higher CRP levels tended to have more prevalent and incident lacunar infarcts.
Conclusions:
Inflammatory processes may be involved in the pathogenesis of cerebral small-vessel disease, in particular, the development of white matter lesions.
Insights
Higher C-reactive protein (CRP) levels are linked to the development and progression of white matter lesions in the brain, a key indicator of cerebral small-vessel disease. This suggests inflammation plays a role in this condition.
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.
