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White matter hyperintensity volume is increased in small vessel stroke subtypes

N S Rost1, R M Rahman, A Biffi

  • 1J. Philip Kistler Stroke Research Center, Center for Human Genetics Research, Massachusetts General Hospital, 175 Cambridge St, Suite 300, Boston, MA 02114, USA. nrost@partners.org

Neurology
|November 10, 2010
PubMed
Abstract

Insights

White matter hyperintensity (WMH) volume is linked to small vessel (SV) disease severity. Greater WMH burden indicates more severe SV disease, particularly in lacunar stroke and intracerebral hemorrhage (ICH).

Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Disease

Background:

  • White matter hyperintensities (WMH) are potential indicators of cerebral small vessel (SV) disease.
  • Cerebral small vessel changes are central to the pathophysiology of lacunar stroke and intracerebral hemorrhage (ICH).

Purpose of the Study:

  • To test the hypothesis that WMH severity correlates with SV disease.
  • To investigate the association between WMH volume and stroke subtypes, specifically lacunar stroke and ICH.

Main Methods:

  • WMH volume (WMHV) was quantified in prospectively ascertained patient cohorts with acute ischemic stroke (AIS) and ICH.
  • Two independent cohorts were utilized: Massachusetts General Hospital (MGH) AIS (n=628) and Ischemic Stroke Genetics Study (ISGS) AIS (n=263), along with MGH ICH (n=122).

Main Results:

  • Increased WMHV was significantly associated with lacunar stroke compared to other ischemic stroke subtypes in both MGH and ISGS cohorts.
  • Patients with ICH exhibited greater WMHV compared to those with lacunar stroke and all ischemic stroke subtypes combined.
  • Odds ratios indicated a higher likelihood of lacunar stroke and ICH with increasing WMHV.

Conclusions:

  • Elevated WMH burden is associated with small vessel (SV) stroke subtypes and intracerebral hemorrhage (ICH).
  • These findings support WMHV as a marker for the severity of cerebral SV disease.
  • The study provides further evidence linking the biology of WMH to SV stroke.

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