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Severity of White Matter Lesions Correlates with Subcortical Diffusion-Weighted Imaging Abnormalities and Predicts
Background And Purpose:
The severity of white matter lesions (WMLs) has been strongly linked to small-vessel diseases or lacunar infarction. The present study aimed to investigate the correlation between severity of WMLs and distribution of diffusion-weighted imaging (DWI) hyperintensities, and to explore whether the severity of WMLs is an independent neuroimaging predictor of stroke risk after transient symptoms with infarction (TSI).
Methods:
We evaluated the presence and severity of WMLs on fluid-attenuated inversion recovery sequences using the age-related white matter changes scale and the location and size of hyperintensities on DWI sequences, respectively, in a prospective cohort study of TSI patients. The primary end point was recurrent stroke within 90 days.
Results:
A total of 191 consecutive TSI patients were eligible for inclusion in the present analysis. The average age of the patients was 57.3 ± 12.8 years. DWI abnormalities occurred more often in the deep white matter with increasing severity of WMLs (P < .001). During 90-day follow-up, Kaplan-Meier analysis showed that recurrent stroke was correlated to the severity of WMLs (P = .01). The Cox proportional hazards model revealed that WMLs were predictive of recurrent stroke (hazard ratio, 1.748; 95% confidence interval, 1.16-2.634; P = .008).
Conclusions:
Severe WMLs were correlated with DWI hyperintensities in the deep white matter in TSI patients and contributed to an increased risk of recurrent stroke.
Insights
Severe white matter lesions (WMLs) correlate with deep white matter diffusion-weighted imaging (DWI) hyperintensities. These WMLs predict a higher risk of recurrent stroke in patients with transient symptoms with infarction (TSI).
Area of Science:
- Neurology
- Neuroimaging
- Stroke Research
Background:
- White matter lesions (WMLs) are linked to small-vessel diseases and lacunar infarction.
- Understanding WMLs' role in stroke risk is crucial for patient management.
Purpose of the Study:
- Investigate the correlation between WML severity and diffusion-weighted imaging (DWI) hyperintensities.
- Determine if WML severity independently predicts stroke risk in transient symptoms with infarction (TSI) patients.
Main Methods:
- Prospective cohort study of 191 TSI patients.
- Assessed WMLs using age-related white matter changes scale and DWI hyperintensities.
- Primary endpoint: recurrent stroke within 90 days.
Main Results:
- DWI abnormalities were more frequent in deep white matter with increasing WML severity (P < .001).
- Recurrent stroke within 90 days correlated with WML severity (P = .01).
- WMLs were an independent predictor of recurrent stroke (HR, 1.748; P = .008).
Conclusions:
- Severe WMLs are associated with DWI hyperintensities in the deep white matter of TSI patients.
- WML severity is a significant predictor of recurrent stroke risk.
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