Arterial Stiffness and Cerebral Small Vessel Disease

Area of Science:

• Neurology
• Cardiology
• Radiology

Background:

• Cerebral small vessel disease (CSVD) encompasses various radiological features.
• Limited research exists on the relationship between arterial stiffness and the full spectrum of CSVD markers.
• Arterial stiffness is a known cardiovascular risk factor.

Purpose of the Study:

• To investigate the association between arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV), and key CSVD imaging markers.
• To examine associations with lacunes, white matter hyperintensities (WMH), microbleeds (CMBs), dilated perivascular spaces (PVS), and brain atrophy.
• To explore age-related differences in these associations.

Main Methods:

• Included 953 community-based participants (mean age 55.7 years) who underwent baPWV and brain MRI.
• CSVD features (lacunes, CMBs, PVS) were visually rated; WMH and brain atrophy (via brain parenchyma fraction, BPF) were automatically segmented.
• Multivariable regression models analyzed associations between baPWV and CSVD markers, with age-stratified analyses.

Main Results:

• Increased baPWV correlated with severe white matter PVS, larger WMH volume, and lower BPF (brain atrophy).
• A marginal association was found between baPWV and strictly lobar CMBs; no association with lacunes.
• WMH volume mediated the relationship between baPWV and brain atrophy. Age subgroup analysis revealed differential associations for PVS and brain atrophy.

Conclusions:

• Elevated arterial stiffness is associated with prevalent CSVD imaging markers, including PVS, WMH, CMBs, and brain atrophy.
• Arterial stiffness does not appear to be associated with lacunes.
• Further research is needed to elucidate the mechanisms and clinical implications of these associations.