Nonfocal Transient Neurological Attacks Are Associated With Cerebral Small Vessel Disease

Area of Science:

• Neurology
• Neuroimaging
• Vascular Medicine

Background:

• Nonfocal transient neurological attacks (TNAs) are associated with increased stroke and dementia risk.
• The exact mechanisms behind TNAs, such as unsteadiness or confusion, remain unclear.
• Cerebral ischemia is implicated, but the specific role of small vessel disease is under investigation.

Purpose of the Study:

• To investigate the association between TNAs and markers of cerebral small vessel disease.
• To assess the relationship between TNAs and magnetic resonance imaging (MRI) findings.

Main Methods:

• Participants from the Heart-Brain Connection (HBC) study were analyzed.
• Eight types of TNAs were assessed via standardized interviews, excluding individuals with prior stroke or TIAs.
• Logistic regression analysis correlated TNAs with lacunes and white matter hyperintensities (Fazekas score ≥2), adjusting for age, sex, and hypertension.

Main Results:

• Of 304 participants, 21% reported at least one TNA.
• Lacunes were more prevalent in participants with TNAs (35% vs. 20%; aOR=2.32).
• White matter hyperintensities (Fazekas ≥2) were also more common in those with TNAs (48% vs. 27%; aOR=2.65).

Conclusions:

• TNAs are significantly associated with lacunes and white matter hyperintensities.
• These findings suggest that cerebral small vessel disease may contribute to the pathogenesis of TNAs.
• Cerebral small vessel disease is a potential underlying factor for nonfocal transient neurological attacks.