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Brain white matter hyperintensities in Kawasaki disease: A case-control study.
Dan Laukka1,2, Riitta Parkkola3, Jussi Hirvonen3
1Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland.
Frontiers in Neuroscience
|November 4, 2022
Summary
Childhood Kawasaki disease (KD) is linked to increased white matter hyperintensities (WMH) in adulthood, indicating potential long-term cerebrovascular risks. This suggests KD may impact small vessel health later in life.
Area of Science:
- Neurology
- Pediatrics
- Cardiology
Background:
- Cerebrovascular complications of Kawasaki disease (KD) are understudied.
- White matter hyperintensities (WMH) are markers of cerebral small vessel disease and stroke risk.
Purpose of the Study:
- To determine if childhood KD is associated with adult WMH and other cerebrovascular findings.
- Investigate long-term neurological sequelae of KD.
Main Methods:
- Case-control study comparing KD patients (n=40) with migraine controls (n=160) using brain MRI.
- WMH burden assessed via modified Scheltens' scale and manual volume segmentation.
- Matched controls by age and sex; blinded neuroradiologist evaluation.
Main Results:
- KD patients showed significantly higher total WMH volume (0.26 vs 0.065 cm³), burden, and periventricular WMHs compared to controls.
- Increased odds of severe WMH scores (Scheltens' scale ≥2 or ≥3) in KD cases.
- Myocarditis during acute KD phase correlated with periventricular WMH; lacunes of presumed vascular origin were more frequent in KD cases.
Conclusions:
- Childhood KD history may be associated with increased adult WMH burden.
- Further research is needed to confirm these findings and elucidate the underlying mechanisms.
