Total Small Vessel Disease Score in Neurologically Healthy Japanese Adults in the Kashima Scan Study

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Author(s)

    • Yakushiji Yusuke
    • Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Japan
    • Hara Hideo
    • Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Japan
    • Charidimou Andreas
    • J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, USA
    • Eriguchi Makoto
    • Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Japan
    • Nanri Yusuke
    • Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Japan
    • Kawaguchi Atsushi
    • Center for Comprehensive Community Medicine, Saga University Faculty of Medicine, Japan
    • Werring David J.
    • Stroke Research Group, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, UK

Abstract

<p><b>Objective </b>We explored the association between the total small vessel disease (SVD) score obtained with magnetic resonance imaging and risk factors and outcomes in the Japanese population. </p><p><b>Methods </b>The presence of SVD features, including lacunes, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on MRI, was summed to obtain a "total SVD score" (range 0-4). Ordinal and multinomial logistic regression analyses were performed to investigate the association of higher total SVD scores with vascular risk factors, the Mini-Mental State Examination (MMSE) score, and cerebral atrophy. </p><p><b>Results </b>We included 1,451 neurologically healthy adults (mean age, 57.1 years; 47% male). A multivariate ordinal logistic regression analysis showed that the total SVD score was associated with aging, hypertension, blood pressure (BP), diabetes mellitus, MMSE score, and deep cerebral atrophy, but the equal slopes assumption between scores did not hold. A multivariate multinomial logistic regression analysis (total SVD score 0=reference) showed that aging, hypertension, and BP were positively associated with scores of 1, 2, or ≥3. These effects, presented as odds ratios (ORs), increased as the score increased and were strongest with a score of ≥3 [aging (per 10-year increment), OR 4.00, 95% confidence interval (CI) 2.47-6.46; hypertension, OR 5.68, 95% CI 2.52-12.80; systolic BP (per standard deviation increase), OR 1.96, 95% CI 1.41-2.74, respectively]. Diabetes mellitus and deep cerebral atrophy tended to be associated with the SVD scores. The MMSE score showed no consistent associations. </p><p><b>Conclusion </b>The total SVD score may be a promising tool for indexing SVD, even in the Japanese population. </p>

Journal

  • Internal Medicine

    Internal Medicine 57(2), 189-196, 2018

    The Japanese Society of Internal Medicine

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