Abstract Body (Do not enter title and authors here): Introduction
Previous studies have shown that intracranial large artery atherosclerosis is associated with cerebral small vessel disease (CSVD). The pathophysiological mechanisms of intracranial atherosclerosis (ICAS) include plaque growth and calcification, but intracranial artery calcification (IAC) sometimes exists independently of ICAS. Few studies have analyzed the the association between these two characteristics and white matter hyperintensity (WMH) progression. We aimed to investigate the association of ICAS burden (ICASB) and IAC features with WMH in the elderly non-acute infarction population.
Methods
Elderly patients (≥65 years old) with non-acute cerebral infarction were continuously enrolled from a single center registration cohort. The degree of arterial stenosis and IAC were evaluated on head and neck CTA. On brain MRI, WML was graded according to Fazekas scale, and the scores of PVWMH and DWMH were recorded. The differences of clinical features, ICASB and IAC features among WMH groups were compared. Multiple logistic regression and binary logistic regression were performed to evaluate the relationship between ICASB, IAC features and WML.
Results
Among the 278 patients included in the study, 147 patients (52.9%) had intimal IAC and 123 patients (44.2%) had medial IAC. There were 103 patients (37.1%) with no or mild WMH, 128 patients (46.0%) with moderate WMH, and 47 patients (16.9%) with severe WMH.
ICASB (p= 0.009) , qualitative calcium burden score, medial IAC and number of arteries involved in medial IAC were correlated with the severity of WMH (p<0.001, respectively). Multivariate ordered logistics regression showed that age (p=0.021) and the number of arteries involved in medial IAC (p＜0.001) were positively correlated with WMH. Binary logistics regression showed that age (p=0.026) and the number of arteries involved in medial IAC (p=0.006) were associated with PVWMH, while sex (p=0.034) and the number of arteries involved in medial IAC (p=0.042) were associated with DWMH.
Conclusions
In the elderly population, the ICASB is positively correlated with IAC burden and the severity of medial IAC. Medial IAC is an independent risk factor for severe WMH, and there is a dose-effect relationship.