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Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events
Xuemei Chen
The Affiliated Jiangning Hospital with Nanjing Medical University
Corresponding Author
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View the published version at BMC Neurology.
Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events.
Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence.
Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence.
Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.
Keywords
white matter hyperintensity, cerebral small vessel disease, burden, minor cerebrovascular events, outcome
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CURRENT STATUS: Published
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Posted 12 Jan, 2021
Published
On 13 Jan, 2021
No community comments so far
Editorial decision: Accept
On 30 Dec, 2020
Review #1 received
Received 27 Dec, 2020
Reviewer #1 agreed
On 24 Dec, 2020
Editor assigned
On 21 Dec, 2020
Reviewers invited
Invitations sent on 21 Dec, 2020
Submission checks complete
On 21 Dec, 2020
Editor invited
On 21 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 14 Dec, 2020
Review #1 received
Received 12 Dec, 2020
Reviewers invited
Invitations sent on 25 Nov, 2020
Reviewer #1 agreed
On 25 Nov, 2020
Editor assigned
On 24 Nov, 2020
Submission checks complete
On 24 Nov, 2020
Editor invited
On 24 Nov, 2020
No comments provided
Review #2 received
Received 18 Nov, 2020
Editorial decision: Major revision
On 18 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
Review #1 received
Received 04 Nov, 2020
Editor assigned
On 02 Nov, 2020
Submission checks complete
On 02 Nov, 2020
Editor invited
On 02 Nov, 2020
No comments provided
Editorial decision: Major revision
On 18 Oct, 2020
Review #2 received
Received 18 Oct, 2020
Reviewer #2 agreed
On 14 Oct, 2020
Review #1 received
Received 02 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 19 Aug, 2020
Editor invited
On 18 Aug, 2020
First submitted
On 10 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 09 Aug, 2020
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This preprint is under consideration at BMC Neurology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Association of Neuroimaging Markers of Cerebral Small Vessel Disease With Short-Term Outcomes in Patients With Minor Cerebrovascular Events
Xuemei Chen
The Affiliated Jiangning Hospital with Nanjing Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 12 Jan, 2021
Published
On 13 Jan, 2021
No community comments so far
Editorial decision: Accept
On 30 Dec, 2020
Review #1 received
Received 27 Dec, 2020
Reviewer #1 agreed
On 24 Dec, 2020
Editor assigned
On 21 Dec, 2020
Reviewers invited
Invitations sent on 21 Dec, 2020
Submission checks complete
On 21 Dec, 2020
Editor invited
On 21 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 14 Dec, 2020
Review #1 received
Received 12 Dec, 2020
Reviewers invited
Invitations sent on 25 Nov, 2020
Reviewer #1 agreed
On 25 Nov, 2020
Editor assigned
On 24 Nov, 2020
Submission checks complete
On 24 Nov, 2020
Editor invited
On 24 Nov, 2020
No comments provided
Review #2 received
Received 18 Nov, 2020
Editorial decision: Major revision
On 18 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
Review #1 received
Received 04 Nov, 2020
Editor assigned
On 02 Nov, 2020
Submission checks complete
On 02 Nov, 2020
Editor invited
On 02 Nov, 2020
No comments provided
Editorial decision: Major revision
On 18 Oct, 2020
Review #2 received
Received 18 Oct, 2020
Reviewer #2 agreed
On 14 Oct, 2020
Review #1 received
Received 02 Sep, 2020
Reviewer #1 agreed
On 31 Aug, 2020
Reviewers invited
Invitations sent on 19 Aug, 2020
Editor invited
On 18 Aug, 2020
First submitted
On 10 Aug, 2020
Editor assigned
On 10 Aug, 2020
Submission checks complete
On 09 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Neurology.
Background: Increasing evidences have showed that neuroimaging markers of SVD can predict the short-term outcome of acute ischemic stroke (AIS).It is unclear that whether neuroimaging markers of SVD are also associated with short-term outcomes of minor cerebrovascular events. In the present study, we investigate neuroimaging markers of SVD in order to explore their roles in prediction of short-term outcome in patients with minor cerebrovascular events.
Methods: Consecutive first-ever stroke patients (n=546) from the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled. A total of 388 patients were enrolled according to minor cerebrovascular events definition（National Institutes of Health Stroke Scale Score≤3）and exclusion criteria. MRI scans were performed within seven days of stroke onset, and then neuroimaging markers of SVD including WMH, lacunes, cerebral microbleeds (CMB), and perivascular spaces (PVS) , SVD burden scores were assessed. We completed baseline characteristics and evaluated the relationships of short-term outcomes to SVD neuroimaging markers and SVD scores. The 90-day modified Rankin Scale (mRS) was thought as primary outcome and was dichotomized as good functional outcome (mRS 0-1) and poor outcome (mRS 2-6). Secondary outcomes were stroke progression and stroke recurrence.
Results: Higher age, National Institutes of Health Stroke Scale (NIHSS) upon admission, lipoprotein-associated phospholipase A2 (LP-PLA2) and lacunes, Fazekas score were correlated with poor functional outcome (P<0.05), But after adjusting for confounding variables, among the neuroimaging markers of cerebral small vessel disease, only Fazekas score (OR, 1.343; 95% confidence interval, 1.020-1.770; P=0.036) was found to be associated with poor outcome at 90 days. Higher Fazekas and SVD scores were not associated with stroke progression or stroke recurrence.
Conclusion: WMH can predict the poor functional outcome of minor cerebrovascular events. Adding other neuroimaging markers of SVD and total SVD burden score, however, does not improve the prediction, which indicated WMH can as neuroimaging markers for guiding the treatment of minor cerebrovascular events.
Figure 1
Figure 2