Evidence map›Paper›PMID 37368130›Full record

ArticleJournal of neurology2023

A typology of cerebral small vessel disease based on imaging markers.

Christoph Sperber, Arsany Hakim, Laura Gallucci, David Seiffge, Beata Rezny-Kasprzak, Eugen Jäger, Thomas Meinel, Roland Wiest, Urs Fischer, Marcel Arnold and 1 more

Abstract read
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In one paragraph

Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  5. Immune system activation and cognitive impairment in arterial hypertension.American journal of physiology. Cell physiology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Christoph SperberDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0001-6493-6543
Arsany HakimUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Laura GallucciDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
David SeiffgeDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Beata Rezny-KasprzakUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Eugen JägerUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Thomas MeinelDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Roland WiestUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Roza UmarovaDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland. roza.umarova@insel.ch.ORCID http://orcid.org/0000-0003-4451-679X

Funding

Stiftung Synapsis - Alzheimer Forschung Schweiz AFS 2019-PI05
6 · The paper itself

Abstract

backgroundLacunes, microbleeds, enlarged perivascular spaces (EPVS), and white matter hyperintensities (WMH) are brain imaging features of cerebral small vessel disease (SVD). Based on these imaging markers, we aimed to identify subtypes of SVD and to evaluate the validity of these markers as part of clinical ratings and as biomarkers for stroke outcome.

methodsIn a cross-sectional study, we examined 1207 first-ever anterior circulation ischemic stroke patients (mean age 69.1 ± 15.4 years; mean NIHSS 5.3 ± 6.8). On acute stroke MRI, we assessed the numbers of lacunes and microbleeds and rated EPVS and deep and periventricular WMH. We used unsupervised learning to cluster patients based on these variables.

resultsWe identified five clusters, of which the last three appeared to represent distinct late stages of SVD. The two largest clusters had no to only mild or moderate WMH and EPVS, respectively, and favorable stroke outcome. The third cluster was characterized by the largest number of lacunes and a likewise favorable outcome. The fourth cluster had the highest age, most pronounced WMH, and poor outcome. Showing the worst outcome, the fifth cluster presented pronounced microbleeds and the most severe SVD burden.

conclusionThe study confirmed the existence of different SVD types with different relationships to stroke outcome. EPVS and WMH were identified as imaging features of presumably early progression. The number of microbleeds and WMH severity appear to be promising biomarkers for distinguishing clinical subgroups. Further understanding of SVD progression might require consideration of refined SVD features, e.g., for EPVS and type of lacunes.

Indexed as

Cerebral Small Vessel DiseasesStrokeAgedAged, 80 and overBrainCerebral HemorrhageCross-Sectional StudiesHumansMagnetic Resonance ImagingMiddle AgedEnlarged perivascular spacesk-meansLacuneMicrobleedStroke outcomeWhite matter hyperintensities

Identifiers

PMID37368130
PMCPMC10511610

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.