Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: A systematic review and meta-analysis

Sytze P. Rensma, Thomas T. van Sloten*, Lenore J. Launer, Coen D. A. Stehouwer

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

123 Citations (Web of Science)

Abstract

MRI features of cerebral small vessel disease (CSVD), i.e. white matter hyperintensities, lacunes, microbleeds, perivascular spaces, and cerebral atrophy, may be associated with clinical events, but the strength of these associations remains unclear. We conducted a systematic review and meta-analysis on the association between these features and incident ischaemic and haemorrhagic stroke, all-cause dementia and depression, and all-cause mortality. For the association with stroke, 36 studies were identified (number of individuals/events [n] = 38,432/4,136), for dementia 28 (n = 16,458/1,709), for depression nine (n = 9,538/1,746), and for mortality 28 (n = 23,031/2,558). Only two studies evaluated perivascular spaces; these results were not pooled. Pooled analyses showed that all other features were associated with all outcomes (hazard ratios ranged 1.22-2.72). Combinations of two features were more strongly associated with stroke than any individual feature. Individual features and combinations of CSVD features are strongly associated with incident ischaemic and haemorrhagic stroke, all-cause dementia and depression, and all-cause mortality. If these associations are causal, the strength of these associations suggests that a substantial burden of disease is attributable to CSVD.
Original languageEnglish
Pages (from-to)164-173
Number of pages10
JournalNeuroscience and Biobehavioral Reviews
Volume90
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • Cerebral small vessel disease
  • White matter hyperintensities
  • Lacunes
  • Microbleeds
  • Perivascular spaces
  • Cerebral atrophy
  • Stroke
  • Dementia
  • Depression
  • Mortality
  • Systematic review
  • Meta-analysis
  • BLOOD-PRESSURE
  • RECURRENT STROKE
  • ISCHEMIC-STROKE
  • MICROBLEEDS
  • COHORT
  • HYPERTENSION
  • POPULATION
  • TRENDS

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