Magnetic resonance imaging-based scores of small vessel diseases: Associations with intracerebral haemorrhage location

Ghil Schwarz; Gargi Banerjee; Isabel Charlotte Hostettler; Gareth Ambler; David J Seiffge; Tenzin S Brookes; Duncan Wilson; Hannah Cohen; Tarek Yousry; Rustam Al-Shahi Salman; Gregory Y H Lip; Martin M Brown; Keith W Muir; Henry Houlden; Rolf Jäger; David J Werring; Julie Staals; CROMIS-2 investigators

doi:10.1016/j.jns.2022.120165

Magnetic resonance imaging-based scores of small vessel diseases: Associations with intracerebral haemorrhage location

Ghil Schwarz, Gargi Banerjee, Isabel Charlotte Hostettler, Gareth Ambler, David J Seiffge, Tenzin S Brookes, Duncan Wilson, Hannah Cohen, Tarek Yousry, Rustam Al-Shahi Salman, Gregory Y H Lip, Martin M Brown, Keith W Muir, Henry Houlden, Rolf Jäger, David J Werring, Julie Staals^*, CROMIS-2 investigators

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

INTRODUCTION: Total small vessel disease (SVD) score and cerebral amyloid angiopathy (CAA) score are magnetic resonance imaging-based composite scores built to preferentially capture deep perforator arteriopathy-related and CAA-related SVD burden, respectively. Non-lobar intracerebral haemorrhage (ICH) is related to deep perforator arteriopathy, while lobar ICH can be associated with deep perforator arteriopathy or CAA; however, the associations between ICH location and these scores are not established.

METHODS: In this post-hoc analysis from a prospective cohort study, we included 153 spontaneous non-cerebellar ICH patients. Wald test, univariable and multivariable logistic regression analysis were performed to investigate the association between each score (and individual score components) and ICH location.

RESULTS: Total SVD score was associated with non-lobar ICH location (Wald test: unadjusted, p = 0.017; adjusted, p = 0.003); however, no individual component of total SVD score was significantly associated with non-lobar ICH. CAA score was not significantly associated with lobar location (Wald test: unadjusted, p = 0.056; adjusted, p = 0.126); cortical superficial siderosis (OR 8.85 [95%CI 1.23-63.65], p = 0.030) and ≥ 2 strictly lobar microbleeds (OR 1.63 [95%CI 1.04-2.55], p = 0.035) were related with lobar ICH location, while white matter hyperintensities showed an inverse relation (OR 0.53 [95%CI 0.26-1.08; p = 0.081]).

CONCLUSIONS: Total SVD score was associated with non-lobar ICH location. The lack of significant association between CAA score and lobar ICH may in part be due to the mixed aetiology of lobar ICH, and to the inclusion of white matter hyperintensities, a non-specific marker of SVD type, in the CAA score.

Original language	English
Article number	120165
Number of pages	6
Journal	Journal of the Neurological Sciences
Volume	434
Early online date	24 Jan 2022
DOIs	https://doi.org/10.1016/j.jns.2022.120165
Publication status	Published - 15 Mar 2022

Keywords

BURDEN
CAA score
CEREBRAL AMYLOID ANGIOPATHY
Cerebral amyloid angiopathy
Intracerebral haemorrhage
MRI
MRI-based score
RISK-FACTORS
STROKE
SUPERFICIAL SIDEROSIS
Small vessel disease
Total SVD score

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Schwarz, G., Banerjee, G., Hostettler, I. C., Ambler, G., Seiffge, D. J., Brookes, T. S., Wilson, D., Cohen, H., Yousry, T., Salman, R. A.-S., Lip, G. Y. H., Brown, M. M., Muir, K. W., Houlden, H., Jäger, R., Werring, D. J., Staals, J., & CROMIS-2 investigators (2022). Magnetic resonance imaging-based scores of small vessel diseases: Associations with intracerebral haemorrhage location. Journal of the Neurological Sciences, 434, Article 120165. https://doi.org/10.1016/j.jns.2022.120165

@article{37d82399a38444f59cc02af6f2c70dcb,

title = "Magnetic resonance imaging-based scores of small vessel diseases: Associations with intracerebral haemorrhage location",

abstract = "INTRODUCTION: Total small vessel disease (SVD) score and cerebral amyloid angiopathy (CAA) score are magnetic resonance imaging-based composite scores built to preferentially capture deep perforator arteriopathy-related and CAA-related SVD burden, respectively. Non-lobar intracerebral haemorrhage (ICH) is related to deep perforator arteriopathy, while lobar ICH can be associated with deep perforator arteriopathy or CAA; however, the associations between ICH location and these scores are not established.METHODS: In this post-hoc analysis from a prospective cohort study, we included 153 spontaneous non-cerebellar ICH patients. Wald test, univariable and multivariable logistic regression analysis were performed to investigate the association between each score (and individual score components) and ICH location.RESULTS: Total SVD score was associated with non-lobar ICH location (Wald test: unadjusted, p = 0.017; adjusted, p = 0.003); however, no individual component of total SVD score was significantly associated with non-lobar ICH. CAA score was not significantly associated with lobar location (Wald test: unadjusted, p = 0.056; adjusted, p = 0.126); cortical superficial siderosis (OR 8.85 [95%CI 1.23-63.65], p = 0.030) and ≥ 2 strictly lobar microbleeds (OR 1.63 [95%CI 1.04-2.55], p = 0.035) were related with lobar ICH location, while white matter hyperintensities showed an inverse relation (OR 0.53 [95%CI 0.26-1.08; p = 0.081]).CONCLUSIONS: Total SVD score was associated with non-lobar ICH location. The lack of significant association between CAA score and lobar ICH may in part be due to the mixed aetiology of lobar ICH, and to the inclusion of white matter hyperintensities, a non-specific marker of SVD type, in the CAA score.",

keywords = "BURDEN, CAA score, CEREBRAL AMYLOID ANGIOPATHY, Cerebral amyloid angiopathy, Intracerebral haemorrhage, MRI, MRI-based score, RISK-FACTORS, STROKE, SUPERFICIAL SIDEROSIS, Small vessel disease, Total SVD score",

author = "Ghil Schwarz and Gargi Banerjee and Hostettler, {Isabel Charlotte} and Gareth Ambler and Seiffge, {David J} and Brookes, {Tenzin S} and Duncan Wilson and Hannah Cohen and Tarek Yousry and Salman, {Rustam Al-Shahi} and Lip, {Gregory Y H} and Brown, {Martin M} and Muir, {Keith W} and Henry Houlden and Rolf J{\"a}ger and Werring, {David J} and Julie Staals and {CROMIS-2 investigators}",

year = "2022",

month = mar,

day = "15",

doi = "10.1016/j.jns.2022.120165",

language = "English",

volume = "434",

journal = "Journal of the Neurological Sciences",

issn = "0022-510X",

publisher = "Elsevier Science",

}

Schwarz, G, Banerjee, G, Hostettler, IC, Ambler, G, Seiffge, DJ, Brookes, TS, Wilson, D, Cohen, H, Yousry, T, Salman, RA-S, Lip, GYH, Brown, MM, Muir, KW, Houlden, H, Jäger, R, Werring, DJ, Staals, J & CROMIS-2 investigators 2022, 'Magnetic resonance imaging-based scores of small vessel diseases: Associations with intracerebral haemorrhage location', Journal of the Neurological Sciences, vol. 434, 120165. https://doi.org/10.1016/j.jns.2022.120165

TY - JOUR

T1 - Magnetic resonance imaging-based scores of small vessel diseases

T2 - Associations with intracerebral haemorrhage location

AU - Schwarz, Ghil

AU - Banerjee, Gargi

AU - Hostettler, Isabel Charlotte

AU - Ambler, Gareth

AU - Seiffge, David J

AU - Brookes, Tenzin S

AU - Wilson, Duncan

AU - Cohen, Hannah

AU - Yousry, Tarek

AU - Salman, Rustam Al-Shahi

AU - Lip, Gregory Y H

AU - Brown, Martin M

AU - Muir, Keith W

AU - Houlden, Henry

AU - Jäger, Rolf

AU - Werring, David J

AU - Staals, Julie

AU - CROMIS-2 investigators

PY - 2022/3/15

Y1 - 2022/3/15

N2 - INTRODUCTION: Total small vessel disease (SVD) score and cerebral amyloid angiopathy (CAA) score are magnetic resonance imaging-based composite scores built to preferentially capture deep perforator arteriopathy-related and CAA-related SVD burden, respectively. Non-lobar intracerebral haemorrhage (ICH) is related to deep perforator arteriopathy, while lobar ICH can be associated with deep perforator arteriopathy or CAA; however, the associations between ICH location and these scores are not established.METHODS: In this post-hoc analysis from a prospective cohort study, we included 153 spontaneous non-cerebellar ICH patients. Wald test, univariable and multivariable logistic regression analysis were performed to investigate the association between each score (and individual score components) and ICH location.RESULTS: Total SVD score was associated with non-lobar ICH location (Wald test: unadjusted, p = 0.017; adjusted, p = 0.003); however, no individual component of total SVD score was significantly associated with non-lobar ICH. CAA score was not significantly associated with lobar location (Wald test: unadjusted, p = 0.056; adjusted, p = 0.126); cortical superficial siderosis (OR 8.85 [95%CI 1.23-63.65], p = 0.030) and ≥ 2 strictly lobar microbleeds (OR 1.63 [95%CI 1.04-2.55], p = 0.035) were related with lobar ICH location, while white matter hyperintensities showed an inverse relation (OR 0.53 [95%CI 0.26-1.08; p = 0.081]).CONCLUSIONS: Total SVD score was associated with non-lobar ICH location. The lack of significant association between CAA score and lobar ICH may in part be due to the mixed aetiology of lobar ICH, and to the inclusion of white matter hyperintensities, a non-specific marker of SVD type, in the CAA score.

AB - INTRODUCTION: Total small vessel disease (SVD) score and cerebral amyloid angiopathy (CAA) score are magnetic resonance imaging-based composite scores built to preferentially capture deep perforator arteriopathy-related and CAA-related SVD burden, respectively. Non-lobar intracerebral haemorrhage (ICH) is related to deep perforator arteriopathy, while lobar ICH can be associated with deep perforator arteriopathy or CAA; however, the associations between ICH location and these scores are not established.METHODS: In this post-hoc analysis from a prospective cohort study, we included 153 spontaneous non-cerebellar ICH patients. Wald test, univariable and multivariable logistic regression analysis were performed to investigate the association between each score (and individual score components) and ICH location.RESULTS: Total SVD score was associated with non-lobar ICH location (Wald test: unadjusted, p = 0.017; adjusted, p = 0.003); however, no individual component of total SVD score was significantly associated with non-lobar ICH. CAA score was not significantly associated with lobar location (Wald test: unadjusted, p = 0.056; adjusted, p = 0.126); cortical superficial siderosis (OR 8.85 [95%CI 1.23-63.65], p = 0.030) and ≥ 2 strictly lobar microbleeds (OR 1.63 [95%CI 1.04-2.55], p = 0.035) were related with lobar ICH location, while white matter hyperintensities showed an inverse relation (OR 0.53 [95%CI 0.26-1.08; p = 0.081]).CONCLUSIONS: Total SVD score was associated with non-lobar ICH location. The lack of significant association between CAA score and lobar ICH may in part be due to the mixed aetiology of lobar ICH, and to the inclusion of white matter hyperintensities, a non-specific marker of SVD type, in the CAA score.

KW - BURDEN

KW - CAA score

KW - CEREBRAL AMYLOID ANGIOPATHY

KW - Cerebral amyloid angiopathy

KW - Intracerebral haemorrhage

KW - MRI

KW - MRI-based score

KW - RISK-FACTORS

KW - STROKE

KW - SUPERFICIAL SIDEROSIS

KW - Small vessel disease

KW - Total SVD score

U2 - 10.1016/j.jns.2022.120165

DO - 10.1016/j.jns.2022.120165

M3 - Article

C2 - 35121207

SN - 0022-510X

VL - 434

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

M1 - 120165

ER -