Abstract Details

Title Premature White Matter Changes on Brain Imaging in Relation to Ischaemic Stroke Subtypes: Population-Based Case-Control Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S09 - (-)

Poster/Presentation
Number 003

Objective

Background Cohort studies suggest that leukoaraiosis is associated with an increased risk of ischaemic stroke.Cross-sectional studies in stroke populations show that this association is strongest in the small vessel (SV) subtype. However, it is uncertain whether leukoaraiosis is associated only with lacunar stroke or whether it indicates a wider susceptibility to white matter ischaemia that might also increase the risk of stroke in the face of other types of arterial or embolic disease. We studied the associations of leukoaraiosis with different aetiological subtypes of ischaemic stroke in a population-based case-control study.

Design/Methods 1765 incident TIA/stroke patients from Oxford Vascular Study and 358 healthy controls were included. The presence and severity of leukoaraiosis was evaluated in 1766 with CT brain imaging (OXVASC 1453, Control 313) and in 693 with MRI brain imaging (OXVASC 562, Control 131) using modified Blennow/Fazekas scale and ARWMC scale respectively. We compared the prevalence of moderate-to-severe leukoaraiosis between each aetiological subtype (TOAST) and controls stratified by age groups.

Results In comparison with controls, moderate-to-severe leukoaraiosis (ARWMC scale) was associated with TIA or stroke (OR=1.42, 95%CI 1.03-1.96, p=0.04). However, this association only existed in small vessel TIA/stroke subtype after adjustment for age, sex and hypertension (2.93, 1.86-4.62,p<0.0001) with no significant associations with other subtypes: large artery (1.45, 0.87-2.41, 0.15),cardioembolic (0.99, 0.65-1.51, 0.96) or undetermined (1.02, 0.69-1.51, 0.93). The association of moderate-to-severe leukoaraiosis and TIA or stroke was stronger in patients < 75 years than those ?75 (OR<75=4.50, 1.93-10.45, p<0.0001; OR75-84=3.99, 1.97-8.06, p<0.0001; OR?85=1.23, 0.40-3.73,p=0.72).These results were consistent for other scales and for MRI and CT.

Conclusions Leukoaraiosis is independently associated with SV TIA/Stroke alone. The lack of association between leukoaraiosis and non-SVevents suggests that leukoaraiosis is unlikely to have an independent role in non-SV ischaemic events.

Authors/Disclosures
Linxin Li, MD PRESENTER	The institution of Dr. Li has received research support from Medical Research Foundation.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Alexander H. Rajput, MD, FAAN (Royal Univ Hosp/division of Neuro)	Dr. Rajput has received personal compensation in the range of $500-$4,999 for serving as a Peer reviewer with CQDM.
	No disclosure on file
	No disclosure on file

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