Abstract Details

Title Erythrocyte Sedimentation Rate (ESR) as a Predictor of White Matter Lesion (WML) Progression

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-031

Objective To evaluate the role of erythrocyte sedimentation rate (ESR) as a surrogate of inflammation in predicting white matter lesion (WML) progression.

Background ESR is a non-specific test that measures increased inflammatory activity within the body. WMLs are microvascular injuries within the white matter of the brain. It has been suggested that inflammation may play a role in the genesis and progression of WML. We hypothesized that high levels of ESR may predict WML progression.

Design/Methods

We retrospectively evaluated the records of 2356 patients with chronic microvascular ischemia identified by a natural language processing algorithm seen at a healthcare network from 2011 to 2015 with 2 serial MRIs of the brain at least 1 year apart. High ESR was defined as >23 mm/hr (Q4). WML volume was quantified using an automated deep-learning algorithm applied to axial T2 FLAIR images with the primary outcome measured as an annual change in WML volume (cc/year). Univariate linear regression analysis was used to determine if ESR was a predictor of WML progression, and a subsequent multivariate model was used to adjust for potential confounders.

Results Of the 1377 patients who met our final inclusion criteria, 54.2% were female and the median age was 69 (60-76) years. About 24.7% of patients had a high ESR and the median WML progression was 0.79 (0.15-1.96) cc/year. The univariate linear regression model showed that a high ESR significantly predicted WML progression (β = 0.42, p < 0.013). After adjusting for age, sex, comorbidities, medications, and metabolic biomarkers in the multivariate model, a high ESR remained an independent predictor of WML progression (β = 1.24, p < 0.021).

Conclusions ESR is an independent predictor of WML progression, suggesting that inflammation may play a role in the progression of cerebral small vessel disease.

Authors/Disclosures
Omar Abdelkader, MD (Westchester Medical Center) PRESENTER	Dr. Abdelkader has nothing to disclose.
Hans Mautong	No disclosure on file
Bhrugun Anisetti, MBBS	Dr. Anisetti has nothing to disclose.
Md Manjurul Islam Shourav, MBBS	Mr. Shourav has nothing to disclose.
Michelle P. Lin, CRC (Mayo Clinic Florida)	Dr. Lin has nothing to disclose.

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