Journal
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 90, Issue -, Pages 164-173Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2018.04.003
Keywords
Cerebral small vessel disease; White matter hyperintensities; Lacunes; Microbleeds; Perivascular spaces; Cerebral atrophy; Stroke; Dementia; Depression; Mortality; Systematic review; Meta-analysis
Categories
Funding
- Intramural NIH HHS [ZIA AG007480-06, Z99 AG999999, ZIA AG007480, ZIA AG007420-10, ZIA AG007420] Funding Source: Medline
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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.
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