期刊
CLINICAL SCIENCE
卷 132, 期 1, 页码 157-171出版社
PORTLAND PRESS LTD
DOI: 10.1042/CS20171280
关键词
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资金
- China Scholarships Council
- NHS Lothian Research and Development Office
- Scottish Funding Council and Chief Scientist Office through the Scottish Imaging Network A Platform for Scientific Excellence (SINAPSE)
- Medical Research Council through the Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE)
- Fondation Leducq Network for the Study of Perivascular Spaces in Small Vessel Disease [16 CVD 05]
- European Union Horizon [PHC-03-15, 666881]
- Chief Scientist Office [ETM/326] Funding Source: researchfish
- Medical Research Council [MR/K026992/1, UKDRI-4002] Funding Source: researchfish
Growing evidence suggests that increased intracranial pulsatility is associated with cerebral small vessel disease (SVD). We systematically reviewed papers that assessed intracranial pulsatility in subjects with SVD. We included 27 cross-sectional studies (n=3356): 20 used Doppler ultrasound and 7 used phase-contrast MRI. Most studies measured pulsatility in the internal carotid or middle cerebral arteries (ICA, MCA), whereas few assessed veins or cerebrospinal fluid (CSF). Methods to reduce bias and risk factor adjustment were poorly reported. Substantial variation between studies in assessment of SVD and of pulsatility indices precluded a formal meta-analysis. Eight studies compared pulsatility by SVD severity (n=26-159, median = 74.5): arterial pulsatility index was generally higher in more severe SVD (e.g. MCA: standardized mean difference = 3.24, 95% confidence interval [2.40, 4.07]), although most did not match for age. Seventeen studies (n=9-700; median = 110) performed regression or correlation analysis, of which most showed that increased pulsatility was associated with SVD after adjustment for age. In conclusion, most studies support a cross-sectional association between higher pulsatility in large intracranial arteries and SVD. Future studies should minimize bias, adjust for potential confounders, include pulsatility in veins and CSF, and examine longitudinal relationship between pulsatility and SVD. Agreement on reliable measures of intracranial pulsatility would be helpful.
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