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White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis.

ABSTRACT: OBJECTIVE:We aimed to perform a systematic review and meta-analysis to clarify the association between white matter hyperintensities (WMHs) and carotid artery (CA) stenosis. STUDY DESIGN:Systematic review and meta-analysis. PARTICIPANTS:CA stenosis was set at ?50%, and WMHs were assessed by MRI and evaluated quantitatively or semiquantitatively. DATA SOURCES:A comprehensive literature search was performed in PubMed, EMBASE and Cochrane Library for studies evaluating the association between WMHs and CA stenosis ?50% from inception to 13 September 2017. MAIN OUTCOMES AND MEASURES:Standardised mean difference (SMD) with 95%?CI was used to evaluate the association between WMHs and CA stenosis. Results were presented in a forest plot with a fixed-effects model or random-effects model. We assessed the quality of included studies using the Newcastle-Ottawa Scale. Funnel plots and Egger's and Begg's tests were conducted to assess publication bias. Sensitivity analysis was performed to evaluate the influence of each individual study. RESULTS:Eight studies enrolling 677 patients were included. There was a positive relationship between the total WMHs and CA stenosis, with a pooled fixed-effects SMD of 0.326 (95% CI 0.194 to 0.459, p=0.000). Heterogeneity and publication bias were low among these studies. Subgroup analysis of three studies enrolling 225 patients showed an association between periventricular WMHs and CA stenosis, with a pooled fixed-effects SMD of 0.412 (95% CI 0.202 to 0.622, p=0.000). CONCLUSION:This meta-analysis showed that the total WMHs and periventricular WMHs were associated with CA stenosis. WMHs may be considered as an individual risk stratification score when choosing a proper plan for therapy of CA stenosis.

SUBMITTER: Ye H

PROVIDER: S-EPMC5961568 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis.

Ye Huirong H Wang Yujie Y Qiu Jianting J Wu Qing Q Xu Mengmeng M Wang Jian J

BMJ open 20180516 5

<h4>Objective</h4>We aimed to perform a systematic review and meta-analysis to clarify the association between white matter hyperintensities (WMHs) and carotid artery (CA) stenosis.<h4>Study design</h4>Systematic review and meta-analysis.<h4>Participants</h4>CA stenosis was set at ≥50%, and WMHs were assessed by MRI and evaluated quantitatively or semiquantitatively.<h4>Data sources</h4>A comprehensive literature search was performed in PubMed, EMBASE and Cochrane Library for studies evaluating ...[more]

PMID: 29769255

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Project description:BackgroundWhite matter hyperintensities are an important marker of cerebral small vessel disease. This disease burden is commonly described as hyperintense areas in the cerebral white matter, as seen on T2-weighted fluid attenuated inversion recovery magnetic resonance imaging data. Studies have demonstrated associations with various cognitive impairments, neurological diseases, and neuropathologies, as well as clinical and risk factors, such as age, sex, and hypertension. Due to their heterogeneous appearance in location and size, studies have started to investigate spatial distributions and patterns, beyond summarizing this cerebrovascular disease burden in a single metric-its volume. Here, we review the evidence of association of white matter hyperintensity spatial patterns with its risk factors and clinical diagnoses.Design/methodsWe performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement. We used the standards for reporting vascular changes on neuroimaging criteria to construct a search string for literature search on PubMed. Studies written in English from the earliest records available until January 31st, 2023, were eligible for inclusion if they reported on spatial patterns of white matter hyperintensities of presumed vascular origin.ResultsA total of 380 studies were identified by the initial literature search, of which 41 studies satisfied the inclusion criteria. These studies included cohorts based on mild cognitive impairment (15/41), Alzheimer's disease (14/41), Dementia (5/41), Parkinson's disease (3/41), and subjective cognitive decline (2/41). Additionally, 6 of 41 studies investigated cognitively normal, older cohorts, two of which were population-based, or other clinical findings such as acute ischemic stroke or reduced cardiac output. Cohorts ranged from 32 to 882 patients/participants [median cohort size 191.5 and 51.6% female (range: 17.9-81.3%)]. The studies included in this review have identified spatial heterogeneity of WMHs with various impairments, diseases, and pathologies as well as with sex and (cerebro)vascular risk factors.ConclusionThe results show that studying white matter hyperintensities on a more granular level might give a deeper understanding of the underlying neuropathology and their effects. This motivates further studies examining the spatial patterns of white matter hyperintensities.

Dataset Information

White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis.

Publications

White matter hyperintensities and their subtypes in patients with carotid artery stenosis: a systematic review and meta-analysis.

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