Abstract
Background:: Diagnosis of cerebral small vessel disease (SVD) is a challenge in remote areas where magnetic resonance imaging (MRI) is not available. Hospital-based studies in high-risk or stroke patients have found an association between the pulsatility index (PI) of intracranial arteries as derived from transcranial Doppler (TCD) and white matter hyperintensities (WMH) of presumed vascular origin. We aimed to assess the reliability of cerebral pulsatility indices to identify candidates for MRI screening in population-based studies assessing prevalence of SVD. Methods:: A representative sample of stroke-free Atahualpa residents aged 65 years investigated with MRI underwent TCD. Using generalized linear models, we evaluated whether the PI of major intracranial arteries correlate with WMH (used as a proxy of diffuse SVD), after adjusting for demographics and cardiovascular risk factors. Results:: Out of 70 participants (mean age 70.6 4.6 years, 57% women), 28 (40%) had moderate-to-severe WMH. In multivariate models, there were no differences across categories of WMH in the mean PI of middle cerebral arteries (1.10 0.16 vs. 1.22 0.24, : 0.065, 95% confidence interval (CI): 0.0840.177, P = 0.474) or vertebrobasilar arteries (1.11 0.16 vs. 1.29 0.27, : 0.066, 95% CI: 0.00240.156, P = 0.146). Conclusions:: Cerebral PI should not be used to identify candidates for MRI screening in population-based studies assessing the burden of SVD.
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
