- Sang Won Han, MD*, Tae Jin Song, MD†, Sung-Soo Lee, MD‡, Seo Hyun Kim, MD, PhD‡, Jun Hong Lee, MD, PhD§, Gyu Sik Kim, MD§, Ok-Joon Kim, MD, PhD||, Im-Seok Koh, MD¶, Jong Yun Lee, MD, PhD¶, Seung-Han Suk, MD, PhD**, Sung Ik Lee, MD**, Hyo Suk Nam, MD, PhD††, Won-Joo Kim, MD,
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine*, Seoul; Ewha Womans University School of Medicine†, Seoul; Yonsei University Wonju College of Medicine‡, Wonju; National Health Insurance Corporation Ilsan Hospital§, Ilsan; CHA University School of Medicine||, Bundang; National Medical Center¶, Seoul; Sanbon Hospital, Wonkwang University School of Medicine**, Sanbon; Yonsei University College of Medicine††, Seoul, Korea
Background: The Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of the
Transcranial Doppler (ECLIPse) study showed a significant decrease in the transcranial Doppler
(TCD) pulsatility index (PI) with cilostazol treatment at 90 days after acute lacunar infarction. The aim of the present study was to perform a subgroup analysis of the ECLIPse study in order to explore the relationship between TCD PI and cerebral white matter hyperintensities (WMH) volume in acute lacunar infarction.
Methods: For this subgroup analysis, WMH volume was measured for those subjects
for whom fluid-attenuated inversion recovery (FLAIR) images were available using semi-automated computerized software.
Results: Of the 203 patients in eight hospitals in the ECLIPse study, 130 participants from six hospitals were included in this subgroup analysis. The mean WMH volume was 11.57 cm3 (0.13 to 68.45, median 4.86) and the mean MCA PI was 0.95 (0.62 to 1.50). The WMH volume was strongly correlated with age (r=0.388, p<0.001) and mMCA PI (r=0.178, p=0.043). Multiple linear regression analysis revealed that age (p<0.001, β coefficient=0.384) was significantly associated with WMH volume.
Conclusions: Though multiple linear regression analysis revealed
that only age was significantly associated with WMH volume, our findings indicate that TCD PIs are elevated when small vessel disease (SVD) is present. These parameters may be a useful physiologic index of the presence and severity of SVD. Further clinical trials focusing on WMH volume and clinical outcomes are required to assess the TCD as a screening tool for SVD.
Journal of Neurosonology 6(1):11-15, 2014
Key Words: Lacunar infarcts, Pulsatility index, White matter hyperintensities
