- Jin Hee Im, MD*, Hwa Reung Lee, MD*, Hye Weon Kim, MD*, Sang Won Han, MD*, Sook Young Roh, MD, PhD†
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine*, Seoul; Department of Neurology, Bundang Jesaeng General Hospital†, Seongnam, Korea
Background: Atherosclerosis and osteoporosis are two major public health problems. These are
both multifactorial and degenerative diseases that accompany aging. Co-morbidities are common,
with a high prevalence of cardiovascular risk factors including hypertension, smoking, and sedentary
lifestyle. The transcranial Doppler (TCD) pulsatility index (PI) is increasing with age but alterations in
PI are the reflection of multifactorial, pleiotropic events occurring in the cardio and cerebral vascular
system. We hypothesized that TCD PI would reflect the atherosclerotic component of intracranial
vessels which in turn is related to systemic atherosclerosis. In this context, we investigated the relationship
between TCD PI and bone mineral density (BMD) in acute ischemic stroke patients. Methods:
Patients having their first ischemic stroke within 7 days were screened for the study. Doppler signals
from the main stem of the middle cerebral artery were obtained transtemporally with a traditional
2-MHz transducer at depths of 56, 58, and 60 mm. BMD was measured at total hip and lumbar spine
in the anterior-posterior projection, using dual-energy x-ray absorptiometry. Results: A total of 146
patients were enrolled in the study and the mean age was 68.4±10.03 years. Multiple linear regression
analysis reveals that age (p=0.001) and BMD T-score (p=0.038) were significantly associated
with increased TCD PI. Old age and decreased T-score were significantly related to increased
TCD PI. Age adjusted scatterplots showed that BMD T-score was inversely related to TCD PI in
acute ischemic stroke patients (r=-0.202, p=0.028). Conclusions: This study showed that TCD PI
was inversely related to BMD in patients with acute ischemic stroke. Our findings indicate that decreased
BMD may be associated with intracranial atherosclerosis.
Journal of Neurosonology 8(1):30-36, 2016
Key Words: Atherosclerosis, Bone mineral density, Pulsatility index, Stroke