Total small vessel disease score and risk of recurrent stroke

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objective:

In patients with TIA and ischemic stroke, we validated the total small vessel disease (SVD) score by determining its prognostic value for recurrent stroke.

Methods:

Two independent prospective studies were conducted, one comprising predominantly Caucasian patients with TIA/ischemic stroke (Oxford Vascular Study [OXVASC]) and one predominantly Chinese patients with ischemic stroke (University of Hong Kong [HKU]). Cerebral MRI was performed and assessed for lacunes, microbleeds, white matter hyperintensities (WMH), and perivascular spaces (PVS). Predictive value of total SVD score for risk of recurrent stroke was determined and potential refinements considered.

Results:

In 2,002 patients with TIA/ischemic stroke (OXVASC n = 1,028, HKU n = 974, 6,924 patient-years follow-up), a higher score was associated with an increased risk of recurrent ischemic stroke (adjusted hazard ratio [HR] per unit increase: 1.32, 1.16–1.51, p < 0.0001; c statistic 0.61, 0.56–0.65, p < 0.0001) and intracerebral hemorrhage (ICH) (HR 1.54, 1.11–2.13, p = 0.009; c statistic 0.65, 0.54–0.76, p = 0.006). A higher score predicted recurrent stroke in SVD and non-SVD TIA/ischemic stroke subtypes ( c statistic 0.67, 0.59–0.74, p < 0.0001 and 0.60, 0.55–0.65, p < 0.0001). Including burden of microbleeds and WMH and adjusting the cutoff of basal ganglia PVS potentially improved predictive power for ICH ( c statistic 0.71, 0.60–0.81, p _het = 0.45), but not for recurrent ischemic stroke ( c statistic 0.60, 0.56–0.65, p _het = 0.76) on internal validation.

Conclusions:

The total SVD score has predictive value for recurrent stroke after TIA/ischemic stroke. Prediction of recurrence in patients with nonlacunar events highlights the potential role of SVD in wider stroke etiology.

Related collections

Most cited references 10

Record: found
Abstract: found
Article: not found

Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study).

P M Rothwell, A Coull, M F Giles … (2004)

The incidence of stroke is predicted to rise because of the rapidly ageing population. However, over the past two decades, findings of randomised trials have identified several interventions that are effective in prevention of stroke. Reliable data on time-trends in stroke incidence, major risk factors, and use of preventive treatments in an ageing population are required to ascertain whether implementation of preventive strategies can offset the predicted rise in stroke incidence. We aimed to obtain these data. We ascertained changes in incidence of transient ischaemic attack and stroke, risk factors, and premorbid use of preventive treatments from 1981-84 (Oxford Community Stroke Project; OCSP) to 2002-04 (Oxford Vascular Study; OXVASC). Of 476 patients with transient ischaemic attacks or strokes in OXVASC, 262 strokes and 93 transient ischaemic attacks were incident events. Despite more complete case-ascertainment than in OCSP, age-adjusted and sex-adjusted incidence of first-ever stroke fell by 29% (relative incidence 0.71, 95% CI 0.61-0.83, p=0.0002). Incidence declined by more than 50% for primary intracerebral haemorrhage (0.47, 0.27-0.83, p=0.01) but was unchanged for subarachnoid haemorrhage (0.83, 0.44-1.57, p=0.57). Thus, although 28% more incident strokes (366 vs 286) were expected in OXVASC due to demographic change alone (33% increase in those aged 75 or older), the observed number fell (262 vs 286). Major reductions were recorded in mortality rates for incident stroke (0.63, 0.44-0.90, p=0.02) and in incidence of disabling or fatal stroke (0.60, 0.50-0.73, p<0.0001), but no change was seen in case-fatality due to incident stroke (17.2% vs 17.8%; age and sex adjusted relative risk 0.85, 95% CI 0.57-1.28, p=0.45). Comparison of premorbid risk factors revealed substantial reductions in the proportion of smokers, mean total cholesterol, and mean systolic and diastolic blood pressures and major increases in premorbid treatment with antiplatelet, lipid-lowering, and blood pressure lowering drugs (all p<0.0001). The age-specific incidence of major stroke in Oxfordshire has fallen by 40% over the past 20 years in association with increased use of preventive treatments and major reductions in premorbid risk factors.

0 comments Cited 273 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Cerebral Perivascular Spaces Visible on Magnetic Resonance Imaging: Development of a Qualitative Rating Scale and its Observer Reliability

Gillian M Potter, Francesca M. Chappell, Zoe Morris … (2015)

Background Perivascular spaces (PVS) are an important component of cerebral small vessel disease (SVD), several inflammatory disorders, hypertension and blood-brain barrier breakdown, but are difficult to quantify. A recent international collaboration of SVD experts has highlighted the need for a robust, easy-to-use PVS rating scale for the effective investigation of the diagnostic and prognostic significance of PVS. The purpose of the current study was to develop and extend existing PVS scales to provide a more comprehensive scale for the measurement of PVS in the basal ganglia, centrum semiovale and midbrain, and to test its intra- and inter-rater agreement, assessing reasons for discrepancy. Methods We reviewed previously published PVS scales, including site of PVS assessed, rating method, and size and morphological criteria. Retaining key features, we devised a more comprehensive scale in order to improve the reliability of PVS rating. Two neuroradiologists tested the new scale in MRI brain scans of 60 patients from two studies (stroke, ageing population), chosen to represent a full range of PVS, and demonstrating concomitant features of SVD such as lacunes and white matter hyperintensities. We rated basal ganglia, centrum semiovale, and midbrain PVS. Basal ganglia and centrum semiovale PVS were rated 0 (none), 1 (1–10), 2 (11–20), 3 (21–40) and 4 (>40), and midbrain PVS were rated 0 (none visible) or 1 (visible). We calculated kappa statistics for rating, assessed consistency in use of PVS categories (Bhapkar test) and reviewed sources of discrepancy. Results Intra- and inter-rater kappa statistics were highest for basal ganglia PVS (range 0.76–0.87 and 0.8–0.9, respectively) than for centrum semiovale PVS (range 0.68–0.75 and 0.61–0.8, respectively) or midbrain PVS (inter-rater range 0.51–0.52). Inter-rater consistency was better for basal ganglia compared to centrum semiovale PVS (Bhapkar statistic 2.49–3.72, compared to 6.79–21.08, respectively). Most inter-rater disagreements were due to very faint PVS, coexisting extensive white matter hyperintensities (WMH) or the presence of lacunes. Conclusions We developed a more inclusive and robust visual PVS rating scale allowing rating of all grades of PVS severity on structural brain imaging. The revised PVS rating scale has good observer reliability for basal ganglia and centrum semiovale PVS, best for basal ganglia PVS, and moderate reliability for midbrain PVS. Agreement is influenced by PVS severity and the presence of background features of SVD. The current scale can be used in further studies to assess the clinical implications of PVS.

0 comments Cited 179 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Incidence, outcome, risk factors, and long-term prognosis of cryptogenic transient ischaemic attack and ischaemic stroke: a population-based study

Linxin Li, Gabriel S Yiin, Olivia Geraghty … (2015)

Summary Background A third of transient ischaemic attacks (TIAs) and ischaemic strokes are of undetermined cause (ie, cryptogenic), potentially undermining secondary prevention. If these events are due to occult atheroma, the risk-factor profile and coronary prognosis should resemble that of overt large artery events. If they have a cardioembolic cause, the risk of future cardioembolic events should be increased. We aimed to assess the burden, outcome, risk factors, and long-term prognosis of cryptogenic TIA and stroke. Methods In a population-based study in Oxfordshire, UK, among patients with a first TIA or ischaemic stroke from April 1, 2002, to March 31, 2014, we compared cryptogenic events versus other causative subtypes according to the TOAST classification. We compared markers of atherosclerosis (ie, risk factors, coronary and peripheral arterial disease, asymptomatic carotid stenosis, and 10-year risk of acute coronary events) and of cardioembolism (ie, risk of cardioembolic stroke, systemic emboli, and new atrial fibrillation [AF] during follow-up, and minor-risk echocardiographic abnormalities and subclinical paroxysmal AF at baseline in patients with index events between 2010 and 2014). Findings Among 2555 patients, 812 (32%) had cryptogenic events (incidence of cryptogenic stroke 0·36 per 1000 population per year, 95% CI 0·23–0·49). Death or dependency at 6 months was similar after cryptogenic stroke compared with non-cardioembolic stroke (23% vs 27% for large artery and small vessel subtypes combined; p=0·26) as was the 10-year risk of recurrence (32% vs 27%; p=0·91). However, the cryptogenic group had fewer atherosclerotic risk factors than the large artery disease (p<0·0001), small vessel disease (p=0·001), and cardioembolic (p=0·008) groups. Compared with patients with large artery events, those with cryptogenic events had less hypertension (adjusted odds ratio [OR] 0·41, 95% CI 0·30–0·56; p<0·0001), diabetes (0·62, 0·43–0·90; p=0·01), peripheral vascular disease (0·27, 0·17–0·45; p<0·0001), hypercholesterolaemia (0·53, 0·40–0·70; p<0·0001), and history of smoking (0·68, 0·51–0·92; p=0·01), and compared with small vessel and cardioembolic subtypes, they had no excess risk of asymptomatic carotid disease (adjusted OR 0·64, 95% CI 0·37–1·11; p=0·11) or acute coronary events (adjusted hazard ratio [HR] 0·76, 95% CI 0·49–1·18; p=0·22) during follow-up. Compared with large artery and small vessel subtypes combined, patients with cryptogenic events also had no excess of minor-risk echocardiographic abnormalities (cryptogenic 37% vs 45%; p=0·18) or paroxysmal AF (6% vs 10%; p=0·17) at baseline or of new AF (adjusted HR 1·23, 0·78–1·95; p=0·37) or presumed cardioembolic events (1·16, 0·62–2·17; p=0·64) during follow-up. Interpretation The clinical burden of cryptogenic TIA and stroke is substantial. Although stroke recurrence rates are comparable with other subtypes, cryptogenic events have the fewest atherosclerotic markers and no excess of cardioembolic markers. Funding Wellcome Trust, Wolfson Foundation, UK Stroke Association, British Heart Foundation, Dunhill Medical Trust, National Institute for Health Research, Medical Research Council, and the NIHR Oxford Biomedical Research Centre.

0 comments Cited 144 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Kui Kai Lau:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

NONE

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Linxin Li:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

NONE

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Ursula Schulz:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for travel or speaker honoraria:

Invited speaker at the Conference of the European Stroke Organisation.

Editorial Boards:

NONE

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NIHR Clinician Scientist Fellowship (2008 - 2013)

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Michela Simoni:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

NONE

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Koon Ho Chan:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for travel or speaker honoraria:

Honorarium for invited lectures from Biogen Idec and UCB Pharma Ltd. Payment to Dr Chan through The University of Hong Kong. Sponsorship to attend conferences from Novartis Pharmaceutical Ltd, Bayer HealthCare Ltd, UCB Pharma Ltd and Sanofi Genzyme. Direct Payment by Pharma companies

Editorial Boards:

(1) Associate Editor of Open Journal of Immunology (09/2012- 8/2014) (2) Editor, Expert consensus statements on the use of IVIG IN NEUROLOGY. The Asia-Pacific IVIG Advisory Board. 2nd Edition. 2008 (3) Member of Editorial Board, Journal of Clinical & Experimental Immunology (since 8/2016) (4) Issue Editor, The Hong Kong Medical Diary, March 2017. Neuroimmunology

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

(1) Honorary Consultant, Myasthenia Gravis Mutual Help Group (non-profit entity) (Hong Kong) 2009 ? present

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

(1) Merck Pharmaceutical Ltd. (2) Novartis Pharmaceutical Ltd. (3) Bayer HealthCare Ltd.

Research Support, Government Entities:

(1) Health and Medical Research Fund (HMRF): Investigation of adiponectin gene therapy in an animal model of Alzheimer?s disease (Project No: 03143886), Principal Investigator,2016 (8/2016-7/2018) (2) Health and Medical Research Fund (HMRF): Small molecule of Adiponectin receptor agonist, AdipoRon ? a potential therapeutic medication of Alzheimer?s disease (Project No: 03143856), Co-Investigator, 2016 (7/2016-6/2018) (3) RGC General Research Fund : Role of adiponectin in regulating microglia reactivation and synaptic plasticity in Alzheimer?s disease (Project Number:17163516), Principal Investigator, 2016 (4) Seed Funding for Collaborative Research Fund. Project: ?Adiponectin gene therapy in mouse model of Alzheimer?s disease? (102009392), Principal Investigator, 2015 (1/2015- 12/2016) (5) Shenzhen Research and Development Grant (Basic Research), Municipal Science and Technology Innovation Council, 2015 (0630031) External competitive grant, Principal Investigator, 2015 (7/2015-6/2018) (6) Strategic Research Theme (SRT): Neuroscience Funding Support: Insulin Resistance and Alzheimer?s Disease (102009274), Principal Investigator, 2014 (4/2014-12/2016)

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Shu Leong Ho:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

1) Clinical Neuropharmacology (Associate Editor) since 2006. 2) Brain & Behavior (Editorial Board member) since 2011.

Patents:

Human catechol-O-methyltransferase (COMT) assay. a) US patent granted on 6th January 2015; patent no. US 8,927,225 B2 b) China patent granted on 12th November 2014; patent no. ZL 200980138401.0 c) European patent granted on 23rd October 2013; patent no. 2328909 Listed inventors: PWL Ho, DB Ramsden, SL Ho. An assay to quantify COMT expression as a measure of estrogenicity. It includes a novel synthetic peptide and epitope, and specific (polyclonal and monoclonal) antibodies against the epitope. It has applications in ELISA assays to detect and quantify other proteins, immunohistochemistry and purification.

Publishing Royalties:

Neurology in Practice 2nd to 5th editions. Publisher: HKU Press, Hong Kong.

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Raymond Tak Fai Cheung:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

(1) Chinese version of Stroke (Editorial Board Member from June 2007 till now) (2) Journal of Pineal Research (Editorial Board Member since Jan 2007) (3) Chinese Journal of Neurology (Editorial Board Member since January 2009) (4) Reviews on Recent Clinical Trials (Editorial Board Member since Jan 2006) (5) Stroke Research and Treatment (Editorial Board Member since May 2009) (6) The Open Physiology Journal (Editorial Board Member since 2007) (7) The Open Medical Imaging Journal (Editorial Board Member since 2007) (8) The Open Nuclear Medicine Journal (Editorial Board Member since 2009) (9) The Open Neuroimaging Journal (Editorial Board Member since 2007)

Patents:

(1) Method for treating ischemic stroke with melatonin (U.S. non-provisional patent 10/770,371; China PCT/CN2004/000089; 50%) (2) Method and system for treating ischemic stroke with melatonin (European 04707186.5; 50%)

Publishing Royalties:

(1) In Yu, Y.L., J.K.Y. Fong, S.L. Ho, and R.T.F. Cheung (eds): Neurology in Practice, Hong Kong University Press, Hong Kong, September 2008, 4th edition

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Wilhelm Küker:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

Editorial Board Neuroradiology 5 years

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Henry Ka Fung Mak:

Comment :

Scientific Advisory Boards:

NONE

Gifts:

NONE

Funding for Travel or Speaker Honoraria:

NONE

Editorial Boards:

NONE

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Peter M. Rothwell:

Comment :

Scientific Advisory Boards:

Bayer - Executive Committee of ARRIVE Trial - 2006 onwards Servier - Executive Committee of PERFORM trial - 2005 -2010 Pfizer - IDMC if Rocket-AF Trial - 2006 - 2009 Biotronic - Executive Committee of device trial - 2005 - 2011

Gifts:

NONE

Funding for travel or speaker honoraria:

I don't keep a record. Certainly had travel expenses paid by Sanofi-Aventis, Servier, Astra-Zeneca and Bayer in past. However, nothing relevant to this manuscript.

Editorial Boards:

Editorial Board - Lancet Neurology, International Journal of Stroke

Patents:

NONE

Publishing Royalties:

NONE

Employment, Commercial Entity:

NONE

Consultancies:

NONE

Speakers' Bureaus:

NONE

Other Activities:

NONE

Clinical Procedures or Imaging Studies:

NONE

Research Support, Commercial Entities:

NONE

Research Support, Government Entities:

NONE

Research Support, Academic Entities:

NONE

Research Support, Foundations and Societies:

NONE

Stock/Stock Options/Board of Directors Compensation:

NONE

License Fee Payments, Technology or Inventions:

NONE

Royalty Payments, Technology or Inventions:

NONE

Stock/Stock Options, Research Sponsor:

NONE

Stock/Stock Options, Medical Equipment & Materials:

NONE

Legal Proceedings:

NONE

Journal

Journal ID (nlm-ta): Neurology

Journal ID (iso-abbrev): Neurology

Journal ID (hwp): neurology

Journal ID (publisher-id): neur

Journal ID (pmc): neurology

Journal ID (publisher-id): NEUROLOGY

Title: Neurology

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 0028-3878

ISSN (Electronic): 1526-632X

Publication date (Print): 13 June 2017

Publication date PMC-release: 13 June 2017

Volume: 88

Issue: 24

Pages: 2260-2267

Affiliations

From the Centre for Prevention of Stroke and Dementia (K.K.L., L.L., U.S., M.S., W.K., P.M.R.), Nuffield Department of Clinical Neurosciences, University of Oxford, UK; and Division of Neurology, Department of Medicine (K.K.L., K.H.C., S.L.H., R.T.F.C.), and Department of Diagnostic Radiology (H.K.F.M.), Li Ka Shing Faculty of Medicine, University of Hong Kong.

Author notes

Correspondence to Prof. Rothwell: peter.rothwell@ 123456ndcn.ox.ac.uk

Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was funded by Wellcome Trust.

Article

Publisher ID: NEUROLOGY2017793893

DOI: 10.1212/WNL.0000000000004042

PMC ID: 5567324

PubMed ID: 28515266

SO-VID: 7368e62d-2a90-4e59-bff1-9c5f3093ccf2

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 05 January 2017

Date accepted : 24 March 2017

Funding

Funded by: Wellcome Trust

Custom metadata

OPEN-ACCESS TRUE

Data availability:

Comments

Comment on this article

scite_

Cited by 97

See all cited by

Most referenced authors 529

See all reference authors

Total small vessel disease score and risk of recurrent stroke : Validation in 2 large cohorts

Read this article at

Abstract

Objective:

Methods:

Results:

Conclusions:

Related collections

Karger: Neurology and Neuroscience

Most cited references 10

Change in stroke incidence, mortality, case-fatality, severity, and risk factors in Oxfordshire, UK from 1981 to 2004 (Oxford Vascular Study).

Cerebral Perivascular Spaces Visible on Magnetic Resonance Imaging: Development of a Qualitative Rating Scale and its Observer Reliability

Incidence, outcome, risk factors, and long-term prognosis of cryptogenic transient ischaemic attack and ischaemic stroke: a population-based study

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 274

Cited by 97

Most referenced authors 529