sTWEAK is a leukoaraiosis biomarker associated with neurovascular angiopathy

• Published in: Annals of clinical and translational neurology Vol. 9; no. 2; pp. 171 - 180
• Main Authors: Silva‐Candal, Andrés, Custodia, Antia, López‐Dequidt, Iria, Rodríguez‐Yáñez, Manuel, Alonso‐Alonso, Maria Luz, Ávila‐Gómez, Paulo, Pumar, José M., Castillo, José, Sobrino, Tomás, Campos, Francisco, Iglesias‐Rey, Ramón, Hervella, Pablo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2022; John Wiley & Sons, Inc; Wiley
• Subjects: Aged; Aged, 80 and over; Alzheimer's disease; Asymptomatic; Biomarkers; Cerebral Hemorrhage - blood; Cerebral Hemorrhage - epidemiology; Cerebral Hemorrhage - pathology; Comorbidity; Cytokine TWEAK - blood; Diabetes; Diabetes Mellitus - blood; Diabetes Mellitus - epidemiology; Diabetes Mellitus - pathology; Female; Humans; Hypertension - blood; Hypertension - epidemiology; Hypertension - pathology; Ischemic Attack, Transient - blood; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - pathology; Leukoaraiosis - blood; Leukoaraiosis - epidemiology; Leukoaraiosis - pathology; Male; Medical imaging; Middle Aged; Patients; Prevalence; Registries; Stroke; Stroke, Lacunar - blood; Stroke, Lacunar - epidemiology; Stroke, Lacunar - pathology; Tumor necrosis factor-TNF; Variables
• ISSN: 2328-9503; 2328-9503
• DOI: 10.1002/acn3.51502

Objective Leukoaraiosis (LA) refers to white matter lesions of undetermined etiology associated with the appearance and worsening of vascular pathologies. The aim is to confirm an increased frequency and intensity of LA in symptomatic patients with neurovascular pathology compared with asymptomatic subjects, and its association with circulating serum levels of soluble tumor necrosis factor‐like weak inducer of apoptosis (sTWEAK). Methods An observational study was conducted in which two groups of patients were compared. Group I (N = 242) comprised of asymptomatic subjects with arterial hypertension and/or diabetes or with a history of transient ischemic attacks, and Group II (N = 382) comprised patients with lacunar stroke or deep hemispheric intracerebral hemorrhage (ICH) of hypertensive origin. Serum levels of sTWEAK were analyzed and correlated with prevalence and intensity of LA according to the Fazekas scale. Results The prevalence of LA was higher in symptomatic (85.1%) versus asymptomatic patients (62.0%). Logistic regression model showed a significant relation of LA with neurovascular pathologies (OR: 2.69, IC 95%: 1.10–6.59, p = 0.003). When stratified according to the Fazekas scale, LA of grade II (OR: 3.53, IC 95%: 1.10–6.59, p = 0.003) and specially grade III (OR: 4.66, 95% CI: 1.09–19.84, p = 0.037) showed correlation with neurovascular pathologies. Increased sTWEAK levels were found in the symptomatic group in all LA grades (p < 0.0001), and associated with 5.06 times more risk of presenting clinical symptoms (OR: 5.06, 95% CI: 2.66–9.75, p < 0.0001). Interpretation LA showed a higher prevalence in patients with symptomatic lacunar stroke or deep hemispheric ICH. There is an association between sTWEAK levels and LA degree.