Short-term effects of air pollution and weather on reversible cerebral vasoconstriction syndrome: a retrospective bicenter study.

IF 4.6 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-08-22 DOI:10.1007/s00415-025-13306-7

Pacôme Constant Dit Beaufils, Matilde Karakachoff, Frédéric Penven, Cédric Urbanczyck, Pierre-Antoine Gourraud, Solène de Gaalon

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引用次数: 0

Abstract

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headaches and transient cerebral vasoconstriction. The influence of environmental factors, particularly air pollution and weather conditions, on RCVS remains poorly understood.

Methods: From 2010 to 2022, clinical data from two hospitals were analyzed alongside air pollution and meteorological data provided by Air Pays de la Loire and Météo-France. A time-stratified case-crossover design was used to evaluate the association between RCVS onset and daily mean concentrations of O₃, PM₁₀, PM_2.5, and NO₂, using spatial modeling of residential exposure. Pollutant effects were examined over lag periods of up to three days, with adjustments for temperature and atmospheric pressure.

Results: A total of 216 patients were included (mean age: 39.9 years; SD: 12.3; sex ratio: 1:1). In the three days preceding RCVS onset, only PM₁₀ concentrations remained significantly higher compared to the day of onset (19.03 vs. 17.99 µg/m³, P = 0.0029). A significant downward trend in PM₁₀ levels was observed over this period (slope -0.735, P = 0.0286), whereas no significant changes were found for PM_2.5, O₃, or NO₂. PM₁₀ was the only pollutant significantly associated with RCVS onset across lag days (Lag 0: OR 0.747, 95% CI: 0.579-0.962, P = 0.024; Lag 1: OR 0.770, 95% CI: 0.599-0.989, P = 0.041; Lag 2: OR 0.776, 95% CI: 0.604-0.997, P = 0.047; Lag 3: OR 0.768, 95% CI: 0.599-0.984, P = 0.037). After adjusting for atmospheric pressure and temperature, these associations were no longer statistically significant.

Conclusion: This study suggests a short-term decrease in PM₁₀ levels prior to RCVS onset and a negative association between PM₁₀ concentration and occurrence. These findings contribute to understanding the potential environmental triggers of RCVS in the context of changing air quality and climate.

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空气污染和天气对可逆性脑血管收缩综合征的短期影响：一项回顾性双中心研究。

背景：可逆性脑血管收缩综合征（RCVS）以雷击头痛和短暂性脑血管收缩为特征。环境因素，特别是空气污染和天气条件对RCVS的影响仍然知之甚少。方法：对2010 - 2022年两所医院的临床数据，以及卢瓦尔省空气污染监测中心和msamtsamo - france提供的空气污染和气象数据进行分析。采用时间分层病例交叉设计，通过住宅暴露空间建模，评估RCVS发病与O3、PM10、PM2.5和NO2日平均浓度之间的关系。污染物的影响在长达三天的滞后期内进行了研究，并对温度和大气压力进行了调整。结果：共纳入216例患者，平均年龄39.9岁，SD: 12.3，性别比：1:1。在RCVS发病前3天，只有PM10浓度显著高于发病当天（19.03 vs. 17.99µg/m3, P = 0.0029）。在此期间，PM10水平呈显著下降趋势（斜率为-0.735,P = 0.0286），而PM2.5、O3或NO2没有显著变化。PM10是唯一与滞后日RCVS发病显著相关的污染物（滞后0:OR 0.747, 95% CI: 0.579-0.962, P = 0.024；滞后1:OR 0.770, 95% CI: 0.599-0.989, P = 0.041；滞后2:OR 0.776, 95% CI: 0.604-0.997, P = 0.047；滞后3:OR 0.768, 95% CI: 0.599-0.984, P = 0.037）。在调整了大气压力和温度后，这些关联不再具有统计学意义。结论：该研究表明，在RCVS发病前，PM10水平短期下降，PM₁₀浓度与发生负相关。这些发现有助于理解在空气质量和气候变化的背景下RCVS的潜在环境触发因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.