Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism最新文献

{"title":"Fibrinogen contributes to myelin deficit and cognitive impairment in aged mice after anesthesia and surgery.","authors":"Xueji Wang, Sufang Jiang, Tianyu Cao, Peiying Huang, Lichao Di, Jiaqi Li, Lining Huang","doi":"10.1177/0271678X251338953","DOIUrl":"10.1177/0271678X251338953","url":null,"abstract":"<p><p>Perioperative neurocognitive disorder (PND) is a common complication of anesthesia and surgery, which is more prevalent in elderly patients. Fibrinogen is known to contribute to the pathophysiology of neurodegenerative disorders. This study investigated whether fibrinogen induces myelin deficit and cognitive impairment in aged mice after anesthesia and surgery. Here, abdominal surgery was performed on 17-month-old C57BL/6 mice to establish a PND model. Following anesthesia and surgery, cognitive function and exploratory locomotion of mice were assessed using behavioral tests. We used in vivo two-photon brain microscopy to track the perivascular accumulation of blood-derived fibrinogen in the central nervous system (CNS). Immunostaining, electron microscopy (EM), and western blotting were used to measure myelin sheath density and oligodendrocyte alterations, and inflammatory markers were determined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In the current study, we found that fibrinogen deposited in the CNS after blood-brain barrier (BBB) disruption, induces oligodendrocyte loss, myelin deficits and causes behavioral abnormalities in PND model. Fibrinogen depletion could reverse myelin deficits and cognitive function which induced by anesthesia and surgery. In summary, our data support that fibrinogen is a key determinant in the early pathogenesis of PND.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251338953"},"PeriodicalIF":4.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal vascular reactivity is associated with white matter hyperintensities and dysfunctional cerebrovascular reactivity in cerebral small vessel disease.","authors":"Gordon W Blair, Ian J C MacCormick, Sarah McGrory, Tom MacGillivray, Iona Hamilton, Yulu Shi, Francesca Chappell, Michael J Thrippleton, Michael S Stringer, Fergus Doubal, Joanna M Wardlaw","doi":"10.1177/0271678X251366079","DOIUrl":"10.1177/0271678X251366079","url":null,"abstract":"<p><p>Cerebral small vessel disease (cSVD) is characterised by white matter hyperintensities (WMH) and contributes to stroke and dementia. Cerebrovascular reactivity (CVR) declines with worsening cSVD but estimates of CVR from brain scans give limited information about the coordination of individual arterioles or venules. Retinovascular reactivity can provide separate data about arterioles and venules, but it is not known if retinovascular reactivity correlates with CVR in people with cSVD. We aimed to assess retinal vascular reactivity in people with cSVD and explore associations with WMH and CVR in a cross-sectional study. Participants had retinal photographs and magnetic resonance brain imaging (MRI) before and during inhalation of 6% CO₂ in air. We recruited 60 participants. 48 provided analysable retinal vessel reactivity data. Retinal arteriole/venule ratio was inversely related to WMH severity (adjusted R2 = 0.47 β-5.2 95%CI-7.9 to -2.5) and directly related to CVR (adjusted R2 = 0.21 β0.15 95%CI 0.04 to 0.25). In general, participants whose arteriole/venule ratio increased with CO₂ had milder WMH and higher (better) CVR, while participants whose arteriole/venule ratio decreased had more severe WMH and lower (worse) CVR. Retinovascular reactivity to CO₂ inhalation in people with cSVD suggests loss of normal arteriovenous coordination and inefficient perfusion of the capillary bed.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251366079"},"PeriodicalIF":4.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The age-associated decline in neuroplasticity and its implications for post-stroke recovery in animal models of cerebral ischemia: The therapeutic role of extracellular vesicles.","authors":"Aurel Popa-Wagner, Dirk M Hermann, Thorsten R Doeppner, Roxana Surugiu, Denisa Fv Pirscoveanu","doi":"10.1177/0271678X251365020","DOIUrl":"10.1177/0271678X251365020","url":null,"abstract":"<p><p>Older individuals are typically more susceptible to stroke, and age-related differences in brain plasticity significantly affect recovery and treatment responses following cerebral ischemia and traumatic brain injury. Extracellular vesicles (EVs) have emerged as promising diagnostic and therapeutic tools due to their role in intercellular communication and ability to cross the blood-brain barrier. While EVs hold potential in promoting brain repair, their efficacy is influenced by donor age-those derived from young stem cells exhibit more regenerative profiles, whereas aged donor EVs may carry senescence-related signals that impede recovery. Emerging therapies, including senolytics, exosome-based approaches, and immune modulation, aim to enhance post-stroke repair, yet a substantial translational gap persists, especially in adapting these strategies to the aged brain. Differences in immune responses, neurovascular integrity, and repair mechanisms between young and aged individuals further complicate therapeutic development. Incorporating aged animal models in preclinical research is thus essential for ensuring the relevance and safety of interventions in elderly patients. These findings underscore the need for age-tailored strategies that reflect the unique biological landscape of aging, paving the way for more effective treatments for stroke and related neurological conditions in older adults.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251365020"},"PeriodicalIF":4.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the genetic architecture of cerebral small vessel disease in the context of stroke.","authors":"Sathyaseelan Chakkarai, Quentin Le Grand, Lucas Wang Shaoxuan, Stephanie Debette, Muralidharan Sargurupremraj","doi":"10.1177/0271678X251362977","DOIUrl":"10.1177/0271678X251362977","url":null,"abstract":"<p><p>Cerebral small vessel disease (cSVD) is a major contributor to stroke, dementia, and cognitive decline. Despite significant progress through large-scale genome-wide association studies (GWAS) for cSVD and stroke, the genetic architecture underlying these conditions remains poorly understood. This review highlights recent advancements in statistical tools and provides a comprehensive overview of current insights into the genetic underpinnings of cSVD and stroke. We focus on the relevance of non-additive effects, local heritability, and polygenicity in shaping these traits. While single nucleotide polymorphism (SNP)-based heritability estimates for stroke and cSVD traits remain lower than pedigree-based estimates, we explore challenges and opportunities in addressing this \"missing heritability.\" In particular, we emphasize the importance of investigating both common and rare variants, to better characterize the genetic basis of cSVD. Furthermore, we discuss the role of negative selection in shaping complex disease traits and the relevance of the \"omnigenic\" model in the context of cSVD traits. In summary, we aim to provide a more nuanced understanding of cSVD and stroke genetics, paving the way for future research into their molecular mechanisms.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251362977"},"PeriodicalIF":4.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal dynamics of computed tomography perfusion (CTP) parameters following aneurysmal subarachnoid hemorrhage (SAH).","authors":"Vivien Szabo, Quentin Mesnildrey, Cyril Dargazanli, Florentin Kucharczak, Alexandre Kobbai, Pierre-François Perrigault, Kévin Chalard","doi":"10.1177/0271678X251361254","DOIUrl":"10.1177/0271678X251361254","url":null,"abstract":"<p><p>Preclinical and clinical studies suggest an early and progressive deterioration in cerebral perfusion leading to delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH). Computed Tomography Perfusion (CTP) has then been investigated for DCI diagnosis and prognosis. However, spatial and temporal evolution of CTP-derived metrics have not been established, such that optimal CTP periodicity for monitoring and metrics thresholds for triggering intervention remain unclear. We developed an image processing pipeline to quantify CTP parameters' dynamics in SAH patients. Sixty-two patients were retrospectively included. Cerebral vasospasm (CVS) occurrence was 68%, that of DCI 15%. CTP parameters displayed specific dynamics in each of the noCVS, <i>CVS</i>, and <i>DCI</i> groups. In the <i>DCI</i> category, <i>CBF</i> showed early hyperemia and global flow homogenization, followed by an increased mean and variability of <i>TMax</i>. These features were included in a DCI predictive model (AUC = 0.94 after bootstrapping correction). Two types of dynamics emerged in DCI patients, one characterized by high asymmetry between hemispheric parameters, the other by a rapid whole-brain deterioration of brain perfusion. In conclusion, CTP parameters' early dynamics allow to sort SAH patients that will develop either CVS or DCI, advocating for repeating CTP examinations to adapt therapeutic strategies.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251361254"},"PeriodicalIF":4.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DCE-MRI reveals spatial pattern in heterogeneous blood-brain barrier leakage within white matter in cerebral small vessel disease.","authors":"Damon Verstappen, Joost J A de Jong, Paulien H M Voorter, Maud van Dinther, Robert J van Oostenbrugge, Julie Staals, Jacobus F A Jansen, Walter H Backes","doi":"10.1177/0271678X251364151","DOIUrl":"10.1177/0271678X251364151","url":null,"abstract":"<p><p>Cerebral small vessel disease (cSVD) is associated with vascular cognitive impairment, dementia, and stroke. Blood-brain barrier (BBB) dysfunction is central to its pathophysiology and is involved in the formation of tissue lesions. The spatial heterogeneity of BBB leakage remains largely unclear. This cross-sectional study assessed BBB leakage rate (K_i), fractional volume of leaking tissue (v_l), and blood plasma volume (v_p) in various tissue regions, including gray matter (GM), normal appearing white matter (NAWM), and white matter hyperintensities (WMH) of 59 patients with cSVD and 32 controls using a high spatial resolution dynamic-contrast enhanced MRI protocol. Using regionally averaged measures, patients with cSVD had higher v_l (p = 0.020) and lower v_p (p < 0.001) within WMH compared to controls, K_i did not differ in any region. To evaluate the spatial heterogeneity of leakage in the NAWM, we analyzed 2-mm-wide shells extending outward from WMH edges. This revealed stronger BBB leakage in perilesional NAWM (p = 0.032) of cSVD patients compared to controls, with a striking dip close to the WMH. K_i, v_l, and v_p increased with distance from WMH edges (all p < 0.001). This pattern of lower BBB leakage in the perilesional NAWM could be caused by local reductions in microvascular blood flow or vessel surface area.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251364151"},"PeriodicalIF":4.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel blood-free analytical framework for the quantification of neuroinflammatory load from TSPO PET imaging.","authors":"Lucia Maccioni, Ludovica Brusaferri, Leonardo Barzon, Julia J Schubert, Maria A Nettis, Oliver Cousins, Ivana Rosenzweig, Yuya Mizuno, Marta Vicente-Rodríguez, Nisha Singh, Tiago R Marques, Neil A Harrison, Tim Fryer, Edward T Bullmore, Diana Cash, Valeria Mondelli, Carmine Pariante, Oliver Howes, Federico E Turkheimer, Marco L Loggia, Mattia Veronese","doi":"10.1177/0271678X251361261","DOIUrl":"10.1177/0271678X251361261","url":null,"abstract":"<p><p>Positron Emission Tomography (PET) of 18 kDa translocator protein (TSPO) has been investigated as putative marker of neuroinflammation but faces substantial methodological challenges. These include issues with arterial blood sampling for kinetic modeling, the absence of suitable reference regions, genetic polymorphisms affecting tracer affinity, altered blood-to-brain tracer delivery in inflammatory conditions, and high signal variability. This study presents a novel blood-free reference-free method for TSPO PET quantification, leveraging a logistic regression model to estimate the probability of TSPO overexpression across brain regions. Validation was performed on 323 human brain scans from five datasets and three radiotracers. The quantified TSPO topology in healthy controls showed strong concordance with constitutive TSPO gene expression for all tracers. When using [¹¹C]PBR28 PET data, the method replicated previous findings in schizophrenia, Alzheimer's disease, chronic pain, and XBD173 blocking. However, model extension to [¹⁸F]DPA-714 and [¹¹C]-(R)-PK11195 revealed small effect sizes and high variability, suggesting the need for tracer-specific model optimization. Finally, validation in a rat model of lipopolysaccharide-induced neuroinflammation confirmed previous evidence of increased brain TSPO uptake after systemic challenge. This novel non-invasive method provides individualized TSPO PET quantification, demonstrating broad applicability across TSPO PET tracers and imaging sites, assuming sufficient training data for model development.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251361261"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vessel architecture imaging reveals microvascular rarefaction and capillary-to-arteriole shift in cerebral small vessel disease.","authors":"Paulien Hm Voorter, Maud van Dinther, Gerhard S Drenthen, Elles P Elschot, Julie Staals, Robert J van Oostenbrugge, Jacobus Fa Jansen, Walter H Backes","doi":"10.1177/0271678X251358968","DOIUrl":"10.1177/0271678X251358968","url":null,"abstract":"<p><p>In cerebral small vessel disease, clinical imaging markers such as white matter hyperintensities are often considered late-stage indicators, with limited understanding of (early) underlying microvascular alterations. This prospective, cross-sectional study utilized vessel architecture imaging to assess microvascular alterations <i>in vivo</i> in 40 patients with cerebral small vessel disease and 21 controls at 3T MRI. Quantitative measures for vessel density, radius, and vessel type composition were derived. Overall, patients had lower vessel density and larger microvessel radius than controls, while blood perfusion levels remained similar between groups. Moreover, a shift from capillaries to arterioles was observed in cortical gray matter and normal-appearing white matter in patients. White matter hyperintensities demonstrated lower vessel density and larger radii than normal-appearing white matter, with no difference in vessel type composition. Our findings support the role of microvascular rarefaction in the pathophysiology of cerebral small vessel disease. The remaining vascular network with relatively more larger or more dilated (arteriolar) blood vessels and less dense microvessels may reflect uneven flow patterns, leading to less efficient delivery of oxygen, nutrients, and removal of metabolic waste products. Vessel architecture imaging can provide an early biomarker in future trials on microvascular growth therapy.<b>Clinical Trial Registration Information:</b> Measuring the blood vessel density in patients with heart failure or reduced cognitive function of vascular origin: CRUCIAL. https://doi.org/10.1186/ISRCTN22301128. 848109.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251358968"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired dynamic cerebral autoregulation predicts silent ischemic lesions after carotid artery stenting: A hemodynamic biomarker beyond plaque morphology.","authors":"Yunlu Tao, Songwei Chen, Yifan Yang, Fubo Zhou, Hongxiu Chen, Liuping Cui, Zihao Ni, Xia Lu, Shengnan Li, Yan Ma, Liqun Jiao, Yingqi Xing","doi":"10.1177/0271678X251362000","DOIUrl":"10.1177/0271678X251362000","url":null,"abstract":"<p><p>Carotid artery stenting (CAS) induces hemodynamic disturbances that may trigger silent cerebral ischemia (ASILs), though the relative contributions of impaired cerebral autoregulation (dCA) versus plaque characteristics remain unclear. In this prospective cohort study, we evaluated 59 patients with severe carotid stenosis undergoing CAS, assessing dCA via transcranial Doppler (TCD) and transfer function analysis (TFA) pre- and post-procedurally, with postoperative MRI to detect ASILs. ASILs occurred in 30.5% (18/59) of patients and were associated with dyslipidemia (P = 0.010) and low-echo plaques (P = 0.022). Critically, the ASILs group exhibited significantly reduced dCA phase in the very low frequency (VLF) range post-CAS (P < 0.001), indicating impaired autoregulation. Multivariate analysis identified postoperative VLF phase (adjusted OR: 0.925, P = 0.002), dyslipidemia (OR: 11.909), and plaque morphology (OR: 10.798) as independent ASILs predictors. ROC analysis demonstrated superior predictive accuracy when combining dCA parameters with clinical/plaque features (AUC = 0.917). These findings establish dCA dysfunction as a key hemodynamic biomarker of ASILs post-CAS, surpassing plaque characteristics alone. Integration of perioperative dCA monitoring with traditional risk stratification may optimize patient selection and neuroprotective strategies during carotid revascularization.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251362000"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral small vessel disease does not impair leptomeningeal collateral supply in large-vessel occlusion - Results from quantitative collateral mapping with MRI.","authors":"Christoph Polkowski, Niklas Helwig, Fatih Seker, Markus A Möhlenbruch, Marlies Wagner, Alexander Seiler","doi":"10.1177/0271678X251358972","DOIUrl":"10.1177/0271678X251358972","url":null,"abstract":"<p><p>We hypothesized that cerebral small vessel disease (CSVD) burden might not relevantly affect leptomeningeal collateral supply in patients with acute ischemic stroke (AIS) due to large-vessel occlusion (LVO). In n = 154 patients with anterior circulation LVO, CSVD imaging markers (white matter hyperintensities [WMH], lacunes, cerebral microbleeds and enlarged perivascular spaces) were assessed with MRI, using established criteria. Besides the extent of WMH, assessed using total Fazekas sum score, overall CSVD burden was determined with a total CSVD summary score ranging from 0-4. A quantitative and rater-independent collateral vessel index was computed from automated processing of T2*-weighted time series in perfusion-weighted imaging (PWI) to assess the pial collateral status. The overall burden of WMH and CSVD were not significantly associated with poor collaterals (adjusted odds ratios 0.830 (0.328-2.104) and 0.995 (0.666-1.488), p = 0.695 and p = 0.982) and did not modify the significant relationship of leptomeningeal collaterals with clinical stroke severity, ischemic core volume and infarct growth rate. Quantitative and objective analysis of collaterals with a signal variance-based approach in PWI revealed no overt association between CSVD burden and collaterals in LVO patients. Factors favoring or impairing collateral supply in case of acute cerebral ischemia warrant further exploration in future studies.</p>","PeriodicalId":520660,"journal":{"name":"Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism","volume":" ","pages":"271678X251358972"},"PeriodicalIF":4.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}