Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

aterosclerosis intracraneal

 

The association between pineal gland calcification and intracranial atherosclerotic disease in older adults. Asociación entre calcificaciones de la glándula pineal y enfermedad aterosclerótica intracraneal en adultos mayores

Background: This study assesses whether pineal gland calcification (PGC) – a surrogate for reduced endogenous melatonin production – is associated with significant stenosis of large intracranial arteries – a biomarker of intracranial atherosclerotic disease (ICAD). 

Methods: Individuals aged ≥60 years enrolled in the Three Villages Study received head CT to assess PGC and MRA to estimate stenosis of large intracranial arteries. Multivariate logistic regression models were fitted to assess the association between PGC and ICAD, after adjusting for relevant confounders. Inverse probability of exposure weighting was used to estimate the effect of PGC on ICAD. 

Results: A total of 581 individuals were enrolled. PGC and ICAD were associated in a fully-adjusted logistic regression model (p=0.032). Inverse probability of exposure weighting showed an estimate for the proportion of ICAD among those without PGC of 3.7% and the adjusted-effect coefficient was 5.7% higher among those with PGC (p=0.031). 

Conclusions: PGC is associated with ICAD. Study results provide grounds for evaluating the role of melatonin deficiency in ICAD progression. 

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Palabras clave: Adultos Mayores, aterosclerosis intracraneal, calcificación de la glándula pineal, estenosis de arterias cerebrales de mediano calibre, estudio poblacional,

Keywords: intracranial atherosclerosis, melatonin, older adults, pineal gland calcification, population study, stenosis of large intracranial arteries,

Intracranial atherosclerotic disease and severe tooth loss and in community-dwelling older adults. Enfermedad aterosclerótica intracraneal y pérdida dental severa en adultos mayores.

Background: Information on the association between tooth loss and intracranial atherosclerotic disease (ICAD) is limited. Here, we aimed to assess whether non-traumatic severe tooth loss – as a surrogate for chronic inflammatory periodontal disease – is associated with ICAD in a cohort of older adults (aged ≥60 years) living in rural Ecuador.

Methods: ICAD was identified by CT determinations of high calcium content in the carotid siphons or MRA findings of significant stenosis of intracranial arteries. An oral exam assessed the level of non-traumatic severe tooth loss (<10 remaining teeth). Logistic regression models were fitted to assess the independent association between severe tooth loss and ICAD, after adjusting for demographics, cardiovascular risk factors and MRI evidence of cerebrovascular damage.

Results: Of 581 individuals, 269 (46%) had severe tooth loss and 205 (35%) had ICAD. Univariate analysis found a significant association between the two variables (p=0.002). Significance persisted when age and sex were added to the model (p=0.047), although it became non-significant in a logistic regression model including all confounders. Covariates with a significance p<0.1 included age, poor body mass index, high fasting glucose, the presence of >10 enlarged basal ganglia perivascular spaces, and both lacunar and non-lacunar strokes. After factoring in age partitioned by the median and other significant covariates, severe tooth loss remained significantly associated with ICAD.

Conclusions: Severe tooth loss and age are both associated with ICAD in the study population. Some of the effect of severe tooth loss on ICAD is captured by age.

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Palabras clave: aterosclerosis intracraneal, calcificaciones de sifones carotideos, Edentulismo, estenosis de arterias intracraneales,

Keywords: carotid siphon calcifications, intracranial artery stenosis, intracranial atherosclerosis, Tooth loss,

Intracranial Atherosclerosis And The Earlobe Crease (Frank’s Sign). A Population Study. Aterosclerosis Intracraneal y Pliegue Auricular (Signo De Frank). Estudio Poblacional.

Background: The earlobe crease (ELC) has been linked to coronary artery disease and other vascular conditions, but there is no information on its association with intracranial atherosclerosis. Objective: This study aimed to assess the association between high calcium content in the carotid siphons (as a surrogate of intracranial atherosclerosis) and ELC in communitydwelling adults living in rural Ecuador. Methods: Atahualpa residents aged ≥40 years underwent head CT to estimate calcium content in the carotid siphons, and visual inspection of both earlobes to evaluate the presence of ELC. The association between both variables was assessed by logistic regression models, after adjusting for demographics and cardiovascular risk factors. Results: Of 651 enrolled individuals (mean age: 59.7±12.8 years; 54% women), 225 (35%) had ELC, and 143 (22%) had high calcium content in the carotid siphons. Univariate logistic regression showed a borderline (non-significant) association between high calcium content in the carotid siphons and ELC presence (OR: 1.44; 95% C.I.: 0.99 – 2.12; p=0.057), which disappeared when age (OR: 0.98; 95% C.I.: 0.65 – 1.48; p=0.923) and other covariables (OR: 0.97; 95% C.I.: 0.63 – 1.49; p=0.890) were added to the model. Conclusion: This population study shows no association between high calcium content in the carotid siphons and ELC presence.

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Palabras clave: aterosclerosis intracraneal, calcificaciones de sifón carotídeo, estudio poblacional, Pliegue auricular, proyecto atahualpa,

Keywords: atahualpa project, carotid siphon calcifications, Earlobe crease, intracranial atherosclerosis, population-based study,
 
 
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