Background-White matter hyperintensities (WMH), patchy areas of hyperintense signal on
T2-weighted or Fluid Attenuated Inversion Recovery sequences on brain magnetic resonance
imaging (MRI), are believed to reflect cerebral burden of ischemic damage and are associated
to incident stroke, dementia and eventually mortality in otherwise healthy subjects. Also
brain atrophy has been related with presence of carotid atherosclerosis and vascular
cognitive impairment. Carotid atherosclerosis may contribute to the genesis of WMH. A recent
meta-analysis by our group comprising 5306 subjects was able to demonstrate an association
between the presence of carotid atherosclerosis and WMH (odds ratio, OR, 1.42, 95% confidence
interval [CI] 1.22-1.66).
Objective-To evaluate the relation between carotid artery plaque characteristics,
cardiovascular risk factors and brain atrophy/WMH burden analyzed quantitatively as number
and volume of lesions and as brain volumes, and progression over 18 months of follow up in
subjects asymptomatic for cerebrovascular disease with a carotid artery stenosis <70%.