Periventricular White Matter Hyperintensities in Cerebral Amyloid Angiopathy and Hypertensive Arteriopathy (PVWMH)

White matter hyperintensities (WMH) are one of the small vessel disease-related MRI characteristics of both cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy (HA). WMH tend to show a peri-basal ganglia pattern in HA, whereas a multiple subcortical spots pattern can be observed in CAA. Periventricular WMH (PVWMH) have been reported to be posterior predominant using a semiautomated segmentation method and logarithmic transformation, not used in daily clinical practice. In these studies including CAA patients, patients initially presented with haemorrhage-related symptoms. In another study analysing PVWMH and cerebral amyloid evidence in patients with mild cognitive impairment, frontal PVWMH burden was associated with high uptake on florbetapir-PET whereas parietal and occipital PVWMH burden was associated with low CSF-amyloid-beta.

The aim of this study is the descriptive comparative analysis of the distribution of PVWMH between CAA and HA patients with radiological tools available in daily practice.

Study Overview

• Status: Completed
• Conditions: Cerebral Amyloid Angiopathy; Hypertensive Arteriopathy
• Intervention / Treatment: Other: None, pure observational study

• Study Type: Observational
• Enrollment (Actual): 315

Contacts and Locations

Study Locations

• France
  • Nîmes, France, 30029
    • CHU de Nîmes

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

CAA and HA patients, managed at Nîmes University Hospital between January 2015 and March 2022

Description

Inclusion Criteria:

CAA and HA patients, managed at Nîmes University Hospital between January 2015 and March 2022.

Exclusion Criteria:

CAA and HA patients, treated at the CHU of Nîmes between January 2015 and March 2022, not objecting to the use of their health data

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
cerebral amyloid angiopathy; Patient with cerebral amyloid angiopathy	Other: None, pure observational study; None, pure observational study
Hypertensive arteriopathy; Patients with hypertensive arteriopathy	Other: None, pure observational study; None, pure observational study

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Distribution of PVWMH	Maximal distance between the outer PVWMH border and the border of the lateral ventricle (on the axis oriented at 90° to the border of the ventricle)	Base line, Day 0
Distribution of PVWMH - total PVWMH extent.	The sum of the PVWMH measurements around the four ventricles horns (i.e. bilateral anterior and posteriors horns) resulted in total PVWMH extent.	Base line, Day 0
Corpus callosum (CC) WMH	Distance between the border of the third ventricle and the outer border of the WMH on the rostro-caudal axis, resulting in anterior and posterior CC-PVWMH extent measurements.	Base line, Day 0
Corpus callosum (CC) WMH - total CC-PVWMH extent.	The sum of the anterior and posterior CC-PVWMH measurements resulted in the total CC-PVWMH extent.	Base line, Day 0
Ratios	Calcul of posterior/anterior ratios for both the PVWMH and CC-PVWMH	base line, day 0
Anterior PVWMH	Comparison of anterior PVWMH between CAA group and HA group.	Base line, Day 0
Posterior PVWMH	Comparison of posterior PVWMH between CAA group and HA group.	Base line, Day 0
Total PVWMH	Comparison of total PVWMH between CAA group and HA group.	Base line, Day 0
Posterior/anterior PVWMH ratio	Comparison of the posterior/anterior PVWMH ratio between CAA and HA groups.	Base line, Day 0
anterior CC-PVWMH	Comparison of anterior CC-PVWMH between CAA group and HA group.	Base line, Day 0
Posterior CC-PVWMH	Comparison of posterior CC-PVWMH between CAA group and HA group.	Base line, Day 0
Total PVWMH and posterior/anterior CC-PVWMH ratio	Comparison of total PVWMH and posterior/anterior CC-PVWMH ratio between CAA group and HA group.	Base line, Day 0

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nīmes
• Investigators: Study Director: Anissa MEGZARI, Centre Hospitalier Universitaire de Nîmes

Publications and helpful links

General Publications

• Deasy L, Laurent-Chabalier S, Wacongne A, Parvu T, Mura T, Thouvenot E, Renard D. Diagnostic Accuracy of Posterior/Anterior Periventricular WMH Ratio to Differentiate CAA From Hypertensive Arteriopathy. Stroke. 2024 Aug;55(8):2086-2093. doi: 10.1161/STROKEAHA.123.046379. Epub 2024 Jun 26.

Study record dates

Study Major Dates

• Study Start (Actual): September 5, 2022
• Primary Completion (Actual): December 15, 2023
• Study Completion (Actual): December 15, 2023

Study Registration Dates

• First Submitted: August 2, 2022
• First Submitted That Met QC Criteria: August 2, 2022
• First Posted (Actual): August 4, 2022

Study Record Updates

• Last Update Posted (Estimated): December 4, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Metabolic Diseases; Proteostasis Deficiencies; Intracranial Arterial Diseases; Cerebral Arterial Diseases; Amyloidosis; Nutritional and Metabolic Diseases; Cerebral Amyloid Angiopathy
• Other Study ID Numbers: LOCAL/2022/DR-04

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No