The Association between Pulmonary Function and Cerebral Small Vessel Diseases
JIN HO PARK1, KYUNGHA MIN2
1Family Medicine, Seoul National University College of Medicine, 2School of Public Health, Seoul National University
Objective:
This study investigated the association between pulmonary function(PFT) and cerebral small vessel diseases (SVD) in neurologically asymptomatic screening adults
Background:
SVD is considered as precursor lesions of many clinical outcomes including stroke. Pulmonary disease, such as chronic obstructive pulmonary disease is an independent risk factor of stroke. However, few studies have examined the association between pulmonary function and the presence of cerebral SVD in healthy adults.
Design/Methods:
We conducted a cross-sectional study of 3,096 neurologically asymptomatic adults (mean age 56.0±9.4; 1,690 men), who underwent screening health checkups including brain magnetic resonance imaging (MRI) and PFT (forced expiratory volume in the first second [FEV1] and forced vital capacity [FVC]) at the Seoul National University Hospital Health Promotion Center in Seoul, South Korea. Possible clinical risk factors for SVD, anthropometric parameters and clinical information were obtained from a structured questionnaire, interview by a family physician, measurement and blood samples in an at least 12-hour overnight fasting state. The presence of silent lacunar infarct (SLI), cerebral microbleeds (CMBs), and the volume of white matter hyperintensity (WMH) were assessed through axial MRI. Each subject’s PFT was conducted according to the recommendation by the American Thoracic Society guideline
Results:
SLI and CMBs were evident in 229 (7.4%) and 128 (4.1%) subjects, respectively. The mean volume of WMH was 2.7±6.7mm3. In multivariable logistic analysis, FVC had a significant negative correlation with the presence of SLI (adjusted odds ratio [aOR] 0.63, 95% confidence interval [CI] 0.45-0.88), and FEV1/FVC ratio was positively associated with the presence of SLI (aOR 1.03, 95% CI 1.00-1.05). The presence of CMBs and the volume of WMH were not associated with any factor of pulmonary function tests after adjustment.
Conclusions:

Lower pulmonary function, especially FVC and FEV1/FVC ratio, is an independent risk factor of SLI in neurologically healthy adults.

10.1212/WNL.0000000000202196