Increased arterial diameters in the posterior cerebral circulation in men with Fabry disease

PLoS One. 2014 Jan 27;9(1):e87054. doi: 10.1371/journal.pone.0087054. eCollection 2014.

Abstract

A high load of white matter lesions and enlarged basilar arteries have been shown in selected patients with Fabry disease, a disorder associated with an increased stroke risk. We studied a large cohort of patients with Fabry disease to differentially investigate white matter lesion load and cerebral artery diameters. We retrospectively analyzed cranial magnetic resonance imaging scans of 87 consecutive Fabry patients, 20 patients with ischemic stroke, and 36 controls. We determined the white matter lesion load applying the Fazekas score on fluid-attenuated inversion recovery sequences and measured the diameters of cerebral arteries on 3D-reconstructions of the time-of-flight-MR-angiography scans. Data of different Fabry patient subgroups (males-females; normal-impaired renal function) were compared with data of patients with stroke and controls. A history of stroke or transient ischemic attacks was present in 4/30 males (13%) and 5/57 (9%) females with Fabry disease, all in the anterior circulation. Only one man with Fabry disease showed confluent cerebral white matter lesions in the Fazekas score assessment (1%). Male Fabry patients had a larger basilar artery (p<0.01) and posterior cerebral artery diameter (p<0.05) compared to male controls. This was independent of disease severity as measured by renal function and did not lead to changes in arterial blood flow properties. A basilar artery diameter of >3.2 mm distinguished between men with Fabry disease and controls (sensitivity: 87%, specificity: 86%, p<0.001), but not from stroke patients. Enlarged arterial diameters of the posterior circulation are present only in men with Fabry disease independent of disease severity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebrum / blood supply*
  • Fabry Disease / pathology*
  • Female
  • Germany
  • Humans
  • Kidney / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Posterior Cerebral Artery / pathology*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Statistics, Nonparametric

Grant support

The study was supported exclusively by intramural funds of the University of Würzburg. The publication of our study was funded by the German Research Foundation (DFG) and the University of Würzburg in the funding programme Open Access Publishing. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.