Central arterial stiffness is involved in the pathophysiology of reversible cerebral vasoconstriction syndrome

Patients with reversible cerebral vasoconstriction syndrome have increased central arterial stiffness compared with healthy controls, and this appears to be associated with blood-brain barrier disruption.

Dr Yu-Hsiang Ling (Taipei General Veterans Hospital, Taiwan) and colleagues hypothesised that an increased arterial stiffness leading to a blood pressure surge and increased central pulsatile flow can impact the blood-brain barrier in patients with reversible cerebral vasoconstriction syndrome. They applied contrast-enhanced T2 fluid-attenuated inversion recovery imaging in patients with reversible cerebral vasoconstriction syndrome and healthy controls [1]. Arterial stiffness was assessed using carotid-femoral pulse wave velocity, augmentation index, and central blood pressure.

In total, 65 patients with reversible cerebral vasoconstriction syndrome and 65 age- and sex-matched healthy volunteers were included in the study. Of participants with reversible cerebral vasoconstriction syndrome, 50.8% presented with blood-brain barrier disruption. They also tended to have higher carotid-femoral pulse wave velocity values than healthy controls (P<0.001), suggesting increased central arterial stiffness. Furthermore, when assessing participants with blood-brain barrier disruption, values for carotid-femoral pulse wave velocity measurement and the augmentation index were significantly higher for patients with blood-brain barrier disruption than for those without disruption.

“We confirmed that patients with reversible cerebral vasoconstriction syndrome had elevated central arterial stiffness, and we also confirmed its association with blood-brain barrier disruption”, said Dr Ling. “This finding supports the conclusion that increased central arterial stiffness may play a pivotal role in the pathogenesis of blood-brain barrier disruption and probably the overall pathophysiology of reversible cerebral vasoconstriction syndrome.”

1. Ling YH, et al. Increased systemic arterial stiffness is associated with blood-brain barrier disruption in reversible cerebral vasoconstriction syndrome. 18^th European Headache Congress, 4–7 December 2024, Rotterdam, the Netherlands.

Copyright ©2024 Medicom Medical Publishers



Posted on 6 January 20256 January 2025