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The aim is to confirm an increased frequency and intensity of LA in symptomatic patients with neurovascular pathology compared with asymptomatic subjects, and its association with circulating serum levels of soluble tumor necrosis factor\u2010like weak inducer of apoptosis (sTWEAK).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An observational study was conducted in which two groups of patients were compared. Group I (<jats:italic>N<\/jats:italic>\u2009=\u2009242) comprised of asymptomatic subjects with arterial hypertension and\/or diabetes or with a history of transient ischemic attacks, and Group II (N\u2009=\u2009382) comprised patients with lacunar stroke or deep hemispheric intracerebral hemorrhage (ICH) of hypertensive origin. Serum levels of sTWEAK were analyzed and correlated with prevalence and intensity of LA according to the Fazekas scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of LA was higher in symptomatic (85.1%) versus asymptomatic patients (62.0%). Logistic regression model showed a significant relation of LA with neurovascular pathologies (OR: 2.69, IC 95%: 1.10\u20136.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). When stratified according to the Fazekas scale, LA of grade II (OR: 3.53, IC 95%: 1.10\u20136.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) and specially grade III (OR: 4.66, 95% CI: 1.09\u201319.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.037) showed correlation with neurovascular pathologies. Increased sTWEAK levels were found in the symptomatic group in all LA grades (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and associated with 5.06 times more risk of presenting clinical symptoms (OR: 5.06, 95% CI: 2.66\u20139.75, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>LA showed a higher prevalence in patients with symptomatic lacunar stroke or deep hemispheric ICH. There is an association between sTWEAK levels and LA degree.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51502","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T09:43:56Z","timestamp":1642758236000},"page":"171-180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["<scp>sTWEAK<\/scp> is a leukoaraiosis biomarker associated with neurovascular angiopathy"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5014-2224","authenticated-orcid":false,"given":"Andr\u00e9s","family":"da Silva\u2010Candal","sequence":"first","affiliation":[{"name":"Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS)  Santiago de Compostela Spain"},{"name":"Neurovascular Diseases Laboratory Neurology Service University Hospital Complex of A Coru\u00f1a Biomedical Research Institute (INIBIC)  A Coru\u00f1a 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