{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:40:32Z","timestamp":1790095232553,"version":"4.0.1"},"reference-count":31,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"CAMS Innovation Fund for Medical Sciences","award":["CIFMS #2021-I2M-1-025"],"award-info":[{"award-number":["CIFMS #2021-I2M-1-025"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271368"],"award-info":[{"award-number":["82271368"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-D-007"],"award-info":[{"award-number":["2022-PUMCH-D-007"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2025,9,3]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Covert MRI markers of cerebral small vessel disease (CSVD) can coexist with large artery atherosclerosis. We aimed to explore whether the spatial distributions of these markers were diverse in people with or without intracranial artery stenosis (ICAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional analysis included 1206 stroke-free participants (aged 55.69\u00b19.27, 62.94% female) with brain MRI and MR angiography from community-based Shunyi cohort. We analysed the relationships between ICAS and CSVD markers. We also compared the probability maps of lacunes, cerebral microbleeds (CMB), white matter hyperintensities (WMH) and cortex morphology at a voxel\/vertex-wise level in groups with and without ICAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICAS increased the risk of lacunes by 2.99-fold (95%\u2009CI 1.99 to 4.50, p&lt;0.001), lacunes \u22653 by 5.32 times (95%\u2009CI 2.76 to 10.28, p&lt;0.001), correlated with WMH volume (\u03b2=0.332, SE=0.059, p&lt;0.001), WMH Fazekas scores \u22655 (OR 4.50, 95%\u2009CI 2.44 to 8.29, p&lt;0.001) and brain parenchymal fraction (\u03b2=\u22120.012, SE=0.002, p&lt;0.001), but not with CMB. ICAS is associated with lacunes in the corresponding blood supply area. Lacunes that coexist with ICAS were prone in basal ganglia, while the lacunes without ICAS appeared in centrum semiovale more often. WMH with ICAS was prone to present in deep white matter involving the bilateral pyramidal tracts and superior thalamic radiation. People with ICAS were susceptible to worse cortical atrophy of right superior frontal and left rostral anterior cingulate. No obvious distributional differences were found for CMB between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Since ICAS may be involved in the upstream pathogenesis of lacunes, white matter lesions and cortical atrophy, the impact of ICAS should not be ignored when evaluating MRI markers of CSVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/svn-2025-004471","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T16:05:12Z","timestamp":1758038712000},"page":"289-295","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of brain structural damage related to cerebral small vessel disease in general population with intracranial artery stenosis"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-8150","authenticated-orcid":false,"given":"Zi-Ang","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi-Yue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing-Qi","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei-Fei","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding-Ding","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"},{"name":"Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Xin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Yu","family":"Jin","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"},{"name":"Department of Radiology, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"},{"name":"Department of Cardiology, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ying","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8966-1379","authenticated-orcid":false,"given":"Yi-Cheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Beijing, China"},{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"2026062907450609000_11.3.289.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70104-6"},{"key":"2026062907450609000_11.3.289.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30079-1"},{"key":"2026062907450609000_11.3.289.3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.020130"},{"key":"2026062907450609000_11.3.289.4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.neurobiolaging.2021.04.005","article-title":"Intracranial arteriosclerosis is related to cerebral small vessel disease: a prospective cohort study","volume":"105","author":"Vinke","year":"2021","journal-title":"Neurobiol Aging"},{"key":"2026062907450609000_11.3.289.5","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X20958517"},{"key":"2026062907450609000_11.3.289.6","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1212\/WNL.0b013e318281ccc2","article-title":"Large-vessel correlates of cerebral small-vessel disease","volume":"80","author":"Brisset","year":"2013","journal-title":"Neurology (ECronicon)"},{"key":"2026062907450609000_11.3.289.7","article-title":"Large artery: an important target for cerebral small vessel diseases","volume":"2","author":"Xu","year":"2014","journal-title":"Ann Transl Med"},{"key":"2026062907450609000_11.3.289.8","doi-asserted-by":"crossref","DOI":"10.21037\/atm-20-4195","article-title":"Design of the Shunyi study on cardiovascular disease and age-related brain changes: a community-based, prospective, cohort study","volume":"8","author":"Han","year":"2020","journal-title":"Ann Transl Med"},{"key":"2026062907450609000_11.3.289.9","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis","volume":"21","author":"Samuels","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2026062907450609000_11.3.289.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70124-8"},{"key":"2026062907450609000_11.3.289.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2014.01.060"},{"key":"2026062907450609000_11.3.289.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.07.018"},{"key":"2026062907450609000_11.3.289.13","first-page":"e1979","article-title":"Pattern of Brain Parenchymal Damage Related to Cerebral Small Vessel Disease in Carriers of Rare NOTCH3 Variants","volume":"101","author":"Liu","year":"2023","journal-title":"Neurology (ECronicon)"},{"key":"2026062907450609000_11.3.289.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2012.01.021"},{"key":"2026062907450609000_11.3.289.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2011.09.015"},{"key":"2026062907450609000_11.3.289.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2008.03.061"},{"key":"2026062907450609000_11.3.289.17","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1002\/acn3.70005","article-title":"The burden of intracranial atherosclerosis on cerebral small vessel disease: A community cohort study","volume":"12","author":"Ackah","year":"2025","journal-title":"Ann Clin Transl Neurol"},{"key":"2026062907450609000_11.3.289.18","doi-asserted-by":"crossref","first-page":"922","DOI":"10.5551\/jat.52530","article-title":"Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population","volume":"27","author":"Zhang","year":"2020","journal-title":"J Atheroscler Thromb"},{"key":"2026062907450609000_11.3.289.19","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1111\/ene.15908","article-title":"Association of intracranial atherosclerosis with cerebral small vessel disease in a community\u2010based population","volume":"30","author":"Wang","year":"2023","journal-title":"Euro J of Neurology"},{"key":"2026062907450609000_11.3.289.20","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s12975-022-01016-5","article-title":"Histopathology of Cerebral Microinfarcts and Microbleeds in Spontaneous Intracerebral Hemorrhage","volume":"14","author":"Jolink","year":"2023","journal-title":"Transl Stroke Res"},{"key":"2026062907450609000_11.3.289.21","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70060-7"},{"key":"2026062907450609000_11.3.289.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2010.07.008"},{"key":"2026062907450609000_11.3.289.23","doi-asserted-by":"crossref","first-page":"106406","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106406","article-title":"Association Between Intracranial Pulsatility and White Matter Hyperintensities in Asymptomatic Intracranial Arterial Stenosis: A Population-Based Study in Shandong, China","volume":"31","author":"Zhao","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026062907450609000_11.3.289.24","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-06019-8","article-title":"Effects of white matter hyperintensities distribution and clustering on late-life cognitive impairment","volume":"12","author":"Jim\u00e9nez-Balado","year":"2022","journal-title":"Sci Rep"},{"key":"2026062907450609000_11.3.289.25","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.535245"},{"key":"2026062907450609000_11.3.289.26","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22392"},{"key":"2026062907450609000_11.3.289.27","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1159\/000526261","article-title":"Carotid Artery Stenosis and Progression of Hemispheric Brain Atrophy: The SMART-MR Study","volume":"52","author":"Ghaznawi","year":"2023","journal-title":"Cerebrovasc Dis"},{"key":"2026062907450609000_11.3.289.28","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.171"},{"key":"2026062907450609000_11.3.289.29","doi-asserted-by":"publisher","DOI":"10.1097\/00044067-200510000-00005"},{"key":"2026062907450609000_11.3.289.30","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23523"},{"key":"2026062907450609000_11.3.289.31","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-021-01214-z"}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2025-004471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T14:46:06Z","timestamp":1782744366000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2025-004471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,29]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/svn-2025-004471"],"URL":"https:\/\/doi.org\/10.1136\/svn-2025-004471","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"value":"2059-8688","type":"print"},{"value":"2059-8696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]}}}