{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:51:34Z","timestamp":1780105894943,"version":"3.54.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Blood\u2013brain barrier dysfunction may be an early phenomenon in the development of the small vessel disease, which underlies white matter lesions. Because vitamin B12 plays a role in maintaining the integrity of the blood\u2013brain barrier, we studied serum vitamin B12 level in relation to such lesions.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            In 124 patients with first lacunar stroke, we measured serum vitamin B12 level and rated the degree of white matter lesions on MRI.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Mean vitamin B12 level was 202 pmol\/L (SD, 68.9). Thirty-nine patients (31.5%) had a vitamin B12 level less than the lower reference value of 150 pmol\/L. Lower vitamin B12 level was (statistically significant) associated with more severe periventricular white matter lesions (odds ratio\/100 pmol\/L decrease, 1.773; 95% CI, 1.001\u20133.003), but not with deep white matter lesions (odds ratio\/100 pmol\/L decrease, 1.441; 95% CI, 0.881\u20132.358; ordered multivariate regression analysis).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            More severe periventricular white matter lesions in lacunar stroke patients relate to lower vitamin B12 levels. A possible causal relationship should now be studied prospectively.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.108.523431","type":"journal-article","created":{"date-parts":[[2009,3,13]],"date-time":"2009-03-13T02:07:37Z","timestamp":1236910057000},"page":"1623-1626","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Periventricular White Matter Lucencies Relate to Low Vitamin B12 Levels in Patients With Small Vessel Stroke"],"prefix":"10.1161","volume":"40","author":[{"given":"Barbe","family":"Pieters","sequence":"first","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Staals","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Knottnerus","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Rouhl","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Menheere","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AlFons","family":"Kessels","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Lodder","sequence":"additional","affiliation":[{"name":"From Departments of Neurology (B.P., J.S., I.K., R.R., J.L.), Clinical Chemistry (P.M.), Clinical Epidemiology and Medical Technology Assessment (A.K.), University Hospital Maastricht, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000058480.77236.b3"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1042\/bj20030059"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000071002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000022807.06923.a3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.2.351"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000185929.38534.f3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.107.486068"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh023"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10111"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2004.12.020"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.9.1683"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.9.1369"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/114.2.761"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10294"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.168.4.477"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000147034.25760.3d"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2431052111"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000251302.55202.73"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.107.489112"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000049766.26453.e9"},{"key":"e_1_3_2_21_2","first-page":"760","volume":"43","year":"2005","unstructured":"Hvas A-M, Gravholt CH, Nex\u00f8 E. 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