{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:20:27Z","timestamp":1792797627785,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Extracranial internal carotid artery (ICA) stenosis is a known cause of large artery ischemic stroke. However, its association with cerebral arterial hemodynamics has been relatively underexplored. This study investigates the relationship between extracranial ICA stenosis and signal intensity gradient (SIG) in major cerebral arteries. The SIG is a surrogate marker for arterial wall shear rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the cross-sectional, retrospective study, we included individuals who underwent health screenings for vascular risk factors, as well as Time-of-Flight Magnetic Resonance Angiography and carotid Doppler ultrasonography. Extracranial ICA stenosis was categorized into three groups: normal, &amp;lt;50% stenosis, and \u226550% stenosis. In each group, SIGs were measured in major cerebral arteries. The association between ICA status and SIG in major cerebral arteries was analyzed using logistic regression, with SIG tertiles as the variable of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,138 individuals (mean age \u00b1 SD, 63.3\u202f\u00b1\u202f9.6\u202fyears) were included. ICA stenosis \u226550% was significantly associated with cerebral artery SIGs, with age and basilar artery (BA) SIG showing the strongest correlations. Multinomial logistic regression revealed that individuals in the lowest tertile of BA SIG had a significantly higher odds ratio (OR) for ICA stenosis (OR: 2.72, 95% CI: 1.27\u20135.82; <jats:italic>p<\/jats:italic>\u202f=\u202f0.010) compared to those in the highest tertile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ICA stenosis is significantly correlated with BA SIG, indicating a possibility of link between ICA stenosis and intracranial hemodynamics. A prospective longitudinal study is warranted to clarify the causal link between ICA stenosis and BA SIG.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1576655","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T06:21:06Z","timestamp":1754893266000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of carotid artery stenosis with cerebral artery signal intensity gradient on time-of-flight magnetic resonance angiography"],"prefix":"10.3389","volume":"16","author":[{"given":"Chan-Hyuk","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seul-Ki","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Rosenson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wookjin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keun-Hwa","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.1016\/j.jvs.2014.12.050","article-title":"Role of high shear rate in thrombosis","volume":"61","author":"Casa","year":"2015","journal-title":"J Vasc Surg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1161\/01.ATV.6.2.220","article-title":"Correlation of endothelial cell shape and wall shear stress in a stenosed dog aorta","volume":"6","author":"Levesque","year":"1986","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4639","DOI":"10.1093\/emboj\/20.17.4639","article-title":"Activation of integrins in endothelial cells by fluid shear stress mediates rho-dependent cytoskeletal alignment","volume":"20","author":"Tzima","year":"2001","journal-title":"EMBO J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1161\/CIRCRESAHA.115.306301","article-title":"Endothelial cell dysfunction and the pathobiology of atherosclerosis","volume":"118","author":"Gimbrone","year":"2016","journal-title":"Circ Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2115","DOI":"10.3390\/ijms22042115","article-title":"Role of shear stress and tPA concentration in the fibrinolytic potential of thrombi","volume":"22","author":"Whyte","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2482","DOI":"10.1073\/pnas.0305938101","article-title":"Coexisting proinflammatory and antioxidative endothelial transcription profiles in a disturbed flow region of the adult porcine aorta","volume":"101","author":"Passerini","year":"2004","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1038\/nature03952","article-title":"A mechanosensory complex that mediates the endothelial cell response to fluid shear stress","volume":"437","author":"Tzima","year":"2005","journal-title":"Nature"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/j.ejmp.2008.01.003","article-title":"Wall shear stress calculation in ascending aorta using phase contrast magnetic resonance imaging. Investigating effective ways to calculate it in clinical practice","volume":"24","author":"Efstathopoulos","year":"2008","journal-title":"Phys Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/978-1-4419-1686-0_2","article-title":"Time-of-flight angiography","volume-title":"Magnetic resonance angiography: Principles and applications","author":"Kim","year":"2012"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"7087086","DOI":"10.1155\/2017\/7087086","article-title":"Direct assessment of wall shear stress by signal intensity gradient from time-of-flight magnetic resonance angiography","volume":"2017","author":"Han","year":"2017","journal-title":"Biomed Res Int"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1007\/s10278-024-00991-5","article-title":"Validation of signal intensity gradient from TOF-MRA for wall shear stress by phase-contrast MR","volume":"37","author":"Lee","year":"2024","journal-title":"J Imaging Inform Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1220840","DOI":"10.3389\/fneur.2023.1220840","article-title":"Cerebral artery signal intensity gradient from time-of-flight magnetic resonance angiography and clinical outcome in lenticulostriate infarction: a retrospective cohort study","volume":"14","author":"Lee","year":"2023","journal-title":"Front Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1159\/000514141","article-title":"Association of carotid artery endothelial signal intensity gradient with unilateral large artery ischemic stroke","volume":"50","author":"Lee","year":"2021","journal-title":"Cerebrovasc Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1159\/000533167","article-title":"Geometric versus hemodynamic indexes for rupture-destined aneurysms: a retrospective cohort and a repeated-measures study","volume":"53","author":"Lee","year":"2024","journal-title":"Cerebrovasc Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1161\/STROKEAHA.119.028117","article-title":"Impact of endothelial shear stress on the bilateral progression of unilateral moyamoya disease","volume":"51","author":"Lee","year":"2020","journal-title":"Stroke"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1161\/01.STR.28.5.993","article-title":"In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis","volume":"28","author":"Gnasso","year":"1997","journal-title":"Stroke"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1161\/01.RES.53.4.502","article-title":"Carotid bifurcation atherosclerosis: quantitative correlation of plaque localization with flow velocity profiles and wall shear stress","volume":"53","author":"Zarins","year":"1983","journal-title":"Circ Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1161\/CIRCIMAGING.110.958504","article-title":"In vivo wall shear stress distribution in the carotid artery: effect of bifurcation geometry, internal carotid artery stenosis, and recanalization therapy","volume":"3","author":"Markl","year":"2010","journal-title":"Circ Cardiovasc Imaging"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3216","DOI":"10.1161\/STROKEAHA.109.558403","article-title":"Homocysteine and pulsatility index of cerebral arteries","volume":"40","author":"Lim","year":"2009","journal-title":"Stroke"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2279","DOI":"10.1161\/01.STR.0000086465.41263.06","article-title":"Collateral circulation","volume":"34","author":"Liebeskind","year":"2003","journal-title":"Stroke"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.jacc.2010.07.058","article-title":"Prevalence and predictors of concomitant carotid and coronary artery atherosclerotic disease","volume":"57","author":"Steinvil","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"9052","DOI":"10.1073\/pnas.160130297","article-title":"The NF-kappa B signal transduction pathway in aortic endothelial cells is primed for activation in regions predisposed to atherosclerotic lesion formation","volume":"97","author":"Hajra","year":"2000","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"980","DOI":"10.5455\/medscience.2019.08.9076","article-title":"Morphometry and geometry of the formation of basilar artery","volume":"8","author":"Akka\u015fo\u011flu","year":"2019","journal-title":"Med Sci"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"6463","DOI":"10.1113\/JP272857","article-title":"Parasympathetic innervation of vertebrobasilar arteries: is this a potential clinical target?","volume":"594","author":"Roloff","year":"2016","journal-title":"J Physiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"509","DOI":"10.5551\/jat.26245","article-title":"Basilar artery angulation in association with aging and pontine lacunar infarction: a multicenter observational study","volume":"22","author":"Jeong","year":"2015","journal-title":"J Atheroscler Thromb"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/S1474-4422(15)00089-7","article-title":"Pathophysiology, presentation, prognosis, and management of intracranial arterial dolichoectasia","volume":"14","author":"Pico","year":"2015","journal-title":"Lancet Neurol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3988\/jcn.2006.2.1.74","article-title":"Extreme duplication-type, nonseparated fenestration of the basilar artery in a patient with pontine infarction: confirmation with virtual arterial endoscopy","volume":"2","author":"Woo","year":"2006","journal-title":"J Clin Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1161\/01.STR.29.7.1389","article-title":"Prognosis of patients with symptomatic vertebral or basilar artery stenosis","volume":"29","year":"1998","journal-title":"Stroke"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1161\/01.STR.0000111597.34179.47","article-title":"Wall shear stress is associated with intima-media thickness and carotid atherosclerosis in subjects at low coronary heart disease risk","volume":"35","author":"Irace","year":"2004","journal-title":"Stroke"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"H1641","DOI":"10.1152\/ajpheart.01204.2003","article-title":"5-HT-mediated inhibition of cardiovagal baroreceptor reflex response during defense reaction in the rat","volume":"287","author":"Comet","year":"2004","journal-title":"Am J Physiol Heart Circ Physiol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1576655\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T06:21:07Z","timestamp":1754893267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1576655\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":30,"alternative-id":["10.3389\/fneur.2025.1576655"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1576655","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"article-number":"1576655"}}