Transcranial Doppler Pulsatility Index and Bone Mineral Density in Ischemic Stroke Patients

Original Article

Journal of Neurosonology 2016;8(1):30-36.

뇌경색 환자에서 경두개도플러초음파 박동성 지수와 골밀도와의 관련성

Abstract

Background
Atherosclerosis and osteoporosis are two major public health problems. These are both multifactorial and degenerative diseases that accompany aging. Co-morbidities are common, with a high prevalence of cardiovascular risk factors including hypertension, smoking, and sedentary lifestyle. The transcranial Doppler (TCD) pulsatility index (PI) is increasing with age but alterations in PI are the reflection of multifactorial, pleiotropic events occurring in the cardio and cerebral vascular system. We hypothesized that TCD PI would reflect the atherosclerotic component of intracranial vessels which in turn is related to systemic atherosclerosis. In this context, we investigated the relationship between TCD PI and bone mineral density (BMD) in acute ischemic stroke patients.
Methods
Patients having their first ischemic stroke within 7 days were screened for the study. Doppler signals from the main stem of the middle cerebral artery were obtained transtemporally with a traditional 2-MHz transducer at depths of 56, 58, and 60 mm. BMD was measured at total hip and lumbar spine in the anterior-posterior projection, using dual-energy x-ray absorptiometry.
Results
A total of 146 patients were enrolled in the study and the mean age was 68.4±10.03 years. Multiple linear regression analysis reveals that age (p＝0.001) and BMD T-score (p＝0.038) were significantly associated with increased TCD PI. Old age and decreased T-score were significantly related to increased TCD PI. Age adjusted scatterplots showed that BMD T-score was inversely related to TCD PI in acute ischemic stroke patients (r＝-0.202, p＝0.028).

Conclusion
s
This study showed that TCD PI was inversely related to BMD in patients with acute ischemic stroke. Our findings indicate that decreased BMD may be associated with intracranial atherosclerosis.