C-reactive protein and cerebral small-vessel disease

Little is known about the pathophysiology of cerebral small-vessel disease-causing cerebral white matter lesions and lacunar brain infarcts, which are associated with an increased risk of stroke, dementia and depression. In the prospective population-based Rotterdam Scan Study, the relationship between C-reactive protein (CRP) and magnetic resonance imaging was assessed: higher CRP levels were associated with a higher prevalence of arteriolosclerotic lesions as well as with progression of these lesions within 3.3 years in subjects aged 60-90 years free of dementia at baseline. This association between inflammation and severity of cerebrovascular disease was independent of other cardiovascular risk factors and severity of carotid atherosclerosis. These data - if confirmed - are important for case findings in an asymptomatic elderly population, for the elucidation of cerebral small-vessel disease processes and possibly for a new therapeutic target of brain disease.