Fandler-Höfler, SimonSimonFandler-HöflerEppinger, SebastianSebastianEppingerAmbler, GarethGarethAmblerNash, PhilipPhilipNashKneihsl, MarkusMarkusKneihslLee, Keon-JooKeon-JooLeeLim, Jae-SungJae-SungLimShiozawa, MasayukiMasayukiShiozawaKoga, MasatoshiMasatoshiKogaLi, LinxinLinxinLiLovelock, CarolineCarolineLovelockChabriat, HuguesHuguesChabriatHennerici, MichaelMichaelHennericiWong, Yuen KwunYuen KwunWongMak, Henry Ka FungHenry Ka FungMakPrats-Sanchez, LuisLuisPrats-SanchezMartínez-Domeño, AlejandroAlejandroMartínez-DomeñoInamura, ShigeruShigeruInamuraYoshifuji, KazuhisaKazuhisaYoshifujiArsava, Ethem MuratEthem MuratArsavaHorstmann, SolveigSolveigHorstmannPurrucker, JanJanPurruckerLam, Bonnie Yin KaBonnie Yin KaLamWong, AdrianAdrianWongKim, Young DaeYoung DaeKimSong, Tae-JinTae-JinSongLemmens, RobinRobinLemmensUysal, EnderEnderUysalTanriverdi, ZeynepZeynepTanriverdiBornstein, Natan MNatan MBornsteinBen Assayag, EinorEinorBen AssayagHallevi, HenHenHalleviMolad, JeremyJeremyMoladNishihara, MasashiMasashiNishiharaTanaka, JunJunTanakaCoutts, Shelagh BShelagh BCouttsPolymeris, AlexandrosAlexandrosPolymerisWagner, BenjaminBenjaminWagnerSeiffge, David JDavid JSeiffgeLyrer, PhilippePhilippeLyrerKappelle, L JaapL JaapKappelleSalman, Rustam Al-ShahiRustam Al-ShahiSalmanHernandez, Maria ValdesMaria ValdesHernandezJäger, Hans RHans RJägerLip, Gregory Y HGregory Y HLipFischer, UrsUrsFischerEl-Koussy, MarwanMarwanEl-KoussyMas, Jean-LouisJean-LouisMasLegrand, LaurenceLaurenceLegrandKarayiannis, ChristopherChristopherKarayiannisPhan, ThanhThanhPhanGunkel, SarahSarahGunkelChrist, NicolasNicolasChristAbrigo, JillJillAbrigoChu, WinnieWinnieChuLeung, ThomasThomasLeungChappell, FrancescaFrancescaChappellMakin, StephenStephenMakinHayden, DerekDerekHaydenWilliams, David JDavid JWilliamsMess, Werner HWerner HMessKooi, M ElineM ElineKooiBarbato, CarmenCarmenBarbatoBrowning, SimoneSimoneBrowningTuladhar, Anil MAnil MTuladharMaaijwee, NoortjeNoortjeMaaijweeGuevarra, Anne CristineAnne CristineGuevarraMendyk, Anne-MarieAnne-MarieMendykDelmaire, ChristineChristineDelmaireKöhler, SebastianSebastianKöhlervan Oostenbrugge, RobertRobertvan OostenbruggeZhou, YingYingZhouXu, ChaoChaoXuHilal, SaimaSaimaHilalRobert, CarolineCarolineRobertChen, ChristopherChristopherChenLou, MinMinLouStaals, JulieJulieStaalsBordet, RégisRégisBordetKandiah, NagaendranNagaendranKandiahde Leeuw, Frank-ErikFrank-Erikde LeeuwSimister, RobertRobertSimisterBos, DanielDanielBosKelly, Peter JPeter JKellyWardlaw, JoannaJoannaWardlawSoo, YannieYannieSooFluri, FelixFelixFluriSrikanth, VelandaiVelandaiSrikanthCalvet, DavidDavidCalvetJung, SimonSimonJungKwa, Vincent I HVincent I HKwaEngelter, Stefan TStefan TEngelterPeters, NilsNilsPetersSmith, Eric EEric ESmithHara, HideoHideoHaraYakushiji, YusukeYusukeYakushijiOrken, Dilek NeciogluDilek NeciogluOrkenThijs, VincentVincentThijsHeo, Ji HoeJi HoeHeoMok, VincentVincentMokVeltkamp, RolandRolandVeltkampAy, HakanHakanAyImaizumi, ToshioToshioImaizumiLau, Kui KaiKui KaiLauJouvent, EricEricJouventRothwell, Peter MPeter MRothwellToyoda, KazunoriKazunoriToyodaBae, Hee-JoonHee-JoonBaeMarti-Fabregas, JoanJoanMarti-FabregasWilson, DuncanDuncanWilsonBest, JonathanJonathanBestFazekas, FranzFranzFazekasEnzinger, ChristianChristianEnzingerWerring, David JDavid JWerringGattringer, ThomasThomasGattringer2024-11-192024-11-192024-10-01https://boris-portal.unibe.ch/handle/20.500.12422/188956Importance Cerebral small vessel disease (SVD) is associated with various cerebrovascular outcomes, but data on sex differences in SVD are scarce.Objective To investigate whether the frequency, severity, and distribution of cerebral microbleeds (CMB), other SVD markers on magnetic resonance imaging (MRI), and outcomes differ by sex.Design, Setting, And Participants This cohort study used pooled individual patient data from the Microbleeds International Collaborative Network, including patients from 38 prospective cohort studies in 18 countries between 2000 and 2018, with clinical follow-up of at least 3 months (up to 5 years). Participants included patients with acute ischemic stroke or transient ischemic attack with available brain MRI. Data were analyzed from April to December 2023.Main Outcomes And Measures Outcomes of interest were presence of CMB, lacunes, and severe white matter hyperintensities determined on MRI. Additionally, mortality, recurrent ischemic stroke, and intracranial hemorrhage during follow-up were assessed. Multivariable random-effects logistic regression models, Cox regression, and competing risk regression models were used to investigate sex differences in individual SVD markers, risk of recurrent cerebrovascular events, and death.Results A total of 20 314 patients (mean [SD] age, 70.1 [12.7] years; 11 721 [57.7%] male) were included, of whom 5649 (27.8%) had CMB. CMB were more frequent in male patients, and this was consistent throughout different age groups, locations, and in multivariable models (female vs male adjusted odds ratio [aOR], 0.86; 95% CI, 0.80-0.92; P < .001). Female patients had fewer lacunes (aOR, 0.82; 95% CI, 0.74-0.90; P < .001) but a higher prevalence of severe white matter hyperintensities (aOR, 1.10; 95% CI, 1.01-1.20; P = .04) compared with male patients. A total of 2419 patients (11.9%) died during a median (IQR) follow-up of 1.4 (0.7-2.5) years. CMB presence was associated with a higher risk of mortality in female patients (hazard ratio, 1.15; 95% CI, 1.02-1.31), but not male patients (hazard ratio, 0.95; 95% CI, 0.84-1.07) (P for interaction = .01). A total of 1113 patients (5.5%) had recurrent ischemic stroke, and 189 patients (0.9%) had recurrent intracranial hemorrhage, with no sex differences.Conclusions And Relevance This cohort study using pooled individual patient data found varying frequencies of individual SVD markers between female and male patients, indicating potential pathophysiological differences in manifestation and severity of SVD. Further research addressing differences in pathomechanisms and outcomes of SVD between female and male patients is required.en600 - Technology::610 - Medicine & healtharticle10.48620/763623940505810.1001/jamanetworkopen.2024.39571