Journal of Neurology

, Volume 256, Issue 5, pp 750–757

Effects of statins on the progression of cerebral white matter lesion

Post hoc analysis of the ROCAS (Regression of Cerebral Artery Stenosis) study
  • Vincent C. T. Mok
  • Wynnie W. M. Lam
  • Yu Hua Fan
  • Adrian Wong
  • Ping Wing Ng
  • Tak Hon Tsoi
  • Vincent Yeung
  • Ka Sing Wong
Original Communication

DOI: 10.1007/s00415-009-5008-7

Cite this article as:
Mok, V.C.T., Lam, W.W.M., Fan, Y.H. et al. J Neurol (2009) 256: 750. doi:10.1007/s00415-009-5008-7

Abstract

Arteriosclerotic related cerebral white matter lesion (WML) is associated with increased risk of death, stroke, dementia, depression, gait disturbance, and urinary incontinence. We investigated the effects of statins on WML progression by performing a post hoc analysis on the ROCAS (Regression of Cerebral Artery Stenosis) study, which is a randomized, double-blind, placebo-controlled study evaluating the effects of statins upon asymptomatic middle cerebral artery stenosis progression among stroke-free individuals. Two hundreds and eight randomized subjects were assigned to either placebo (n = 102) or simvastatin 20 mg daily (n = 106) for 2 years. Baseline severity of WML was graded visually into none, mild, and severe. Volume (cm3) of WML was determined quantitatively at baseline and at end of study using a semi-automated method based on MRI. Primary outcome was the change in WML volume over 2 years. After 2 years of follow-up, there was no significant change in WML volume between the active and the placebo group as a whole. However, stratified analysis showed that for those with severe WML at baseline, the median volume increase in the active group (1.9 cm3) was less compared with that in the placebo group (3.0 cm3; P = 0.047). Linear multivariate regression analysis identified that baseline WML volume (β = 0.63, P < 0.001) and simvastatin treatment (β = −0.214, P = 0.043) independently predicted change in WML volume. Our findings suggest that statins may delay the progression of cerebral WML only among those who already have severe WML at baseline.

Keywords

StatinsWhite matter lesion progression

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Vincent C. T. Mok
    • 1
  • Wynnie W. M. Lam
    • 2
  • Yu Hua Fan
    • 3
  • Adrian Wong
    • 1
  • Ping Wing Ng
    • 4
  • Tak Hon Tsoi
    • 5
  • Vincent Yeung
    • 6
  • Ka Sing Wong
    • 1
  1. 1.Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong SARChina
  2. 2.Department of Radiology and Organ ImagingThe Chinese University of Hong KongHong Kong SARChina
  3. 3.Department of NeurologyThe First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhouChina
  4. 4.Department of Medicine and GeriatricsUnited Christian HospitalHong Kong SARChina
  5. 5.Department of MedicinePamela Youde Nethersole Eastern HospitalHong Kong SARChina
  6. 6.Department of MedicineOur Lady of Maryknoll HospitalHong Kong SARChina