Abstract Background and aims Cerebral small vessel disease (CSVD) and heart disease share common vascular pathologies and exhibit high clinical comorbidity. Patients with these conditions often suffer from multiple symptoms. Therefore, this study aims to explore the symptom clusters in patients with CSVD and comorbid heart disease, including core symptoms and bridge symptoms, to provide insights for identifying more precise intervention targets. Methods This patients recruited from the China Imaging-based Biobank of Cerebral Small Vessel Diseases (CIBB-CSVD) at Beijing Tiantan Hospital between January 2020 and May 2023. Symptom clusters were extracted using exploratory factor analysis. Finally, network structures were constructed with the “qgraph” packages in R to characterize symptom relationships and calculate centrality indices. The bootnet package was used to evaluate the accuracy and stability. Results This study included a total of 648 patients, with an average age of 67.61 ± 8.29 years. A total of three symptom clusters were extracted: the pain-emotion-cognitive symptom cluster, the urgency urinary disorder symptom cluster, and the abnormal urination rhythm symptom cluster (Figure 1). Based on node centrality indices (Figure 2), difficulty in holding urine was identified as the core symptom. Frequent urination was selected as the key bridge symptom.The case-dropping bootstrap showed good centrality stability (exceeding the recommended threshold of 0.7), and the nonparametric bootstrap indicated adequate edge-weight accuracy with relatively narrow 95% confidence intervals (Figure 3). Conclusions This study identified core and bridge symptoms within symptom clusters of CSVD-heart disease comorbidity, providing precise targets for integrated management and a novel network-based intervention framework. Conflict of interest Weige Sun, Yunting Wu, Xuejiao Zhou, Ran Zhang, Weixin Cai: nothing to disclose Figure 1 - belongs to Results Figure 2 - belongs to Results Figure 3 - belongs to Results
Sun et al. (Fri,) studied this question.