Atherosclerosis severity in the internal carotid artery is associated with elevated white matter lesion burden in the supplied brain territories

Motivation: To understand the effect of extracranial carotid artery disease on white matter lesion (WML) accumulation. Goal(s): Analyze WML burden on specific cerebrovascular territories. Approach: An automated neural network-trained software was used for WML quantification in participants with and without vascular disease. Results: Carotid stenosis severity is associated with increased WMLs in supplied cerebral territories, but not in the posterior circulation, which has alternative blood supply. Age is associated with increased WML in all cerebrovascular territories. No other vascular risk factors had a significant association. Impact: Understanding vascular factors that exacerbate white matter lesion (WML) burden is highly relevant for treating and mitigating neurodegeneration This work describes the impact of large vessel disease on WM degeneration in contrast to previous work focused on small vessel disease.