Effects of high-grade asymptomatic carotid artery stenosis on grey and white matter structure

Internal carotid artery stenosis (ICAS) is a known risk factor for stroke, additionally affecting brain structure and function. We investigated ICAS effects on white and grey matter structure using diffusion tensor imaging (DTI) and cortical thickness assessment, revealing alterations in various indices focused on the corpus callosum without signs of atrophy in grey matter. In addition, small vessel disease (SVD) burden, assessed by peak width of skeletonized mean diffusivity (PSMD), was increased in ICAS patients. Taken together, the structural alterations in white matter might precede those in grey matter, supporting the relevance of assessment of microstructure to detect early changes.