Associations between Earlobe Creases and Magnetic Resonance Imaging Small Vessel Disease Markers in a Chinese Cohort of Patients with Ischemic Stroke.

\n<bold><italic>Introduction:</italic></bold> The association between earlobe crease (ELC) and cerebral small vessel disease, including white matter hyperintensities (WMHs) and brain atrophy, is unclear, especially in the setting of acute ischemic stroke (AIS). Here, we aimed to investigate the association between ELC and WMHs as well as brain atrophy among AIS patients. <bold><italic>Methods:</italic></bold> A total of 730 AIS patients from China were enrolled. Patients were divided into groups without and with ELC, unilateral and bilateral ELC according to pictures of bilateral ears. Logistic regression models were employed to assess the impact of ELC, bilateral ELC on WMHs, periventricular hyperintensities (PVHs), deep white matter hyperintensities (DWMHs), and brain atrophy, as measured by the Fazekas scale and global cortical atrophy scale, in brain magnetic resonance imaging. <bold><italic>Results:</italic></bold> There were 520 (71.2%) AIS patients with WMHs, 445 (61.0%) with PVH, 462 (63.3%) with DWMH, and 586 (80.3%) with brain atrophy. Compared to those without ELC, patients with ELC were significantly associated with an increased risk of PVH (odds ratio [OR] 1.79; 95% confidence interval [CI], 1.15–2.77) and brain atrophy (OR: 6.18; 95% CI: 3.60–10.63) but not WMHs and DWMH. The presence of bilateral ELC significantly increased the odds of WMHs (OR: 1.60; 95% CI: 1.00–2.56), PVH (OR: 1.87; 95% CI: 1.18–2.96), and brain atrophy (OR: 8.50; 95% CI: 4.62–15.66) when compared to individuals without ELC. Furthermore, we discovered that the association between bilateral ELC and WMHs, PVH, and DWMH was significant only among individuals aged ≤68 (median age) years (all <italic>p</italic> trend ≤0.041). However, this association was not observed in patients older than 68 years. <bold><italic>Conclusions:</italic></bold> In Chinese AIS patients, the presence of the visible aging sign, ELC, especially bilateral ELC, showed independent associations with both WMHs and brain atrophy, particularly among those younger than 68 years old. Early detection of subtle white matter hyperintensities (WMHs) or brain atrophy might be important in terms of diagnosis and treatment. We hypothesize that earlobe crease (ELC), a visible sign of aging, may correlate with and aid in the early identification of WMHs and brain atrophy. We reported the association between the ELC and WMHs and brain atrophy among 730 patients with acute ischemic stroke (AIS). We observed that in AIS patients the presence of ELC, especially bilateral ELC, showed independent associations with both WMHs and brain atrophy, particularly among those younger than 68 years old. Our findings suggest that ELC, especially bilateral ELC, might be an easy-to-observe and widely used indicator for predicting the presence of WMHs or brain atrophy. [ABSTRACT FROM AUTHOR]