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April 3, 2026Journal of Neurosciences in Rural Practice0 citationsOpen Access

Association between occupational stress and asymptomatic cerebrovascular disease: A cross-sectional magnetic resonance imaging study

VDVladina Dimitrova-Kirilova MTMihael Tsalta-Mladenov MAMilena Andonova

Key Points

This study aims to assess the relationship between occupational stress and asymptomatic cerebrovascular disease, particularly in individuals with established vascular risk factors.
Case-control study involving 151 employed individuals with vascular risk factors.
Participants underwent brain magnetic resonance imaging (MRI) to assess for asymptomatic cerebrovascular disease.
Occupational stress was measured using the Workplace Stress Scale (WSS).
Logistic regression analysis was employed to examine associations between stress levels and white-matter hyperintensities.
Participants with asymptomatic cerebrovascular disease reported higher levels of occupational stress compared to controls.
Unadjusted analyses indicated higher occupational stress scores correlated with increased odds of white-matter hyperintensities, though statistical significance was lost after adjustments.
Significant positive correlations were found between occupational stress and factors like professional experience, weekly working hours, and shift work.

Abstract

Objectives: Asymptomatic cerebrovascular disease (ACVD) represents a group of clinically silent yet socially significant conditions associated with an increased risk of stroke and cognitive impairment. Occupational stress (OS) has been increasingly recognized as a potential contributor to cerebrovascular pathology. This study aimed to evaluate the association between OS and ACVD and to examine its interaction with established vascular risk factors (RFs). Materials and Methods: We conducted a case–control study including 151 employed individuals with vascular RFs who underwent brain magnetic resonance imaging (MRI). Based on MRI findings, participants were categorized into two groups: individuals with imaging features consistent with ACVD (n = 41) and controls without such changes (n = 110). Occupational stress was assessed using the Workplace Stress Scale (WSS). Additional demographic, occupational, and clinical data were collected through a structured questionnaire. Logistic regression analysis was performed to evaluate the association between OS and white-matter hyperintensities (WMH), adjusting for potential confounders. Results: Participants with ACVD demonstrated higher OS levels compared to controls. In unadjusted analyses, higher OS scores were associated with increased odds of WMH; however, this association did not remain statistically significant after adjustment for age (OR = 1.734; 95% CI: 0.492–1.093). Occupational stress was not identified as an independent predictor of WMH in multivariable logistic regression models. Significant positive correlations were observed between OS and professional experience (Rho = 0.172, P = 0.036), weekly working hours (Rho = 0.244, P = 0.003), and shift work (Rho = 0.209, P = 0.010). Conclusion: Occupational stress may contribute to ACVD, particularly in individuals with hypertension, shift work, and prolonged working hours (>55 hours/week), potentially through synergistic interactions with vascular risk factors. Although OS was not an independent predictor of WMH, its cumulative impact warrants further.

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