Brain White Matter Hyperintensities: Relative Importance of Vascular Risk Factors in Nondemented Elderly People

Murray, Alison; Staff, Roger T.; Shenkin, Susan D.; Deary, Ian J.; Starr, John M.; Whalley, Lawrence J.

doi:10.1148/radiol.2371041496

Cited by 187 publications

(143 citation statements)

References 43 publications

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“…Both have been associated with changes in microperfusion and damage of the blood-brain barrier, and both are risk factors for WMH and atrophy. [34][35][36][37][38] Our finding that the presence of diabetes reduces histogram peak height while preserving the mean MTR value in the white matter (ie, the MTR peak position), most likely reflects brain tissue loss rather than demyelination or global changes of the microstructure. In contrast, hypertension affected the peak position only, which means that changes related to hypertension were more likely global and diffuse in nature.…”

Section: Discussionmentioning

confidence: 83%

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

Ropele¹,

Enzinger²,

Söllinger³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 83%

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

Ropele¹,

Enzinger²,

Söllinger³

et al. 2010

AJNR Am J Neuroradiol

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“…Although the pathophysiology of WMH is not completely understood, the presence of cerebrovascular risk factors has clearly been associated with increased WMH [7,22], suggesting that WMH are considered part of the spectrum of vascular-related injury, one of the markers for chronic end organ damage of the brain due to tissue ischemia [8,29,34]. As for the influence of autonomic failure on peripheral organs, especially cardiac function, recent studies [20,33] reported that the majority of patients with MSA had target-organ damage of hypertensive heart disease, similar to that observed in essential hypertension.…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in patients with multiple system atrophy

et al. 2009

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Recent studies have reported that the majority of patients with multiple system atrophy (MSA) had hypertensive heart disease. However, the effect of autonomic failure on the brain in MSA has not been studied. We consecutively enrolled 63 patients with MSA and selected 63 age-and sex-matched healthy subjects. We performed a comparative analysis of cerebrovascular lesions between the patients with MSA and the control subjects and analyzed predisposing factors for cerebrovascular lesions in the patients with MSA. There was no significant difference in lacune and territorial infarcts between the patients with MSA and the control subjects. The median grading score of white matter hyperintensity (WMH) was significantly higher in the patients with MSA (1.0, interquartile range 0.5-2.0) than the control subjects (0.0, interquartile range 0.0-1.0; P \ 0.01). In the patients with MSA, there was strong correlation between the grading score of WMH and supine systolic blood pressure (r = 0.529, P \ 0.001) after adjusting for age. Multiple linear regression analysis showed that age and supine systolic blood pressure was significantly and independently correlated with the grading score of WMH. The present study demonstrates that patients with MSA had more severe WMH and that supine systolic pressure is a major contributing factor for the severity of WMH, suggesting that patients with MSA have target-organ damage of the brain.

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“…However, they are also associated with hypertension, diabetes, and other vascular risk factors (Murray et al, 2005;Pantoni and Garcia, 1997). Development of WMLs is known to be a cause of cognitive impairment, dementia, and disability (Prins et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Preserved Acetazolamide Reactivity in Lacunar Patients with Severe White-Matter Lesions: ¹⁵O-Labeled Gas and H₂O Positron Emission Tomography Studies

Nezu

Yokota

Uehara

et al. 2012

J Cereb Blood Flow Metab

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Limited evidence exists on the relationships between severity of white-matter lesions (WMLs) and cerebral hemodynamics in patients without major cerebral artery disease. To examine changes of cerebral blood flow (CBF), oxygen metabolism, and vascular reserve capacity associated with severity of WML in patients with lacunar stroke, we used a positron emission tomography (PET). Eighteen lacunar patients were divided into two groups according to the severity of WMLs, assessed by Fazekas classification; grades 0 to 1 as mild WML group and grades 2 to 3 as severe WML group. Rapid dual autoradiography was performed with 15 O-labeled gas-PET followed by 15 O-labeled water-PET with acetazolamide (ACZ) challenge. Compared with the mild WML group, the severe WML group showed lower CBF (20.6±4.4 versus 29.9±8.2 mL/100 g per minute, P = 0.008), higher oxygen extraction fraction (OEF) (55.2 ± 7.4 versus 46.7 ± 5.3%, P = 0.013), and lower cerebral metabolic rate of oxygen (CMRO 2 ) (1.95±0.41 versus 2.44±0.42 mL/100 g per minute, P = 0.025) in the centrum semiovale. There were no significant differences in the ACZ reactivity between the two groups (48.6±22.6% versus 42.5±17.2%, P = 0.524). Lacunar patients with severe WMLs exhibited reduced CBF and CMRO 2 , and increased OEF in the centrum semiovale. The ACZ reactivity was preserved in both patients with severe and mild WMLs in each site of the brain.

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Brain White Matter Hyperintensities: Relative Importance of Vascular Risk Factors in Nondemented Elderly People

Abstract: White matter hyperintensities are associated with elevated levels of glycated hemoglobin in nondemented community-dwelling elderly subjects. Hypertension and decreased normalized PEFR are the principal predictors of deep white matter hyperintensities in nondiabetic subjects.

Cited by 187 publications

References 43 publications

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

White matter hyperintensities in patients with multiple system atrophy

Preserved Acetazolamide Reactivity in Lacunar Patients with Severe White-Matter Lesions: ¹⁵O-Labeled Gas and H₂O Positron Emission Tomography Studies

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Brain White Matter Hyperintensities: Relative Importance of Vascular Risk Factors in Nondemented Elderly People

Abstract: White matter hyperintensities are associated with elevated levels of glycated hemoglobin in nondemented community-dwelling elderly subjects. Hypertension and decreased normalized PEFR are the principal predictors of deep white matter hyperintensities in nondiabetic subjects.

Cited by 187 publications

References 43 publications

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

The Impact of Sex and Vascular Risk Factors on Brain Tissue Changes with Aging: Magnetization Transfer Imaging Results of the Austrian Stroke Prevention Study

White matter hyperintensities in patients with multiple system atrophy

Preserved Acetazolamide Reactivity in Lacunar Patients with Severe White-Matter Lesions: 15O-Labeled Gas and H2O Positron Emission Tomography Studies

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Product

Resources

About

Preserved Acetazolamide Reactivity in Lacunar Patients with Severe White-Matter Lesions: ¹⁵O-Labeled Gas and H₂O Positron Emission Tomography Studies