The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis

Debette, Stéphanie; Markus, Hugh S.

doi:10.1136/bmj.c3666

Cited by 1,888 publications

(1,826 citation statements)

References 88 publications

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“…White-matter hyperintensity, which represents brain injury related to cerebral small vessel disease, is an established risk factor for CVD and dementia. 34,35 In a subset of participants older than 60 years, the greater total volume of WMH was associated with higher systolic and pulsatile CBFV% and lower diastolic CBFV% (Supplementary Figure S5). While limited by a small sample, our observations are, at least in part, consistent with the findings by Webb et al who reported the associations of WMH with higher CBF pulsatility and lower diastolic blood pressure in patients within 6 weeks of a transient ischemic attack or minor stroke.…”

Section: Cerebral Hemodynamics and Central Arterial Aging T Tarumi Et Almentioning

confidence: 98%

Cerebral Hemodynamics in Normal Aging: Central Artery Stiffness, Wave Reflection, and Pressure Pulsatility

Tarumi

Khan

Liu

et al. 2014

J Cereb Blood Flow Metab

171

143

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Blood ejected from the left ventricle perfuses the brain via central elastic arteries, which stiffen with advancing age and may elevate the risk of end-organ damage. The purpose of this study was to determine the impact of central arterial aging on cerebral hemodynamics. Eighty-three healthy participants aged 22 to 80 years underwent the measurements of cerebral blood flow (CBF) and CBF velocity (CBFV) using magnetic resonance imaging (MRI) and transcranial Doppler, respectively. The CBF pulsatility was determined by the relative amplitude of CBFV to the mean value (CBFV%). Central arterial stiffness (carotid-femoral pulse wave velocity), wave reflection (carotid augmentation index), and pressure were measured using applanation tonometry. Total volume of white-matter hyperintensity (WMH) was quantified from MR images. Total CBF decreased with age while systolic and pulsatile CBFV% increased and diastolic CBFV% decreased. Women showed greater total CBF and lower cerebrovascular resistance than men. Diastolic CBFV% was lower in women than in men. Age-and sex-related differences in CBF pulsatility were independently associated with carotid pulse pressure and arterial wave reflection. In older participants, higher pulsatility of CBF was associated with the greater total volume of WMH. These findings indicate that central arterial aging has an important role in age-related differences in cerebral hemodynamics.

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Section: Cerebral Hemodynamics and Central Arterial Aging T Tarumi Et Almentioning

confidence: 98%

Cerebral Hemodynamics in Normal Aging: Central Artery Stiffness, Wave Reflection, and Pressure Pulsatility

Tarumi

Khan

Liu

et al. 2014

J Cereb Blood Flow Metab

171

143

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“…Cross-sectional imaging studies in humans MRI studies of age effects on WM have reported signal abnormalities that are manifested as an increase in hyperintensities (WMH), which are considered to be a result of vascular dysfunction (Yoshita et al 2005;Debette and Markus 2010), as well as WM volumetric loss and structural changes measured by diffusivity . Studies of age effects on WM volume historically show some disparity of results, such as an age-related loss that is restricted to women (Good et al 2001;Kruggel 2006), or an increase in WM volume with age (Mortamet et al 2005).…”

mentioning

confidence: 99%

Age-related changes in human and non-human primate white matter: from myelination disturbances to cognitive decline

Kohama

Rosene

Sherman

2011

AGE

116

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The cognitive decline associated with normal aging was long believed to be due primarily to decreased synaptic density and neuron loss. Recent studies in both humans and non-human primates have challenged this idea, pointing instead to disturbances in white matter (WM) including myelin damage. Here, we review both cross-sectional and longitudinal studies in humans and non-human primates that collectively support the hypothesis that WM disturbances increase with age starting at middle age in humans, that these disturbances contribute to age-related cognitive decline, and that age-related WM changes may occur as a result of free radical damage, degenerative changes in cells in the oligodendrocyte lineage, and changes in microenvironments within WM.

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“…[27]. In addition, a current meta-analysis has described a relationship between the extent of WMH and the risk of stroke, cognitive dysfunction and development of dementia [26]. Therefore, in cases of extensive WMH (Fazekas Grade II/II), there should be further investigation (Category II) with respect to cardiovascular risk factors [25,28].…”

Section: ▼ Leukoaraiosismentioning

confidence: 99%

Management of Intracranial Incidental Findings on Brain MRI

Langner

Buelow

Fleck

et al. 2016

Fortschr Röntgenstr

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The wider use of MRI for imaging of the head in both research and clinical practice has led to an increasing number of intracranial incidental findings. Most of these findings have no immediate medical consequences. Nevertheless, knowledge of common intracranial incidental findings and their clinical relevance is necessary to adequately discuss the findings with the patient. Based on the author?s experiences from a large population-based study, the most common incidental MR findings in the brain will be presented, discussing their clinical relevance and giving recommendations for management according to the current literature and guidelines. Key points: ??Intracranial incidental findings are common. ??The majority of these findings have no immediate medical consequences. ??Knowledge of common incidental findings is necessary for appropriate management. Citation Format: ??Langner S, Buelow R, Fleck S et?al. Management of Intracranial Incidental Findings on Brain MRI. Fortschr R?ntgenstr 2016; 188: 1123???1133

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The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis

Cited by 1,888 publications

References 88 publications

Cerebral Hemodynamics in Normal Aging: Central Artery Stiffness, Wave Reflection, and Pressure Pulsatility

Cerebral Hemodynamics in Normal Aging: Central Artery Stiffness, Wave Reflection, and Pressure Pulsatility

Age-related changes in human and non-human primate white matter: from myelination disturbances to cognitive decline

Management of Intracranial Incidental Findings on Brain MRI

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