IC-P-014: The functional impact of cerebral white matter hyperintensities in the elderly

Abstract Background Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. Methods In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (0.8–3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). Results Patients with T2DM had a higher PWV than controls (8.8 ± 2.2 vs. 7.9 ± 1.4 m/s, p < 0.01). WMH progression were similar in the two groups (p = 0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1–32%], p < 0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p < 0.05). We found no interaction between diabetes and PWV on cWMH progression. Conclusions PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.

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Cerebral white matter lesions and hypertension status in the elderly Korean: the Ansan Study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2004.09.003 ◽

2005 ◽

Vol 40 (3) ◽

pp. 265-273 ◽

Cited By ~ 7

Author(s):

Min Kyu Park ◽

Inho Jo ◽

Moon Ho Park ◽

Taik Kun Kim ◽

Sangmee Ahn Jo ◽

...

Keyword(s):

White Matter ◽

White Matter Lesions ◽

The Elderly ◽

Cerebral White Matter ◽

Hypertension Status ◽

Cerebral White Matter Lesions

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Development and validation of morphological segmentation of age-related cerebral white matter hyperintensities

NeuroImage ◽

10.1016/j.neuroimage.2009.03.055 ◽

2009 ◽

Vol 47 (1) ◽

pp. 199-203 ◽

Cited By ~ 31

Author(s):

Richard Beare ◽

Velandai Srikanth ◽

Jian Chen ◽

Thanh G. Phan ◽

Jennifer Stapleton ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Cerebral White Matter ◽

Morphological Segmentation ◽

Age Related ◽

Development And Validation

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Re: The Relationship between Cerebral White Matter Hyperintensities and Lower Urinary Tract Function in a Population Based, Geriatric Cohort

The Journal of Urology ◽

10.1016/j.juro.2014.07.048 ◽

2014 ◽

Vol 192 (4) ◽

pp. 1164-1165

Author(s):

Tomas L. Griebling

Keyword(s):

Urinary Tract ◽

White Matter ◽

Lower Urinary Tract ◽

White Matter Hyperintensities ◽

Population Based ◽

Cerebral White Matter ◽

Lower Urinary Tract Function ◽

Tract Function ◽

The Relationship ◽

Lower Urinary

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Cerebral white matter Hyperintensities in HIV–positive patients

Brain Imaging and Behavior ◽

10.1007/s11682-018-9966-1 ◽

2018 ◽

Vol 14 (1) ◽

pp. 10-18 ◽

Cited By ~ 2

Author(s):

Alice Trentalange ◽

Adolfo Prochet ◽

Daniele Imperiale ◽

Jessica Cusato ◽

Mariacristina Tettoni ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Cerebral White Matter ◽

Hiv Positive

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Abstract TP442: Periventricular Not Deep White Matter Hyperintensities Are Associated With Vascular Cognitive Impairment

Stroke ◽

10.1161/str.48.suppl_1.tp442 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Yan Chen ◽

Renyuan Liu ◽

Shuwei Qiu ◽

Yun Xu

Keyword(s):

Regression Analysis ◽

Cognitive Impairment ◽

White Matter ◽

Linear Regression ◽

Cognitive Performance ◽

White Matter Hyperintensities ◽

Rating Scale ◽

Linear Regression Analysis ◽

Vascular Cognitive Impairment ◽

Cerebral White Matter

Introduction: Cerebral White matter hyperintensities(WMH) are frequent findings on MRI scan. They are well known to correlate with vascular cognitive impairment(VCI). However, controversies still remain about the relationship between WMH locations and cognitive function across studies. Hypothesis: Periventricular WMHs(PWH) rather than deep WMHs(DWH) are associated with cognitive decline in VCI. Methods: Fifty-nine subjects with WMHs on MRI were divided into three groups, normal control(NC), mild cognitive impairment(MCI) and vascular dementia(VaD), according to clinical manifestation and neuropsychological performance. WMH volumes were evaluated by Fazekas rating scale and segmental volumetric. Correlations between cognitive performance and WMH volumes were determined in virtue of Spearman correlation analysis. Receiver operator characteristic (ROC) curves were generated to define the classification cut-off value of WMH volumes for distinguishing VCI versus normal controls. Multiple linear regression analysis was used to predict cognitive performance with WMH volumes and locations after adjusting for sex ,age and education level. Results: Cognitive capacities were gradually declined from NC through MCI to VaD patients while WMH volumes and Fazekas scores altered oppositely. Both PWH and DWH volumes and Fazekas scores were correlated with cognitive performance, and moreover, WMH volumes were correlated with Fazekas scores. ROC analysis showed a cut-off value of PWH rather than DWH to distinguish VCI from NC(AUC=0.745 and 0.635, p =0.001 and 0.076, respectively). Linear regression analysis demonstrated that only PWH volumes were associated with cognitive performance( p < 0.001). Conclusion: Our study demonstrate that PWHs are independent predictors for vascular contribution in white matter lesions and suggest clinicians that PWH should be emphasized on evaluating vascular cognitive impairment related with white matter load.

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White Matter Hyperintensities Predict Cognitive Decline: A Community-Based Study

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2019.47 ◽

2019 ◽

Vol 46 (04) ◽

pp. 383-388 ◽

Cited By ~ 1

Author(s):

Xuemei Qi ◽

Huidong Tang ◽

Qi Luo ◽

Bei Ding ◽

Jie Chen ◽

...

Keyword(s):

White Matter ◽

Cognitive Decline ◽

White Matter Hyperintensities ◽

Smoking Status ◽

Brain Magnetic Resonance Imaging ◽

The Elderly ◽

Brain Regions ◽

Cholinergic Pathways ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri

ABSTRACT:Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009–2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009–2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (–0.187 points/year, 95% confidence interval: –0.349, –0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

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