Vascular and non-vascular risk factors for deep white matter lesions in community-dwelling elderly subjects

2003 ◽  
Vol 3 (1) ◽  
pp. 36-43
Author(s):  
Hiroshi Yao ◽  
Takefumi Yuzuriha ◽  
Hiroshi Koga ◽  
Yuki Takashima ◽  
Kenji Fukuda ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Community Dwelling ◽  
Elderly Subjects ◽  
Vascular Risk ◽  
Deep White Matter

Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors

2004 ◽  
Vol 34 (1) ◽  
pp. 125-136 ◽  
Author(s):  
R. BALDWIN ◽  
S. JEFFRIES ◽  
A. JACKSON ◽  
C. SUTCLIFFE ◽  
N. THACKER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
White Matter ◽  
Depressive Disorder ◽  
Late Onset ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Group Differences ◽  
Vascular Risk ◽  
Control Subjects

Background. Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors.Method. This was a case–control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan.Results. After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease.Conclusion. The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

Silent Cerebral White Matter Lesions and Their Relationship With Vascular Risk Factors in Middle-Aged Predialysis Patients With CKD

2006 ◽  
Vol 47 (2) ◽  
pp. 241-250 ◽  
Author(s):  
Alberto Martinez-Vea ◽  
Esther Salvadó ◽  
Alfredo Bardají ◽  
Cristina Gutierrez ◽  
Ana Ramos ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Cerebral White Matter ◽  
Vascular Risk ◽  
Middle Aged ◽  
Cerebral White Matter Lesions

Changes in Vascular Risk Factors from Midlife to Late Life and White Matter Lesions: A 20-Year Follow-Up Study

2011 ◽  
Vol 31 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Miika Vuorinen ◽  
Alina Solomon ◽  
Suvi Rovio ◽  
Lasse Nieminen ◽  
Ingemar Kåreholt ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Late Life ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Follow Up Study

Vascular White Matter Lesions in Young Adults: A Neurology Outpatient Clinic Registry

2019 ◽  
Vol 82 (1-3) ◽  
pp. 23-31
Author(s):  
Miguel Viana-Baptista ◽  
Vera Cruz-e-Silva ◽  
André Caetano ◽  
João Pedro Marto ◽  
Elsa Azevedo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
White Matter ◽  
Genetic Disorder ◽  
Previous History ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Outpatient Clinics ◽  
Vascular Risk ◽  
History Of

Introduction: Although frequently assumed to be age-related changes, vascular white matter lesions (WML) are sometimes found in young adults. Etiology is usually attributed to sporadic small vessel disease; nevertheless, genetic disorders may also be implicated. We aimed to characterize the population of young adults with vascular WML in Neurology outpatient clinics. Methods: Neurologists from 12 Portuguese hospitals were invited to include patients aged 18–55 years evaluated in consultation, with vascular WML on MRI, scoring II or III in the Fazekas scale. Central imaging validation was performed by 2 independent, blinded, Neuroradiologists. Demographic and clinical data were collected as well as results of investigations performed. Results: During 2 years, 77 patients were included (mean age 47.7 years). Vascular risk factors were present in 88.3% patients (hypertension in 53.2%) and previous history of stroke in 36.4%. Patients without history of stroke were younger (46.6 ± 7.2 vs. 49.6 ± 3.9 years, p = 0.045) and had fewer vascular risk factors (p < 0.001). They were more frequently females (87.8 vs. 46.4%, p < 0.001), and headache (30.6 vs. 3.6%, p = 0.007), contrary to focal symptoms (16.3 vs. 53.6%, p = 0.001), was the most frequent reason of referral. Etiological investigations performed differed between Neurologists. A genetic disorder was identified in 6 out of 58 patients (CADASIL n = 5; COL4A1 n = 1). Conclusion: Young adults with vascular WML evaluated in Neurology outpatient clinics concentrate in the oldest age groups. Vascular risk factors should be screened carefully in this population. Among patients without history of stroke, females largely outweigh males. Diagnostic investigations performed do not follow a standardized protocol.

scholarly journals Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

2009 ◽  
Vol 40 (8) ◽  
pp. 1389-1399 ◽  
Author(s):  
R. B. Dalby ◽  
M. M. Chakravarty ◽  
J. Ahdidan ◽  
L. Sørensen ◽  
J. Frandsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Lesion Load ◽  
Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

scholarly journals Characterization of Lenticulostriate Arteries and Its Associations With Vascular Risk Factors in Community-Dwelling Elderly

2021 ◽  
Vol 13 ◽  
Author(s):  
Xiaopei Xu ◽  
Xiao Wu ◽  
Chengcheng Zhu ◽  
Ruiting Zhang ◽  
Yeerfan Jiaerken ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Artery ◽  
Vascular Risk Factors ◽  
Community Dwelling ◽  
Small Vessel ◽  
Imaging Biomarkers ◽  
Elderly Subjects ◽  
Vascular Risk ◽  
Lenticulostriate Arteries ◽  
Vessel Tortuosity

Lenticulostriate arteries (LSAs) supply blood to important subcortical areas and are, therefore, essential for maintaining the optimal functioning of the brain’s most metabolically active nuclei. Past studies have demonstrated the potential for quantifying the morphology of LSAs as biomarkers of vascular fragility or underlying arteriopathies. Thus, the current study aims to evaluate the morphological features of LSAs, their potential value in cerebrovascular risk stratification, and their concordance with other vascular risk factors in community-dwelling elderly people. A total of 125 community-dwelling elderly subjects who underwent a brain MRI scan were selected from our prospectively collected imaging database. The morphological measures of LSAs were calculated on the vascular skeletons obtained by manual tracing, and the number of LSAs was counted. Additionally, imaging biomarkers of small vessel disease were evaluated, and the diameters of major cerebral arteries were measured. The effects of vascular risk factors on LSA morphometry, as well as the relationship between LSA measures and other imaging biomarkers, were investigated. We found that smokers had shorter (p = 0.04) and straighter LSAs (p &lt; 0.01) compared to nonsmokers, and the presence of hypertension is associated with less tortuous LSAs (p = 0.03) in community-dwelling elderly. Moreover, the middle cerebral artery diameter was positively correlated with LSA count (r = 0.278, p = 0.025) and vessel tortuosity (r = 0.257, p = 0.04). The posterior cerebral artery diameter was positively correlated with vessel tortuosity and vessel length. Considering the scarcity of noninvasive methods for measuring small artery abnormalities in the brain, the LSA morphological measures may provide valuable information to better understand cerebral small vessel degeneration during aging.

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