White Matter Lesions in Migraine and Right-to-Left Shunt: A Conventional and Diffusion MRI Study

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 376-382 ◽  
Author(s):  
M Del Sette ◽  
L Dinia ◽  
L Bonzano ◽  
L Roccatagliata ◽  
C Finocchi ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Lesions ◽  
Clinical Feature ◽  
Hyperintense Lesion ◽  
Significant Difference ◽  
High Prevalence ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Study ◽  
The Relationship ◽  
And Diffusion

Subjects with migraine with aura (MA) have a high prevalence of white matter lesions (WMLs) on magnetic resonance imaging (MRI). Moreover, right-to-left shunt (RILES), mainly due to patent foramen ovale, is frequently associated with MA. The aim of this study was to clarify the relationship between RILES and WML in MA. We enrolled 87 consecutive subjects affected by MA. Patients were screened for migraine characteristics and cerebrovascular risk factors. Transcranial Doppler was used to diagnose RILES and MRI with T2-weighted and diffusion-weighted imaging (DWI) to evaluate presence, number and volume of WMLs. RILES was present in 45% of patients. We did not detect any DWI hyperintense lesion; WMLs were present in 61% of patients on T2-weighted images. Presence of WMLs did not correlate with any migraine clinical feature, whereas the presence, number and volume of WMLs increased with subjects' age. There was no significant difference in the total volume and number of WMLs in the group with and without RILES. In conclusion, RILES does not increase the likelihood of finding WMLs in migraineurs.

scholarly journals A Study on the Relationship Between Patent Foramen Ovale and White Matter Lesions in Migraine Patients

2021 ◽  
Author(s):  
Junyan Huo ◽  
Mengxia Wan ◽  
Nan Li ◽  
Juan Wang ◽  
Xiao Cai ◽  
...  
Keyword(s):  
White Matter ◽  
Transcranial Doppler ◽  
Patent Foramen Ovale ◽  
White Matter Lesions ◽  
Primary Headache ◽  
Transcranial Doppler Ultrasound ◽  
Foramen Ovale ◽  
Significant Difference ◽  
The Difference ◽  
The Relationship

Abstract Background Migraine is a common clinical primary headache with unclear aetiology. In recent years, studies have shown that migraine is related to patent foramen ovale, and some patients with migraine have white matter lesions. However, the relationship among the three is unclear.Objective To explore the characteristics of white matter lesions (WMLs) in migraine patients with patent foramen ovale and to predict the occurrence of patent foramen ovale through magnetic resonance imaging (MRI) characteristics in patients with migraine.Methods Seventy-seven patients clinically diagnosed with migraine were examined by transcranial Doppler ultrasound (cTCD) and MRI. The patients were grouped according to the presence of WMLs, with matching by age, sex, hypertension, diabetes, PFO and other characteristic data. We observed the MRI fluid attenuation inversion recovery sequence (FLAIR) image and compared and analysed the difference in WMLs between the PFO-positive group and the PFO-negative group.Results There were 42 cases and 35 cases of migraine with and without WMLs, respectively. A statistically significant difference in near-cortical WMLs with PFO in migraine patients was observed (P=0.001). Logistic regression analysis adjusted by age, sex, hypertension and diabetes identified PFO status as the sole determinant for the presence of near-cortical WMLs (OR = 0.14; 95%CI 0.045–0.421; p < 0.001)Conclusion Near-cortical white matter lesions in migraine patients are related to PFO. Transcranial Doppler ultrasonography may reveal more PFO in patients with migraine and near-cortical WMLs.

scholarly journals Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

2017 ◽  
Vol 08 (02) ◽  
pp. 216-220 ◽  
Author(s):  
Artit Potigumjon ◽  
Arvemas Watcharakorn ◽  
Pornpatr A. Dharmasaroja
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Magnetic Resonance ◽  
White Matter Lesions ◽  
Cerebral Microbleeds ◽  
National Institutes Of Health ◽  
Asian Origin ◽  
Chinese Study ◽  
Japanese Studies ◽  
Magnetic Resonance Imaging Mri

ABSTRACT Background: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. Methods: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. Results: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs. Conclusions: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

Abstract TP181: Serum Eiocosapentaenoic Acids Is Protective Against White Matter Lesions

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Daiki Takano ◽  
Takashi Yamazaki ◽  
Tetsuya Maeda ◽  
Yuichi Satoh ◽  
Yasuko Ikeda ◽  
...  
Keyword(s):  
White Matter ◽  
Cognitive Decline ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
White Matter Lesions ◽  
White Matter Hyperintensity ◽  
Partial Regression Coefficient ◽  
The Relationship ◽  
Total Pufa ◽  
Periventricular Hyperintensity

[Introduction] White matter hyperintensities (WMH) are considered manifestation of arteriosclerotic small vessel disease and WMH burden increases risk of ischemic stroke and cognitive decline. There are only a few evidences concerning the relationship between polyunsaturated fatty acids (PUFA) and WMH. The present study was designed to elucidate the association between WMH and PUFA profile including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and arachidonic acid (AA) in patients with Alzheimer’s disease (AD). [Methods] The present study was based on 119 patients who were diagnosed as having a probable AD according to the NINCDS-ADRDA criteria. Their mean age was 78.3 years old. All subjects underwent neuropsychological evaluation including mini mental state exam (MMSE) and 1.5-Tesla MRI. Fasting blood samples were also collected for the PUFA measurements. We measured the ratio of serum EPA, DHA and AA concentration to the total PUFA concentration. The WMH were evaluated on T2-weight images and classified into periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH). The severity of WMH was graded 5 categories. We investigated the relationship between WMH and PUFA profiles. [Results] The EPA ratio correlated negatively with both PVH (rs=-0.2036, p=0.0264) and DWMH grade (rs=-0.3155, p=0.0005). It remained still significant after adjustment for age, sex, statins use, antithrombotics use, mean blood pressure and presence of hypertension (standardized partial regression coefficient(β)=-0.2516, p=0.0122 for PVH, β=-0.3598, p=0.0001 for DWMH). Neither DHA nor AA ratio correlated with DWMH or PVH grade. The EPA ratio but not DHA or AA ratio correlated positively with total MMSE score (rs=0.2310, p=0.0115). [Conclusions] Our data revealed that the serum EPA was protective against WMH as well as cognitive decline in AD patients. Pathophysiology underlying WMH is complex and the possible mechanisms involved in the pathogenesis of WMH encompass incomplete brain ischemia, increased permeability of blood-brain barrier, and inflammation responses. The relationship between serum EPA and WMH can be partly explained by those anti-ischemic and anti-arteriosclerotic effects of EPA.

Abstract 37: Increased Mean Transit Time and Blood Brain Permeability in Asymptomatic White Matter Lesions of Ischemic Origin

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Blake Dewey ◽  
Xiang Xu ◽  
Linda Knutson ◽  
Amod Jog ◽  
Jerry Prince ◽  
...  
Keyword(s):  
White Matter ◽  
Transit Time ◽  
Gray Matter ◽  
Mean Transit Time ◽  
White Matter Lesions ◽  
Lesion Volume ◽  
Dynamic Susceptibility ◽  
Automated Segmentation ◽  
Blood Brain ◽  
Significant Difference

Introduction: White matter lesions of presumed ischemic origin (WMH) have been associated with increased risk of stroke, cognitive and motor decline, and are a subject of public health research. Engineering new MRI pipelines allowing for determination of mean transit time (MTT), and blood brain barrier permeability (BBBP), within WMH lesions is required for long-term population-based studies of lesion progression in patients with dementia and vascular cognitive impairment. Methods: WMH lesion volumes in 24 asymptomatic individuals was determined using an automated segmentation methodology, S3DL, with manual correction to remove false positives. A double contrast injection scheme was used to measure both K trans using dynamic contrast enhanced (DCE) imaging and K 2 using dynamic susceptibility contrast (DSC) imaging which also provided perfusion-related measures. BBBP was measured as k 2 within segmented WMH lesions and compared with normal white and gray matter. Results: The mean transit time (MTT) was found to be significantly prolonged (8.11, p<0.001Wilcoxon Signed-Rank Test) in WMH lesions when compared to normal appearing white and gray matter. There was no significant difference in DCE-K trans (0.018, p=0.351) between the lesions and the white/gray matter. Permeability measured in the WMH lesions using the DSC-K 2 method was increased and was correlated withincreasing total WMH lesion volume (spearman correlation 0.44; p< 0.046). Conclusion: In this first study using an advanced WMH lesion automated segmentation pipeline, we measured DCE and DSC perfusion and permeability variables within WMH lesions and compared them to normal white and grey matter in healthy people. We observed increasing MTT, within WMH lesions as compared to unaffected white and gray matter. Using the DSC-K 2 method, BBBP was higher within WMH lesions in these asymptomatic people, and correlated with increasing total lesion volume.

scholarly journals An Assessment of the Relationship between Structural and Functional Imaging of Cerebrovascular Disease and Cognition-Related Fibers

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Xiaoping Tang ◽  
Xinlan Xiao ◽  
Jianhua Yin ◽  
Ting Yang ◽  
Bingliang Zeng
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Cerebrovascular Disease ◽  
Cognitive Dysfunction ◽  
Functional Imaging ◽  
Small Vessel Disease ◽  
White Matter Lesions ◽  
Cerebral Small Vessel Disease ◽  
Vessel Disease ◽  
The Relationship

In order to assess the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers, this paper chooses a total of 120 patients who underwent cerebral small vessel disease (CSVD) treatment at a designated hospital by this study from June 2013 to June 2018 and divides them into 3 groups according to the random number table method: vascular dementia (VaD) group, vascular cognitive impairment no dementia (VCIND) group, and noncognition impairment (NCI) group with 40 cases of patients in each group. Cognitive function measurement and imaging examination were performed for these 3 groups of patients, and the observation indicators of cognitive state examination (CSE), mental assessment scale (MAS), clock drawing test (CDT), adult intelligence scale (AIS), frontal assessment battery (FAB), verbal fluency test (VFT), trail making test (TMT), cognitive index (CI), white matter lesions (WML), third ventricle width (TVW), and frontal horn index (FHI) were tested, respectively. The results shows that the average scores of CSE, MAS, AIS, and VFT in the VaD and VCIND group are lower than those of the NCI group and the differences are statistically significant (P<0.05); the average scores of FAB, TMT, and CI in the VaD group are higher than those of the VCIND group and the differences are also statistically significant (P<0.05); the average scores of FHI and TVW in the VaD group are lower than those of the VCIND and NCI group with statistically significant differences (P<0.05); the average scores of WML, CDT, and AIS in the VaD group are higher than those of the VCIND and NCI group with statistically significant differences (P<0.05). Therefore, it is believed that the structural and functional imaging features of cerebrovascular disease are closely related to cognition-related fibers, and the incidence of white matter lesions is closely related to the degree of lesions and cognitive dysfunction of cerebral small vessel disease, in which a major risk factor for cognitive dysfunction in patients with small blood vessels is the severity of white matter lesions; brain imaging and neuropsychiatric function assessment can better understand the relationship between cerebrovascular disease and cognitive impairment. The results of this study provide a reference for the further research studies on the relationship between structural and functional imaging of cerebrovascular disease and cognition-related fibers.

scholarly journals Clinical manifestations and imaging features of white matter demyelination in older patients

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096680
Author(s):  
Jian Li ◽  
Yi-Ming Zhao
Keyword(s):  
White Matter ◽  
Clinical Diagnosis ◽  
Older Patients ◽  
Demyelinating Disease ◽  
Clinical Manifestations ◽  
Imaging Features ◽  
Significant Difference ◽  
Clinical Diagnoses ◽  
Chief Complaints ◽  
Magnetic Resonance Imaging Mri

Objective To investigate the clinical manifestations and imaging features of older patients with white matter demyelination diagnosed by magnetic resonance imaging (MRI). Methods Ninety-six patients with leukoaraiosis diagnosed by MRI were divided by their clinical diagnoses into a demyelinating group (40 cases) and a non-demyelinating group (56 cases). The imaging and clinical features of the patients in the two groups were analyzed. Results Compared with the non-demyelinating group, there were significantly more women in the demyelinating group than men. There was no significant difference in age between the two groups. Of the 37 cases who had an imaging report of “white matter demyelination and multiple sclerosis,” 36 cases had a clinical diagnosis in accordance with white matter demyelination (97.3%). Of the 59 cases who had an imaging report of “white matter demyelination”, only four cases had a clinical diagnosis in accordance with demyelination (6.8%). Conclusion In older patients with headaches, vertigo, other head symptoms, and unilateral numbness as the chief complaints, a clinical diagnosis of demyelinating disease is very unlikely when the imaging report states white matter demyelination only.

scholarly journals Relationship Between Type 2 Diabetes and White Matter Hyperintensity: A Systematic Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Dan-Qiong Wang ◽  
Lei Wang ◽  
Miao-Miao Wei ◽  
Xiao-Shuang Xia ◽  
Xiao-Lin Tian ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
White Matter ◽  
Structural Changes ◽  
White Matter Lesions ◽  
Poor Performance ◽  
White Matter Hyperintensity ◽  
Diabetic Microangiopathy ◽  
The Relationship ◽  
The Brain

White matter (WM) disease is recognized as an important cause of cognitive decline and dementia. White matter lesions (WMLs) appear as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging (MRI) scans of the brain. Previous studies have shown that type 2 diabetes (T2DM) is associated with WMH. In this review, we reviewed the literature on the relationship between T2DM and WMH in PubMed and Cochrane over the past five years and explored the possible links among the presence of T2DM, the course or complications of diabetes, and WMH. We found that: (1) Both from a macro- and micro-scopic point of view, most studies support the relationship of a larger WMH and a decrease in the integrity of WMH in T2DM; (2) From the relationship between brain structural changes and cognition in T2DM, the poor performance in memory, attention, and executive function tests associated with abnormal brain structure is consistent; (3) Diabetic microangiopathy or peripheral neuropathy may be associated with WMH, suggesting that the brain may be a target organ for T2DM microangiopathy; (4) Laboratory markers such as insulin resistance and fasting insulin levels were significantly associated with WMH. High HbA1c and high glucose variability were associated with WMH but not glycemic control.

Brain magnetic resonance imaging does not contribute to the diagnosis of chronic neuroborreliosis

2007 ◽  
Vol 48 (7) ◽  
pp. 755-762 ◽  
Author(s):  
A. Aalto ◽  
J. Sjöwall ◽  
L. Davidsson ◽  
P. Forsberg ◽  
Ö. Smedby
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Duration ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Significant Difference ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri

Background: Borrelia infections, especially chronic neuroborreliosis (NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive. Purpose: To evaluate brain magnetic resonance imaging (MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration. Material and Methods: Sixteen well-characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- (with and without gadolinium), T2-, and diffusion-weighted imaging plus fluid-attenuated inversion recovery (FLAIR) imaging were used. Results: White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls (no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients (ρ = 0.83, P<0.01) and in controls (ρ = 0.61, P<0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2-weighted imaging. Conclusion: A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.

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