Different cardiovascular risk factors are related to distinct white matter hyperintensity MRI phenotypes in older adults

Keller, Jasmin Annica; Kant, Ilse; Slooter, Arjen J. C.; Montfort, Simone J.T. van; Buchem, Mark A. van; Osch, Matthias J.P. van; Hendrikse, Jeroen; Bresser, Jeroen de

doi:10.1016/j.nicl.2022.103131

Cited by 15 publications

(13 citation statements)

References 32 publications

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“…Elevated arterial blood pressure may directly increase the intima-media shear force, thickening the vessel wall and leading to hypoperfusion in the blood-supplied area, with high pressure further disrupting the BBB and causing chronic endothelial injury. The moderate-and-severe WMH subgroup in this study was positively correlated with age and hypertension, which is consistent with the findings of previous studies showing that age and hypertension are important factors affecting WMHs ( 29 , 30 ). This may be explained by the fact that older age and hypertension are associated with the formation of atherosclerotic plaques.…”

Section: Discussionsupporting

confidence: 93%

Association of vulnerable plaques with white matter hyperintensities on high-resolution magnetic resonance imaging

Li,

Tian,

Shi

et al. 2024

Quant Imaging Med Surg

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Background One of the widespread manifestations of cerebral small vessel disease (CSVD) of the brain parenchyma is white matter lesion, which appears as white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). Previous studies have illustrated that large artery atherosclerosis is related to CSVD, but the precise progress of pathogenesis remains unknown. High-resolution MRI (HR-MRI) has the ability to delineate intracranial vascular walls, enabling a thorough exploration of the structure and composition of unstable plaques. This study aimed to apply HR-MRI to characterize the wall changes and plaque characteristics of middle cerebral arteries in patients with WMHs and to investigate the correlation between plaque vulnerability parameters and different degrees of WMHs. Methods In this study, 138 patients with acute ischemic stroke at Harbin Medical University’s First Clinical Hospital (May 2021 to October 2023) were cross-sectionally reviewed and underwent conventional brain and HR-MRI using T1-weighted 3D volumetric isotropic turbo spin echo acquisition (T1W-3D-VISTA) of the unilateral middle cerebral artery (MCA). According to Fazekas grade (0–6), the patients were divided into two groups: Fazekas score 0–2, no-or-mild WMHs; and Fazekas 3–6, moderate-to-severe WMHs. The intraplaque hemorrhage, plaque distribution, plaque enhancement, plaque load, remodeling pattern, and stenosis of the two groups were measured. Binary logistic regression analysis was conducted to evaluate the relationship between vulnerable plaques and WMHs. Results Of the participants who were initially considered for inclusion, 71 were deemed eligible, among whom 34 were placed in the no-or-mild WMH group and 37 in the moderate-to-severe WMH group. Between the two groups, there were significant differences in intraplaque hemorrhage (P=0.01), a wide distribution (P=0.02), and plaque enhancement (P=0.02). Univariate analysis showed that WMHs were associated with age [odds ratio (OR) =1.080; 95% confidence interval (CI): 1.020–1.144; P=0.008], hypertension (OR =3.500; 95% CI: 1.276–9.597; P=0.01), intraplaque hemorrhage (OR =3.955; 95% CI: 1.247–12.538; P=0.02), a wide distribution (OR =3.067; 95% CI: 1.159–8.115; P=0.02), and significant plaque enhancement (OR =4.372; 95% CI: 1.101–17.358; P=0.03); however, the multivariate results showed that the only independent factors associated with WMHs were age (OR =1.095; 95% CI: 1.019–1.176; P=0.01) and intraplaque hemorrhage (OR =5.88; 95% CI: 1.466–23.592; P=0.01). Conclusions Our findings suggest that age and intraplaque hemorrhage may be associated with more severe WMHs in patients with acute ischemic stroke, which may be helpful for further clinical examination and intervention treatment.

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Section: Discussionsupporting

confidence: 93%

Association of vulnerable plaques with white matter hyperintensities on high-resolution magnetic resonance imaging

Li,

Tian,

Shi

et al. 2024

Quant Imaging Med Surg

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“…WMH refers to hyperintense lesions in the white matter that are best visualized using FLAIR MRI (Botz et al., 2023). While a limited load of WMH is considered normal among the elderly population, with more than 90% of individuals over 60 years showing some degree of WMH, larger amounts of WMH, particularly in the deep (periventricular) white matter, may indicate cerebrovascular disease (Keller et al., 2022). Furthermore, a high burden of WMH is associated with cardiovascular risk factors and is linked to an increased risk of dementia, stroke, and mortality (Sheibani et al., 2021; Wardlaw et al., 2015).…”

Section: Discussionmentioning

confidence: 99%

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Parsaei,

Taebi,

Arvin

et al. 2024

J of Neuroscience Research

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Tension‐type headache (TTH) stands as the most prevalent form of headache, yet an adequate understanding of its underlying mechanisms remains elusive. This article endeavors to comprehensively review structural and functional magnetic resonance imaging (MRI) studies investigating TTH patients, to gain valuable insights into the pathophysiology of TTH, and to explore new avenues for enhanced treatment strategies. We conducted a systematic search to identify relevant articles examining brain MRI disparities between TTH individuals and headache‐free controls (HFC). Fourteen studies, encompassing 312 diagnosed TTH patients, were selected for inclusion. Among these, eight studies utilized conventional MRI, one employed diffusion tensor imaging, and five implemented various functional MRI modalities. Consistent findings across these studies revealed a notable increase in white matter hyperintensity (WMH) in TTH patients. Furthermore, the potential involvement of the specific brain areas recognized to be involved in different dimensions of pain perception including cortical regions (anterior and posterior cingulate cortex, prefrontal cortex, anterior and posterior insular cortex), subcortical regions (thalamus, caudate, putamen, and parahippocampus), cerebellum in TTH pathogenesis was identified. However, no significant association was established between TTH and intracranial abnormalities or total intracranial volume. In conclusion, these findings support the hypotheses regarding the role of central mechanisms in TTH pathophysiology and offer probable brain regions implicated in these mechanisms. Due to the scarce data on the precise role of these regions in the TTH, further preclinical and clinical investigations should be done to advance our knowledge and enhance targeted therapeutic options of TTH.

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“…Alternatively, the moderate‐to‐severe WMH rating is heavily influenced by location and morphology of WMH, which is not necessarily taken into full account by the CHS scale. For instance, deep WMH volume is less related to hypertension than circumferential periventricular lesions 22 . The location and morphology influences cognitive outcomes, too 18 .…”

Section: Discussionmentioning

confidence: 99%

“…For instance, deep WMH volume is less related to hypertension than circumferential periventricular lesions. 22 The location and morphology influences cognitive outcomes, too. 18 Frontal WMH tend to affect executive function while parietotemporal WMH affect memory.…”

Section: Measures Of Scd Are Presented Inmentioning

confidence: 99%

Impact of white matter hyperintensities on subjective cognitive decline phenotype in a diverse cohort of cognitively normal older adults

Rothstein

Zhang

Briggs

et al. 2023

Int J Geriat Psychiatry

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Objectives Subjective cognitive decline (SCD) is a preclinical stage of AD. White matter hyperintensities (WMH), an MRI marker of cerebral small vessel disease, associate with AD biomarkers and progression. The impact of WMH on SCD phenotype is unclear. Methods/Design A retrospective, cross‐sectional analysis was conducted on a diverse cohort with SCD evaluated at the NYU Alzheimer's Disease Research Center between January 2017 and November 2021 (n = 234). The cohort was dichotomized into none‐to‐mild (n = 202) and moderate‐to‐severe (n = 32) WMH. Differences in SCD and neurocognitive assessments were evaluated via Wilcoxon or Fisher exact tests, with p‐values adjusted for demographics using multivariable logistic regression. Results Moderate‐to‐severe WMH participants reported more difficulty with decision making on the Cognitive Change Index (1.5 SD 0.7 vs. 1.2 SD 0.5, p = 0.0187) and worse short‐term memory (2.2 SD 0.4 vs. 1.9 SD 0.3, p = 0.0049) and higher SCD burden (9.5 SD 1.6 vs. 8.7 SD 1.7, p = 0.0411) on the Brief Cognitive Rating Scale. Moderate‐to‐severe WMH participants scored lower on the Mini‐Mental State Examination (28.0 SD 1.6 vs. 28.5 SD 1.9, p = 0.0491), and on delayed paragraph (7.2 SD 2.0 vs. 8.8 SD 2.9, p = 0.0222) and designs recall (4.5 SD 2.3 vs. 6.1 SD 2.5, p = 0.0373) of the Guild Memory Test. Conclusions In SCD, WMH impact overall symptom severity, specifically in executive and memory domains, as well as objective performance on global and domain‐specific tests in verbal memory and visual working/associative memory.

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Different cardiovascular risk factors are related to distinct white matter hyperintensity MRI phenotypes in older adults

Cited by 15 publications

References 32 publications

Association of vulnerable plaques with white matter hyperintensities on high-resolution magnetic resonance imaging

Association of vulnerable plaques with white matter hyperintensities on high-resolution magnetic resonance imaging

Brain structural and functional abnormalities in patients with tension‐type headache: A systematic review of magnetic resonance imaging studies

Impact of white matter hyperintensities on subjective cognitive decline phenotype in a diverse cohort of cognitively normal older adults

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