Pathogeneses and Imaging Features of Cerebral White Matter Lesions of Vascular Origins

Wu, Xinxin; Ya, Jingyuan; Zhou, Da; Ding, Yuchuan; Ji, Xunming; Wang, Mengqi

doi:10.14336/ad.2021.0414

Cited by 15 publications

(12 citation statements)

References 148 publications

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“…The precise pathophysiological mechanisms of WMH have not been fully elucidated, but may include hypoxia-ischemia, blood–brain barrier (BBB) breakdown, endothelial dysfunction, oxidative stress, venous collagen deposition. 26 , 27 In recent years, increasing evidence indicates an extraordinarily critical role of inflammation in the progression of WMH. 9 , 24 , 28 , 29 As a glycoprotein mediating inflammation, YKL-40 has been reported to correlated with pulmonary diseases, diabetes mellitus, coronary heart disease, Alzheimer’s disease and stroke.…”

Section: Discussionmentioning

confidence: 99%

Serum YKL-40 Levels and White Matter Hyperintensities in Patients with Acute Ischemic Stroke

Shi¹,

Ke²,

Gong³

et al. 2023

JIR

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Background White matter hyperintensity (WMH) is associated with risk of acute ischemic stroke (AIS) and poor outcomes after AIS. The purpose of this prospective study was to evaluate the association between serum YKL-40 levels and WMH burden in patients with AIS. Methods From February 2020 to March 2021, a total of 672 consecutive AIS patients with magnetic resonance imaging data were prospectively recruited form two centers. Serum YKL-40 levels were quantified using enzyme-linked immunosorbent assay. The burden of WMH was semiquantitatively measured by the Fazekas visual grading scale. According to severity of overall WMH, patients were dichotomized into none–mild WMH group (Fazekas score 0–2) or moderate–severe WMH group (Fazekas score 3–6). Besides, based on severity of periventricular WMH (PV-WMH) and deep WMH (D-WMH), patients were categorized as none–mild (Fazekas score 0–1) or moderate–severe (Fazekas score 2–3). Results Among the 672 patients, 335 (49.9%) participants were identified with moderate–severe overall WMH, 326 (48.5%) with moderate–severe PV-WMH and 262 (39.0%) with moderate–severe D-WMH. Compared with the first quartile of serum YKL-40, the adjusted odds ratio (OR) of the fourth quartile for moderate–severe PV-WMH was 2.473 (95% confidence interval [CI] 1.316–4.646; P =0.005). No significant association was observed between YKL-40 and overall WMH (OR 0.762; 95% CI 0.434–1.336; P =0.343) or D-WMH (OR 0.695; 95% CI 0.413–1.171; P =0.172). Conclusion Our results suggested that higher YKL-40 levels appeared to be associated with PV-WMH, but not with overall WMH or D-WMH in patients with AIS.

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Section: Discussionmentioning

confidence: 99%

Serum YKL-40 Levels and White Matter Hyperintensities in Patients with Acute Ischemic Stroke

Shi¹,

Ke²,

Gong³

et al. 2023

JIR

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“…In addition, this phenomenon is distinct from arteriovenous malformations, which result in physical shunts and may also play a role in white matter lesion pathophysiology. 51…”

Section: Discussionmentioning

confidence: 99%

Oxygen extraction efficiency and white matter lesion burden in older adults exhibiting radiological evidence of capillary shunting

Juttukonda

Stephens

Yen

et al. 2022

J Cereb Blood Flow Metab

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White matter lesions (WML) have been linked to cognitive decline in aging as well as in Alzheimer’s disease. While hypoperfusion is frequently considered a cause of WMLs due to the resulting reduction in oxygen availability to brain tissue, such reductions could also be caused by impaired oxygen exchange. Here, we tested the hypothesis that venous hyperintense signal (VHS) in arterial spin labeling (ASL) magnetic resonance imaging (MRI) may represent a marker of impaired oxygen extraction in aging older adults. In participants aged 60–80 years (n = 30), we measured cerebral blood flow and VHS with arterial spin labeling, maximum oxygen extraction fraction (OEFmax) with dynamic susceptibility contrast, and WML volume with T1-weighted MRI. We found a significant interaction between OEFmax and VHS presence on WML volume ( p = 0.02), where lower OEFmax was associated with higher WML volume in participants with VHS, and higher OEFmax was associated with higher WML volume in participants without VHS. These results indicate that VHS in perfusion-weighted ASL data may represent a distinct cerebrovascular aging pattern involving oxygen extraction inefficiency as well as hypoperfusion.

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“…However, venous white matter lesions may have symmetrical cloud patterns around bilateral periventricular (signal intensity is often lower than WMH). Multiple ischemic foci may be caused by asymptomatic cardiogenic embolism; cerebral amyloid angiopathy-related WMH may be unevenly distributed, but it is more likely to occur in the occipital lobe ( 76 ).…”

Section: Discussionmentioning

confidence: 99%

Research Progress on MRI for White Matter Hyperintensity of Presumed Vascular Origin and Cognitive Impairment

Meng

Jin

2022

Front. Neurol.

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White matter hyperintensity of presumed vascular origin (WMH) is a common medical imaging manifestation in the brains of middle-aged and elderly individuals. WMH can lead to cognitive decline and an increased risk of cognitive impairment and dementia. However, the pathogenesis of cognitive impairment in patients with WMH remains unclear. WMH increases the risk of cognitive impairment, the nature and severity of which depend on lesion volume and location and the patient's cognitive reserve. Abnormal changes in microstructure, cerebral blood flow, metabolites, and resting brain function are observed in patients with WMH with cognitive impairment. Magnetic resonance imaging (MRI) is an indispensable tool for detecting WMH, and novel MRI techniques have emerged as the key approaches for exploring WMH and cognitive impairment. This article provides an overview of the association between WMH and cognitive impairment and the application of dynamic contrast-enhanced MRI, structural MRI, diffusion tensor imaging, 3D-arterial spin labeling, intravoxel incoherent motion, magnetic resonance spectroscopy, and resting-state functional MRI for examining WMH and cognitive impairment.

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Pathogeneses and Imaging Features of Cerebral White Matter Lesions of Vascular Origins

Cited by 15 publications

References 148 publications

Serum YKL-40 Levels and White Matter Hyperintensities in Patients with Acute Ischemic Stroke

Serum YKL-40 Levels and White Matter Hyperintensities in Patients with Acute Ischemic Stroke

Oxygen extraction efficiency and white matter lesion burden in older adults exhibiting radiological evidence of capillary shunting

Research Progress on MRI for White Matter Hyperintensity of Presumed Vascular Origin and Cognitive Impairment

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