Pathologic Correlates of Increased Signals of the Centrum Ovale on Magnetic Resonance Imaging

Muñoz, David G.; Hastak, Shirish; Harper, B.; Lee, Donald; Hachinski, Vladimir

doi:10.1001/archneur.1993.00540050044013

Cited by 181 publications

(157 citation statements)

References 28 publications

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“…In line with the previous reports [15,20,21,50], the MRC-CFAS also showed that periventricular lesion severity was also associated with loss of ventricular ependyma, while for deep/subcortical white matter lesions arteriolar The sample of subjects with 3-year and 6-year follow-up scans comprised of 468 and 232 community-dwelling individuals aged 47-87 years a Lesion type refers to baseline MRI readings. Several subjects had more than one lesion type.…”

Section: Molecular Pathologysupporting

confidence: 82%

“…As can be derived from Table 3, it is important to distinguish between the punctate lesion type, and more widespread early confluent and confluent changes. Punctate hyperintensities are commonly of non-ischemic origin as their most common correlate is widening of periarteriolar spaces [15,20,21,50] accompanied by reduced myelination with atrophy of the neuropil around fibrohyalinotic arteries (Fig. 3c, d).…”

Section: Deep/subcortical Wmcmentioning

confidence: 99%

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Heterogeneity in age-related white matter changes

et al. 2011

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White matter changes occur endemically in routine magnetic resonance imaging (MRI) scans of elderly persons. MRI appearance and histopathological correlates of white matter changes are heterogeneous. Smooth periventricular hyperintensities, including caps around the ventricular horns, periventricular lining and halos are likely to be of non-vascular origin. They relate to a disruption of the ependymal lining with subependymal widening of the extracellular space and have to be differentiated from subcortical and deep white matter abnormalities. For the latter a distinction needs to be made between punctate, early confluent and confluent types. Although punctate white matter lesions often represent widened perivascular spaces without substantial ischemic tissue damage, early confluent and confluent lesions correspond to incomplete ischemic destruction. Punctate abnormalities on MRI show a low tendency for progression, while early confluent and confluent changes progress rapidly. The causative and modifying pathways involved in the occurrence of sporadic age-related white matter changes are still incompletely understood, but recent microarray and genome-wide association approaches increased the notion of pathways that might be considered as targets for therapeutic intervention. The majority of differentially regulated transcripts in white matter lesions encode genes associated with immune function, cell cycle, proteolysis, and ion transport. Genome-wide association studies identified six SNPs mapping to a locus on chromosome 17q25 to be related to white matter lesion load in the general population. We also report first and preliminary data that demonstrate apolipoprotein E (ApoE) immunoreactivity in white matter lesions and support epidemiological findings indicating that ApoE is another factor possibly related to white matter lesion occurrence. Further insights come from modern MRI techniques, such as diffusion tensor and magnetization transfer imaging, as they provide tools for the characterization of

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Section: Molecular Pathologysupporting

confidence: 82%

Section: Deep/subcortical Wmcmentioning

confidence: 99%

Heterogeneity in age-related white matter changes

et al. 2011

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“…However, there is a risk for overestimating lesions (78,79) and FLAIR may be less sensitive to the lesions in the posterior fossa (79). Although the sensitivity of T2 and PD channels for detecting WMLs was fairly high, the false negative rate was not negligible and was mainly associated with milder pathology (80,81). FLAIR sensitivity and specificity reported for PVWMLs was 95% (87-99%) and 71% (44-90%), and those for DWMLs were 86% (79-93%) and 80% (72-88%).…”

Section: Image Acquisitionmentioning

confidence: 93%

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Kim

MacFall

Payne

2008

Biological Psychiatry

434

415

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White matter lesions, commonly seen on magnetic resonance images of elderly people, are related to various geriatric disorders including cerebrovascular diseases, cardiovascular diseases, dementia, and psychiatric disorders. Currently, white matter lesions are divided into periventricular white matter lesions and deep white matter lesions. Although the meaning of these terms vary by study and this dichotomization itself is still in debate, a possible dissimilarity in pathogenic mechanisms between periventricular white matter lesions and deep white matter lesions are providing some clues for understanding pathophysiology of many geriatric syndromes associated with white matter lesions.We have reviewed the distinctions between periventricular white matter lesions and deep white matter lesions in terms of etiology, histopathology, functional correlates, and imaging methodologies. We suggest a new sub-classification of white matter lesions which may have better etiological and functional relevance than the current simple dichotomization. The new categories are juxtaventricular, periventricular, deep white, and juxtacortical. This new classification scheme may contribute to reducing the heterogeneity of white matter lesion findings in future research.

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“…Histopathologic findings in LA include demyelination, loss of glial cells (especially oligodendrocytes), axon damage, and spongiosis [2][3][4]. LA is thought to be due to insufficient blood supply to the cerebral deep white matter (DWM) due to vascular pathology [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Vascular dementia in leukoaraiosis may be a consequence of capillary loss not only in the lesions, but in normal-appearing white matter and cortex as well

Brown

Moody

Thore

et al. 2007

Journal of the Neurological Sciences

145

129

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We investigated capillary density in 12 subjects with leukoaraiosis (LA), in 9 age-matched normal subjects, in 7 cases of Alzheimer's disease (AD), and 4 after whole-brain irradiation for brain tumors. In the LA study (which as been published), autopsy brains were evaluated by MRI. The presence of LA was indicated by confluent or patchy areas of hyperintensity in the deep white matter. We employed a stereology method using computerized image processing and analysis to determine microvascular density. Afferent vessels (arterioles and capillaries, but not veins or venules) were stained for alkaline phosphatase in 100 μm thick celloidin sections. Microvascular density in LA lesions in the deep white matter (2.56%) was significantly lower than in the corresponding deep white matter of normal subjects (3.20%, p = 0.0180). LA subjects demonstrated decreased vascular density at early ages (55 -65 years) when compared to normal subjects. Our findings indicate that LA affects the brain globally, with capillary loss, although the parenchymal damage is found primarily in the deep white matter. In ongoing studies of the deep white matter in AD brains, we found a pattern of decreased vascular density compared to normal, as well as an age-related decline. In the four irradiated brains, we found very low vessel densities, similar to those found in LA, without an additional age-related decline.

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Pathologic Correlates of Increased Signals of the Centrum Ovale on Magnetic Resonance Imaging

Cited by 181 publications

References 28 publications

Heterogeneity in age-related white matter changes

Heterogeneity in age-related white matter changes

Classification of White Matter Lesions on Magnetic Resonance Imaging in Elderly Persons

Vascular dementia in leukoaraiosis may be a consequence of capillary loss not only in the lesions, but in normal-appearing white matter and cortex as well

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