White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination

Tullberg, Mats; Hultin, Leif; Ekholm, Sven; Månsson, Jan‐Eric; Fredman, Pam; Wikkelsø, Carsten

doi:10.1034/j.1600-0404.2002.01189.x

Cited by 117 publications

(90 citation statements)

References 33 publications

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“…WMLs were also found to be associated with cortical atrophy and cortical hypometabolism in both dementia patients and normal elderly (24,46,47). The regional cerebral blood volume (rCBV) was also correlated with the volume of WMLs in the same lobe.…”

Section: Histopathologic Correlatesmentioning

confidence: 93%

“…The disruption of subcorticalcortical connections by WMLs may be detrimental to cortical gray matter integrity and result in cognitive and emotional dysfunctions. Although executive function can be impaired by WMLs regardless to their locations due to substantial convergence of fiber pathways on the frontal lobes (24), neurobehavioral conditions associated with WMLs were not uniform by the location of WMLs. The risk of dementia (15,20) and severity of cognitive impairment in demented patients (34) were preferentially associated with PVWML rather than DWML.…”

Section: Functional Correlatesmentioning

confidence: 95%

“…Furthermore, WMLs are related to various geriatric disorders: cerebrovascular diseases (11)(12)(13), cardiovascular diseases (1,9,14), dementia (15)(16)(17), psychiatric disorders such as major depressive disorder (18)(19)(20), bipolar disorder (21), and schizophrenia (22), neurologic disorders such as multiple sclerosis (23) and normal pressure hydrocephalus (24), and inflammatory diseases such as systemic lupus erythematosus (25). Therefore, the presence, form and severity of WMLs may provide additional characterization of aging, pathophysiology of geriatric disorders, and the relation between aging and geriatric disorders.…”

Section: Introductionmentioning

confidence: 99%

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

Kim

MacFall

Payne

2008

Biological Psychiatry

433

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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Section: Histopathologic Correlatesmentioning

confidence: 93%

Section: Functional Correlatesmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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

Kim

MacFall

Payne

2008

Biological Psychiatry

433

415

View full text Add to dashboard Cite

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“…[28][29][30] Furthermore, postoperative reduction of WMLs in iNPH correlates with clinical improvement. 31,32 It is thus possible that clinical improvement after shunt surgery is attributable to reversal of white matter changes.…”

mentioning

confidence: 99%

“…It has been shown that shunt surgery improves symptoms in those with coexisting iNPH and dementia due to extensive white matter disease, 39 and white matter changes are reduced following CSF drainage. 31,32,39 Another main limitation was the use of CT. WMLs are better visualized with MRI and were rated in a rather crude way. Several of the CT scans were made using imaging techniques that are inferior to modern standards and we were thus unable to quantify volume of WMLs or analyze blood flow.…”

mentioning

confidence: 99%

Vascular factors in suspected normal pressure hydrocephalus

et al. 2016

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Objective: We examined clinical and imaging findings of suspected idiopathic normal pressure hydrocephalus (iNPH) in relation to vascular risk factors and white matter lesions (WMLs), using a nested case-control design in a representative, population-based sample.Methods: From a population-based sample, 1,235 persons aged 70 years or older were examined with CT of the brain between 1986 and 2000. We identified 55 persons with hydrocephalic ventricular enlargement, i.e., radiologic findings consistent with iNPH. Among these, 26 had clinical signs that fulfilled international guideline criteria for probable iNPH. These cases were labeled suspected iNPH. Each case was matched to 5 controls from the same sample, based on age, sex, and study cohort. Data on risk factors were obtained from clinical examinations and the Swedish Hospital Discharge Register. History of hypertension, diabetes mellitus (DM), smoking, overweight, history of coronary artery disease, stroke/TIA, and WMLs on CT were examined. Risk factors associated with iNPH with a p value ,0.1 in x 2 tests were included in conditional logistic regression models. Idiopathic normal pressure hydrocephalus (iNPH) is probably more common than previously supposed. We have recently reported that 5.9% of persons older than 80 years have this disorder. 1 Treatment with shunt surgery improves symptoms in more than 80% of patients. 2 Despite this, iNPH is underdiagnosed and undertreated.1,3 Furthermore, little is known about the underlying disease mechanisms. It is important to learn more about risk factors for the disease in order to understand pathophysiologic mechanisms and suggest preventive measures. Vascular risk factors, such as hypertension, diabetes, and ischemic heart disease, have previously been associated with iNPH in hospital-based, case-control studies.4-9 Also, cerebral white matter lesions (WMLs), which are associated with small vessel disease and white matter ischemia, 10 are common in iNPH. 11,12 It has therefore been suggested that vascular mechanisms may be related to the development of iNPH. However, previous studies on risk factors have not been population-based. Furthermore, there are no previous epidemiologic investigations regarding WMLs in iNPH.

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