White Matter Hyperintensities in Young Patients from a Neurological Outpatient Clinic: Prevalence, Risk Factors, and Correlation with Enlarged Perivascular Spaces

Objective: To explore the correlation between enlarged perivascular spaces (EPVS) in the basal ganglia (BG-EPVS) and centrum semiovale (CSO-EPVS) and changes in adult brain cerebral blood flow (CBF). Methods: This cross-sectional single-center cohort study included individuals with varying degrees of EPVS, divided into the BG and CSO based on the established rating scale. Subsequently, the arterial spin labeling (ASL) sequence and its post-processing operation were utilized to obtain CBF values for different grades of BG-EPVS and CSO-EPVS. Logistic regression was conducted to identify risk factors associated with BG-EPVS and CSO-EPVS, and correlation analysis was employed to explore the associations between different grades of BG-EPVS and CSO-EPVS with CBF of the whole brain and specific regions of interest. Results: The regression analysis revealed that BG-EPVS was associated with age (odds ratio [OR]: 1.10, 95% confidence interval [CI]: 1.04-1.15), hypertension (4.91,1.55-15.6), and periventricular white matter hyperintensities (PVWMH) (4.34,1.46-12.95). Conversely, CSO-EPVS was linked to hypertension (4.40,1.43-13.57), drinking history (2.84,1.08-7.45), sleep duration (2.01,1.19-3.40), and PVWMH (12.20,3.83-38.85). Correlation analysis revealed a negative correlation between BG-EPVS and the CBF of the whole brain (r=-0.28, p=0.00) and most brain regions, except for the brain stem (r=-0.19, p=0.05). Conversely, CSO-EPVS was negatively correlated with CBF of temporal lobe white matter (r=-0.25, p=0.01); however, the significance was lost after FDR correction. CSO-EPVS was not correlated with CBF across various brain regions. Conclusion: Brain CBF decreased with the increasing severity of BG-EPVS, suggesting that BG-EPVS could serve as an imaging marker for reflecting the changes in brain CBF and an effective indicator for early ischemic stroke.

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Association between H-type Hypertension and White Matter Hyperintensity in Patients with Acute Ischemic Stroke

Zhu

Yang

Cao

et al. 2023

CNR

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Objective: White matter hyperintensity (WMH) is related to the increased risk of ischemic stroke. It is unclear if H-type hypertension(H-type HBP) is associated with periventricular WMH (PWMH) and deep WMH (DWMH) of acute ischemic stroke. This study investigated the correlation between H-type HBP and the severity of PWMH and DWMH in acute ischemic stroke. Methods: Consecutive patients with acute ischemic stroke were included in this cross-sectional observational study. The patients were divided into the following groups: the normal group, the simple hypertension group(Simple HBP), the simple hyperhomocysteinemia group(Simple HHcy) and the H-type HBP group. MR imaging and relevant clinical variables were obtained from the medical records. PWMH and DWMH were rated by using the Fazekas scale(score 0-3). All patients were defined to have moderate-severe PWMH or DWMH (score 2-3) and no or mild group (score 0-1). Multivariate binary logistic regression analysis was performed to determine the relationship between H-type HBP and the severity of PWMH and DWMH. Results: Among 542 patients, 227 had moderate-severe PWMH and 228 had moderate-severe DWMH. Compared to the no or mild group, patients with moderate-severe PWMH (median age: 73 vs. 63 years) and DWMH (median age: 70 vs. 65.5 years) were older. Compared to the no or mild group, moderate-severe PWMH and DWMH were associated with a history of ischemic stroke (moderate-severe PWMH vs. no or mild group 20.7% vs. 11.7%, p = 0.004；moderate-severe DWMH vs. no or mild group 20.2% vs. 12.1%, p = 0.010); We found that H-type HBP was an independent risk factor for PWMH(OR 2.64, 95% CI 1.34-5.21) and DWMH (OR 3.64, 95% CI 1.82-7.26) after adjusting for the effect of relevant risk factors. Conclusion: This study suggests that H-type HBP is associated with the severity of PWMH and DWMH in acute ischemic stroke patients, which deserves further prevention measures.

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White Matter Hyperintensities in Young Patients from a Neurological Outpatient Clinic: Prevalence, Risk Factors, and Correlation with Enlarged Perivascular Spaces

Cited by 4 publications

References 22 publications

White matter hyperintensity load mediates the relationship between age and cognition

White matter hyperintensity load mediates the relationship between age and cognition

Brain cerebral blood flow with MRI-visible enlarged perivascular space in adults

Association between H-type Hypertension and White Matter Hyperintensity in Patients with Acute Ischemic Stroke

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