Document Detail

Hypertension and cerebral diffusion tensor imaging in small vessel disease.
MedLine Citation:
PMID:  21030696     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Hypertension is a risk factor for cerebral small vessel disease, which includes white matter lesions (WML) and lacunar infarcts. These lesions are frequently observed on MRI scans of elderly people and play a role in cognitive decline. Preferably, one would like to evaluate the effect of hypertension before fluid-attenuated inversion recovery visible macrostructural lesions occur, possibly by investigating its effect on the microstructural integrity of the white matter. Diffusion tensor imaging provides measures of structural integrity.
METHODS: In 503 patients with small vessel disease, aged between 50 and 85 years, we cross-sectionally studied the relation between blood pressure, hypertension, and hypertension treatment status and diffusion tensor imaging parameters in both normal-appearing white matter (NAWM) and WMLs. All of the subjects underwent 1.5-T MRI and diffusion tensor imaging scanning. Fractional anisotropy and mean diffusivity were calculated in both NAWM and WMLs.
RESULTS: Increased blood pressure and hypertension were significantly related to lower fractional anisotropy in both NAWM and WMLs and to higher mean diffusivity in WMLs. For hypertensives, odds ratios for the risk of impaired microstructural integrity (fractional anisotropy) were 3.1 (95% CI: 1.8 to 5.7) and 2.1 (95% CI: 1.2 to 3.5) in NAWM and WMLs, respectively, compared with normotensives. Fractional anisotropy odds ratios for treated uncontrolled subjects were 6.5 (95% CI: 3.3 to 12.7) and 2.7 (95% CI: 1.5 to 5.1) in NAWM and WMLs, respectively, compared with normotensives.
CONCLUSIONS: Our data show that diffusion tensor imaging may be an appropriate tool to monitor the effect of blood pressure and the response to treatment on white matter integrity, probably even before the development of WMLs on fluid-attenuated inversion recovery.
Rob A R Gons; Karlijn F de Laat; Anouk G W van Norden; Lucas J B van Oudheusden; Inge W M van Uden; David G Norris; Marcel P Zwiers; Frank-Erik de Leeuw
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-28
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2801-6     Citation Subset:  IM    
Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Center for Neuroscience, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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MeSH Terms
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology
Cerebrovascular Disorders / pathology*
Cognition Disorders / pathology,  psychology
Cross-Sectional Studies
Diffusion Magnetic Resonance Imaging
Drug Resistance
Hypertension / drug therapy,  pathology*
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Middle Aged
Odds Ratio
Risk Factors
Smoking / epidemiology
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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