Document Detail


White matter hyperintensity penumbra.
MedLine Citation:
PMID:  21636811     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: White matter hyperintensities (WMHs) are associated with progressive age-related cognitive decline and cardiovascular risk factors, but their biological relevance as indicators of generalized white matter injury is unclear. Diffusion tensor imaging provides more sensitive indications of subtle white matter disruption and can therefore clarify whether WMHs represent foci of generalized white matter damage that extends over a broader neighborhood.
METHODS: Two hundred eight participants from the University of California, Davis Alzheimer's Disease Center received a comprehensive clinical evaluation and brain MRI including fluid-attenuated inversion recovery and diffusion tensor imaging sequences. Voxelwise maps of WMHs were produced from fluid-attenuated inversion recovery using a standardized WMH detection protocol. Fractional anisotropy maps were calculated from diffusion tensor imaging. All WMH and fractional anisotropy maps were coregistered to a standardized space. For each normal-appearing white matter voxel in each subject fluid-attenuated inversion recovery scan, a neighborhood white matter injury score was calculated that increased with increasing number and proximity of WMH in the vicinity of the normal-appearing white matter voxel. Fractional anisotropy was related to neighborhood white matter injury using a nonlinear mixed effect model controlling for relevant confounding factors.
RESULTS: Fractional anisotropy was found to decrease as neighborhood white matter injury increased (β = -0.0017/%, P < 0.0001) with an accelerated rate (P < 0.0001) for neighborhood white matter injury >0.4. An increase of 1% in neighborhood white matter injury score was associated with a decrease in mean fractional anisotropy of 0.012 (P < 0.001).
CONCLUSIONS: WMH may represent foci of more widespread and subtle white matter changes rather than distinct, sharply delineated anatomic abnormalities. We use the term white matter hyperintensities penumbra to explain this phenomenon.
Authors:
Pauline Maillard; Evan Fletcher; Danielle Harvey; Owen Carmichael; Bruce Reed; Dan Mungas; Charles DeCarli
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-06-02
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-28     Completed Date:  2011-09-09     Revised Date:  2012-05-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1917-22     Citation Subset:  IM    
Affiliation:
Department of Neurology and Center for Neuroscience, School of Medicine, University of California, Davis, Davis, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anisotropy
Brain / pathology*
Cardiology
Cardiovascular Diseases / diagnosis
Case-Control Studies
Cognition Disorders / pathology
Diffusion Tensor Imaging / methods
Female
Humans
Leukoencephalopathies / pathology*
Magnetic Resonance Imaging / methods
Male
Middle Aged
Risk
Grant Support
ID/Acronym/Agency:
K01 AG030514/AG/NIA NIH HHS; K01 AG030514/AG/NIA NIH HHS; K01 AG030514-04/AG/NIA NIH HHS; P30 AG010129/AG/NIA NIH HHS; R01 AG 031563/AG/NIA NIH HHS; R01 AG010220/AG/NIA NIH HHS; R01 AG021028/AG/NIA NIH HHS

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


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