Spatial distribution of white-matter hyperintensities in Alzheimer disease, cerebral amyloid angiopathy, and healthy aging
Spatial distribution of white-matter hyperintensities in Alzheimer disease, cerebral amyloid angiopathy, and healthy aging
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DOI：
10.1161/strokeaha.107.497438
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发表时间：
2008-04-01
期刊：
影响因子：
8.3
通讯作者：
Greenberg, Steven M.
中科院分区：
文献类型：
--
作者：
Holland, Christopher M.;Smith, Eric E.;Greenberg, Steven M.
背景和目的-磁共振成像检测到的白质高信号(WMH)被认为代表了脑小血管疾病和神经退行性变化的影响。我们试图确定WMHs的空间分布是否在不同疾病组和健康老年人之间存在差异，以及这些分布是否与局部脑血流灌注模式有关。方法-我们通过T2/液体衰减反转恢复加权磁共振成像检查了3组受试者的WMHs模式：脑淀粉样血管病(n=32)、阿尔茨海默病或轻度认知障碍(n=41)和健康老龄化(n=29)。计算每组的WMH频率图，并用体素Logistic回归分析比较其空间分布。结果：尽管脑淀粉样血管病和阿尔茨海默病/轻度认知障碍患者的WMH体积大于健康老年人，但在控制总WMH体积时，WMH体积在空间分布上没有一致的差异。3组脑室周围深部白质均以高信号为主。高信号频率与正常脑血流灌注呈显著负相关，提示WMH多见于正常脑血流灌注相对较低的区域。结论-WMH在脑WM区域表现出共同的分布模式和倾向，无论其基础诊断是什么。这些数据表明，在不同的疾病过程中，WM损伤可能以一种反映潜在组织属性的模式发生，例如相对灌注。
Background and Purpose - White-matter hyperintensities (WMHs) detected by magnetic resonance imaging are thought to represent the effects of cerebral small-vessel disease and neurodegenerative changes. We sought to determine whether the spatial distribution of WMHs discriminates between different disease groups and healthy aging individuals and whether these distributions are related to local cerebral perfusion patterns.Methods - We examined the pattern of WMHs by T2/fluid-attenuated inversion recovery-weighted magnetic resonance imaging in 3 groups of subjects: cerebral amyloid angiopathy (n = 32), Alzheimer disease or mild cognitive impairment (n = 41), and healthy aging (n = 29). WMH frequency maps were calculated for each group, and spatial distributions were compared by voxel-wise logistic regression. WMHs were also analyzed as a function of normal cerebral perfusion patterns by overlaying a single photon emission computed tomography atlas.Results - Although WMH volume was greater in cerebral amyloid angiopathy and Alzheimer disease/mild cognitive impairment than in healthy aging, there was no consistent difference in the spatial distributions when controlling for total WMH volume. Hyperintensities were most frequent in the deep periventricular WM in all 3 groups. A strong inverse correlation between hyperintensity frequency and normal perfusion was demonstrated in all groups, demonstrating that WMHs were most common in regions of relatively lower normal cerebral perfusion.Conclusions - WMHs show a common distribution pattern and predilection for cerebral WM regions with lower atlas-derived perfusion, regardless of the underlying diagnosis. These data suggest that across diverse disease processes, WM injury may occur in a pattern that reflects underlying tissue properties, such as relative perfusion.