Dirty-Appearing White Matter in the Brain is Associated with Altered Cerebrospinal Fluid Pulsatility and Hypertension in Individuals without Neurologic Disease
Dirty-Appearing White Matter in the Brain is Associated with Altered Cerebrospinal Fluid Pulsatility and Hypertension in Individuals without Neurologic Disease
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DOI：
10.1111/jon.12249
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发表时间：
2016-01-01
影响因子：
2.4
通讯作者：
Zivadinov, Robert
中科院分区：
文献类型：
--
作者：
Beggs, Clive B.;Magnano, Christopher;Zivadinov, Robert
背景和目的健康大脑的衰老特征是局灶性或非局灶性白质（WM）信号异常（SA）变化，通常被检测为脑白质疏松（LA）。高血压是 WM 病变形成的危险因素。本研究调查了 LA 是否可能与动脉高血压相关的脑脊液 (CSF) 搏动增加有关。 方法 共有 101 名年龄在 18 至 75 岁之间、无神经系统疾病的个体（53 名女性和 48 名男性）在知情同意后接受了 3T 脑部 MRI 和电影相位对比成像以估计 CSF 流量。 LA 被定义为存在局灶性 T2 WM SA 变化和/或信号增加的非局灶性均匀区域，称为脏白质 (DAWM)。还收集了与心血管危险因素相关的信息。 结果当控制年龄和高血压时，观察到以下之间存在显着的偏相关： DAWM 体积和： 净负流量 (r = -.294，P = .014)；净正流量 (NPF)（r = .406，P = .001）；和峰值正速度（r = .342，P = .004）。多元线性回归分析显示 DAWM 体积与 CSF NPF (P = .019) 和高血压 (P = .007) 显着相关，而 T2 WM SA 体积仅与年龄显着相关 (P = .002)。组合 DAWM 和 T2 WM SA 体积与年龄 (P = .001) 和 CSF 峰值负速度 (P = .041) 显着相关。结论 WM 减弱导致 LA 是一个多因素过程，其中高血压诱导的 DAWM 形成和脑导水管脑脊液搏动增加可能发挥促成作用。这两个因素似乎在一个与年龄无关的过程中彼此独立地发挥作用。
BACKGROUND AND PURPOSEAging of the healthy brain is characterized by focal or nonfocal white matter (WM) signal abnormality (SA) changes, which are typically detected as leukoaraiosis (LA). Hypertension is a risk factor for WM lesion formation. This study investigated whether LA might be associated with increased cerebrospinal fluid (CSF) pulsatility linked to arterial hypertension.METHODSA total of 101 individuals without neurologic diseases (53 females and 48 males) aged between 18 and 75 years underwent 3T brain MRI with cine phase contrast imaging for CSF flow estimation, after providing their informed consent. LA was defined as the presence of focal T2 WM SA changes and/or nonfocal uniform areas of signal increase termed dirty appearing white matter (DAWM). Relevant information relating to cardiovascular risk factors was also collected.RESULTSWhen controlled for age and hypertension, significant partial correlations were observed between: DAWM volume and: net negative flow (r = -.294, P = .014); net positive flow (NPF) (r = .406, P = .001); and peak positive velocity (r = .342, P = .004). Multiple linear regression analysis revealed DAWM volume to be significantly correlated with CSF NPF (P = .019) and hypertension (P = .007), whereas T2 WM SA volume was only significantly correlated with age (P = .002). Combined DAWM and T2 WM SA volumes were significantly related with age (P = .001) and CSF peak negative velocity (P = .041).CONCLUSIONSRarefaction of WM leading to LA is a multifactorial process, in which formation of DAWM induced by hypertension and increased aqueductal CSF pulsatility, may play a contributory role. These two factors appear to act independently of each other in a process that is independent of age.