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White matter hypertensities

Freddy J Alfaro, Vasileios-Arsenios Lioutas, Daniela A Pimentel, Chen-Chih Chung, Francisco Bedoya, Woo-Kyoung Yoo, Vera Novak
Subjects with metabolic syndrome (MetS) often show worse cognitive performance compared with the healthy population. We investigated whether microstructural white matter abnormalities are associated with cognitive performance in adults with MetS using diffusion tensor MR imaging. A total of 32 subjects with MetS (age 64.8 ± 7.8, 56.25 % female) and 23 age-, gender-, and education-matched healthy controls completed a battery of neuropsychological tests and diffusion tensor imaging (DTI) at 3-T MRI. Brain global and regional volumes, white matter fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (LD) were calculated...
October 11, 2016: Journal of Neurology
Reshmi Srinath, Rebecca F Gottesman, Sherita Hill Golden, Kathryn A Carson, Adrian Dobs
BACKGROUND AND PURPOSE: Epidemiological studies in men suggest a relationship between endogenous testosterone and ischemic vascular events. We hypothesized that low testosterone is independently associated with ischemic stroke and ischemic brain changes. METHODS: In 1558 male participants (mean [SD] age, 63.1 [5.6] years; body mass index, 28.2 [4.3] kg/m(2)) from visit 4 (1996-1998) of the ARIC study (Atherosclerosis Risk in Communities) without cardiovascular disease, stroke, and previous testosterone therapy, we measured plasma total testosterone by liquid chromatography mass spectrometry using morning samples and divided levels into tertiles (median [25th-75th percentile], 377...
October 11, 2016: Stroke; a Journal of Cerebral Circulation
Song Yang, Jing Cai, Rulan Lu, Jian Wu, Min Zhang, Xianju Zhou
OBJECTIVE: Chronic kidney disease (CKD) is associated with cerebral small vessel disease (cSVD). However, the relationship between serum cystatin C (CysC) level, a highly sensitive marker of impaired kidney function, and cSVD has not been fully understood. This study aimed to investigate the association between serum CysC level and total burden of cSVD on magnetic resonance imaging (MRI) in patients with acute lacunar stroke. MATERIALS AND METHODS: A total of 210 patients with first-ever acute lacunar stroke occurring within 1 week after onset were included in this study...
October 7, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Lixia Zong, Ming Yao, Jun Ni, Lixin Zhou, Jing Yuan, Bin Peng, Yi-Cheng Zhu, Liying Cui
BACKGROUND: Previous studies suggested the potential interactions between cerebrovascular diseases and impaired renal function. However, the relationship between renal function and white matter hyperintensity (WMH), marker of cerebral small vessel disease, in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) remains unknown. METHODS: We consecutively enrolled 1632 subjects with AIS or TIA who underwent brain MRI for this analysis. The severity of WMH in both of periventricular (PVH) and deep subcortical white matter (SDWMH) was evaluated using Fazekas scale...
October 6, 2016: BMC Neurology
Koichi Shibata, Yoshiko Nishimura, Kuniaki Otsuka, Hiroshi Sakura
AIM: We investigated the characteristics of elderly medical patients with white matter hyperintensities on magnetic resonance imaging. METHODS: A total of 213 patients (123 men and 90 women; mean age 74.8 years) reported their history of hypertension, diabetes, dyslipidemia, previous stroke, coronary heart disease and chronic kidney disease (CKD). All patients completed the Mini-Mental State Examination and Geriatric Depression Scale. White matter hyperintensities were evaluated for the periventricular region, basal ganglia (BGH), deep white matter and infratentorial region, and brain atrophy was calculated as bicaudate ratios...
September 29, 2016: Geriatrics & Gerontology International
Marianna Bugiani, Sietske H Kevelam, Hannah S Bakels, Quinten Waisfisz, Chantal Ceuterick-de Groote, Hans W M Niessen, Truus E M Abbink, Saskia A M J Lesnik Oberstein, Marjo S van der Knaap
OBJECTIVE: To characterize the clinical and MRI features of 2 families with adult-onset dominant leukoencephalopathy and strokes and identify the underlying genetic cause. METHODS: We applied MRI pattern recognition, whole-exome sequencing, and neuropathology. RESULTS: Based on brain imaging, 13 family members of 40 years or older from 2 families were diagnosed with the disease; in 11 family members of the same age, MRI was normal. In the affected family members, MRI showed a leukoencephalopathy that was disproportionately severe compared to the clinical disease...
September 24, 2016: Neurology
Julia Kim, Tom A Schweizer, Corinne E Fischer, David G Munoz
BACKGROUND: The pathophysiology behind psychosis in patients with Alzheimer's disease (AD) remains unknown. Vascular risk factors have been recognized as an important modifier of the clinical presentation of AD. OBJECTIVE: The purpose of our study is to investigate the mechanism through which vascular risk factors mediate psychosis and whether or not it involves cerebrovascular lesions. METHODS: Data was provided by the National Alzheimer's Coordinating Centre...
September 21, 2016: Journal of Alzheimer's Disease: JAD
Jean-Philippe David, Emilie Ferrat, Juliette Parisot, Henri Naga, Samia Lakroun, Feriel Menasria, Sofiane Saddedine, Pierre-André Natella, Elena Paillaud, Isabelle Fromentin, Sylvie Bastuji-Garin
BACKGROUND: To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes. METHODS: Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis...
September 21, 2016: Dementia and Geriatric Cognitive Disorders
Yuda Turana
Observational studies have conveyed the connection between hypertension and cognitive impairment. Several forms of dementia are more frequent in hypertensive subjects or those with previous history of hypertension compared to subjects with normal blood pressure.In many studies, hypertension occuring in mid-life is a risk factor of dementia occuring in later age. Long-standing hypertension will induce structural damages in the brain. It is also widely known that hypertension attributes to small vessel diseases causing lacunar infarcts and white matter lesions associated with cognitive decline...
September 2016: Journal of Hypertension
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Pingjin Gao, Dingliang Zhu
OBJECTIVE: Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). We hereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population...
September 2016: Journal of Hypertension
Julia A Scott, Meredith N Braskie, Duygu Tosun, Pauline Maillard, Paul M Thompson, Michael Weiner, Charles DeCarli, Owen T Carmichael
Cross-sectional studies show that elevated cerebral amyloid is associated with greater white-matter hyperintensity (WMH) burden in cognitively normal (CN) older adults. However, the relative time courses of amyloid and WMH accrual are unclear. To address this, we tested the associations between known WMH correlates-age, hypertension, and amyloid-with WMH accrual rate. We used brain magnetic resonance imaging to measure WMH change in 112 CN Alzheimer's Disease Neuroimaging Initiative (GO/2) participants over a 2-year period...
August 24, 2016: Neurobiology of Aging
M L P Portegies, P J Koudstaal, M A Ikram
With 16.9 million people who suffered a first-ever stroke in 2010 worldwide, stroke is a very common vascular disease. Epidemiologic studies have played an essential role in assessing this burden and in detecting the risk factors for stroke. Primary prevention of these risk factors, primarily hypertension, smoking, diabetes, and atrial fibrillation, has reduced the incidence in high-income countries. However, stroke remains a major cause of death and disability, and therefore research should be continued. Subarachnoid hemorrhages are less prevalent than strokes but have an even higher risk of death...
2016: Handbook of Clinical Neurology
Jack McCain
Dr. White, known worldwide as an expert in the use of 24-hour ambulatory blood pressure monitoring (ABPM), discusses hypertension, the importance of accurate measurement, and the utility of ABPM for effective diagnoses and treatment.
September 2016: P & T: a Peer-reviewed Journal for Formulary Management
Yeo Jin Kim, Hee Jin Kim, Jae-Hyun Park, Seonwoo Kim, Sook-Young Woo, Ki-Chang Kwak, Jong Min Lee, Na-Yeon Jung, Jae Seung Kim, Yearn Seong Choe, Kyung-Han Lee, Seung Hwan Moon, Jae-Hong Lee, Yun Joong Kim, David J Werring, Duk L Na, Sang Won Seo
OBJECTIVE: To determine whether amyloid and hypertensive cerebral small vessel disease (hCSVD) changes synergistically affect the progression of lobar microbleeds in patients with subcortical vascular mild cognitive impairment (svMCI). METHODS: Among 72 patients with svMCI who underwent brain MRI and [(11)C] Pittsburgh compound B (PiB)-PET, 52 (72.2%) completed the third year of follow-up. These patients were evaluated by annual neuropsychological testing, brain MRI, and follow-up PiB-PET...
September 14, 2016: Neurology
Chih-Ping Chung, Kun-Hsien Chou, Wei-Ta Chen, Li-Kuo Liu, Wei-Ju Lee, Liang-Kung Chen, Ching-Po Lin, Pei-Ning Wang
BACKGROUND AND PURPOSE: Different distributions of cerebral microbleeds (CMBs) are associated with distinct pathological mechanisms. Lobar CMBs are thought to be related to cerebral amyloid angiopathy, whereas deep or infratentorial CMBs are related to hypertensive vasculopathy. The present study aimed to evaluate the effects of CMBs and their locations on a variety of cognitive domains. METHODS: Study subjects were selected from the community-based I-Lan Longitudinal Aging Study...
October 2016: Stroke; a Journal of Cerebral Circulation
Martin Seule, Rimmon Isaak, Renan Sanchez-Porras, Oliver Sakowitz, Emanuela Keller, Andreas Unterberg, Berk Orakcioglu
BACKGROUND: Bedside monitoring of cerebral blood flow (CBF) may provide new insights into the pathophysiology of brain injury, allow early detection of secondary ischemia, and help guide therapy. OBJECTIVE: To evaluate a new brain tissue probe for serial CBF monitoring using near-infrared spectroscopy and indocyanine green dye dilution (NeMo Probe) compared with the existing thermal diffusion probe (QFlow 500 Probe). METHODS: In 7 pigs, the NeMo Probe and QFlow 500 Probe were inserted into the subcortical white matter...
September 9, 2016: Neurosurgery
Fang-Chi Hsu, Mingxia Yuan, Donald W Bowden, Jianzhao Xu, S Carrie Smith, Lynne E Wagenknecht, Carl D Langefeld, Jasmin Divers, Thomas C Register, J Jeffrey Carr, Jeff D Williamson, Kaycee M Sink, Joseph A Maldjian, Barry I Freedman
AIMS: To assess associations between body mass index (BMI), waist circumference (WC), and computed tomography-determined volumes of pericardial, visceral, and subcutaneous adipose tissue with magnetic resonance imaging-(MRI) based cerebral structure and cognitive performance in individuals with type 2 diabetes (T2D). METHODS: This study was performed in 348 African Americans (AAs) and 256 European Americans (EAs) with T2D. Associations between adiposity measures with cerebral volumes of white matter (WMV), gray matter (GMV), white matter lesions, hippocampal GMV, and hippocampal WMV, cognitive performance and depression were examined using marginal models incorporating generalized estimating equations...
November 2016: Journal of Diabetes and its Complications
Anine H Stam, Parul H Kothari, Aisha Shaikh, Andreas Gschwendter, Joanna C Jen, Suzanne Hodgkinson, Todd A Hardy, Michael Hayes, Peter A Kempster, Katya E Kotschet, Ingeborg M Bajema, Sjoerd G van Duinen, Marion L C Maat-Schieman, Paulus T V M de Jong, Marc D de Smet, Didi de Wolff-Rouendaal, Greet Dijkman, Nadine Pelzer, Grant R Kolar, Robert E Schmidt, JoAnne Lacey, Daniel Joseph, David R Fintak, M Gilbert Grand, Elizabeth M Brunt, Helen Liapis, Rula A Hajj-Ali, Mark C Kruit, Mark A van Buchem, Martin Dichgans, Rune R Frants, Arn M J M van den Maagdenberg, Joost Haan, Robert W Baloh, John P Atkinson, Gisela M Terwindt, Michel D Ferrari
Cerebroretinal vasculopathy, hereditary vascular retinopathy, and hereditary endotheliopathy, retinopathy, nephropathy and stroke are neurovascular syndromes initially described as distinct entities. Recently they were shown to be one disease caused by C-terminal frame-shift mutations in TREX1, which was termed 'retinal vasculopathy with cerebral leukodystrophy'. Here we defined the genetic and clinicopathologic spectrum of this clinically and pathophysiologically poorly characterized and frequently misdiagnosed fatal neurovascular disorder...
September 6, 2016: Brain: a Journal of Neurology
Saima Hilal, Emiel Sikking, Muhammad Amin Shaik, Qun Lin Chan, Susanne J van Veluw, Henri Vrooman, Ching-Yu Cheng, Charumathi Sabanayagam, Carol Y Cheung, Tien Yin Wong, Narayanaswamy Venketasubramanian, Geert Jan Biessels, Christopher Chen, Mohammad Kamran Ikram
OBJECTIVE: We examined the risk factors of cortical cerebral microinfarcts (CMIs) on 3T MRI and their association with cognitive impairment. METHODS: Participants (aged 60 years and older) from the multiethnic Epidemiology of Dementia In Singapore Study underwent detailed neuropsychological testing and 3T brain MRI. Cortical CMIs were graded using a previously validated protocol. Cognitive impairment was categorized into cognitive impairment, no dementia (CIND)-mild, CIND-moderate, and dementia...
September 2, 2016: Neurology
Fumi Kobayashi, Hidetaka Kato, Miki Suzuki, Ryosuke Usui, Minako Koike, Takashi Ohashi
A 23-year-old woman presented with disturbance of consciousness and seizure. Her blood pressure was remarkably high, and brain magnetic resonance imaging (MRI) showed high-intensity T2 signals in the bilateral basal ganglia, corpus callosum, cerebral white matter, and cortex. With the administration of angiotensin II receptor blocker, the symptoms and MRI findings improved, along with normalization of blood pressure, and a diagnosis of posterior reversible leukoencephalopathy syndrome (PRES) was made. Plasma renin activity was high, and the right kidney was severely atrophic...
September 29, 2016: Rinshō Shinkeigaku, Clinical Neurology
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