Reduced Blood Flow in Normal White Matter Predicts Development of Leukoaraiosis. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Bernbaum, Manya; Menon, Bijoy K; Fick, Gordon; Smith, Eric E; Goyal, Mayank; Frayne, Richard; Coutts, Shelagh B
• Is Part Of: Journal of cerebral blood flow & metabolism. Volume 35:Issue 10(2015)
• Page Start: 1610
• Page End: 1615
• Publication Date: 2015-10
• Subjects: cerebral blood flow -- leukoaraiosis -- white matter hyperintensities; Cerebral circulation -- Periodicals; Brain -- Metabolism -- Periodicals; Brain -- Blood-vessels -- Periodicals; Cerebrovascular disease -- Periodicals; 612.824
• DOI: 10.1038/jcbfm.2015.92
• Languages: English
• ISSNs: 0271-678X

Abstract

The purpose of this study was to investigate whether low cerebral blood flow (CBF) is associated with subsequent development of white matter hyperintensities (WMH). Patients were included from a longitudinal magnetic resonance (MR) imaging study of minor stroke/transient ischemic attack patients. Images were co-registered and new WMH at 18 months were identified by comparing follow-up imaging with baseline fluid-attenuated inversion recovery (FLAIR). Regions-of-interest (ROIs) were placed on FLAIR images in one of three categories: (1) WMH seen at both baseline and follow-up imaging, (2) new WMH seen only on follow-up imaging, and (3) regions of normal-appearing white matter at both time points. Registered CBF maps at baseline were used to measure CBF in the ROIs. A multivariable model was developed using mixed-effects logistic regression to determine the effect of baseline CBF on the development on new WMH. Forty patients were included. Mean age was 61 ± 11 years, 30% were female. Low baseline CBF, female sex, and presence of diabetes were independently associated with the presence of new WMH on follow-up imaging. The odds of having new WMH on follow-up imaging reduces by 0.61 (95% confidence interval = 0.57 to 0.65) for each 1 mL/100 g per minute increase in baseline CBF. We conclude that regions of white matter with low CBF develop new WMH on follow-up imaging.