Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated ...Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated with WMLs. Purpose The aim of this study was to investigate whether total cerebral blood flow (tCBF) is associated with the severity of white matter lesions (WMLs) in a large patient sample. Subjects and methods 228 patients with clinical symptoms of cardiovascular disease had MRI of the brain, consisting of a T2- w FLAIR and a 2D phasecontrast flow measurement of the internal carotid arteries and the basilar artery. WMLs were graded according to prevalence and size of deep and periventricular WMLs. To determine the relation between tCBF and WMLs we used linear and logistic regression analysis adjusted for age, gender, intima media thickness and hypertension. Results We observed an inverse association between the tCBF and the total number of WMLs adjusted for age, gender, intima media thickness and hypertension [B = - 1,0 WML 95 % CI (- 2.0 to 0.0, p = 0.045) per 100 mL increase in tCBF]. The adjusted odds ratio for the presence of severe WMLs in patients with high tCBF ( > 675 mL/min) was 0.5 (95% CI 0.2- 1.0) compared with patients with normal tCBF. Conclusion In this study we found that high tCBF is associated with a decrease in presence and severity of WMLs.展开更多
In contrast to earlier observations, recent studies have demonstrated that sup ratentorial lacunar infarcts in the white matter may cause mild neuropsychologic al impairments. The origin of these cognitive disturbance...In contrast to earlier observations, recent studies have demonstrated that sup ratentorial lacunar infarcts in the white matter may cause mild neuropsychologic al impairments. The origin of these cognitive disturbances is yet unknown. In th e current study proton magnetic resonance spectroscopy ( 1HMRS) was used to eluc idate the hypothesized relation between a lacunar infarct, metabolic alterations , and neuropsychological function. Patients with a single supratentorial lacunar infarct(n=26) were compared with patients with a mild myocardial infarct (n=12) and healthy controls (n=12) on a comprehensive neuropsychological examination, and on the N-acetyl-aspartate/creatine, choline/creatine and lactate/creatine ratios. The volume of interest of the MRI/MRS examination was locatedin normal- appearing white matter of the centrum semiovale ata distance from the infarct, i n both the ipsilateral and contralateral hemisphere. On neuropsychological exami nation patients with a lacunar infarct performed worse than both patients with a myocardial infarct and healthy controls. The N-acetyl-aspartate/creatine rati o was decreased in patients with a lacunar infarct compared with the other two g roups. More important,this decrease in neurometabolites was significantly correl ated to the level of cognitive functioning for the ipsilateral hemisphere and, a lthough to a lesser extent, for the contralateral hemisphere.We conclude that a single symptomatic lacunar infarct in the white matter is associated with (distant) disturbances in neuro metabolites and that this decrease is related to a reduced cognitive capacity.展开更多
文摘Background Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n = 20- 35) to determine whether flow is associated with WMLs. Purpose The aim of this study was to investigate whether total cerebral blood flow (tCBF) is associated with the severity of white matter lesions (WMLs) in a large patient sample. Subjects and methods 228 patients with clinical symptoms of cardiovascular disease had MRI of the brain, consisting of a T2- w FLAIR and a 2D phasecontrast flow measurement of the internal carotid arteries and the basilar artery. WMLs were graded according to prevalence and size of deep and periventricular WMLs. To determine the relation between tCBF and WMLs we used linear and logistic regression analysis adjusted for age, gender, intima media thickness and hypertension. Results We observed an inverse association between the tCBF and the total number of WMLs adjusted for age, gender, intima media thickness and hypertension [B = - 1,0 WML 95 % CI (- 2.0 to 0.0, p = 0.045) per 100 mL increase in tCBF]. The adjusted odds ratio for the presence of severe WMLs in patients with high tCBF ( > 675 mL/min) was 0.5 (95% CI 0.2- 1.0) compared with patients with normal tCBF. Conclusion In this study we found that high tCBF is associated with a decrease in presence and severity of WMLs.
文摘In contrast to earlier observations, recent studies have demonstrated that sup ratentorial lacunar infarcts in the white matter may cause mild neuropsychologic al impairments. The origin of these cognitive disturbances is yet unknown. In th e current study proton magnetic resonance spectroscopy ( 1HMRS) was used to eluc idate the hypothesized relation between a lacunar infarct, metabolic alterations , and neuropsychological function. Patients with a single supratentorial lacunar infarct(n=26) were compared with patients with a mild myocardial infarct (n=12) and healthy controls (n=12) on a comprehensive neuropsychological examination, and on the N-acetyl-aspartate/creatine, choline/creatine and lactate/creatine ratios. The volume of interest of the MRI/MRS examination was locatedin normal- appearing white matter of the centrum semiovale ata distance from the infarct, i n both the ipsilateral and contralateral hemisphere. On neuropsychological exami nation patients with a lacunar infarct performed worse than both patients with a myocardial infarct and healthy controls. The N-acetyl-aspartate/creatine rati o was decreased in patients with a lacunar infarct compared with the other two g roups. More important,this decrease in neurometabolites was significantly correl ated to the level of cognitive functioning for the ipsilateral hemisphere and, a lthough to a lesser extent, for the contralateral hemisphere.We conclude that a single symptomatic lacunar infarct in the white matter is associated with (distant) disturbances in neuro metabolites and that this decrease is related to a reduced cognitive capacity.
