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Wurst Z, Birčák Kuchtová B, Křemen J, Lahutsina A, Ibrahim I, Tintěra J, Bartoš A, Brabec M, Rai T, Zach P, Musil V, Olympiou N, Mrzílková J. Basal Ganglia Compensatory White Matter Changes on DTI in Alzheimer's Disease. Cells 2023; 12:cells12091220. [PMID: 37174620 PMCID: PMC10177535 DOI: 10.3390/cells12091220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
The volume reduction of the gray matter structures in patients with Alzheimer's disease is often accompanied by an asymmetric increase in the number of white matter fibers located close to these structures. The present study aims to investigate the white matter structure changes in the motor basal ganglia in Alzheimer's disease patients compared to healthy controls using diffusion tensor imaging. The amounts of tracts, tract length, tract volume, quantitative anisotropy, and general fractional anisotropy were measured in ten patients with Alzheimer's disease and ten healthy controls. A significant decrease in the number of tracts and general fractional anisotropy was found in patients with Alzheimer's disease compared to controls in the right caudate nucleus, while an increase was found in the left and the right putamen. Further, a significant decrease in the structural volume of the left and the right putamen was observed. An increase in the white matter diffusion tensor imaging parameters in patients with Alzheimer's disease was observed only in the putamen bilaterally. The right caudate showed a decrease in both the diffusion tensor imaging parameters and the volume in Alzheimer's disease patients. The right pallidum showed an increase in the diffusion tensor imaging parameters but a decrease in volume in Alzheimer's disease patients.
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Affiliation(s)
- Zdeněk Wurst
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Barbora Birčák Kuchtová
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jan Křemen
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Anastasiya Lahutsina
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Ibrahim Ibrahim
- Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech Republic
| | - Jaroslav Tintěra
- Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech Republic
| | - Aleš Bartoš
- Department of Neurology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Marek Brabec
- Department of Statistical Modeling, Institute of Computer Science, Academy of Sciences of the Czech Republic, Pod Vodarenskou vezi 271/2, 182 07 Prague, Czech Republic
| | - Tanya Rai
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Petr Zach
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Vladimír Musil
- Centre of Scientific Information, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Nicoletta Olympiou
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
| | - Jana Mrzílková
- Department of Anatomy, Third Faculty of Medicine, Charles University, Ruska 87, 100 00 Prague, Czech Republic
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Zhong T, Qi Y, Li R, Zhou H, Ran B, Wang J, Cai Z. Contribution of intracranial artery stenosis to white matter hyperintensities progression in elderly Chinese patients: A 3-year retrospective longitudinal study. Front Neurol 2022; 13:922320. [PMID: 36212654 PMCID: PMC9539973 DOI: 10.3389/fneur.2022.922320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposeThere have been controversial results in previous studies for the association between intracranial artery stenosis (ICAS) and white matter hyperintensities (WMHs), and the correlation of ICAS with the progression of WMHs is uncertain. The aim of this study was to investigate the association between ICAS and the progression of WMHs.MethodsIn this retrospective longitudinal study, we enrolled 302 patients aged 60 years and older who had received two brain MRI scans with a 3-year interval and was examined by CTA in the first MRI scan. We measured the stenosis of major intracranial arteries by CTA and assessed the progression of WMHs using the modified Rotterdam Progression scale (mRPS). We performed binary logistic regression analyses and established linear regression model to determine the relationship between the degree of ICAS and the progression of WMHs.ResultsA total of 302 patients were enrolled, of which 48.3% experienced WMHs progression. After adjustment for confounding factors, the patients with Grade 2 ICAS had an OR of 2.8 (95% CI 1.4–5.5), and those with Grade 3 ICAS had an OR of 3.0 (95% CI 1.2–7.3) for the progression of WMHs. The ICAS degree remained associated with PVWMHs but had an attenuated relation to SCWMHs. ICAS severity was significantly associated with WMHs progression scores, higher for Grade 3 ICAS [β (SE) = 0.18 (0.18)] followed by Grade 2 ICAS [β (SE) = 0.10 (0.15)] compared with Grade 1 ICAS.ConclusionsPatients with more severe ICAS are more likely to have WMHs progression and have distinct relevancy to PVWMHs and SCWMHs, which may provide clues for understanding mechanisms of WMHs progression.
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Affiliation(s)
- Tingting Zhong
- Chongqing Medical University, Chongqing, China
- Department of Cardiology, Chongqing General Hospital, Chongqing, China
- Department of Neurology, Chongqing General Hospital, Chongqing, China
- Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, China
| | - Yunwen Qi
- Chongqing Medical University, Chongqing, China
- Department of Neurology, Chongqing General Hospital, Chongqing, China
- Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, China
| | - Rui Li
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Huadong Zhou
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Boli Ran
- Department of Cardiology, Chongqing General Hospital, Chongqing, China
| | - Jiao Wang
- Department of Cardiology, Chongqing General Hospital, Chongqing, China
| | - ZhiYou Cai
- Chongqing Medical University, Chongqing, China
- Department of Neurology, Chongqing General Hospital, Chongqing, China
- Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, China
- *Correspondence: ZhiYou Cai
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Wang J, Li R, Liu M, Nie Z, Jin L, Lu Z, Li Y. Impaired cerebral hemodynamics in late-onset depression: computed tomography angiography, computed tomography perfusion, and magnetic resonance imaging evaluation. Quant Imaging Med Surg 2020; 10:1763-1774. [PMID: 32879855 DOI: 10.21037/qims-19-402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Late-onset depression (LOD) is often difficult to recognize when there is an absence of a family history of depression and less severe psychopathology. Increasing evidence has shown that the development and course of LOD symptomatology are associated with cerebrovascular comorbidities and cerebral microvascular lesions. This study was designed to evaluate the associations of LOD with macrovascular and microvascular changes in the brain by using a multi-imaging method, including computed tomography angiography (CTA), CT perfusion (CTP), and magnetic resonance imaging (MRI), to explore the course and pathomechanism of LOD. Methods A total of 116 participants were divided into two groups. Participants older than 60 years who met the diagnostic criteria of depression [International Classification of Diseases (ICD), 10th Edition] were enrolled in the LOD group, and the remainder were age- and sex-matched into the control group. The cognitive/mood status of all participants was evaluated by an experienced neuropsychologist. Global and regional mean cerebral blood flow (CBF) were measured by CT cerebrovascular perfusion imaging; the stenosis of the bilateral intracranial large arteries (internal carotid artery, anterior cerebral artery, middle cerebral artery, posterior cerebral artery, and vertebral artery) was recorded by CTA; regional white matter hyperintensity (WMH) loads were evaluated by fluid-attenuated inversion recovery (FLAIR) MRI; and the Hamilton Depression Scale (HAMD) was used to evaluate depression status. Results Our key findings were the following: (I) participants in the LOD group were more prone to intracranial arterial stenosis (81.1% vs. 74.6%), had more severe stenotic arteries compared with controls (Z=2.024, P<0.05), and significantly more participants with LOD had severe stenosis of the middle cerebral artery (MCA) (9.4% vs. 0%, P<0.05); (II) there was a significant difference in hypoperfusion of the frontal and parietal lobes superposed on global cerebral hypoperfusion between the two groups (P<0.001); (III) and there was a significant difference in high WMH loads in deep white matter (DWM) between the two groups (P<0.05). Conclusions A low global or regional perfusion state, moderate-to-severe stenosis of MCAs, and high WMH loads could be used as imaging biomarkers to indicate diffuse or localized cerebral macrovascular and microvascular pathology in LOD.
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Affiliation(s)
- Jinhong Wang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renren Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Meng Liu
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhiyu Nie
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Lingjing Jin
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
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Xu YY, Zong LX, Zhang CQ, Pan YS, Jing J, Meng X, Li H, Zhao XQ, Liu LP, Wang D, Wang YL, Wang YJ. The association of white matter hyperintensities with stroke outcomes and antiplatelet therapy in minor stroke patients. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:331. [PMID: 32355775 PMCID: PMC7186621 DOI: 10.21037/atm.2020.02.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background To characterize the severity and distribution of white matter hyperintensities (WMHs) and to assess the relationship of WMHs with initial stroke severity, 3-month functional outcome, stroke recurrence and response to antiplatelet therapies. Methods In Clopidogrel High-risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial, 787 minor stroke patients with baseline magnetic resonance imaging (MRI) information were included in this analysis. Deep and periventricular WMHs (DWMHs and PVWMHs) were rated using the Fazekas scale and categorized into mild (grades 0–2), moderate (grades 3–4) and severe (grades 5–6). Multivariable logistic regression was used to examine the associations between WMHs severities and outcomes, including initial stroke severity by the National Institutes of Health Stroke Scale (NIHSS) scores, 3-month functional outcome by modified Rankin Scale (mRS), and stroke recurrence. Cox proportional hazards model was used to assess the treatment-by-subgroup interaction effect. Results Among the 787 patients in this analysis, 432 (54.9%) had moderate or severe WMHs (3-6). Compared with mild WMHs, the adjusted odds ratio (OR) of severe WMHs for risk of higher NIHSS was 2.10, 95% confidence interval (CI), 1.26–3.48 (P=0.004). Both severities of SDWMHs (OR 1.66; 95% CI, 1.15–2.40; P=0.007) and PVWMHs (OR 1.47; 95% CI, 1.02–2.10; P=0.04) were associated with higher NIHSS scores. There were no statistically significant associations of WMHs with 3-month functional outcome and stroke recurrence. There were no significant interactions between WMHs and antiplatelet therapy. Conclusions In patients with minor stroke, both SDWMHs and PVWMHs might related with initial stroke severity. No interaction was detected between the severity of WMHs and antiplatelet treatment.
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Affiliation(s)
- Yu-Yuan Xu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Li-Xia Zong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Chang-Qing Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yue-Song Pan
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Department of Epidemiology and Health Statistics, School of Public Health, Beijing 100070, China
| | - Jing Jing
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Xia Meng
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Hao Li
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Xing-Quan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Li-Ping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - David Wang
- Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Yi-Long Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
| | - Yong-Jun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
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Saba L, Lucatelli P, Anzidei M, di Martino M, Suri JS, Montisci R. Volumetric Distribution of the White Matter Hyper-Intensities in Subject with Mild to Severe Carotid Artery Stenosis: Does the Side Play a Role? J Stroke Cerebrovasc Dis 2018; 27:2059-2066. [PMID: 29803599 DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/16/2018] [Accepted: 02/28/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The purpose of this paper was to assess the difference in the distribution of white matter hyperintensities (WMHs) on left and right sides of the brain hemispheres of subjects with mild to severe carotid artery stenosis. MATERIAL AND METHODS Eighty consecutive patients (mean age 71 ± 6 years, males 66) with carotid artery stenosis were prospectively recruited. FLAIR-WMH lesion volume was performed using a semiautomated segmentation technique (Jim, Xinapse System, Leicester, UK). The Wilcoxon test was applied to verify the differences in the volume of WMHs between the right and left hemispheres. RESULTS A statistically significant difference was found in the middle cerebral artery (MCA) territory for the volume of the lesions (median volume of WMHs of the left side = 889.5 mm3; median volume of WMHs on the right side = 580.5 mm3; P = .0416); no statistically significant difference was found on the other territories by taking into considerations the lesions. By analyzing the degree of stenosis, we found a higher degree of stenosis of the left side (67.9%; 95% confidence interval [CI], 64.8%-70.9%) compared with the right side (65.7%; 95% CI, 62.4%-68.9%), but the Mann-Whitney test did not show a statistically significant difference (P = .3235). CONCLUSIONS Results of our study suggest that there is a difference in the distribution of WMHs in the brain hemispheres according to the left/right side on the MCA territories and for the periventricular white matter in subjects with mild to severe carotid artery stenosis.
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Affiliation(s)
- Luca Saba
- Department of Radiology, University Hospital of Cagliari, Italy, SS554 Monserrato, CA, Italy.
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Michele Anzidei
- Department of Radiology, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Michele di Martino
- Department of Radiology, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Jasjit S Suri
- Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Aff.), ID, USA
| | - Roberto Montisci
- Department of Vascular Surgery, University Hospital of Cagliari, Italy, SS554 Monserrato, CA, Italy
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van Dalen JW, Mutsaerts HJMM, Nederveen AJ, Vrenken H, Steenwijk MD, Caan MWA, Majoie CBLM, van Gool WA, Richard E. White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling. AJNR Am J Neuroradiol 2016; 37:1824-1830. [PMID: 27282862 DOI: 10.3174/ajnr.a4828] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/31/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE White matter hyperintensities of presumed vascular origin in elderly patients with hypertension may be part of a general cerebral perfusion deficit, involving not only the white matter hyperintensities but also the surrounding normal-appearing white matter and gray matter. We aimed to study the relation between white matter hyperintensity volume and CBF and assess whether white matter hyperintensities are related to a general perfusion deficit. MATERIALS AND METHODS In 185 participants of the Prevention of Dementia by Intensive Vascular Care trial between 72 and 80 years of age with systolic hypertension, white matter hyperintensity volume and CBF were derived from 3D FLAIR and arterial spin-labeling MR imaging, respectively. We compared white matter hyperintensity CBF, normal-appearing white matter CBF, and GM CBF across quartiles of white matter hyperintensity volume and assessed the continuous relation between these CBF estimates and white matter hyperintensity volume by using linear regression. RESULTS Mean white matter hyperintensity CBF was markedly lower in higher quartiles of white matter hyperintensity volume, and white matter hyperintensity volume and white matter hyperintensity CBF were negatively related (standardized β = -0.248, P = .001) in linear regression. We found no difference in normal-appearing white matter or GM CBF across quartiles of white matter hyperintensity volume or any relation between white matter hyperintensity volume and normal-appearing white matter CBF (standardized β = -0.065, P = .643) or GM CBF (standardized β = -0.035, P = .382) in linear regression. CONCLUSIONS Higher white matter hyperintensity volume in elderly individuals with hypertension was associated with lower perfusion within white matter hyperintensities, but not with lower perfusion in the surrounding normal-appearing white matter or GM. These findings suggest that white matter hyperintensities in elderly individuals with hypertension relate to local microvascular alterations rather than a general cerebral perfusion deficit.
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Affiliation(s)
- J W van Dalen
- From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.)
| | - H J M M Mutsaerts
- Radiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A J Nederveen
- Radiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - H Vrenken
- Departments of Radiology and Nuclear Medicine (H.V., M.D.S.).,Physics and Medical Technology (H.V.), Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
| | - M D Steenwijk
- Departments of Radiology and Nuclear Medicine (H.V., M.D.S.)
| | - M W A Caan
- Radiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - C B L M Majoie
- Radiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - W A van Gool
- From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.)
| | - E Richard
- From the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.).,Department of Neurology (E.R.), Radboud University Medical Center, Nijmegen, the Netherlands
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Anderson VC, Obayashi JT, Kaye JA, Quinn JF, Berryhill P, Riccelli LP, Peterson D, Rooney WD. Longitudinal relaxographic imaging of white matter hyperintensities in the elderly. Fluids Barriers CNS 2014; 11:24. [PMID: 25379172 PMCID: PMC4209516 DOI: 10.1186/2045-8118-11-24] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 10/04/2014] [Indexed: 11/25/2022] Open
Abstract
Background Incidental white matter hyperintensities (WMHs) are common findings on T2-weighted magnetic resonance images of the aged brain and have been associated with cognitive decline. While a variety of pathogenic mechanisms have been proposed, the origin of WMHs and the extent to which lesions in the deep and periventricular white matter reflect distinct etiologies remains unclear. Our aim was to quantify the fractional blood volume (vb) of small WMHs in vivo using a novel magnetic resonance imaging (MRI) approach and examine the contribution of blood–brain barrier disturbances to WMH formation in the deep and periventricular white matter. Methods Twenty-three elderly volunteers (aged 59–82 years) underwent 7 Tesla relaxographic imaging and fluid-attenuated inversion recovery (FLAIR) MRI. Maps of longitudinal relaxation rate constant (R1) were prepared before contrast reagent (CR) injection and throughout CR washout. Voxelwise estimates of vb were determined by fitting temporal changes in R1 values to a two-site model that incorporates the effects of transendothelial water exchange. Average vb values in deep and periventricular WMHs were determined after semi-automated segmentation of FLAIR images. Ventricular permeability was estimated from the change in CSF R1 values during CR washout. Results In the absence of CR, the total water fraction in both deep and periventricular WMHs was increased compared to normal appearing white matter (NAWM). The vb of deep WMHs was 1.8 ± 0.6 mL/100 g and was significantly reduced compared to NAWM (2.4 ± 0.8 mL/100 g). In contrast, the vb of periventricular WMHs was unchanged compared to NAWM, decreased with ventricular volume and showed a positive association with ventricular permeability. Conclusions Hyperintensities in the deep WM appear to be driven by vascular compromise, while those in the periventricular WM are most likely the result of a compromised ependyma in which the small vessels remain relatively intact. These findings support varying contributions of blood–brain barrier and brain-CSF interface disturbances in the pathophysiology of deep and periventricular WMHs in the aged human brain.
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Affiliation(s)
- Valerie C Anderson
- Advanced Imaging Research Center, L452, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - James T Obayashi
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey A Kaye
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Joseph F Quinn
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Louis P Riccelli
- Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, USA
| | - Dean Peterson
- Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA
| | - William D Rooney
- Advanced Imaging Research Center, L452, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
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Xiong Y, Wong A, Wong K, Chu WCW, Hu X, Chen X, Wong KS, Wong STC, Liu X, Mok V. Predictors for cortical gray matter volume in stroke patients with confluent white matter changes. J Neurol Sci 2014; 338:169-73. [PMID: 24468539 DOI: 10.1016/j.jns.2013.12.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/24/2013] [Accepted: 12/27/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Our previous study found that cortical gray matter (cGM) volume predicted vascular cognitive impairment independent of age-related white matter changes (WMC). We aimed to investigate predictors for cGM volume in ischemic stroke patients with confluent WMC. METHODS One-hundred post-stroke patients with confluent WMC were recruited into the study. All volumetric measures were standardized by intracranial volume as volume ratio. Univariate analyses and multivariate linear regression models were used to test relationship of cGM volume with basic demography, vascular risk factors, APOE status, WMC volume (periventricular and deep WMC), infarct measures (volume, number and location) and microbleed (number, presence and location). RESULTS After controlling for significant variables in the univariate analyses, multivariate linear regression models found that old age (β=-0.288, p=0.001), low triglyceride (β=0.194, p=0.027), periventricular WMC (PVWMC) (β=-0.392, p<0.001) and presence of thalamic microbleed (β=-0.197, p=0.041) were independently predictive of less cGM volume ratio. CONCLUSIONS Age, PVWMC and left thalamic microbleed predict less cGM volume.
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Affiliation(s)
- Yunyun Xiong
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China; Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, China
| | - Adrian Wong
- Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, China
| | - Kelvin Wong
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Winnie C W Chu
- Department of Radiology and Organ Imaging, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Xintao Hu
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Xiangyan Chen
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Ka Sing Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Stephen T C Wong
- Bioinformatics and Imaging Programmatic Cores, The Methodist Hospital Research Institute, Weill Cornell Medical College, Houston, TX, USA
| | - Xinfeng Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, Jiangsu Province, People's Republic of China
| | - Vincent Mok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China.
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CNS involvement in primary Sjogren Syndrome: assessment of gray and white matter changes with MRI and voxel-based morphometry. AJR Am J Roentgenol 2011; 197:1207-12. [PMID: 22021516 DOI: 10.2214/ajr.10.5984] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate with MRI the involvement of gray matter and white matter structures in patients with primary Sjögren syndrome. SUBJECTS AND METHODS Fifty-three patients with primary Sjögren syndrome, 18 age- and disease duration-matched patients with systemic sclerosis, and 35 age-matched control subjects were examined for differences in white matter hyperintensities (WMHIs) detected on FLAIR MR images. Differences in brain volume between patients with primary Sjögren syndrome and controls were studied by application of voxel-based morphometry to a 3D T1-weighted sequence. RESULTS WMHIs were observed in 38 of the 53 patients with primary Sjögren syndrome, six of 18 patients with systemic sclerosis, and 17 of 35 controls. The numbers of WMHIs 2 mm or larger and the number smaller than 2 mm were higher in patients with primary Sjögren syndrome than in controls (≥ 2 mm, p = 0.004; < 2 mm, p < 0.001). No significant difference was observed in the number of WMHIs in primary Sjögren syndrome patients and that in systemic sclerosis patients. After control for age, a positive relation was found between disease duration and total number of WMHIs (p = 0.037) and number of WMHIs 2 mm or larger (p = 0.023) in patients with primary Sjögren syndrome. In comparison with the controls, patients with primary Sjögren syndrome had decreased gray matter volume in the cortex, deep gray matter, and cerebellum. Associated loss of white matter volume was observed in areas corresponding to gray matter atrophy and in the corpus callosum (p < 0.05). CONCLUSION Patients with primary Sjögren syndrome have WMHIs and gray and white matter atrophy, probably related to cerebral vasculitis.
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McMurtray A, Nakamoto B, Shikuma C, Valcour V. Cortical atrophy and white matter hyperintensities in HIV: the Hawaii Aging with HIV Cohort Study. J Stroke Cerebrovasc Dis 2008; 17:212-7. [PMID: 18589342 DOI: 10.1016/j.jstrokecerebrovasdis.2008.02.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 02/24/2008] [Accepted: 02/25/2008] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND As many human immunodeficiency virus (HIV)-seropositive individuals are now living longer after infection because of highly active antiretroviral therapy, aging-related manifestations of cerebral small-vessel ischemic vascular disease, such as brain white matter hyperintensities (WMHs), are becoming increasingly important in this population. GOALS This study was designed to determine the relationship between WMHs and cortical volumes in HIV-seropositive individuals. MATERIALS AND METHODS Voxel-based morphometry was used to compare cortical volumes among 62 HIV-seropositive individuals participating in the Hawaii Aging with HIV Cohort Study, 30 with moderate WMHs and 32 with minimal or no WMHs. RESULTS Presence of moderate WMHs was associated with decreased cortical volumes in the frontal lobes bilaterally. CONCLUSION These findings suggest that age-related WMHs are associated with reduced frontal gray matter volumes in HIV-seropositive individuals, supporting the hypothesis that the frontal lobes may have greater susceptibility to the effects of small-vessel ischemic vascular disease.
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Affiliation(s)
- Aaron McMurtray
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
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11
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Kim KW, MacFall JR, Payne ME. Classification of white matter lesions on magnetic resonance imaging in elderly persons. Biol Psychiatry 2008; 64:273-80. [PMID: 18471801 PMCID: PMC2593803 DOI: 10.1016/j.biopsych.2008.03.024] [Citation(s) in RCA: 347] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 03/06/2008] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
Abstract
White matter lesions, commonly seen on MRIs of elderly people, are related to various geriatric disorders, including cerebrovascular diseases, cardiovascular diseases, dementia, and psychiatric disorders. Currently, white matter lesions are divided into periventricular white matter lesions and deep white matter lesions. Although the meaning of these terms varies by study and this dichotomization itself is still in debate, a possible dissimilarity in pathogenic mechanisms between periventricular white matter lesions and deep white matter lesions are providing some clues for understanding pathophysiology of many geriatric syndromes associated with white matter lesions. We have reviewed the distinctions between periventricular white matter lesions and deep white matter lesions in terms of etiology, histopathology, functional correlates, and imaging methodologies. We suggest a new subclassification of white matter lesions that might have better etiological and functional relevance than the current simple dichotomization. The new categories are juxtaventricular, periventricular, deep white, and juxtacortical. This new classification scheme might contribute to reducing the heterogeneity of white matter lesion findings in future research.
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Affiliation(s)
- Ki Woong Kim
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA,Neuropsychiatric Imaging Research Laboratory, Duke University Medical Center, 2200 West Main Street, Suite B210, Durham, NC 27705 USA,Department of Neuropsychiatry, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - James R. MacFall
- Neuropsychiatric Imaging Research Laboratory, Duke University Medical Center, 2200 West Main Street, Suite B210, Durham, NC 27705 USA,Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA,Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Martha E. Payne
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710 USA,Neuropsychiatric Imaging Research Laboratory, Duke University Medical Center, 2200 West Main Street, Suite B210, Durham, NC 27705 USA,CORRESPONDENCE: Martha E. Payne, PhD, RD, MPH, Duke University Medical Center, 2200 West Main Street, Suite B210, Durham, NC 27705, USA, Tel.: (919) 416-7543 Fax: (919) 416-7547
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Abstract
PURPOSE OF REVIEW White matter hyperintensities on T2-weighted magnetic resonance imaging are frequent incidental findings in the brains of elderly individuals. Recent studies have reported that they may also be common in middle-aged individuals, and their systematic evaluation in younger populations is necessary. RECENT FINDINGS Incidental white matter hyperintensities are common in brains of healthy individuals in their 60s and may be seen as early as the 30s and 40s. They are associated with subtle functional impairment and higher prevalence of neuropsychiatric disorders. While cerebrovascular risk factors such as hypertension, diabetes, high homocysteine, and so forth, are known risk factors for white matter hyperintensities, a significant proportion of the variance is unexplained. Genetic factors, alone or in interaction with environmental factors, appear to be important. There is a slight excess of white matter hyperintensities in women, the basis for which is not understood. Longitudinal studies show that those with baseline lesions have a greater progression over time. SUMMARY New imaging techniques present an opportunity to examine white matter pathology in great detail in younger populations. Standardized methods to examine such pathology and its determinants will help inform strategies for their prevention, which is an important component of a healthy ageing agenda.
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Rosano C, Aizenstein HJ, Studenski S, Newman AB. A regions-of-interest volumetric analysis of mobility limitations in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2007; 62:1048-55. [PMID: 17895446 DOI: 10.1093/gerona/62.9.1048] [Citation(s) in RCA: 131] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In community-dwelling older adults, greater mobility impairment is associated with greater burden of diffuse brain structural abnormalities, such as higher white matter hyperintensities. This study examined the association between gray matter volumes of regions related to motor control, gait, and balance and whether this association is independent of burden of white matter hyperintensities. METHODS A random sample of 327 participants of the Cardiovascular Health Study (78.3 +/- 4.1 years old, 57% women) contributed brain magnetic resonance imaging (MRI) and mobility data. A brain imaging automated method measured gray matter volume in cerebellum, basal ganglia, and prefrontal and parietal cortex in both hemispheres. Gait speed was measured while walking 15 feet at usual pace. Standing balance was assessed by timing tandem stance. Associations between each region's volume and gait speed or balance were measured before and after adjustment for demographics, head size, cardiovascular risk factors, and 0-9 grading scores of white matter hyperintensities. RESULTS Smaller left cerebellum and left prefrontal regions were associated with slower gait, independently of covariates and of white matter hyperintensities. Smaller right putamen, right posterior superior parietal cortex, and both left and right cerebellum were associated with balance difficulty, independently of covariates and white matter hyperintensities. CONCLUSIONS Smaller gray matter volumes in regions crucial for motor control are associated with slower gait and poorer balance, and the association appears to be independent of other diffuse brain abnormalities such as white matter hyperintensities.
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Affiliation(s)
- Caterina Rosano
- School of Public Health, Department of Epidemiology, University of Pittsburgh, Pennsylvania, USA.
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14
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Zanetti MV, Cordeiro Q, Busatto GF. Late onset bipolar disorder associated with white matter hyperintensities: a pathophysiological hypothesis. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:551-6. [PMID: 17107742 DOI: 10.1016/j.pnpbp.2006.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Revised: 10/13/2006] [Accepted: 10/16/2006] [Indexed: 10/23/2022]
Abstract
Vascular depression is, nowadays, a well-established concept in the literature. However, the possible emergence of late onset bipolar disorder in subjects with no antecedents of mood disorder or after a chronic or recurrent course of unipolar depression constitutes a poorly studied issue, despite its importance in clinical practice. Here, we present the case of a 72-year-old female patient who began to present recurrent major depressive symptoms, resistant to pharmacological treatment, from the age of 58. Three years later, she started to present phases of mania with rapid cycling features. A brain MRI scan showed prominent white matter hyperintensities (WMH). WMH are frequently found in the elderly population, but with greater burden in individuals with hypertension and cerebrovascular disease. WMH impair cortical function and damage the cerebral tissue. WMH have been associated with adult-onset bipolar disorder and late onset depression, and are linked to a worse prognosis of both conditions. The present case report highlights the possibility that vascular-related WMH may provoke late onset bipolar disorder by damaging frontolimbic circuits implicated in the pathophysiology of mania.
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Affiliation(s)
- Marcus Vinicus Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM 21), Institute and Department of Psychiatry, University of São Paulo, Brazil.
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15
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Caroli A, Testa C, Geroldi C, Nobili F, Guerra UP, Bonetti M, Frisoni GB. Brain perfusion correlates of medial temporal lobe atrophy and white matter hyperintensities in mild cognitive impairment. J Neurol 2007; 254:1000-8. [PMID: 17375260 DOI: 10.1007/s00415-006-0498-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Revised: 11/03/2006] [Accepted: 11/27/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the association of Medial Temporal lobe Atrophy (MTA) and White Matter Hyperintensities (WMHs) with gray matter perfusion in Mild Cognitive Impairment (MCI). METHODS 56 MCI patients (age = 69.3 +/- 7.0, 32 females) underwent brain MR scan and (99m)Tc ECD SPECT. We evaluated MTA according to Scheltens' fivepoint scale on T1 MR images, and assessed WMHs using the rating scale for age-related white matter changes on T2-weighted and FLAIR MR images. We divided MCI into age-matched subgroups with high and low MTA and high and low WMHs load. We processed SPECT images with SPM2 following an optimized protocol and performed a voxel-based statistical analysis comparing high vs. low MTA and high vs. low WMHs, setting p-value at 0.001 uncorrected, thresholding cluster extent at 100 voxels, using proportional scaling and entering age and WMHs or MTA respectively as nuisance covariates. RESULTS MCI with high compared with low MTA showed hypoperfusion in the left hippocampus and in the left parahippocampal gyrus. MCI with high compared with low WMHs showed a hypoperfusion area in the left insular region and superior temporal gyrus. CONCLUSIONS MTA in MCI is associated with hippocampal gray matter hypoperfusion while WMHs is associated with gray matter hypoperfusion in areas of the insula and temporal neocortex. These results confirm that MTA is associated with local functional changes and suggest that WMHs may be associated with remote brain cortical dysfunction.
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Affiliation(s)
- Anna Caroli
- LENITEM Laboratory of Epidemiology, Neuroimaging, & Telemedicine - IRCCS, S. Giovanni di Dio-FBF, via Pilastroni 4, 25125, Brescia, Italy
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Christensen H, Anstey KJ, Parslow RA, Maller J, Mackinnon A, Sachdev P. The brain reserve hypothesis, brain atrophy and aging. Gerontology 2006; 53:82-95. [PMID: 17057394 DOI: 10.1159/000096482] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 09/01/2006] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Researchers have used the concept of brain reserve to explain the dissociation between pathological brain damage and cognitive and functional performance. A variety of brain reserve hypotheses exist, and different empirical strategies have been employed to investigate these variants. OBJECTIVE The study investigates (i) the relationship between measures of brain burden (atrophy, white matter hyperintensities (WMH)) and measures of reserve (education, creativity, and intelligence); (ii) the relationship between cognitive decline and reserve; (iii) whether measures of reserve mediate the effect of atrophy on estimated cognitive change, and (iv) the association between brain risk factors, education and atrophy. METHODS A cross-sectional study of a sample of 446 individuals 60-64 years of age who underwent MRI scans as part of a large epidemiological study. Measures were taken of education, intelligence, creativity, cognitive speed, brain volume, WMH, estimated cognitive decline from earlier in life and brain atrophy. RESULTS No association was found between estimated cognitive decline and brain burden (atrophy, WMH). Risk factors for brain insult were not associated with greater brain atrophy in the less well educated. Neither education, nor any other measure including intelligence or creativity, provided a buffer for cognitive decline in individuals with high levels of brain atrophy. CONCLUSION Little support was found for the brain reserve hypothesis.
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Affiliation(s)
- Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
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17
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Rossi R, Boccardi M, Sabattoli F, Galluzzi S, Alaimo G, Testa C, Frisoni GB. Topographic correspondence between white matter hyperintensities and brain atrophy. J Neurol 2006; 253:919-27. [PMID: 16502217 DOI: 10.1007/s00415-006-0133-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Revised: 08/01/2005] [Accepted: 09/07/2005] [Indexed: 10/25/2022]
Abstract
White matter hyperintensities (WMHs) are a common finding in normal elderly persons. We studied the biological damage associated with WMHs by assessing the correspondence between WMH location and regional gray matter loss.Voxel-based morphometry of the gray matter was carried out with statistical parametric mapping on high resolution MR images.Neurologically intact persons with mainly anterior (frontal>parieto-occipital; N = 39) and mainly posterior WMHs (parieto- occipital>frontal; N = 14) were compared with a group devoid of WMHs (N = 80). Subjects with mainly frontal WMHs had bilateral frontal (medial, superior, and inferior gyri) atrophy in gray matter, while subjects with mainly posterior WMHs had more diffuse atrophy, involving mainly the frontal but also the right insular region. Our findings suggest that frontal WMHs are associated with frontal gray matter damage while parietooccipital WMHs seem to have a weaker and more diffuse impact on gray matter.
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Affiliation(s)
- R Rossi
- Laboratory of Epidemiology,Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio-FBF, via Pilastroni 4, 25125, Brescia, Italy.
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18
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Wen W, Sachdev PS, Chen X, Anstey K. Gray matter reduction is correlated with white matter hyperintensity volume: A voxel-based morphometric study in a large epidemiological sample. Neuroimage 2006; 29:1031-9. [PMID: 16253521 DOI: 10.1016/j.neuroimage.2005.08.057] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2005] [Revised: 08/23/2005] [Accepted: 08/30/2005] [Indexed: 10/25/2022] Open
Abstract
Both brain atrophy and T2-weighted white matter hyperintensities (WMH) are common findings in the brains of asymptomatic elderly individuals as well as in disease-specific brains. The study of the relationship between these two salient features is therefore important. To investigate such a relationship, we performed a brain magnetic resonance imaging (MRI) study on 397 asymptomatic individuals aged between 60 and 64 years, who were recruited randomly from a large community sample. WMH were delineated on T2-weighted fluid attenuation inversion recovery (FLAIR) whole brain scans using an automated procedure. The results showed that gray matter reduction, subarachnoid CSF (SA-CSF) increase and lateral ventricular dilation were significantly correlated with WMH load. Deep white matter hyperintensity (DWMH) had significant correlation with all three global atrophy indices, but periventricular white matter hyperintensity (PVWMH) was correlated only with gray matter volume. Voxel-based morphometric (VBM) analysis showed that regional gray matter reduction correlated more closely with WMH load of the proximate region than with WMH elsewhere. The results suggest that WMH have a relationship with brain atrophy in middle age, although the study cannot determine which process, i.e. the development of WMH or atrophy, is primary. The study also demonstrates that DWMH has a more significant relationship with structural brain changes, and may therefore be more functionally relevant than PVWMH. Further delineation of this relationship needs a longitudinal study of the changes in both WMH and indices of brain atrophy.
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Affiliation(s)
- Wei Wen
- School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
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Calhoun VD, Adali T, Giuliani NR, Pekar JJ, Kiehl KA, Pearlson GD. Method for multimodal analysis of independent source differences in schizophrenia: combining gray matter structural and auditory oddball functional data. Hum Brain Mapp 2006; 27:47-62. [PMID: 16108017 PMCID: PMC6871470 DOI: 10.1002/hbm.20166] [Citation(s) in RCA: 170] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2004] [Accepted: 04/18/2005] [Indexed: 11/05/2022] Open
Abstract
The acquisition of both structural MRI (sMRI) and functional MRI (fMRI) data for a given study is a very common practice. However, these data are typically examined in separate analyses, rather than in a combined model. We propose a novel methodology to perform independent component analysis across image modalities, specifically, gray matter images and fMRI activation images as well as a joint histogram visualization technique. Joint independent component analysis (jICA) is used to decompose a matrix with a given row consisting of an fMRI activation image resulting from auditory oddball target stimuli and an sMRI gray matter segmentation image, collected from the same individual. We analyzed data collected on a group of schizophrenia patients and healthy controls using the jICA approach. Spatially independent joint-components are estimated and resulting components were further analyzed only if they showed a significant difference between patients and controls. The main finding was that group differences in bilateral parietal and frontal as well as posterior temporal regions in gray matter were associated with bilateral temporal regions activated by the auditory oddball target stimuli. A finding of less patient gray matter and less hemodynamic activity for target detection in these bilateral anterior temporal lobe regions was consistent with previous work. An unexpected corollary to this finding was that, in the regions showing the largest group differences, gray matter concentrations were larger in patients vs. controls, suggesting that more gray matter may be related to less functional connectivity in the auditory oddball fMRI task.
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Affiliation(s)
- V D Calhoun
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, Connecticut 06106, USA.
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Lin HF, Kuo YT, Chiang IC, Chen HM, Chen CS. Structural abnormality on brain magnetic resonance imaging in late-onset major depressive disorder. Kaohsiung J Med Sci 2005; 21:405-11. [PMID: 16248124 DOI: 10.1016/s1607-551x(09)70142-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to examine the structural abnormalities of patients with late-onset major depressive disorder using brain magnetic resonance imaging (MRI) and to assess clinical correlates of these structural abnormalities. Thirty-seven elderly patients with DSM-IV major depressive disorder that first occurred after the age of 50 years, and 18 control subjects without depression were recruited. All participants underwent comprehensive psychiatric assessment and cerebral MRI. Brain ventricular and sulcal sizes and white matter hyperintensities were assessed visually. Relative to control subjects, patients with late-life major depressive disorder showed more severe brain atrophy (p = 0.043) and white matter hyperintensities (p = 0.024), especially in the periventricular area (p = 0.012). Over 60% of the patient group had significant brain MRI hyperintensities. White matter hyperintensity was correlated with later onset of depressive illness (r = 0.49, p = 0.002) among patients. Brain atrophy and white matter hyperintensities are prevalent in patients with late-onset major depressive disorders. These two abnormalities may represent different pathophysiologic processes of depressive disorders. White matter hyperintensities may be predisposing factors for late-onset major depressive disorder.
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Affiliation(s)
- Hsiu-Fen Lin
- Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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21
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Sachdev P, Wen W. Should we distinguish between periventricular and deep white matter hyperintensities? Stroke 2005; 36:2342-3; author reply 2343-4. [PMID: 16239634 DOI: 10.1161/01.str.0000185694.52347.6e] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barbeau EJ, Felician O, Joubert S, Sontheimer A, Ceccaldi M, Poncet M. Preserved visual recognition memory in an amnesic patient with hippocampal lesions. Hippocampus 2005; 15:587-96. [PMID: 15884094 DOI: 10.1002/hipo.20079] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is ongoing debate about whether performance on tests of recognition memory can remain preserved after hippocampal damage. In the present study, we report F.R.G., a patient who became severely amnesic following herpes simplex encephalitis. Although F.R.G. failed all tests involving recall and verbal recognition, she obtained normal performance on a wide number of tests evaluating visual recognition memory (14 of 18 different tests). Her performance was independent of various factors, such as test difficulty, duration of exposure to the stimuli, or delay separating encoding and recognition. F.R.G. also achieved normal performance on two tasks requiring that she associate pairs of visual stimuli. In addition, she demonstrated spared feeling of knowing, suggesting that her performance on recognition tests was explicit and likely to rely on familiarity. Brain imaging (MRI) revealed bilateral lesions of the hippocampus and lesions of the left parahippocampal gyrus, while the right parahippocampal gyrus remained relatively spared. The results of this study support the view that recognition memory can be preserved despite severe hippocampal damage and that familiarity is a distinct memory process that can be dissociated from recollection.
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Affiliation(s)
- Emmanuel J Barbeau
- Service de Neurologie et de Neuropsychologie, AP-HM Timone, Laboratoire de Neurophysiologie et de Neuropsychologie, INSERM EMI-U 9926, Université Mediterranée, Marseille, France.
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