Cerebral White Matter Lesions (cerebral + white_matter_lesion)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Serum Carotenoids and Cerebral White Matter Lesions: The Rotterdam Scan Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2001
Tom Den Heijer MSc
OBJECTIVES: To study the relation between serum levels of carotenoids and white matter lesions (WMLs) on magnetic resonance imaging (MRI). DESIGN: Evaluation of cross-sectional data from a cohort study. SETTING: The Rotterdam Scan Study. PARTICIPANTS: Two hundred and three nondemented older persons, age 60 to 90, from the Rotterdam Scan Study. MEASUREMENTS: Serum levels of carotenoids were determined. WMLs on MRIs were rated separately into periventricular and subcortical WMLs. Odds ratios (ORs) for the presence of severe WMLs (upper decile) were calculated per standard deviation (SD) increase in serum carotenoid level and per SD increase in overall carotenoid serum level. Effect modification by smoking status was studied through stratified analyses. RESULTS: Increasing levels of all the separate carotenoids were associated with less severe periventricular WMLs, which reached statistical significance for the overall carotenoid serum level (OR 0.4 per SD; 95% confidence interval (CI) = 0.2,0.9). We found no association between carotenoid levels and the presence of severe subcortical WMLs (OR 1.2 per SD; 95% CI = 0.7,2.0). The association of carotenoid levels with severe periventricular WMLs was more marked in those who ever smoked (OR 0.1 per SD; 95% CI = 0.0,0.9) than in those who had never smoked (OR 0.9 per SD; 95% CI = 0.4,2.1). CONCLUSIONS: These findings are compatible with the view that high levels of carotenoids may protect against WMLs in the periventricular region, in particular in smokers. Longitudinal studies with repeated measurements of both carotenoids and WMLs are necessary to explore this hypothesis further. [source]

Antihypertensive treatment in elderly hypertensives without a history of stroke and the risk of cognitive disorders

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2008
D. I. Hadjiev
Objectives,,, The role of the antihypertensive therapy in preventing cognitive disorders in elderly persons without a history of stroke is a matter of debate. This review focuses on the pathogenesis of the cognitive disorders in elderly hypertensives and on the risk factors of their occurrence. Methods,,, Relevant papers were identified by searches in PubMed from 1946 until October 2007, using the key words ,vascular risk factors', ,vascular cognitive impairment', ,vascular dementia', ,neuroimaging in hypertension' and ,antihypertensive treatment'. Results,,, Blood pressure lowering in elderly patients with long-standing hypertension below a certain critical level may increase the risk of cerebral hypoperfusion and cognitive decline, particularly in cases with additional vascular risk factors. Cerebral white matter lesions have been found in the majority of elderly hypertensives. They have been shown to correlate with cognitive disorders. Conclusions,,, Appropriate neuropsychological assessment and follow-up of the cognitive functions could be considered with the aim to individualize the antihypertensive therapy and slow down cognitive decline. Prospective studies are needed to confirm such a treatment strategy. [source]

The location of white matter lesions and gait,A voxel-based study

ANNALS OF NEUROLOGY, Issue 2 2010
Velandai Srikanth PhD
Little is known about the influence of cerebral white matter lesion (WML) location on gait. We applied partial least squares regression in brain magnetic resonance imaging scans (n = 385) to evaluate which WML voxel systems were independently associated with a composite gait score and identified affected tracts using a diffusion tensor imaging template. Bilateral frontal and periventricular WML-affected voxels corresponding to major anterior projection fibers (thalamic radiations, corticofugal motor tracts) and adjacent association fibers (corpus callosum, superior fronto-occipital fasciculus, short association fibers) showed the greatest covariance with poorer gait. WMLs probably contribute to age-related gait decline by disconnecting motor networks served by these tracts. ANN NEUROL 2010;67:265,269 [source]

Severity of cerebral white matter lesions and infarcts in patients with transient or moderately disabling cerebral ischaemia: reproducibility of grading by neurologists

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2006
E. L. L. M. De Schryver
Diffuse or multifocal ischaemic white matter lesions increase the risk of intracranial haemorrhage in patients using oral anticoagulants for secondary prevention after cerebral ischaemia of arterial origin. We studied whether neurologists could reliably assess the presence of these white matter abnormalities. As part of the European/Australian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), the severity of white matter lesions and presence of ischaemic lesions were twice assessed in a consensus meeting of three neurologists (from a pool of nine) as absent, moderate or severe, in a sample of 126 randomly selected CT or MRI scans. The neurologists were not aware of the duplicate grading. The degree of agreement between the first and second observation was calculated with kappa statistics. The kappa value for agreement between the first and second assessment of white matter lesions was 0.58 (95% CI 0.40,0.76). The kappa value for the presence of clinically relevant and/or irrelevant ischaemic lesions was 0.68 (95% CI 0.58,0.78). Clinicians can assess the presence of white matter lesions with sufficient reliability. Such assessment may prevent unnecessary risk with oral anticoagulation in secondary prevention after cerebral ischaemia of arterial origin, of which the efficacy is currently being assessed in ESPRIT. [source]