de Leeuw F E, de Groot J C, Bots M L, Witteman J C, Oudkerk M, Hofman A, van Gijn J, Breteler M M
Department of Epidemiology and Biostatistics, Erasmus Medical Center Rotterdam, The Netherlands.
J Neurol. 2000 Apr;247(4):291-6. doi: 10.1007/s004150050586.
Cerebral white matter lesions are frequently observed on magnetic resonance imaging of elderly, nondemented persons. There is evidence that white matter lesions are involved in the pathophysiology of cognitive decline and dementia. White matter lesions can be divided into those in the periventricular and those in the subcortical region. Pathological and epidemiological studies suggest that atherosclerosis is involved in the pathogenesis of these lesions. Our study reports on the association between atherosclerosis in the carotid arteries and white matter lesions in a population-based study among 1077 elderly subjects. We randomly sampled 1077 subjects aged between 60-90 years from two prospective population-based studies. All subjects underwent ultrasonography of the carotid artery. In addition, 1.5 T magnetic resonance imaging was performed; white matter lesions in the subcortical and periventricular regions were rated separately. With increasing number of plaques in the carotid artery the severity of periventricular white matter lesions increased (Ptrend = 0.03), but not the severity of subcortical white matter lesions (Ptrend = 0.19). In addition, an increase in intima media thickness was borderline significantly associated with an increased severity of periventricular white matter lesions (Ptrend = 0.09), but not of subcortical white matter lesions (Ptrend = 0.68). These findings suggest that partly dissimilar pathogenetic mechanisms are involved in the etiology of periventricular and subcortical white matter lesions.
在老年非痴呆人群的磁共振成像中经常观察到脑白质病变。有证据表明，白质病变与认知能力下降和痴呆的病理生理学有关。白质病变可分为脑室周围病变和皮质下区域病变。病理和流行病学研究表明，动脉粥样硬化与这些病变的发病机制有关。我们的研究在一项基于人群的研究中报告了1077名老年受试者颈动脉粥样硬化与白质病变之间的关联。我们从两项基于人群的前瞻性研究中随机抽取了1077名年龄在60至90岁之间的受试者。所有受试者均接受了颈动脉超声检查。此外，还进行了1.5T磁共振成像；分别对皮质下和脑室周围区域的白质病变进行评分。随着颈动脉斑块数量的增加，脑室周围白质病变的严重程度增加（P趋势=0.03），但皮质下白质病变的严重程度未增加（P趋势=0.19）。此外，内膜中层厚度的增加与脑室周围白质病变严重程度的增加有临界显著关联（P趋势=0.09），但与皮质下白质病变严重程度的增加无关（P趋势=0.68）。这些发现表明，脑室周围和皮质下白质病变的病因涉及部分不同的发病机制。
