Fischer P, Krampla W, Mostafaie N, Zehetmayer S, Rainer M, Jungwirth S, Huber K, Bauer K, Hruby W, Riederer P, Tragl K H
Department of Psychiatry and Psychotheraphy, Medical University Vienna, Vienna, Austria.
J Neural Transm Suppl. 2007(72):181-8. doi: 10.1007/978-3-211-73574-9_23.
The etiology of white matter hyperintensities (WMH) seen on T2-weighted cranial magnetic resonance images is a matter of debate. We investigated deep and periventricular WMH in the brains of a community-based cohort of 532 subjects aged 75-76 years. The objective of this study was to determine whether WMH at age of 75 years were associated rather with vascular factors than with degenerative factors. Arterial hypertension treated with antihypertensive drugs favored WMH, and WMH were found more frequently in subjects with focal vascular lesions. Additionally, we found significant associations between both, deep white matter and periventricular hyperintensities, and focal atrophy of medial temporal lobe structures. The odds ratio for deep WMH in subjects with more severe medial temporal atrophy was 4.4 (95%-CI: 1.9-9.8) that for periventricular hyperintensities was 3.9 (95%-CI: 1.7-8.8). These findings might indicate that not only vascular factors alone but also degenerative factors favor the occurrence of WMH after the age of 75 years.
在T2加权头颅磁共振图像上所见的脑白质高信号（WMH）的病因存在争议。我们对一个基于社区的队列中532名75 - 76岁受试者的大脑深部和脑室周围WMH进行了研究。本研究的目的是确定75岁时的WMH是否与血管因素而非退行性因素相关。使用抗高血压药物治疗的动脉高血压易引发WMH，并且在有局灶性血管病变的受试者中更频繁地发现WMH。此外，我们发现深部白质和脑室周围高信号与内侧颞叶结构的局灶性萎缩之间均存在显著关联。内侧颞叶萎缩更严重的受试者中深部WMH的优势比为4.4（95%可信区间：1.9 - 9.8），脑室周围高信号的优势比为3.9（95%可信区间：1.7 - 8.8）。这些发现可能表明，75岁以后不仅血管因素，而且退行性因素也易引发WMH。
