Godin Ophélia, Maillard Pauline, Crivello Fabrice, Alpérovitch Annick, Mazoyer Bernard, Tzourio Christophe, Dufouil Carole
Inserm U708 'Neuroepidemiology', Paris, France.
Cerebrovasc Dis. 2009;28(2):177-84. doi: 10.1159/000226117. Epub 2009 Jun 25.
Brain atrophy and white-matter lesions (WML) are common features at cerebral MRI of both normal and demented elderly people. In a population-based study of 1,792 elderly subjects aged 65-80 years, free of dementia, who had a cerebral MRI at entry, we investigated the relationship between WML volume and brain atrophy markers estimated by hippocampal, gray matter (GM) and cerebrospinal fluid (CSF) volumes.
An automated algorithm of detection and quantification of WML was developed, and voxel-based morphometry methods were used to estimate GM, CSF and hippocampal volumes. To evaluate the relation between those volumes and WML load, we used analysis of covariance and multiple linear regression models adjusting for potential confounders and total intracranial volumes.
Age was highly correlated with WML load and all brain atrophy markers. Total WML volume was negatively associated with both GM (beta = -0.03, p < 0.0001) and hippocampal volumes (beta = -0.75, p = 0.0009) and positively with CSF volumes (beta = 0.008, p = 0.02) after controlling for sex, age, education level, hypertension and apolipoprotein E genotype. Evidence for a relationship between brain atrophy markers and WML was stronger for periventricular WML. We found that the relationship between WML and hippocampal volumes was independent of other brain tissue volumes.
These results suggest that, in the brain of nondemented elderly subjects, degenerative processes and vascular changes co-occur and are related independently of vascular risk factors.
脑萎缩和白质病变（WML）是正常老年人和痴呆老年人脑部MRI的常见特征。在一项基于人群的研究中，我们对1792名年龄在65 - 80岁、无痴呆且在入组时进行了脑部MRI检查的老年人进行了研究，调查了WML体积与通过海马体、灰质（GM）和脑脊液（CSF）体积估计的脑萎缩标志物之间的关系。
开发了一种用于检测和量化WML的自动化算法，并使用基于体素的形态计量学方法来估计GM、CSF和海马体体积。为了评估这些体积与WML负荷之间的关系，我们使用协方差分析和多元线性回归模型，并对潜在的混杂因素和总颅内体积进行了调整。
年龄与WML负荷和所有脑萎缩标志物高度相关。在控制了性别、年龄、教育水平、高血压和载脂蛋白E基因型后，总WML体积与GM（β = -0.03，p < 0.0001）和海马体体积（β = -0.75，p = 0.0009）均呈负相关，与CSF体积呈正相关（β = 0.008，p = 0.02）。脑室周围WML的脑萎缩标志物与WML之间的关系证据更强。我们发现WML与海马体体积之间的关系独立于其他脑组织体积。
这些结果表明，在非痴呆老年人的大脑中，退行性过程和血管变化同时发生，并且独立于血管危险因素相关。
