Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark.
Neuroimage. 2012 Apr 15;60(3):1597-607. doi: 10.1016/j.neuroimage.2012.01.106. Epub 2012 Jan 28.
White matter hyperintensities (WMH) are a frequent finding on brain MRI of elderly subjects, and have been associated with various risk factors, as well as with development of cognitive and functional impairment. While an overall association between WMH load and risk factors is well described, possible spatially restricted vulnerability remains to be established. The aim of this study was to investigate the spatial distribution of WMH in normally functioning elderly subjects. We introduce a voxel-based approach in which lesion probability is mapped as a function of clinical risk factors using logistic regression, and validate the method using simulated datasets. The method was then applied in a total of 605 participants of the LADIS study (age 74 ± 5 years, all with WMH), and the location of manually delineated WMH was investigated after spatial normalisation. Particularly strong and widespread associations were found for age, gender and hypertension. Different distribution patterns were found for men and women. Further, increased probability was found in association with self-reported alcohol and tobacco consumption, as well as in those with a history of migraine. It is concluded that the location of WMH is dependent on the risk factors involved pointing towards a regionally different pathogenesis and/or vulnerability of the white matter.
脑白质高信号（WMH）是老年患者脑 MRI 的常见表现，与多种危险因素有关，并与认知和功能障碍的发生发展有关。虽然 WMH 负荷与危险因素之间存在总体关联，但可能存在空间受限的易损性仍有待确定。本研究旨在探讨正常功能的老年患者脑白质高信号的空间分布。我们采用基于体素的方法，使用逻辑回归将病变概率映射为临床危险因素的函数，并使用模拟数据集对该方法进行验证。然后将该方法应用于总共 605 名 LADIS 研究参与者（年龄 74 ± 5 岁，均有 WMH）中，并在空间归一化后研究手动描绘的 WMH 的位置。结果发现年龄、性别和高血压与病变的相关性特别强且广泛。男女之间的分布模式不同。此外，与自我报告的酒精和烟草消费以及偏头痛病史相关的病变概率也有所增加。结论是，WMH 的位置取决于所涉及的危险因素，这表明其发病机制和/或脑白质易损性存在区域性差异。
