Beggs Clive B, Magnano Christopher, Shepherd Simon J, Belov Pavel, Ramasamy Deepa P, Hagemeier Jesper, Zivadinov Robert
Centre for Infection Control and Biophysics, University of Bradford, Bradford, UK.
Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY.
J Neuroimaging. 2016 Jan-Feb;26(1):136-43. doi: 10.1111/jon.12249. Epub 2015 Apr 20.
Aging of the healthy brain is characterized by focal or nonfocal white matter (WM) signal abnormality (SA) changes, which are typically detected as leukoaraiosis (LA). Hypertension is a risk factor for WM lesion formation. This study investigated whether LA might be associated with increased cerebrospinal fluid (CSF) pulsatility linked to arterial hypertension.
A total of 101 individuals without neurologic diseases (53 females and 48 males) aged between 18 and 75 years underwent 3T brain MRI with cine phase contrast imaging for CSF flow estimation, after providing their informed consent. LA was defined as the presence of focal T2 WM SA changes and/or nonfocal uniform areas of signal increase termed dirty appearing white matter (DAWM). Relevant information relating to cardiovascular risk factors was also collected.
When controlled for age and hypertension, significant partial correlations were observed between: DAWM volume and: net negative flow (r = -.294, P = .014); net positive flow (NPF) (r = .406, P = .001); and peak positive velocity (r = .342, P = .004). Multiple linear regression analysis revealed DAWM volume to be significantly correlated with CSF NPF (P = .019) and hypertension (P = .007), whereas T2 WM SA volume was only significantly correlated with age (P = .002). Combined DAWM and T2 WM SA volumes were significantly related with age (P = .001) and CSF peak negative velocity (P = .041).
Rarefaction of WM leading to LA is a multifactorial process, in which formation of DAWM induced by hypertension and increased aqueductal CSF pulsatility, may play a contributory role. These two factors appear to act independently of each other in a process that is independent of age.
健康大脑的老化以局灶性或非局灶性白质（WM）信号异常（SA）变化为特征，这些变化通常被检测为脑白质疏松症（LA）。高血压是WM病变形成的一个危险因素。本研究调查LA是否可能与与动脉高血压相关的脑脊液（CSF）搏动性增加有关。
在获得101名年龄在18至75岁之间无神经系统疾病的个体（53名女性和48名男性）的知情同意后，对其进行3T脑MRI检查，并采用电影相位对比成像来估计CSF流量。LA被定义为存在局灶性T2 WM SA变化和/或信号增加的非局灶性均匀区域，即所谓的“脏白质”（DAWM）。还收集了与心血管危险因素相关的信息。
在控制年龄和高血压后，观察到DAWM体积与以下各项之间存在显著的偏相关性：净负流量（r = -.294，P = .014）；净正流量（NPF）（r = .406，P = .001）；以及峰值正向速度（r = .342，P = .004）。多元线性回归分析显示，DAWM体积与CSF NPF（P = .019）和高血压（P = .007）显著相关，而T2 WM SA体积仅与年龄显著相关（P = .002）。DAWM和T2 WM SA体积的总和与年龄（P = .001）和CSF峰值负向速度（P = .041）显著相关。
导致LA的WM稀疏是一个多因素过程，其中高血压诱导的DAWM形成和导水管CSF搏动性增加可能起促成作用。这两个因素在一个独立于年龄的过程中似乎相互独立起作用。
