McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.
Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
Neurobiol Aging. 2023 Feb;122:112-119. doi: 10.1016/j.neurobiolaging.2022.11.012. Epub 2022 Nov 25.
White matter hyperintensities (WMHs) may be one of the earliest pathological changes in aging. Race differences in WMH burden has been conflicting. This study examined if race influences WMHs and whether these differences are influenced by vascular risk factors. Alzheimer's Disease Neuroimaging Initiative participants were included if they had a baseline MRI, diagnosis, and WMH measurements. Ninety-one Blacks and 1937 Whites were included. Using bootstrap re-sampling, 91 Whites were randomly sampled and matched to Blacks based on age, sex, education, and diagnosis 1000 times. Linear models examined the influence of race on baseline WMHs, and change of WMHs over time, with and without vascular factors. Vascular risk factors had higher prevalence in Blacks than Whites. When not including vascular factors, Blacks had greater frontal, parietal, deep, and total WMH burden compared to Whites. There were no race differences in longitudinal progression of WMH accumulation. After controlling for vascular factors, only overall longitudinal parietal WMH group differences remained significant, suggesting that vascular factors contribute to racial group differences observed in WMHs.
脑白质高信号（WMHs）可能是衰老过程中最早出现的病理改变之一。种族间WMHs 负担的差异存在争议。本研究旨在探讨种族是否影响 WMHs，以及这些差异是否受血管危险因素的影响。阿尔茨海默病神经影像学倡议（Alzheimer's Disease Neuroimaging Initiative）的参与者，如果有基线 MRI、诊断和 WMH 测量数据，则被纳入研究。共纳入 91 名黑人参与者和 1937 名白人参与者。通过自举重采样（bootstrap re-sampling），随机抽取了 91 名白人参与者，并基于年龄、性别、教育程度和诊断与黑人进行 1000 次匹配。线性模型用于检验种族对基线 WMHs 以及 WMHs 随时间变化的影响，同时考虑和不考虑血管因素。血管危险因素在黑人中的患病率高于白人。不考虑血管因素时，与白人相比，黑人的额叶、顶叶、深部和总 WMH 负担更大。WMHs 累积的纵向进展在不同种族间没有差异。在控制血管因素后，仅总体纵向顶叶 WMH 组间差异仍然显著，这表明血管因素导致了 WMHs 中观察到的种族群体差异。
