Kuhn-Keller Jasmin Annica, Sigurdsson Sigurdur, Launer Lenore J, van Buchem Mark A, van Osch Matthias Jp, Gudnason Vilmundur, de Bresser Jeroen
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Icelandic Heart Association, Kopavogur, Iceland.
J Cereb Blood Flow Metab. 2025 Jan;45(1):187-195. doi: 10.1177/0271678X241270538. Epub 2024 Aug 7.
White matter hyperintensity (WMH) shape is associated with long-term dementia risk in community-dwelling older adults, however, the underlying structural correlates of this association are unknown. We therefore aimed to investigate the association between baseline WMH shape and cerebrovascular disease progression over time in community-dwelling older adults. The association of WMH shape and cerebrovascular disease markers was investigated using linear and logistic regression models in the Age, Gene/Environment Susceptibility-Reykjavik (AGES) study (n = 2297; average time to follow-up: 5.2 years). A more irregular shape of periventricular/confluent WMH at baseline was associated with a larger increase in WMH volume, and with occurrence of new subcortical infarcts, new microbleeds, new enlarged perivascular spaces, and new cerebellar infarcts at the 5.2-year follow-up (all p < 0.05). Furthermore, less elongated and more irregularly shaped deep WMHs were associated with a larger increase in WMH volume, and new cortical infarcts at follow-up (p < 0.05). A less elongated shape of deep WMH was associated with new microbleeds at follow-up (p < 0.05). Our findings show that WMH shape may be indicative of the type of cerebrovascular disease marker progression. This underlines the significance of WMH shape to aid in the assessment of cerebrovascular disease progression.
脑白质高信号（WMH）的形态与社区居住的老年人患长期痴呆症的风险相关，然而，这种关联背后的结构相关性尚不清楚。因此，我们旨在研究社区居住的老年人基线WMH形态与随时间推移的脑血管疾病进展之间的关联。在年龄、基因/环境易感性-雷克雅未克（AGES）研究（n = 2297；平均随访时间：5.2年）中，使用线性和逻辑回归模型研究了WMH形态与脑血管疾病标志物之间的关联。基线时脑室周围/融合性WMH形状越不规则，与WMH体积增加越大相关，并且与5.2年随访时新的皮质下梗死、新的微出血、新的血管周围间隙扩大和新的小脑梗死的发生相关（所有p < 0.05）。此外，深部WMH的拉长程度越低且形状越不规则，与WMH体积增加越大以及随访时新的皮质梗死相关（p < 0.05）。深部WMH的拉长程度越低与随访时新的微出血相关（p < 0.05）。我们的研究结果表明，WMH形态可能指示脑血管疾病标志物进展的类型。这突出了WMH形态在辅助评估脑血管疾病进展方面的重要性。
