Thammasart Siriluk, Harvey Danielle J, Maillard Pauline, DeCarli Charles, Donnay Corinne A, Wheeler Gregory J, Fan Audrey P
Biological Engineering Program, Faculty of Engineering, King Mongkut's University of Technology Thonburi, Bangkok, Thailand.
Public Health Sciences, University of California Davis School of Medicine, Davis, CA, United States.
Front Neuroimaging. 2025 Jan 21;3:1463311. doi: 10.3389/fnimg.2024.1463311. eCollection 2024.
In an aging population, white matter hyperintensities (WMHs), observed on FLAIR MRI sequences, are indicators of cognitive decline, motor impairment, and increased vascular risk. However, the pathophysiological mechanisms underlying WMHs, including dynamic changes in cerebral blood flow (CBF) within and adjacent to lesions, remain poorly understood.
Our study examined a diverse cohort of 300 elderly participants through arterial spin labeling (ASL) on 3 Tesla MRI, analyzing both cross-sectional and longitudinal data. We characterized the relationship between CBF and WMH development in different lesion locations (based on distance from ventricles) and brain tissue types (WMH lesion, penumbra, and normal white matter).
Our findings reveal that WMHs exhibit significantly lower relative CBF (rCBF) compared to penumbra, normal-appearing white matter, and gray matter, with juxtaventricular WMHs (JVWMH) displaying the most substantial reductions. Longitudinally, WMHs that increased in size over a two-year period had lower baseline rCBF than those that remained stagnant, particularly in juxtaventricular and periventricular regions.
This study not only highlights the predictive value of rCBF in WMH progression but also provides location-specific hemodynamic information about WMHs that can guide clinical management of WMH-related brain changes and their clinical manifestations.
在老龄化人群中，液体衰减反转恢复（FLAIR）磁共振成像（MRI）序列上观察到的白质高信号（WMHs）是认知功能下降、运动障碍和血管风险增加的指标。然而，WMHs潜在的病理生理机制，包括病变内部及周围脑血流量（CBF）的动态变化，仍知之甚少。
我们的研究通过在3特斯拉MRI上进行动脉自旋标记（ASL），对300名老年参与者的不同队列进行了检查，分析了横断面和纵向数据。我们描述了不同病变位置（基于与脑室的距离）和脑组织类型（WMH病变、半暗带和正常白质）中CBF与WMH发展之间的关系。
我们的研究结果显示，与半暗带、外观正常的白质和灰质相比，WMHs的相对脑血流量（rCBF）显著降低，脑室周围白质高信号（JVWMH）的降低最为明显。纵向来看，在两年内体积增加的WMHs的基线rCBF低于保持稳定的WMHs，特别是在脑室周围和脑室旁区域。
本研究不仅强调了rCBF在WMH进展中的预测价值，还提供了关于WMHs的特定位置血流动力学信息，可指导与WMH相关的脑部变化及其临床表现的临床管理。
