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Research ArticleAdult Brain
Open Access

White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling

J.W. van Dalen, H.J.M.M. Mutsaerts, A.J. Nederveen, H. Vrenken, M.D. Steenwijk, M.W.A. Caan, C.B.L.M. Majoie, W.A. van Gool and E. Richard
American Journal of Neuroradiology October 2016, 37 (10) 1824-1830; DOI: https://doi.org/10.3174/ajnr.A4828
J.W. van Dalen
aFrom the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.)
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H.J.M.M. Mutsaerts
bRadiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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A.J. Nederveen
bRadiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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H. Vrenken
cDepartments of Radiology and Nuclear Medicine (H.V., M.D.S.)
dPhysics and Medical Technology (H.V.), Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Amsterdam, the Netherlands
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M.D. Steenwijk
cDepartments of Radiology and Nuclear Medicine (H.V., M.D.S.)
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M.W.A. Caan
bRadiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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C.B.L.M. Majoie
bRadiology (H.J.M.M.M., A.J.N., M.W.A.C., C.B.L.M.M.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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W.A. van Gool
aFrom the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.)
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E. Richard
aFrom the Departments of Neurology (J.W.v.D., W.A.v.G., E.R.)
eDepartment of Neurology (E.R.), Radboud University Medical Center, Nijmegen, the Netherlands.
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    Fig 1.

    Regional cerebral blood flow. Cerebral blood in the gray matter, white matter, normal-appearing white matter unaffected by WMHs (NAWM), and white matter hyperintensities. Shown are means (SDs) and P values of paired sample t tests.

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    Fig 2.

    Cerebral blood flow per quartiles of WMH load. Cerebral blood flow in the gray matter, normal-appearing white matter unaffected by WMHs, and white matter hyperintensities in subgroups based on quartiles of WMH volume. Shown are means (SDs) and significant P values of 1-way analysis of variance.

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    Fig 3.

    Scatterplots of relations between CBF and WMH volume, adjusted for total brain volume. Lines denote the regression line with 95% CI. Log WMH volume is logarithmically transformed.

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    Table 1:

    General characteristicsa

    Characteristics (n = 181)
    Age (yr)77 (2)
    Female96 (53%)
    MMSE29 (28–30)
    BMI (kg/m2)26 (24–28)
    History of stroke or TIA19 (11%)
    History of cardiovascular disease41 (23%)
    Diabetes mellitus20 (11%)
    Smoking status
        Never82 (45%)
        Former88 (49%)
        Current11 (6%)
    Antihypertensive drug use108 (60%)
    World Health Organization hypertension grade:
        Normotension47 (26%)
        Grade I hypertension73 (41%)
        Grade II hypertension38 (21%)
        Grade III hypertension20 (11%)
    Systolic blood pressure (mm Hg)148 (138–165)
    Diastolic blood pressure (mm Hg)81 (74–90)
    Brain parenchymal fraction0.61 (0.025)
    WMH volume (mL)6.5 (3.6–11.2)
    • Note:—MMSE indicates Mini-Mental State Examination; BMI, body mass index.

    • ↵a Reported are means and SDs, numbers and valid percentages, or medians with interquartile range. Cardiovascular disease comprises peripheral arterial disease, angina pectoris, and myocardial infarction. Brain parenchymal fraction = (total cerebral volume)/total intracranial volume.

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    Table 2:

    Association between cerebral perfusion and white matter hyperintensity volumea

    PredictorModel 1Model 2
    βP ValueR2βP ValueR2
    CBF in WMH−.248.0010.06−.201.0290.06
    CBF in NAWM−.035.6430.00.175.0980.05
    CBF in GM−.065.3820.00.175.1330.05
    • ↵a R2 is the adjusted R2 representing the proportion of variation in white matter hyperintensity volume explained by all variables in the model, corrected for the number of variables—model 1: adjusted for total brain volume; model 2: adjusted for total brain volume, age, antihypertensive use, brain parenchymal fraction, and transit time.

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American Journal of Neuroradiology: 37 (10)
American Journal of Neuroradiology
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1 Oct 2016
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J.W. van Dalen, H.J.M.M. Mutsaerts, A.J. Nederveen, H. Vrenken, M.D. Steenwijk, M.W.A. Caan, C.B.L.M. Majoie, W.A. van Gool, E. Richard
White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling
American Journal of Neuroradiology Oct 2016, 37 (10) 1824-1830; DOI: 10.3174/ajnr.A4828

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White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling
J.W. van Dalen, H.J.M.M. Mutsaerts, A.J. Nederveen, H. Vrenken, M.D. Steenwijk, M.W.A. Caan, C.B.L.M. Majoie, W.A. van Gool, E. Richard
American Journal of Neuroradiology Oct 2016, 37 (10) 1824-1830; DOI: 10.3174/ajnr.A4828
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