BACKGROUND AND PURPOSE: Cerebral blood flow (CBF) abnormalities are previously demonstrated in white matter disease. A gradation of change may exist between patients with mild and more severe white matter disease. An association between blood brain barrier dysfunction, increasing age and white matter disease is also suggested. The purpose of this study was to quantify and correlate white matter disease severity and CT perfusion (CTP)-derived CBF and to determine whether permeability surface abnormality increases with white matter disease severity. MATERIALS AND METHODS: One hundred twenty patients with strokelike symptoms underwent CTP and MR imaging. Of these, 35 patients (15 women, 20 men; age, 66 +/- 15.7 years) with rapidly resolving symptoms and normal imaging characteristics consistent with transient ischemic attack were retrospectively reviewed and constituted the study cohort. Two blinded neurologists rated white matter severity, assigning age-related white matter change (ARWMC) scores. Patients were dichotomized a priori into mild and moderate-to-severe. CBF, cerebral blood volume (CBV), mean transit time (MTT), and permeability surface product maps were calculated for periventricular and subcortical white matter regions and average white and gray matter. Associations with white matter severity were tested by uni- and multivariate logistic regression analyses. Receiver operating characteristic analysis was performed. RESULTS: White matter disease was mild in 26 patients and moderate-to-severe in 9. Age was associated with increased likelihood of having moderate-to-severe white matter disease (P = .02). ARWMC correlated with subcortical (r = -0.50, P < .001) and average CBF (r = -0.55, P < .001). White matter severity was associated with subcortical (P = .03) and average (P = .03) white matter CBF, with a trend toward periventricular white matter CBF (P = .05). Uni- and multivariate analysis controlling for the confounding effect of age demonstrated significant association between white matter severity and subcortical (P = .032) white matter CBF. Area under the curve was 0.82. No permeability surface abnormality was found. CONCLUSIONS: CTP-derived subcortical white matter CBF is independently associated with white matter disease severity.
BACKGROUND AND PURPOSE: Cerebral blood flow (CBF) abnormalities are previously demonstrated in white matter disease. A gradation of change may exist between patients with mild and more severe white matter disease. An association between blood brain barrier dysfunction, increasing age and white matter disease is also suggested. The purpose of this study was to quantify and correlate white matter disease severity and CT perfusion (CTP)-derived CBF and to determine whether permeability surface abnormality increases with white matter disease severity. MATERIALS AND METHODS: One hundred twenty patients with strokelike symptoms underwent CTP and MR imaging. Of these, 35 patients (15 women, 20 men; age, 66 +/- 15.7 years) with rapidly resolving symptoms and normal imaging characteristics consistent with transient ischemic attack were retrospectively reviewed and constituted the study cohort. Two blinded neurologists rated white matter severity, assigning age-related white matter change (ARWMC) scores. Patients were dichotomized a priori into mild and moderate-to-severe. CBF, cerebral blood volume (CBV), mean transit time (MTT), and permeability surface product maps were calculated for periventricular and subcortical white matter regions and average white and gray matter. Associations with white matter severity were tested by uni- and multivariate logistic regression analyses. Receiver operating characteristic analysis was performed. RESULTS:White matter disease was mild in 26 patients and moderate-to-severe in 9. Age was associated with increased likelihood of having moderate-to-severe white matter disease (P = .02). ARWMC correlated with subcortical (r = -0.50, P < .001) and average CBF (r = -0.55, P < .001). White matter severity was associated with subcortical (P = .03) and average (P = .03) white matter CBF, with a trend toward periventricular white matter CBF (P = .05). Uni- and multivariate analysis controlling for the confounding effect of age demonstrated significant association between white matter severity and subcortical (P = .032) white matter CBF. Area under the curve was 0.82. No permeability surface abnormality was found. CONCLUSIONS:CTP-derived subcortical white matter CBF is independently associated with white matter disease severity.
Authors: Malee S Fernando; Julie E Simpson; Fiona Matthews; Carol Brayne; Claire E Lewis; Robert Barber; Raj N Kalaria; Gill Forster; Filomena Esteves; Stephen B Wharton; Pamela J Shaw; John T O'Brien; Paul G Ince Journal: Stroke Date: 2006-04-20 Impact factor: 7.914
Authors: J M Starr; J Wardlaw; K Ferguson; A MacLullich; I J Deary; I Marshall Journal: J Neurol Neurosurg Psychiatry Date: 2003-01 Impact factor: 10.154
Authors: Blake D Murphy; Allan J Fox; Donald H Lee; Demetrios J Sahlas; Sandra E Black; Matthew J Hogan; Shelagh B Coutts; Andrew M Demchuk; Mayank Goyal; Richard I Aviv; Sean Symons; Irene B Gulka; Vadim Beletsky; David Pelz; Richard K Chan; Ting-Yim Lee Journal: Radiology Date: 2008-04-18 Impact factor: 11.105
Authors: Anna Zimny; Marek Sasiadek; Jerzy Leszek; Anna Czarnecka; Elzbieta Trypka; Andrzej Kiejna Journal: J Neurol Sci Date: 2007-03-23 Impact factor: 3.181
Authors: Vladimir Hachinski; Costantino Iadecola; Ron C Petersen; Monique M Breteler; David L Nyenhuis; Sandra E Black; William J Powers; Charles DeCarli; Jose G Merino; Raj N Kalaria; Harry V Vinters; David M Holtzman; Gary A Rosenberg; Anders Wallin; Martin Dichgans; John R Marler; Gabrielle G Leblanc Journal: Stroke Date: 2006-08-17 Impact factor: 7.914
Authors: Natalia S Rost; Kaitlin Fitzpatrick; Alessandro Biffi; Allison Kanakis; William Devan; Christopher D Anderson; Lynelle Cortellini; Karen L Furie; Jonathan Rosand Journal: Stroke Date: 2010-10-14 Impact factor: 7.914
Authors: Yulu Shi; Michael J Thrippleton; Stephen D Makin; Ian Marshall; Mirjam I Geerlings; Anton J M de Craen; Mark A van Buchem; Joanna M Wardlaw Journal: J Cereb Blood Flow Metab Date: 2016-08-05 Impact factor: 6.200
Authors: Ajay Gupta; Sreejit Nair; Andrew D Schweitzer; Sirish Kishore; Carl E Johnson; Joseph P Comunale; Apostolos J Tsiouris; Pina C Sanelli Journal: Aging Dis Date: 2012-09-19 Impact factor: 6.745
Authors: Lauren R Binnie; Mathilde M H Pauls; Philip Benjamin; Mohani-Preet K Dhillon; Shai Betteridge; Brian Clarke; Rita Ghatala; Fearghal A H Hainsworth; Franklyn A Howe; Usman Khan; Christina Kruuse; Jeremy B Madigan; Barry Moynihan; Bhavini Patel; Anthony C Pereira; Egill Rostrup; Anan B Y Shtaya; Catherine A Spilling; Sarah Trippier; Rebecca Williams; Jeremy D Isaacs; Thomas R Barrick; Atticus H Hainsworth Journal: Transl Stroke Res Date: 2022-01-26 Impact factor: 6.800