Aiko Tamura1,2, Nagato Kuriyama3, Kentaro Akazawa4, Etsuko Ozaki3, Isao Watanabe3, Yoichi Ohshima2,5, Masaki Kondo2, Nobuo Takezawa2, Akihiro Takada6, Sanae Matsumoto7, Kazuo Takeda6, Kengo Yoshii8, Kei Yamada4, Yoshiyuki Watanabe3, Masanori Nakagawa9, Toshiki Mizuno10. 1. Department of Neurology, Matsushita Memorial Hospital, 5-55, Sotojima-cho, Moriguchi-shi, Osaka-fu, 570-8540, Japan. 2. Department of Neurology, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto-shi, Kyoto-fu, 602-8566, Japan. 3. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto-shi, Kyoto-fu, 602-8566, Japan. 4. Department of Radiology, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto-shi, Kyoto-fu, 602-8566, Japan. 5. Department of Neurology, Kyoto Yamashiro General Medical Center, 1-27, Kizuekimae, Kizugawa-shi, Kyoto-fu, 619-0214, Japan. 6. Kyoto Industrial Health Association, 67, Kitatsuboi-cho, Nishinokyo, Kyoto-shi, Kyoto-fu, 604-8472, Japan. 7. Matsumotonaika Clinic, 61 Yonnotsubo-cho, Iwakuraminami, Sakyo-ku, Kyoto-shi, Kyoto-fu, 606-0033, Japan. 8. Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, 1-5, Hanki-cho, Shimogamo, Sakyo-ku, Kyoto-shi, Kyoto-fu, 606-0823, Japan. 9. Department of Neurology, North Medical Center, Kyoto Prefectural University of Medicine, 481, Azaotokoyama, Yosano-cho, Yosa-gun, Kyoto-fu, 629-2261, Japan. 10. Department of Neurology, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto-shi, Kyoto-fu, 602-8566, Japan. mizuno@koto.kpu-m.ac.jp.
Abstract
PURPOSE: Deep white matter lesions (DWMLs), T2 high-intensity areas in the subcortical white matter on magnetic resonance imaging (MRI), are a clinical phenotype of cerebral small vessel disease. Factors such as age and hypertension have been reported to significantly contribute to the presence and severity of DWMLs in cross-sectional studies. We herein report a 10-year longitudinal study on DWMLs in elderly Japanese subjects to reveal the clinical variables contributing to the progression of DWMLs. METHODS: A total of 469 Japanese subjects were invited to participate in the study. Of the participants at baseline, 259 subjects completed the revisit MRI study 10 years later. In those 259 subjects, we evaluated the correlation between the progression of DWMLs and clinical variables, such as the gender, age, and overt vascular risk factors. To clarify the role of hypertension, 200 subjects with grade 1 DWMLs at baseline were categorized into three groups according to their status of hypertension and its treatment. RESULTS: Of the 200 subjects with grade 1 DWMLs, 47 subjects (23.5%) showed progression of DWMLs (progression group). In the progression group, the percentage of subjects with hypertension and the systolic blood pressure values were higher than in the non-progression group. In addition, subjects ≥ 60 years old at baseline tended to show deterioration of DWMLs in the group with hypertension without antihypertensive treatment. CONCLUSION: The results of this 10-year longitudinal study imply a positive correlation between long-standing hypertension and the progression of DWMLs.
PURPOSE:Deep white matter lesions (DWMLs), T2 high-intensity areas in the subcortical white matter on magnetic resonance imaging (MRI), are a clinical phenotype of cerebral small vessel disease. Factors such as age and hypertension have been reported to significantly contribute to the presence and severity of DWMLs in cross-sectional studies. We herein report a 10-year longitudinal study on DWMLs in elderly Japanese subjects to reveal the clinical variables contributing to the progression of DWMLs. METHODS: A total of 469 Japanese subjects were invited to participate in the study. Of the participants at baseline, 259 subjects completed the revisit MRI study 10 years later. In those 259 subjects, we evaluated the correlation between the progression of DWMLs and clinical variables, such as the gender, age, and overt vascular risk factors. To clarify the role of hypertension, 200 subjects with grade 1 DWMLs at baseline were categorized into three groups according to their status of hypertension and its treatment. RESULTS: Of the 200 subjects with grade 1 DWMLs, 47 subjects (23.5%) showed progression of DWMLs (progression group). In the progression group, the percentage of subjects with hypertension and the systolic blood pressure values were higher than in the non-progression group. In addition, subjects ≥ 60 years old at baseline tended to show deterioration of DWMLs in the group with hypertension without antihypertensive treatment. CONCLUSION: The results of this 10-year longitudinal study imply a positive correlation between long-standing hypertension and the progression of DWMLs.
Entities:
Keywords:
Deep white matter lesions; Healthy elderly subjects; Hypertension; Longitudinal study; Magnetic resonance imaging
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