Changes in Vascular Risk Factors from Midlife to Late Life and White Matter Lesions: A 20-Year Follow-Up Study

2011 ◽  
Vol 31 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Miika Vuorinen ◽  
Alina Solomon ◽  
Suvi Rovio ◽  
Lasse Nieminen ◽  
Ingemar Kåreholt ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Late Life ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Follow Up Study

Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors

2004 ◽  
Vol 34 (1) ◽  
pp. 125-136 ◽  
Author(s):  
R. BALDWIN ◽  
S. JEFFRIES ◽  
A. JACKSON ◽  
C. SUTCLIFFE ◽  
N. THACKER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
White Matter ◽  
Depressive Disorder ◽  
Late Onset ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Group Differences ◽  
Vascular Risk ◽  
Control Subjects

Background. Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors.Method. This was a case–control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan.Results. After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease.Conclusion. The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

Silent Cerebral White Matter Lesions and Their Relationship With Vascular Risk Factors in Middle-Aged Predialysis Patients With CKD

2006 ◽  
Vol 47 (2) ◽  
pp. 241-250 ◽  
Author(s):  
Alberto Martinez-Vea ◽  
Esther Salvadó ◽  
Alfredo Bardají ◽  
Cristina Gutierrez ◽  
Ana Ramos ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Cerebral White Matter ◽  
Vascular Risk ◽  
Middle Aged ◽  
Cerebral White Matter Lesions

Vascular White Matter Lesions in Young Adults: A Neurology Outpatient Clinic Registry

2019 ◽  
Vol 82 (1-3) ◽  
pp. 23-31
Author(s):  
Miguel Viana-Baptista ◽  
Vera Cruz-e-Silva ◽  
André Caetano ◽  
João Pedro Marto ◽  
Elsa Azevedo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
White Matter ◽  
Genetic Disorder ◽  
Previous History ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Outpatient Clinics ◽  
Vascular Risk ◽  
History Of

Introduction: Although frequently assumed to be age-related changes, vascular white matter lesions (WML) are sometimes found in young adults. Etiology is usually attributed to sporadic small vessel disease; nevertheless, genetic disorders may also be implicated. We aimed to characterize the population of young adults with vascular WML in Neurology outpatient clinics. Methods: Neurologists from 12 Portuguese hospitals were invited to include patients aged 18–55 years evaluated in consultation, with vascular WML on MRI, scoring II or III in the Fazekas scale. Central imaging validation was performed by 2 independent, blinded, Neuroradiologists. Demographic and clinical data were collected as well as results of investigations performed. Results: During 2 years, 77 patients were included (mean age 47.7 years). Vascular risk factors were present in 88.3% patients (hypertension in 53.2%) and previous history of stroke in 36.4%. Patients without history of stroke were younger (46.6 ± 7.2 vs. 49.6 ± 3.9 years, p = 0.045) and had fewer vascular risk factors (p < 0.001). They were more frequently females (87.8 vs. 46.4%, p < 0.001), and headache (30.6 vs. 3.6%, p = 0.007), contrary to focal symptoms (16.3 vs. 53.6%, p = 0.001), was the most frequent reason of referral. Etiological investigations performed differed between Neurologists. A genetic disorder was identified in 6 out of 58 patients (CADASIL n = 5; COL4A1 n = 1). Conclusion: Young adults with vascular WML evaluated in Neurology outpatient clinics concentrate in the oldest age groups. Vascular risk factors should be screened carefully in this population. Among patients without history of stroke, females largely outweigh males. Diagnostic investigations performed do not follow a standardized protocol.

scholarly journals Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

2009 ◽  
Vol 40 (8) ◽  
pp. 1389-1399 ◽  
Author(s):  
R. B. Dalby ◽  
M. M. Chakravarty ◽  
J. Ahdidan ◽  
L. Sørensen ◽  
J. Frandsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Lesion Load ◽  
Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

Abstract 51: Effects of Vascular Risk Factors on Microstructural White Matter: A Voxel-Based Longitudinal Diffusion Tensor Imaging Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Pauline Maillard ◽  
Evan Fletcher ◽  
Owen Carmichael ◽  
Dan Mungas ◽  
Bruce Reed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Brain Aging ◽  
Diffusion Tensor ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Local Contraction

Background: Diabetes mellitus type II (DMT2) and hypertension (HTN) have been reported as increasing the risk of dementia. Because recent cross-sectional diffusion tensor imaging (DTI) studies have identified association between vascular risk factors (VRF) and microstructural white matter (WM) abnormalities in elderly, longitudinal DTI studies are needed to determine whether VRF may be associated with accelerated WM degeneration over time. Methods: 114 cognitively normal participants from University of California, Davis Alzheimer’s Disease Center, aged 73.9±6.7, received a comprehensive clinical evaluation and brain MRI including T1-weighted and DTI sequences on two dates (mean delay: 3.3 years). Baseline and follow-up FA maps were calculated, aligned, and subtracted to provide FA change ([[Unable to Display Character: &#8710;]]FA) maps and warped to a common template (MDT). Coregistration of baseline and follow-up T1 maps to MDT enabled computation of Jacobian images (i.e. the local contraction factor). VRF score (VRFS) was computed as the sum of DMT2, HTN and hyperlipidemia (HYP) incidence based on the subject’s medical history. We then used voxel-based linear regressions to relate annual [[Unable to Display Character: &#8710;]]FA and Jacobian determinants to VRFS, adjusting for potential confounders. Resulting T maps were corrected for multiple comparisons. Results: Poorer VRF score was associated with higher rate of [[Unable to Display Character: &#8710;]]FA loss and of GM atrophy with regions most heavily implicated including the corpus callosum and the frontal GM (see Figure1). Conclusions: This is one of very few studies of longitudinal DTI change in the elderly. DMT2, HTH and HYP are associated with accelerated WM degeneration and GM atrophy in areas whose integrity is known to be reduced in mild cognitive impairment and dementia. Future work should clarify the independent role of these vascular risk factors in accelerating brain aging.

Vascular risk factors and the effect of white matter lesions on extrapyramidal signs in Alzheimer's disease

2010 ◽  
Vol 23 (5) ◽  
pp. 780-787 ◽  
Author(s):  
Moon Ho Park ◽  
Joo Young Min ◽  
Do-Young Kwon ◽  
Seung Hwan Lee ◽  
Hae Ri Na ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
White Matter ◽  
White Matter Lesions ◽  
Postural Instability ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Postural Instability Gait Difficulty ◽  
Extrapyramidal Signs

ABSTRACTBackground: Extrapyramidal signs (EPSs), which are important characteristics of Parkinson's disease (PD), occur frequently in Alzheimer's disease (AD). Although AD and PD share common clinical features such as EPSs, these diseases vary with respect to vascular risk factors. The presence of vascular risk factors increases the risk of AD; however, these factors have been known to be inversely associated with PD. We aimed to assess the effect of vascular risk factors and white matter lesions (WMLs) on EPSs in AD.Methods: We recruited 1,187 AD patients and 333 controls with neither cognitive impairment nor EPSs. All participants underwent detailed clinical evaluations which included assessments of vascular risk factors, cognitive function, and EPSs, as well as WMLs on brain MRIs. EPS subtypes were classified into tremor-dominant, postural instability gait difficulty, or indeterminate; WMLs subtypes were classified into periventricular WML (pvWML) or deep WML (dWML).Results: EPSs were present in 17.9% of subjects with AD and were significantly associated with vascular risk factors such as age, male gender, diabetes mellitus, and WMLs. Additionally, a multivariate logistic regression analysis showed that EPSs in AD were associated with pvWML (odds ratio (OR), 1.61–2.52), not with dWML. With respect to EPS subtypes, the majority (78.4%) of EPSs in AD were postural instability gait difficulty, which was also associated with WMLs (OR 1.84–2.41), pvWML (OR 2.09–3.14), and dWML (OR 1.83–3.42).Conclusions: EPSs in AD are associated with selected vascular risk factors as well as WMLs.

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