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11.06.2021 | Neuro

Risk factors analysis according to regional distribution of white matter hyperintensities in a stroke cohort

verfasst von: Santiago Medrano-Martorell, Jaume Capellades, Jordi Jiménez-Conde, Sofía González-Ortiz, Marta Vilas-González, Ana Rodríguez-Campello, Ángel Ois, Elisa Cuadrado-Godia, Carla Avellaneda, Isabel Fernández, Elisa Merino-Peña, Jaume Roquer, Joan Martí-Fàbregas, Eva Giralt-Steinhauer

Erschienen in: European Radiology | Ausgabe 1/2022

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Abstract

Objectives

The spectrum of distribution of white matter hyperintensities (WMH) may reflect different functional, histopathological, and etiological features. We examined the relationships between cerebrovascular risk factors (CVRF) and different patterns of WMH in MRI using a qualitative visual scale in ischemic stroke (IS) patients.

Methods

We assembled clinical data and imaging findings from patients of two independent cohorts with recent IS. MRI scans were evaluated using a modified visual scale from Fazekas, Wahlund, and Van Swieten. WMH distributions were analyzed separately in periventricular (PV-WMH) and deep (D-WMH) white matter, basal ganglia (BG-WMH), and brainstem (B-WMH). Presence of confluence of PV-WMH and D-WMH and anterior-versus-posterior WMH predominance were also evaluated. Statistical analysis was performed with SPSS software.

Results

We included 618 patients, with a mean age of 72 years (standard deviation [SD] 11 years). The most frequent WMH pattern was D-WMH (73%). In a multivariable analysis, hypertension was associated with PV-WMH (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.29–2.50, p = 0.001) and BG-WMH (OR 2.13, 95% CI 1.19–3.83, p = 0.012). Diabetes mellitus was significantly related to PV-WMH (OR 1.69, 95% CI 1.24–2.30, p = 0.001), D-WMH (OR 1.46, 95% CI 1.07–1.49, p = 0.017), and confluence patterns of D-WMH and PV-WMH (OR 1.62, 95% CI 1.07–2.47, p = 0.024). Hyperlipidemia was found to be independently related to brainstem distribution (OR 1.70, 95% CI 1.08–2.69, p = 0.022).

Conclusions

Different CVRF profiles were significantly related to specific WMH spatial distribution patterns in a large IS cohort.

Key Points

• An observational study of WMH in a large IS cohort was assessed by a modified visual evaluation.

• Different CVRF profiles were significantly related to specific WMH spatial distribution patterns.

• Distinct WMH anatomical patterns could be related to different pathophysiological mechanisms.

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Titel: Risk factors analysis according to regional distribution of white matter hyperintensities in a stroke cohort
verfasst von: Santiago Medrano-Martorell
Jaume Capellades
Jordi Jiménez-Conde
Sofía González-Ortiz
Marta Vilas-González
Ana Rodríguez-Campello
Ángel Ois
Elisa Cuadrado-Godia
Carla Avellaneda
Isabel Fernández
Elisa Merino-Peña
Jaume Roquer
Joan Martí-Fàbregas
Eva Giralt-Steinhauer
Publikationsdatum: 11.06.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2022
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08106-2

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Risk factors analysis according to regional distribution of white matter hyperintensities in a stroke cohort