title: High total cerebral blood flow is associated with a decrease of white matter lesions.
abstract: BACKGROUND
  Low cerebral blood flow (CBF) has been associated with the presence of white matter lesions (WMLs). However, the power of these studies was insufficient (n=20-35) to determine whether flow is associated with WMLs.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether total cerebral blood flow (tCBF) is associated with the severity of white matter lesions (WMLs) in a large patient sample.
  
  
  METHODS
  228 patients with clinical symptoms of cardiovascular disease had MRI of the brain, consisting of a T2-w FLAIR and a 2D phase-contrast flow measurement of the internal carotid arteries and the basilar artery. WMLs were graded according to prevalence and size of deep and periventricular WMLs. To determine the relation between tCBF and WMLs we used linear and logistic regression analysis adjusted for age, gender, intima media thickness and hypertension.
  
  
  RESULTS
  We observed an inverse association between the tCBF and the total number of WMLs adjusted for age, gender, intima media thickness and hypertension [B=-1, 0 WML 95% CI (-2.0 to 0.0, p=0.045) per 100 mL increase in tCBF]. The adjusted odds ratio for the presence of severe WMLs in patients with high tCBF (> 675 mL/min) was 0.5 (95% CI 0.2-1.0) compared with patients with normal tCBF.
  
  
  CONCLUSIONS
  In this study we found that high tCBF is associated with a decrease in presence and severity of WMLs.
authors.affiliation: Department of Radiology E01.132, University Medical Center Utrecht, PO Box 85500, 3508, GA Utrecht, The Netherlands.
authors.forename: R H C
authors.initials: RH
authors.lastname: Bisschops
authors.forename: Y
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: W P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: J
authors.initials: J
authors.lastname: van der Grond
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000150:complications; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012720:Severity of Illness Index