White matter brain lesions in midlife familial hypercholesterolemic patients at 3-Tesla magnetic resonance imaging.
BACKGROUND
Patients with hypercholesterolemia of 60 years and older have an increased risk for white matter brain lesions and dementia.


OBJECTIVE
To investigate whether patients with familial hypercholesterolemia (FH) develop white matter lesions at 3-Tesla (T) MRI as early as in midlife.


METHODS
Non-diabetic, nonsmoking, and non-hypertensive heterozygous FH patients on treatment with maximally tolerated dose of a statin for more than 5 years (n = 14) and matched controls (n = 22) aged 25 to 60 years of age were studied. Imaging was performed at 3T with a fluid-attenuated T2-weighted MR pulse sequence and a T1-weighted spin-echo pulse sequence following 10 ml of i.v. gadopentetate dimeglumine. Images were evaluated by two independent readers. Fasting blood samples were taken. Student's t test was employed at P<0.05.


RESULTS
Three volunteers and one FH patient had white matter lesions (P<0.53). No other evidence of past ischemic stroke was observed. Mean total serum cholesterol and low-density lipoprotein (LDL) cholesterol were significantly higher in the FH group (6.0+/-1.1 vs. 5.1+/-0.9 mmol/l, P<0.02 and 4.1+/-0.9 vs. 3.1+/-0.8 mmol/l, P<0.004, respectively).


CONCLUSIONS
Heterozygous FH patients on statin treatment in the age range of 25 to 60 years are not at increased risk of white matter lesions at 3T MRI.
Schmitz
S A
SA
Imaging Sciences Department and Clinical Research Facility, MRC Clinical Sciences Centre, London, UK. stephan.schmitz@imperial.ac.uk
O'Regan
D P
DP
Fitzpatrick
J
J
Neuwirth
C
C
Potter
E
E
Tosi
I
I
Hajnal
J V
JV
Naoumova
R P
RP
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology*; D002784:Cholesterol / Q000097:blood; D003287:Contrast Media / Q000008:administration & dosage; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D018570:Risk Assessment; D012307:Risk Factors
D003287:Contrast Media; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol; D019786:Gadolinium DTPA