title: White matter hyperintensities in patients with multiple system atrophy.
abstract: BACKGROUND
  Although white matter hyperintensities (WMHs) are prevalent in the elderly, the clinical significance and the underlying pathophysiological mechanisms of WMHs in neurodegenerative disorders have not been fully clarified.
  
  
  OBJECTIVE
  The present study aimed to determine the degree of WMHs in patients with multiple system atrophy (MSA), and analyze the predisposing factors for WMHs.
  
  
  METHODS
  Two raters blinded to clinical information assessed cerebrovascular lesions in brain MRIs from patients with MSA and age-matched controls. Patients with Parkinson's disease (PD) were similarly studied as a disease control. The results obtained were compared with the clinical characteristics of the patients and statistically analyzed.
  
  
  RESULTS
  WMHs in patients with MSA were statistically greater compared with PD patients or controls. There were no significant differences in either lacunar or territorial infarcts. Multiple linear regression analysis demonstrated that age, supine systolic blood pressure, and a drop in orthostatic blood pressure were significantly and independently correlated with WMH scores in MSA.
  
  
  CONCLUSIONS
  The present study suggests that white matter is differentially involved in MSA. In addition to aging, cerebral hypoperfusions caused by fluctuations of blood pressure may be a significant contributing factor to WMHs in MSA, although the possibility that degenerative processes occurring in oligodendrocytes may be associated with WMHs should not be excluded.
authors.affiliation: Department of Neurology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Umoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Miwa
authors.forename: Ryuki
authors.initials: R
authors.lastname: Ando
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kajimoto
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000453:epidemiology / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*