title: Reduced blood flow in normal white matter predicts development of leukoaraiosis.
abstract: The purpose of this study was to investigate whether low cerebral blood flow (CBF) is associated with subsequent development of white matter hyperintensities (WMH). Patients were included from a longitudinal magnetic resonance (MR) imaging study of minor stroke/transient ischemic attack patients. Images were co-registered and new WMH at 18 months were identified by comparing follow-up imaging with baseline fluid-attenuated inversion recovery (FLAIR). Regions-of-interest (ROIs) were placed on FLAIR images in one of three categories: (1) WMH seen at both baseline and follow-up imaging, (2) new WMH seen only on follow-up imaging, and (3) regions of normal-appearing white matter at both time points. Registered CBF maps at baseline were used to measure CBF in the ROIs. A multivariable model was developed using mixed-effects logistic regression to determine the effect of baseline CBF on the development on new WMH. Forty patients were included. Mean age was 61±11 years, 30% were female. Low baseline CBF, female sex, and presence of diabetes were independently associated with the presence of new WMH on follow-up imaging. The odds of having new WMH on follow-up imaging reduces by 0.61 (95% confidence interval=0.57 to 0.65) for each 1 mL/100 g per minute increase in baseline CBF. We conclude that regions of white matter with low CBF develop new WMH on follow-up imaging.
authors.affiliation: Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.
authors.forename: Manya
authors.initials: M
authors.lastname: Bernbaum
authors.affiliation: Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Department of Radiology, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Bijoy K
authors.initials: BK
authors.lastname: Menon
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gordon
authors.initials: G
authors.lastname: Fick
authors.affiliation: Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Department of Radiology, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
authors.affiliation: Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
authors.affiliation: Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Frayne
authors.affiliation: Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Hotchkiss Brain Institute, Calgary, Alberta, Canada.|Seaman Family MR Research Center, Foothills Medical Centre, Calgary, Alberta, Canada.|Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.|Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000473:pathology*; D002560:Cerebrovascular Circulation; D048909:Diabetes Complications / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002546:Ischemic Attack, Transient / Q000473:pathology*; D049292:Leukoaraiosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D020521:Stroke / Q000473:pathology*; D066127:White Matter / Q000098:blood supply*