title: Gray matter blood flow and volume are reduced in association with white matter hyperintensity lesion burden: a cross-sectional MRI study.
abstract: Cerebral White Matter Hyperintensities (WMH) are associated with vascular risk factors and age-related cognitive decline. WMH have primarily been associated with global white matter and gray matter (GM) changes and less is known about regional effects in GM. The purpose of this study was to test for an association between WMH and two GM imaging measures: cerebral blood flow (CBF) and voxel-based morphometry (VBM). Twenty-six elderly adults with mild to severe WMH participated in this cross-sectional 3 Tesla magnetic resonance imaging (MRI) study. MRI measures of GM CBF and VBM were derived from arterial spin labeling (ASL) and T1-weighted images, respectively. Fluid-attenuated inversion recovery (FLAIR) images were used to quantify the WMH lesion burden (mL). GM CBF and VBM data were used as dependent variables. WMH lesion burden, age and sex were used in a regression model. Visual rating of WMH with the Fazekas method was used to compare the WMH lesion volume regression approach. WMH volume was normally distributed for this group (mean volume of 22.7 mL, range: 2.2-70.6 mL). CBF analysis revealed negative associations between WMH volume and CBF in the left anterior putamen, subcallosal, accumbens, anterior caudate, orbital frontal, anterior insula, and frontal pole (corrected p < 0.05). VBM analysis revealed negative associations between WMH and GM volume in lingual gyrus, intracalcarine, and bilateral hippocampus (corrected p < 0.05). The visual rating scale corroborated the regression findings (corrected p < 0.05). WMH lesion volume was associated with intra-group GM CBF and structural differences in this cohort of WMH adults with mild to severe lesion burden.
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada.
authors.forename: David E
authors.initials: DE
authors.lastname: Crane
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Division of Neurology, Department of Medicine, University of Toronto Toronto, ON, Canada ; Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto Toronto, ON, Canada.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada.
authors.forename: Anoop
authors.initials: A
authors.lastname: Ganda
authors.affiliation: Department of Medical Imaging, The Toronto Western Hospital and the University of Toronto Toronto, ON, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Institute of Medical Sciences, University of Toronto Toronto, ON, Canada ; MD/PhD Program, Faculty of Medicine, University of Toronto Toronto, ON, Canada.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Nestor
authors.affiliation: Departments of Radiology and Radiological Sciences, Psychiatry, and Physics and Astronomy, Vanderbilt University Nashville, TN, USA.
authors.forename: Manus J
authors.initials: MJ
authors.lastname: Donahue
authors.affiliation: Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada ; Department of Medical Biophysics, University of Toronto Toronto, ON, Canada.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: MacIntosh
keywords: arterial spin labeling; cerebral blood flow; hippocampus; insula; small vessel disease; white matter hyperintensities