title: Long-term cerebral white and gray matter changes after preeclampsia.
abstract: OBJECTIVE
  To determine whether changes in cerebral structure are present after preeclampsia that may explain increased cerebrovascular risk in these women.
  
  
  METHODS
  We conducted a case control study in women between 5 and 15 years after either a preeclamptic or normotensive pregnancy. Brain MRI was performed. Analysis of white matter structure was undertaken using voxel-based segmentation of fluid-attenuation inversion recovery sequences to assess white matter lesion volume and diffusion tensor imaging to measure microstructural integrity. Voxel-based analysis of gray matter volumes was performed with adjustment for skull size.
  
  
  RESULTS
  Thirty-four previously preeclamptic women (aged 42.8 ± 5.1 years) and 49 controls were included. Previously preeclamptic women had reduced cortical gray matter volume (523.2 ± 30.1 vs 544.4 ± 44.7 mL,p< 0.05) and, although both groups displayed white matter lesions, changes were more extensive in previously preeclamptic women. They displayed increased temporal lobe white matter disease (lesion volume: 23.2 ± 24.9 vs 10.9 ± 15.0 μL,p< 0.05) and altered microstructural integrity (radial diffusivity: 538 ± 19 vs 526 ± 18 × 10-6mm2/s,p< 0.01), which also extended to occipital and parietal lobes. The degree of temporal lobe white matter change in previously preeclamptic women was independent of their current cardiovascular risk profile (p< 0.05) and increased with time from index pregnancy (p< 0.05).
  
  
  CONCLUSIONS
  A history of preeclampsia is associated with temporal lobe white matter changes and reduced cortical volume in young women, which is out of proportion to their classic cardiovascular risk profile. The severity of changes is proportional to time since pregnancy, which would be consistent with continued accumulation of damage after pregnancy.
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Siepmann
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Boardman
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Amy
authors.initials: A
authors.lastname: Bilderbeck
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Griffanti
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Kenworthy
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Zwager
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: David
authors.initials: D
authors.lastname: McKean
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Grace Z
authors.initials: GZ
authors.lastname: Yu
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Yrsa Bergmann
authors.initials: YB
authors.lastname: Sverrisdottir
authors.affiliation: From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. paul.leeson@cardiov.ox.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000473:pathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D056324:Diffusion Tensor Imaging; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000473:pathology*; D011247:Pregnancy; D066127:White Matter / Q000000981:diagnostic imaging*