This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fukuda, H. Articles by Kitani, M. Search for Related Content PubMed PubMed Citation Articles by Fukuda, H. Articles by Kitani, M.

(Stroke. 1996;27:645-649.)
© 1996 American Heart Association, Inc.

Articles

Cigarette Smoking Is Correlated With the Periventricular Hyperintensity Grade on Brain Magnetic Resonance Imaging

Hitoshi Fukuda, MD Mitsuhiro Kitani, MD

From the Department of Neurology, Masuda Red Cross Hospital, Japan.

Correspondence to Hitoshi Fukuda, MD, Masuda Red Cross Hospital, I-103-1, Otoyoshi, Masuda, Shimane, 698, Japan.

Background and Purpose A few studies have observed a significant inverse correlation between cigarette smoking or lipid abnormalities and periventricular hyperintensities (PVHs) on T₂-weighted magnetic resonance imaging (MRI) scans of the brain, which is surprising because smoking and hyperlipidemia are considered risk factors for cerebrovascular disease. We investigated the relation between smoking and lipid abnormalities and PVHs on T₂-weighted MRIs.

Methods MRI scans were performed in 253 patients over the age of 40 years, and PVHs were assessed retrospectively by use of a five-point scale. Patients who were receiving medical treatment for hyperlipidemia were excluded. Serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides were determined in the fasting state by an automated enzymatic procedure. The low-density lipoprotein (LDL) cholesterol level was calculated by use of Friedewald's equation. Age, sex, hypertensive status, antihypertensive treatment, presence or absence of diabetes mellitus, and history of stroke were included in the analysis.

Results Multiple linear regression analysis showed that age, hypertension, smoking, and antihypertensive treatment were significantly and independently correlated with the PVH score. The standard partial regression coefficients were .39 (P<.0001) for age, .33 (P<.0001) for hypertension, .16 (P=.0062) for smoking, and -.18 (P=.0124) for antihypertensive treatment. Hypercholesterolemia (total cholesterol level >220 mg/dL), HDL hypocholesterolemia (HDL cholesterol level <40 mg/dL), LDL hypercholesterolemia (LDL cholesterol level >130 mg/dL), hypertriglyceridemia (triglyceride level >150 mg/dL), sex, diabetes mellitus, and a history of stroke were not correlated with the PVH score.

Conclusions Cigarette smoking was a weak but significant positive predictor of the PVH score and was independent of age, hypertension, and antihypertensive treatment. Lipid abnormalities were not related to the PVH score.

Key Words: cigarette smoking • magnetic resonance imaging • leukoaraiosis • white matter

This article has been cited by other articles:

				B. C. Healy, E. N. Ali, C. R. G. Guttmann, T. Chitnis, B. I. Glanz, G. Buckle, M. Houtchens, L. Stazzone, J. Moodie, A. M. Berger, et al. Smoking and Disease Progression in Multiple Sclerosis Arch Neurol, July 1, 2009; 66(7): 858 - 864. [Abstract] [Full Text] [PDF]

				T. C. Durazzo, S. Gazdzinski, and D. J. Meyerhoff The neurobiological and neurocognitive consequences of chronic cigarette smoking in alcohol use disorders Alcohol Alcohol., May 1, 2007; 42(3): 174 - 185. [Abstract] [Full Text] [PDF]

				B. van Harten, F.-E. de Leeuw, H. C. Weinstein, P. Scheltens, and G. J. Biessels Brain Imaging in Patients With Diabetes: A systematic review. Diabetes Care, November 1, 2006; 29(11): 2539 - 2548. [Full Text] [PDF]

				E. Zambrelli, E. Emanuele, S. Marcheselli, L. Montagna, D. Geroldi, and G. Micieli Apo(a) size in ischemic stroke: Relation with subtype and severity on hospital admission Neurology, April 26, 2005; 64(8): 1366 - 1370. [Abstract] [Full Text] [PDF]

				H Yamauchi, H Fukuda, and C Oyanagi Significance of white matter high intensity lesions as a predictor of stroke from arteriolosclerosis J. Neurol. Neurosurg. Psychiatry, May 1, 2002; 72(5): 576 - 582. [Abstract] [Full Text] [PDF]

				D. Sander, K. Winbeck, J. Klingelhofer, and B. Conrad Extent of Cerebral White Matter Lesions Is Related to Changes of Circadian Blood Pressure Rhythmicity Arch Neurol, September 1, 2000; 57(9): 1302 - 1307. [Abstract] [Full Text] [PDF]

				R. Mantyla, T. Erkinjuntti, O. Salonen, H. J. Aronen, T. Peltonen, T. Pohjasvaara, and C.-G. Standertskjold-Nordenstam Variable Agreement Between Visual Rating Scales for White Matter Hyperintensities on MRI : Comparison of 13 Rating Scales in a Poststroke Cohort Stroke, August 1, 1997; 28(8): 1614 - 1623. [Abstract] [Full Text]

				P. B. Gorelick Status of Risk Factors for Dementia Associated With Stroke Stroke, February 1, 1997; 28(2): 459 - 463. [Abstract] [Full Text]