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 Hatazawa, J. Articles by Okudera, T. Search for Related Content PubMed PubMed Citation Articles by Hatazawa, J. Articles by Okudera, T.

(Stroke. 1997;28:1944-1947.)
© 1997 American Heart Association, Inc.

Articles

Subcortical Hypoperfusion Associated With Asymptomatic White Matter Lesions on Magnetic Resonance Imaging

Jun Hatazawa, MD, PhD; Eku Shimosegawa, MD; Takao Satoh, MD; Hideto Toyoshima, BSc; Toshio Okudera, MD, PhD

From the Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels (J.H., E.S., T.S., H.T., T.O), and Department of Psychiatry, University of Tokyo Faculty of Medicine (T.S.) (Japan).

Background and Purpose We examined whether hemodynamic and metabolic abnormalities in the cerebral white matter, basal ganglia, and thalamus are associated with asymptomatic white matter lesions (WML) depicted on MR images.

Methods A positron emission tomographic study with H₂¹⁵O, C¹⁵O, and ¹⁵O₂ was performed in eight normal control subjects without any WML (mean±1 SD age, 68.5±10.2 years) and in 15 asymptomatic subjects with WML (71.3±8.5 years) to measure regional cerebral blood flow (CBF), cerebral blood volume, oxygen extraction fraction (OEF), and oxygen metabolic rate.

Results In the cerebral white matter in the asymptomatic subjects with WML, significantly lower CBF (20.3±3.9 mL/100 mL per minute; P<.05) and significantly higher OEF (0.43±0.08; P<.05) were found compared with those for control subjects (23.5±2.6 mL/100 mL per minute and 0.37±0.06, respectively). The severity of WML was not related to the magnitude of hypoperfusion. In the basal ganglia, significantly lower CBF (44.9±6.9 mL/100 mL per minute; P<.01) and significantly higher OEF (0.54±0.08; P<.01) were found in the WML group than in control subjects (70.1±12.0 mL/100 mL/min and 0.39±0.03, respectively). In the thalamus, there was no significant difference in CBF and OEF between the control and WML groups.

Conclusions Hypoperfusion of the cerebral white matter and basal ganglia in asymptomatic WML subjects may be induced by the arteriosclerosis of long penetrating medullary arteries and lenticulostriate arteries but may not be directly related to the production of WML. The role of hypoperfusion in the production of WML and acceleration of its development remains to be elucidated.

Key Words: cerebral blood flow • magnetic resonance imaging • metabolism • tomography, emission computed • white matter

This article has been cited by other articles:

				T.J. Huynh, B. Murphy, J.A. Pettersen, H. Tu, D.J. Sahlas, L. Zhang, S.P. Symons, S. Black, T.-Y. Lee, and R.I. Aviv CT Perfusion Quantification of Small-Vessel Ischemic Severity AJNR Am. J. Neuroradiol., November 1, 2008; 29(10): 1831 - 1836. [Abstract] [Full Text] [PDF]

				R. M. Wiseman, B. K. Saxby, E. J. Burton, R. Barber, G. A. Ford, and J. T. O'Brien Hippocampal atrophy, whole brain volume, and white matter lesions in older hypertensive subjects Neurology, November 23, 2004; 63(10): 1892 - 1897. [Abstract] [Full Text] [PDF]

				J. van der Grond, A. F. van Raamt, Y. van der Graaf, W. P.T.M. Mali, and R. H.C. Bisschops A fetal circle of Willis is associated with a decreased deep white matter lesion load Neurology, October 26, 2004; 63(8): 1452 - 1456. [Abstract] [Full Text] [PDF]

				L. D. Atwood, P. A. Wolf, N. L. Heard-Costa, J. M. Massaro, A. Beiser, R. B. D'Agostino, and C. DeCarli Genetic Variation in White Matter Hyperintensity Volume in the Framingham Study Stroke, July 1, 2004; 35(7): 1609 - 1613. [Abstract] [Full Text] [PDF]

				S. R. Waldstein, E. L. Siegel, D. Lefkowitz, K. J. Maier, J. R. Pelletier Brown, A. M. Obuchowski, and L. I. Katzel Stress-Induced Blood Pressure Reactivity and Silent Cerebrovascular Disease Stroke, June 1, 2004; 35(6): 1294 - 1298. [Abstract] [Full Text] [PDF]

				J. Harbison, G. J. Gibson, D. Birchall, I. Zammit-Maempel, and G. A. Ford White matter disease and sleep-disordered breathing after acute stroke Neurology, October 14, 2003; 61(7): 959 - 963. [Abstract] [Full Text] [PDF]

				T. Yoshikawa, K. Murase, N. Oku, M. Imaizumi, M. Takasawa, P. Rishu, Y. Kimura, Y. Ikejiri, K. Kitagawa, M. Hori, et al. Heterogeneity of Cerebral Blood Flow in Alzheimer Disease and Vascular Dementia AJNR Am. J. Neuroradiol., August 1, 2003; 24(7): 1341 - 1347. [Abstract] [Full Text] [PDF]

				T. Yoshikawa, K. Murase, N. Oku, K. Kitagawa, M. Imaizumi, M. Takasawa, T. Nishikawa, M. Matsumoto, J. Hatazawa, and M. Hori Statistical Image Analysis of Cerebral Blood Flow in Vascular Dementia with Small-Vessel Disease J. Nucl. Med., April 1, 2003; 44(4): 505 - 511. [Abstract] [Full Text] [PDF]

				M. O'Sullivan, D. J. Lythgoe, A. C. Pereira, P. E. Summers, J. M. Jarosz, S. C.R. Williams, and H. S. Markus Patterns of cerebral blood flow reduction in patients with ischemic leukoaraiosis Neurology, August 13, 2002; 59(3): 321 - 326. [Abstract] [Full Text] [PDF]

				J.R. Marstrand, E. Garde, E. Rostrup, P. Ring, S. Rosenbaum, E.L. Mortensen, and H.B.W. Larsson Cerebral Perfusion and Cerebrovascular Reactivity Are Reduced in White Matter Hyperintensities Stroke, April 1, 2002; 33(4): 972 - 976. [Abstract] [Full Text] [PDF]

				D. Mungas, W. J. Jagust, B. R. Reed, J. H. Kramer, M. W. Weiner, N. Schuff, D. Norman, W. J. Mack, L. Willis, and H. C. Chui MRI predictors of cognition in subcortical ischemic vascular disease and Alzheimer's disease Neurology, December 26, 2001; 57(12): 2229 - 2235. [Abstract] [Full Text] [PDF]

				G. Fein, V. Di Sclafani, J. Tanabe, V. Cardenas, M. W. Weiner, W. J. Jagust, B. R. Reed, D. Norman, N. Schuff, L. Kusdra, et al. Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease Neurology, December 12, 2000; 55(11): 1626 - 1635. [Abstract] [Full Text] [PDF]

				H S Markus, D J Lythgoe, L Ostegaard, M O'Sullivan, and S C R Williams Reduced cerebral blood flow in white matter in ischaemic leukoaraiosis demonstrated using quantitative exogenous contrast based perfusion MRI J. Neurol. Neurosurg. Psychiatry, July 1, 2000; 69(1): 48 - 53. [Abstract] [Full Text] [PDF]

				D. C. Steffens, M. J. Helms, K. R. R. Krishnan, and G. L. Burke Cerebrovascular Disease and Depression Symptoms in the Cardiovascular Health Study Stroke, October 1, 1999; 30(10): 2159 - 2166. [Abstract] [Full Text] [PDF]

				S. L. M. Bakker, F.-E. de Leeuw, J. C. de Groot, A. Hofman, P. J. Koudstaal, and M. M. B. Breteler Cerebral vasomotor reactivity and cerebral white matter lesions in the elderly Neurology, February 1, 1999; 52(3): 578 - 578. [Abstract] [Full Text] [PDF]