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(Stroke. 2005;36:2064.)
© 2005 American Heart Association, Inc.

Editorials

A New Visual Scale to Assess White Matter Hyperintensities Within Cholinergic Pathways

Mikolaj Pawlak, MD Jaroslaw Krejza, MD, PhD

From the Department of Radiology, Division of Neuroradiology (M.P., J.K.), University of Pennsylvania, Philadelphia; and the Department of Neurology (M.P.) and the Department of Radiology (J.K.), Poznan University of Medical Sciences, Poznan, Poland.

Correspondence to Mikolaj Pawlak, MD, Department of Radiology, Division of Neuroradiology, University of Pennsylvania, 3600 Market Street, Science Bldg, Ste 370, Philadelphia, PA 19104. E-mail mikolaj.pawlak@uphs.upenn.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Neural networks of the human cerebral cortex responsible for attention, memory, and emotions are modulated by cholinergic input from the 4 overlapping Ch1–Ch4 cell groups of the basal forebrain.^1,2 Cholinergic neurons of the medial septal nucleus (Ch1 cell group) and the vertical limb nucleus of the diagonal band (Ch2) provide the major cholinergic input to the hippocampus. Cholinergic neurons of the horizontal limb nucleus of the diagonal band (Ch3) provide the major cholinergic input of the olfactory bulb, and cholinergic neurons of the nucleus basalis of Meynert (nbM-Ch4) provide the principal cholinergic input of the remaining cerebral cortex and amygdala. Trajectories of these cholinergic fibers in white matter have been described recently in humans.²

Cholinergic system damage leads to cognitive decline,³ thus, it is expected that the magnitude and extent of the damage will correlate with the degree of decline. White matter hyperintensities (WMHs) are encountered frequently on magnetic resonance (MR) scans of normal elderly people as well as in patients with various types of dementia. These hyperintensities are presumably related to small infarcts and lacunes caused by cerebrovascular disease.⁴ Therefore, their spatial relationships with the cholinergic system should be taken into account in addition to the number of lesions, their size, and volume, while trying to quantify the contribution of WMH to the cognitive decline.

The Cholinergic Pathways Hyperintensities Scale (CHIPS) proposed by Bocti et al,⁵ unlike previously published scales,^6–9 takes into account the spatial relationships of WMHs and cholinergic pathways projecting from the nucleus basalis of Meynert. Bocti . . . [Full Text of this Article]

Related Article:

A New Visual Rating Scale to Assess Strategic White Matter Hyperintensities Within Cholinergic Pathways in Dementia

Christian Bocti, Richard H. Swartz, Fu-Qiang Gao, Demetrios J. Sahlas, Pearl Behl, and Sandra E. Black
Stroke 2005 36: 2126-2131. [Abstract] [Full Text] [PDF]

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