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(Stroke. 1995;26:1171-1177.)
© 1995 American Heart Association, Inc.
Articles |
White Matter Hyperintensities on MRI in the Neurologically Nondiseased Elderly
Analysis of Cohorts of Consecutive Subjects Aged 55 to 85 Years Living at Home
From the Departments of Neurology, Memory Research Unit (A.Y., T.E., R.S.), Radiology (R.R.), Public Health (S.S.), and Geriatrics (R.T.), University of Helsinki; and the Department of Community Health and General Practice, University of Kuopio (R.S.), Finland.
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Abstract |
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 Top Abstract IntroductionSubjects and MethodsResultsDiscussionReferences |
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Background and Purpose We undertook this study to evaluate the frequency and risk factors of white matter hyperintensities seen on T2-weighted MR imaging. We examined cohorts of neurologically nondiseased elderly subjects participating in a general-community study, the Helsinki (Finland) Aging Brain Study. Cohorts of consecutive subjects aged 55, 60, 65, 70, 75, 80, and 85 years (n=20, 18, 20, 18, 19, 18, and 15, respectively; total, n=128) were divided into a young-old (age <75 years, n=76) group and an old-old (age
75 years, n=52) group. Methods Frequency of hyperintensities seen on T2-weighted axial and coronal MR images (0.02 T) was rated using a four-point scale in periventricular and centrum semiovale areas.
Results The majority of the subjects showed only mild white matter hyperintensities, which were more frequent in the periventricular areas. Age was the most important factor to explain the presence of hyperintensities. A logistic regression analysis related periventricular hyperintensities in the entire group to central atrophy (odds ratio [OR], 4.7; 95% confidence interval [CI], 1.7 to 12.9) and silent infarcts (OR, 5.6; 95% CI, 1.0 to 19.8); among the young-old, hyperintensities related to diabetes (OR, 17.0; 95% CI, 1.9 to 154.2) and central atrophy (OR, 14.7; 95% CI, 3.5 to 61.8). Centrum semiovale hyperintensities related in the entire group to cardiac arrhythmia (OR, 4.0; 95% CI, 1.0 to 15.5), central atrophy (OR, 3.9; 95% CI, 1.2 to 12.4), and silent infarcts (OR, 3.6; 95% CI, 1.0 to 12.5).
Conclusions These mild white matter hyperintensities in the neurologically nondiseased elderly related especially to age and also to concomitant silent infarcts, atrophy, and some vascular risk factors. The known factors, however, explained only part of the variation. The young-old and old-old groups showed different associations. In contrast to former assumptions, the presence of white matter hyperintensities among the aged is likely to be linked to other as yet unidentified age-related factors.
Key Words: aged • leukoaraiosis • magnetic resonance imaging • white matter
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Introduction |
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TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
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White matter changes in the brain, also termed leukoaraiosis,1 are frequently seen in elderly people.2 3 4 5 6 7 8 9 On CT, leukoaraiosis is seen as focal or diffuse areas of decreased density and on MRI as areas of increased signal intensity.4 10 11
White matter hyperintensities have been related not only to age but also to cerebrovascular disorders10 12 13 and different vascular risk factors.6 14 15 16 However, findings have been conflicting. A distinction between normal and successful aging17 18 in relation to these hyperintensities has been highlighted.19
Most previous studies have concentrated either on different patient groups or on series of healthy volunteers.2 6 7 8 9 12 13 14 15 20 21 22 23 24 25 26 27 28 29 30 Few reports have been based on a randomly selected group, which can be generalized to a community-dwelling population.31 32 33 The high frequency of mild leukoaraiosis in the normal elderly has cast doubt on its clinical importance, and the sensitivity of MRI has been regarded as a problem. Finally, the clinical significance of leukoaraiosis in normal aging has not been clearly established.
In light of this controversy, we evaluated the frequency and extent of white matter hyperintensities in distinct white matter areas and their association with age, with putative risk factors, and with other MRI findings. This study improves on the designs of many previous studies by examining a large community sample of the neurologically nondiseased elderly living at home, by examining the hyperintensities in clearly defined brain areas, and by controlling not only for age and known risk factors but also for concomitant MRI findings.
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Subjects and Methods |
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TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
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Between 1989 and 1991, the Helsinki (Finland) Aging Study examined three random cohorts of 274, 266, and 255 persons aged 75, 80, and 85 years, respectively, living in the city of Helsinki. Altogether, 651 subjects were examined (8.1% of the whole subpopulation), of whom 79% were living at home. For the Aging Brain Study, a random sample of these 514 persons living at home were invited to participate. These new cohorts included 52, 63, and 50 Finns aged 75, 80, and 85 years, respectively. The sample selected for the neurological examination with additional investigations was, by design, weighted toward elderly persons free of disease.
The study was extended separately for younger age groups, adding samples from unselected persons who were invited to a local health center for physical examination and were 55, 60, 65, and 70 years old. These younger cohorts, all living at home, included 40, 43, 37, and 53 subjects, respectively. From 338 subjects, 79% participated in the present study, and a neurologist (A.Y.) clinically examined all of the 268 subjects available. Of these, 37 subjects (13.8%) had conditions affecting the central nervous system or a major psychiatric disorder: 12 stroke, 8 questionable or mild dementia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, edition 3, revised (DSM-III-R),34 3 Parkinson's disease, 4 epilepsy, 3 severe head trauma, 3 central nervous system infection, 2 brain tumor treated surgically, and 2 either schizophrenia or major depression.
For further investigations the neurologist chose participants by order
of their entrance to the clinical examination until a maximum of 20
were included in each age group. Of the 231 neurologically nondiseased
subjects, 128 underwent MRI of the brain. Only one 85-year-old woman
from the group of eligible subjects for MRI refused to participate. The
neuropsychological findings and part of the MRI findings for these
subjects have been published earlier.35 Table 1
shows the sizes of the eligible random cohorts aged
75, 80, and 85 years; the invited unselected sample in each age group;
the number of subjects who refused, died, or moved, were neurologically
examined, showed diseases affecting the central nervous system, and/or
refused to participate in additional MRI study; and finally the number
of neurologically nondiseased subjects in whom the MRI was
performed.
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Neurological evaluation included a detailed medical history using all available files, interview of a closely associated informant when available, a structured medical and neurological examination, glucose testing, and an electrocardiogram, as well as the Mini-Mental State Examination.36 Classification of high social class included persons in senior managerial positions or with an academic education, plus tradesmen or senior office personnel. Classification of low social class included skilled workers or office personnel and unskilled workers, auxiliary persons, or persons without occupation.37 Housewives were classified according to their husbands' occupations.
Each history was obtained regarding arterial hypertension and any
cardiac disorder including coronary heart disease, myocardial
infarction, cardiac failure, and cardiac arrhythmias. The definitions
included a previously documented diagnosis, a permanent medication,
systolic blood pressure 160 or diastolic blood pressure 95, and
atrial fibrillation on electrocardiogram. Diabetes was defined as a
previously documented diagnosis, current use of insulin or oral
hypoglycemic medication, fB-gluc 6 or 7 mmol/L.
MRI was performed with an ultralow field imager operating at 0.02 T (Acutscan, Instrumentarium Corp). Axial and coronal T2-weighted images (repetition time, 2000 milliseconds; time to echo, 150 milliseconds) were obtained without gaps between the 10-mm-thick sections. The field of view was 30 cm, and the matrix was 128x256.35
Analysis of hyperintensities was performed by an experienced radiologist (R.R.) who was blinded to the clinical findings. Periventricular hyperintensities were rated in eight areas: adjacent to frontal horns, ventricular body, trigones, and occipital horns in both hemispheres. In each, periventricular hyperintensities were rated from 0 to 3: 0, no hyperintensity; 1, mild (punctate, small foci); 2, moderate (cap, pencil-thin lining); and 3, severe (nodular band, extending hyperintensity). The hyperintensities in the centrum semiovale including the watershed areas were rated similarly in the eight areas from 0 to 3: 0, no hyperintensity; 1, mild (punctate, small foci); 2, moderate (beginning confluent); and 3, severe (large confluent areas). The rating system for centrum semiovale hyperintensities was similar to that of Fazekas et al,20 but the rating of periventricular hyperintensities was slightly modified; the mild changes were divided into two classes because we saw no subject with the so-called smooth halo. The corresponding figures have been published earlier.35
Semiquantitative regional scores were obtained by taking the grade and anatomic distribution of the high signal abnormalities into account. The total scores reflecting hyperintensities were calculated by adding all the scores in the eight different periventricular and centrum semiovale areas: periventricular, 0 to 24; centrum semiovale, 0 to 24; and the total hyperintensity score, 0 to 48. Central (enlargement of the lateral and third ventricles) and peripheral (widening of the sulci) atrophy was rated as none, mild, moderate, and severe; the presence of silent infarcts (subjects with a history of stroke excluded) was noted.
Statistical Analysis
Group differences among subject characteristics and risk factors
were tested for statistical significance using the t test
and 
2 test. The means of total hyperintensity
scores were counted in each age group to evaluate the age-related white
matter changes. First, univariate analysis using the
2 test was used to identify variables related to
the presence/absence of hyperintensities; then logistic regression
analysis was applied to control for age and all other covariates in
the model. Age was used as a categorical independent variable. Adjusted
odds ratios (OR) were computed to measure the strength of relatedness.
A 5% significance level was chosen.
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Results |
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TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
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Subject Characteristics
Subject characteristics, risk factors, and presence of other MRI findings are summarized in Table 2
. Compared with
the young-old group, the old-old more frequently showed low Mini-Mental
State Examination scores (<27), coronary heart disease, cardiac
failure, any silent infarcts, silent deep infarcts, and central and
cortical atrophy. Fourteen subjects had one and 6 had two silent
infarcts, which were mostly sized under 10 mm and situated frontally.
Five subjects had 10- to 30-mm-sized infarcts, one of which was in deep
gray matter. Five infarcts were situated temporally and two parietally.
Deep silent infarcts were in deep gray matter.
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MRI Hyperintensities
The hyperintensity scores reflecting the frequency and
extent of white matter hyperintensity were low in these neurologically
nondiseased subjects, and they increased with increasing age
(Figure). The mean (SD, range) periventricular
hyperintensity score (0 to 24) for the young-old group was 0.55 (1.33,
0 to 6), for the old-old 3.15 (3.56, 0 to 12), and for the entire group
1.61 (2.79, 0 to 12). The corresponding values for the centrum
semiovale hyperintensity scores (0 to 24) were 0.32 (1.09, 0 to 6),
1.08 (1.57, 0 to 6), and 0.62 (1.35, 0 to 6), respectively.
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The frequencies of different hyperintensity ratings in the various
defined brain areas are shown in Table 3.
Periventricular hyperintensities were seen in 21% of the young-old, in
65% of the old-old, and in 39% in the whole series, with the
corresponding values for centrum semiovale hyperintensities being 11%,
38%, and 22%, respectively.
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Due to the low frequency, mild degree, and skewed distribution of the hyperintensity scores, they were not treated as correlates in further analyses. Instead the subjects were dichotomized into those with and those without periventricular or centrum semiovale white matter hyperintensities.
Relationships Between Hyperintensities and Other Factors
Periventricular hyperintensities were significantly correlated by
2 analyses (Table 4) in the total
group to high age, to the presence of cardiac failure, to central and
peripheral atrophy, and to silent infarcts. Among the young-old,
periventricular hyperintensities significantly correlated to diabetes
and to central atrophy and among the old-old group to cardiac
failure.
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Centrum semiovale hyperintensities (Table 5) in the
total group significantly correlated to high age, to the presence of
central atrophy, to cardiac failure, and to silent infarcts. In the
young-old group, centrum semiovale hyperintensities significantly
correlated to cardiac arrhythmia and to central atrophy and in the
old-old group to cardiac failure.
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In multivariate analyses, when age and other covariates were controlled
for by use of a multiple logistic model, independent variables
correlated to periventricular hyperintensities (Table 6)
in the entire group were central atrophy, silent infarcts, and high
age. Among the young-old, correlating variables were central atrophy
and diabetes. Centrum semiovale hyperintensities in the total group
correlated to the presence of cardiac arrhythmia, central atrophy, and
silent infarcts.
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Discussion |
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TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
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Our study shows that periventricular and centrum semiovale white matter hyperintensities on MRI are frequent but of mild degree in neurologically nondiseased elderly subjects. The frequency of hyperintensities increased with age, and the hyperintensity scores were higher in periventricular areas. In the total group, periventricular and centrum semiovale hyperintensities were independently correlated to the presence of central atrophy and silent infarcts, and centrum semiovale hyperintensities correlated to cardiac arrhythmias. The periventricular hyperintensities among the young-old correlated to central atrophy and diabetes.
The present series reports the frequency and extent of white matter hyperintensities in different brain areas in community-based samples of consecutive neurologically nondiseased subjects living at home. The series was representative, since the refusal rate among the consecutive subjects invited was only 13.3% among the young-old and 17.0% among the old-old. The age range was wide, from 55 to 85 years, and sampling by 5-year intervals strengthened the statistical power with regard to age.
The MRI images were obtained with an ultralow-field MRI unit (0.02 T), which is not as sensitive as those operating at higher field strengths but is much more sensitive than CT.4 10 11 Compared with a 1.5-T unit, the 0.02-T unit is expected to reveal about half of the tiny incidental focal hyperintensities but to reveal equally well the more extensive changes.11 We analyzed both axial and coronal images, thus intensifying detection of periventricular changes. Low-field MRI has been regarded as appropriate in screening38 as well as in larger population studies such as ours.39
Frequency of Hyperintensities
Some degree of white matter hyperintensity in aging populations
has been reported in 18% to 85% of control
populations.2 5 8 9 14 22 23 30 31 33 However, rating of
hyperintensities in different distinct brain areas is favored by
differences in vascular vulnerability,40 different
neuropathological correlates,41 42 43 44 45 46 47 and clinical
correlates.6 21 26
Frequency of hyperintensities in periventricular areas in previous reports on aging populations has varied from 30% to 100%6 7 12 13 15 20 21 24 26 29 32 48 and in the centrum semiovale areas from 17% to 96%.6 7 12 13 15 20 21 24 26 27 29 32 The present series showed periventricular hyperintensities in 21% of the young-old and in 65% of the old-old; the corresponding values for centrum semiovale hyperintensities were 11% and 38%, respectively.
The variation in findings of previous reports reflects the selection of rating methods of the hyperintensities and the MRI equipment, as well as differences in age distribution and in the imaging parameters used.
Age and Gender
In most studies both periventricular and centrum semiovale
hyperintensities have been related to high age2 3 4 5 6 7 8 9 but not
in all studies for centrum semiovale hyperintensities.13
We found a significant, nonlinear increase in the periventricular
hyperintensity rating with increasing age, especially in persons aged
65 years and older.
Gender distribution has usually not been mentioned13 14 20 22 28 29 32 or taken into account in the analyses.2 4 6 7 12 15 21 22 23 24 25 26 27 30 48 Wahlund et al23 found no sex difference between relaxation times on MRI. Similarly, Schmidt et al9 reported no association with sex using linear regression analysis and a four-point scale for hyperintensities. In contrast, three studies3 31 32 have reported high frequency of hyperintensities in women, but this association was lost after correction for age. Using a method similar to ours, Zubenko et al8 reported an independent relation between female sex and white matter hyperintensities (OR, 21.9; 95% confidence interval, 1.27 to 3.75; P<.05) in a series of 44 subjects with a mean age of 68 years. We found no independent relation between hyperintensities and sex.
Atrophy and Silent Infarcts
The presence and absence of atrophy,12 26 as well as
silent infarcts,8 26 30 have rarely been taken into
account in studies on white matter hyperintensities. Our series is the
first large series that uses these factors as covariates in
multivariate analyses.
In our series, central atrophy was independently associated both with periventricular and centrum semiovale hyperintensities in the entire group, as well as among the young-old. This accords with the previous reports by Mirsen et al,26 showing an association between periventricular hyperintensities and dilatation of the lateral ventricles, and by Kobari et al,12 who related periventricular hyperintensities to overall cerebral atrophy. However, since our study graded only T2-weighted images for sulcal size, the prevalences of peripheral atrophy demonstrated here should not be generalized to other populations. In contrast, the associations presented here may be more applicable to a general population.31
The frequency of silent infarcts in our series was 16%, and this related both to periventricular and to centrum semiovale hyperintensities in the multivariate analyses. Previous estimates of silent infarcts vary by approximately 10%.8 26 Since our study used only T2-weighted images, the frequency of silent infarcts in this series may overestimate the true rate in the general population from which it was drawn.
Vascular Risk Factors
White matter hyperintensities have been previously related to the
presence of arterial hypertension,3 7 21 22 27
diabetes,9 21 22 and cardiac diseases22 or
risk factors for vascular diseases.6 14 15 16 Kertesz et
al21 specified diabetes and periventricular
hyperintensities, whereas they and van Swieten et al27
related arterial hypertension to centrum semiovale hyperintensities. On
the other hand, Kozachuk et al7 related systolic blood
pressure, and Lindgren et al32 arterial hypertension, to
periventricular hyperintensities. Manolio et al31 related
diastolic blood pressure to any white matter hyperintensities. In some
series, however, these trends have not been
observed.5 25 28 32 Manolio et al31 also
related diuretic use and maximum internal carotid thickness, and
Breteler et al33 related myocardial infarction, factor
VIIc activity, and fibrinogen level to total white matter
hyperintensities. In the present series, arterial hypertension did
not significantly correlate to white matter hyperintensities, but
diabetes significantly correlated to periventricular hyperintensities
in the young-old and cardiac arrhythmia correlated to centrum semiovale
hyperintensities in the entire group.
Young-Old Versus Old-Old Group
Hyperintensities in the periventricular and centrum semiovale
areas also showed different independent associations. This was
especially true between the young-old and old-old subgroups. The
clinical consequences and etiology of hyperintensities in the
periventricular and centrum semiovale areas thus may be different, and
factors such as arterial hypertension or diabetes may become less
detrimental regarding white matter hyperintensities with advancing
age.
In the present study, age and all other factors in the multivariate analyses could explain only part of the total variation in both periventricular and centrum semiovale hyperintensities. Thus, other still-uncovered age-related factors likely exist.
On the other hand, hyperintensities may facilitate the distinction between normal (usual) and successful (superior) aging.19 With fuller knowledge of the characteristics of the populations under scrutiny, the sometimes confusing findings regarding normal aging do not necessarily conflict.18 Normal aging consists of changes that occur in individuals free of overt diseases affecting the central nervous system.49 Very old people may represent a continuum deriving from the tail of a distribution curve or a discrete subpopulation altogether. Since normality is relative, there may be discrete subpopulations existing within different cohorts. Cohort studies therefore can show different risk factors for different ages, independent of aging itself. Longitudinal studies are needed to verify the latter assumption.
Previous Limitations
Previous studies on the frequency and causes of white matter
changes during normal aging have been limited by use of volunteers as
control subjects2 6 7 8 9 12 13 14 15 20 21 22 23 24 25 26 27 28 29 30 ; by limited age range,
with the series usually including relatively young
subjects6 9 12 14 21 22 24 27 28 29 ; by modest sample sizes,
usually fewer than 30 cases2 7 12 14 15 20 22 23 24 25 28 29 ; by
limited clinical examinations and evaluations of risk
factors2 8 13 22 48 ; by lack of reliable criteria for
hyperintensities rated by formal rating scales38 ; by lack
of appropriate multivariate analyses to control for age and other
covariates5 7 9 12 14 15 21 22 23 24 25 26 27 29 30 48 ; by ignorance of
concomitant MRI
findings5 7 13 15 16 20 22 24 25 27 31 32 33 48 ; and finally
by use of inappropriate statistics that were designed for normally
distributed variables.9 20 22 Our series reports white
matter hyperintensities on MRI in large, representative,
community-based samples of subjects aged 55 to 85 years living at home.
The type and extent of hyperintensities were rated in different
distinct brain areas, and the sample size was large enough to make
multivariate analyses possible. Thus, some limitations have been
overcome in the present series. However, the present series
still has a limited power for assessing relations with MRI findings. A
more careful study of these associations would need extension of the
series, with higher numbers of subjects with cardiovascular conditions
and diabetes present.
Conclusion
The mild white matter hyperintensities in the healthy elderly
related especially to age, concomitant MRI findings, and various
vascular risk factors. All the known factors, however, explained only
part of the variation. The young-old and old-old groups showed
different associations. The presence of white matter hyperintensities
on MRI among the normal elderly is thus likely to be linked to other as
yet unidentified age-related factors.
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Acknowledgments |
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This work has been supported in part by grants from the Paulo Foundation, The Finnish Alzheimer Foundation for Research, and the Ragnar Ekberg Foundation, Helsinki, Finland. A. Ylikoski is supported by the Paulo Foundation, Helsinki, Finland. T. Erkinjuntti is supported by the Paavo Nurmi Foundation and the Medical Council of the Academy of Finland, Helsinki, Finland. We thank Vladimir C. Hachinski, MD, DSc(Med), Andrew Kertesz, MD (University of Western Ontario, London, Ontario, Canada), Franz Fazekas, MD (University of Graz, Austria), and Lars-Olof Wahlund, MD (University of Stockholm, Sweden) for their useful suggestions during the preparation of the manuscript and Carolyn B. Norris, PhD (Language Centre, University of Helsinki, Finland), for revising the language of the manuscript.
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Footnotes |
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Reprint requests to Dr Timo Erkinjuntti, Department of Neurology, Memory Research Unit, University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, Finland. E-mail Timo.Erkinjuntti@ HYKS.Mailnet.Fi.
Received November 21, 1994; revision received January 31, 1995; accepted March 13, 1995.
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References |
|---|
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TopAbstractIntroductionSubjects and MethodsResultsDiscussionReferences |
|---|
1. Hachinski VC, Potter P, Merskey H. Leuko-araiosis. Arch Neurol. 1987;44:21-23.
2. Brant-Zawadzki M, Fein G, Dyke C, Kiernan R, Davenport L, Groot J. MR imaging of the aging brain: patchy white-matter lesions and dementia. AJNR. 1985;6:675-682. [Abstract]
3.
Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R.
Incidental subcortical lesions identified on magnetic resonance
imaging in the elderly, I: correlation with age and cerebrovascular
risk factors. Stroke. 1986;17:1084-1089.
4. George AJ, de Leon MJ, Kalnin A, Rosner L, Goodgold A, Chase N. Leukoencephalopathy in normal and pathologic aging: II, MRI of brain lucencies. AJNR. 1986;7:567-570. [Abstract]
5. Hendrie HC, Farlow MR, Austrom MG, Edwards MK, Williams MA. Foci of increased T2 signal intensity on brain MR scans of healthy elderly subjects. AJNR. 1989;10:703-707. [Abstract]
6. Fazekas F. Magnetic resonance signal abnormalities in asymptomatic individuals: their incidence and functional correlates. Eur Neurol. 1989;29:164-168. [Medline] [Order article via Infotrieve]
7.
Kozachuk WE, DeCarli C, Schapiro MB, Wagner EE,
Rapoport SI, Horwitz B. White matter hyperintensities in
dementia of Alzheimer's type and in healthy subjects without
cerebrovascular risk factors. Arch Neurol. 1990;47:1306-1310.
8.
Zubenko GS, Sullivan P, Nelson JP, Belle SH, Huff FJ,
Wolf GL. Brain imaging abnormalities in mental disorders of late
life. Arch Neurol. 1990;47:1107-1111.
9.
Schmidt R, Fazekas F, Kleinert G, Offenbacher H, Gindl
K, Payer F, Freidl W, Niederkorn K, Lechner H. Magnetic
resonance imaging signal hyperintensities in the deep and subcortical
white matter. Arch Neurol. 1992;49:825-827.
10.
Erkinjuntti T, Ketonen L, Sulkava R, Sipponen J,
Vuorialho M, Iivanainen M. Do white matter changes on MRI and CT
differentiate vascular dementia from Alzheimer's
disease? J Neurol Neurosurg Psychiatry. 1987;50:37-42.
11. Raininko R, Elovaara I, Virta A, Valanne L, Haltia M, Valle S-L. Radiological study of the brain at various stages of human immunodeficiency virus infection: early development of brain atrophy. Neuroradiology. 1992;34:190-196. [Medline] [Order article via Infotrieve]
12. Kobari M, Meyer JS, Ichijo M, Oravez WT. Leukoaraiosis: correlation of MR and CT findings with blood flow, atrophy and cognition. AJNR. 1990;11:273-281. [Abstract]
13. Bowen BC, Parker WW, Loewenstein DA, Sheldon J, Duara R. MR signal abnormalities in memory disorder and dementia. AJNR. 1990;11:283-290. [Abstract]
14.
Lechner H, Schmidt R, Bertha G, Justich E, Offenbacher
H, Schneider G. Nuclear magnetic resonance image white matter
lesions and risk factors for stroke in normal individuals.
Stroke. 1988;19:263-265.
15.
Coffey CE, Figiel GS, Djang WT, Weiner RD.
Subcortical hyperintensity on magnetic resonance imaging: a
comparison of normal and depressed elderly subjects. Am J
Psychiatry. 1990;147:187-189.
16.
Erkinjuntti T, Fuqiang G, Donald HL, Eliasziw M,
Merskey H, Hachinski VC. Lack of difference in brain
hyperintensities between patients with early Alzheimer's
disease and control subjects. Arch Neurol. 1994;51:260-268.
17.
Rowe JW, Kahn RL. Human aging: usual and
successful. Science. 1987;237:143-149.
18. Calne DB, Eisen A, Meneilly G. Normal aging of the nervous system. Ann Neurol. 1991;30:206-207. [Medline] [Order article via Infotrieve]
19.
Drayer BP. Imaging of the aging brain: I, normal
findings. Radiology. 1988;166:785-796.
20. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJNR. 1987;8:421-426.
21.
Kertesz A, Black SE, Tokar G, Benke T, Carr T,
Nicholson L. Periventricular and subcortical hyperintensities on
magnetic resonance imaging: `rims, caps, and unidentified bright
objects.' Arch Neurol. 1988;45:404-408.
22.
Fazekas F, Niederkorn K, Schmidt R, Offenbacher H,
Horner S, Bertha G, Lechner H. White matter signal abnormalities
in normal individuals: correlation with carotid ultrasonography,
cerebral blood flow measurements, and cerebrovascular risk
factors. Stroke. 1988;19:1285-1288.
23.
Wahlund LO, Agartz I, Almqvist O, Basun H, Forssell L,
Sääf J, Wetterberg L. The brain in healthy aged
individuals: MR imaging. Radiology. 1990;175:675-679.
24.
Leys D, Soetaert G, Petit H, Fauquette A, Pruvo JP,
Steinling M. Periventricular and white matter magnetic resonance
imaging hyperintensities do not differ between Alzheimer's
disease and normal aging. Arch Neurol. 1990;47:524-527.
25. Meguro K, Hatazawa J, Yamaguchi T, Itoh M, Matsuzawa T, Ono S, Miyazawa H, Hishinuma T, Yanai K, Sekita Y, Yamada K. Cerebral circulation and oxygen metabolism associated with subclinical periventricular hyperintensity as shown by magnetic resonance imaging. Ann Neurol. 1990;28:378-383. [Medline] [Order article via Infotrieve]
26.
Mirsen TR, Lee DH, Wong CJ, Diaz JF, Fox AJ, Hachinski
VC, Merskey H. Clinical correlates of white matter changes on
magnetic resonance imaging scans of the brain. Arch
Neurol. 1991;48:1015-1021.
27. van Swieten JC, Geyskes GG, Derix MMA, Peeck BM, Ramos LMP, van Latum JC, van Gijn J. Hypertension in the elderly is associated with white matter lesions and cognitive decline. Ann Neurol. 1991;30:825-830. [Medline] [Order article via Infotrieve]
28.
Harrell LE, Duvall E, Folks DG, Duke L, Bartolucci A,
Coboy T, Callaway R, Kerns D. The relationship of high-intensity
signals on magnetic resonance images to cognitive and psychiatric state
in Alzheimer's disease. Arch Neurol. 1991;48:1136-1140.
29. McDonald WM, Ranga R, Krishnan R, Doraiswamy PM, Figiel GS, Husain MM, Boyko OB, Heyman A. Magnetic resonance findings in patients with early-onset Alzheimer's disease. Biol Psychiatry. 1991;29:799-810. [Medline] [Order article via Infotrieve]
30.
Matsubayashi K, Shimada K, Kawamoto A, Ozawa T.
Incidental brain lesions on magnetic resonance imaging and
neurobehavioral functions in the apparently healthy elderly.
Stroke. 1992;23:175-180.
31. Manolio TA, Kronmal RA, Burke GL, Poirier V, O'Leary DH, Gardin JM, Fried LP, Steinberg EP, Bryan RN, for the Cardiovascular Health Study Collaborative Research Group. Magnetic resonance abnormalities and cardiovascular disease in older adults. Stroke. 1994;25:318-327. [Abstract]
32. Lindgren A, Roijer A, Rudling O, Norrving B, Larsson E-M, Eskilsson J, Wallin L, Olsson B, Johansson BB. Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke. Stroke. 1994;25:929-934. [Abstract]
33.
Breteler MMB, van Swieten JC, Bots ML, Grobbee DE,
Claus JJ, van den Hout JHW, van Harskamp F, Tanghe HLJ, de Jong PTVM,
van Gijn J, Hofman A. Cerebral white matter lesions, vascular
risk factors, and cognitive function in a population-based study: the
Rotterdam study. Neurology. 1994;44:1246-1252.
34. American Psychiatric Association. American Psychiatric Association Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). 3rd ed, revised ed. Washington, DC: American Psychiatric Association; 1987.
35.
Ylikoski R, Ylikoski A, Erkinjuntti T, Sulkava R,
Raininko R, Tilvis R. White matter changes in healthy elderly
persons correlate with attention and speed of mental
processing. Arch Neurol. 1993;50:818-824.
36. Folstein MF, Folstein SE. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198. [Medline] [Order article via Infotrieve]
37. Bruun K. Social Groups. Helsinki, Finland: The Statistical Office; 1954.
38. Scheltens P, Barkhof F, Leys D, Pruvo JP, Nauta JJP, Vermersch P, Steinling M, Valk J. A semiquantitative rating scale for the assessment of signal hyperintensities on magnetic resonance imaging. J Neurol Sci. 1993;114:7-12. [Medline] [Order article via Infotrieve]
39. Agartz I, Marions O, Sääf J, Wahlund L-O, Wetterberg L. Visual rating of magnetic resonance images of human cerebrospinal fluid spaces and white matter: relation to sex and age in healthy volunteers. Magn Reson Imaging. 1992;10:135-142. [Medline] [Order article via Infotrieve]
40. Moody DM, Bell MA, Challa VR. Features of the cerebral vascular pattern that predict vulnerability to perfusion or oxygenation deficiency: an anatomical study. AJNR. 1990;11:431-439. [Abstract]
41.
Awad IA, Johnson PC, Spetzler RF, Hodak JA.
Incidental subcortical lesions identified on magnetic resonance
imaging in the elderly: II, postmortem pathologic correlations.
Stroke. 1986;17:1090-1097.
42. Braffman BH, Zimmerman RA, Trojanowski JQ, Gonatas JQ, Hickey WF, Schlaepfer WW. Brain MR: pathologic correlation with cross and histopathology: I, lacunar infarction and Virchow-Robin spaces. AJNR. 1988;9:621-628.
43. Braffman BH, Zimmerman RA, Trojanowski JQ, Gonatas JQ, Hickey WF, Schlaepfer WW. Brain MR: pathologic correlation with cross and histopathology: II, hyperintense white-matter foci in the elderly. AJNR. 1988;9:629-636.
44. Sze G, De Armond SJ, Brandt-Zawadzki M, Davis RL, Norman D, Newton TH. Foci of MRI signal (pseudo lesions) anterior to frontal horns: histologic correlations of a normal finding. AJNR. 1986;17:381-387.
45.
Leifer D, Buonanno FS, Richardson EP Jr.
Clinicopathologic correlations of cranial magnetic resonance
imaging of periventricular white matter. Neurology. 1990;40:911-918.
46.
Chimowitz MI, Estes ML, Furlan AJ, Awad IA.
Further observations on the pathology of subcortical lesions
identified on magnetic resonance imaging. Arch
Neurol. 1992;49:747-752.
47.
Fazekas F, Kleinert R, Offenbacher H, Schmidt R,
Kleinert G, Payer F, Radner H, Lechner H. Pathologic correlates
of incidental MRI white matter signal hyperintensities.
Neurology. 1993;43:1683-1689.
48. Zimmerman RD, Fleming CA, Lee BCP, Saint-Louis LA, Deck MDF. Periventricular hyperintensity as seen by magnetic resonance: prevalence and significance. AJNR. 1986;7:13-20.
49. Katzman R, Terry R. Normal aging of the nervous system. In: Katzman R, Terry RD, eds. The Neurology of Aging. Philadelphia, Pa: FA Davis Co; 1983:15-50.
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|
|
|
|
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|
|
|
|
|
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|
|
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|
|
|
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|
|
|
|
|
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|
|
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|
|
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|
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|
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|
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|
|
|
|
|
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|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
G. C. Roman From UBOs to Binswanger's Disease: Impact of Magnetic Resonance Imaging on Vascular Dementia Research Stroke, August 1, 1996; 27(8): 1269 - 1273. [Full Text]
|
|
|
|
|
|
W.T. Longstreth, T. A. Manolio, A. Arnold, G. L. Burke, N. Bryan, C. A. Jungreis, P. L. Enright, D. O'Leary, and L. Fried Clinical Correlates of White Matter Findings on Cranial Magnetic Resonance Imaging of 3301 Elderly People: The Cardiovascular Health Study Stroke, August 1, 1996; 27(8): 1274 - 1282. [Abstract] [Full Text]
|
|
|
|
|
|
M. van Zagten, J. Boiten, F. Kessels, and J. Lodder Significant Progression of White Matter Lesions and Small Deep (Lacunar) Infarcts in Patients With Stroke Arch Neurol, July 1, 1996; 53(7): 650 - 655. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Amar and G. Wilcock Fortnightly Review: Vascular dementia BMJ, January 27, 1996; 312(7025): 227 - 231. [Abstract] [Full Text]
|
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