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(Stroke. 2009;40:e6.)
© 2009 American Heart Association, Inc.

Letters to the Editor

Response to Letter by Park and Yasuda

Department of Neurology, Faculty of Medicine, Shimane University, Izumo, Japan

Response:

We thank Drs Park and Yasuda for their interesting comments. They pointed out the importance of using MRI FLAIR images to diagnose leukoaraiosis (LA). In fact, we also used FLAIR images to evaluate periventricular hyperintensities (PVH) and subcortical white matter lesions (SWML).¹ It is important to note that the LA in the study of Park et al² included both PVH and SWML. Moreover, we evaluated PVH and SWML separately because of differences in their locations and underlying pathology, depending on their severity.³

We re-examined the association between metabolic syndrome (MetS) and PVH and SWML, including minimal LA. The logistic analysis adjusted for age, gender, and smoking revealed that MetS was not associated with minimal PVH (OR=0.80, 95% CI: 0.48 to 1.29 for PVH grade 1; OR=1.14, 95% CI: 0.65 to 2.00 for PVH grade 2). Furthermore, MetS was not associated with minimal SWML (OR=0.94, 95% CI: 0.58 to 1.52 for SWML grade 1). Therefore, our study disagreed with theirs. More data and longitudinal studies are required to determine whether minimal LA is related to MetS.

Acknowledgments

Disclosures

None.

References

1. Bokura H, Yamaguchi S, Iijima K, Iijima K, Nagai A, Oguro H. Metabolic syndrome is associated with silent ischemic brain lesions. Stroke. 2008; 39: 1607–1609.[Abstract/Free Full Text]

2. Park K, Yasuda N, Toyonaga S, Yamada SM, Nakabayashi H, Nakasato M, Nakagomi T, Tsubosaki E, Shimizu K. Significant association between leukoaraiosis and metabolic syndrome in healthy subjects. Neurology. 2007; 69: 974–978.[Abstract/Free Full Text]

3. 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.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) All Versions of this Article: 40/1/e6    most recent STROKEAHA.108.539163v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bokura, H. Articles by Yamaguchi, S. Search for Related Content PubMed Articles by Bokura, H. Articles by Yamaguchi, S.