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Cerebral blood flow correlated with carotid blood flow in neurologically normal elderly with severe white matter
1The Institute for Tuberculosis and Cancer, Tohoku University, Sendai, Japan.
Abstract:
Previous studies of white matter signal hyperintensity (WMSH) on T2-weighted MRI (magnetic resonance imaging) have shown it to be related to decreased cerebral blood flow (CBF). However, there have been few studies on the relationship of WMSH and the internal carotid blood flow (CaBF). Doppler ultrasound sonography is widely used for evaluation of CaBF. We analyzed the relationship between CBF, CaBF, and WMSH. The subjects had not suffered cerebral ischemic episodes although they had some risk factors for stroke. They received MRI and were classified into three groups, i.e. mild, moderate, and severe WMSH. The % stenosis of the internal carotid artery (ICA) was measured with angiography. Doppler sonography was used to measure the mean bilateral CaBF. The oxygen-15 steady-state technique and PET (positron emission tomography) were used to measure CBF. There were significant correlations between the % stenosis of ICA and the ipsilateral CaBF and between the % stenosis of ICA and hemispheric CBF. There was a significant relationship between CBF and CaBF in the severe WMSH group, remaining significant after partialling out of the effects of the % stenosis. This indicated that an atherosclerotic change of the cerebral artery occurred in a way that carotid vascular resistence and cerebrovascular resistence were 'proportional'. Copyright Rapid Science Ltd
Insights
White matter signal hyperintensity (WMSH) is linked to reduced cerebral blood flow (CBF). In severe WMSH, cerebral blood flow correlates with internal carotid artery blood flow, suggesting proportional vascular resistance in atherosclerosis.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- White matter signal hyperintensity (WMSH) on T2-weighted MRI is associated with decreased cerebral blood flow (CBF).
- Limited research exists on the relationship between WMSH and internal carotid artery blood flow (CaBF).
Purpose of the Study:
- To investigate the relationship between cerebral blood flow (CBF), internal carotid artery blood flow (CaBF), and white matter signal hyperintensity (WMSH).
Main Methods:
- Subjects with stroke risk factors but no prior ischemic episodes underwent MRI for WMSH classification (mild, moderate, severe).
- Internal carotid artery (ICA) stenosis was measured via angiography.
- Bilateral CaBF was measured using Doppler sonography.
- CBF was measured using oxygen-15 steady-state technique and positron emission tomography (PET).
Main Results:
- Significant correlations were found between ICA stenosis and ipsilateral CaBF, and between ICA stenosis and hemispheric CBF.
- A significant relationship between CBF and CaBF was observed in the severe WMSH group, independent of ICA stenosis.
Conclusions:
- In severe WMSH, cerebral blood flow is significantly related to carotid artery blood flow, even after accounting for stenosis.
- This suggests proportional carotid and cerebrovascular resistance in atherosclerotic changes.
