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High total cerebral blood flow is associated with a decrease of white matter lesions
R H C Bisschops1, Y van der Graaf, W P Th M Mali
1Department of Radiology E01.132, University Medical Center Utrecht, PO Box 85500, 3508, GA Utrecht, The Netherlands.
Journal of Neurology
|January 13, 2005
Summary
Higher total cerebral blood flow (tCBF) is linked to fewer and less severe white matter lesions (WMLs). This large study suggests improved brain circulation may protect against WMLs in cardiovascular disease patients.
Area of Science:
- Neurology
- Cardiovascular Science
- Medical Imaging
Background:
- Low cerebral blood flow (CBF) is associated with white matter lesions (WMLs).
- Previous studies were underpowered (n=20-35) to confirm this association.
- The relationship between CBF and WML severity requires further investigation.
Purpose of the Study:
- To investigate the association between total cerebral blood flow (tCBF) and white matter lesion (WML) severity.
- To examine this relationship in a large patient cohort.
- To determine if higher tCBF correlates with reduced WML presence and severity.
Main Methods:
- MRI including T2-w FLAIR and 2D phase-contrast flow measurement in 228 cardiovascular disease patients.
- WMLs were graded based on prevalence and size of deep and periventricular lesions.
- Linear and logistic regression analyses adjusted for age, gender, intima media thickness, and hypertension were used.
Main Results:
- An inverse association was found between tCBF and the total number of WMLs (B=-1.0 WML per 100 mL/min increase in tCBF, p=0.045).
- Patients with high tCBF (> 675 mL/min) had a 50% lower odds of severe WMLs compared to those with normal tCBF (OR=0.5, 95% CI 0.2-1.0).
- These associations remained significant after adjusting for key demographic and clinical factors.
Conclusions:
- High total cerebral blood flow is associated with a reduced presence and severity of white matter lesions.
- This suggests that maintaining adequate cerebral blood flow may be protective against WMLs.
- Findings highlight the potential role of cerebral hemodynamics in white matter integrity.