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Higher systolic blood pressure is associated with increased water diffusivity in normal-appearing white matter

Alasdair M J Maclullich, Karen J Ferguson, Louise M Reid

    Stroke
    |October 24, 2009
    PubMed
    Abstract

    Insights

    Higher blood pressure (BP) in older men is linked to increased mean diffusivity (MD) in normal-appearing white matter, suggesting early fluid changes before structural damage. Fractional anisotropy remained unchanged.

    Area of Science:

    • Neuroimaging
    • Cardiovascular Health
    • Gerontology

    Background:

    • Hypertension is a known risk factor for white matter lesions in older adults.
    • Diffusion Tensor MRI (DT-MRI) parameters like mean diffusivity (MD) and fractional anisotropy (FA) can detect early white matter damage.
    • The relationship between blood pressure (BP) and DT-MRI parameters in normal-appearing white matter is not fully understood.

    Discussion:

    • This study investigated the correlation between BP and DT-MRI parameters in elderly men.
    • Mean diffusivity (MD) showed significant positive correlations with both systolic and diastolic BP in multiple white matter regions.
    • Fractional anisotropy (FA) did not show significant correlations with BP, suggesting a specific type of microstructural change.

    Key Insights:

    • Elevated systolic BP is associated with increased MD in normal-appearing white matter across all analyzed regions.
    • Increased MD, without changes in FA, suggests an early stage of white matter alteration possibly due to increased extracellular fluid.
    • Fazekas scores for deep white matter lesions correlated with diastolic BP, indicating a link between BP and visible damage.

    Outlook:

    • These findings highlight the potential of DT-MRI to identify early, sub-clinical white matter changes related to hypertension.
    • Further research could explore the longitudinal effects of BP on white matter integrity and the clinical implications of these early changes.
    • Understanding these early fluid shifts may inform strategies for preventing or delaying the progression of cerebrovascular damage in hypertensive individuals.

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