Hypertension and cerebral diffusion tensor imaging in small vessel disease

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Hypertension is a key risk factor for cerebral small vessel disease (CSVD), including white matter lesions (WML) and lacunar infarcts.
• These CSVD manifestations are common in the elderly and contribute to cognitive decline.
• Evaluating hypertension's impact on white matter microstructural integrity before macrostructural lesions emerge is crucial.

Purpose of the Study:

• To investigate the relationship between blood pressure, hypertension, and hypertension treatment status with white matter microstructural integrity.
• To assess diffusion tensor imaging (DTI) parameters in normal-appearing white matter (NAWM) and WMLs in patients with CSVD.

Main Methods:

• Cross-sectional study of 503 patients (aged 50-85) with CSVD.
• Utilized 1.5-T MRI and DTI scanning.
• Calculated fractional anisotropy (FA) and mean diffusivity (MD) in NAWM and WMLs.

Main Results:

• Elevated blood pressure and hypertension were significantly associated with reduced FA in both NAWM and WMLs.
• Higher MD was observed in WMLs of hypertensive individuals.
• Hypertensives showed increased odds of impaired microstructural integrity (lower FA) in NAWM and WMLs compared to normotensives.

Conclusions:

• Diffusion tensor imaging (DTI) shows promise for monitoring the effects of blood pressure on white matter integrity.
• DTI may detect microstructural changes before the development of visible white matter lesions on MRI.
• This technique could be valuable for assessing treatment response in managing hypertension-related white matter changes.