Related Experiment Video
Updated: Apr 6, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Gray matter blood flow and volume are reduced in association with white matter hyperintensity lesion burden: a
David E Crane1, Sandra E Black2, Anoop Ganda1
1Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute Toronto, ON, Canada.
Abstract:
Cerebral White Matter Hyperintensities (WMH) are associated with vascular risk factors and age-related cognitive decline. WMH have primarily been associated with global white matter and gray matter (GM) changes and less is known about regional effects in GM. The purpose of this study was to test for an association between WMH and two GM imaging measures: cerebral blood flow (CBF) and voxel-based morphometry (VBM). Twenty-six elderly adults with mild to severe WMH participated in this cross-sectional 3 Tesla magnetic resonance imaging (MRI) study. MRI measures of GM CBF and VBM were derived from arterial spin labeling (ASL) and T1-weighted images, respectively. Fluid-attenuated inversion recovery (FLAIR) images were used to quantify the WMH lesion burden (mL). GM CBF and VBM data were used as dependent variables. WMH lesion burden, age and sex were used in a regression model. Visual rating of WMH with the Fazekas method was used to compare the WMH lesion volume regression approach. WMH volume was normally distributed for this group (mean volume of 22.7 mL, range: 2.2-70.6 mL). CBF analysis revealed negative associations between WMH volume and CBF in the left anterior putamen, subcallosal, accumbens, anterior caudate, orbital frontal, anterior insula, and frontal pole (corrected p < 0.05). VBM analysis revealed negative associations between WMH and GM volume in lingual gyrus, intracalcarine, and bilateral hippocampus (corrected p < 0.05). The visual rating scale corroborated the regression findings (corrected p < 0.05). WMH lesion volume was associated with intra-group GM CBF and structural differences in this cohort of WMH adults with mild to severe lesion burden.
Insights
White Matter Hyperintensities (WMH) are linked to reduced gray matter blood flow and volume in specific brain regions. This study reveals regional gray matter changes associated with WMH burden in elderly adults.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cerebral White Matter Hyperintensities (WMH) are linked to vascular risk factors and cognitive decline.
- While WMH are associated with global brain changes, regional effects on gray matter (GM) are less understood.
Purpose of the Study:
- To investigate the association between WMH lesion burden and regional GM imaging measures.
- Specifically, to examine relationships with cerebral blood flow (CBF) and voxel-based morphometry (VBM).
Main Methods:
- Cross-sectional 3 Tesla MRI study of 26 elderly adults with varying WMH severity.
- GM CBF derived from arterial spin labeling (ASL); VBM from T1-weighted images.
- WMH lesion burden quantified using Fluid-attenuated inversion recovery (FLAIR) images and Fazekas visual rating.
Main Results:
- Negative associations found between WMH volume and GM CBF in several brain regions including the left anterior putamen and orbital frontal cortex.
- Negative associations also observed between WMH and GM volume in the lingual gyrus and bilateral hippocampus.
- Regression findings were corroborated by visual rating scales.
Conclusions:
- WMH lesion volume is associated with regional GM CBF and structural differences in elderly adults.
- These findings highlight the localized impact of WMH on brain structure and function.
