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Updated: Jul 29, 2026
A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology
Published on: March 17, 2016
Risk factors analysis according to regional distribution of white matter hyperintensities in a stroke cohort
Santiago Medrano-Martorell1,2, Jaume Capellades3, Jordi Jiménez-Conde4
1Department of Neuroradiology, Hospital Clínic i Provincial, Villarroel, 170, Barcelona, Spain. santimedra@gmail.com.
Objectives:
The spectrum of distribution of white matter hyperintensities (WMH) may reflect different functional, histopathological, and etiological features. We examined the relationships between cerebrovascular risk factors (CVRF) and different patterns of WMH in MRI using a qualitative visual scale in ischemic stroke (IS) patients.
Methods:
We assembled clinical data and imaging findings from patients of two independent cohorts with recent IS. MRI scans were evaluated using a modified visual scale from Fazekas, Wahlund, and Van Swieten. WMH distributions were analyzed separately in periventricular (PV-WMH) and deep (D-WMH) white matter, basal ganglia (BG-WMH), and brainstem (B-WMH). Presence of confluence of PV-WMH and D-WMH and anterior-versus-posterior WMH predominance were also evaluated. Statistical analysis was performed with SPSS software.
Results:
We included 618 patients, with a mean age of 72 years (standard deviation [SD] 11 years). The most frequent WMH pattern was D-WMH (73%). In a multivariable analysis, hypertension was associated with PV-WMH (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.29-2.50, p = 0.001) and BG-WMH (OR 2.13, 95% CI 1.19-3.83, p = 0.012). Diabetes mellitus was significantly related to PV-WMH (OR 1.69, 95% CI 1.24-2.30, p = 0.001), D-WMH (OR 1.46, 95% CI 1.07-1.49, p = 0.017), and confluence patterns of D-WMH and PV-WMH (OR 1.62, 95% CI 1.07-2.47, p = 0.024). Hyperlipidemia was found to be independently related to brainstem distribution (OR 1.70, 95% CI 1.08-2.69, p = 0.022).
Conclusions:
Different CVRF profiles were significantly related to specific WMH spatial distribution patterns in a large IS cohort.
Key Points:
• An observational study of WMH in a large IS cohort was assessed by a modified visual evaluation. • Different CVRF profiles were significantly related to specific WMH spatial distribution patterns. • Distinct WMH anatomical patterns could be related to different pathophysiological mechanisms.
Insights
Cerebrovascular risk factors (CVRF) are linked to specific white matter hyperintensities (WMH) patterns in patients with ischemic stroke (IS). Understanding these relationships aids in diagnosing distinct pathophysiological mechanisms.
Area of Science:
- Neurology
- Radiology
- Epidemiology
Background:
- White matter hyperintensities (WMH) distribution on MRI may indicate varying functional, histopathological, and etiological characteristics.
- Cerebrovascular risk factors (CVRF) are crucial in the development and progression of cerebrovascular diseases.
Purpose of the Study:
- To investigate the association between CVRF and distinct WMH patterns in patients with ischemic stroke (IS).
- To utilize a qualitative visual scale on MRI for analyzing WMH distribution.
Main Methods:
- Clinical data and MRI findings from two independent IS cohorts were analyzed.
- WMH distribution was assessed using a modified visual scale, evaluating periventricular (PV-WMH), deep (D-WMH), basal ganglia (BG-WMH), and brainstem (B-WMH).
- Statistical analyses were performed to identify significant relationships between CVRF and WMH patterns.
Main Results:
- Hypertension correlated with PV-WMH and BG-WMH.
- Diabetes mellitus was associated with PV-WMH, D-WMH, and confluent PV-WMH/D-WMH patterns.
- Hyperlipidemia showed an independent relationship with brainstem WMH distribution.
Conclusions:
- Specific CVRF profiles are significantly associated with distinct spatial distribution patterns of WMH in a large IS cohort.
- These findings suggest that different anatomical WMH patterns may arise from diverse pathophysiological mechanisms.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
01:17Hemorrhagic Stroke l: Introduction