Abstract
Purpose
Hypertension is associated with substantial morbidity in Japan. The aim of this work was to evaluate whether hypertension is associated with white matter microstructural changes by using diffusional kurtosis imaging (DKI).
Methods
We explored the regional patterns of white matter alteration in 15 hypertensive middle-aged male participants and 11 normotensive controls by using DKI-based whole-brain analysis. In addition, we investigated whether the observed white matter microstructural changes were related to systolic or diastolic blood pressure by using Pearson’s correlation coefficient analysis.
Results
Mean diffusional kurtosis (MDK) values were significantly higher in hypertensive participants than in normotensive participants (P < 0.05; family-wise error correction for multiple comparisons), indicating widespread microstructural changes in white matter. Moreover, we noted a statistically significant positive correlation between systolic and diastolic blood pressure and MDK values of the whole brain.
Conclusion
Our study suggests that microstructural white matter changes occur in middle-aged men with hypertension, even before the onset of cerebrovascular disease. Thus, DKI might be used as a screening tool for risk of cerebrovascular disease. This highlights the need to further elucidate the relationship between hypertension and DKI of the brain.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sliwa K, Stewart S, Gersh BJ. Hypertension: a global perspective. Circulation. 2011;123(24):2892–6. doi:10.1161/circulationaha.110.992362.
Maclullich AM, Ferguson KJ, Reid LM, Deary IJ, Starr JM, Seckl JR, et al. Higher systolic blood pressure is associated with increased water diffusivity in normal-appearing white matter. Stroke. 2009;40(12):3869–71. doi:10.1161/STROKEAHA.109.547877.
Gons RA, de Laat KF, van Norden AG, van Oudheusden LJ, van Uden IW, Norris DG, et al. Hypertension and cerebral diffusion tensor imaging in small vessel disease. Stroke. 2010;41(12):2801–6. doi:10.1161/STROKEAHA.110.597237.
Gons RA, van Oudheusden LJ, de Laat KF, van Norden AG, van Uden IW, Norris DG, et al. Hypertension is related to the microstructure of the corpus callosum: the RUN DMC Study. J Alzheimers Dis. 2012. doi:10.3233/jad-2012-121006.
Maillard P, Seshadri S, Beiser A, Himali JJ, Au R, Fletcher E, et al. Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study. Lancet Neurol. 2012;11(12):1039–47. doi:10.1016/s1474-4422(12)70241-7.
Jensen JH, Helpern JA, Ramani A, Lu H, Kaczynski K. Diffusional kurtosis imaging: the quantification of non-Gaussian water diffusion by means of magnetic resonance imaging. Magn Reson Med. 2005;53(6):1432–40. doi:10.1002/mrm.20508.
Jensen JH, Helpern JA. MRI quantification of non-Gaussian water diffusion by kurtosis analysis. NMR Biomed. 2010;23(7):698–710. doi:10.1002/nbm.1518.
Grossman EJ, Jensen JH, Babb JS, Chen Q, Tabesh A, Fieremans E, et al. Cognitive impairment in mild traumatic brain injury: a longitudinal diffusional kurtosis and perfusion imaging study. AJNR Am J Neuroradiol. 2012. doi:10.3174/ajnr.A3358.
Hori M, Fukunaga I, Masutani Y, Taoka T, Kamagata K, Suzuki Y, et al. Visualizing non-Gaussian diffusion: clinical application of q-space imaging and diffusional kurtosis imaging of the brain and spine. Magn Reson Med Sci. 2012;11(4):221–33 doi.
Yoshida M, Hori M, Yokoyama K, Fukunaga I, Suzuki M, Kamagata K, et al. Diffusional kurtosis imaging of normal-appearing white matter in multiple sclerosis: preliminary clinical experience. Jpn J Radiol. 2013;31(1):50–5. doi:10.1007/s11604-012-0147-7.
Nakanishi A, Fukunaga I, Hori M, Masutani Y, Takaaki H, Miyajima M, et al. Microstructural changes of the corticospinal tract in idiopathic normal pressure hydrocephalus: a comparison of diffusion tensor and diffusional kurtosis imaging. Neuroradiology. 2013. doi:10.1007/s00234-013-1201-6.
Kamagata K, Tomiyama H, Motoi Y, Kano M, Abe O, Ito K, et al. Diffusional kurtosis imaging of cingulate fibers in Parkinson disease: Comparison with conventional diffusion tensor imaging. Magn Reson Imaging. 2013. doi:10.1016/j.mri.2013.06.009.
Imai Y, Kario K, Shimada K, Kawano Y, Hasebe N, Matsuura H, et al. The Japanese Society of hypertension guidelines for self-monitoring of blood pressure at home (Second Edition). Hypertens Res. 2012;35(8):777–95. doi:10.1038/hr.2012.56.
Lu H, Jensen JH, Ramani A, Helpern JA. Three-dimensional characterization of non-Gaussian water diffusion in humans using diffusion kurtosis imaging. NMR Biomed. 2006;19(2):236–47. doi:10.1002/nbm.1020.
Hori M, Aoki S, Fukunaga I, Suzuki Y, Masutani Y. A new diffusion metric, diffusion kurtosis imaging, used in the serial examination of a patient with stroke. Acta Radiol Short Rep. 2012;1(1). doi:10.1258/arsr.2011.110024.
Sala M, de Roos A, Berg AV, Altmann-Schneider I, Slagboom PE, Westendorp RG, et al. Microstructural brain tissue damage in metabolic syndrome. Diabetes Care. 2013. doi:10.2337/dc13-1160.
Acknowledgments
This study was supported in part by a High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (MEXT). The research was also supported in part by a MEXT Grant-in-Aid for Scientific Research on Innovative Areas (Comprehensive Brain Science Network), and by a MEXT KAKENHI Grant (Number 25861126).
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Shimoji, K., Uka, T., Tamura, Y. et al. Diffusional kurtosis imaging analysis in patients with hypertension. Jpn J Radiol 32, 98–104 (2014). https://doi.org/10.1007/s11604-013-0275-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-013-0275-8