Journal of Neurology

, Volume 259, Issue 3, pp 530–536 | Cite as

Distribution of white matter hyperintensity in cerebral hemorrhage and healthy aging

  • Yi-Cheng Zhu
  • Hugues Chabriat
  • Ophélia Godin
  • Carole Dufouil
  • Jonathan Rosand
  • Steven M. Greenberg
  • Eric E. Smith
  • Christophe Tzourio
  • Anand Viswanathan
Original Communication

Abstract

We compared the severity of white matter T2-hyperintensities (WMH) in the frontal lobe and occipital lobe using a visual MRI score in 102 patients with lobar intracerebral hemorrhage (ICH) diagnosed with possible or probable cerebral amyloid angiopathy (CAA), 99 patients with hypertension-related deep ICH, and 159 normal elderly subjects from a population-based cohort. The frontal-occipital (FO) gradient was used to describe the difference in the severity of WMH between the frontal lobe and occipital lobe. A higher proportion of subjects with obvious occipital dominant WMH (FO gradient ≤−2) was found among patients with lobar ICH than among healthy elderly subjects (FO gradient ≤−2: 13.7 vs. 5.7%, p = 0.03). Subjects with obvious occipital dominant WMH were more likely to have more WMH (p = 0.0006) and a significantly higher prevalence of the apolipoprotein E ε4 allele (45.8% vs. 19.4%, p = 0.04) than those who had obvious frontal dominant WMH. This finding is consistent with the relative predilection of CAA for posterior brain regions, and suggests that white matter lesions may preferentially occur in areas of greatest vascular pathology.

Keywords

Intercerebral hemorrhage White matter hyperintensity Cerebral amyloid angiopathy 

Notes

Acknowledgments

Yi-Cheng Zhu is funded by the French Chinese Foundation for Science and Applications (FFCSA), the China Scholarship Council (CSC), and the Association de Recherche en Neurologie Vasculaire (ARNEVA). Carole Dufouil has received consulting fees from EISAI. Christophe Tzourio has received investigator initiated research funding from the French National Research Agency (ANR) and has received fees from Sanofi-Synthelabo for participation on a data safety monitoring board and from Merck-Sharp & Dohm for participation on a scientific committee. Hugues Chabriat has already received fees from Eisai, Lundbeck, Servier and Johnson and Johnson companies for participating on data safety and scientific committees in studies unrelated to the present study.

Conflicts of interest

The authors report no conflicts of interest in the present study.

References

  1. 1.
    Bartzokis G, Beckson M, Lu PH, Nuechterlein KH, Edwards N, Mintz J (2001) Age-related changes in frontal and temporal lobe volumes in men: a magnetic resonance imaging study. Arch Gen Psychiatry 58:461–465PubMedCrossRefGoogle Scholar
  2. 2.
    Bartzokis G (2004) Age-related myelin breakdown: a developmental model of cognitive decline and Alzheimer’s disease. Neurobiol Aging 25:5–18PubMedCrossRefGoogle Scholar
  3. 3.
    De Leeuw FE, De Groot JC, Achten E, Oudkerk M, Ramos LM, Heijboer R, Hofman A, Jolles J, van Gijn J, Breteler MM (2001) Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam scan study. J Neurol Neurosurg Psychiatry 70:9–14PubMedCrossRefGoogle Scholar
  4. 4.
    Pfefferbaum A, Adalsteinsson E, Sullivan EV (2005) Frontal circuitry degradation marks healthy adult aging: evidence from diffusion tensor imaging. Neuroimage 26:891–899PubMedCrossRefGoogle Scholar
  5. 5.
    Vinters HV, Gilbert JJ (1983) Cerebral amyloid angiopathy: incidence and complications in the aging brain. II. The distribution of amyloid vascular changes. Stroke 14:924–928PubMedCrossRefGoogle Scholar
  6. 6.
    Kim KW, MacFall JR, Payne ME (2008) Classification of white matter lesions on magnetic resonance imaging in elderly persons. Biol Psychiatry 64:273–280PubMedCrossRefGoogle Scholar
  7. 7.
    Smith EE, Gurol ME, Eng JA, Engel CR, Nguyen TN, Rosand J, Greenberg SM (2004) White matter lesions, cognition, and recurrent hemorrhage in lobar intracerebral hemorrhage. Neurology 63:1606–1612PubMedGoogle Scholar
  8. 8.
    Smith EE, Nandigam KR, Chen YW, Jeng J, Salat D, Halpin A, Frosch M, Wendell L, Fazen L, Rosand J, Viswanathan A, Greenberg SM (2010) MRI markers of small vessel disease in lobar and deep hemispheric intracerebral hemorrhage. Stroke 41:1933–1938PubMedCrossRefGoogle Scholar
  9. 9.
    O’Donnell HC, Rosand J, Knudsen KA, Furie KL, Segal AZ, Chiu RI, Ikeda D, Greenberg SM (2000) Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage. N Engl J Med 342:240–245PubMedCrossRefGoogle Scholar
  10. 10.
    Knudsen KA, Rosand J, Karluk D, Greenberg SM (2001) Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria. Neurology 56:537–539PubMedGoogle Scholar
  11. 11.
    Alperovitch A (2003) Vascular factors and risk of dementia: Design of the three-city study and baseline characteristics of the study population. Neuroepidemiology 22:316–325CrossRefGoogle Scholar
  12. 12.
    Viswanathan A, Patel P, Rahman R, Nandigam RN, Kinnecom C, Bracoud L, Rosand J, Chabriat H, Greenberg SM, Smith EE (2008) Tissue microstructural changes are independently associated with cognitive impairment in cerebral amyloid angiopathy. Stroke 39:1988–1992PubMedCrossRefGoogle Scholar
  13. 13.
    Holland CM, Smith EE, Csapo I, Gurol ME, Brylka DA, Killiany RJ, Blacker D, Albert MS, Guttmann CR, Greenberg SM (2008) Spatial distribution of white-matter hyperintensities in Alzheimer disease, cerebral amyloid angiopathy, and healthy aging. Stroke 39:1127–1133PubMedCrossRefGoogle Scholar
  14. 14.
    Smith EE, Vijayappa M, Lima F, Delgado P, Wendell L, Rosand J, Greenberg SM (2008) Impaired visual evoked flow velocity response in cerebral amyloid angiopathy. Neurology 71:1424–1430PubMedCrossRefGoogle Scholar
  15. 15.
    Johnson KA, Gregas M, Becker JA, Kinnecom C, Salat DH, Moran EK, Smith EE, Rosand J, Rentz DM, Klunk WE, Mathis CA, Price JC, Dekosky ST, Fischman AJ, Greenberg SM (2007) Imaging of amyloid burden and distribution in cerebral amyloid angiopathy. Ann Neurol 62:229–234PubMedCrossRefGoogle Scholar
  16. 16.
    Ly JV, Donnan GA, Villemagne VL, Zavala JA, Ma H, O’Keefe G, Gong SJ, Gunawan RM, Saunder T, Ackerman U, Tochon-Danguy H, Churilov L, Phan TG, Rowe CC (2010) 11C-PIB binding is increased in patients with cerebral amyloid angiopathy-related hemorrhage. Neurology 74:487–493PubMedCrossRefGoogle Scholar
  17. 17.
    Godin O, Tzourio C, Rouaud O, Zhu Y, Maillard P, Pasquier F, Crivello F, Alperovitch A, Mazoyer B, Dufouil C (2010) Joint effect of white matter lesions and hippocampal volumes on severity of cognitive decline: the 3C-Dijon MRI study. J Alzheimers Dis 20:453–463PubMedGoogle Scholar
  18. 18.
    Yoshita M, Fletcher E, Harvey D (2006) Extent and distribution of white matter hyperintensities in normal aging, MCI, and AD. Neurology 67:2192–2198PubMedCrossRefGoogle Scholar
  19. 19.
    van Swieten JC, Hijdra A, Koudstaal PJ, van Gijn J (1990) Grading white matter lesions on CT and MRI: a simple scale. J Neurol Neurosurg Psychiatry 53:1080–1083PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Yi-Cheng Zhu
    • 1
    • 2
    • 3
  • Hugues Chabriat
    • 2
  • Ophélia Godin
    • 3
    • 4
  • Carole Dufouil
    • 3
    • 4
  • Jonathan Rosand
    • 5
  • Steven M. Greenberg
    • 6
  • Eric E. Smith
    • 6
    • 7
  • Christophe Tzourio
    • 3
    • 4
  • Anand Viswanathan
    • 6
  1. 1.Department of NeurologyPeking Union Medical College HospitalBeijingChina
  2. 2.Department of Neurology CHU LariboisièreAssistance Publique des Hôpitaux de Paris, INSERM U740ParisFrance
  3. 3.Unit 708 NeuroepidemiologyINSERMParisFrance
  4. 4.UPMC Univ Paris 6ParisFrance
  5. 5.Center for Human Genetic ResearchMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  6. 6.Department of Neurology, Hemorrhagic Stroke Research ProgramMassachusetts General Hospital Stroke Research Center, Harvard Medical SchoolBostonUSA
  7. 7.Calgary Stroke Program, Department of Clinical NeurosciencesUniversity of CalgaryCalgaryCanada

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