Distribution of white matter hyperintensity in cerebral hemorrhage and healthy aging
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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.
KeywordsIntercerebral hemorrhage White matter hyperintensity Cerebral amyloid angiopathy
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.
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