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White matter hyperintensities in patients with multiple system atrophy

Journal of Neurology volume 256, pages 1663–1670 (2009)Cite this article

Abstract

Recent studies have reported that the majority of patients with multiple system atrophy (MSA) had hypertensive heart disease. However, the effect of autonomic failure on the brain in MSA has not been studied. We consecutively enrolled 63 patients with MSA and selected 63 age- and sex-matched healthy subjects. We performed a comparative analysis of cerebrovascular lesions between the patients with MSA and the control subjects and analyzed predisposing factors for cerebrovascular lesions in the patients with MSA. There was no significant difference in lacune and territorial infarcts between the patients with MSA and the control subjects. The median grading score of white matter hyperintensity (WMH) was significantly higher in the patients with MSA (1.0, interquartile range 0.5–2.0) than the control subjects (0.0, interquartile range 0.0–1.0; P < 0.01). In the patients with MSA, there was strong correlation between the grading score of WMH and supine systolic blood pressure (r = 0.529, P < 0.001) after adjusting for age. Multiple linear regression analysis showed that age and supine systolic blood pressure was significantly and independently correlated with the grading score of WMH. The present study demonstrates that patients with MSA had more severe WMH and that supine systolic pressure is a major contributing factor for the severity of WMH, suggesting that patients with MSA have target-organ damage of the brain.

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Acknowledgments

This research was supported by a grant from Stem Cell Research Center of the 21st Century Frontier Research Program (SC-4111) funded by the Ministry of Science and Technology, Republic of Korea.

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Affiliations

  1. Department of Neurology, Ajou University School of Medicine, Suwon, South Korea

    Tae Sung Lim & Seok Woo Yong

  2. Department of Neurology, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, 120-752, Seoul, South Korea

    Phil Hyu Lee

  3. Section of Neuroradiology, Department of Diagnostic Radiology, Ajou University School of Medicine, Suwon, South Korea

    Ho Sung Kim

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  1. Tae Sung Lim
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Correspondence to Phil Hyu Lee.

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Lim, T.S., Lee, P.H., Kim, H.S. et al. White matter hyperintensities in patients with multiple system atrophy. J Neurol 256, 1663–1670 (2009). https://doi.org/10.1007/s00415-009-5176-5

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  • DOI: https://doi.org/10.1007/s00415-009-5176-5

Keywords

  • White matter hyperintensities
  • Multiple systemic atrophy
  • Supine blood pressure