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Relationship between androgenic alopecia and white matter hyperintensities in apparently healthy subjects

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Abstract

A healthy brain is essential for living a longer and fuller life. Detecting asymptomatic white matter hyperintensities (WMHs) may be clinically important in terms of treatment and prognostic evaluation. WMHs in brain may reflect brain aging. Androgenic alopecia (AGA) is associated with significant cardiovascular risk factors that also have a negative impact on brain aging. The main purpose of present study was to know whether alopecia might provide predictive information of WMHs that may be considered as a surrogate marker of cerebral small vessel disease which is related to arteriolosclerosis and vascular risk factors. From January 2017 to March 2018, 256 cases were enrolled consecutively. Patients under 18 years old, older than 90 years old, known to be affected by neurodegenerative diseases, demyelinating disorders or stroke and/or a brain tumor, were excluded from the study. A 4-point cerebral white matter Magnetic Resonance Imaging (MRI) hyperintensities scoring system, the Fazekas scale, was used to evaluate brain aging. Presence of AGA was evaluated with inspection according to Hamilton-Norwood classification system (grade I to VII). Two hundred eleven (82%) of individuals had mild alopecia (grade I, II, III), 28 (11%) had moderate alopecia (grade IV, V) and 17 (7%) had severe alopecia (grade VI, VII). Frequency of abnormal WMHs was significantly higher in patients with AGA compared to the without AGA. Hypertension (HT) (95% confidence interval [CI]: 1.873–9.487, p < 0.001) and the AGA (95% CI: 2.989–12.916, p < 0.0001) were independent determinants of abnormal WMHs. AGA may be regarded as a surrogate marker of asymptomatic WMHs which is related to arteriolosclerosis and vascular risk factors that has a significant impact on people’s life.

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Funding

This study was done in compliance with the Helsinki Declaration, good clinical practice guidelines of Turkey Ministry of Health and was approved by the local Scientific Research ethical committee of Kanuni Research and Education Hospital, Trabzon, Turkey (Approval number is 2017/46).

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  1. Department of Radiology, University of Health Science, Kanuni Research and Education Hospital, Trabzon, Turkey

    Hatice Ayca Ata Korkmaz

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Correspondence to Hatice Ayca Ata Korkmaz.

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Key Points

The degree of alopecia may be considered a surrogate marker of asymptomatic WMHs that are related to cerebral small vessel disease and vascular risk factors, which have significant impact on the quality of life of individuals. Assessing the degree of alopecia may be considered by the physicians because its detection does not require any specialized equipment or testing methods. Individuals with androgenetic alopecia may be referred to further examinations in to assess asymptomatic cerebral small vessel disease in the early phase.

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Ata Korkmaz, H.A. Relationship between androgenic alopecia and white matter hyperintensities in apparently healthy subjects. Brain Imaging and Behavior 14, 527–533 (2020). https://doi.org/10.1007/s11682-019-00147-y

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