White matter hyperintensity

Breeze, J. L., Hesdorffer, D. C., Hong, X. et al. Clinical significance of brain white matter hyperintensities in young adults with psychiatric illness. Harv. Rev. Psychiat. 11 269-283, 2003. 

Purandare, N., Oude Voshaar, R.C., Davidson, Y., et al. (2006) Deletion/insertion polymorphism of the angiotensin-converting enzyme gene and white matter hyperintensities in dementia a pilot study. J. Am. Geriatr. Soc., 54, 1395-1400. 

Nebes, R.D., Vora, I.J., Meltzer, C.C., et al. (2001) Relationship of deep white matter hyperintensities and apolipoprotein E genotype to depressive symptoms in older adults without clinical depression. Am. J. Psychiatry, 158, 878-884. 

Botteron et al., 1995 8 BD 5 NC 8-16 Structural MRI BD > NC deep white matter hyperintensities BD > NC ventricular volume (temporal horn)... 

Kato, T., Murashita, J., Kamiya, A., Shioiri, T, Kato, N., and Inubushi, T. (1998) Decreased brain intracellular pH measured by 31P-MRS in bipolar disorder a confirmation in drug-free patients and correlation with white matter hyperintensity. Eur Arch Psychiatry Clin Neurosci, 248 301—306. 

Mezzapesa DM, Rocca MA, Pagani E, Comi G, Filippi M (2003) Evidence of subtle gray-matter pathologic changes in healthy elderly individuals with nonspecific white-matter hyperintensities. Arch Neurol 60 1109-1112... 

Fig. 10.6. AT2-weighted (a) and diffusion-weighted (b) MRI in a 60-year-old woman who had awoken three weeks before with slurred speech. On examination, there was very mild dysarthria. Several white matter hyperintensities are seen on the T2-weighted image but the acute causative lesion in seen clearly in the diffusion-weighted image.

Smith CD, Snowdon DA, Wang H et al. (2000). White matter volumes and periventricular white matter hyperintensities in aging and dementia. Neurology 54 838-842 Stebbins GT, Nyenhuis DL, Wang C et al. (2008). Gray matter atrophy in patients with ischemic stroke with cognitive impairment. Stroke 39 785-793... 

Wright CB, Festa JR, Paik MC et al. (2008). White matter hyperintensities and subclinical infarction associations with psychomotor speed and cognitive flexibility. Stroke 39 800-805... 

As part of the initial assessment of a patient with dementia, brain imaging is required. With imaging one can get information on structure or function, or a combination of the two. In AD, clinical structural MRI findings are not specific, with reports of neocortical, hippocampal, or global atrophy and white matter hyperintensities and/or associated mircovascular disease. The main reason to perform a MRI is... 

Brickman AM, Honig LS, Scarmeas N, Tatarina O, Sanders L, Albert MS, Brandt J, Blacker D, Stem Y (2008) Measuring cerebral atrophy and white matter hyperintensity burden to predict the rate of cognitive decline in Alzheimer disease. Arch Neurol 65(9) 1202-1208 Brody DL, Magnoni S, Schwetye KE, Spinner ML, Esparza TJ, Stocchetti N, Zipfel GJ, Holtzman DM (2008) Amyloid-beta dynamics correlate with neurological status in the injured human brain. Science 321(5893) 1221-1224... 

Parkinson, R.B., Hopkins, R.O., Cleavinger, H.B., Weaver, L.K., Victoroff, J., Foley, J.F., Bigler, E.D. (2002). White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology 58 1525-32. 

Hypoperfusion in frontal, parietal, and temporal regions is a common finding in AD. White matter hyperintensities correlate... 

Kim JH, Hwang KJ, Kim JH, Lee YH, Rhee HY, Park KC (2011) Regional white matter hyperintensities in normal aging, single domain amnestic mild cognitive impairment, and mild Alzheimer s disease. J Clin Neurosci 18 1101-1106... 

Wen W, Sachdev PS (2004) Extent and distribution of white matter hyperintensities in stroke patients the Sydney Stroke Study. Stroke 35 2813-2819... 

Regenold, W.T., Hisley, K.C., Obuchowski, A., Lefkowitz, D.M., Marano, C., and Hauser, P. 2005. Relationship of white matter hyperintensities to cerebrospinal fluid glucose polyol pathway metabo-htes - a pilot study in treatment-resistant affective disorder patients. J. Affect. Disord. 85 341-350. Regenold, W.T., Phatak, R, KUng, M.A., and Hauser, P. 2004. Post-mortem evidence from human brain tissue of disturbed glucose metabolism in mood and psychotic disorders. Mol. Psychiatry 9 731-733. 

That white matter hyperintensities on MRI represent small vessel damage has been shown by observational and pathological studies (Fazekas et al., 1993) and is supported by the association of tHcy with WMHV in this sample. Recent data suggest it may do so by contributing to endothelial dysfunction (Hassan... 

Carmelli D, DeCarU C, Swan GE, Jack LM, Reed T, Wolf PA, Miller BL. Evidence for genetic variance in white matter hyperintensity volume in normal elderly male twins. Stroke 1998 29 1177-1181. 

Dufouil C, Alperovitch A, Ducros V, Tzourio C. Homocysteine, white-matter hyperintensities and cognition in healthy elderly people. Ann Neurol 2003 53 214-221. 

Jeerakatlul T, Wolf PA, Beiser A, Massaro J, Seshadri S, D Agostino RB, DeCarU C. Stroke risk profile predicts white matter hyperintensity volume the Framingham Study. Stroke 2004 35 1857-1861. 

Lenze E, Cross D, McKeel D, Neuman RJ, Shehna YI. White-matter hyperintensities and gray-matter lesions in physically healthy depressed subjects. Am J Psychiatr 1999 1602-1607. 

Wright CB, Paik MC, Brown TR, Stabler SP, AUen RH, Sacco RL, DeCarh C. Total homocysteine is associated with white matter hyperintensity volume the Northern Manhattan Study. Stroke 2005 Jun 36 1207-1211. 

Sensory systems - eyes Three weeks after initiation of adalimumab therapy, a patient was diagnosed with retrobulbar optic neuritis and, despite full visual recovery, to also have white matter hyperintensities lesions on T2/fluid-attenuated inversion recovery brain MRI. Six months later the lesions still persisted. The authors suggested tiiat the case may represent an unmasking of an underlying demyelinating process by adalimumab [76 ]. 

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