Abstract
Background and Purpose: Leukoaraiosis, also called white matter hyperintensities (WMH), is frequently encountered in the brain of older adults. During aging, gray matter structure is also highly affected. WMH or gray matter defects are commonly associated with a higher prevalence of mild cognitive impairment. However, little is known about the relationship between WMH and gray matter. Our aim was thus to explore the relationship between leukoaraiosis severity and gray matter volume in a cohort of healthy older adults.Methods: Leukoaraiosis was rated in participants from the PROOF cohort using the Fazekas scale. Voxel-based morphometry was performed on brain scans to examine the potential link between WMH and changes of local brain volume. A neuropsychological evaluation including attentional, executive, and memory tests was also performed to explore cognition.Results: Out of 315 75-year-old subjects, 228 had punctuate foci of leukoaraiosis and 62 had begun the confluence of foci. Leukoaraiosis was associated with a decrease of gray matter in the middle temporal gyrus, in the right medial frontal gyrus, and in the left parahippocampal gyrus. It was also associated with decreased performances in memory recall, executive functioning, and depression.Conclusion: In a population of healthy older adults, leukoaraiosis was associated with gray matter defects and reduced cognitive performance. Controlling vascular risk factors and detecting early cerebrovascular disease may prevent, at least in part, dementia onset and progression.
Highlights
Leukoaraiosis is a rarefaction of white matter found on magnetic resonance imaging (MRI) as white matter hyperintensities (WMH) (Hachinski et al, 1987)
They are considered as silent manifestations of aging, WMH do correlate with age but they are associated with numerous cardiovascular risk factors including hypertension, diabetes mellitus (Scharf et al, 2019; Grosu et al, 2021), and obstructive sleep apnea
In older untreated prehypertensive patients, increased ambulatory blood pressure (BP) was significantly associated with higher occurrence of leukoaraiosis (Avet et al, 2014), an alteration found with a relative low mean load value of 24-h systolic BP
Summary
Leukoaraiosis is a rarefaction of white matter found on magnetic resonance imaging (MRI) as white matter hyperintensities (WMH) (Hachinski et al, 1987). WMH are commonly observed on brain MRIs in older adults, leading some authors to speak of age-related white matter changes. They are considered as silent manifestations of aging, WMH do correlate with age but they are associated with numerous cardiovascular risk factors including hypertension, diabetes mellitus (Scharf et al, 2019; Grosu et al, 2021), and obstructive sleep apnea. In older untreated prehypertensive patients, increased ambulatory blood pressure (BP) was significantly associated with higher occurrence of leukoaraiosis (Avet et al, 2014), an alteration found with a relative low mean load value of 24-h systolic BP Such frailty of the peripheral vascular cerebral tree in older adults challenges the general practitioners to apply a more important use of antihypertensive medication in older adults, optimal and consider the other risk factors of obstructive sleep apnea and diabetes as well. Our aim was to explore the relationship between leukoaraiosis severity and gray matter volume in a cohort of healthy older adults
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