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Determinants of cerebral white matter changes in patients with stroke
Author(s) -
Chou P.S.,
Chen C.H.,
Wu M.N.,
Lin Y.H.,
Lai C.L.,
Lin R.T.,
Yang Y.H.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12704
Subject(s) - medicine , odds ratio , confidence interval , leukoaraiosis , stroke (engine) , logistic regression , magnetic resonance imaging , white matter , cardiology , radiology , mechanical engineering , engineering
Background/Aim Cerebral white matter changes ( WMC ) are commonly observed in magnetic resonance imaging ( MRI ) scans of elderly people. Information about the prevalence of WMC is limited, and little is known about site‐specific risk factors for the subcortical and periventricular regions in patients with ischaemic stroke. The study aims to analyse the prevalence and severity of WMC and investigate the risk factors of periventricular WMC ( PVWMC ) and deep WMC ( DWMC ) separately in patients with ischaemic stroke. Methods The data were collected between J anuary and D ecember 2013 from a medical centre in southern T aiwan. Every patient underwent a cerebral MRI scan, and WMC was separately rated as PVWMC and DWMC by using the modified F azekas scale. Results In total, 527 patients who had experienced ischaemic stroke were included. The mean age of the patients was 67.0 ± 12.5 years (range: 31–94) and 62% of them were men. The mean age was significantly different among the four grades of severity in both the PVWMC ( P < 0.001) and DWMC ( P < 0.001) groups after adjustments for sex and vascular risk factors. Hypertension was independently correlated with severity of DWMC ( P = 0.032) but not with PVWMC ( P = 0.222). In multiple logistic regressions model, hypertension was a significant independent indicator of DWMC (odds ratio = 4.30; 95% confidence interval = 1.70–10.89). Conclusion Our results suggest a region‐specific pathogenesis of cerebral white matter in A sian patients with ischaemic stroke that may differ from those in the general population.