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European Radiology
Published in: European Radiology 4/2013

01-04-2013 | Neuro

Brain atrophy associations with white matter lesions in the ageing brain: the Lothian Birth Cohort 1936

Authors: Benjamin S. Aribisala, Maria C. Valdés Hernández, Natalie A. Royle, Zoe Morris, Susana Muñoz Maniega, Mark E. Bastin, Ian J. Deary, Joanna M. Wardlaw

Published in: European Radiology | Issue 4/2013

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Abstract

Objective

Cerebral atrophy and white matter lesions (WMLs) are common in older people with common risk factors, but it is unclear if they are related. We investigated whether and to what degree they are related in deep and superficial structures using both volumetric and visual ratings.

Methods

The intracranial, total brain tissue (TBV), cerebrospinal fluid (CSF), ventricular superficial subarachnoid space (SSS), grey matter, normal-appearing white matter, WMLs, and combined CSF, venous sinuses and dural volumes were measured. WMLs were also rated using the Fazekas scale.

Results

Amongst 672 adults (mean age 73 ± 1 years), WMLs were associated with global brain atrophy (TBV, β = −0.43 mm3, P < 0.01) and specifically with deep (ventricular enlargement, β = 0.10 mm3, P = 0.03) rather than superficial (SSS, β = 0.09 mm3, P = 0.55) atrophy. A 1 mm3 increase in WML volume was associated with a 0.43 mm3 decrease in TBV and 0.10 mm3 increase in ventricular volume. WMLs were associated with combined CSF + Venous Sinuses + Meninges volumes, but not CSF volume alone. Some of the associations were attenuated after correcting for vascular risk factors. The associations were similar for visually scored WMLs.

Conclusion

WMLs are associated with brain atrophy, primarily with deep brain structures. Measures of brain atrophy should include all intracranial structures when assessing brain shrinkage.

Key Points

• Increasing age-related white matter lesions (WML) are modestly associated with brain atrophy.
• Most associated atrophy affects deep structures (white matter, basal ganglia, etc.).
• This is true whether WMLs are assessed volumetrically or visually scored.
• Precise evaluation of brain atrophy requires assessment of all intracranial tissues.
Appendix
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Metadata
Title
Brain atrophy associations with white matter lesions in the ageing brain: the Lothian Birth Cohort 1936
Authors
Benjamin S. Aribisala
Maria C. Valdés Hernández
Natalie A. Royle
Zoe Morris
Susana Muñoz Maniega
Mark E. Bastin
Ian J. Deary
Joanna M. Wardlaw
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2677-x

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