Back to Search
Start Over
Paradoxical embolisation and cerebral white matter lesions in dementia
- Source :
- British Journal of Radiology, 81, 30-4, British Journal of Radiology, 81, 961, pp. 30-4
- Publication Year :
- 2008
- Publisher :
- British Institute of Radiology, 2008.
-
Abstract
- Item does not contain fulltext The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle cerebral artery for 1 h. A "significant" v-aCS (venous-to-arterial circulation shunt indicative of PFO; > or =15 embolic signals within 12 cardiac cycles) was detected by intravenous injection of "air in saline" ultrasound contrast. Deep white matter hyperintensities (DWMH) and periventricular hyperintensities (PVH) were assessed using Schelten's scale. After correction for cardiovascular risk factors, both DWMH and PVH were significantly associated with the presence of a PFO in AD (beta = 0.31, p = 0.02 for DWMH, odds ratio 8.7, p = 0.011 for PVH) but not in VaD. No consistent relationship was found between SCE and WMH in AD. In VaD, the severity of DWMH was negatively correlated with SCE (beta = -0.55; p = 0.001). In conclusion, the presence of a significant venous-to-arterial shunt is associated with more severe DWMH in AD, and may play a part in the aetiology of the disorder. In addition, there is a significant negative correlation between SCE and DWMH in VaD, which supports the hypothesis that VaD may be the result of ischaemic injury, predominantly reflecting embolic aetiology.
- Subjects :
- Male
Middle Cerebral Artery
medicine.medical_specialty
Pathology
Ultrasonography, Doppler, Transcranial
Foramen Ovale, Patent
Mental health [NCEBP 9]
White matter
Central nervous system disease
Alzheimer Disease
Internal medicine
medicine.artery
Determinants in Health and Disease [EBP 1]
medicine
Humans
Dementia
Radiology, Nuclear Medicine and imaging
Vascular dementia
Aged
Aged, 80 and over
business.industry
Dementia, Vascular
Brain
General Medicine
Odds ratio
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Hyperintensity
Transcranial Doppler
medicine.anatomical_structure
Intracranial Embolism
Middle cerebral artery
Cardiology
Female
business
Subjects
Details
- ISSN :
- 1748880X and 00071285
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- The British Journal of Radiology
- Accession number :
- edsair.doi.dedup.....9f06ff7cc6657e07af5c34243873b51f