Prevalence of White Matter Hyperintensities in a Young Healthy Population

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00047.x Byline: Ramona O. Hopkins (1), Callie J. Beck (1), David L. Burnett (1), Lindell K. Weaver (1), Jeff Victoroff (1), Erin D. Bigler (1) Keywords: White matter hyperintensities; healthy normals; periventricular; centrum semiovale Abstract: ABSTRACT Background and Purpose. White matter hyperintensities (WMHs) are bright objects observed in the white matter on brain magnetic resonance (MR) imaging. WMHs are often reported as 'normal' findings but may represent pathological changes. The prevalence of WMHs appears to increase with increasing age although both the typical timing and clinical significance of their appearance among medically and neurologically healthy persons remains unclear. We assessed the prevalence of WMHs in a cohort of younger healthy subjects. Methods. Our study comprised 243 healthy subjects ages 16-65 years from our prospective normative MR imaging database. MR scans were rated for presence of periventricular and centrum semiovale WMHs using a four-point visual semi-quantitative scale. Results. WMHs occurred in 5.3% (13 of 243) of subjects. All WMHs were small (rating of 0.5) except one subject age 65 years who had large WMHs (ratings of 2). The median age for subjects with no WMHs was 34.5 years compared to 57.0 years for subjects with WMHs. There were no gender differences (P= .76). Older age correlated with presence of WMHs (r= 0.24; P= .01). Age greater than 55 years had a 10-fold increase in the prevalence of WMHs compared to age [less than or equal to]55 years (odds ratio = 10.01; 95% confidence interval = 3.1-32.3; P < .001). Conclusion. WMHs were uncommon in a younger healthy population screened for comorbid diseases, but increased 10-fold in subjects over 55 years of age. When present, the WMHs are generally small (rating of 0.5). While large WMHs appear to be associated with cognitive deterioration, the optimum threshold for identification, clinical significance, and prognostic value of smaller white matter changes requires further research. Author Affiliation: (1)From the Psychology Department, Brigham Young University, Provo, Utah (ROH, CJB, DLB, EDB); Neuroscience Center, Brigham Young University, Provo, Utah (ROH, EDB); Department of Medicine, Pulmonary and Critical Care Division, LDS Hospital, Salt Lake City, Utah (ROH, LKW); Pulmonary Division, Department of Medicine, University of Utah, Salt Lake City, Utah (LKW); Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California (JV); and Departments of Radiology and Psychiatry, University of Utah, Salt Lake City, Utah (EVB). Article History: Received December 15, 2005, and in revised form February 27, 2006 and March 23, 2006. Accepted for publication March 27, 2006. Article note: Address correspondence to Ramona O. Hopkins, PhD, Psychology Department, 1054 SWKT, Brigham Young University, Provo, Utah 84602. E-mail: mona_hopkins@byu.edu.