Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

Longitudinal Study of Carotid Atherosclerosis and White Matter Hyperintensities: The EVA-MRI Cohort

Pico F.a · Dufouil C.a · Lévy C.b · Besançon V.a · de Kersaint-Gilly A.c · Bonithon-Kopp C.d · Ducimetière P.e · Tzourio C.a · Alpérovitch A.a

Author affiliations

Departments of Radiology,aINSERM U-360, Paris, bMassy and cNantes, dINSERM EPI 106, Dijon, and eINSERM U-258, Villejuif, France

Related Articles for ""

Cerebrovasc Dis 2002;14:109–115

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 11, 2001
Accepted: February 19, 2002
Published online: August 16, 2002
Issue release date: August 2002

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Background and Purpose: White matter hyperintensities (WMHs) are often observed on cerebral magnetic resonance imaging (MRI) of elderly individuals. Epidemiological studies have shown that age and hypertension are associated with WMHs, suggesting a vascular mechanism in WMH pathogenesis. In a population-based prospective study, we examined the association of carotid atherosclerosis measured at baseline and 4-year follow-up with severity of WMHs assessed at 4-year follow-up. Methods: The sample consisted of 640 healthy subjects aged 59–71 years at entry enrolled in the prospective EVA Study. Systolic and diastolic blood pressures were measured at each wave. Ultrasonographic measures of intima-media thickness (IMT) of the common carotid arteries and plaques were made at baseline and at 4-year follow-up examination. An MRI examination was performed at 4-year follow-up. The presence and severity of WMHs were evaluated by a single radiologist. Results: After adjusting for age, gender, and hypertension, the presence of carotid plaques at baseline was significantly associated with the presence of severe WMHs 4 years later [odds ratio (OR) = 1.70; 95% confidence interval (CI): 1.05–2.74]. The association was stronger in men than in women. A 0.1-mm increase of baseline IMT was associated with an increased risk of severe WMHs in both sexes (adjusted OR = 1.17; 95% CI: 0.96–1.41), but the association was not significant (p = 0.12). Cross-sectional relationships between carotid plaques and severe WMHs at 4-year follow-up showed that the risk of having severe WMHs was stronger in the group of subjects who had already plaques at study entry compared to the group of subjects whose plaques occurred during 4-year follow-up. Conclusion: This study confirmed an association between carotid atherosclerosis and WMHs independently of age and hypertension. It also suggested that the older the carotid plaques, the higher the risk of having severe WMHs.

© 2002 S. Karger AG, Basel


References

  1. Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R: Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. Stroke 1986;17:1084–1089.
  2. Lechner H, Schmidt R, Bertha G, Justich E, Offenbacher H, Schneider G: Nuclear magnetic resonance image white matter lesions and risk factors for stroke in normal individuals. Stroke 1988;19:263–265.
    External Resources
  3. Lindgren A, Roijer A, Rudling O, Nonving B, Larsson EM, Eskilsson J, Wallin L, Olsson B, Johansson BB: Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke: A population-based study. Stroke 1994;25:929–934.
  4. Longstreth WTJ, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, Enright PL, O’Leary D, Fried L: Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3,301 elderly people: The Cardiovascular Health Study. Stroke 1996;27:1274–1282.
  5. Ylikoski A, Erkinjuntti T, Raininko R, Sarna S, Sulkava R, Tilvis R: White matter hyperintensities on MRI in the neurologically nondiseased elderly: Analysis of cohorts of consecutive subjects aged 55 to 85 years living at home. Stroke 1995;26:1171–1177.
  6. Breteler MM, van Swieten JC, Bots ML, et al: Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: The Rotterdam Study. Neurology 1994;44:1246–1252.
  7. van Swieten JC, van den Hout JH, van Ketel BA, Hijdra A, Wokke JH, van Gijn J: Periventricular lesions in the white matter on magnetic resonance imaging in the elderly: A morphometric correlation with arteriolosclerosis and dilated perivascular spaces. Brain 1991;114:761–774.
    External Resources
  8. Fazekas F, Kleinert R, Offenbacher H, Payer F, Schmidt R, Kleinert G, Radner H, Lechner H: The morphologic correlate of incidental punctate white matter hyperintensities on MR images. AJNR Am J Neuroradiol 1991;12:915–921.
  9. Grafton ST, Sumi SM, Stimac GK, Alvord EC, Shaw CM, Nochlin D: Comparison of postmortem magnetic resonance imaging and neuropathologic findings in the cerebral white matter. Arch Neurol 1991;48:293–298.
  10. Fazekas F, Schmidt R, Kleinert R, Kapeller P, Roob G, Flooh E: The spectrum of age-associated brain abnormalities: Their measurement and histopathological correlates. J Neural Transm Suppl 1998;53:31–39.
  11. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R: Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation 1986;74:1399–1406.
  12. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SKJ: Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14–22.
  13. Manolio TA, Burke GL, O’Leary DH, Evans G, Beauchamp N, Knepper L, Ward B: Relationships of cerebral MRI findings to ultrasonographic carotid atherosclerosis in older adults: The Cardiovascular Health Study. CHS Collaborative Research Group. Arterioscler Thromb Vasc Biol 1999;19:356–365.
  14. Bots ML, van Swieten JC, Breteler MM, de Jong PT, van Gijn J, Hofman A, Grobbee DE: Cerebral white matter lesions and atherosclerosis in the Rotterdam Study. Lancet 1993;341:1232–1237.
  15. de Leeuw FE, de Groot JC, Bots ML, Witteman JC, Oudkerk M, Hofman A, van Gijn J, Breteler MM: Carotid atherosclerosis and cerebral white matter lesions in a population-based magnetic resonance imaging study. J Neurol 2000;247:291–296.
  16. Dufouil C, Ducimetière P, Alpérovitch A: Sex differences in the association between alcohol consumption and cognitive performance. EVA Study Group. Epidemiology of Vascular Aging. Am J Epidemiol 1997;146:405–412.
  17. Bonithon-Kopp C, Touboul PJ, Berr C, Leroux C, Mainard F, Courbon D, Ducimetière P: Relation of intima-media thickness to atherosclerotic plaques in carotid arteries. The Vascular Aging (EVA) Study. Arterioscler Thromb Vasc Biol 1996;16:310–316.
  18. Touboul PJ, Prati P, Scarabin PY, Adrai V, Thibout E, Ducimetière P: Use of monitoring software to improve the measurement of carotid wall thickness by B-mode imaging. J Hypertens Suppl 1992;10:S37–S41.
    External Resources
  19. Tzourio C, Levy C, Dufouil C, Touboul PJ, Ducimetière P, Alpérovitch A: Low cerebral blood flow velocity and risk of white matter hyperintensities. Ann Neurol 2001;49:411–414.
  20. Dufouil C, de Kersaint-Gilly A, Besançon V, Lévy C, Auffray E, Brunnereau L, Alpérovitch A, Tzourio C: Longitudinal study of blood pressure and white matter hyperintensities: The EVA MRI Cohort. Neurology 2001;56:921–926.
    External Resources
  21. Verpillat P, Alpérovitch A, Cambien F, Besançon V, Desal H, Tzourio C: Aldosterone synthase (CYP11B2) gene polymorphism and cerebral white matter hyperintensities. Neurology 2001;56:673–675.
    External Resources
  22. Scheltens P, Barkhof F, Leys D, Pruvo JP, Nauta JJ, Vermersch P, Steinling M, Valk J: A semiquantitative rating scale for the assessment of signal hyperintensities on magnetic resonance imaging. J Neurol Sci 1993;114:7–12.
  23. Kauma H, Paivansalo M, Savolainen MJ, Rantala AO, Kiema TR, Lilja M, Reunanen A, Kesaniemi YA: Association between angiotensin converting enzyme gene polymorphism and carotid atherosclerosis. J Hypertens 1996;14:1183–1187.
  24. Kogawa K, Nishizawa Y, Hosoi M, Kawagishi R, Maekawa K, Shoji T, Okuno Y, Morii H: Effect of polymorphism of apolipoprotein E and angiotensin-converting enzyme genes on arterial wall thickness. Diabetes 1997;46:682–687.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: October 11, 2001
Accepted: February 19, 2002
Published online: August 16, 2002
Issue release date: August 2002

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.