Cerebral white matter hyperintensities (WMH): an analysis of cerebrovascular risk factors in Lebanon

Abstract

Background: Cerebral white matter hyperdensities (WMH) are frequently reported on brain magnetic resonance images (MRI) of elderly people; its significance is still under debate. Methods: WMH subtypes may correlate with vascular risk factors, such as aging, hypertension (HTN) and diabetes mellitus (DM). The suggested hypothesis was to find if any of the periventricular WMH (PVWMH) or the deep WMH (DWMH) would be significantly more correlated with the above vascular risk factors. According to the Fazekas semiquantitative rating scale, we classified WMH into four subtypes: (1) absence of WMH, (2) presence of DWML, (3) presence of PVWMH, (4) presence of both DWML and PVWML. The study was performed on 257 Lebanese inpatients aged 40 years and above who underwent a brain MRI, regardless of their underlying pathology and who were admitted to an Internal Medicine Department in Beirut. The study patients were categorized into five subgroups by age intervals of 10 years. Results: Mean age was 62; 54.1% were females; WMH were observed in 59.5% of study population; we found a linear correlation with WMH and aging with a clear shift for patients over age 60, reaching 84% in patients subgroup of 70–79-year-old and 94% patients subgroup over 80-year-old. PVWMH was found significantly more frequently and in linear correlation with aging and HTN. WMH were also found more frequently among the DM individuals. Conclusion: From this first ever retrospective Lebanese study, WMH was reported increasingly with aging in accordance with data from the literature; PVWMH was found significantly more correlated with aging and HTN than was DWMH alone.

KEYWORDS: :

• cerebral white matter hyperintensities
• leukoaraiosis
• cerebrovasular disease
• stroke
• hypertension
• diabetes mellitus
• aging
• cognitive impairment