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Hippocampal atrophy, whole brain volume, and white matter lesions in older hypertensive subjects

2004; Lippincott Williams & Wilkins; Volume: 63; Issue: 10 Linguagem: Inglês

10.1212/01.wnl.0000144280.59178.78

1526-632X

Rebecca Wiseman, Brian K. Saxby, Emma J. Burton, Robert Barber, Gary A. Ford, John T. O’Brien,

Neurological Disease Mechanisms and Treatments

Objective: To determine the potential role of whole brain atrophy, hippocampal atrophy, or both, and small vessel disease/white matter lesions as mechanisms underlying the cognitive impairment associated with hypertension. Methods: Using MRI scanning the authors determined hippocampal volumes, whole brain volumes, and location and severity of white matter lesions, using Scheltens scale, in 103 hypertensive (166 ± 8/88 ± 7 mm Hg, 54 female) and 51 normotensive (132 ± 12/74 ± 7 mm Hg, 21 female) subjects age ≥ 70 years. Results: Compared to normotensive subjects, older hypertensive subjects had significantly smaller whole brain volumes (887 ± 109 vs 930 ± 97 cm 3 , p = 0.02) and nonsignificantly reduced hippocampal volumes (5.39 ± 1.60 vs 5.67 ± 1.80 cm 3 , p = 0.33). Hypertensive subjects had an increased burden of periventricular lesions: bands ( p = 0.03), frontal caps ( p = 0.08), occipital caps ( p = 0.07), and total periventricular hyperintensities ( p = 0.02). They also had higher scores in subcortical areas: frontal ( p = 0.04), temporal ( p = 0.03), and deep white matter areas ( p = 0.05). A correlation was found between whole brain volumes and systolic blood pressure ( r = −0.19, p = 0.02). No correlation was seen between whole brain volumes and white matter lesion burden. Conclusions: Moderate hypertension in non-impaired older subjects is associated with smaller whole brain volume and an increased burden of subcortical and periventricular white matter lesions.