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

Lookup NU author(s): Dr Rebecca Wiseman, Dr Brian Saxby, Dr Emma Burton, Dr Robert Barber, Professor Gary Ford, Professor John O'Brien


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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 cm3, 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.

Publication metadata

Author(s): Wiseman RM, Saxby BK, Burton EJ, Barber R, Ford GA, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2004

Volume: 63

Issue: 10

Pages: 1892-1897

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/01.WNL.0000144280.59178.7

PubMed id: 15557507


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