Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T11:32:17.476Z Has data issue: false hasContentIssue false
  • English
  • Français

Neurologic Signs Predict Periventricular White Matter Lesions on MRI

Published online by Cambridge University Press:  16 February 2016

Charles J. Bae  and
Jonathan H. Pincus
Charles J. Bae*
Affiliation:
Cleveland Clinic Foundation, Cleveland OH, USA
Jonathan H. Pincus
Affiliation:
Veterans Administration Medical Center, Washington DC, USA
*
Cleveland Clinic Foundation, Department of Neurology-S51, 9500 Euclid Avenue, Cleveland, OH 44195, USA
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

Periventricular white matter disease (PVWD) is associated with abnormalities on tests that involve complex cognitive processes, along with an increased risk of cerebrovascular events which are associated with significant morbidity in older patients. This study investigates whether the neurological examination can predict the presence of PVWD on magnetic resonance imaging (MRI). No prior studies have assessed whether the neurological examination can predict the presence of PVWD on MRI.

Methods:

A focused neurological examination was performed on a random selection of patients referred for a MRI of the brain. Staff neuroradiologists who were blinded to the results of the physical examination independently read the MRI scans. The MRI interpretations were divided into four categories based on the degree of PVWD: none, mild, moderate, severe.

Results:

Twenty-three subjects had some degree of PVWD, while 25 subjects had none. The total number of neurologic signs correlated significantly with the severity of PVWD even when adjusting for the effect of age (rho=0.67, p<0.001). Ninety-one percent of subjects with PVWD had three or more abnormal signs, while 76% of subjects without PVWD had fewer than three. Abnormalities with the three step motor sequencing and horizontal visual tracking tests were maximally predictive of PVWD. One or both of these tests were abnormal in 96% of subjects with PVWD, while 64% of subjects without PVWD had no problems with either test.

Conclusion:

Simple neurologic tests can predict the presence or absence of PVWD on MRI.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 242 - 247
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Junque, C, Pujol, J, Vendrell, P, et al.Leuko-araiosis on magnetic resonance imaging and speed of mental processing. Arch Neurol 1990; 47:151–156.CrossRefGoogle ScholarPubMed
2.Amar, K, Bucks, RS, Lewis, T, Scott, M, Wilcock, GK. The effect of white matter low attenuation on cognitive performance in dementia of the Alzheimer type. Age Ageing 1996; 25:443–448.CrossRefGoogle ScholarPubMed
3.Steingart, A, Hachinski, VC, Lau, C, et al.Cognitive and neurologic findings in demented patients with diffuse white matter lucencies on computed tomographic scan (leukoaraiosis). Arch Neurol 1987; 44:36–39.CrossRefGoogle ScholarPubMed
4.Kertesz, A, Polk, M, Carr, T. Cognition and white matter changes on magnetic resonance imaging in dementia. Arch Neurol 1990; 47:387–391.CrossRefGoogle ScholarPubMed
5.Jenkyn, LR, Walsh, DB, Culver, CM, Reeves, AG. Clinical signs in diffuse cerebral dysfunction. J Neurol Neurosurg Psychiatry 1977; 40:956–966.CrossRefGoogle ScholarPubMed
6.Jenkyn, LR, Reeves, AG, Warren, T, et al.Neurologic signs in senescence. Arch Neurol 1985; 42:1154-1157.CrossRefGoogle ScholarPubMed
7.Luria, AR. Higher Cortical Functions in Man. New York: Basic Books, Inc., 1966:330–333.Google Scholar
8.Borkowski, JG, Benton, AL, Spreen, O. Word fluency and brain damage. Neuropsychologia 1967; 5:135–140.CrossRefGoogle Scholar
9.Ylikoski, RY, Ylikoski, A, Erkinjuntti, T, et al.White matter changes in healthy elderly persons correlate with attention and speed of mental processing. Arch Neurol 1993; 50:824–828.CrossRefGoogle ScholarPubMed
10.Hachinski, VC, Potter, P, Merskey, H. Leuko-Araiosis. Arch Neurol 1987; 44:21–23.CrossRefGoogle ScholarPubMed
11.Pantoni, L, Garcia, JH. Pathogenesis of leukoaraiosis. Stroke 1997; 28:652–659.CrossRefGoogle ScholarPubMed
12.Kozachuk, WE, DeCarli, C, Schapiro, MB, et al.White matter hyperintensities in dementia of Alzheimer’s type and in healthy subjects without cerebrovascular risk factors. Arch Neurol 1990; 47:1306–1310.CrossRefGoogle ScholarPubMed
13.Mirsen, TR, Lee, DH, Wong, CJ, et al.Clinical correlates of white-matter changes on magnetic resonance imaging scans of the brain. Arch Neurol 1991; 48:1015–1021.CrossRefGoogle ScholarPubMed
14.Hunt, AL, Orrison, WW, Yeo, RA, et al.Clinical significance of MRI white matter lesions in the elderly. Neurology 1989; 39:1470–1474.CrossRefGoogle ScholarPubMed
15.Kobari, M, Meyer, JS, Ichijo, M. Leuko-araiosis, cerebral atrophy, and cerebral perfusion in normal aging. Arch Neurol 1990; 47:161–165.CrossRefGoogle ScholarPubMed
16.Fazekas, F, Chawluk, JB, Alavi, A, Hurtig, HI, Zimmerman, RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJNR Am J Neuroradiol 1987; 8:421–426.Google Scholar
17.Pantoni, L, Garcia, JH. The significance of cerebral white matter abnormalities 100 years after Binswanger’s report. Stroke 1995; 26:1293–1301.CrossRefGoogle ScholarPubMed
18.Breteler, MMB, 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.CrossRefGoogle Scholar
19.Streifer, JY, Eliasziw, M, Benavente, OR, et al.Prognostic importance of leukoaraiosis in patients with symptomatic internal carotid artery stenosis. Stroke 2002; 33: 1651–1655.CrossRefGoogle Scholar
20.Inzitari, D, Cadelo, M, Marranci, ML, Pracucci, G, Pantoni, L. Vascular deaths in elderly neurological patients with leukoaraiosis. J Neurol Neurosurg Psychiatry 1997; 62:177–181.CrossRefGoogle ScholarPubMed
21.Gorter, JW. Major bleeding during anticoagulation after cerebral ischemia. Neurology 1999; 53:1319–1327.CrossRefGoogle ScholarPubMed
22.Smith, EE, Rosand, J, Knudsen, KA, et al.Leukoaraiosis is associated with warfarin-related hemorrhage following ischemic stroke. Neurology 2002; 59:193–197.CrossRefGoogle ScholarPubMed
23.Briley, DP, Haroon, S, Sergent, SM, Thomas, S. Does leukoaraiosis predict morbidity and mortality? Neurology 2000; 54:90–94.CrossRefGoogle ScholarPubMed
24.Tarvonen-Schroder, S, Roytta, M, Raiha, I, et al.Clinical features of leuko-araiosis. J Neurol Neurosurg Psychiatry 1996; 60:431–436.CrossRefGoogle ScholarPubMed