Beschreibung:
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<jats:italic>Background</jats:italic>
White matter lesions are frequently observed on cerebral MRI scans. There is evidence that white matter lesions are involved in the pathophysiology of cognitive decline, dementia and late-onset depression. Cardiovascular risk factors are associated with these lesions. A high homocysteine level is associated with an increased risk of cardiovascular disease. Therefore, we studied the association between homocysteine and white matter lesions.
<jats:italic>Method</jats:italic>
This study forms part of the Rotterdam Scan Study, a prospective population-based cohort study among 1077 subjects, aged 60 to 90 years. All participants underwent MRI scanning of the brain. White matter lesions were defined as hyperintense lesions on both proton-density and T2-weighted images, without prominent hypointensity on T1-weighted images. Periventricular white matter lesions were rated on a nine-point scale. For subcortical white matter lesions an approximated total lesion volume was calculated. Homocysteine levels were determined in plasma samples, obtained within 3 weeks before scanning. The association between total plasma homocysteine and white matter lesions was assessed through multiple linear regression analysis, adjusted for age and gender.
<jats:italic>Results</jats:italic>
The total plasma homocysteine levels ranged from 3.4 to 70.7 μmol/l with a mean of 11.7 μmol/l [95%CI 11.4–12.0]. We found a mean value of 2.4 [95%CI 2.3–2.5] for periventricular white matter lesion severity and of 1.4 ml [95%CI 1.2–1.6] for subcortical white matter lesion volume. Periventricular white matter lesions increased with 0.4 [95%CI 0.1–0.6] and subcortical white matter lesions with 0.5 ml [95%CI 0.1–0.8] per 10 μmol/l increase in homocysteine level.
<jats:italic>Conclusion</jats:italic>
Higher homocysteine levels are associated with an increased severity of both periventricular and subcortical white matter lesions.
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