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The topography of white matter hyperintensities on brain MRI in healthy 60- to 64-year-old individuals
Abstract
We report the topography of brain white matter hyperintensities (WMHs) on T2-weighted fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging in 477 healthy subjects aged 60-64 years selected randomly from the community. WMHs were delineated by using a computer algorithm. We found that all subjects had periventricular WMHs and 96.6% subjects also had deep WMHs. The mean volume of WMHs was 4.9 ml, comprising 0.83% of the white matter, of which 1.2 ml was severe in intensity. The deep WMHs were distributed throughout the cerebral hemispheres, with the occipital and frontal white matter bearing the greatest burden. The territory of the lenticulostriate arteries had the greatest WMHs. A white matter region of 4 mm adjacent to the cortex was not affected by hyperintensities. The mean (SD) number of discrete WMHs was 19.6 (7.1) per subject, of which 6.1 (4.4) were severe in intensity. Nearly half (48.6%) of the subjects had at least one large WMH (>12 mm diameter) and one eighth (12.5%) of the subjects had at least one large WMH that appeared to be severe in MRI. The overall load of WMHs was similar in men and women, but the latter had a higher proportion of their white matter so affected. This study provides the first detailed topographic analysis of WMHs in a large representative middle-aged sample, emphasizes their high prevalence in mid-adult life and raises issues about their etiology and significance.
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“WMLs are highly prevalent in the brains of elderly and even middle-aged individuals,54,55 and the lesions have to be extensive to be clinically significant.”
From Diagnostic Criteria for Vascular Cognitive Disorders: A VASCOG Statement (2014) · cites this paper as [54]
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Metadata
- Authors
- Wen, W., & Sachdev, P.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Sachdev, Perminder
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2004-05
- Volume
- 22
- Issue
- 1
- Pages
- 144-154
- ISSN
- 1053-8119 (ISSN-L)
- OpenAlex
- W2070268750
- Cited by
- 315
- References
- 50
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 8 · 2023: 13 · 2022: 13 · 2021: 18 · 2020: 8 · 2019: 12 · 2018: 14 · 2017: 13 · 2016: 14 · 2015: 13 · 2014: 19 · 2013: 15 · 2012: 19
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of New South Wales
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Clinical Neurology › Cerebrovascular and genetic disorders
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Keywords
- white matter hyperintensities, periventricular white matter, deep white matter hyperintensities, FLAIR MRI, lenticulostriate arteries, white matter volume, middle-aged adults, sex differences, prevalence, white matter disease
- MeSH terms
- Aging, Australia, Brain, Brain Mapping, Cerebral Arteries, Education, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Reference Values, Sex Characteristics, Reproducibility of Results
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