ABSTRACT
OBJECTIVE: To study the integrity of the white matter in Binswanger's disease (BD) patients with quantitative fractional anisotropy (DTI-FA). METHOD: Controls (12) and patients with BD (12) were included. Scans performed with MR (GE Signa Horizon/1.5T). Fazekas's score=6 with white matter hyperintensities extension >75% assessed on FLAIR scans. Standard parameters for DTI-FA were used. ROIs placed in symmetrical regions on two axial planes, data pooled in anterior (frontal) and posterior (temporo-parieto-occipital) regions. Analysis with Functool. Statistics for anterior and posterior regions comparison. RESULTS: DTI-FA showed reduction of anisotropy, reflecting axonal damage and demyelination of fibers, more prominent in anterior in relation to posterior region, in BD patients in comparison to controls. CONCLUSION: Loss of integrity of fiber tracts reflects interruption of neural networks that subserve cognitive, behavioral, and motor integration. The more severely affected frontal region is related to executive dysfunction, a characteristic feature of Binswanger's disease.
Subject(s)
Brain/pathology , Dementia, Vascular/pathology , Aged , Anisotropy , Case-Control Studies , Female , Humans , Magnetic Resonance Imaging , MaleABSTRACT
OBJECTIVE: To study the integrity of the white matter in Binswanger's disease (BD) patients with quantitative fractional anisotropy (DTI-FA). METHOD: Controls (12) and patients with BD (12) were included. Scans performed with MR (GE Signa Horizon/1.5T). Fazekas's score=6 with white matter hyperintensities extension >75 percent assessed on FLAIR scans. Standard parameters for DTI-FA were used. ROIs placed in symmetrical regions on two axial planes, data pooled in anterior (frontal) and posterior (temporo-parieto-occipital) regions. Analysis with Functool. Statistics for anterior and posterior regions comparison. RESULTS: DTI-FA showed reduction of anisotropy, reflecting axonal damage and demyelination of fibers, more prominent in anterior in relation to posterior region, in BD patients in comparison to controls. CONCLUSION: Loss of integrity of fiber tracts reflects interruption of neural networks that subserve cognitive, behavioral, and motor integration. The more severely affected frontal region is related to executive dysfunction, a characteristic feature of Binswanger's disease.
OBJETIVO: Estudar a integridade da substância branca em pacientes com doença de Binswanger (DB) com anisotropia fracionada quantitativa (DTI-FA). MÉTODO: Incluídos controles (12) e pacientes com DB (12). Obtidas imagens de RM (GE Signa Horizon/1,5T). Escore=6 de Fazekas com hiperintensidades da substância branca com extensão >75 por cento avaliados em imagens em FLAIR. Utilizados parâmetros padrão para DTI-FA. ROIs colocados em regiões simétricas de dois planos axiais, dados das regiões anterior (frontal) e posterior (têmporo-parieto-occipital) reunidos. Análise com Functool. Estatística para comparar regiões anteriores e posteriores. RESULTADOS: DTI-FA mostrou redução da anisotropia, refletindo lesão axonal e desmielinazação de fibras, com predomínio na região anterior em relação à posterior, nos pacientes com DB em comparação aos controles. CONCLUSÃO: Perda da integridade de feixes de fibras reflete interrupção de redes neurais subjacentes à integração cognitiva, comportamental e motora. A região frontal, mais gravemente atingida, está relacionada à disfunção executiva, aspecto característico da doença de Binswanger.
Subject(s)
Aged , Female , Humans , Male , Brain/pathology , Dementia, Vascular/pathology , Anisotropy , Case-Control Studies , Magnetic Resonance ImagingABSTRACT
To study the integrity of the corpus callosum in Binswanger's disease (BD) patients using quantitative fractional anisotropy (DTI-FA). METHODS: Controls (12) and patients with BD (12) were included. MR [GE Signa Horizon-1.5T] scans were performed. BD patients presented Fazekas's score=6 and leukoaraiosis extension =75%, as assessed on FLAIR sequence. Standard parameters for DTI-FA acquisition were used. Functool was employed for post-processing, and ROIs placed on the genu and splenium of the corpus callosum on one axial plane at the basal ganglia level. Statistics [ANOVA] for genu and splenium comparison were analyzed. RESULTS: DTI-FA showed reduction of anisotropy in both regions of the corpus callosum, more prominently in anterior (genu) than posterior (splenium) in BD patients versus controls. CONCLUSION: The reduction of anisotropy reflects loss of integrity of fibers of the studied regions of the corpus callosum. This finding indicates an interruption of the most important inter-hemispheric commissure, and component of neural networks that underlies cognitive, behavioral, motor and sensory integration. The affected genu and splenium, together with damage to other fiber systems that connect the prefrontal and parietal-occipital regions, may manifest clinically as dysfunction of high-level integrative regions linked to the domains of executive and sensory functions, respectively, that can occur in Binswanger's disease.
Estudar a integridade do corpo caloso em pacientes com doença de Binswanger (DB) com anisotropia fracionada quantitativa (DTI-FA). MÉTODOS: Foram incluídos controles (12) e pacientes com DB (12). Imagens de RM [GE Signa Horizon-1,5T] foram obtidas. Os pacientes com DB apresentavam escore=6 de Fazekas e leucoaraiose com extensão =75% como avaliado na seqüência em FLAIR. Foram utilizados parâmetros padrão para DTI-FA e utilizado Functool para pós-processamento. ROIs localizados no joelho e no esplênio do corpo caloso em um plano axial no nível dos gânglios da base. Estatística [ANOVA] feita para comparar joelho e esplênio. RESULTADOS: DTI-FA mostrou redução da anisotropia em ambas as regiões do corpo caloso, com predomínio na anterior (joelho) em relação à posterior (esplênio), nos pacientes com DB em comparação aos controles. CONCLUSÕES: A redução da anisotropia reflete perda da integridade de fibras das regiões estudadas do corpo caloso. Esses achados indicam interrupção da mais importante comissura inter-hemisférica e componente de redes neurais subjacentes à integração cognitiva, comportamental e de funções motora e sensorial. O comprometimento do joelho e do esplênio, juntamente com a lesão de outros sistemas de fibras, que conectam regiões pré-frontais e parieto-occipitais, podem ser expressas clinicamente por disfunção de regiões de alto nível de integração, relacionadas aos domínios das funções executiva e sensorial, respectivamente, que pode ocorrer na doença de Binswanger.
