Regional Low Cerebral Blood Flow Predicts Leukoaraiosis Development at 18 Months in Patients with TIA and Minor Stroke

Abstract

The purpose of this study was to investigate whether low cerebral blood flow (CBF) is associated with subsequent white matter hyperintensity (WMH) development in minor stroke and transient ischemic attack (TIA) patients. New WMH at 18 months were identified by comparing follow-up with baseline FLAIR, and regions of interest (ROI) were placed in normal appearing and hyperintense white matter. Co-registered CBF maps were used to quantify relative CBF. Forty patients were evaluated, where mean age was 62+/-12 years, 78% male and 9% diabetic. A mixed effects logistic regression accounting for “within patient” clustering, showed that as CBF increases by 1mL/100g/min, the odds of having a new WMH decrease by 0.61. Results suggest that regions of white matter that develop WMH at 18 months have low baseline CBF. Future studies aiming to improve cerebral perfusion in normal appearing white matter might provide a target for arresting the development of WMH.