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Magnetic Resonance Imaging White Matter Lesions and Cognitive Impairment in Hypertensive Individuals

Magnetic Resonance Imaging White Matter Lesions and Cognitive Impairment in Hypertensive Individuals Abstract • To search for a morphologic basis of cognitive impairment possibly associated with essential hypertension, we studied 35 otherwise asymptomatic hypertensive individuals (mean age, 38.7 years; range, 22 to 49 years) and 20 normotensive control subjects (mean age, 37.9 years; range, 26 to 49 years) using neuropsychologic tests and magnetic resonance imaging. Irrespective of drug treatment, hypertensive individuals performed significantly worse than did control subjects when assessed for verbal memory and total learning and memory capacity, while there were no differences in test results of visual memory, attention, vigilance, and reaction time. The hypertensive individuals also described themselves as less active but ranked similar on five other mood subscales. Punctate high-signal intensities of the white matter were found almost twice as often in the hypertensive group (38%) as in the control group (20%). There was no difference in test performance between hypertensive individuals with and those without white matter lesions, however. Our results confirm the presence of subtle neuropsychologic deficits and indicate a higher frequency of white matter signal abnormalities in essential hypertension, as shown on magnetic resonance imaging, but do not indicate a correlation of these findings with each other. References 1. Wilkie F, Eisendorfer C. Intelligence and blood pressure in the aged . Science . 1971;172:959-962.Crossref 2. Boller F, Vrtunski B, Mack JL, Kim Y. Neuropsychological correlates of hypertension . Arch Neurol . 1977;34:701-705.Crossref 3. Pentz CA, Elias MF, Wood WG, Schultz NA, Dineen J. Relationship of age and hypertension to neuropsychological test performance . Exp Aging Res . 1979;5:351-372.Crossref 4. Franceschi M, Tancredi O, Smirne S, Mercinelli A, Canal N. Cognitive processes in hypertension . Hypertension . 1982;4:226-229.Crossref 5. Mazzuchi A, Mutti A, Paletti A, Ravenetti C, Novarini A, Parma M. Neuropsychological deficits in arterial hypertension . Acta Neurol Scand . 1986;73:619-627.Crossref 6. Elias MF, Robbins MA, Schultz NR, Streeten DHP, Elias PK. Clinical significance of cognitive performance by hypertensive patients . Hypertension . 1987;9:192-197.Crossref 7. Evans PH. Relation of longstanding blood-pressure levels to atherosclerosis . Lancet . 1965;1:516-519.Crossref 8. Fisher CM. Cerebral miliary aneurysms in hypertension . Am J Pathol . 1972;66:313-330. 9. Rodriguez G, Arvigo F, Marenco S, et al. Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system . Stroke . 1987;18:13-20.Crossref 10. Brant-Zawadzki M. MR imaging of the brain . Radiology . 1988;166:1-10.Crossref 11. Bradley WG, Waluch V, Brant-Zawadzki M, Yadley RA, Wycoff DR. Patchy periventricular white matter lesions in the elderly: a common observation during NMR imaging . Noninv Med Imag . 1984;1:35-41. 12. Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly, I: correlations with age and cerebrovascular risk factors . Stroke . 1986;17:1584-1589. 13. Gerard G, Weisberg LA. MRI periventricular lesions in adults . Neurology . 1986;36:998-1101.Crossref 14. George AE, Leon MJ, Kalnin A, Rosner L, Goodgold A, Chase N. Leukoencephalopathy in normal and pathologic aging, II: MRI of brain lucencies . AJNR . 1986;7:567-570. 15. Lechner H, Schmidt R, Bertha G, Justich E, Offenbacher H, Schneider G. Nuclear magnetic resonance image white matter lesions and risk factors for stroke in normal individuals . Stroke . 1988;19:263-265.Crossref 16. Kertesz A, Black SE, Tokar G, Benke T, Carr T, Nicholson L. Periventricular and subcortical hyperintensities on magnetic resonance imaging . Arch Neurol . 1988;45:404-408.Crossref 17. Schmidt R, Fazekas F, Offenbacher H, Horner S, Bertha G, Lechner H. 1.5 T magnetic resonance imaging signal hyperintensities in asymptomatic individuals within decades of age . Stroke . 1989;20:156. Abstract. 18. Rao SM, Mittenberg W, Bernadin L, Haughton V, Lec GJ. Neuropsychologic test findings in subjects with leuko-araiosis . Arch Neurol . 1989;46:40-44.Crossref 19. Bäumler G. Lern- und Gedächtnistest-LGT 3 . Göttingen, Federal Republic of Germany: Verlag für Psychologie; 1974. 20. Brickenkamp R, Rump G. Die Stabilität des Aufmerksamkeits-Belastungstest (Test d2) über längere Zeitabschnitte . Diagnostica . 1966;12:17-24. 21. Quatember R, Maly J. Neuropsychologische Untersuchungsmethoden altersspezifischer Leistungsparameter . Wien Med Wochenschr . 1980;21:688-692. 22. Janke WJ, Debus G. Die Eigenschaftswörterliste EWL . Göttingen, Federal Republic of Germany: Dr CJ Hogrefe, Verlag für Psychologie; 1977. 23. Norusis MJ. SPSS/PC+ for IBM PC/XT/AT . Chicago, Ill: Statistical Program for Social Sciences; 1986. 24. Dimsdale JE, Newton RP, Joist T. Neuropsychological side effects of β-blockers . Arch Intern Med . 1989;149:514-525.Crossref 25. Shapiro AP, Miller RE, King HE, Ginchereau EH, Fitzgibbon K. Behavioral consequences of mild hypertension . Hypertension . 1982;4:355-360.Crossref 26. Kirkpatrick JB, Hayman LA. White matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis . Radiology . 1987;162:509-511.Crossref 27. Braffman BH, Zimmermann RA, Trojanowski JQ, Gonates NK, Hickey WF, Schlaepfer WW. Brain MRI: pathologic correlation with gross and histopathology, II: hyperintense white matter foci in the elderly . AJNR . 1987;9:629-636. 28. Marshall VG, Bradley WG, Marshall CE, Bhoopat T, Rhodes RH. Deep white matter infarction: correlation of MR imaging and histopathologic findings . Radiology . 1988;167:517-522.Crossref 29. Kinkel WR, Jacobs L, Polachini I, Bates V, Heffner RR. Subcortical arteriosclerotic encephalopathy (Binswanger's disease) . Arch Neurol . 1985;42:951-959.Crossref 30. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmermann RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging . AJNR . 1987;8:421-426. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Magnetic Resonance Imaging White Matter Lesions and Cognitive Impairment in Hypertensive Individuals

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References (35)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1991.00530160087019
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Abstract

Abstract • To search for a morphologic basis of cognitive impairment possibly associated with essential hypertension, we studied 35 otherwise asymptomatic hypertensive individuals (mean age, 38.7 years; range, 22 to 49 years) and 20 normotensive control subjects (mean age, 37.9 years; range, 26 to 49 years) using neuropsychologic tests and magnetic resonance imaging. Irrespective of drug treatment, hypertensive individuals performed significantly worse than did control subjects when assessed for verbal memory and total learning and memory capacity, while there were no differences in test results of visual memory, attention, vigilance, and reaction time. The hypertensive individuals also described themselves as less active but ranked similar on five other mood subscales. Punctate high-signal intensities of the white matter were found almost twice as often in the hypertensive group (38%) as in the control group (20%). There was no difference in test performance between hypertensive individuals with and those without white matter lesions, however. Our results confirm the presence of subtle neuropsychologic deficits and indicate a higher frequency of white matter signal abnormalities in essential hypertension, as shown on magnetic resonance imaging, but do not indicate a correlation of these findings with each other. References 1. Wilkie F, Eisendorfer C. Intelligence and blood pressure in the aged . Science . 1971;172:959-962.Crossref 2. Boller F, Vrtunski B, Mack JL, Kim Y. Neuropsychological correlates of hypertension . Arch Neurol . 1977;34:701-705.Crossref 3. Pentz CA, Elias MF, Wood WG, Schultz NA, Dineen J. Relationship of age and hypertension to neuropsychological test performance . Exp Aging Res . 1979;5:351-372.Crossref 4. Franceschi M, Tancredi O, Smirne S, Mercinelli A, Canal N. Cognitive processes in hypertension . Hypertension . 1982;4:226-229.Crossref 5. Mazzuchi A, Mutti A, Paletti A, Ravenetti C, Novarini A, Parma M. Neuropsychological deficits in arterial hypertension . Acta Neurol Scand . 1986;73:619-627.Crossref 6. Elias MF, Robbins MA, Schultz NR, Streeten DHP, Elias PK. Clinical significance of cognitive performance by hypertensive patients . Hypertension . 1987;9:192-197.Crossref 7. Evans PH. Relation of longstanding blood-pressure levels to atherosclerosis . Lancet . 1965;1:516-519.Crossref 8. Fisher CM. Cerebral miliary aneurysms in hypertension . Am J Pathol . 1972;66:313-330. 9. Rodriguez G, Arvigo F, Marenco S, et al. Regional cerebral blood flow in essential hypertension: data evaluation by a mapping system . Stroke . 1987;18:13-20.Crossref 10. Brant-Zawadzki M. MR imaging of the brain . Radiology . 1988;166:1-10.Crossref 11. Bradley WG, Waluch V, Brant-Zawadzki M, Yadley RA, Wycoff DR. Patchy periventricular white matter lesions in the elderly: a common observation during NMR imaging . Noninv Med Imag . 1984;1:35-41. 12. Awad IA, Spetzler RF, Hodak JA, Awad CA, Carey R. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly, I: correlations with age and cerebrovascular risk factors . Stroke . 1986;17:1584-1589. 13. Gerard G, Weisberg LA. MRI periventricular lesions in adults . Neurology . 1986;36:998-1101.Crossref 14. George AE, Leon MJ, Kalnin A, Rosner L, Goodgold A, Chase N. Leukoencephalopathy in normal and pathologic aging, II: MRI of brain lucencies . AJNR . 1986;7:567-570. 15. Lechner H, Schmidt R, Bertha G, Justich E, Offenbacher H, Schneider G. Nuclear magnetic resonance image white matter lesions and risk factors for stroke in normal individuals . Stroke . 1988;19:263-265.Crossref 16. Kertesz A, Black SE, Tokar G, Benke T, Carr T, Nicholson L. Periventricular and subcortical hyperintensities on magnetic resonance imaging . Arch Neurol . 1988;45:404-408.Crossref 17. Schmidt R, Fazekas F, Offenbacher H, Horner S, Bertha G, Lechner H. 1.5 T magnetic resonance imaging signal hyperintensities in asymptomatic individuals within decades of age . Stroke . 1989;20:156. Abstract. 18. Rao SM, Mittenberg W, Bernadin L, Haughton V, Lec GJ. Neuropsychologic test findings in subjects with leuko-araiosis . Arch Neurol . 1989;46:40-44.Crossref 19. Bäumler G. Lern- und Gedächtnistest-LGT 3 . Göttingen, Federal Republic of Germany: Verlag für Psychologie; 1974. 20. Brickenkamp R, Rump G. Die Stabilität des Aufmerksamkeits-Belastungstest (Test d2) über längere Zeitabschnitte . Diagnostica . 1966;12:17-24. 21. Quatember R, Maly J. Neuropsychologische Untersuchungsmethoden altersspezifischer Leistungsparameter . Wien Med Wochenschr . 1980;21:688-692. 22. Janke WJ, Debus G. Die Eigenschaftswörterliste EWL . Göttingen, Federal Republic of Germany: Dr CJ Hogrefe, Verlag für Psychologie; 1977. 23. Norusis MJ. SPSS/PC+ for IBM PC/XT/AT . Chicago, Ill: Statistical Program for Social Sciences; 1986. 24. Dimsdale JE, Newton RP, Joist T. Neuropsychological side effects of β-blockers . Arch Intern Med . 1989;149:514-525.Crossref 25. Shapiro AP, Miller RE, King HE, Ginchereau EH, Fitzgibbon K. Behavioral consequences of mild hypertension . Hypertension . 1982;4:355-360.Crossref 26. Kirkpatrick JB, Hayman LA. White matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis . Radiology . 1987;162:509-511.Crossref 27. Braffman BH, Zimmermann RA, Trojanowski JQ, Gonates NK, Hickey WF, Schlaepfer WW. Brain MRI: pathologic correlation with gross and histopathology, II: hyperintense white matter foci in the elderly . AJNR . 1987;9:629-636. 28. Marshall VG, Bradley WG, Marshall CE, Bhoopat T, Rhodes RH. Deep white matter infarction: correlation of MR imaging and histopathologic findings . Radiology . 1988;167:517-522.Crossref 29. Kinkel WR, Jacobs L, Polachini I, Bates V, Heffner RR. Subcortical arteriosclerotic encephalopathy (Binswanger's disease) . Arch Neurol . 1985;42:951-959.Crossref 30. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmermann RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging . AJNR . 1987;8:421-426.

Journal

Archives of Neurology – American Medical Association

Published: Apr 1, 1991

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