Research Article
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Comparison of Temporal Horn Diameters of Normal Patients and Asymptomatic Patients with T2 Hyperintensity in the Brain White Matter

Year 2018, , 1056 - 1063, 15.12.2018
https://doi.org/10.30569/adiyamansaglik.458155

Abstract

Purpose : Our aim is to investigate whether there is an early onset of dementia in the presence of T2 hyperintensities in periventricular, subcortical white matter in young asymptomatic patients. For this purpose, we planned to measure the diameter of temporal horns as the temporal horns of the lateral ventricles enlarge especially in Alzheimer's disease.

Materials and methods: We examined 45 patients aged 30-49 years. Patients who did not have a known disease and who underwent cranial magnetic resonance (MR) for any reason were included in the study. Patients were examined whether hyperintensity in white matter in T2 and FLAIR sequences. In patients with T2 hyperintensities, both temporal horn widths were measured and averaged of temporal horns collected.

Results: Thirty two of the patients were female, 13 were male. Twenty-three of 45 patients had hyperintense lesions in T2 and FLAIR sequences in white matter. In 22 patients, there was no pathological signal in the white matter. The temporal horn width was found 2.6 mm in the patients with T2 hyperintensity and 2.16 mm in the control group. Although the temporal horn width was within normal limits in both groups, it was found higher in patients with T2 hyperintensity.

Conclusion: There are many publications showing that there is a strong association between white matter hyperintensities and stroke, dementia and mortality. In our study, in the young age group patients with T2-FLAIR hyperintense white matter lesions increased the temporal horn diameter compared to the normal group. The high diameter may be significant in terms of early signs of dementia and atrophy.

References

  • 1- Saka E, Apaydın Doğan E, Topçuoğlu MA, Senol U, Balkan S. Linear measures of temporal lobe atrophy on brain magnetic resonance imaging (MRI) but not visual rating of white matter changes can help discrimination of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Arch Gerontol Geriatr 2007;44:141-151.
  • 2- Açık M, Yabancı Ayhan N. D Vitamini ve Alzheimer Hastalığı. Adıyaman Üni. Sağlık Bilimleri Derg, 2018;4(2):980-991.
  • 3- Karaali K. Demansta Radyolojik Bulgular. Nükleer Tıp Seminerleri 2016;3:139-143 doi:10.4274/nts.019.
  • 4- Grueter BE, Schulz UG. Age-related cerebral white matter disease (leukoaraiosis): a review. Postgraduate medical journal. 88 (1036): 79-87. doi:10.1136/postgradmedj-2011-130307.
  • 5- Selekler K. Alzheimer ve diğer demanslar. Ankara: Güneş Kitabevi, 2003 s1–24.
  • 6- Alzheimer’s disease International. World Alzheimer Report 2015.
  • 7- Petrella JR. Neuroimaging and the Search for a cure for Alzheimer disease. Radiology 2013;269:671-691.
  • 8- A.C. McClelland, W.A. Gomes, S. Shinnar, D.C. Hesdorffer, E. Bagiella, D.V. Lewis, J.A. Bello, S. Chan, J. MacFall, M. Chen, J.M. Pellock, D.R. Nordli, L.M. Frank, S.L. Moshé, R.C. Shinnar and S. Sun for the FEBSTAT Study Team. Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study. American Journal of Neuroradiology December 2016;37(12):2356-2362.
  • 9- Jack CR Jr, Petersen RC, Xu Y, et al. Rate of medial temporal lobe atrophy in typical aging and Alzheimer’s disease. Neurology 1998;51:993–999.
  • 10- G B Frisoni, A Beltramello, C Weiss, C Geroldi, A Bianchetti and M Trabucchi, Linear Measures of Atrophy in Mild Alzheimer Disease, American Journal of Neuroradiology May 1996;17(5):913-923.
  • 11- Silbert L.C., Dodge H.H., Perkins L.G., Sherbakov L., Lahna D., Erten-Lyons D. Trajectory of white matter hyperintensity burden preceding mild cognitive impairment. Neurology. 2012;79:741–747.
  • 12- Zhuang L., Sachdev P.S., Trollor J.N., Kochan N.A., Reppermund S., Brodaty H. Microstructural white matter changes in cognitively normal individuals at risk of amnestic MCI. Neurology. 2012;79:748–754.
  • 13- Carmichael O., Mungas D., Beckett L., Harvey D., Farias S.T., Reed B. MRI predictors of cognitive change in a diverse and carefully characterized elderly population. Neurobiol Aging. 2012;33:83–95.e2.
  • 14- B.M. Kandel, B.B. Avants, J.C. Gee, C.T. McMillan, G. Erus, J.Doshi, et al.White matter hyperintensities are more highly associated with preclinical Alzheimer's disease than imaging and cognitive markers of neurodegeneration. Alzheimers Dement (Amst), 4 (2016), pp. 18-27.

BEYİNDE AK MADDEDE T2 HİPERİNTENSİTELERİ OLAN ASEMPTOMATİK HASTALARDA TEMPORAL HORN ÇAPININ NORMAL HASTALARLA KARŞILAŞTIRILMASI

Year 2018, , 1056 - 1063, 15.12.2018
https://doi.org/10.30569/adiyamansaglik.458155

Abstract

Amaç:



Asemptomatik genç hastalarda periventriküler,
subkortikal ak maddede T2 hiperintensiteleri varlığında demansa erken bir gidiş
olabilir mi diye araştırmaktır. Bu amaçla özellikle Alzheimer hastalığında  lateral ventriküllerin temporal hornları
genişlediği için temporal hornların çapını ölçmeyi planladık.



Materyal
metod:



Yaşları 30-49 arasında değişen 45 hasta inceledik. Bilinen
bir hastalığı olmayan ve herhangi bir sebeple kranial manyetik rezonans (MR)
çektirmiş hastalar çalışmaya dahil edildi. Hastalarda T2 ve FLAIR (sıvı
zayıflatılmış inversiyon kurtarma ağırlıklı) sekansında beyaz cevherde
hiperintensite olup olmadığına bakıldı. T2 hiperintensitesi saptanan hastalarda
her iki temporal horn genişliği ölçüldü ve toplanarak temporal hornların
ortalaması alındı.



Bulgular:



Hastaların 32’si kadın, 13 tanesi erkekti. Kırk beş hastanın
23 tanesinde beyaz cevherde T2 ve FLAIR sekanslarda hiperintens lezyonlar
bulunmaktaydı. Kalan 22 hastanın ise beyaz cevherinde patolojik bir sinyal
yoktu. T2 hiperintensitesi saptanan hastalarda temporal horn genişliği 2.6 mm,
kontrol grubunda ise 2.16 mm olarak saptandı. Her iki grupta temporal horn
genişliği normal sınırlar içinde olmasına rağmen T2 hiperintensitesi olan
hastalarda daha yüksek olarak bulunmuştur.



Sonuç:



Beyaz cevher hiperintensiteleri ile stroke, demans ve
mortalite arasında kuvvetli ilişki olduğunu gösteren birçok yayın mevcuttur. Yaptığımız
çalışmamızda genç yaş grubunda T2-FLAIR hiperintens beyaz cevher lezyonlarına
sahip hastalarda temporal horn çapını normal gruba göre artmış bulduk, çapın yüksek
çıkması demans ve atrofiye gidişte erken bulgu açısından anlamlı olabilir.



References

  • 1- Saka E, Apaydın Doğan E, Topçuoğlu MA, Senol U, Balkan S. Linear measures of temporal lobe atrophy on brain magnetic resonance imaging (MRI) but not visual rating of white matter changes can help discrimination of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Arch Gerontol Geriatr 2007;44:141-151.
  • 2- Açık M, Yabancı Ayhan N. D Vitamini ve Alzheimer Hastalığı. Adıyaman Üni. Sağlık Bilimleri Derg, 2018;4(2):980-991.
  • 3- Karaali K. Demansta Radyolojik Bulgular. Nükleer Tıp Seminerleri 2016;3:139-143 doi:10.4274/nts.019.
  • 4- Grueter BE, Schulz UG. Age-related cerebral white matter disease (leukoaraiosis): a review. Postgraduate medical journal. 88 (1036): 79-87. doi:10.1136/postgradmedj-2011-130307.
  • 5- Selekler K. Alzheimer ve diğer demanslar. Ankara: Güneş Kitabevi, 2003 s1–24.
  • 6- Alzheimer’s disease International. World Alzheimer Report 2015.
  • 7- Petrella JR. Neuroimaging and the Search for a cure for Alzheimer disease. Radiology 2013;269:671-691.
  • 8- A.C. McClelland, W.A. Gomes, S. Shinnar, D.C. Hesdorffer, E. Bagiella, D.V. Lewis, J.A. Bello, S. Chan, J. MacFall, M. Chen, J.M. Pellock, D.R. Nordli, L.M. Frank, S.L. Moshé, R.C. Shinnar and S. Sun for the FEBSTAT Study Team. Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study. American Journal of Neuroradiology December 2016;37(12):2356-2362.
  • 9- Jack CR Jr, Petersen RC, Xu Y, et al. Rate of medial temporal lobe atrophy in typical aging and Alzheimer’s disease. Neurology 1998;51:993–999.
  • 10- G B Frisoni, A Beltramello, C Weiss, C Geroldi, A Bianchetti and M Trabucchi, Linear Measures of Atrophy in Mild Alzheimer Disease, American Journal of Neuroradiology May 1996;17(5):913-923.
  • 11- Silbert L.C., Dodge H.H., Perkins L.G., Sherbakov L., Lahna D., Erten-Lyons D. Trajectory of white matter hyperintensity burden preceding mild cognitive impairment. Neurology. 2012;79:741–747.
  • 12- Zhuang L., Sachdev P.S., Trollor J.N., Kochan N.A., Reppermund S., Brodaty H. Microstructural white matter changes in cognitively normal individuals at risk of amnestic MCI. Neurology. 2012;79:748–754.
  • 13- Carmichael O., Mungas D., Beckett L., Harvey D., Farias S.T., Reed B. MRI predictors of cognitive change in a diverse and carefully characterized elderly population. Neurobiol Aging. 2012;33:83–95.e2.
  • 14- B.M. Kandel, B.B. Avants, J.C. Gee, C.T. McMillan, G. Erus, J.Doshi, et al.White matter hyperintensities are more highly associated with preclinical Alzheimer's disease than imaging and cognitive markers of neurodegeneration. Alzheimers Dement (Amst), 4 (2016), pp. 18-27.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Article
Authors

Safiye Tokgöz Özal 0000-0003-1690-4744

Sema Aksoy This is me 0000-0002-1283-2344

Publication Date December 15, 2018
Submission Date September 7, 2018
Acceptance Date November 1, 2018
Published in Issue Year 2018

Cite

AMA Tokgöz Özal S, Aksoy S. BEYİNDE AK MADDEDE T2 HİPERİNTENSİTELERİ OLAN ASEMPTOMATİK HASTALARDA TEMPORAL HORN ÇAPININ NORMAL HASTALARLA KARŞILAŞTIRILMASI. ADYÜ Sağlık Bilimleri Derg. December 2018;4(3):1056-1063. doi:10.30569/adiyamansaglik.458155