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A study on the relationship between brain atrophy and leukopathy

Methods Two hundred and seventy-two patients with WML admitted to the Department of Neurology of Taizhou Central Hospital from January 2015 to December 2017 were enrolled, by adopting MCMxxxVI 9.0 TM image processing tool and Analyze 9.0TM image editing tool, the volume within the skull, whole brain tissue, cerebrospinal fluid, subarachnoid volume on the surface of the brain, gray matter, normal brain white matter and diseased white matter were quantitatively determined in the MRI, Fazekas visual score was used to qualitatively evaluate the WML of MRI, and the correlation between brain atrophy and WML was analyzed.

General linear model analysis showed that the WML volume had a negative correlation with total brain atrophy or decreased whole brain volume (β = -0.432, P = 0.004), especially with deep brain atrophy, namely WML volume had a significant positive correlation with the increase of ventricular volume (β = 0.098, P = 0.031), and it had no correlation with superficial brain atrophy or the increase of subarachnoid volume on the surface of the brain (β = 0.088, P = 0.547). Fazekas rating scale used for the correlation analysis of WML and brain atrophy also showed similar results. After adjusting for the gender and skull content volume, it was shown that the WML volume was well fitted with brain volume model, and so was the WML with the following volumes: cerebral white matter volume without any pathological changes, the whole brain tissue volume, gray matter volume models (brain volume R2 = 0.25, cerebral white matter volume with no pathological changes R2 = 0.35, whole brain tissue volume R2 = 0.77, gray matter volume R2 = 0.25, all P < 0.05).

MRI analysis showed WML was associated with brain atrophy, primarily with deep brain atrophy.Brain atrophy is a physiological phenomenon in the elderly. Autopsy shows that the quality of human brain decreases with age after 40 years old. Brain white matter accounts for half of the brain mass. The main blood supply artery of brain white matter is terminal artery with few anastomotic branches. It is not easy to establish collateral circulation and prone to ischemia. Therefore, the development of brain white matter atrophy is earlier than that of gray matter. Some studies have shown that the degree of brain atrophy in patients with WML is significantly higher than that in patients without WML at the end of follow-up. Therefore, WML may be one of the causes of brain atrophy. Therefore, actively controlling the occurrence and development of WML may be beneficial to retarding the process of brain atrophy, thus reducing the decline of cognitive function and even the occurrence of dementia.