Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction

Wi Sun Ryu, Dawid Schellingerhout, Hee Seung Ahn, Soo Hyun Park, Keun Sik Hong, Sang Wuk Jeong, Man Seok Park, Kang Ho Choi, Joon Tae Kim, Beom Joon Kim, Moon Ku Han, Jun Lee, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook Nah, Soo Joo Lee, Yong Jin Cho, Byung Chul Lee, Kyung Ho Yu, Mi Sun OhJong Moo Park, Kyusik Kang, Kyung Bok Lee, Tai Hwan Park, Sang Soon Park, Eric E. Smith, Juneyoung Lee, Hee Joon Bae, Dong Eog Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background—White matter hyperintensities (WMHs) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric WMHs associated with lacunar infarcts. Methods and Results—A total of 267 consecutive patients with small first-ever supratentorial infarcts (≤20 mm) were included. None had a relevant vascular stenosis. WMH asymmetry was measured based on the hemispheric difference of a modified Scheltens scale score (≥3 defined as asymmetric). We analyzed the association of the hemispheric WMH asymmetry with old silent lacunar infarcts or acute lacunar infarcts. We compared lesion frequency maps between groups and generated t-statistics maps. The mean age of patients was 64 years, and 63% were men. Asymmetric WMH was more than 3-fold as frequent (P<0.001) in the group with old silent lacunar infarcts (42%, 43/102) than in the group without old silent lacunar infarcts (15%, 24/165). In patients with left hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located in the left (versus right) hemisphere (74% versus 26%, P<0.001). In patients with right hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located on the right (versus left) hemisphere (81% versus 19%, P<0.001). Mapping studies showed that the side of hemispheric dominance of WMHs was associated with acute and silent lacunes on the same side. Conclusions—These are the first data to show that asymmetric WMHs are associated with both old silent lacunar infarcts and acute lacunar infarcts ipsilateral to the greatest WMH burden. This suggests that the hemisphere with relatively large WMHs is more vulnerable to ischemia.

Original languageEnglish
Article numbere010653
JournalJournal of the American Heart Association
Volume7
Issue number22
DOIs
Publication statusPublished - 2018 Nov 1

Fingerprint

Lacunar Stroke
White Matter
Patient Rights
Blood Vessels
Pathologic Constriction
Ischemia

Keywords

  • Asymmetry
  • Lacunar infarct
  • Lacunar stroke
  • Leukoaraiosis
  • Magnetic resonance imaging
  • White matter disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ryu, W. S., Schellingerhout, D., Ahn, H. S., Park, S. H., Hong, K. S., Jeong, S. W., ... Kim, D. E. (2018). Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction. Journal of the American Heart Association, 7(22), [e010653]. https://doi.org/10.1161/JAHA.118.010653

Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction. / Ryu, Wi Sun; Schellingerhout, Dawid; Ahn, Hee Seung; Park, Soo Hyun; Hong, Keun Sik; Jeong, Sang Wuk; Park, Man Seok; Choi, Kang Ho; Kim, Joon Tae; Kim, Beom Joon; Han, Moon Ku; Lee, Jun; Cha, Jae Kwan; Kim, Dae Hyun; Nah, Hyun Wook; Lee, Soo Joo; Cho, Yong Jin; Lee, Byung Chul; Yu, Kyung Ho; Oh, Mi Sun; Park, Jong Moo; Kang, Kyusik; Lee, Kyung Bok; Park, Tai Hwan; Park, Sang Soon; Smith, Eric E.; Lee, Juneyoung; Bae, Hee Joon; Kim, Dong Eog.

In: Journal of the American Heart Association, Vol. 7, No. 22, e010653, 01.11.2018.

Research output: Contribution to journalArticle

Ryu, WS, Schellingerhout, D, Ahn, HS, Park, SH, Hong, KS, Jeong, SW, Park, MS, Choi, KH, Kim, JT, Kim, BJ, Han, MK, Lee, J, Cha, JK, Kim, DH, Nah, HW, Lee, SJ, Cho, YJ, Lee, BC, Yu, KH, Oh, MS, Park, JM, Kang, K, Lee, KB, Park, TH, Park, SS, Smith, EE, Lee, J, Bae, HJ & Kim, DE 2018, 'Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction', Journal of the American Heart Association, vol. 7, no. 22, e010653. https://doi.org/10.1161/JAHA.118.010653
Ryu, Wi Sun ; Schellingerhout, Dawid ; Ahn, Hee Seung ; Park, Soo Hyun ; Hong, Keun Sik ; Jeong, Sang Wuk ; Park, Man Seok ; Choi, Kang Ho ; Kim, Joon Tae ; Kim, Beom Joon ; Han, Moon Ku ; Lee, Jun ; Cha, Jae Kwan ; Kim, Dae Hyun ; Nah, Hyun Wook ; Lee, Soo Joo ; Cho, Yong Jin ; Lee, Byung Chul ; Yu, Kyung Ho ; Oh, Mi Sun ; Park, Jong Moo ; Kang, Kyusik ; Lee, Kyung Bok ; Park, Tai Hwan ; Park, Sang Soon ; Smith, Eric E. ; Lee, Juneyoung ; Bae, Hee Joon ; Kim, Dong Eog. / Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 22.
@article{ba5f328eb9154e899be25675a112f476,
title = "Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction",
abstract = "Background—White matter hyperintensities (WMHs) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric WMHs associated with lacunar infarcts. Methods and Results—A total of 267 consecutive patients with small first-ever supratentorial infarcts (≤20 mm) were included. None had a relevant vascular stenosis. WMH asymmetry was measured based on the hemispheric difference of a modified Scheltens scale score (≥3 defined as asymmetric). We analyzed the association of the hemispheric WMH asymmetry with old silent lacunar infarcts or acute lacunar infarcts. We compared lesion frequency maps between groups and generated t-statistics maps. The mean age of patients was 64 years, and 63{\%} were men. Asymmetric WMH was more than 3-fold as frequent (P<0.001) in the group with old silent lacunar infarcts (42{\%}, 43/102) than in the group without old silent lacunar infarcts (15{\%}, 24/165). In patients with left hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located in the left (versus right) hemisphere (74{\%} versus 26{\%}, P<0.001). In patients with right hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located on the right (versus left) hemisphere (81{\%} versus 19{\%}, P<0.001). Mapping studies showed that the side of hemispheric dominance of WMHs was associated with acute and silent lacunes on the same side. Conclusions—These are the first data to show that asymmetric WMHs are associated with both old silent lacunar infarcts and acute lacunar infarcts ipsilateral to the greatest WMH burden. This suggests that the hemisphere with relatively large WMHs is more vulnerable to ischemia.",
keywords = "Asymmetry, Lacunar infarct, Lacunar stroke, Leukoaraiosis, Magnetic resonance imaging, White matter disease",
author = "Ryu, {Wi Sun} and Dawid Schellingerhout and Ahn, {Hee Seung} and Park, {Soo Hyun} and Hong, {Keun Sik} and Jeong, {Sang Wuk} and Park, {Man Seok} and Choi, {Kang Ho} and Kim, {Joon Tae} and Kim, {Beom Joon} and Han, {Moon Ku} and Jun Lee and Cha, {Jae Kwan} and Kim, {Dae Hyun} and Nah, {Hyun Wook} and Lee, {Soo Joo} and Cho, {Yong Jin} and Lee, {Byung Chul} and Yu, {Kyung Ho} and Oh, {Mi Sun} and Park, {Jong Moo} and Kyusik Kang and Lee, {Kyung Bok} and Park, {Tai Hwan} and Park, {Sang Soon} and Smith, {Eric E.} and Juneyoung Lee and Bae, {Hee Joon} and Kim, {Dong Eog}",
year = "2018",
month = "11",
day = "1",
doi = "10.1161/JAHA.118.010653",
language = "English",
volume = "7",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "22",

}

TY - JOUR

T1 - Hemispheric asymmetry of white matter hyperintensity in association with lacunar infarction

AU - Ryu, Wi Sun

AU - Schellingerhout, Dawid

AU - Ahn, Hee Seung

AU - Park, Soo Hyun

AU - Hong, Keun Sik

AU - Jeong, Sang Wuk

AU - Park, Man Seok

AU - Choi, Kang Ho

AU - Kim, Joon Tae

AU - Kim, Beom Joon

AU - Han, Moon Ku

AU - Lee, Jun

AU - Cha, Jae Kwan

AU - Kim, Dae Hyun

AU - Nah, Hyun Wook

AU - Lee, Soo Joo

AU - Cho, Yong Jin

AU - Lee, Byung Chul

AU - Yu, Kyung Ho

AU - Oh, Mi Sun

AU - Park, Jong Moo

AU - Kang, Kyusik

AU - Lee, Kyung Bok

AU - Park, Tai Hwan

AU - Park, Sang Soon

AU - Smith, Eric E.

AU - Lee, Juneyoung

AU - Bae, Hee Joon

AU - Kim, Dong Eog

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background—White matter hyperintensities (WMHs) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric WMHs associated with lacunar infarcts. Methods and Results—A total of 267 consecutive patients with small first-ever supratentorial infarcts (≤20 mm) were included. None had a relevant vascular stenosis. WMH asymmetry was measured based on the hemispheric difference of a modified Scheltens scale score (≥3 defined as asymmetric). We analyzed the association of the hemispheric WMH asymmetry with old silent lacunar infarcts or acute lacunar infarcts. We compared lesion frequency maps between groups and generated t-statistics maps. The mean age of patients was 64 years, and 63% were men. Asymmetric WMH was more than 3-fold as frequent (P<0.001) in the group with old silent lacunar infarcts (42%, 43/102) than in the group without old silent lacunar infarcts (15%, 24/165). In patients with left hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located in the left (versus right) hemisphere (74% versus 26%, P<0.001). In patients with right hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located on the right (versus left) hemisphere (81% versus 19%, P<0.001). Mapping studies showed that the side of hemispheric dominance of WMHs was associated with acute and silent lacunes on the same side. Conclusions—These are the first data to show that asymmetric WMHs are associated with both old silent lacunar infarcts and acute lacunar infarcts ipsilateral to the greatest WMH burden. This suggests that the hemisphere with relatively large WMHs is more vulnerable to ischemia.

AB - Background—White matter hyperintensities (WMHs) are commonly asymmetric between hemispheres but for unknown reasons. We investigated asymmetric WMHs associated with lacunar infarcts. Methods and Results—A total of 267 consecutive patients with small first-ever supratentorial infarcts (≤20 mm) were included. None had a relevant vascular stenosis. WMH asymmetry was measured based on the hemispheric difference of a modified Scheltens scale score (≥3 defined as asymmetric). We analyzed the association of the hemispheric WMH asymmetry with old silent lacunar infarcts or acute lacunar infarcts. We compared lesion frequency maps between groups and generated t-statistics maps. The mean age of patients was 64 years, and 63% were men. Asymmetric WMH was more than 3-fold as frequent (P<0.001) in the group with old silent lacunar infarcts (42%, 43/102) than in the group without old silent lacunar infarcts (15%, 24/165). In patients with left hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located in the left (versus right) hemisphere (74% versus 26%, P<0.001). In patients with right hemispheric dominance of WMHs, an acute lacunar infarct was more likely to be located on the right (versus left) hemisphere (81% versus 19%, P<0.001). Mapping studies showed that the side of hemispheric dominance of WMHs was associated with acute and silent lacunes on the same side. Conclusions—These are the first data to show that asymmetric WMHs are associated with both old silent lacunar infarcts and acute lacunar infarcts ipsilateral to the greatest WMH burden. This suggests that the hemisphere with relatively large WMHs is more vulnerable to ischemia.

KW - Asymmetry

KW - Lacunar infarct

KW - Lacunar stroke

KW - Leukoaraiosis

KW - Magnetic resonance imaging

KW - White matter disease

UR - http://www.scopus.com/inward/record.url?scp=85057121243&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057121243&partnerID=8YFLogxK

U2 - 10.1161/JAHA.118.010653

DO - 10.1161/JAHA.118.010653

M3 - Article

C2 - 30571500

AN - SCOPUS:85057121243

VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 22

M1 - e010653

ER -