Agnieszka Sabisz 1, Patrycja Naumczyk 2, Anna Marcinkowska 1, Beata Graff 3, Dariusz Gąsecki 4, Anna Glińska 4, Marta Witkowska 2, Anna Jankowska 1, Aleksandra Konarzewska 1, Jerzy Kwela 5, Krzysztof Jodzio 2, Edyta Szurowska 1, Krzysztof Narkiewicz 3
1 Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
2 Institute of Psychology, University of Gdansk, Gdansk, Poland
3 Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
4 Department of Neurology of Adults, Medical University of Gdansk, Gdansk, Poland
5 Institute of Experimental Physics, University of Gdansk, Gdansk, Poland
Introduction: Brain areas that revealed the highest vulnerability to the damage, due to heightened blood pressure, included the prefrontal cortex, the hippocampus and inferior temporal cortex. The hypertension was also shown to affect other brain regions that are moderately sensitive to aging, such as the cuneus and the thalamus. In this project we wanted to check whether patients with well controlled hypertension have also changes in volume of brain regions. MRI analysis included rating of white matter lesions and automatic volume measuring of white matter, grey matter and also left and right hemisphere subcortical structures.
Method: 84 participants with hypertension (SUB, N=39) and control group (CON, N=45) took part in this study. Participants were divided in three age subgroups: group I – to 39 years old, group II – age from 40 to 59 years old, group III – age from 60 years old.
MRI examinations were performed with a 3.0 T scanner (Achieva TX, Philips, Best, The Netherlands) using a 32-channel head coil. MRI protocol contained T1-weighted 3D TFE sequence, FLAIR axial sequence.
Changes in the white matter were classified based on the Fazekas scale by two experienced radiologists. Volumes of the grey matter (GM), white matter (WM) and total volume of the brain (BRAIN) were counted in the SIENAX FSL software. Subcortical structures were segmented in the FIRST FSL. The effect of age and hypertension on volumes of brain structures were tested by a two-way ANOVA.
Results: In between group analysis of leukoaraiosis in Fazekas scale no effect was found. The two-way ANOVA of volume analysis showed: grey matter – a significant main effect of age, white matter – no effects , subcortical structures – in almost all structures a significant effect of age was found, no structure presented effect connected with hypertension. Only right thalamus showed interaction between factors. The simple effect analysis presented a significance between CON and SUB in age group III and age-related effects in all comparisons.
Conclusions: Patients with controlled hypertension do not show increased atrophy of the brain, except the right thalamus. The aging of brain in patients with well controlled hypertension is similar to healthy controls.