White matter integrity of watershed areas is potentially influenced by hypoperfusion in the presence permanent atrial fibrillation
Open Access
- 17 July 2021
- journal article
- Published by Silicea - Poligraf, LLC in Cardiovascular Therapy and Prevention
- Vol. 20 (4), 2915
- https://doi.org/10.15829/1728-8800-2021-2915
Abstract
Aim. To test a hypothesis of hypoperfusion-induced white matter changes in patients with atrial fibrillation (AFib) and to present statistics to compute sample size for the upcoming studies. Material and methods. We included 30 inpatients with AFib and investigated them with magnetic resonance imaging (MRI) with standard sequencies and diffusion tensor imaging (DTI). DTI data were analyzed with conventional ROI analysis in the Olea Sphere software and with watershed areas (WSA) mask in the FSL toolbox after nonlinear transformation of images to the Montreal Neurological Institute (MNI) space. Wilcoxon test was used to compare diffusion characteristics across subgroups. Results. Median age of participants was 73 years (69-78), 18 (60%) patients had moderate signs of small vessel disease with Fazekas score of one. Twenty-one patients had paroxysmal AFib. Analysis of WSA revealed decreased white matter integrity in the parieto-occipital cortical WSA with a pattern of significantly increased mean diffusivity (p=0,039), and marginally significant decrease in fractional anisotropy (p=0,056). Rank-based effect size across areas under comparison was either small (0,2) or negligible, and with statistical power in the range of 0,05-1. Conclusion. Atrial fibrillation could have pathophysiologically feasible mechanism to affect white matter integrity in the watershed areas.Keywords
This publication has 16 references indexed in Scilit:
- Global epidemiology of atrial fibrillation: An increasing epidemic and public health challengeInternational Journal of Stroke, 2020
- MRtrix3: A fast, flexible and open software framework for medical image processing and visualisationNeuroImage, 2019
- Association of Atrial Fibrillation With White Matter DiseaseStroke, 2019
- Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusionEP Europace, 2017
- Atrial fibrillation is associated with anterior predominant white matter lesions in patients presenting with embolic strokeJournal of Neurology, Neurosurgery & Psychiatry, 2017
- Atrial Fibrillation is Associated With Reduced Brain Volume and Cognitive Function Independent of Cerebral InfarctsStroke, 2013
- Border Zone Infarcts: Pathophysiologic and Imaging CharacteristicsRadioGraphics, 2011
- Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion dataNeuroImage, 2006
- Impaired Clearance of Emboli (Washout) Is an Important Link Between Hypoperfusion, Embolism, and Ischemic StrokeArchives of Neurology, 1998
- Atheromatous embolism in the brainNeurology, 1994