Correlation between ventricular enlargement and white matter changes

The clinical significance of white matter changes including periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH) on MRI in patients with normal pressure hydrocephalus is unclear. We investigated the correlation between ventricular size and white matter changes in healthy individuals. We performed MRI in 683 (mean age 59; 55% men) neurologically normal adults without a history or radiological findings of brain disease or trauma, who were undergoing brain health screening. The correlation between Evans' index and severity of white matter changes was analyzed. Multiple linear regression analysis was used to identify the main clinical factors influencing ventricular enlargement and white matter changes. Evans' index was 0.248 ± 0.026 (mean ± SD). Incidence of PVH was 40% and DWMH was 29%. Evans' index was weakly correlated with PVH grading (ρ = 0.24; P < .01) and DWMH grading (ρ = 0.24; P < .01). Multiple linear regression analysis showed that age (β = 0.034; SE = 0.003) diastolic blood pressure (0.004; 0.002), Evans' index (0.019; 0.009), and a history of hypertension (0.173; 0.053) had a significant impact on PVH grade, whereas age (0.030; 0.003) and history of hypertension (0.224; 0.049) were related to DWMH grade. It was suggested that there is an independent correlation between ventricular enlargement and PVH in normal adults. This finding in a normal population could be due to the presence of preclinical disease, but its bearing on the changes that occur in normal pressure hydrocephalus remain uncertain at the present time.