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Leukoaraiosis and dementia in hypertensive patients
Yao H, Sadoshima S, Ibayashi S, Kuwabara Y, Ichiya Y, Fujishima M.. Stroke, 1992-11-01
Topic: Risk, prevention and care in population studies
Background and purpose Although our previous study demonstrated that dementia of the Binswanger type may be a disconnection dementia caused by leukoaraiosis, some hypertensive patients with marked leukoaraiosis do not develop dementia. The goal of the present study is to elucidate the pathophysiology of nondemented hypertensive patients with leukoaraiosis. Methods We performed clinical and neuroradiological studies, including positron emission tomography, in eight hypertensive patients with leukoaraiosis. Results Four patients were demented, and two among the other four who were not demented at the first examination developed dementia during the follow-up period. Digital subtraction angiography of the cervical and intracranial arteries demonstrated stenotic lesions in only one patient. Cerebral blood flow and oxygen metabolism in patients with dementia were markedly reduced in the white matter (59-67% of control values). In contrast, cerebral blood flow in the white matter of patients without dementia was reduced less markedly (74% of control), oxygen extraction fraction in the white matter was significantly increased (130% of control), and oxygen metabolism remained at almost-normal levels not only in the white matter but also in the cortical area. Conclusions Hypertension-caused arteriosclerotic changes of the long penetrating medullary arteries may cause misery perfusion and later ischemic damage in the periventricular white matter. Preserved oxygen metabolism in hypertensive patients with leukoaraiosis may represent the early stage of vascular dementia of the Binswanger type.
Key findings
- Background and purpose Although our previous study demonstrated that dementia of the Binswanger type may be a disconnection dementia caused by leukoaraiosis, some hypertensive patients with marked leukoaraiosis do not develop dementia.
- Results Four patients were demented, and two among the other four who were not demented at the first examination developed dementia during the follow-up period.
- Digital subtraction angiography of the cervical and intracranial arteries demonstrated stenotic lesions in only one patient.
- In contrast, cerebral blood flow in the white matter of patients without dementia was reduced less markedly (74% of control), oxygen extraction fraction in the white matter was significantly increased (130% of control), and oxygen metabolism remained at almost-normal levels not only in the white matter but also in the cortical area.
Why it matters
This small study of eight hypertensive patients with leukoaraiosis found that those with dementia had markedly reduced white matter blood flow and oxygen metabolism, while those without dementia had less reduction and near-normal oxygen metabolism. It is a small clinical and imaging study and does not test any treatment, cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1992 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 126 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.5 citations a year over 36 year(s) since 1992 |
| Impact for its field and year | 3 / 6 | Cited 4.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Masatoshi Fujishima: h-index 67 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Kyushu University: institution h-index 721 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 1440720) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 41 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Yao, H., Sadoshima, S., Ibayashi, S., Kuwabara, Y., Ichiya, Y., & Fujishima, M. (1992). Leukoaraiosis and dementia in hypertensive patients. Stroke. https://doi.org/10.1161/01.str.23.11.1673
Vancouver
Yao H, Sadoshima S, Ibayashi S, Kuwabara Y, Ichiya Y, Fujishima M. Leukoaraiosis and dementia in hypertensive patients. Stroke. 1992. doi:10.1161/01.str.23.11.1673. PMID: 1440720.
BibTeX
@article{yao1992-1440720,
author = {Yao, H. and Sadoshima, S. and Ibayashi, S. and Kuwabara, Y. and Ichiya, Y. and Fujishima, M.},
title = {{Leukoaraiosis and dementia in hypertensive patients}},
journal = {Stroke},
year = {1992},
doi = {10.1161/01.str.23.11.1673},
pmid = {1440720},
url = {https://doi.org/10.1161/01.str.23.11.1673}
}
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