![]() All participants and their guardians gave written informed consent before taking part in the study. A total of 870 participants were included in the subsequent analysis. Of the 1011 study patients extracted from our database during the study period, 141 patients were excluded for the following reasons: 1) inadequate medical information (n=5) 2) no laboratory tests performed (n=75) 3) no data on brain magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA) (n=24) 4) previous history of hematologic, hepatic and/or renal disorders (n=29) or 5) abnormal neurological findings at the time of examination (n=8). We did not include patients with hematologic, renal, haptic disorder, and recent history of infection. Only participants whose records contained adequate information on demographic, laboratory, and radiological data were included. A retrospective analysis was performed for subjects who arrived for health screening. The study subjects were neurologically healthy volunteers, aged ≥41 years, who visited the healthcare center at CHA Bundang Medical Center, Seongnam, Korea, for routine health examination between March 2008 and August 2014. 23, 24, 25 In the present study, we investigated the relationship between platelets in the blood and cerebral WMH in the brain in clinically non-stroke neurology outpatients. ![]() Although a few studies have investigated the association between MPV and brain volume, the association has not yet been clearly established. However, little is known about the relationship between MPV in blood and the severity of cerebral WMH due to the paucity of data to date. 19, 20, 21, 22 MPV is also a marker of increased platelet metabolism and enzymatic activity, which has been shown to be associated with vascular injury and inflammatory processes. Furthermore, high MPV predicts poor clinical outcome of ischemic heart disease 16, 17, 18 and ischemic stroke. 12, 13 Recent studies have demonstrated that high MPV is associated with HTN 14 and diabetes mellitus (DM), 15 both of which contribute to the development of ischemic heart disease and ischemic stroke. The mean platelet volume (MPV), defined as a machine-calculated measurement of the average size of platelets in blood, is an easily accessible parameter on blood sampling. ![]() These findings indicate the role of platelets in the development of cerebral WMH. 6, 7, 8, 9 Recent studies have reported that platelet-derived thrombogenic microvesicles 10, 11 were increased in patients with the presence of cerebral WMH. 5 It has been also reported that CSVD is associated with high dietary glucose, obstructive sleep apnea, low levels of plasma omega 3-polyunsaturated fatty acids, and aortic atheroma, suggesting that various pathophysiological processes are involved in WMH. ![]() In addition to vascular risk factor for atherosclerosis, endothelial dysfunction, vascular inflammation, and microthrombosis of the cerebral microvasculature may also contribute to the development of cerebral WMH. 1 Some of the underlying risk factors for cerebral WMH are increased age and arterial hypertension (HTN). The underlying pathomechanism of cerebral WMH is hypothesized to be diffuse CSVD in response to chronic ischemic injury. On brain imaging, cerebral small vessel disease (CSVD) usually presents as silent lacunar infarction, cerebral microbleeds, and cerebral WMH. 2, 3 The presence of cerebral WMH corresponds to the pathological conditions of neuronal loss, ischemic demyelination, and gliosis in the brain. 1 Furthermore, recent evidence has suggested that cerebral WMH play a causal role in the development and progression of neurodegenerative and cerebrovascular diseases. Cerebral WMH are initially mild and asymptomatic in the early stages, but their progression results in the development of serious neurological diseases, including neurodegenerative ones, as well as cognitive decline and mood disorder. Cerebral white matter hyperintensities (WMH) are a common finding in brain imaging in the elderly, especially in those with cerebrovascular and neurodegenerative diseases.
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