Pilot Investigation: Older Adults With Atrial Fibrillation Demonstrate Greater Brain Leukoaraiosis in Infracortical and Deep Regions Relative to Non-Atrial Fibrillation Peers

Background

This pilot study explored differences in distribution of white matter hyperintensities (called leukoaraiosis; LA) in older adults (mean age = 67 years) with atrial fibrillation (AF) vs. non-AF peers measured by: (1) depth distribution; (2) anterior-posterior distribution; (3) associations between LA and cortical thickness; and (4) presence of lacunae and stroke.

Methods

Participant data (AF n = 17; non-AF peers n = 17) were acquired with the same magnetic resonance imaging protocols. LA volume was quantified by cortical depth (periventricular, deep, infracortical) and in anterior and posterior regions. Cortical thickness by lobe was assessed relative to LA load.

Results

Relative to non-AF peers, the AF group had twice the total LA volume (AF = 2.1% vs. Non-AF = 0.9%), over 10 times greater infracortical LA (AF = 0.72% vs. Non-AF = 0.07%), and three times greater deep LA (AF = 2.1% vs. Non-AF = 0.6%). Examinations of the extent of LA in anterior vs. posterior regions revealed a trend for more posterior relative to anterior LA. In the entire sample, total LA and infracortical LA were negatively associated with temporal lobe thickness. Only those with AF presented with lacunae or stroke.

Conclusion

Aging adults with AF had more total white matter disease than those without AF, particularly near the cortical mantle and deep within the cortex. Total and infracortical white matter disease in the entire sample negatively associated with temporal lobe thickness. Results suggest that those with AF have a distinct pattern of LA relative to those without AF, and that LA severity for all individuals may associate with structural changes in the cortex.