American Journal of Neuroradiology
J.M. Prager, jprager at northshore.org, C. Thomas, W.J. Ankenbrandt, J.R. Meyer, Y. Gao, A. Ragin, S. Sidharthan, R. Hutten and Y.G. Wu
From the Department of Radiology (J.M.P., W.J.A., J.R.M., R.H., Y.G.W.), NorthShore University Health System, Evanston, Illinois; Department of Endocrinology (C.T.), University of Chicago, Chicago, Illinois; Departments of Statistics (Y.G.) and Radiology (A.R.), Northwestern University, Evanston, Illinois; and Department of Radiology (S.S.), Monmouth Medical Center, Long Branch, New Jersey.
BACKGROUND AND PURPOSE: Vitamin D deficiency is associated with cognitive impairment in the elderly and with increased white matter T2 hyperintensities in elderly debilitated patients. We investigated the relationship between serum vitamin D and brain MR findings in adult outpatients.
MATERIALS AND METHODS: Brain MR studies of 56 patients ages 30–69 years were selected when vitamin D level had been obtained within 90 days of the MRI. White matter T2 hyperintensities were characterized by size and location by two neuroradiologists. Manual volumetric analysis was assessed in patients more than 50 years of age.
RESULTS: The entire cohort showed a significant negative relationship between serum 25-hydroxyvitamin D and the number of confluent juxtacortical white matter T2 hyperintensities (P = .047). The cohort ages 50 years and older showed stronger correlation between confluent white matter T2 hyperintensities and serum 25-hydroxyvitamin D in the juxtacortical region; number (P = .015) and size of white matter T2 hyperintensities (P = .048). Atrophy was not significantly related to serum 25-hydroxyvitamin D by radiologist visual analysis or by the bicaudate ratio.
CONCLUSIONS: We found a significant relationship between vitamin D and white matter T2 hyperintensities in independent adult outpatients, especially over the age of 50 years.
- Fact: Hyperintensities (low blood flow) are fewer in those with lots of vitamin D (see above)
- Fact: Multiple Sclerosis Hyperintensities go into remission with lots of vitamin D (see below)
- Fact: Hypertensities predict Dimentia, Mortality, and Stroke (BMJ 2010, below)
- Fact: Vitamin D prevents dimentia, mortality, and stroke
Hypothesis: Will be able look at brain scans, and not wait for dimentia, mortality, or stoke to determin how much vitamin D is needed.
- Multiple Sclerosis: number needed to treat with vitamin D may be as low as 1.3 – Meta-analysis Oct 2013
- Brain lesions might be associated with vitamin D deficiency – March 2012
- Stroke – many MRI measures are strongly associated with low vitamin D – Jan 2015 discusses lesions
- Brains of seniors had 60 percent more white matter abnormalities if low vitamin D – March 2015
- 44X increase in Bipolar Disorder in youth in a decade – Sept 2007 - reports on hyperintense area with Bipolar Disorder
- Parkinsons' disease and MRI white matter in brain
- Appears that Vitamin D can induce remission in recent Multiple Sclerosis Less hyperintense areas on MRI after LOTS of vitamin D
Before = 2008
Starting daily dose 25,000 IU; increased in stages to 80,000 IU on October 28, 2010. Asymptomatic since 2010.
After = 2013
- Hyperintensity Wikipedia Jan 2014
They are usually seen in normal aging but also in a number of neurological disorders and psychiatric illnesses.
For example deep white matter hyperintensites are 2.5 to 3 times more likely to occur in bipolar disorder and major depressive disorder than control subjects.
- What Is White Matter Hyperintensity? WiseGeek
No matter where in the brain it occurs, white matter hyperintensity reflects what is called demyelination, a deterioration of neural pathways caused by decreasing blood flow and/or disease.
Alzheimer's disease, strokes, multiple sclerosis and heart disease.
Also referred to as brain rust,
- The clinical importance of white matter hyperintensities on brain magnetic resonance imaging:
systematic review and meta-analysis BMJ July 2010, PDF at bottom of this page