Physical activity and nutrition correlation with white matter hyperintensities on brain MRI

OBJECTIVE Our aim is to identify a correlation between the level of physical activity or nutritional intake and white matter hyperintensity (WMH) on MRI of the brain. BACKGROUND White matter hyperintensities are a radiographic marker of cerebral small vessel disease (CSVD). Individual's levels of physical activity and nutritional intake have been hypothesized to be involved in the pathogenesis of WMH, although prior results have been inconsistent. Regular exercise can significantly reduce the risk of developing dementia and a diet rich in fiber and antioxidants can have similar effects. We will be performing a cross-sectional analysis of the association between prospectively-collected nutritional data obtained from an Automated Self-Administered 24-hour Dietary Assessment Tool and physical activity data obtained from the International Physical Activity Questionnaire and WMH on a standard-of-care brain MRI. METHOD A retrospective chart review was conducted on adults with a brain MRI from the EPIC database. The primary outcome was the burden of WHM measured on the Fazekas score, as a total score and either periventricular (PVWM) or deep white matter (DWM). The Fazekas score was read with the individual predictors of the brain MRI measurements and adjusted for potential confounders such as patient age, sex, and hypertension. RESULTS We identified 12 patients aged 60 years or older who had a brain MRI done within the last year and were capable of all activities of daily living. Using logistic regression, levels of physical activity and nutritional quality were analyzed against WMH Fazekas scores. Our initial analysis, although underpowered, showed a possible association between healthy diet and regular exercise and WMH burden on MRI scans. CONCLUSION Physical activity and nutritional intake might help determine the extent of WMH in an individual. Due to the small sample size, we are unable to determine the exact role exercise and diet has in reducing WMH burden, but this initial analysis was promising for future studies. Discovering a relationship in asymptomatic patients could give vital information for understanding the cause of WMH which could help provide preventive treatment for the aging population.