Arterial oxygen saturation, COPD, and cerebral small vessel disease

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 75; no. 5; pp. 733 - 736
• Main Authors: van Dijk, E J, Vermeer, S E, de Groot, J C, van de Minkelis, J, Prins, N D, Oudkerk, M, Hofman, A, Koudstaal, P J, Breteler, M M B
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01-05-2004; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Aged; ageing; arterial oxygen saturation; Attention deficit hyperactivity disorder; Biological and medical sciences; Body Mass Index; Brain - blood supply; Brain - metabolism; Brain - pathology; Brain Infarction - complications; Brain Infarction - metabolism; Brain Infarction - pathology; Cholesterol - blood; chronic obstructive pulmonary disease; COPD; Diabetes Mellitus - epidemiology; Female; Hemoglobins - metabolism; Humans; Hypertension - epidemiology; Hypertrophy, Left Ventricular - epidemiology; Hypertrophy, Left Ventricular - pathology; lacunar infarcts; Magnetic Resonance Imaging; Male; Medical sciences; Myocardial Infarction - epidemiology; Neurology; Older people; Oximetry - methods; Oxygen; Oxygen - metabolism; oxygen saturation; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - metabolism; SaO2; Smoking - epidemiology; Studies; white matter lesions; Oxygen; Nervous system diseases; Saturation; Central nervous system; Encephalon
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2003.022012

Objective: To study whether lower arterial oxygen saturation (SaO2) and chronic obstructive pulmonary disease (COPD) are associated with cerebral white matter lesions and lacunar infarcts. Methods: We measured SaO2 twice with a pulse oximeter, assessed the presence of COPD, and performed MRI in 1077 non-demented people from a general population (aged 60–90 years). We rated periventricular white matter lesions (on a scale of 0–9) and approximated a total subcortical white matter lesion volume (range 0–29.5 ml). All analyses were adjusted for age and sex and additionally for hypertension, diabetes, body mass index, pack years smoked, cholesterol, haemoglobin, myocardial infarction, and left ventricular hypertrophy. Results: Lower SaO2 was independent of potential confounders associated with more severe periventricular white matter lesions (score increased by 0.12 per 1% decrease in SaO2 (95% confidence interval 0.01 to 0.23)). Participants with COPD had more severe periventricular white matter lesions than those without (adjusted mean difference in score 0.70 (95% confidence interval 0.23 to 1.16)). Lower SaO2 and COPD were not associated with subcortical white matter lesions or lacunar infarcts. Conclusion: Lower SaO2 and COPD are associated with more severe periventricular white matter lesions.