Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Neurol Neurosurg Psychiatry. May 2004; 75(5): 733–736.
PMCID: PMC1763550

Arterial oxygen saturation, COPD, and cerebral small vessel disease


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.

Full Text

The Full Text of this article is available as a PDF (289K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Longstreth WT, Jr, Manolio TA, Arnold A, Burke GL, Bryan N, Jungreis CA, Enright PL, O'Leary D, Fried L. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke. 1996 Aug;27(8):1274–1282. [PubMed]
  • Liao D, Cooper L, Cai J, Toole J, Bryan N, Burke G, Shahar E, Nieto J, Mosley T, Heiss G. The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology. 1997;16(3):149–162. [PubMed]
  • de Leeuw FE, de Groot JC, Achten E, Oudkerk M, Ramos LM, Heijboer R, Hofman A, Jolles J, van Gijn J, Breteler MM. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry. 2001 Jan;70(1):9–14. [PMC free article] [PubMed]
  • Vermeer Sarah E, Koudstaal Peter J, Oudkerk Matthijs, Hofman Albert, Breteler Monique M B. Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke. 2002 Jan;33(1):21–25. [PubMed]
  • de Groot JC, de Leeuw FE, Oudkerk M, van Gijn J, Hofman A, Jolles J, Breteler MM. Cerebral white matter lesions and cognitive function: the Rotterdam Scan Study. Ann Neurol. 2000 Feb;47(2):145–151. [PubMed]
  • Kuller LH, Shemanski L, Manolio T, Haan M, Fried L, Bryan N, Burke GL, Tracy R, Bhadelia R. Relationship between ApoE, MRI findings, and cognitive function in the Cardiovascular Health Study. Stroke. 1998 Feb;29(2):388–398. [PubMed]
  • van Gijn J. Leukoaraiosis and vascular dementia. Neurology. 1998 Sep;51(3 Suppl 3):S3–S8. [PubMed]
  • Pantoni L, Garcia JH. Pathogenesis of leukoaraiosis: a review. Stroke. 1997 Mar;28(3):652–659. [PubMed]
  • Miyamoto O, Auer RN. Hypoxia, hyperoxia, ischemia, and brain necrosis. Neurology. 2000 Jan 25;54(2):362–371. [PubMed]
  • Soriano JB, Maier WC, Egger P, Visick G, Thakrar B, Sykes J, Pride NB. Recent trends in physician diagnosed COPD in women and men in the UK. Thorax. 2000 Sep;55(9):789–794. [PMC free article] [PubMed]
  • Lange P, Groth S, Nyboe J, Appleyard M, Mortensen J, Jensen G, Schnohr P. Chronic obstructive lung disease in Copenhagen: cross-sectional epidemiological aspects. J Intern Med. 1989 Jul;226(1):25–32. [PubMed]
  • Lacasse Y, Brooks D, Goldstein RS. Trends in the epidemiology of COPD in Canada, 1980 to 1995. COPD and Rehabilitation Committee of the Canadian Thoracic Society. Chest. 1999 Aug;116(2):306–313. [PubMed]
  • Peña VS, Miravitlles M, Gabriel R, Jiménez-Ruiz CA, Villasante C, Masa JF, Viejo JL, Fernández-Fau L. Geographic variations in prevalence and underdiagnosis of COPD: results of the IBERPOC multicentre epidemiological study. Chest. 2000 Oct;118(4):981–989. [PubMed]
  • Chaouat A, Weitzenblum E, Kessler R, Schott R, Charpentier C, Levi-Valensi P, Zielinski J, Delaunois L, Cornudella R, Moutinho dos Santos J. Outcome of COPD patients with mild daytime hypoxaemia with or without sleep-related oxygen desaturation. Eur Respir J. 2001 May;17(5):848–855. [PubMed]
  • Plywaczewski R, Sliwinski P, Nowinski A, Kaminski D, Zieliński J. Incidence of nocturnal desaturation while breathing oxygen in COPD patients undergoing long-term oxygen therapy. Chest. 2000 Mar;117(3):679–683. [PubMed]
  • Coffee and cholesterol. N Engl J Med. 1983 Nov 17;309(20):1248–1250. [PubMed]
  • Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991 Jul;7(4):403–422. [PubMed]
  • de Bruyne MC, Kors JA, Hoes AW, Kruijssen DA, Deckers JW, Grosfeld M, van Herpen G, Grobbee DE, van Bemmel JH. Diagnostic interpretation of electrocardiograms in population-based research: computer program research physicians, or cardiologists? J Clin Epidemiol. 1997 Aug;50(8):947–952. [PubMed]
  • Brittin GM, Brecher G, Johnson CA. Evaluation of the Coulter Counter Model S. Am J Clin Pathol. 1969 Dec;52(6):679–689. [PubMed]
  • de Leeuw FE, de Groot JC, Oudkerk M, Witteman JC, Hofman A, van Gijn J, Breteler MM. A follow-up study of blood pressure and cerebral white matter lesions. Ann Neurol. 1999 Dec;46(6):827–833. [PubMed]
  • Yelderman M, New W., Jr Evaluation of pulse oximetry. Anesthesiology. 1983 Oct;59(4):349–352. [PubMed]
  • Severinghaus JW, Kelleher JF. Recent developments in pulse oximetry. Anesthesiology. 1992 Jun;76(6):1018–1038. [PubMed]
  • Pearigen P, Gwinn R, Simon RP. The effects in vivo of hypoxia on brain injury. Brain Res. 1996 Jul 1;725(2):184–191. [PubMed]
  • Simon RP. Hypoxia versus ischemia. Neurology. 1999 Jan 1;52(1):7–8. [PubMed]
  • Cohen PJ, Alexander SC, Smith TC, Reivich M, Wollman H. Effects of hypoxia and normocarbia on cerebral blood flow and metabolism in conscious man. J Appl Physiol. 1967 Aug;23(2):183–189. [PubMed]
  • De Reuck J. The human periventricular arterial blood supply and the anatomy of cerebral infarctions. Eur Neurol. 1971;5(6):321–334. [PubMed]
  • De Reuck J, Santens P, Strijckmans K, Lemahieu I. Cobalt-55 positron emission tomography in vascular dementia: significance of white matter changes. J Neurol Sci. 2001 Dec 15;193(1):1–6. [PubMed]
  • Meguro K, Hatazawa J, Yamaguchi T, Itoh M, Matsuzawa T, Ono S, Miyazawa H, Hishinuma T, Yanai K, Sekita Y, et al. Cerebral circulation and oxygen metabolism associated with subclinical periventricular hyperintensity as shown by magnetic resonance imaging. Ann Neurol. 1990 Sep;28(3):378–383. [PubMed]
  • Markus HS, Lythgoe DJ, Ostegaard L, O'Sullivan M, Williams SC. Reduced cerebral blood flow in white matter in ischaemic leukoaraiosis demonstrated using quantitative exogenous contrast based perfusion MRI. J Neurol Neurosurg Psychiatry. 2000 Jul;69(1):48–53. [PMC free article] [PubMed]
  • Bakker SL, de Leeuw FE, de Groot JC, Hofman A, Koudstaal PJ, Breteler MM. Cerebral vasomotor reactivity and cerebral white matter lesions in the elderly. Neurology. 1999 Feb;52(3):578–583. [PubMed]
  • De Reuck J, Decoo D, Hasenbroekx MC, Lamont B, Santens P, Goethals P, Strijckmans K, Lemahieu I. Acetazolamide vasoreactivity in vascular dementia: a positron emission tomographic study. Eur Neurol. 1999 Jan;41(1):31–36. [PubMed]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Compound
    PubChem Compound links
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...