Assessment of Brain Deep White Matter Hyperintensities in Smokers in Azerbaijan

Lala Guluzade1,2, Prof. Malakhat Sultanova1, Kamran Yakubov 3, PHD Hasan Isayev 2, Aygul Nadirova 4, Ulviyya Ismayılova 5

1 Azerbaijan Medical University Educational-Surgical Clinic
2 Zafaran hospital, Baku, Azerbaijan
3 Central Clinic Hospital, Baku, Azerbaijan
4 Baku Health Center
5 Sahhat German-Azerbaijani Medical center, Baku, Azerbaijan

Abstract. Bacground: T2 hyperintense foci (white matter hyperintensities) are seen in the white matter of the brain on magnetic resonance imaging (MRI) in smokers. The aim of the study is to reveal the relationship, number and size of these white matter hyperintensities with smoking in Azerbaijani smoking men and to compare them with the control group. Materials and Methods: Total of 120 patients between 37 and 70 years were included in this study. The mean age was 50,2±0,8. Eighty(80) of the patients were smokers and 40 of them was healthy individuals. In our study we exam the location(according to the brain lobes), size and frequency of T2 hyperintense foci on MRI. We used 1.5-Tesla Magnetom Aera MRI equipment and images obtained with T2 turbo inversion recovery magnitude (TIRM) sequences. MRI images were obtained using TR-9200, TI 2450, TE 84 and 3.5 mm slice thickness, and 10% interslice gap. Results: The mean age of the smokers was 50,7±1,0 (37-70) years. The mean age of the healthy individuals was 49±1,1(39-62) (Pu=0,556). WMH was not found in 21(52,5%) patient from 40 healthy individuals. The average number of WMH detected in 47.5%(19) of patients was 3.2±0,8 (min0-max20) and the average size was 1.9±0,1 mm (min1.5-max 2.5). According to the measurements and numbers performed on 80 smokers included in the study, the average number of WMHs was 8.8±1,5(min0-max70) and the average size was 2.3±1,0 mm(min1.5-max6). At the same time, WMHs were not observed in 28 (35,0%) smokers. It was found that the number of WMH in smokers was higher than in control group-healthy individuals(Pu=0,025). But the size of WMH in smokers was not differ so much than in healthy individuals(Pu=0,459). Conclusion: An increase in the number of white matter hyperintensities in the brain was found in smoking men in Azerbaijan compared to the healthy individuals. There was no significant difference in the statistically correct correlation (in the number and size of the WMH) between those who had smoked for longer years-50 years and those who had smoked the least-15 years. The number of WMH increases with age, regardless of whether the patient smokes or not.

Key words: MRI, white matter hyperintensities, smoking

Download.PDF (eng)

Для цитування:

  1. Guluzade, L. Assessment of Brain Deep White Matter Hyperintensities in Smokers in Azerbaijan / L. Guluzade, M. Sultanova, K. Yakubov, H. Isayev, A. Nadirova, U. Ismayılova // Східноєвропейський журнал внутрішньої та сімейної медицини. – 2022. – № 2. – С. 25-31. doi: 15407/internalmed2022.02.025
  2. Guluzade L, Sultanova M, Yakubov K, Isayev H, Nadirova A, Ismayılova U. [Assessment of Brain Deep White Matter Hyperintensities in Smokers in Ukraine]. Shidnoevr. z. vnutr. simejnoi med. 2022;2:25-31. doi: 10.15407/internalmed2022.02.025


  1. Wang S, Zhang R, Deng Y, Chen K, Xiao D, Peng P, Jiang T. Discrimination of smoking status by MRI based on deep learning method. Quantitative Imaging in Medicine and Surgery. 2018;8(11):1113-1120.
  2. Peng P, Li M, Liu H, Tian Y, Chu S, Van Halm-Lutterodt N, Jing B, Jiang T. Brain Structure Alterations in Respect to Tobacco Consumption and Nicotine Dependence: A Comparative Voxel-Based Morphometry Study. Frontiers in Neuroanatomy. 2018;12:.
  3. Altermatt A, Gaetano L, Magon S, Bauer L, Feurer R, Gnahn H, Hartmann J, Seifert C, Poppert H, Wuerfel J, Radue E, Kappos L, Sprenger T. Clinical associations of T2-weighted lesion load and lesion location in small vessel disease: Insights from a large prospective cohort study. NeuroImage. 2019;189:727-733.
  4. Wardlaw J, Valdés Hernández M, Muñoz‐Maniega S. What are White Matter Hyperintensities Made of?. Journal of the American Heart Association. 2015;4(6):.
  5. Weinberger A, Platt J, Esan H, Galea S, Erlich D, Goodwin R. Cigarette Smoking Is Associated With Increased Risk of Substance Use Disorder Relapse. The Journal of Clinical Psychiatry. 2017;78(02):e152-e160.
  6. Jørgensen K, Psychol C, Skjærvø I, Mørch-Johnsen L, Haukvik U, Lange E, Melle I, Andreassen O, Agartz I. Cigarette smoking is associated with thinner cingulate and insular cortices in patients with severe mental illness. Journal of Psychiatry and Neuroscience. 2015;40(4):241-249.
  7. Yuan C, Morales-Oyarvide V, Babic A, Clish C, Kraft P, Bao Y, Qian Z, Rubinson D, Ng K, Giovannucci E, Ogino S, Stampfer M, Gaziano J, Sesso H, Cochrane B, Manson J, Fuchs C, Wolpin B. Cigarette Smoking and Pancreatic Cancer Survival. Journal of Clinical Oncology. 2017;35(16):1822-1828.
  8. Bailey E, Smith C, Sudlow C, Wardlaw J. Pathology of Lacunar Ischemic Stroke in Humans-A Systematic Review. Brain Pathology. 2012;22(5):583-591.
  9. Peterson L, Hecht S. Tobacco, E-Cigarettes and Child Health. Curr Opin Pediatr. 2017;29(2): 225–230. DOI: 10.1097/ MOP.0000000000000456
  10. Cao R, Nosofsky R, Shiffrin R. The development of automaticity in short-term memory search: Item-response learning and category learning.. Journal of Experimental Psychology: Learning, Memory, and Cognition. 2017;43(5):669-679.
  11. Zanchi D, Brody A, Montandon M, Kopel R, Emmert K, Preti M, Van De Ville D, Haller S. Cigarette smoking leads to persistent and dose-dependent alterations of brain activity and connectivity in anterior insula and anterior cingulate. Addiction Biology. 2015;20(6):1033-1041.
  12. Dager S, Friedman S. Brain imaging and the effects of caffeine and nicotine. Annals of Medicine. 2000;32(9):592-599.
  13. Power M, Deal J, Sharrett A, Jack C, Knopman D, Mosley T, Gottesman R. Smoking and white matter hyperintensity progression: The ARIC-MRI Study. Neurology. 2015;84(8):841-848.
  14. Martinez Sosa S, Smith K. Understanding a role for hypoxia in lesion formation and location in the deep and periventricular white matter in small vessel disease and multiple sclerosis. Clinical Science. 2017;131(20):2503-2524.
  15. Rusznák K, Csekő K, Varga Z, Csabai D, Bóna Á, Mayer M, Kozma Z, Helyes Z, Czéh B. Long-Term Stress and Concomitant Marijuana Smoke Exposure Affect Physiology, Behavior and Adult Hippocampal Neurogenesis. Frontiers in Pharmacology. 2018;9:.
  16. Liu J, Claus E, Calhoun V, Hutchison K. Brain Regions Affected by Impaired Control Modulate Responses to Alcohol and Smoking Cues. Journal of Studies on Alcohol and Drugs. 2014;75(5):808-816.
  17. Power M, Deal J, Sharrett A, Jack C, Knopman D, Mosley T, Gottesman R. Smoking and white matter hyperintensity progression: The ARIC-MRI Study. Neurology. 2015;84(8):841-848.
  18. Ding X, Yang Y, Stein E, Ross T. Multivariate classification of smokers and nonsmokers using SVM‐RFE on structural MRI images. Human Brain Mapping. 2015;36(12):4869-4879.
  19. Li Y, Yuan K, Guan Y, Cheng J, Bi Y, Shi S, Xue T, Lu X, Qin W, Yu D, Tian J. The implication of salience network abnormalities in young male adult smokers. Brain Imaging and Behavior. 2016;11(4):943-953.
  20. Gray J, Thompson M, Benca-Bachman C, Owens M, Murphy M, Palmer R. Associations of cigarette smoking with gray and white matter in the UK Biobank. 2019;:.
  21. Wang C, Shen Z, Huang P, Qian W, Yu X, Sun J, Yu H, Yang Y, Zhang M. Altered spontaneous activity of posterior cingulate cortex and superior temporal gyrus are associated with a smoking cessation treatment outcome using varenicline revealed by regional homogeneity. Brain Imaging and Behavior. 2016;11(3):611-618.
  22. Topiwala A, Allan C, Valkanova V, Zsoldos E, Filippini N, Sexton C, Mahmood A, Fooks P, Singh-Manoux A, Mackay C, Kivimäki M, Ebmeier K. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ. 2017;:j2353.
  23. Viswanath H, Velasquez K, Thompson-Lake D, Savjani R, Carter A, Eagleman D, Baldwin P, De La Garza, II R, Salas R. Alterations in interhemispheric functional and anatomical connectivity are associated with tobacco smoking in humans. Frontiers in Human Neuroscience. 2015;9:.