Shades of white: diffusion properties of T1- and FLAIR-defined white matter signal abnormalities differ in stages from cognitively normal to dementia

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The underlying pathology of white matter signal abnormalities (WMSAs) is heterogeneous and may vary dependent on the magnetic resonance imaging contrast used to define them. We investigated differences in white matter diffusivity as an indicator for white matter integrity underlying WMSA based on T1-weighted and fluid-attenuated inversion recovery (FLAIR) imaging contrast. In addition, we investigated which white matter region of interest (ROI) could predict clinical diagnosis best using diffusion metrics. One hundred three older individuals with varying cognitive impairment levels were included and underwent neuroimaging. Diffusion metrics were extracted from WMSA areas based on T1 and FLAIR contrast and from their overlapping areas, the border surrounding the WMSA and the normal-appearing white matter (NAWM). Regional diffusivity differences were calculated with linear mixed effects models. Multinomial logistic regression determined which ROI diffusion values classified individuals best into clinically defined diagnostic groups. T1-based WMSA showed lower white matter integrity compared to FLAIR WMSA-defined regions. Diffusion values of NAWM predicted diagnostic group best compared to other ROI's. To conclude, T1- or FLAIR-defined WMSA provides distinct information on the underlying white matter integrity associated with cognitive decline. Importantly, not the "diseased" but the NAWM is a potentially sensitive indicator for cognitive brain health status.

Original languageEnglish
Pages (from-to)48-58
Number of pages11
JournalNeurobiology of Aging
Volume68
Early online date5 Apr 2018
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Journal Article
  • SURFACE-BASED ANALYSIS
  • CORTICAL SURFACE
  • SMALL VESSEL DISEASE
  • MULTIPLE-SCLEROSIS LESIONS
  • MRI
  • MAGNETIC-RESONANCE IMAGES
  • White matter hyper intensities
  • TEMPORAL-LOBE ATROPHY
  • ALZHEIMERS ASSOCIATION WORKGROUPS
  • White matter
  • Diffusion tensor imaging
  • PARTICIPANTS AGED 24-81
  • HUMAN CEREBRAL-CORTEX
  • Aging
  • Alzheimer's disease
  • AGING BRAIN
  • Neuroimaging
  • Humans
  • Middle Aged
  • Male
  • Cognition
  • White Matter/diagnostic imaging
  • Cognitive Aging/physiology
  • Aged, 80 and over
  • Female
  • Alzheimer Disease/diagnostic imaging
  • Severity of Illness Index
  • Disease Progression
  • Dementia/diagnostic imaging
  • Diffusion Magnetic Resonance Imaging
  • Aged
  • Cognitive Dysfunction/diagnostic imaging

Cite this

@article{b1c07362a46f4b6c89dd2d9056d49be6,
title = "Shades of white: diffusion properties of T1- and FLAIR-defined white matter signal abnormalities differ in stages from cognitively normal to dementia",
abstract = "The underlying pathology of white matter signal abnormalities (WMSAs) is heterogeneous and may vary dependent on the magnetic resonance imaging contrast used to define them. We investigated differences in white matter diffusivity as an indicator for white matter integrity underlying WMSA based on T1-weighted and fluid-attenuated inversion recovery (FLAIR) imaging contrast. In addition, we investigated which white matter region of interest (ROI) could predict clinical diagnosis best using diffusion metrics. One hundred three older individuals with varying cognitive impairment levels were included and underwent neuroimaging. Diffusion metrics were extracted from WMSA areas based on T1 and FLAIR contrast and from their overlapping areas, the border surrounding the WMSA and the normal-appearing white matter (NAWM). Regional diffusivity differences were calculated with linear mixed effects models. Multinomial logistic regression determined which ROI diffusion values classified individuals best into clinically defined diagnostic groups. T1-based WMSA showed lower white matter integrity compared to FLAIR WMSA-defined regions. Diffusion values of NAWM predicted diagnostic group best compared to other ROI's. To conclude, T1- or FLAIR-defined WMSA provides distinct information on the underlying white matter integrity associated with cognitive decline. Importantly, not the {"}diseased{"} but the NAWM is a potentially sensitive indicator for cognitive brain health status.",
keywords = "Journal Article, SURFACE-BASED ANALYSIS, CORTICAL SURFACE, SMALL VESSEL DISEASE, MULTIPLE-SCLEROSIS LESIONS, MRI, MAGNETIC-RESONANCE IMAGES, White matter hyper intensities, TEMPORAL-LOBE ATROPHY, ALZHEIMERS ASSOCIATION WORKGROUPS, White matter, Diffusion tensor imaging, PARTICIPANTS AGED 24-81, HUMAN CEREBRAL-CORTEX, Aging, Alzheimer's disease, AGING BRAIN, Neuroimaging, Humans, Middle Aged, Male, Cognition, White Matter/diagnostic imaging, Cognitive Aging/physiology, Aged, 80 and over, Female, Alzheimer Disease/diagnostic imaging, Severity of Illness Index, Disease Progression, Dementia/diagnostic imaging, Diffusion Magnetic Resonance Imaging, Aged, Cognitive Dysfunction/diagnostic imaging",
author = "Riphagen, {Joost M.} and Gronenschild, {Ed H.B.M.} and Salat, {David H.} and Freeze, {Whitney M.} and Dimo Ivanov and Lies Clerx and Verhey, {Frans R. J.} and Pauline Aalten and Jacobs, {Heidi I. L.}",
note = "Copyright {\circledC} 2018 The Authors. Published by Elsevier Inc. All rights reserved.",
year = "2018",
month = "8",
doi = "10.1016/j.neurobiolaging.2018.03.029",
language = "English",
volume = "68",
pages = "48--58",
journal = "Neurobiology of Aging",
issn = "0197-4580",
publisher = "Elsevier Science",

}

TY - JOUR

T1 - Shades of white

T2 - diffusion properties of T1- and FLAIR-defined white matter signal abnormalities differ in stages from cognitively normal to dementia

AU - Riphagen, Joost M.

AU - Gronenschild, Ed H.B.M.

AU - Salat, David H.

AU - Freeze, Whitney M.

AU - Ivanov, Dimo

AU - Clerx, Lies

AU - Verhey, Frans R. J.

AU - Aalten, Pauline

AU - Jacobs, Heidi I. L.

N1 - Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2018/8

Y1 - 2018/8

N2 - The underlying pathology of white matter signal abnormalities (WMSAs) is heterogeneous and may vary dependent on the magnetic resonance imaging contrast used to define them. We investigated differences in white matter diffusivity as an indicator for white matter integrity underlying WMSA based on T1-weighted and fluid-attenuated inversion recovery (FLAIR) imaging contrast. In addition, we investigated which white matter region of interest (ROI) could predict clinical diagnosis best using diffusion metrics. One hundred three older individuals with varying cognitive impairment levels were included and underwent neuroimaging. Diffusion metrics were extracted from WMSA areas based on T1 and FLAIR contrast and from their overlapping areas, the border surrounding the WMSA and the normal-appearing white matter (NAWM). Regional diffusivity differences were calculated with linear mixed effects models. Multinomial logistic regression determined which ROI diffusion values classified individuals best into clinically defined diagnostic groups. T1-based WMSA showed lower white matter integrity compared to FLAIR WMSA-defined regions. Diffusion values of NAWM predicted diagnostic group best compared to other ROI's. To conclude, T1- or FLAIR-defined WMSA provides distinct information on the underlying white matter integrity associated with cognitive decline. Importantly, not the "diseased" but the NAWM is a potentially sensitive indicator for cognitive brain health status.

AB - The underlying pathology of white matter signal abnormalities (WMSAs) is heterogeneous and may vary dependent on the magnetic resonance imaging contrast used to define them. We investigated differences in white matter diffusivity as an indicator for white matter integrity underlying WMSA based on T1-weighted and fluid-attenuated inversion recovery (FLAIR) imaging contrast. In addition, we investigated which white matter region of interest (ROI) could predict clinical diagnosis best using diffusion metrics. One hundred three older individuals with varying cognitive impairment levels were included and underwent neuroimaging. Diffusion metrics were extracted from WMSA areas based on T1 and FLAIR contrast and from their overlapping areas, the border surrounding the WMSA and the normal-appearing white matter (NAWM). Regional diffusivity differences were calculated with linear mixed effects models. Multinomial logistic regression determined which ROI diffusion values classified individuals best into clinically defined diagnostic groups. T1-based WMSA showed lower white matter integrity compared to FLAIR WMSA-defined regions. Diffusion values of NAWM predicted diagnostic group best compared to other ROI's. To conclude, T1- or FLAIR-defined WMSA provides distinct information on the underlying white matter integrity associated with cognitive decline. Importantly, not the "diseased" but the NAWM is a potentially sensitive indicator for cognitive brain health status.

KW - Journal Article

KW - SURFACE-BASED ANALYSIS

KW - CORTICAL SURFACE

KW - SMALL VESSEL DISEASE

KW - MULTIPLE-SCLEROSIS LESIONS

KW - MRI

KW - MAGNETIC-RESONANCE IMAGES

KW - White matter hyper intensities

KW - TEMPORAL-LOBE ATROPHY

KW - ALZHEIMERS ASSOCIATION WORKGROUPS

KW - White matter

KW - Diffusion tensor imaging

KW - PARTICIPANTS AGED 24-81

KW - HUMAN CEREBRAL-CORTEX

KW - Aging

KW - Alzheimer's disease

KW - AGING BRAIN

KW - Neuroimaging

KW - Humans

KW - Middle Aged

KW - Male

KW - Cognition

KW - White Matter/diagnostic imaging

KW - Cognitive Aging/physiology

KW - Aged, 80 and over

KW - Female

KW - Alzheimer Disease/diagnostic imaging

KW - Severity of Illness Index

KW - Disease Progression

KW - Dementia/diagnostic imaging

KW - Diffusion Magnetic Resonance Imaging

KW - Aged

KW - Cognitive Dysfunction/diagnostic imaging

U2 - 10.1016/j.neurobiolaging.2018.03.029

DO - 10.1016/j.neurobiolaging.2018.03.029

M3 - Article

C2 - 29704648

VL - 68

SP - 48

EP - 58

JO - Neurobiology of Aging

JF - Neurobiology of Aging

SN - 0197-4580

ER -