Mathematical modeling for the prediction of cerebral white matter lesions based on clinical examination data

Abstract

Cerebral white matter lesions are ischemic symptoms caused mainly by microangiopathy; they are diagnosed by MRI because they show up as abnormalities in MRI images. Because patients with white matter lesions do not have any symptoms, MRI often detects the lesions for the first time. Generally, head MRI for the diagnosis and grading of cerebral white matter lesions is performed as an option during medical checkups in Japan. In this study, we develop a mathematical model for the prediction of white matter lesions using data from routine medical evaluations that do not include a head MRI. Linear discriminant analysis, logistic discrimination, Naive Bayes classifier, support vector machine, and random forest were investigated and evaluated by ten-fold cross-validation, using clinical data for 1,904 examinees (988 males and 916 females) from medical checkups that did include the head MRI. The logistic regression model was selected based on a comparison of accuracy and interpretability. The model variables consisted of age, gender, plaque score (PS), LDL, systolic blood pressure (SBP), and administration of antihypertensive medication (odds ratios: 2.99, 1.57, 1.18, 1.06, 1.12, and 1.52, respectively) and showed Areas Under the ROC Curve (AUC) 0.805, the model displayed sensitivity of 72.0%, and specificity 75.1% when the most appropriate cutoff value was used, 0.579 as given by the Youden Index. This model has shown to be useful to identify patients with a high-risk of cerebral white matter lesions, who can then be diagnosed with a head MRI examination in order to prevent dementia, cerebral infarction, and stroke.

Association of Carotid Atherosclerosis With White Matter Hyperintensity in an Asymptomatic Japanese Population: A Cross-Sectional Study

“…Our research was undertaken via Shinkawa et al's findings ( 12 ). Their cross-sectional study involved a comprehensive medical checkup of 1,904 asymptomatic participants, including 988 men and 916 women, who were admitted to Shin Takeo Hospital between April 1, 2016, and October 31, 2017, some patients underwent head MRI, blood tests and carotid ultrasonography, and completed standard questionnaires all within this period.…”

“…Exclusion of subjects was undertaken on the basis of criteria outlined below: presence of (1) a number of devices frequently utilized surgically; (2) a psychiatry-dependent disease; (3) paralysis or a history of stroke, traumatic brain injuries, and other definitive encephalopathies; and (4) poorly recorded carotid ultrasonograms precluding measurement; (5) subjects who were unintended to cooperate. Procedures related to consent to participate and confirming the protocol were detailed in the native manuscript ( 12 ).…”

“…As described previously ( 12 ), it was attempted to extract data outlined below: smoking habits (smoking >100 cigarettes or subsequent smoking for 6 months as well as attempting to smoke in the recent 1 month; drinking status (rarely, sometimes, and daily); and drinking volume (with respect to quantify the consumption of alcoholic beverage/day) in form of <180, 180–360, 360–540 or >540 mL. Hypertension was defined as SBP >140 or DBP > 90 mmHg (or both) on at least two diverse conditions.…”

Sex Differences In The Association Between Hemoglobin A1c And Cerebral White Matter Lesions In The General Japanese Population

“…Shinkawa Yuya et al completed the entire study. The speci c details are described in the original report by Shinkawa Yuya 24 . Participant data were nonselectively and consecutively collected from subjects who underwent brain MRI and blood tests during the brain dock course of a comprehensive medical checkup some time between April 1, 2016, and October 31, 2017, at Shin Takeo Hospital.…”

“…In this study, a secondary data analysis was performed using existing data from a published paper 24 . In the secondary analysis, the independent variable and dependent variable were HbA1c level and cerebral WMLs, respectively.…”