Toward MRI‐based whole‐brain health assessment: The brain atrophy and lesion index (BALI)

Abstract

There have been many attempts to assess the elements of age-and dementia-related neurodegenerative changes in the brain using MRI; however, traditionally assessments focus only on single deficit. Over the past few years, our group has worked to create and validate the Brain Atrophy and Lesion Index (BALI) as an MRI-based whole-brain structural degeneration rating scale. The BALI can be used for applications in aging and dementia across the entire brain and can be applied to common clinical MR images. As a whole-brain structural health assessment, the BALI gives a more representative picture of how the brain ages. During the aging process, multiple elements of degeneration accumulate and interact to overwhelm repair processes and cause high-level failure in the function of the brain. To reflect this process, the BALI combines the assessment of several neurodegeneration changes into one scale. The BALI evaluation can be performed quickly and has been validated for use by nonneuroradiology expert raters trained with the method. This review gives a brief overview of the content of the BALI; covers the development, refinement, and application of the method; and provides insights about future development and clinical implementation of MRI-based whole-brain health assessment in aging and dementia. K E Y W O R D SAlzheimer's disease, brain aging, brain atrophy and lesion index, dementia, magnetic resonance imaging 1 | INTRODUCTION As we age, structural degeneration occurs throughout the brain.These degenerative changes are nearly inescapable; they are seen in normal aging, and with increased severity in individuals with dementia and cognitive decline. 1-4 Some of these, such as atrophy and white matter lesions, are well recognized as markers of cognitive decline and dementia, 5,6 and others, such as dilated perivascular spaces and microvascular changes, have received less attention. 1 While most literature has focused on evaluating the impact of each of these changes, a number of studies have noted that certain changes are more likely to occur in tandem and can combine to increase the risk of cognitive decline and dementia. 7-10 This makes intuitive sense. As a complex and interconnected system, the activities of the brain can be disrupted not only by a large insult, but also by diffuse damage from multiple smaller deficits across subsystems. While the individual effect of each of these small changes may be minor, their combined impact can cumulate to produce negative outcomes in the higherlevel functions of the brain. While research has pointed to this cumulative impact of small changes on general health, 11 a standardized methodology for assessing neurodegenerative changes across the entire brain is yet to be established.Even though it has not been extensively utilized to address this specific problem, magnetic resonance imaging (MRI) is a superb ---This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provide...

Multimodal dementia identification using lifestyle and brain lesions, a machine learning approach

“…Specifically, the presence and severity of gray matter lesions and subcortical dilated perivascular spaces (GM-SV), deep white matter lesions (DWM), periventricular white matter lesions (PV), lesions in the basal ganglia and surrounding areas (BG), infratentorial lesions and atrophy (IT), global atrophy (GA), and microhemorrhages (MH) were evaluated. 41,42 Diffusion tensor imaging (DTI) data were acquired from nine major white matter tracts known to be implicated in cognitive function and neurodegenerative disorders. Specifically, DTI measurements were obtained from the left and right arcuate fasciculi, the frontal-parietal portions of the left and right cingulum bundles, the left and right superior longitudinal fasciculi, and the genu, body, and splenium of the corpus callosum.…”

Untitled

“…Наукові дослідження діабетичних церебральних васкулопатій із застосуванням високопольної МРТ із дифузійними послідовностями сконцентровані переважно на візуалізації лакунарних інфарктів, мікрокрововиливів та інсультів [4,[8][9][10]. Коліно мозолястого тіла 0,508 ± 0,020 0,467 ± 0,032 0,500 ± 0,023 0,284 0,794 0,373 Семіовальні центри ПП 0,471 ± 0,023 0,290 ± 0,026 0,387 ± 0,034 0,000 0,047 0,028 ЛП 0,469 ± 0,019 0,286 ± 0,031 0,389 ± 0,029 0,000 0,027 0,019…”

“…Разом з тим, сучасна магнітно-резонансна томографія (МРТ) володіє ефективними технологіями ранньої діагно стики церебральних мікроангіопатій, які за схо жістю променевої семіотики об'єднані під загальною назвою: «хвороба малих судин» (ХМС, Small Vessel Disease -SVD) [2,6]. До певної міри диференціальна діагностика різних за походженням та патогенезом захворювань здійснюється за бальною системою із застосуванням напівкількісних шкал [6][7][8]. Перші опубліковані результати провадження дифузійних послідовностей МРТ (дифузійно-зважена -DWI; дифузійно-тензорна -DTI) свідчать про їх високу специфічність щодо оцінки мікроструктурних змін білої речовини головного мозку (БРГМ), яка через особливості кровопостачання зазнає найбільших пошкоджень при ХМС [4,5,[8][9][10].…”

Age-Related Whole-Brain Structural Changes in Relation to Cardiovascular Risks Across the Adult Age Spectrum

“…The Brain Atrophy and Lesion Index (BALI) has been developed to summarize several common structural changes in the brain (Zhang et al, 2011; Guo et al, 2014a,b; Grajauskas et al, 2018). These include gray matter lesions and subcortical dilated perivascular spaces, periventricular and white matter lesions, lesions in the basal ganglia and surrounding areas, lesions in the infratentorial compartment, and global atrophy (GA).…”