White matter hyperintensity distribution differences in aging and neurodegenerative disease cohorts

Dadar, Mahsa; Mahmoud, Sawsan M.; Zhernovaia, Maryna; Camicioli, Richard; Maranzano, Josefina; Duchesne, Simon

doi:10.1016/j.nicl.2022.103204

Cited by 16 publications

(8 citation statements)

References 83 publications

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“…In a study of individuals with severe cerebral small vessel disease, in a younger population, single task and dual task gait performance was relatively preserved and showed little decline compared to healthy controls ( Finsterwalder et al, 2019 ). In our sample WMH increased with cognitive impairment raising the possibility of a neurodegenerative contribution to white matter changes ( Dadar et al, 2022 ). Although a positive correlation between cognitive function and gait speed under normal and dual task conditions has been shown ( Chen et al, 2021 ), the lack of effect seen when MoCA is added to the model suggests that the relationship between DTC and WMH is not solely driven by global cognitive ability.…”

Section: Discussionmentioning

confidence: 82%

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Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Fatokun

Gee

Nelles

et al. 2023

Front. Aging Neurosci.

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BackgroundParkinson’s disease (PD) and dementia with Lewy bodies (DLB) are part of a spectrum of Lewy body disorders, who exhibit a range of cognitive and gait impairments. Cognitive-motor interactions can be examined by performing a cognitive task while walking and quantified by a dual task cost (DTC). White matter hyperintensities (WMH) on magnetic resonance imaging have also been associated with both gait and cognition. Our goal was to examine the relationship between DTC and WMH in the Lewy body spectrum, hypothesizing DTC would be associated with increased WMH volume.MethodsSeventy-eight participants with PD, PD with mild cognitive impairment (PD-MCI), PD with dementia or DLB (PDD/DLB), and 20 cognitively unimpaired participants were examined in a multi-site study. Gait was measured on an electronic walkway during usual gait, counting backward, animal fluency, and subtracting sevens. WMH were quantified from magnetic resonance imaging using an automated pipeline and visual rating. A median split based on DTC was performed. Models included age as well as measures of global cognition and cardiovascular risk.ResultsCompared to cognitively unimpaired participants, usual gait speed was lower and DTC was higher in PD-MCI and PDD/DLB. Low DTC participants had higher usual gait speed. WMH burden was greater in high counting DTC participants. Frontal WMH burden remained significant after adjusting for age, cardiovascular risk and global cognition.ConclusionIncreased DTC was associated with higher frontal WMH burden in Lewy body disorders after adjusting for age, cardiovascular risk, and global cognition. Higher DTC was associated with age.

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Section: Discussionmentioning

confidence: 82%

“…Additionally, the presence and severity of WMH was rated qualitatively using Fazekas Visual Rating Scale ( Fazekas et al, 1987 ). Illustrative images and technical details are published ( Dadar et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Fatokun

Gee

Nelles

et al. 2023

Front. Aging Neurosci.

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“…Among the risk factors, WMHs are associated with aging and small vessel disease and can also be observed in a variety of other conditions. 28,29,36 However, the underlying origin of WMH remains controversial due to the complex mechanisms responsible for their appearance and pathologies. 37 Previous studies have demonstrated decreased CBF and delayed arterial transit time associated with WMH.…”

Section: Discussionmentioning

confidence: 99%

Effect of Menopause Status on Brain Perfusion Hemodynamics

Guo,

Wang,

Chen

et al. 2024

Stroke

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BACKGROUND: The menopause transition is associated with an increasing risk of cerebrovascular disorders. However, the direct effect of menopause status on brain perfusion hemodynamics remains unclear. This study aimed to explore the influence of menopause status on cerebral blood flow (CBF) using arterial spin labeling magnetic resonance imaging. METHODS: In this cross-sectional study, 185 subjects underwent arterial spin labeling magnetic resonance imaging at a hospital in China between September 2020 and December 2022, including 38 premenopausal women (mean age, 47.74±2.02 years), 42 perimenopausal women (mean age, 50.62±3.15 years), 42 postmenopausal women (mean age, 54.02±4.09 years), and 63 men (mean age, 52.70±4.33 years) of a similar age range. Mean CBF values in the whole brain, gray matter, white matter, cortical gray matter, subcortical gray matter, juxtacortical white matter, deep white matter, and periventricular white matter were extracted. ANCOVA was used to compare mean CBF among the 4 groups, controlling for confounding factors. Student t test was applied to compare mean CBF between the 3 female groups and age-matched males, respectively. Multivariable regression analysis was used to analysis the effect of age, sex, and menopause status on the CBF of the whole brain, gray matter, white matter, and subregions. RESULTS: Perimenopausal and postmenopausal women showed a higher proportion of white matter hyperintensities compared with the other 2 groups ( P <0.001). Premenopausal women exhibited higher CBF in the whole brain, gray matter, white matter, and subregions, compared with perimenopausal, postmenopausal women and men ( P ≤0.001). Multivariable regression analysis demonstrated significant effect of age and insignificant effect of sex on CBF for all participants. In addition, menopause status and the interaction between age and menopause status on CBF of whole brain, gray matter, white matter, and the subregions were observed in female participants, except for the deep and periventricular white matter regions, with premenopausal women exhibited a slight increase in CBF with age, while perimenopausal and postmenopausal women exhibited declines in CBF with age. CONCLUSIONS: The current findings suggest that alterations of brain perfusion hemodynamics begin during the perimenopause period, which may be due to the increased burden of white matter hyperintensities.

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“…The detection of small lesions is of paramount interest in the clinical and scientific fields, especially in studies focused on healthy aging or premorbid stages of pathological aging, where vascular damage is usually mild, or in longitudinal studies intended to follow the evolution of the disease from the growth of the subtle lesion. For instance, the WMH location and pattern of distribution (i.e., extent or symmetry) in the brain have been also associated with different underlying pathologies (Balakrishnan et al, 2021;Dadar et al, 2022) and with the degree of impairment for different cognitive functions (Jiménez-Balado et al, 2022). Therefore, in studies like ours, this factor is key, because most automatic segmentation tools have been optimized by maximizing Dice's sensitivity, precision, and score values.…”

Section: Individual Lesion Size Biasmentioning

confidence: 98%

Decoding the Best Automated Segmentation Tools for Vascular White Matter Hyperintensities in the Aging Brain: A Clinician’s Guide to Precision and Purpose

Torres-Simón

Cerro-León

Yus

et al. 2023

Preprint

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Cerebrovascular damage consequent to small vessel disease (SVD) is a common companion of healthy and pathological aging. Neuroimaging signatures of SVD are present in virtually all people older than 60 years, and their prevalence increases with age. According to the STRIVE criteria, white matter hyperintensities (WMH) have been associated with different clinical symptoms and constitute a good clinical proxy for SVD. This is important as WMH can be directly assessed via MRI. Currently, the most widely used method to detect and assess the severity of WMH are clinical scales based on visual assessment, but these scales do not offer real quantitative information, making it difficult to assess progression. Quantitative information can be approached through the manual segmentation of physicians, but this process is extremely time-consuming and presents a high inter and intra evaluators variability, which makes its application in routine protocols unfeasible. Therefore, it is imperative to facilitate the use of automatic protocols capable of providing WMH load measurements that are as accurate as possible to those obtained by manual segmentation. In this study, we aim to identify the most accurate software for WMH segmentation, providing not only methodological insights but also usability knowledge that would enlighten the tradeoff between clinical accuracy and real-world implementation. The data set consisted of T1 and Flair images of 45 cognitively healthy older participants (mean age 71 ± 5). The study analyzed WMH segmentations obtained with clinician manual segmentation and four tools included in three of the most widely used neuroimaging toolkits: 1) Lesion Prediction Algorithm (LPA) and Lesion Growth Algorithm (LGA) of the lesion segmentation tool (LST); 2) sequence adaptive multimodal segmentation (SAMSEG); and 3) the brain intensity anomalies classification algorithm (BIANCA). The analysis evaluated the correlations with the Fazekas clinical scale, the influence of the WMH load and evaluated the performance at the individual lesion level. The results showed that the supervised methods (LST-LPA and BIANCA) performed better in all the analyses and were the only ones capable of consistently capturing small lesions (<26 mm3). However, these tools lose performance when applied to new data. Considering the results (accuracy and ease of use), we concluded that, in the general case, the combined use of the two FSL tools emerged as the best option. We confirmed this conclusion by evaluating WMH segmentation in a dataset of 500 older individuals and found that the LPA results, using LGA to control for divergences, offered valuable and actionable clinical information, both to help clinicians make treatment decisions treatment and to monitor pathological progression.

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White matter hyperintensity distribution differences in aging and neurodegenerative disease cohorts

Cited by 16 publications

References 83 publications

Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis

Effect of Menopause Status on Brain Perfusion Hemodynamics

Decoding the Best Automated Segmentation Tools for Vascular White Matter Hyperintensities in the Aging Brain: A Clinician’s Guide to Precision and Purpose

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