White matter hyperintensities classified according to intensity and spatial location reveal specific associations with cognitive performance

Melazzini, L., Mackay, C. E., Bordin, V., Suri, S., Zsoldos, E., Filippini, N., Mahmood, A., Sundaresan, V., Codari, M., Duff, E., Singh-Manoux, A., Kivimäki, M., Ebmeier, K. P., Jenkinson, M., Sardanelli, F., Griffanti, L.  (2021). NeuroImage: Clinical


White matter hyperintensities (WMHs) on T2-weighted  images are radiological  signs  of cerebral small vessel disease. As their total volume is variably associated with cognition, a new approach that integrates multiple radiological criteriais warranted. Location may matter, as  periventricular WMHs have  been  shown  to  be associated  with  cognitive  impairments. WMHs that appear as hypointense in T1-weighted images (T1w) may also indicate the most severe component of WMHs. We developed an automatic method that classifies WMHs into four categories (periventricular/deep and T1w-hypointense/nonT1w-hypointense) using MRI data from 684 community-dwelling older adults from the Whitehall II study. To test if location and intensity information can impact cognition, we derived two general linear models using either overall  or  subdivided  volumes.Results showed that periventricular  T1w-hypointense WMHs were significantly associated with poorer performance in several cognitive tests. We found no association between total WMH volume and cognition. These findings suggest that classifying WMHs according to both location and intensity in T1w adds value over and above total WMH volume.

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Tags: Aging, cerebral small vessel diseases, cognition, magnetic resonance imaging, white matter
Published Aug. 12, 2020 3:07 PM - Last modified Mar. 17, 2021 2:22 PM