A Novel Imaging Marker for Small Vessel Disease Based on Skeletonization of White Matter Tracts and Diffusion Histograms

磁共振弥散成像 白质 磁共振成像 神经影像学 骨骼化 高强度 病理 医学 放射科 解剖 精神科
作者
Ebru Baykara,Benno Gesierich,Ruth Adam,Anil M. Tuladhar,J. Matthijs Biesbroek,Huiberdina L. Koek,Stefan Ropele,Éric Jouvent,Hugues Chabriat,Birgit Ertl‐Wagner,Michael Ewers,Reinhold Schmidt,Frank‐Erik de Leeuw,Geert Jan Biessels,Martin Dichgans,Marco Duering
出处
期刊:Annals of Neurology [Wiley]
卷期号:80 (4): 581-592 被引量:279
标识
DOI:10.1002/ana.24758
摘要

Objective To establish a fully automated, robust imaging marker for cerebral small vessel disease (SVD) and related cognitive impairment that is easy to implement, reflects disease burden, and is strongly associated with processing speed, the predominantly affected cognitive domain in SVD. Methods We developed a novel magnetic resonance imaging marker based on diffusion tensor imaging, skeletonization of white matter tracts, and histogram analysis. The marker (peak width of skeletonized mean diffusivity [PSMD]) was assessed along with conventional SVD imaging markers. We first evaluated associations with processing speed in patients with genetically defined SVD (n = 113). Next, we validated our findings in independent samples of inherited SVD (n = 57), sporadic SVD (n = 444), and memory clinic patients with SVD (n = 105). The new marker was further applied to healthy controls (n = 241) and to patients with Alzheimer's disease (n = 153). We further conducted a longitudinal analysis and interscanner reproducibility study. Results PSMD was associated with processing speed in all study samples with SVD (p‐values between 2.8 × 10 −3 and 1.8 × 10 −10 ). PSMD explained most of the variance in processing speed ( R 2 ranging from 8.8% to 46%) and consistently outperformed conventional imaging markers (white matter hyperintensity volume, lacune volume, and brain volume) in multiple regression analyses. Increases in PSMD were linked to vascular but not to neurodegenerative disease. In longitudinal analysis, PSMD captured SVD progression better than other imaging markers. Interpretation PSMD is a new, fully automated, and robust imaging marker for SVD. PSMD can easily be applied to large samples and may be of great utility for both research studies and clinical use. Ann Neurol 2016;80:581–592.
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