Development of a protocol to assess within-subject, regional white matter hyperintensity changes in aging and dementia.

Journal Article (Journal Article)

BACKGROUND: White matter hyperintensities (WMH), associated with both dementia risk and progression, can individually progress, remain stable, or even regress influencing cognitive decline related to specific cerebrovascular-risks. This study details the development and validation of a registration protocol to assess regional, within-subject, longitudinal WMH changes (ΔWMH) that is currently lacking in the field. NEW METHOD: 3D-FLAIR images (baseline and one-year-visit) were used for protocol development and validation. The method was validated by assessing the correlation between forward and reverse longitudinal registration, and between summated regional progression-regression volumes and Global ΔWMH. The clinical relevance of growth-regression ΔWMH were explored in relation to an executive function test. RESULTS: MRI scans for 79 participants (73.5 ± 8.8 years) were used in this study. Global ΔWMH vs. summated regional progression-regression volumes were highly associated (r2 = 0.90; p-value < 0.001). Bi-directional registration validated the registration method (r2 = 0.999; p-value < 0.001). Growth and regression, but not overall ΔWMH, were associated with one-year declines in performance on Trial-Making-Test-B. COMPARISON WITH EXISTING METHOD(S): This method presents a unique registration protocol for maximum tissue alignment, demonstrating three distinct patterns of longitudinal within-subject ΔWMH (stable, growth and regression). CONCLUSIONS: These data detail the development and validation of a registration protocol for use in assessing within-subject, voxel-level alterations in WMH volume. The methods developed for registration and intensity correction of longitudinal within-subject FLAIR images allow regional and within-lesion characterization of longitudinal ΔWMH. Assessing the impact of associated cerebrovascular-risks and longitudinal clinical changes in relation to dynamic regional ΔWMH is needed in future studies.

Full Text

Duke Authors

Cited Authors

  • Bahrani, AA; Smith, CD; Barber, JM; Al-Janabi, OM; Powell, DK; Andersen, AH; Ramey, BD; Abner, EL; Goldstein, LB; Winder, Z; Gold, BT; Van Eldik, L; Wilcock, DM; Jicha, GA

Published Date

  • August 1, 2021

Published In

Volume / Issue

  • 360 /

Start / End Page

  • 109270 -

PubMed ID

  • 34171312

Pubmed Central ID

  • PMC8513808

Electronic International Standard Serial Number (EISSN)

  • 1872-678X

Digital Object Identifier (DOI)

  • 10.1016/j.jneumeth.2021.109270


  • eng

Conference Location

  • Netherlands