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

Ahmed A. Bahrani, Charles D. Smith, Justin M. Barber, Omar M. Al-Janabi, David K. Powell, Anders H. Andersen, Brandon D. Ramey, Erin L. Abner, Larry B. Goldstein, Zachary Winder, Brian T. Gold, Linda Van Eldik, Donna M. Wilcock, Gregory A. Jicha

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish
Article number109270
JournalJournal of Neuroscience Methods
Volume360
DOIs
StatePublished - Aug 1 2021

Bibliographical note

Funding Information:
This study was funded by NIH P30 AG028383 , UH2 NS100606 , and R01 AG042419 .

Publisher Copyright:
© 2021 Elsevier B.V.

Keywords

  • Aging
  • Cerebrovascular disease
  • Dementia
  • Longitudinal
  • Small vessel ischemic disease
  • White matter hyperintensity

ASJC Scopus subject areas

  • Neuroscience (all)

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