Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK.
Neuroimage Clin. 2021;30:102616. doi: 10.1016/j.nicl.2021.102616. Epub 2021 Mar 7.
White matter hyperintensities (WMHs) on T-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 criteria is warranted. Location may matter, as periventricular WMHs have been shown to be associated with cognitive impairments. WMHs that appear as hypointense in T-weighted images (Tw) may also indicate the most severe component of WMHs. We developed an automatic method that sub-classifies WMHs into four categories (periventricular/deep and Tw-hypointense/nonTw-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 Tw-hypointense WMHs were significantly associated with poorer performance in the trail making A (p = 0.011), digit symbol (p = 0.028) and digit coding (p = 0.009) tests. We found no association between total WMH volume and cognition. These findings suggest that sub-classifying WMHs according to both location and intensity in Tw reveals specific associations with cognitive performance.
脑白质高信号（WMH）在 T 加权图像上是脑小血管疾病的影像学标志。由于其总体积与认知能力存在差异，因此需要采用新的方法来整合多种影像学标准。位置可能很重要，因为脑室周围的 WMH 与认知障碍有关。在 T 加权图像（Tw）上呈低信号的 WMH 也可能表明 WMH 最严重的部分。我们使用来自 Whitehall II 研究的 684 名社区居住的老年人的 MRI 数据，开发了一种自动方法，将 WMH 分为四类（脑室周围/深部和 Tw 低信号/非 Tw 低信号）。为了测试位置和强度信息是否会影响认知能力，我们使用总体积或细分体积分别推导了两个线性模型。结果表明，脑室周围 Tw 低信号的 WMH 与 Trail Making A（p=0.011）、数字符号（p=0.028）和数字编码（p=0.009）测试的表现较差显著相关。我们没有发现总 WMH 体积与认知之间的关联。这些发现表明，根据 Tw 中的位置和强度对 WMH 进行细分可以揭示与认知表现的特定关联。
