scholarly journals White matter lesions defined by diffusion tensor imaging in older adults

2011 ◽  
Vol 70 (3) ◽  
pp. 465-476 ◽  
Author(s):  
Stephen A. Back ◽  
Christopher D. Kroenke ◽  
Larry S. Sherman ◽  
Gus Lawrence ◽  
Xi Gong ◽  
...  
Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
John Conklin ◽  
Frank L Silver ◽  
David J Mikulis ◽  
Daniel M Mandell

INTRODUCTION: Leukoaraiosis, the presence of “incidental” white matter lesions in the aging brain, is increasingly recognized as a predictor for dementia, ischemic stroke, intracerebral hemorrhage and vascular death. The pathogenesis of leukoaraiosis remains controversial, with abnormalities of small arterioles hypothesized to play an important role. To investigate this hypothesis, we sought to characterize the temporal evolution of the individual lesions making up leukoaraiosis. HYPOTHESIS: Discrete occlusive events at the level of small arterioles play a key role in the pathogenesis of leukoaraiosis. METHODS: Participants were prospectively recruited through an outpatient neurology clinic (inclusion criteria: age > 60 years, Fazekas grade 3 leukoaraiosis burden; exclusion criteria: cortical infarct, cardioembolic disease, dissection, carotid stenosis > 50%). Subjects underwent an identical MRI protocol in each of 16 consecutive weeks, including diffusion tensor imaging (DTI) and multi-echo T2-weighted imaging. Parametric maps of the apparent diffusion coefficient (ADC), fractional anisotropy (FA) and T2 relaxation time were constructed and coregistered (Analysis of Functional NeuroImages, NIH; 3D Slicer, www.slicer.org; Matlab, The MathWorks). Images were reviewed for new diffusion restricting lesions, and such lesions were manually segmented. Plots of lesion ADC, FA and T2 were generated and temporally aligned to the onset of acute diffusion restriction. RESULTS: Five subjects (mean age 69 ± 8 years) met criteria and completed all 16 MRI scans. There were no lacunar or large artery infarcts during the study period. A total of 9 new diffusion restricting white matter lesions were identified (mean volume 0.06 ± 0.03 cc). Evolution of these lesions showed striking similarity to that of cerebral infarction, with acute reduction in ADC, followed by gradual rise in ADC and T2, and corresponding decline in FA. At 8 weeks, new lesions were indistinguishable from pre-existing white matter disease. CONCLUSION: Leukoaraiosis evolves through temporally and spatially discrete acute ischemic injuries. This supports the hypothesized role of small vessel arteriolar pathology as a key pathogenetic mechanism.


2017 ◽  
Vol 33 (7) ◽  
pp. 861-874 ◽  
Author(s):  
Catherine M Mewborn ◽  
Douglas P Terry ◽  
Lisa M Renzi-Hammond ◽  
Billy R Hammond ◽  
L Stephen Miller

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1586-1593 ◽  
Author(s):  
Niklas Lenfeldt ◽  
Anne Larsson ◽  
Lars Nyberg ◽  
Richard Birgander ◽  
Anders Eklund ◽  
...  

Abstract BACKGROUND: Idiopathic normal-pressure hydrocephalus (INPH) is associated with white matter lesions, but the extent and severity of the lesions do not cohere with symptoms or improvement after shunting, implying the presence of further, yet undisclosed, injuries to white matter in INPH. OBJECTIVE: To apply diffusion tensor imaging (DTI) to explore white matter lesions in patients with INPH before and after drainage of cerebrospinal fluid (CSF). METHODS: Eighteen patients and 10 controls were included. DTI was performed in a 1.5T MRI scanner before and after 3-day drainage of 400 mL of CSF. Regions of interest included corpus callosum, capsula interna, frontal and lateral periventricular white matter, and centrum semiovale. White matter integrity was quantified by assessing fractional anisotropies (FA) and apparent diffusion coefficients (ADC), comparing them between patients and controls and between patients before and after drainage. The significance level corresponded to .05 (Bonferroni corrected). RESULTS: Decreased FA in patients was found in 3 regions (P < .002, P < .001, and P < .001) in anterior frontal white matter, whereas elevated ADC was found in genu corpus callosum (P < .001) and areas of centrum semiovale associated with the precentral gyri (P < .002). Diffusion patterns in these areas did not change after drainage. CONCLUSION: DTI reveals subtle injuries—interpreted as axonal loss and gliosis—to anterior frontal white matter where high-order motor systems between frontal cortex and basal ganglia travel, further supporting the notion that motor symptoms in INPH are caused by a chronic ischemia to the neuronal systems involved in the planning processes of movements.


2008 ◽  
Vol 14 ◽  
pp. S12
Author(s):  
K.F. De Laat ◽  
A.G.W. Van Norden ◽  
R.A.R. Gons ◽  
L.J.B. Van Oudheusden ◽  
I. Van Ouden ◽  
...  

2008 ◽  
Vol 14 ◽  
pp. S12-S13
Author(s):  
R.A.R. Gons ◽  
K.F. De Laat ◽  
A.G.W. Van Norden ◽  
L.J.B. Van Oudheusden ◽  
M.P. Zwiers ◽  
...  

2021 ◽  
Vol 13 ◽  
Author(s):  
Stephanie Matijevic ◽  
Lee Ryan

Well-established literature indicates that older adults have poorer cerebral white matter integrity, as measured through diffusion tensor imaging (DTI). Age differences in DTI have been observed widely across white matter, although some tracts appear more sensitive to the effects of aging than others. Factors like APOE ε4 status and sex may contribute to individual differences in white matter integrity that also selectively impact certain tracts, and could influence DTI changes in aging. The present study explored the degree to which age, APOE ε4, and sex exerted global vs. tract specific effects on DTI metrics in cognitively healthy late middle-aged to older adults. Data from 49 older adults (ages 54–92) at two time-points separated by approximately 2.7 years were collected. DTI metrics, including fractional anisotropy (FA) and mean diffusivity (MD), were extracted from nine white matter tracts and global white matter. Results showed that across timepoints, FA and MD increased globally, with no tract-specific changes observed. Baseline age had a global influence on both measures, with increasing age associated with lower FA and higher MD. After controlling for global white matter FA, age additionally predicted FA for the genu, callosum body, inferior fronto-occipital fasciculus (IFOF), and both anterior and posterior cingulum. Females exhibited lower global FA on average compared to males. In contrast, MD was selectively elevated in the anterior cingulum and superior longitudinal fasciculus (SLF), for females compared to males. APOE ε4 status was not predictive of either measure. In summary, these results indicate that age and sex are associated with both global and tract-specific alterations to DTI metrics among a healthy older adult cohort. Older women have poorer white matter integrity compared to older men, perhaps related to menopause-induced metabolic changes. While age-related alterations to white matter integrity are global, there is substantial variation in the degree to which tracts are impacted, possibly as a consequence of tract anatomical variability. The present study highlights the importance of accounting for global sources of variation in DTI metrics when attempting to investigate individual differences (due to age, sex, or other factors) in specific white matter tracts.


2014 ◽  
Vol 71 (12) ◽  
pp. 1547 ◽  
Author(s):  
Kejal Kantarci ◽  
Christopher G. Schwarz ◽  
Robert I. Reid ◽  
Scott A. Przybelski ◽  
Timothy G. Lesnick ◽  
...  

Stroke ◽  
2009 ◽  
Vol 40 (12) ◽  
pp. 3816-3820 ◽  
Author(s):  
Refeeque A. Bhadelia ◽  
Lori Lyn Price ◽  
Kurtis L. Tedesco ◽  
Tammy Scott ◽  
Wei Qiao Qiu ◽  
...  

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