Diffusion Tensor Imaging detects age-related white matter change over a two-year follow-up which is associated with working memory decline

Clinical Neuroscience, St George's University of London, London, UK.
Journal of neurology, neurosurgery, and psychiatry (Impact Factor: 6.81). 09/2009; 81(1):13-9. DOI: 10.1136/jnnp.2008.167288
Source: PubMed

ABSTRACT Diffusion tensor imaging (DTI) is a sensitive method for detecting white matter damage, and in cross sectional studies DTI measures correlate with age related cognitive decline. However, there are few data on whether DTI can detect age related changes over short time periods and whether such change correlates with cognitive function.
In a community sample of 84 middle-aged and elderly adults, MRI and cognitive testing were performed at baseline and after 2 years. Changes in DTI white matter histograms, white matter hyperintensity (WMH) volume and brain volume were determined. Change over time in performance on tests of executive function, working memory and information processing speed were also assessed.
Significant change in all MRI measures was detected. For cognition, change was detected for working memory and this correlated with change in DTI only. In a stepwise regression, with change in working memory as the dependent variable, a DTI histogram measure explained 10.8% of the variance in working memory. Change in WMH or brain volume did not contribute to the model.
DTI is sensitive to age related change in white matter ultrastructure and appears useful for monitoring age related white matter change even over short time periods.

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Available from: Rebecca A Charlton, Sep 28, 2015
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    • "conditions with diffuse tissue lesions such as hypertension related cSVD or CADASIL, a quantitative approach based on whole brain histograms of diffusion was found to reflect the overall disease severity and various DTI histogram parameters (mean value, median value, peak location, peak height, kurtosis, skewness) have been reported to correlate with clinical scores both in cross-sectional and longitudinal studies.[10]–[20]Some DTI metrics were even found more sensitive than clinical scales in detecting the disease progression over time[11], [15], [21]. In CADASIL, mean value of MD histograms obtained over the whole brain has been previously found to increase before any significant clinical change during follow up and to predict disease progression [21], [22]. "
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    ABSTRACT: Diffusion tensor imaging (DTI) histogram metrics are correlated with clinical parameters in cerebral small vessel diseases (cSVD). Whether ADC histogram parameters derived from simple diffusion weighted imaging (DWI) can provide relevant markers for long term studies of cSVD remains unknown. CADASIL patients were evaluated by DWI and DTI in a large cohort study overa6-year period. ADC histogram parameters were compared to those derived from mean diffusivity (MD) histograms in 280 patients using intra-class correlation and Bland-Altman plots. Impact of image corrections applied to ADC maps was assessed and a mixed effect model was used for analyzing the effects of scanner upgrades. The results showed that ADC histogram parameters are strongly correlated to MD histogram parameters and that image corrections have only limited influence on these results. Unexpectedly, scanner upgrades were found to have major effects on diffusion measures with DWI or DTI that can be even larger than those related to patients' characteristics. These data support that ADC histograms from daily used DWI can provide relevant parameters for assessing cSVD, but the variability related to scanner upgrades as regularly performed in clinical centers should be determined precisely for longitudinal and multicentric studies using diffusion MRI in cSVD.
    PLoS ONE 05/2014; 9(5):e97173. DOI:10.1371/journal.pone.0097173 · 3.23 Impact Factor
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    • "Thus, DTI seems to be much more sensitive than VBM to detect subtle degenerative changes of respiratory control centers within the brainstem. These findings were in accordance with other studies showing that DTI changes correlate with clinical symptoms, histopathological changes, and functional deficits in early stages of vascular and degenerative brain damage [23]–[25], [66]. Furthermore, DTI has a proven sensitivity to detect subtle structural brain changes even in primary cortical degenerative disease, and FA was shown to be the most sensitive MR-imaging correlate of neurodegeneration [23], [67], [68]. "
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    ABSTRACT: The exact underlying pathomechanism of central sleep apnea with Cheyne-Stokes respiration (CSA-CSR) is still unclear. Recent studies have demonstrated an association between cerebral white matter changes and CSA. A dysfunction of central respiratory control centers in the brainstem was suggested by some authors. Novel MR-imaging analysis tools now allow far more subtle assessment of microstructural cerebral changes. The aim of this study was to investigate whether and what severity of subtle structural cerebral changes could lead to CSA-CSR, and whether there is a specific pattern of neurodegenerative changes that cause CSR. Therefore, we examined patients with Fabry disease (FD), an inherited, lysosomal storage disease. White matter lesions are early and frequent findings in FD. Thus, FD can serve as a "model disease" of cerebral microangiopathy to study in more detail the impact of cerebral lesions on central sleep apnea. Genetically proven FD patients (n = 23) and age-matched healthy controls (n = 44) underwent a cardio-respiratory polysomnography and brain MRI at 3.0 Tesla. We applied different MR-imaging techniques, ranging from semiquantitative measurement of white matter lesion (WML) volumes and automated calculation of brain tissue volumes to VBM of gray matter and voxel-based diffusion tensor imaging (DTI) analysis. In 5 of 23 Fabry patients (22%) CSA-CSR was detected. Voxel-based DTI analysis revealed widespread structural changes in FD patients when compared to the healthy controls. When calculated as a separate group, DTI changes of CSA-CSR patients were most prominent in the brainstem. Voxel-based regression analysis revealed a significant association between CSR severity and microstructural DTI changes within the brainstem. Subtle microstructural changes in the brainstem might be a neuroanatomical correlate of CSA-CSR in patients at risk of WML. DTI is more sensitive and specific than conventional structural MRI and other advanced MR analyses tools in demonstrating these abnormalities.
    PLoS ONE 04/2013; 8(4):e60304. DOI:10.1371/journal.pone.0060304 · 3.23 Impact Factor
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    • ". A few longitudinal studies showed that DTI is sensitive to change over a short period of time and correlated with change in cognitive test scores, while this is not the case for conventional MRI markers [26] [31] [32]. However , more longitudinal studies are needed to replicate these results with serial DTI analysis to establish the predictive value of DTI parameters in cognitive decline additional to conventional MRI parameters. "
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    ABSTRACT: The structural integrity of the cerebral white matter, including that of the white matter lesions (WML) and of the surrounding normal appearing white matter (NAWM), can be assessed with diffusion tensor imaging (DTI), which is suggested to be of added value in the explanation of cognitive dysfunction in cerebral small vessel disease (SVD). We investigated the value of DTI of NAWM and WML in addition to conventional magnetic resonance imaging (MRI) parameters in the variance of cognitive performance in subjects with SVD. 499 individuals with SVD, 50-85 years, without dementia, underwent MRI scanning, including a DTI sequence. Grey matter, white matter (WM), and WML volume, number of microbleeds, lacunar and territorial infracts, and mean diffusivity (MD) and fractional anisotropy (FA) in NAWM, WML, and total WM were related to cognitive performance in multivariate regression analyses, after adjustment for age, gender, and education. All MRI parameters together accounted for 1-6% of the variance in cognitive function on top of 22-36% already explained by age, gender, and level of education. Both mean MD and FA of the NAWM, WML, and total WM did not substantially contribute to the explained variance of cognitive function, to that already explained by conventional MRI parameters. When considered separately, the MD of the (NA)WM had the strongest association with cognitive performance. In conclusion, DTI of NAWM and WML has limited additional value to conventional MRI parameters in the etiological explanation of the variance in cognitive function among individuals with SVD.
    Journal of Alzheimer's disease: JAD 07/2012; 32(3). DOI:10.3233/JAD-2012-120784 · 4.15 Impact Factor
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