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Quantitation of brain tissue changes associated with white matter hyperintensities by diffusion‐weighted and magnetization transfer imaging: The LADIS (leukoaraiosis and disability in the elderly) study
Authors:Stefan Ropele PhD  Alexandra Seewann MD  Alida A Gouw MD  Wiesje M van der Flier MD  Reinhold Schmidt MD  Leonardo Pantoni MD  PhD  Domenico Inzitari MD  Timo Erkinjuntti MD  PhD  Philip Scheltens MD  PhD  Lars O Wahlund MD  PhD  Gunhild Waldemar MD  DMSc  Hugues Chabriat MD  PhD  José Ferro MD  PhD  Michael Hennerici MD  John O'Brien MD  Anders Wallin MD  PhD  Peter Langhorne MD  PhD  Marieke C Visser MD  PhD  Frederik Barkhof MD  PhD  Franz Fazekas MD
Institution:1. Department of Neurology, Medical University of Graz, Austria;2. Department of Neurology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands;3. Department of Radiology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands;4. Department of Neuroradiology, Medical University of Graz, Austria;5. Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy;6. Memory Research Unit, Department of Clinical Neurosciences, Helsinki University, Helsinki, Finland;7. Neurotec Department, Section of Clinical Geriatrics, Karolinska Institute, Huddinge, Sweden;8. Memory Disorders Research Unit, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark;9. Department of Neurology, H?pital Lariboisière, Paris, France;10. Servi?o de Neurologia, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal;11. Department of Neurology, University of Heidelberg, Klinikum Mannheim, Mannheim, Germany;12. Institute for Ageing and Health, University of Newcastle, Newcastle‐upon‐Tyne, United Kingdom;13. Institute of Clinical Neuroscience, G?teborg University, G?teborg, Sweden;14. Academic Section of Geriatric Medicine, Royal Infirmary, Glasgow, United Kingdom
Abstract:

Purpose

To explore the value of diffusion‐weighted imaging (DWI) and magnetization transfer imaging (MTI) for the improved detection and quantification of cerebral tissue changes associated with ageing and white matter hyperintensities (WMH).

Materials and Methods

DWI (n = 340) and MTI (n = 177) were performed in nine centers of the multinational Leukoaraiosis And DISability (LADIS) study investigating the impact of WMH on 65‐ to 85‐year‐old individuals without prior disability. We assessed the apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) of normal appearing brain tissue (NABT) and within WMH and related them to subjects' age and WHM severity according to the Fazekas score.

Results

ADC and MTR values showed a significant inter‐site variation, which was stronger for the MTR. After z‐transformation multiple regression analysis revealed WMH severity and age as significant predictors of global ADC and MTR changes. Only lesional ADC, but not MTR was related to WMH severity.

Conclusion

ADC and MTR are both sensitive for age and WMH related changes in NABT. The ADC is more sensitive for tissue changes within WMH and appears to be more robust for multicenter settings. J. Magn. Reson. Imaging 2009;29:268–274. © 2009 Wiley‐Liss, Inc.
Keywords:brain  ageing  white matter hyperintensities  magnetization transfer  diffusion
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