Peak Width of Skeletonized Mean Diffusivity as a Marker of Diffuse Cerebrovascular Damage
Open Access
- 19 March 2020
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Neuroscience
- Vol. 14, 238
- https://doi.org/10.3389/fnins.2020.00238
Abstract
Background: The peak width of skeletonized mean diffusivity (PSMD) has been proposed as a fully automated imaging marker of relevance to cerebral small vessel disease (SVD). We assessed PSMD in relation to conventional SVD markers, global measures of neurodegeneration, and cognition. Methods: 145 participants underwent 3T brain MRI and cognitive assessment. 112 were patients with mild cognitive impairment, Alzheimer’s disease, progressive supranuclear palsy, dementia with Lewy bodies, or frontotemporal dementia. PSMD, SVD burden [white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), microbleeds, lacunes], average mean diffusivity (MD), gray matter (GM), white matter (WM), and total intracranial volume were quantified. Robust linear regression was conducted to examine associations between variables. Dominance analysis assessed the relative importance of markers in predicting various outcomes. Regional analyses examined spatial overlap between PSMD and WMH. Results: PSMD was associated with global and regional SVD measures, especially WMH and microbleeds. Dominance analysis demonstrated that among SVD markers, WMH was the strongest predictor of PSMD. Furthermore, PSMD was more closely associated to WMH than with GM and WM volumes. PSMD was associated with WMH across all regions, and correlations were not significantly stronger in corresponding regions (e.g., frontal PSMD and frontal WMH) compared to non-corresponding regions. PSMD outperformed all four conventional SVD markers and MD in predicting cognition, but was comparable to GM and WM volumes. Discussion: PSMD was robustly associated with established SVD markers. This new measure appears to be a marker of diffuse brain injury, largely due to vascular pathology, and may be a useful and convenient metric of overall cerebrovascular burden.Funding Information
- National Institute for Health Research (146281)
This publication has 29 references indexed in Scilit:
- Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegenerationThe Lancet Neurology, 2013
- Mechanisms of sporadic cerebral small vessel disease: insights from neuroimagingThe Lancet Neurology, 2013
- Accumulation of MRI Markers of Cerebral Small Vessel Disease is Associated with Decreased Cognitive Function. A Study in First-Ever Lacunar Stroke and Hypertensive PatientsFrontiers in Aging Neuroscience, 2013
- Diffusion tensor imaging and cognition in cerebral small vessel disease: The RUN DMC studyBiochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 2012
- Magnetic Resonance Imaging in Cerebral Small Vessel Disease and its Use as a Surrogate Disease MarkerInternational Journal of Stroke, 2011
- Validation of Automated White Matter Hyperintensity SegmentationJournal of Aging Research, 2011
- The Microbleed Anatomical Rating Scale (MARS)Neurology, 2009
- Cerebral microbleeds: a guide to detection and interpretationThe Lancet Neurology, 2009
- Multimodal MRI in Cerebral Small Vessel DiseaseStroke, 2008
- History and Use of Relative Importance Indices in Organizational ResearchOrganizational Research Methods, 2004