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Magnetization transfer ratio of white matter hyperintensities in subcortical ischemic vascular dementia
J L Tanabe1, F Ezekiel, W J Jagust
1Department of Radiology, New York University Medical Center, New York, USA.
Background And Purpose:
In subjects with subcortical ischemic vascular dementia (SIVD), tissue vacuolization, myelin pallor, and demyelination have been found on pathologic examination of white matter signal hyperintensities (WMSH). Magnetization transfer ratio (MTR) values provide a potential measure of compromised white matter integrity. The purpose of this study was to determine if there were differences in MTR of WMSH between subjects with SIVD and cognitively normal healthy control subjects.
Methods:
Fifteen subjects with SIVD and 16 control subjects of comparable age and sex were studied. MTR images were coregistered to MR images segmented into tissue classes (gray matter, white matter, CSF, WMSH, and lacunar infarcts). MTR of WMSH was compared across groups and examined by WMSH location, size, and total burden.
Results:
WMSH burden was greater in SIVD patients than in control subjects (2.4% vs 0.67%). MTR of WMSH did not differ between groups, but MTR of periventricular WMSH was lower in SIVD patients than in control subjects (37.6% vs 39.4%). Even after accounting for covariant effects of lesion burden, there was still a trend toward reduced periventricular WMSH MTR in the group with dementia. There was no correlation between WMSH MTR and WMSH lesion size.
Conclusion:
These findings are consistent with observations that pathologic changes in vascular dementia are most severe in the periventricular white matter and suggest that insight into the pathophysiology of SIVD might be gleaned from studies of the periventricular region.
Insights
Subcortical ischemic vascular dementia (SIVD) shows reduced white matter integrity, particularly in periventricular regions. Magnetization transfer ratio (MTR) may reveal subtle changes in white matter signal hyperintensities (WMSH) in SIVD patients.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Dementia Research
Background:
- Subcortical ischemic vascular dementia (SIVD) is characterized by white matter signal hyperintensities (WMSH).
- Pathological examination reveals tissue vacuolization, myelin pallor, and demyelination in SIVD WMSH.
- Magnetization transfer ratio (MTR) is a sensitive MRI measure for white matter integrity.
Purpose of the Study:
- To investigate differences in MTR of WMSH between SIVD patients and healthy controls.
- To assess if MTR can detect compromised white matter integrity in SIVD.
Main Methods:
- 15 SIVD patients and 16 healthy controls underwent MRI.
- MTR images were coregistered and segmented into tissue classes.
- MTR of WMSH was analyzed by location, size, and burden, comparing SIVD and control groups.
Main Results:
- SIVD patients had a greater WMSH burden (2.4%) than controls (0.67%).
- Overall WMSH MTR did not differ between groups.
- Periventricular WMSH MTR was lower in SIVD patients (37.6%) compared to controls (39.4%), even after adjusting for lesion burden.
Conclusions:
- Pathological changes in vascular dementia are most pronounced in periventricular white matter.
- Reduced periventricular WMSH MTR in SIVD suggests localized white matter compromise.
- Focusing on the periventricular region may offer insights into SIVD pathophysiology.