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Updated: Jan 4, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
White matter hypointensities and hyperintensities have equivalent correlations with age and CSF β-amyloid in the
Ke Wei1, Thao Tran1, Karen Chu1
1Advanced Imaging and Spectroscopy Center, Huntington Medical Research Institutes, Pasadena, CA, USA.
Introduction:
T1- and T2-weighted sequences from MRI often provide useful complementary information about tissue properties. Leukoaraiosis results in signal abnormalities on T1-weighted images, which are automatically quantified by FreeSurfer, but this marker is poorly characterized and is rarely used. We evaluated associations between white matter hyperintensity (WM-hyper) volume from FLAIR and white matter hypointensity (WM-hypo) volume from T1-weighted images and compared their associations with age and cerebrospinal fluid (CSF) β-amyloid and tau.
Methods:
A total of 56 nondemented participants (68-94 years) were recruited and gave informed consent. All participants went through MR imaging on a GE 1.5T scanner and of these 47 underwent lumbar puncture for CSF analysis. WM-hypo was calculated using FreeSurfer analysis of T1 FSPGR 3D, and WM-hyper was calculated with the Lesion Segmentation Toolbox in the SPM software package using T2-FLAIR.
Results:
WM-hyper and WM-hypo were strongly correlated (r = .81; parameter estimate (p.e.): 1.53 ± 0.15; p < .0001). Age was significantly associated with both WM-hyper (r = .31, p.e. 0.078 ± 0.030, p = .013) and WM-hypo (r = .42, p.e. 0.055 ± 0.015, p < .001). CSF β-amyloid levels were predicted by WM-hyper (r = .33, p.e. -0.11 ± 0.044, p = .013) and WM-hypo (r = .42, p.e. -0.24 ± 0.073, p = .002). CSF tau levels were not correlated with either WM-hyper (p = .9) or WM-hypo (p = .99).
Conclusions:
Strong correlations between WM-hyper and WM-hypo, and similar associations with age, abnormal β-amyloid, and tau suggest a general equivalence between these two imaging markers. Our work supports the equivalence of white matter hypointensity volumes derived from FreeSurfer for evaluating leukoaraiosis. This may have particular utility when T2-FLAIR is low in quality or absent, enabling analysis of older imaging data sets.
Insights
White matter hyperintensity (WM-hyper) and hypointensity (WM-hypo) volumes are equivalent markers for leukoaraiosis. These MRI measures correlate with age and beta-amyloid levels, offering utility even with suboptimal T2-FLAIR sequences.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- T1- and T2-weighted MRI sequences provide complementary tissue information.
- Leukoaraiosis, characterized by signal abnormalities, is poorly understood and underutilized.
- White matter hyperintensity (WM-hyper) on FLAIR and white matter hypointensity (WM-hypo) on T1-weighted images are potential markers.
Purpose of the Study:
- To evaluate the associations between WM-hyper and WM-hypo volumes.
- To compare the associations of these markers with age and cerebrospinal fluid (CSF) β-amyloid and tau levels.
Main Methods:
- 56 non-demented participants (68-94 years) underwent MRI.
- WM-hypo volume calculated using FreeSurfer from T1 FSPGR 3D sequences.
- WM-hyper volume calculated using Lesion Segmentation Toolbox from T2-FLAIR sequences; 47 participants had CSF analysis.
Main Results:
- WM-hyper and WM-hypo volumes were strongly correlated (r=0.81).
- Both markers showed significant associations with age and CSF β-amyloid levels.
- Neither marker correlated with CSF tau levels.
Conclusions:
- WM-hyper and WM-hypo are equivalent imaging markers for leukoaraiosis, showing similar associations with age and β-amyloid.
- FreeSurfer-derived WM-hypo volumes are validated for leukoaraiosis evaluation.
- This equivalence is particularly useful when T2-FLAIR quality is compromised or data is unavailable.
