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RT Journal Article
SR Electronic
T1 Diffuse Tract Damage in the Hemispheric Deep White Matter May Correlate with Global Cognitive Impairment and Callosal Atrophy in Patients with Extensive Leukoaraiosis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 726
OP 732
DO 10.3174/ajnr.A2853
VO 33
IS 4
A1 Otsuka, Y.
A1 Yamauchi, H.
A1 Sawamoto, N.
A1 Iseki, K.
A1 Tomimoto, H.
A1 Fukuyama, H.
YR 2012
UL http://www.ajnr.org/content/33/4/726.abstract
AB BACKGROUND AND PURPOSE: Patients with extensive leukoaraiosis are at high risk for vascular dementia. However, these patients exhibit variable severity of global cognitive impairment correlating with callosal atrophy. We hypothesized that callosal atrophy may reflect the severity of HDWM tract damage, which may explain global cognitive impairment. The purpose of this study was to evaluate HDWM tract damage by DTI and to investigate whether HDWM tract damage is associated with callosal atrophy and global cognitive impairment, in patients with extensive leukoaraiosis. MATERIALS AND METHODS: Twenty-four consecutive outpatients with extensive leukoaraiosis were enrolled prospectively. The patients underwent cognitive evaluation and 3T MR imaging. The intercorrelation between cognitive score, DA of the HDWM, callosal DA, and callosal volume was analyzed statistically. The correlation of the cognitive score with DA of the HDWM and the corpus callosum was also evaluated by voxel-based analyses by using TBSS. RESULTS: The patients' MMSE scores varied from 10 to 30 (mean, 25.1 ± 6.0). Reduced DA of the HDWM, reduced callosal DA, and callosal atrophy intercorrelated significantly. All of these parameters showed a significant correlation with global cognitive impairment. TBSS analyses showed a significant correlation between MMSE score decline and reduced DA in the diffuse HDWM and the corpus callosum. CONCLUSIONS: In patients with extensive leukoaraiosis, atrophy and reduced DA of the corpus callosum may indicate diffuse HDWM tract damage, which may explain global cognitive impairment and development of vascular dementia. BETBrain Extraction ToolDAdiffusion anisotropyFAfractional anisotropyFABFrontal Assessment BatteryFMRIBFunctional MR Imaging of the BrainFWEfamily-wise errorHDWMhemispheric deep white matterMDmean diffusivityMMSEMini-Mental State ExaminationMNIMontreal Neurological InstituteNAWMnormal-appearing white matterTBSSTract-based Spatial StatisticsVFTVerbal Fluency TaskWMLwhite matter high-intensity lesionWMSRWechsler Memory Scale–Revised