Early-Stage White Matter Lesions Detected by Multispectral MRI Segmentation Predict Progressive Cognitive Decline

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Jokinen , H , Goncalves , N , Vigario , R , Lipsanen , J , Fazekas , F , Schmidt , R , Barkhof , F , Madureira , S , Verdelho , A , Inzitari , D , Pantoni , L , Erkinjuntti , T & LADIS Study Grp 2015 , ' Early-Stage White Matter Lesions Detected by Multispectral MRI Segmentation Predict Progressive Cognitive Decline ' , Frontiers in Neuroscience , vol. 9 , 455 . https://doi.org/10.3389/fnins.2015.00455

Title: Early-Stage White Matter Lesions Detected by Multispectral MRI Segmentation Predict Progressive Cognitive Decline
Author: Jokinen, Hanna; Goncalves, Nicolau; Vigario, Ricardo; Lipsanen, Jari; Fazekas, Franz; Schmidt, Reinhold; Barkhof, Frederik; Madureira, Sofia; Verdelho, Ana; Inzitari, Domenico; Pantoni, Leonardo; Erkinjuntti, Timo; LADIS Study Grp
Contributor organization: Behavioural Sciences
Neurologian yksikkö
Date: 2015-12-02
Language: eng
Number of pages: 9
Belongs to series: Frontiers in Neuroscience
ISSN: 1662-453X
DOI: https://doi.org/10.3389/fnins.2015.00455
URI: http://hdl.handle.net/10138/159751
Abstract: White matter lesions (WML) are the main brain imaging surrogate of cerebral small-vessel disease. A new MRI tissue segmentation method, based on a discriminative clustering approach without explicit model based added prior, detects partial WML volumes, likely representing very early-stage changes in normal-appearing brain tissue. This study investigated how the different stages of WML, from a "pre-visible" stage to fully developed lesions, predict future cognitive decline. MRI scans of 78 subjects, aged 65-84 years, from the Leukoaraiosis and Disability (LADIS) study were analyzed using a self supervised multispectral segmentation algorithm to identify tissue types and partial VVML volumes. Each lesion voxel was classified as having a small (33%), intermediate (66%), or high (100%) proportion of lesion tissue. The subjects were evaluated with detailed clinical and neuropsychological assessments at baseline and at three annual follow-up visits. We found that voxels with small partial WML predicted lower executive function compound scores at baseline, and steeper decline of executive scores in follow-up, independently of the demographics and the conventionally estimated hyperintensity volume on fluid-attenuated inversion recovery images. The intermediate and fully developed lesions were related to impairments in multiple cognitive domains including executive functions, processing speed, memory, and global cognitive function. In conclusion, early-stage partial WML, still too faint to be clearly detectable on conventional MRI, already predict executive dysfunction and progressive cognitive decline regardless of the conventionally evaluated WML load. These findings advance early recognition of small vessel disease and incipient vascular cognitive impairment.
Subject: executive functions
image analysis
white matter lesions
small vessel disease
3124 Neurology and psychiatry
515 Psychology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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