JNNP: Is diffusion tensor MRI a predictor of dementia?

Cerebral small vascular disease (SVD) causes a quarter of strokes and is the most common cause of vascular cognitive impairment and dementia
.

Conventional MRI showed SVD features, including lacunar infarction, white matter hyperintensity (WMH), cerebral microhemorrhage (CMB), and enlarged perivascular space

Studies have shown that WMH values ​​can predict stroke and dementia

The use of DTI measurement can better predict the progression of dementia, thereby making high-risk groups the target of therapeutic intervention
.

However, before its wider clinical application, it is important to prove that DTI measurements can indeed predict dementia in different populations, including patients with different severity of SVD

It is important to determine the relative importance of these markers

This article was published in " Journal of Neurology, Neurosurgery & Psychiatry " ( Journal of Neurology, Neurosurgery & Psychiatry )

 

An optimized multimodal MRI marker was established as a surrogate marker for the (optimal) test of vascular cognitive impairment caused by cerebral small vessel disease to determine whether DTI measurement can predict SVD dementia in multiple cohorts
.

Includes 6 cohorts with different severity of SVD

An optimized multimodal MRI marker was established as a surrogate marker for the (optimal) test of vascular cognitive impairment caused by cerebral small vessel disease to determine whether DTI measurement can predict SVD dementia in multiple cohorts

In the clinical DTI model, individual markers contribute to unadjusted cognitive assessment

Calculate the brain volume (BV) from the original T1 image and perform WMH and brain tissue segmentation
.

SVDp is calculated by calculating the ratio of the WMH volume to the total brain volume composed of the sum of gray matter (GM), WM and WMH

Calculate the brain volume (BV) from the original T1 image and perform WMH and brain tissue segmentation

The median average diffusion rate (MD) measured by DTI correlates with cognition in all cohorts The median average diffusion rate (MD) measured by DTI correlates with cognition in all cohorts

In the clinical MRI diffusion tensor imaging model, individual markers contribute to cognitive assessment

In many cohorts at risk of dementia but with varying degrees of SVD, the importance of diffuse WM injury (measured by DTI) as the main determinant of cognitive impairment and dementia was confirmed
.

It further validated the use of DTI measurement as a marker for predicting the risk of dementia in the future

In many cohorts at risk of dementia but with varying degrees of SVD, the importance of diffuse WM injury (measured by DTI) as the main determinant of cognitive impairment and dementia was confirmed

In summary, the results support the important role of WM changes in the pathogenesis of dementia in all cohorts
.
DTI indicators, such as the median MD, may be a meaningful clinical risk predictor
.

EgleM ,HilalS ,TuladharAM , et al Prediction of dementia using diffusion tensor MRI measures: the OPTIMAL collaborationJournal of Neurology, Neurosurgery & PsychiatryPublished Online First:11 September 2021.
doi:10.
1136/jnnp-2021-326571

EgleM ,HilalS ,TuladharAM EgleMEgle HilalSHilal TuladharAMTuladhar, et al Prediction of dementia using diffusion tensor MRI measures: the OPTIMAL collaborationPrediction of dementia using diffusion tensor MRI measures: the OPTIMAL collaborationJournal of Neurology, Neurosurgery & PsychiatryPublished Online First:11 September 2021.
 Published Online First: doi:10.
1136/jnnp-2021-326571doi:

 

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