Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors
Using advanced diffusion MRI, we aimed to assess the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) using 3-tissue diffusion signal compositions in ischemic stroke. Data were obtained from the Cognition and Neocortical...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | NeuroImage |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811921001166 |
| _version_ | 1818580325254561792 |
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| author | Wasim Khan Mohamed Salah Khlif Remika Mito Thijs Dhollander Amy Brodtmann |
| author_facet | Wasim Khan Mohamed Salah Khlif Remika Mito Thijs Dhollander Amy Brodtmann |
| author_sort | Wasim Khan |
| collection | DOAJ |
| description | Using advanced diffusion MRI, we aimed to assess the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) using 3-tissue diffusion signal compositions in ischemic stroke. Data were obtained from the Cognition and Neocortical Volume After Stroke (CANVAS) study. Diffusion-weighted MR and high-resolution structural brain images were acquired 3- (baseline) and 12-months (follow-up) post-stroke. WMHs were automatically segmented and longitudinal assessment at 12-months was used to retrospectively delineate NAWM voxels at baseline converting to WMHs. NAWM voxels converting to WMHs were further dichotomized into either: “growing” WMHs if NAWM adhered to existing WMH voxels, or “isolated de-novo'' WMHs if NAWM was unconnected to WMH voxels identified at baseline. Microstructural properties were assessed using 3-tissue diffusion signal compositions consisting of white matter-like (WM-like: TW), gray matter-like (GM-like: TG), and cerebrospinal fluid-like (CSF-like: TC) signal fractions. Our findings showed that NAWM converting to WMHs already exhibited similar changes in tissue compositions at baseline to WMHs with lower TW and increased TC (fluid-like, i.e. free-water) and TG compared to persistent NAWM. We also found that microstructural properties of persistent NAWM were related to overall WMH burden with greater free-water content in patients with high WMH load. These findings suggest that NAWM preceding conversion to WMHs are accompanied by greater fluid-like properties indicating increased tissue water content. Increased GM-like properties may indicate a more isotropic microstructure of tissue reflecting a degree of hindered diffusion in NAWM regions vulnerable to WMH development. These results support the usefulness of microstructural compositions as a sensitive marker of NAWM vulnerability to WMH pathogenesis. |
| first_indexed | 2024-12-16T07:15:48Z |
| format | Article |
| id | doaj.art-2dc3bf1454064c29ab6a881faabbcdbe |
| institution | Directory Open Access Journal |
| issn | 1095-9572 |
| language | English |
| last_indexed | 2024-12-16T07:15:48Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage |
| spelling | doaj.art-2dc3bf1454064c29ab6a881faabbcdbe2022-12-21T22:39:46ZengElsevierNeuroImage1095-95722021-05-01232117839Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivorsWasim Khan0Mohamed Salah Khlif1Remika Mito2Thijs Dhollander3Amy Brodtmann4Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia; Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, United Kingdom; Corresponding author at: Melbourne Brain center, 245 Burgundy Street, Heidelberg, VIC 3084, Australia.Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, AustraliaFlorey Institute of Neuroscience and Mental Health, Melbourne, VIC, AustraliaDevelopmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, AustraliaFlorey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia; Melbourne Dementia Research Centre, University of Melbourne, Victoria, AustraliaUsing advanced diffusion MRI, we aimed to assess the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) using 3-tissue diffusion signal compositions in ischemic stroke. Data were obtained from the Cognition and Neocortical Volume After Stroke (CANVAS) study. Diffusion-weighted MR and high-resolution structural brain images were acquired 3- (baseline) and 12-months (follow-up) post-stroke. WMHs were automatically segmented and longitudinal assessment at 12-months was used to retrospectively delineate NAWM voxels at baseline converting to WMHs. NAWM voxels converting to WMHs were further dichotomized into either: “growing” WMHs if NAWM adhered to existing WMH voxels, or “isolated de-novo'' WMHs if NAWM was unconnected to WMH voxels identified at baseline. Microstructural properties were assessed using 3-tissue diffusion signal compositions consisting of white matter-like (WM-like: TW), gray matter-like (GM-like: TG), and cerebrospinal fluid-like (CSF-like: TC) signal fractions. Our findings showed that NAWM converting to WMHs already exhibited similar changes in tissue compositions at baseline to WMHs with lower TW and increased TC (fluid-like, i.e. free-water) and TG compared to persistent NAWM. We also found that microstructural properties of persistent NAWM were related to overall WMH burden with greater free-water content in patients with high WMH load. These findings suggest that NAWM preceding conversion to WMHs are accompanied by greater fluid-like properties indicating increased tissue water content. Increased GM-like properties may indicate a more isotropic microstructure of tissue reflecting a degree of hindered diffusion in NAWM regions vulnerable to WMH development. These results support the usefulness of microstructural compositions as a sensitive marker of NAWM vulnerability to WMH pathogenesis.http://www.sciencedirect.com/science/article/pii/S10538119210011663-tissueCompositional analysisDiffusion MRINormal-appearing white matterWhite matter hyperintensities |
| spellingShingle | Wasim Khan Mohamed Salah Khlif Remika Mito Thijs Dhollander Amy Brodtmann Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors NeuroImage 3-tissue Compositional analysis Diffusion MRI Normal-appearing white matter White matter hyperintensities |
| title | Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors |
| title_full | Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors |
| title_fullStr | Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors |
| title_full_unstemmed | Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors |
| title_short | Investigating the microstructural properties of normal-appearing white matter (NAWM) preceding conversion to white matter hyperintensities (WMHs) in stroke survivors |
| title_sort | investigating the microstructural properties of normal appearing white matter nawm preceding conversion to white matter hyperintensities wmhs in stroke survivors |
| topic | 3-tissue Compositional analysis Diffusion MRI Normal-appearing white matter White matter hyperintensities |
| url | http://www.sciencedirect.com/science/article/pii/S1053811921001166 |
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