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      FLAIR MRI biomarkers of the normal appearing brain matter are related to cognition ☆

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          Highlights

          • •

            Normal appearing brain matter (NABM) biomarkers in FLAIR MRI are related to cognition.

          • •

            NABM texture in FLAIR MRI is correlated to mean diffusivity (MD) in dMRI.

          • •

            Analysis conducted on large multicentre FLAIR MRI dataset: 1400 subjects, 87 centers.

          • •

            NABM biomarkers vary differently across age and MoCA categories.

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            Biomarkers showed differences in patients with AD dementia and vascular disease.

          Abstract

          A novel biomarker panel was proposed to quantify macro and microstructural biomarkers from the normal-appearing brain matter (NABM) in multicentre fluid-attenuation inversion recovery (FLAIR) MRI. The NABM is composed of the white and gray matter regions of the brain, with the lesions and cerebrospinal fluid removed. The primary hypothesis was that NABM biomarkers from FLAIR MRI are related to cognitive outcome as determined by MoCA score. There were three groups of features designed for this task based on 1) texture: microstructural integrity (MII), macrostructural damage (MAD), microstructural damage (MID), 2) intensity: median, skewness, kurtosis and 3) volume: NABM to ICV volume ratio. Biomarkers were extracted from over 1400 imaging volumes from more than 87 centres and unadjusted ANOVA analysis revealed significant differences in means of the MII, MAD, and NABM volume biomarkers across all cognitive groups. In an adjusted ANCOVA model, a significant relationship between MoCA categories was found that was dependent on subject age for MII, MAD, intensity, kurtosis and NABM volume biomarkers. These results demonstrate that structural brain changes in the NABM are related to cognitive outcome (with different relationships depending on the age of the subjects). Therefore these biomarkers have high potential for clinical translation. As a secondary hypothesis, we investigated whether texture features from FLAIR MRI can quantify microstructural changes related to how “structured” or “damaged” the tissue is. Based on correlation analysis with diffusion weighted MRI (dMRI), it was shown that FLAIR MRI texture biomarkers (MII and MAD) had strong correlations to mean diffusivity (MD) which is related to tissue degeneration in the GM and WM regions. As FLAIR MRI is routinely collected for clinical neurological examinations, novel biomarkers from FLAIR MRI could be used to supplement current clinical biomarkers and for monitoring disease progression. Biomarkers could also be used to stratify patients into homogeneous disease subgroups for clinical trials, or to learn more about mechanistic development of dementia disease.

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          Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration

          Joanna M. Wardlaw, Eric E. Smith, Geert J Biessels … (2014)
          Summary Cerebral small vessel disease (SVD) is a common accompaniment of ageing. Features seen on neuroimaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. SVD can present as a stroke or cognitive decline, or can have few or no symptoms. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive deficits, physical disabilities, and other symptoms of neurodegeneration. Terminology and definitions for imaging the features of SVD vary widely, which is also true for protocols for image acquisition and image analysis. This lack of consistency hampers progress in identifying the contribution of SVD to the pathophysiology and clinical features of common neurodegenerative diseases. We are an international working group from the Centres of Excellence in Neurodegeneration. We completed a structured process to develop definitions and imaging standards for markers and consequences of SVD. We aimed to achieve the following: first, to provide a common advisory about terms and definitions for features visible on MRI; second, to suggest minimum standards for image acquisition and analysis; third, to agree on standards for scientific reporting of changes related to SVD on neuroimaging; and fourth, to review emerging imaging methods for detection and quantification of preclinical manifestations of SVD. Our findings and recommendations apply to research studies, and can be used in the clinical setting to standardise image interpretation, acquisition, and reporting. This Position Paper summarises the main outcomes of this international effort to provide the STandards for ReportIng Vascular changes on nEuroimaging (STRIVE).
          Article 0 comments Cited 1313 times – based on 0 reviews     Review now
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            Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association.

            Philip Gorelick, Angelo Scuteri, Sandra Black … (2011)
            This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury-not solely stroke-ranging from mild cognitive impairment through fully developed dementia. Dysfunction of the neurovascular unit and mechanisms regulating cerebral blood flow are likely to be important components of the pathophysiological processes underlying VCI. Cerebral amyloid angiopathy is emerging as an important marker of risk for Alzheimer disease, microinfarction, microhemorrhage and macrohemorrhage of the brain, and VCI. The neuropathology of cognitive impairment in later life is often a mixture of Alzheimer disease and microvascular brain damage, which may overlap and synergize to heighten the risk of cognitive impairment. In this regard, magnetic resonance imaging and other neuroimaging techniques play an important role in the definition and detection of VCI and provide evidence that subcortical forms of VCI with white matter hyperintensities and small deep infarcts are common. In many cases, risk markers for VCI are the same as traditional risk factors for stroke. These risks may include but are not limited to atrial fibrillation, hypertension, diabetes mellitus, and hypercholesterolemia. Furthermore, these same vascular risk factors may be risk markers for Alzheimer disease. Carotid intimal-medial thickness and arterial stiffness are emerging as markers of arterial aging and may serve as risk markers for VCI. Currently, no specific treatments for VCI have been approved by the US Food and Drug Administration. However, detection and control of the traditional risk factors for stroke and cardiovascular disease may be effective in the prevention of VCI, even in older people. Vascular contributions to cognitive impairment and dementia are important. Understanding of VCI has evolved substantially in recent years, based on preclinical, neuropathologic, neuroimaging, physiological, and epidemiological studies. Transdisciplinary, translational, and transactional approaches are recommended to further our understanding of this entity and to better characterize its neuropsychological profile. There is a need for prospective, quantitative, clinical-pathological-neuroimaging studies to improve knowledge of the pathological basis of neuroimaging change and the complex interplay between vascular and Alzheimer disease pathologies in the evolution of clinical VCI and Alzheimer disease. Long-term vascular risk marker interventional studies beginning as early as midlife may be required to prevent or postpone the onset of VCI and Alzheimer disease. Studies of intensive reduction of vascular risk factors in high-risk groups are another important avenue of research.
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              Multiresolution gray-scale and rotation invariant texture classification with local binary patterns

              Antti T Ojala, M Pietikäinen, T. Mäenpää (2002)
              Article 0 comments Cited 493 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Neuroimage Clin
                Journal ID (iso-abbrev): Neuroimage Clin
                Title: NeuroImage : Clinical
                Publisher: Elsevier
                ISSN (Electronic): 2213-1582
                Publication date PMC-release: 08 February 2022
                Publication date Collection: 2022
                Publication date (Electronic): 08 February 2022
                Volume: 34
                Electronic Location Identifier: 102955
                Affiliations
                [a ]Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada
                [b ]Hurvitz Brain Sciences Program Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
                [c ]Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
                [d ]Montreal Heart Institute, Montreal, QU, Canada
                [e ]Department of Medicine, Université de Montréal, QU, Canada
                [f ]Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
                [g ]Institute of Medical Science, University of Toronto, Toronto, ON, Canada
                [h ]Keenan Research Center for Biomedical Science, St. Michael’s Hospital, Unity Health Network, Toronto, ON, Canada
                [i ]Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON, Canada
                Author notes
                [* ]Corresponding author.
                Article
                Publisher Item ID: S2213-1582(22)00020-1 Publisher ID: 102955
                DOI: 10.1016/j.nicl.2022.102955
                PMC ID: 8857609
                PubMed ID: 35180579
                SO-VID: b27131fe-bd5a-4ecd-9039-3c65a0a5e4e9
                Copyright © © 2022 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 24 June 2021
                Date revision received : 28 January 2022
                Date accepted : 1 February 2022
                Categories
                Subject: Regular Article

                Keywords: flair,texture analysis,biomarkers,normal-appearing brain matter (nabm),alzheimer’s disease,neurodegeneration
                Data availability:
                Keywords: flair, texture analysis, biomarkers, normal-appearing brain matter (nabm), alzheimer’s disease, neurodegeneration

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