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European Radiology

, Volume 29, Issue 12, pp 7027–7036 | Cite as

Structural and functional MRI correlates of T2 hyperintensities of brain white matter in young neurologically asymptomatic adults

  • Miloš KeřkovskýEmail author
  • Jakub Stulík
  • Marek Dostál
  • Matyáš Kuhn
  • Jan Lošák
  • Petra Praksová
  • Monika Hulová
  • Josef Bednařík
  • Andrea Šprláková-Puková
  • Marek Mechl
Neuro
  • 118 Downloads

Abstract

Objectives

Although white matter hyperintensities (WMHs) are quite commonly found incidentally, their aetiology, structural characteristics, and functional consequences are not entirely known. The purpose of this study was to quantify WMHs in a sample of young, neurologically asymptomatic adults and evaluate the structural and functional correlations of lesion load with changes in brain volume, diffusivity, and functional connectivity.

Methods

MRI brain scan using multimodal protocol was performed in 60 neurologically asymptomatic volunteers (21 men, 39 women, mean age 34.5 years). WMHs were manually segmented in 3D FLAIR images and counted automatically. The number and volume of WMHs were correlated with brain volume, resting-state functional MRI (rs-fMRI), and diffusion tensor imaging (DTI) data. Diffusion parameters measured within WMHs and normally appearing white matter (NAWM) were compared.

Results

At least 1 lesion was found in 40 (67%) subjects, median incidence was 1 lesion (interquartile range [IQR] = 4.5), and median volume was 86.82 (IQR = 227.23) mm3. Neither number nor volume of WMHs correlated significantly with total brain volume or volumes of white and grey matter. Mean diffusivity values within WMHs were significantly higher compared with those for NAWM, but none of the diffusion parameters of NAWM were significantly correlated with WMH load. Both the number and volume of WMHs were correlated with the changes of functional connectivity between several regions of the brain, mostly decreased connectivity of the cerebellum.

Conclusions

WMHs are commonly found even in young, neurologically asymptomatic adults. Their presence is not associated with brain atrophy or global changes of diffusivity, but the increasing number and volume of these lesions correlate with changes of brain connectivity, and especially that of the cerebellum.

Key Points

White matter hyperintensities (WMHs) are commonly found in young, neurologically asymptomatic adults.

The presence of WMHs is not associated with brain atrophy or global changes of white matter diffusivity.

The increasing number and volume of WMHs correlate with changes of brain connectivity, and especially with that of the cerebellum.

Keywords

White matter Healthy volunteers Diffusion tensor imaging Functional magnetic resonance imaging 

Abbreviations

AD

Axial diffusivity

FA

Fractional anisotropy

FFE

Fast field echo

FLAIR

Fluid attenuation inversion recovery

ICC

Interclass correlation coefficient

IQR

Interquartile range

MD

Mean diffusivity

MS

Multiple sclerosis

NAWM

Normally appearing white matter

RD

Radial diffusivity

rs-fMRI

Resting-state functional MRI

TBSS

Tract-based spatial statistics

TE

Echo time

TR

Repetition time

TSE

Turbo spin echo

WM

White matter

WMHs

White matter hyperintensities

Notes

Acknowledgements

This study was supported by grant project AZV-15-32133A of the Czech Health Research Council and by funds from the Faculty of Medicine MU to junior researcher (M. Keřkovský).

Funding

This study has received funding by the Czech Health Research Council and by the Faculty of Medicine MU.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Assoc. Prof. Marek Mechl, M.D., Ph.D., MBA.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Prospective

• Cross-sectional study

• Performed at one institution

Supplementary material

330_2019_6268_MOESM1_ESM.docx (1.3 mb)
ESM 1 (DOCX 1350 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Miloš Keřkovský
    • 1
    Email author
  • Jakub Stulík
    • 1
  • Marek Dostál
    • 1
    • 2
  • Matyáš Kuhn
    • 3
    • 4
  • Jan Lošák
    • 3
  • Petra Praksová
    • 5
  • Monika Hulová
    • 5
  • Josef Bednařík
    • 5
  • Andrea Šprláková-Puková
    • 1
  • Marek Mechl
    • 1
  1. 1.Department of Radiology and Nuclear MedicineThe University Hospital Brno and Masaryk UniversityBrnoCzech Republic
  2. 2.Department of BiophysicsMasaryk UniversityBrnoCzech Republic
  3. 3.Department of PsychiatryThe University Hospital Brno and Masaryk UniversityBrnoCzech Republic
  4. 4.Behavioural and Social NeuroscienceCEITEC MUBrnoCzech Republic
  5. 5.Department of NeurologyThe University Hospital Brno and Masaryk UniversityBrnoCzech Republic

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