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Impact of white matter hyperintensities on surrounding white matter tracts

  • Functional Neuroradiology
  • Published:
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Abstract

Purpose

It is unclear how white matter hyperintensities disrupt surrounding white matter tracts. The aim of this tractography study was to determine the spatial relationship between diffusion characteristics along white matter tracts and the distance from white matter hyperintensities.

Methods

Diffusion tensor 3-T MRI scans were acquired in 29 participants with white matter hyperintensities. In each subject, tractography by the fiber assignment by continuous tracking method was used to segment corticospinal tracts. Mean diffusivity, radial diffusivity, axial diffusivity, and fractional anisotropy were measured along corticospinal tracts in relation to white matter hyperintensities. Diffusion characteristics along tracts were correlated with distance from white matter hyperintensities and were also compared between tracts traversing and not traversing white matter hyperintensities.

Results

In tracts not traversing through white matter hyperintensities, increasing distance from white matter hyperintensities was associated with decreased mean diffusivity (p = 0.002) and increased fractional anisotropy (p = 0.006). In tracts traversing white matter hyperintensities, compared to tracts not traversing white matter hyperintensites, the mean diffusivity was higher at 6–8 voxels, axial diffusivity higher at 4–8 voxels, and radial diffusivity higher at 7 voxels away from white matter hyperintensities (all p < 0.006).

Conclusion

White matter hyperintensities are associated with two patterns of altered diffusion characteristics in the surrounding white matter tract network. Diffusion characteristics along white matter tracts improve further away from white matter hyperintensities suggestive of a local penumbra pattern. Also, altered diffusion extends further along tracts traversing white matter hyperintensities suggestive of a Wallerian-type degenerative pattern.

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Abbreviations

WMH:

White matter hyperintensities

NAWM:

Normal-appearing white matter

CST:

Corticospinal tract

WMH tracts:

Tracts passing through white matter hyperintensities

Lesion-free tracts:

Tracts not passing through white matter hyperintensities

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Authors and Affiliations

  1. Department of Medical Imaging, University of Toronto, 263 McCaul Street, Toronto, ON, M5T 1W7, Canada

    William Reginold, Adrian Crawley & David J. Mikulis

  2. Division of Neuroradiology, Joint Department of Medical Imaging, 3MC-431, Toronto Western Hospital, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

    William Reginold, Kevin Sam, Julien Poublanc, Adrian Crawley & David J. Mikulis

  3. Department of Anesthesia, University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada

    Joe Fisher

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  1. William Reginold
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Correspondence to David J. Mikulis.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Reginold, W., Sam, K., Poublanc, J. et al. Impact of white matter hyperintensities on surrounding white matter tracts. Neuroradiology 60, 933–944 (2018). https://doi.org/10.1007/s00234-018-2053-x

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  • DOI: https://doi.org/10.1007/s00234-018-2053-x

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