Free water determines diffusion alterations and clinical status in cerebral small vessel disease.
Free water determines diffusion alterations and clinical status in cerebral small vessel disease.
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DOI：
10.1016/j.jalz.2017.12.007
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Dichgans M
中科院分区：
文献类型：
--
作者：
Duering M;Finsterwalder S;Baykara E;Tuladhar AM;Gesierich B;Konieczny MJ;Malik R;Franzmeier N;Ewers M;Jouvent E;Biessels GJ;Schmidt R;de Leeuw FE;Pasternak O;Dichgans M
扩散张量成像检测阿尔茨海默病和脑小血管病（SVD）的早期组织改变。然而，SVD中扩散改变的起源在很大程度上是未知的。为了获得进一步的了解，我们对遗传性SVD（CADASIL，n=57）、散发性SVD（n=444）和健康对照（n=28）患者进行了游离水（FW）成像。我们模拟了细胞外空间（FW）中自由扩散的水，并测量了反映纤维结构（组织室）的指标。我们测试了这些措施和临床状态（处理速度和残疾）之间的关联。SVD中的扩散变化主要由FW增加驱动，而组织隔室变化较少。在影像学标记物中，FW与临床状态的相关性最强（R2高达34%，P<0.0001）。CADASIL和散发性SVD患者的结果一致。SVD的扩散改变和临床状态主要取决于细胞外液的增加，而不是白色纤维组织的改变。
Diffusion tensor imaging detects early tissue alterations in Alzheimer’s disease and cerebral small vessel disease (SVD). However, the origin of diffusion alterations in SVD is largely unknown. To gain further insight, we applied free water (FW) imaging to patients with genetically defined SVD (CADASIL, n=57), sporadic SVD (n=444), and healthy controls (n=28). We modelled freely diffusing water in the extracellular space (FW) and measures reflecting fiber structure (tissue compartment). We tested associations between these measures and clinical status (processing speed and disability). Diffusion alterations in SVD were mostly driven by increased FW and less by tissue compartment alterations. Among imaging markers, FW showed the strongest association with clinical status (R2 up to 34%, P<.0001). Findings were consistent across patients with CADASIL and sporadic SVD. Diffusion alterations and clinical status in SVD are largely determined by extracellular fluid increase rather than alterations of white matter fiber organization.
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