Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies.
Using DTI to assess white matter microstructure in cerebral small vessel disease (SVD) in multicentre studies.
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DOI：
10.1042/cs20170146
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发表时间：
2017-06-01
期刊：
影响因子：
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通讯作者：
Markus HS
中科院分区：
文献类型：
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作者：
Croall ID;Lohner V;Moynihan B;Khan U;Hassan A;O'Brien JT;Morris RG;Tozer DJ;Cambridge VC;Harkness K;Werring DJ;Blamire AM;Ford GA;Barrick TR;Markus HS
弥散张量成像（DTI）指标，如各向异性分数（FA）和平均弥散度（MD）已被提议作为脑小血管疾病（SVD）的临床试验标志物，因为它们与认知等结局相关。然而，调查这一点的研究主要是单中心的。由于临床试验可能是多中心的，需要进一步的研究来确定是否可以在多中心环境中检测到与相似强度认知的关联。作为PRESERVE DTI子研究的一部分，在6个研究中心招募了109例症状性腔隙性脑梗死和MRI融合性白色高信号（WMH）患者（平均年龄=68岁）。在处理缺失数据后，可从5个研究中心使用5种扫描仪型号（Siemens和Philips）进行3 T-MRI扫描，并进行神经心理学和生活质量（QoL）评估。从DTI直方图分析中提取FA中值和MD峰高。进行多元线性回归，包括标准化脑体积、WMH病变负荷和n°腔隙作为协变量，以研究FA和MD与认知和QoL的相关性。所有白色物质的DTI指标与整体认知（标准化β =0.268）、心理灵活性（β =0.306）、语言流畅性（β =0.376）和蒙特利尔认知评估（莫卡）（β =0.273）显著相关。这些关联的程度与系统性文献综述中发现的单中心研究中先前报告的结果相当。在这项多中心研究中，我们证实了DTI参数和认知之间的关联，其强度与先前单中心研究中发现的相似。本研究支持在多中心研究中使用DTI指标作为疾病进展的生物标志物。
Diffusion tensor imaging (DTI) metrics such as fractional anisotropy (FA) and mean diffusivity (MD) have been proposed as clinical trial markers of cerebral small vessel disease (SVD) due to their associations with outcomes such as cognition. However, studies investigating this have been predominantly single-centre. As clinical trials are likely to be multisite, further studies are required to determine whether associations with cognition of similar strengths can be detected in a multicentre setting. One hundred and nine patients (mean age =68 years) with symptomatic lacunar infarction and confluent white matter hyperintensities (WMH) on MRI was recruited across six sites as part of the PRESERVE DTI substudy. After handling missing data, 3T-MRI scanning was available from five sites on five scanner models (Siemens and Philips), alongside neuropsychological and quality of life (QoL) assessments. FA median and MD peak height were extracted from DTI histogram analysis. Multiple linear regressions were performed, including normalized brain volume, WMH lesion load, and n° lacunes as covariates, to investigate the association of FA and MD with cognition and QoL. DTI metrics from all white matter were significantly associated with global cognition (standardized β =0.268), mental flexibility (β =0.306), verbal fluency (β =0.376), and Montreal Cognitive Assessment (MoCA) (β =0.273). The magnitudes of these associations were comparable with those previously reported from single-centre studies found in a systematic literature review. In this multicentre study, we confirmed associations between DTI parameters and cognition, which were similar in strength to those found in previous single-centre studies. The present study supports the use of DTI metrics as biomarkers of disease progression in multicentre studies.