Automated and visual scoring methods of cerebral white matter hyperintensities: relation with age and cognitive function.
OBJECTIVE
A reliable scoring method for ischemic cerebral white matter hyperintensities (WMH) will help to clarify the causes and consequences of these brain lesions. We compared an automated and two visual WMH scoring methods in their relations with age and cognitive function.


METHODS
MRI of the brain was performed on 154 participants of the Utrecht Diabetic Encephalopathy Study. WMH volumes were obtained with an automated segmentation method. Visual rating of deep and periventricular WMH (DWMH and PWMH) was performed with the Scheltens scale and the Rotterdam Scan Study (RSS) scale, respectively. Cognition was assessed with a battery of 11 tests.


RESULTS
Within the whole study group, the association with age was most evident for the automated measured WMH volume (beta = 0.43, 95% CI = 0.29-0.57). With regard to cognition, automated measured WMH volume and Scheltens DWMH were significantly associated with information processing speed (beta = -0.22, 95% CI = -0.40 to -0.06; beta = -0.26, 95% CI = -0.42 to -0.10), whereas RSS PWMH were associated with attention and executive function (beta = -0.19, 95% CI = -0.36 to -0.02).


CONCLUSIONS
Measurements of WMH with an automated quantitative segmentation method are comparable with visual rating scales and highly suitable for use in future studies to assess the relationship between WMH and subtle impairments in cognitive function.
Tiehuis
A M
AM
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. a.m.tiehuis@umcutrecht.nl
Vincken
K L
KL
Mali
W P T M
WP
Kappelle
L J
LJ
Anbeek
P
P
Algra
A
A
Biessels
G J
GJ
D000367:Age Factors; D000368:Aged; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009929:Organ Size; D012720:Severity of Illness Index