title: Quantitation of brain tissue changes associated with white matter hyperintensities by diffusion-weighted and magnetization transfer imaging: the LADIS (Leukoaraiosis and Disability in the Elderly) study.
abstract: OBJECTIVE
  To explore the value of diffusion-weighted imaging (DWI) and magnetization transfer imaging (MTI) for the improved detection and quantification of cerebral tissue changes associated with ageing and white matter hyperintensities (WMH).
  
  
  METHODS
  DWI (n = 340) and MTI (n = 177) were performed in nine centers of the multinational Leukoaraiosis And DISability (LADIS) study investigating the impact of WMH on 65- to 85-year-old individuals without prior disability. We assessed the apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR) of normal appearing brain tissue (NABT) and within WMH and related them to subjects' age and WHM severity according to the Fazekas score.
  
  
  RESULTS
  ADC and MTR values showed a significant inter-site variation, which was stronger for the MTR. After z-transformation multiple regression analysis revealed WMH severity and age as significant predictors of global ADC and MTR changes. Only lesional ADC, but not MTR was related to WMH severity.
  
  
  CONCLUSIONS
  ADC and MTR are both sensitive for age and WMH related changes in NABT. The ADC is more sensitive for tissue changes within WMH and appears to be more robust for multicenter settings.
authors.affiliation: Department of Neurology, Medical University of Graz, Austria. stefan.ropele@meduni-graz.at
authors.forename: Stefan
authors.initials: S
authors.lastname: Ropele
authors.forename: Alexandra
authors.initials: A
authors.lastname: Seewann
authors.forename: Alida A
authors.initials: AA
authors.lastname: Gouw
authors.forename: Wiesje M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.forename: Timo
authors.initials: T
authors.lastname: Erkinjuntti
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Lars O
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
authors.forename: Hugues
authors.initials: H
authors.lastname: Chabriat
authors.forename: José
authors.initials: J
authors.lastname: Ferro
authors.forename: Michael
authors.initials: M
authors.lastname: Hennerici
authors.forename: John
authors.initials: J
authors.lastname: O'Brien
authors.forename: Anders
authors.initials: A
authors.lastname: Wallin
authors.forename: Peter
authors.initials: P
authors.lastname: Langhorne
authors.forename: Marieke C
authors.initials: MC
authors.lastname: Visser
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D049292:Leukoaraiosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012720:Severity of Illness Index