Thalamic fractional anisotropy predicts accrual of cerebral white matter damage in older subjects with small-vessel disease.
White matter hyperintensities (WMHs) and lacunes are magnetic resonance imaging hallmarks of cerebral small-vessel disease, which increase the risk of stroke, cognitive, and mobility impairment. Although most studies of cerebral small-vessel disease have focused on white matter abnormalities, the gray matter (GM) is also affected, as evidenced by frequently observed lacunes in subcortical GM. Diffusion tensor imaging (DTI) is sensitive to subtle neurodegenerative changes in deep GM structures. We explored the relationship between baseline DTI characteristics of the thalamus, caudate, and putamen, and the volume and subsequent accrual of WMHs over a 4-year period in 56 community-dwelling older (⩾75 years) individuals. Baseline thalamic fractional anisotropy (FA) was an independent predictor of WMH accrual. WMH accrual also correlated with baseline lacune count and baseline WMH volume, the latter showing the strongest predictive power, explaining 27.3% of the variance. The addition of baseline thalamic FA in multivariate modeling increased this value by 70%, which explains 46.5% of the variance in WMH accrual rate. Thalamic FA might serve as a novel predictor of cerebral small-vessel disease progression in clinical settings and trials. Furthermore, our findings point to the possibility of a causal relationship between thalamic damage and the accrual of WMHs.
1] Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA [2] Dipartimento di Neuroscienze, Salute Mentale e Organi di Senso (NESMOS), Universitaà La Sapienza, Rome, Italy.
Michele
M
Cavallari
Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Nicola
N
Moscufo
Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Dominik
D
Meier
Olin Neuropsychiatry Research Center, Hartford Hospital/IOL, Hartford, Connecticut, USA.
Pawel
P
Skudlarski
1] Olin Neuropsychiatry Research Center, Hartford Hospital/IOL, Hartford, Connecticut, USA [2] Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA [3] Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Godfrey D
GD
Pearlson
Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, Connecticut, USA.
William B
WB
White
Department of Neurology, University of Connecticut Health Center, Farmington, Connecticut, USA.
Leslie
L
Wolfson
Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Charles R G
CR
Guttmann
D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D059345:Cerebral Small Vessel Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056784:Leukoencephalopathies / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D013788:Thalamus / Q000473:pathology* / Q000503:physiopathology