Free water determines diffusion alterations and clinical status in cerebral small vessel disease.

Duering, Marco; Finsterwalder, Sofia; Pasternak, Ofer; Jouvent, Eric; Dichgans, Martin; de Leeuw, Frank-Erik; Baykara, Ebru; Tuladhar, Anil Man; Franzmeier, Nicolai; Biessels, Geert Jan; Malik, Rainer; Schmidt, Reinhold; Gesierich, Benno; Ewers, Michael; Konieczny, Marek J

doi:10.1016/j.jalz.2017.12.007

Journal Article

DZNE-2020-06320

Free water determines diffusion alterations and clinical status in cerebral small vessel disease.

Duering, M. ; Finsterwalder, S. ; Baykara, E. ; Tuladhar, A. M. ; Gesierich, B. ; Konieczny, M. J. ; Malik, R. ; Franzmeier, N. ; Ewers, M. ; Jouvent, E. ; Biessels, G. J. ; Schmidt, R. ; de Leeuw, F.-E. ; Pasternak, O. ; Dichgans, M. (Last author)DZNE*

2018
Elsevier Amsterdam [u.a.]

Alzheimer's and dementia 14(6), 764-774 (2018) [10.1016/j.jalz.2017.12.007]

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Please use a persistent id in citations: doi:10.1016/j.jalz.2017.12.007

Abstract: 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.MethodsTo gain further insight, we applied free water (FW) imaging to patients with genetically defined SVD (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy [CADASIL], n = 57), sporadic SVD (n = 444), and healthy controls (n = 28). We modeled 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).ResultsDiffusion 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.DiscussionDiffusion alterations and clinical status in SVD are largely determined by extracellular fluid increase rather than alterations of white matter fiber organization.

Keyword(s): Aged (MeSH) ; Alzheimer Disease: diagnostic imaging (MeSH) ; Cerebral Small Vessel Diseases: diagnostic imaging (MeSH) ; Diffusion Tensor Imaging: methods (MeSH) ; Female (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Water (MeSH) ; Water