Assessment of white matter hyperintensity severity using multimodal MRI in Alzheimer’s Disease
Bibliographic record
Abstract
Abstract White matter hyperintensities (WMHs) are clinically significant MRI abnormalities often detected in the elderly and early stages of Alzheimer’s Disease. They are indicative of vascular pathology but represent a mixture of microstructural tissue alterations that is highly variable between individuals. To better understand these alterations, we leveraged the signal of different MRI contrasts sampled within WMHs, which have differential sensitivity to microstructural properties. Subsequently, we sought to examine the asso of these WMH signal measures to clinically-relevant measures such as cortical and global brain atrophy, cognitive function, diagnostic and demographic differences, and Alzheimer’s Disease-relevant cardiovascular risk factors. Our sample of 118 subjects was composed of healthy controls ( n =30), high-risk of Alzheimer’s Disease due to familial history ( n =47), mild cognitive impairment ( n =32), and clinical Alzheimer’s Disease ( n =9) as a means of ascertaining a spectrum of impairment. We sampled the median signal within WMHs on weighted MRI images that are commonly acquired (T1-weighted [T1w], T2-weighted [T2w], T1w/T2w ratio, Fluid-Attenuated Inversion Recovery [FLAIR]), and the relaxation times from quantitative T1 (qT1) and T2* (qT2*) images. Main analyses were performed with a periventricular/deep/superficial white matter parcellation and were repeated with a lobar white matter parcellation. We demonstrated that the correlations between WMH signal measures were variable, suggesting that they are likely influenced by different microstructural properties. We observed that the WMH qT2* and FLAIR measures displayed different age- and disease-related trends compared to normal-appearing white matter, highlighting sensitivity to WMH-specific tissue deterioration. Further, WMH qT2* particularly in periventricular and occipital white matter regions was consistently associated with several of our clinical variables of interest using both parcellation schemes in univariate analyses, and further showed high contributions to a pattern of brain variables that was associated with age and cognitive variables in multivariate Partial Least Squares Correlation analyses. qT1 and FLAIR measures showed consistent clinical relationships in multivariate analyses only, while T1w, T2w, and T1w/T2w ratio measures were not consistently associated with clinical variables. We observed that the qT2* signal was sensitive to clinically-relevant microstructural tissue alterations specific to WMHs. Combining volumetric and signal measures of WMH, particularly qT2* and to a lesser extent qT1 and FLAIR, should be considered to more precisely characterize the severity of WMHs in vivo. These findings may have implications in determining the reversibility of WMHs and potential efficacy of cardio- and cerebrovascular treatments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".