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Structural and functional MRI correlates of T2 hyperintensities of brain white matter in young neurologically asymptomatic adults

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Abstract

Objectives

Although white matter hyperintensities (WMHs) are quite commonly found incidentally, their aetiology, structural characteristics, and functional consequences are not entirely known. The purpose of this study was to quantify WMHs in a sample of young, neurologically asymptomatic adults and evaluate the structural and functional correlations of lesion load with changes in brain volume, diffusivity, and functional connectivity.

Methods

MRI brain scan using multimodal protocol was performed in 60 neurologically asymptomatic volunteers (21 men, 39 women, mean age 34.5 years). WMHs were manually segmented in 3D FLAIR images and counted automatically. The number and volume of WMHs were correlated with brain volume, resting-state functional MRI (rs-fMRI), and diffusion tensor imaging (DTI) data. Diffusion parameters measured within WMHs and normally appearing white matter (NAWM) were compared.

Results

At least 1 lesion was found in 40 (67%) subjects, median incidence was 1 lesion (interquartile range [IQR] = 4.5), and median volume was 86.82 (IQR = 227.23) mm3. Neither number nor volume of WMHs correlated significantly with total brain volume or volumes of white and grey matter. Mean diffusivity values within WMHs were significantly higher compared with those for NAWM, but none of the diffusion parameters of NAWM were significantly correlated with WMH load. Both the number and volume of WMHs were correlated with the changes of functional connectivity between several regions of the brain, mostly decreased connectivity of the cerebellum.

Conclusions

WMHs are commonly found even in young, neurologically asymptomatic adults. Their presence is not associated with brain atrophy or global changes of diffusivity, but the increasing number and volume of these lesions correlate with changes of brain connectivity, and especially that of the cerebellum.

Key Points

• White matter hyperintensities (WMHs) are commonly found in young, neurologically asymptomatic adults.

• The presence of WMHs is not associated with brain atrophy or global changes of white matter diffusivity.

• The increasing number and volume of WMHs correlate with changes of brain connectivity, and especially with that of the cerebellum.

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Abbreviations

AD:

Axial diffusivity

FA:

Fractional anisotropy

FFE:

Fast field echo

FLAIR:

Fluid attenuation inversion recovery

ICC:

Interclass correlation coefficient

IQR:

Interquartile range

MD:

Mean diffusivity

MS:

Multiple sclerosis

NAWM:

Normally appearing white matter

RD:

Radial diffusivity

rs-fMRI:

Resting-state functional MRI

TBSS:

Tract-based spatial statistics

TE:

Echo time

TR:

Repetition time

TSE:

Turbo spin echo

WM:

White matter

WMHs:

White matter hyperintensities

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Acknowledgements

This study was supported by grant project AZV-15-32133A of the Czech Health Research Council and by funds from the Faculty of Medicine MU to junior researcher (M. Keřkovský).

Funding

This study has received funding by the Czech Health Research Council and by the Faculty of Medicine MU.

Author information

Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, The University Hospital Brno and Masaryk University, Brno, Czech Republic

    Miloš Keřkovský, Jakub Stulík, Marek Dostál, Andrea Šprláková-Puková & Marek Mechl

  2. Department of Biophysics, Masaryk University, Brno, Czech Republic

    Marek Dostál

  3. Department of Psychiatry, The University Hospital Brno and Masaryk University, Brno, Czech Republic

    Matyáš Kuhn & Jan Lošák

  4. Behavioural and Social Neuroscience, CEITEC MU, Brno, Czech Republic

    Matyáš Kuhn

  5. Department of Neurology, The University Hospital Brno and Masaryk University, Brno, Czech Republic

    Petra Praksová, Monika Hulová & Josef Bednařík

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  1. Miloš Keřkovský
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Correspondence to Miloš Keřkovský.

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The scientific guarantor of this publication is Assoc. Prof. Marek Mechl, M.D., Ph.D., MBA.

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Keřkovský, M., Stulík, J., Dostál, M. et al. Structural and functional MRI correlates of T2 hyperintensities of brain white matter in young neurologically asymptomatic adults. Eur Radiol 29, 7027–7036 (2019). https://doi.org/10.1007/s00330-019-06268-8

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