Towards multicentre diffusion MRI studies in cerebral small vessel disease
Abstract
Diffusion MRI can provide unique insights into the structure of the human brain. By exploiting motion of water molecules as a contrast mechanism, diffusion MRI informs about tissue properties at a scale well beyond conventional structural MRI. Diffusion MRI metrics derived with diffusion tensor imaging and higher order models are emerging as powerful biomarkers of cerebral white matter injury in the context of small vessel disease. For example, the diffusion tensor imagingderived metric peak width of skeletonised mean diffusivity (PSMD) was shown to better explain interindividual variation in cognitive function than conventional small vessel disease MRI lesion markers. While many diffusion MRI metrics have shown promise in dedicated monocentre studies, their applicability in multicentre settings or clinical practice is hindered by limited evidence of repeatability and reproducibility, scanner dependence and lack of normative data. Egle et al present a study on the added value of diffusion tensor imaging metrics over conventional lesion makers to predict cognitive function across six different cohorts with varying small vessel disease burden. Despite substantial heterogeneity in study populations, MRI acquisition parameters and assessment of cognitive outcomes, in all six cohorts the diffusion tensor imagingderived metric mean diffusivity (MD) median consistently explained as much variance in cognitive performance than all other lesion markers combined. Furthermore, baseline…
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