More Than Meets the MRI: Texture Analysis Shows Normal Appearing White Matter is Not So Normal in SVD, Predicts Cognitive Impairment and Decline
Danny R. Rose, Jr., MD
Tozer DJ, Zeestraten E, Lawrence AJ, Barrick TR, Markus HS. Texture Analysis of T1-Weighted and Fluid-Attenuated Inversion Recovery Images Detects Abnormalities That Correlate With Cognitive Decline in Small Vessel Disease. Stroke. 2018
Cerebral small vessel disease (SVD) is a well-established but relatively poorly understood cause of lacunar stroke and vascular dementia. While the complex structural changes underpinning this disease process have yet to be fully elucidated, several MRI imaging markers have been identified in association with SVD, including white matter hyperintensities (WMH), cerebral microbleeds, and evidence of lacunar infarction. While these imaging markers have been useful in assessing severity of disease, they are less strongly associated with cognitive impairment. One particular area of interest as further imaging research into SVD has progressed is the so-called “normal appearing white matter” (NAWM), specifically the areas of white matter on traditional MRI that do not show the typical T2/FLAIR hyperintense changes.