Diffusion tensor imaging (DTI) metrics such as fractional anisotropy (FA) and mean diffusivity (MD) have been proposed as clinical trial markers of cerebral small vessel disease (SVD) due to their associations with outcomes such as cognition. However, studies investigating this have been predominantly single-centre. As clinical trials are likely to be multisite, further studies are required to determine whether associations with cognition of similar strengths can be detected in a multicentre setting. One hundred and nine patients (mean age =68 years) with symptomatic lacunar infarction and confluent white matter hyperintensities (WMH) on MRI was recruited across six sites as part of the PRESERVE DTI substudy. After handling missing data, 3T-MRI scanning was available from five sites on five scanner models (Siemens and Philips), alongside neuropsychological and quality of life (QoL) assessments. FA median and MD peak height were extracted from DTI histogram analysis. Multiple linear regressions were performed, including normalized brain volume, WMH lesion load, and n° lacunes as covariates, to investigate the association of FA and MD with cognition and QoL. DTI metrics from all white matter were significantly associated with global cognition (standardized β =0.268), mental flexibility (β =0.306), verbal fluency (β =0.376), and Montreal Cognitive Assessment (MoCA) (β =0.273). The magnitudes of these associations were comparable with those previously reported from single-centre studies found in a systematic literature review. In this multicentre study, we confirmed associations between DTI parameters and cognition, which were similar in strength to those found in previous single-centre studies. The present study supports the use of DTI metrics as biomarkers of disease progression in multicentre studies.

译文

:由于张量成像(DTI)与认知等结果的关联,因此提出了诸如张量各向异性(FA)和平均扩散率(MD)的扩散张量成像(DTI)指标作为脑小血管疾病(SVD)的临床试验标记。但是,对此进行调查的研究主要是单中心的。由于临床试验可能是多地点的,因此需要进一步的研究来确定在多中心环境中是否可以检测到具有相似优势的认知。作为PRESERVE DTI子研究的一部分,从六个地点招募了119例有症状的腔隙性脑梗塞和融合性白质亢进(WMH)的MRI患者(平均年龄= 68岁)。处理完丢失的数据后,可以从五个扫描仪模型(Siemens和Philips)的五个位置进行3T-MRI扫描,同时进行神经心理学和生活质量(QoL)评估。从DTI直方图分析中提取FA中位数和MD峰高。进行了多个线性回归,包括标准化的脑容量,WMH病变负荷和n°腔隙作为协变量,以研究FA和MD与认知和QoL的关联。来自所有白质的DTI指标与整体认知(标准化的β= 0.268),心理柔韧性(β= 0.306),口语流利度(β= 0.376)和蒙特利尔认知评估(MoCA)显着相关(β= 0.273)。这些关联的程度与以前在系统文献综述中发现的单中心研究报告的程度相当。在这项多中心研究中,我们证实了DTI参数与认知之间的关联,其强度与以前的单中心研究中发现的相似。本研究支持在多中心研究中将DTI指标用作疾病进展的生物标记。

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