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Research ArticleBrain

Normal-Appearing White Matter Permeability Distinguishes Poor Cognitive Performance in Processing Speed and Working Memory

A. Eilaghi, A. Kassner, I. Sitartchouk, P.L. Francis, R. Jakubovic, A. Feinstein and R.I. Aviv
American Journal of Neuroradiology November 2013, 34 (11) 2119-2124; DOI: https://doi.org/10.3174/ajnr.A3539
A. Eilaghi
aFrom the Department of Medical Imaging (A.E., P.L.F., R.J., R.I.A.)
cDepartment of Medical Biophysics (A.E.), University of Western Ontario, London, Ontario, Canada
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A. Kassner
dDepartment of Medical Imaging (A.K., I.S., R.I.A.), University of Toronto, Toronto, Ontario, Canada
eDepartment of Physiology and Experimental Medicine (A.K.), Hospital for Sick Children, Toronto, Ontario, Canada.
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I. Sitartchouk
dDepartment of Medical Imaging (A.K., I.S., R.I.A.), University of Toronto, Toronto, Ontario, Canada
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P.L. Francis
aFrom the Department of Medical Imaging (A.E., P.L.F., R.J., R.I.A.)
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R. Jakubovic
aFrom the Department of Medical Imaging (A.E., P.L.F., R.J., R.I.A.)
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A. Feinstein
bDepartment of Psychiatry (A.F.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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R.I. Aviv
aFrom the Department of Medical Imaging (A.E., P.L.F., R.J., R.I.A.)
dDepartment of Medical Imaging (A.K., I.S., R.I.A.), University of Toronto, Toronto, Ontario, Canada
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    Fig 1.

    A, Estimation of rR by use of the ΔR2* versus time curve measured from the DSC regions of interest (ΔR2*measured) as well as its γ-variate fit (ΔR2*fit). ΔR2*max is the maximum of ΔR2*theoretical. A is the dynamic phase corresponding to the onset of the recirculation phase measured at half-height of the descending aspect of the ΔR2* curve, and N is the final DSC phase. B, Example of rR measurement: case 733, section 11, perfusion scan. MS lesion (red region of interest) and NAWM (blue region of interest) and rR calculation results. rR for WM lesion is 0.142; rR for NAWM region is 0.042.

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    Fig 2.

    rR values of NAWM and WM lesion.

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    Fig 3.

    rR values of NAWM are significantly lower in impaired than in nonimpaired groups by use of A, the Symbol Digit Modalities Test (P = .007), and B, the Paced Auditory Serial Addition Test (P = .024).

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  • Outcomes of multivariate logistic regression analyses for NAWM rR after controlling for potential confounders

    Cognitive TestOdds Ratio (5–95% CI)P Value
    SDMT0.177 (0.040–0.785).023
    COWAT0.662 (0.002–2.226).130
    PASAT 1.60.053 (0.003–0.961).047
    • Note:—SDMT indicates Symbol Digit Modalities Test; COWAT, Controlled Word Association Test; PASAT, Paced Auditory Serial Addition Test.

    • Confounders for Symbol Digit Modalities Test: brain parenchymal fraction, WM fraction, WM lesion fraction; Controlled Word Association Test: WM fraction, WM lesion fraction, gray matter fraction; and Paced Auditory Serial Addition Test: brain parenchymal fraction, WM fraction, WM lesion fraction.

    • NAWM rR continues to be significantly lower in the impaired group for both the Symbol Digit Modalities Test and the Paced Auditory Serial Addition Test.

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American Journal of Neuroradiology: 34 (11)
American Journal of Neuroradiology
Vol. 34, Issue 11
1 Nov 2013
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Cite this article
A. Eilaghi, A. Kassner, I. Sitartchouk, P.L. Francis, R. Jakubovic, A. Feinstein, R.I. Aviv
Normal-Appearing White Matter Permeability Distinguishes Poor Cognitive Performance in Processing Speed and Working Memory
American Journal of Neuroradiology Nov 2013, 34 (11) 2119-2124; DOI: 10.3174/ajnr.A3539

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Normal-Appearing White Matter Permeability Distinguishes Poor Cognitive Performance in Processing Speed and Working Memory
A. Eilaghi, A. Kassner, I. Sitartchouk, P.L. Francis, R. Jakubovic, A. Feinstein, R.I. Aviv
American Journal of Neuroradiology Nov 2013, 34 (11) 2119-2124; DOI: 10.3174/ajnr.A3539
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