Presenter of 1 Presentation
REGRESSION OF WHITE MATTER HYPERINTENSITY LESIONS IN CEREBRAL SMALL VESSEL DISEASE
Abstract
Background and Aims
White matter hyperintensities (WMHs) are a radiological hallmark of cerebral small vessel disease (SVD). Previous studies have found that whole brain WMH burden can reduce over time, but the extent of lesion regression and the factors that drive it are not fully understood. We aimed to assess WMH regression in three SVD cohorts.
Methods
Participants were from the SCANS observational study (n=99; MRI at 0/1/2/3 years) and the PRESERVE trial (intensive blood pressure lowering in SVD; standard treatment arm n=42; MRI at 0/1 year) and had symptomatic lacunar infarcts with moderate WMH burden at baseline (Fazekas score>=2). WMHs in SCANS were calculated using a two-step pipeline mapping individual images to a participant average and then warping to a group average space. WMHs in PRESERVE were calculated using a semi-automatic contouring program with pre- and post-treatment FLAIR images marked in parallel (blinded to timepoint). Regression was defined as WMH reduction >0.25cc between scans.
Results
WMH volume at baseline in SCANS was 45.8cc and the mean change between scans was 4.5+/-6.3cc; no subjects showed regression. WMH at baseline in PRESERVE was 31.0cc and the mean change between scans was 5.9+/-6.0cc); 6 subjects showed regression. Compared to non-regressors there were no significant differences in age, sex, baseline WMH volume, lacune number or brain volume.
Conclusions
Few participants showed WMH regression. To test whether this is due to statistical/imaging factors or SVD severity, we will apply the method used to quantify WMHs in PRESERVE to a third cohort with less severe SVD - the RUN-DMC study (n=276).