Complexity of MRI white matter hyperintensity assessments in relation to cognition in aging and @entity303 from the Sunnybrook XXXX Study.

@entity1 @entity303 @entity73 @entity194 @entity195 @entity62
PURPOSE: Quantification methods for @entity62 ( @entity62 ) on Magnetic Resonance Imaging are heterogeneous, deterring their application. This study compared three @entity62 rating scales, varying in complexity, and a volumetric method, to evaluate trade-offs between complexity and clinical utility in differentiating @entity303 subgroups and in correlating with cognition. METHODS: @entity62 were rated using the Fazekas, Age-Related White Matter Changes (ARWMC) and Scheltens scales, and segmented by computational volumetry in 108 @entity1 with @entity195 ( @entity195 ), 23 with @entity73 ( @entity73 ) and 34 normal controls (NC). Global and hippocampal @entity194 , age and education, were accounted for in correlations of @entity62 with cognitive domains. RESULTS: Intra- and inter-rater reliability were high (intraclass correlation coefficients = 0.88-0.97) across rating scales. @entity62 scores of all scales were highly correlated with volumes (Spearman r = 0.78-0.90, Ps < 0.001), as well as with each other (Spearman r = 0.86-0.91, Ps < 0.001). The Fazekas scale showed significant separation between @entity195 , @entity73 and NC using non-parametric analysis, while the ARWMC and Scheltens' scales, and @entity62 volumes demonstrated significant correlations (standardized b = -0.19 to -0.24, Ps < 0.05) with cognitive domain scores using multivariate regression analysis, controlling for age, education, global and hippocampal @entity194 in @entity1 with @entity195 . CONCLUSIONS: This study suggests that the degree of complexity of @entity62 rating scales did not affect validation against @entity62 volumes, but did vary in validation against cognition. The simplest scale performed best in separating cognitive subgroups, but the more complex scales and quantification correlated better with cognitive measures, especially executive function. Hence the best choice of scale depends on the particular application.
