FLAIR MRI biomarkers of the normal appearing brain matter are related to cognition

M-A. Bahsoun; M.U. Khan; S. Mitha; A. Ghazvanchahi; H. Khosravani; P. Jabehdar Maralani; J-C. Tardif; A.R. Moody; P.N. Tyrrell; A. Khademi

NeuroImage: Clinical (Jan 2022)

FLAIR MRI biomarkers of the normal appearing brain matter are related to cognition

M-A. Bahsoun,
M.U. Khan,
S. Mitha,
A. Ghazvanchahi,
H. Khosravani,
P. Jabehdar Maralani,
J-C. Tardif,
A.R. Moody,
P.N. Tyrrell,
A. Khademi

Affiliations

M-A. Bahsoun: Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada
M.U. Khan: Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada
S. Mitha: Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada
A. Ghazvanchahi: Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada
H. Khosravani: Hurvitz Brain Sciences Program Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
P. Jabehdar Maralani: Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
J-C. Tardif: Montreal Heart Institute, Montreal, QU, Canada; Department of Medicine, Université de Montréal, QU, Canada
A.R. Moody: Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
P.N. Tyrrell: Department of Medical Imaging, University of Toronto, Toronto, ON, Canada; Department of Statistical Sciences, University of Toronto, Toronto, ON, Canada
A. Khademi: Electrical, Computer and Biomedical Engineering Dept., Ryerson University, Toronto, ON, Canada; Keenan Research Center for Biomedical Science, St. Michael’s Hospital, Unity Health Network, Toronto, ON, Canada; Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON, Canada; Corresponding author.

Journal volume & issue: Vol. 34
p. 102955

Abstract

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A novel biomarker panel was proposed to quantify macro and microstructural biomarkers from the normal-appearing brain matter (NABM) in multicentre fluid-attenuation inversion recovery (FLAIR) MRI. The NABM is composed of the white and gray matter regions of the brain, with the lesions and cerebrospinal fluid removed. The primary hypothesis was that NABM biomarkers from FLAIR MRI are related to cognitive outcome as determined by MoCA score. There were three groups of features designed for this task based on 1) texture: microstructural integrity (MII), macrostructural damage (MAD), microstructural damage (MID), 2) intensity: median, skewness, kurtosis and 3) volume: NABM to ICV volume ratio. Biomarkers were extracted from over 1400 imaging volumes from more than 87 centres and unadjusted ANOVA analysis revealed significant differences in means of the MII, MAD, and NABM volume biomarkers across all cognitive groups. In an adjusted ANCOVA model, a significant relationship between MoCA categories was found that was dependent on subject age for MII, MAD, intensity, kurtosis and NABM volume biomarkers. These results demonstrate that structural brain changes in the NABM are related to cognitive outcome (with different relationships depending on the age of the subjects). Therefore these biomarkers have high potential for clinical translation. As a secondary hypothesis, we investigated whether texture features from FLAIR MRI can quantify microstructural changes related to how “structured” or “damaged” the tissue is. Based on correlation analysis with diffusion weighted MRI (dMRI), it was shown that FLAIR MRI texture biomarkers (MII and MAD) had strong correlations to mean diffusivity (MD) which is related to tissue degeneration in the GM and WM regions. As FLAIR MRI is routinely collected for clinical neurological examinations, novel biomarkers from FLAIR MRI could be used to supplement current clinical biomarkers and for monitoring disease progression. Biomarkers could also be used to stratify patients into homogeneous disease subgroups for clinical trials, or to learn more about mechanistic development of dementia disease.

Published in NeuroImage: Clinical

ISSN: 2213-1582 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General): Computer applications to medicine. Medical informatics; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: http://www.journals.elsevier.com/neuroimage-clinical/

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