ArticleFrontiers in neurology2025
Exploration of heterogeneity in risk factors associated with imaging subtypes of white matter hyperintensities on fluid-attenuated inversion recovery magnetic resonance imaging.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: White matter hyperintensity (WMH), a critical early biomarker in cerebrovascular/neurodegenerative diseases, has traditionally been studied via global volume or subjective scoring, which overlooks its spatial heterogeneity, leading to conflicting risk factor conclusions. Recent neuroimaging advances enable "subtype resolution" research, but standardized assessments remain lacking. This study evaluates WMH risk factor spatial variability and constructs a risk stratification model to support precision prevention. Methods: This study retrospectively enrolled inpatients and outpatients aged ≥40 years [median 70.0, (59.0-77.0)] who underwent head MRI examinations due to neurological symptoms or suspected cerebrovascular disease between January 2023 and December 2024.excluding those with imaging contraindications, intracranial masses, or technical artifacts. Data included demographics (age, sex), medical history (hypertension, diabetes), and lab markers (creatinine, cystatin C). FLAIR MRI (3.0 T United Imaging uMR780) was used to acquire images. WMH volume and Fazekas scores were automatically quantified via the United Imaging AI module (UAI. OCR, R001) and validated by two senior neuroradiologists. Stratification included semi-quantitative Fazekas scoring (PWMH:periventricular WMH, DWMH:deep WMH) and anatomical segmentation (4 subregions: ventricular, periventricular, DWMH, juxtacortical). Statistical methods included Mann-Whitney U and chi-square tests for group comparisons, binary logistic regression for risk factors of moderate-severe WMH (Fazekas2-3), and multiple linear regression for volume associations ( Results: Compared with absent or mild WMH (Fazekas 0-1), Group comparisons revealed that advanced age, hypertension, and abnormal renal function markers [creatinine, cystatin C, β2-microglobulin (β2-MG)] were common risk factors for moderate-severe WMH (all Conclusion: WMH exhibits spatial heterogeneity with distinct mechanisms: PWMH associates with coronary/renal issues; DWMH with smoking/diabetes. Spatial classification optimizes risk stratification, guiding subtype-specific interventions and individualized prevention for cerebral small vessel disease.
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