ArticleJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2022
Free-water diffusion MRI detects structural alterations surrounding white matter hyperintensities in the early stage of cerebral small vessel disease.
Article in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 41 citations in OpenAlex.
- Effects of aerobic exercise and cardiorespiratory fitness on white matter free water fraction in older adults: a 1-year randomized controlled trial.GeroScience · 2026Trial
- Blood-brain barrier disruption and increased free water are associated with worse cognitive performance in patients with chronic cerebrovascular disease.NeuroImage. Clinical · 2024Trial
- Association between vascular risk factors and white matter integrity among diverse predominantly older Hispanic/Latino adults from the SOL-INCA MRI study.GeroScience · 2026Article
- Perilesional white matter gradients reveal microstructural differences in cerebral amyloid angiopathy versus Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Free water-mediated associations among choroid plexus enlargement, white matter lesions, and cognitive performance in type 2 diabetes mellitus.Frontiers in endocrinology · 2026Article
- Perivascular diffusion and white matter free water improve identification of cognitive impairment in cerebral small vessel disease.Frontiers in neurology · 2026Article
- Multimodal Magnetic Resonance Imaging Signatures of White Matter Hyperintensities: Mechanistic Insights Into Pathobiological Heterogeneity.Journal of stroke · 2026Review
- Glymphatic system dysfunction in temporal lobe epilepsy with hippocampal sclerosis: MRI-based evaluation of circulatory markers and disease progression.Frontiers in neuroscience · 2026Article
- Mapping the Association of Cerebral Small Vessel Disease, Gray Matter Integrity, and Cognitive Function.Neurology · 2025Article
- Reduced myelin contributes to cognitive impairment in patients with monogenic small vessel disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Article
- Free Water as a Marker of Early Small Vessel Disease in Healthy Aging.European journal of neurology · 2025Article
- Brain perfusion and blood-brain barrier permeability in systemic lupus erythematosus patients: Associations with disease activity, cognitive dysfunction, fatigue and pain.Neuroimage. Reports · 2025Article
- Free water as a potential mediator linking basal ganglia peri-vascular spaces to white matter hyperintensities in cerebral small vessel disease.Frontiers in neuroscience · 2025Article
- Disentangling the contributions of cerebrovascular-related white matter integrity markers to cognitive aging.Cerebral circulation - cognition and behavior · 2025Article
- Free-water imaging of the nucleus basalis of Meynert in apolipoprotein E4 carriers.Frontiers in aging neuroscience · 2025Article
- Enhancing cognitive performance prediction by white matter hyperintensity connectivity assessment.Brain : a journal of neurology · 2024Article
- Association between periodontal disease and microstructural brain alterations in the Hamburg City Health Study.Journal of clinical periodontology · 2024Article
- Choroid Plexus Volume in Rural Chinese Older Adults: Distribution and Association With Cardiovascular Risk Factors and Cerebral Small Vessel Disease.Journal of the American Heart Association · 2024Article
- Mapping the interplay of atrial fibrillation, brain structure, and cognitive dysfunction.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
In cerebral small vessel disease (CSVD), both white matter hyperintensities (WMH) of presumed vascular origin and the normal-appearing white matter (NAWM) contain microstructural brain alterations on diffusion-weighted MRI (DWI). Contamination of DWI-derived metrics by extracellular free-water can be corrected with free-water (FW) imaging. We investigated the alterations in FW and FW-corrected fractional anisotropy (FA-t) in WMH and surrounding tissue and their association with cerebrovascular risk factors. We analysed 1,000 MRI datasets from the Hamburg City Health Study. DWI was used to generate FW and FA-t maps. WMH masks were segmented on FLAIR and T1-weighted MRI and dilated repeatedly to create 8 NAWM masks representing increasing distance from WMH. Linear models were applied to compare FW and FA-t across WMH and NAWM masks and in association with cerebrovascular risk. Median age was 64 ± 14 years. FW and FA-t were altered 8 mm and 12 mm beyond WMH, respectively. Smoking was significantly associated with FW in NAWM (p = 0.008) and FA-t in WMH (p = 0.008) and in NAWM (p = 0.003) while diabetes and hypertension were not. Further research is necessary to examine whether FW and FA-t alterations in NAWM are predictors for developing WMH.
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