ArticleFrontiers in neurology2023
Diffusion tensor free water MRI predicts progression of FLAIR white matter hyperintensities after ischemic stroke.
Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 10 citations in OpenAlex.
- Age, Multidomain Lifestyle Intervention, and White Matter Integrity: Secondary Analysis of the POINTER Randomized Clinical Trial.JAMA network open · 2026Trial
- Blood-brain barrier disruption and increased free water are associated with worse cognitive performance in patients with chronic cerebrovascular disease.NeuroImage. Clinical · 2024Trial
- Operationalizing diffusion magnetic resonance imaging positivity for detection of vascular contributions to impairment and dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Article
- Associations of cardiorespiratory fitness with brain white matter microstructural integrity and white matter hyperintensity volume across the adult lifespan.GeroScience · 2026Article
- Glymphatic system dysfunction in temporal lobe epilepsy with hippocampal sclerosis: MRI-based evaluation of circulatory markers and disease progression.Frontiers in neuroscience · 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
- Distinguishing Early from Late Mild Cognitive Impairment Using Magnetic Resonance Free-Water Diffusion Tensor Imaging.NeuroSci · 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
- Subtle white matter intensity changes on fluid-attenuated inversion recovery imaging in patients with ischaemic stroke.Brain communications · 2024Article
- Assessment of microstructural changes in white matter hyperintensities in aging and mild cognitive impairment revealed by advanced diffusion MRI.Journal of Alzheimer's disease reportsArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Background: The progression of FLAIR white matter hyperintensities (WMHs) on MRI heralds vascular-mediated cognitive decline. Even before FLAIR WMH progression, adjacent normal appearing white matter (NAWM) already demonstrates microstructural deterioration on diffusion tensor imaging (DTI). We hypothesized that elevated DTI free water (FW) would precede FLAIR WMH progression, implicating interstitial fluid accumulation as a key pathological step in the progression of cerebral small vessel disease. Methods: Participants at least 3 months after an ischemic stroke or TIA with WMH on MRI underwent serial brain MRIs every 3 months over the subsequent year. For each participant, the WMHs were automatically segmented, serial MRIs were aligned, and a region of WMH penumbra tissue at risk was defined by dilating lesions at any time point and subtracting baseline lesions. Penumbra voxels were classified as either stable or progressing to WMH if they were segmented as new lesions and demonstrated increasing FLAIR intensity over time. Aligned DTI images included FW and FW-corrected fractional anisotropy (FA Results: In the included participants ( Discussion: Baseline increased interstitial fluid, estimated as FW on DTI, predicted the progression of NAWM to WMH over the following year. These results implicate the presence of FW in the pathogenesis of cerebral small vessel disease progression.
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