Evidence map›Paper›PMID 39357898›Full record

ArticleStroke and vascular neurology2025

Definitions of white matter hyperintensity change: impact on estimates of progression and regression.

Angela C C Jochems, Susana Muñoz Maniega, Una Clancy, Carmen Arteaga Reyes, Daniela Jaime Garcia, Maria Del C Valdés Hernández, Francesca M Chappell, Gayle Barclay, Charlotte Jardine, Donna McIntyre and 6 more

Abstract readComparative Study
In one paragraph

Article in Stroke and vascular neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Location patterns and longitudinal progression of white matter hyperintensities.medRxiv : the preprint server for health sciences · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Angela C C JochemsUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-7392-3066
Susana Muñoz ManiegaCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
Una ClancyUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-8062-7537
Carmen Arteaga ReyesUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.ORCID 0000-0003-2424-7123
Daniela Jaime GarciaUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.
Maria Del C Valdés HernándezCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
Francesca M ChappellUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.
Gayle BarclayThe University of Edinburgh, Edinburgh Imaging Facility, Edinburgh, UK.
Charlotte JardineThe University of Edinburgh, Edinburgh Imaging Facility, Edinburgh, UK.
Donna McIntyreThe University of Edinburgh, Edinburgh Imaging Facility, Edinburgh, UK.
Iona GerrishThe University of Edinburgh, Edinburgh Imaging Facility, Edinburgh, UK.
Stewart WisemanCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
Michael S StringerUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3811-4439
Michael J ThrippletonCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
Fergus DoubalUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-2769-3148
Joanna M WardlawUK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK joanna.wardlaw@ed.ac.uk.ORCID 0000-0002-9812-6642

Funding

Biotechnology and Biological Sciences Research Council BB/W008793/1British Heart Foundation RE/18/5/34216RE/18/5/34216Chief Scientist Office CAF/18/08Wellcome Trust
6 · The paper itself

Abstract

backgroundWhite matter hyperintensity (WMH) progression is well documented; WMH regression is more contentious, which might reflect differences in defining WMH change. We compared four existing WMH change definitions in one population to determine the effect of definition on WMH regression.

methodsWe recruited patients with minor non-disabling ischaemic stroke who underwent MRI 1-3 months after stroke and 1 year later. We assessed WMH volume (in absolute mL and % intracranial volume) and applied four different definitions, including two thresholds (based on SD or mL), percentile and quintile approaches.

resultsIn 198 participants, mean age 65.5 (SD=11.13), baseline WMH volume was 15.46 mL (SD=19.2), the mean net WMH volume change was 0.98 mL (SD=2.84), range -7.98 to +12.84 mL. Proportion regressing/stable/progressing WMH were threshold 1 (SD), 29.8%/55.6%/14.6%; threshold 2(mL), 29.8%/16.7%/53.5%; percentile approach, 28.3%/21.2%/50.5%. The quintile approach includes five groups with quintile 3 reflecting no change (N=40), quintiles 1 and 2 any WMH decrease (N=80) and quintiles 4 and 5 any WMH increase (N=78).

conclusionsDifferent WMH change definitions cause big differences in how participants are categorised; additionally, non-normal WMH distribution precludes use of some definitions. Consistent use of an appropriate definition would facilitate data comparisons, particularly in clinical trials of potential WMH treatments.

Indexed as

Ischemic StrokeLeukoencephalopathiesMagnetic Resonance ImagingTerminology as TopicWhite MatterAgedAged, 80 and overDisease ProgressionFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisTime FactorsBrainCerebrovascular DisordersIschemic StrokeLesionMagnetic Resonance Imaging

Identifiers

PMID39357898
PMCPMC12230215

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.