Neuropathologic scales of cerebrovascular disease associated with diffusion changes on MRI

Aivi T. Nguyen, Naomi Kouri, Sydney A. Labuzan, Scott A. Przybelski, Timothy G. Lesnick, Sheelakumari Raghavan, Robert I. Reid, R. Ross Reichard, David S. Knopman, Ronald C. Petersen, Clifford R. Jack, Michelle M. Mielke, Dennis W. Dickson, Jonathan Graff-Radford, Melissa E. Murray, Prashanthi Vemuri

Research output: Contribution to journalArticlepeer-review


Summarizing the multiplicity and heterogeneity of cerebrovascular disease (CVD) features into a single measure has been difficult in both neuropathology and imaging studies. The objective of this work was to evaluate the association between neuroimaging surrogates of CVD and two available neuropathologic CVD scales in those with both antemortem imaging CVD measures and postmortem CVD evaluation. Individuals in the Mayo Clinic Study of Aging with MRI scans within 5 years of death (N = 51) were included. Antemortem CVD measures were computed from diffusion MRI (dMRI), FLAIR, and T2* GRE imaging modalities and compared with postmortem neuropathologic findings using Kalaria and Strozyk Scales. Of all the neuroimaging measures, both regional and global dMRI measures were associated with Kalaria and Strozyk Scales (p < 0.05) and modestly correlated with global cognitive performance. The major conclusions from this study were: (i) microstructural white matter injury measurements using dMRI may be meaningful surrogates of neuropathologic CVD scales, because they aid in capturing diffuse (and early) changes to white matter and secondary neurodegeneration due to lesions; (ii) vacuolation in the corpus callosum may be associated with white matter changes measured on antemortem dMRI imaging; (iii) Alzheimer’s disease neuropathologic change did not associate with neuropathologic CVD scales; and (iv) future work should be focused on developing better quantitative measures utilizing dMRI to optimally assess CVD-related neuropathologic changes.

Original languageEnglish (US)
Pages (from-to)1117-1125
Number of pages9
JournalActa neuropathologica
Issue number6
StatePublished - Dec 2022


  • Cerebrovascular disease
  • Diffusion MRI
  • Imaging
  • Neuropathology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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