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aging of the brain
This article contains the following attached media: Figure 1, Figure 2
Typical changes in the brain, that are more frequent above the age of 60, include overall brain atrophy and abnormalities in the white matter, that can be visualized by magnetic resonance imaging (MRI)as white matter signal abnormalities (WMSA) [1]. The origin of age-related changes in the white matter has been often ascribed to microvascular disease (microinfarcts), but neurodegenerative causes also may play a role.
Perhaps it is most useful to distinguish between clinically silent and clinically eloquent WMSA. We have studied the brain of aged people without major diseases, and found significantly more WMSA than in younger subjects [1], by applying automated image analysis tools to systematically acquired MRI studies of the whole brain. Our image analysis includes tissue segmentation procedures that have been developed to obtain reproducible estimates of brain components such as white matter (WM), white matter signal abnormalities (WMSA), gray matter (GM), and cerebrospinal fluid (CSF) [2-4].
We are currently interested in establishing the potential role of WMSA in neurologic changes typical in the elderly, such as cognitive decline, and gait impairment. Studies of brain images of aged people with well defined neurologic diseases, such as Alzheimer's Disease (AD) or Huntington Disease are in progress, in collaboration with Dr. Marylin Albert (Massachusetts General Hospital). Further studies of the possible role of WM disease in clinical disturbancies of the elderly that are often considered "normal", such as impaired gait control and balance, or subtle cognitive changes, are underway in collaboration with the Department of Neurology at the University of Connecticut Health Center (Dr. Leslie Wolfson).
Current members of the group working on quantitative imaging of the aging brain at BWH are:
- Charles R.G. Guttmann, M.D.
- Mark Anderson
- Marianna Jakab
- Mariann Polgár-Turcsányi
- Simon Warfield, Ph.D.
- Xingchang Wei, M.D.
- Carl-Fredrik Westin, Ph.D
- Ying Wu, M.D.
References:
- Guttmann CRG, Jolesz FA, Kikinis R, Killiany RJ, Moss MB, Sandor T, Albert MS.
White matter changes with normal aging.
Neurology 1998; 50:972-978. - Guttmann CRG, Kikinis R, Anderson MC, Jakab M, Warfield SK, Killiany RJ, Weiner HL, Jolesz FA.
Quantitative follow-up of patients with multiple sclerosis using MRI: reproducibility.
JMRI 1999; 9:509-518. - Kikinis R, Guttmann CRG, Metcalf D, Wells WM III, Ettinger GJ, Weiner HL, Jolesz FA.
Quantitative follow-up of patients with multiple sclerosis using MRI : technical aspects.
JMRI 1999; 9:519-530. - Warfield S, Dengler J, Zaers J, Guttmann CRG,Wells WM III, Ettinger GJ, Hiller J, Kikinis R.
Automatic identification of grey matter structures from MRI to improve the segmentation of white matter lesions.
Journal of Image Guided Surgery 1996; 1:326-338.