A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities

Young Noh; Yunhwan Lee; Sang Won Seo; Jee H. Jeong; Seong Hye Choi; Joung Hwan Back; Sook Young Woo; Geon Ha Kim; Ji Soo Shin; Chi Hun Kim; Hanna Cho; Joon Sung Park; Jong Min Lee; Chang Hyung Hong; Sang Yun Kim; Jae Hong Lee; Seong Yoon Kim; Kee Hyung Park; Seol Heui Han; Hae Kwan Cheong; Duk L. Na

doi:10.1016/j.jstrokecerebrovasdis.2013.06.002

A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities

Young Noh, Yunhwan Lee, Sang Won Seo, Jee H. Jeong, Seong Hye Choi, Joung Hwan Back, Sook Young Woo, Geon Ha Kim, Ji Soo Shin, Chi Hun Kim, Hanna Cho, Joon Sung Park, Jong Min Lee, Chang Hyung Hong, Sang Yun Kim, Jae Hong Lee, Seong Yoon Kim, Kee Hyung Park, Seol Heui Han, Hae Kwan CheongDuk L. Na

Department of Neurology

Research output: Contribution to journal › Article › peer-review

67 Scopus citations

Abstract

The Clinical Research Center for Dementia of South Korea (CREDOS) group developed a new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities (WMHs). In this study, we aimed to evaluate the validity of the CREDOS ischemia classification system. A total of 352 patients with cognitive impairments were included. Their WMH scores were rated using the CREDOS WMH visual rating scale. These patients were divided into 3 groups according to the CREDOS ischemia classification system. The volume of WMH was also automatically measured. The number of lacunes and microbleeds (MBs) were counted. The CREDOS ischemia classification system was revised with factor analysis using vascular risk factors and cerebrovascular disease (CVD) markers (WMH volume, lacunes, and MBs). External validation was performed in another group of patients with cognitive impairment using multinomial logistic regression analysis. The CREDOS WMH visual rating scale showed excellent correlation with the automatically measured volume of WMH. The factor analysis showed that the severe group was expanded to D3P1 and D3P2 in the revised CREDOS ischemia classification system. In the validation group, the presence of vascular risk factors and the severity of CVD markers could be distinguished according to the revised CREDOS ischemia classification. We validated a newly developed classification system for ischemia. This simple visual classification system was capable of providing information on vascular risk factors and CVD markers by simply rating WMH on magnetic resonance imaging.

Original language	English
Pages (from-to)	636-642
Number of pages	7
Journal	Journal of Stroke and Cerebrovascular Diseases
Volume	23
Issue number	4
DOIs	https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.06.002
State	Published - Apr 2014

Bibliographical note

Funding Information:
This study was supported by a grant from the Korean Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (no. A102065 and A120798); by the Korean Science and Engineering Foundation National Research Laboratory program grant funded by the Korean government (Ministry of Education, Science and Technology; 2011-0028333); and by the Samsung Medical Center Clinical Research Development Program grant (CRL-108011 and CRS 110-14-1).

Keywords

White matter hyperintensities
cerebrovascular disease
classification
ischemia
magnetic resonance imaging
visual rating

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10.1016/j.jstrokecerebrovasdis.2013.06.002

Cite this

Noh, Y., Lee, Y., Seo, S. W., Jeong, J. H., Choi, S. H., Back, J. H., Woo, S. Y., Kim, G. H., Shin, J. S., Kim, C. H., Cho, H., Park, J. S., Lee, J. M., Hong, C. H., Kim, S. Y., Lee, J. H., Kim, S. Y., Park, K. H., Han, S. H., ... Na, D. L. (2014). A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities. Journal of Stroke and Cerebrovascular Diseases, 23(4), 636-642. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.06.002

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title = "A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities",

abstract = "The Clinical Research Center for Dementia of South Korea (CREDOS) group developed a new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities (WMHs). In this study, we aimed to evaluate the validity of the CREDOS ischemia classification system. A total of 352 patients with cognitive impairments were included. Their WMH scores were rated using the CREDOS WMH visual rating scale. These patients were divided into 3 groups according to the CREDOS ischemia classification system. The volume of WMH was also automatically measured. The number of lacunes and microbleeds (MBs) were counted. The CREDOS ischemia classification system was revised with factor analysis using vascular risk factors and cerebrovascular disease (CVD) markers (WMH volume, lacunes, and MBs). External validation was performed in another group of patients with cognitive impairment using multinomial logistic regression analysis. The CREDOS WMH visual rating scale showed excellent correlation with the automatically measured volume of WMH. The factor analysis showed that the severe group was expanded to D3P1 and D3P2 in the revised CREDOS ischemia classification system. In the validation group, the presence of vascular risk factors and the severity of CVD markers could be distinguished according to the revised CREDOS ischemia classification. We validated a newly developed classification system for ischemia. This simple visual classification system was capable of providing information on vascular risk factors and CVD markers by simply rating WMH on magnetic resonance imaging.",

keywords = "White matter hyperintensities, cerebrovascular disease, classification, ischemia, magnetic resonance imaging, visual rating",

author = "Young Noh and Yunhwan Lee and Seo, {Sang Won} and Jeong, {Jee H.} and Choi, {Seong Hye} and Back, {Joung Hwan} and Woo, {Sook Young} and Kim, {Geon Ha} and Shin, {Ji Soo} and Kim, {Chi Hun} and Hanna Cho and Park, {Joon Sung} and Lee, {Jong Min} and Hong, {Chang Hyung} and Kim, {Sang Yun} and Lee, {Jae Hong} and Kim, {Seong Yoon} and Park, {Kee Hyung} and Han, {Seol Heui} and Cheong, {Hae Kwan} and Na, {Duk L.}",

note = "Funding Information: This study was supported by a grant from the Korean Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (no. A102065 and A120798); by the Korean Science and Engineering Foundation National Research Laboratory program grant funded by the Korean government (Ministry of Education, Science and Technology; 2011-0028333); and by the Samsung Medical Center Clinical Research Development Program grant (CRL-108011 and CRS 110-14-1).",

year = "2014",

month = apr,

doi = "10.1016/j.jstrokecerebrovasdis.2013.06.002",

language = "English",

volume = "23",

pages = "636--642",

journal = "Journal of Stroke and Cerebrovascular Diseases",

issn = "1052-3057",

publisher = "W.B. Saunders Ltd",

number = "4",

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Noh, Y, Lee, Y, Seo, SW, Jeong, JH, Choi, SH, Back, JH, Woo, SY, Kim, GH, Shin, JS, Kim, CH, Cho, H, Park, JS, Lee, JM, Hong, CH, Kim, SY, Lee, JH, Kim, SY, Park, KH, Han, SH, Cheong, HK & Na, DL 2014, 'A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities', Journal of Stroke and Cerebrovascular Diseases, vol. 23, no. 4, pp. 636-642. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.06.002

TY - JOUR

T1 - A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities

AU - Noh, Young

AU - Lee, Yunhwan

AU - Seo, Sang Won

AU - Jeong, Jee H.

AU - Choi, Seong Hye

AU - Back, Joung Hwan

AU - Woo, Sook Young

AU - Kim, Geon Ha

AU - Shin, Ji Soo

AU - Kim, Chi Hun

AU - Cho, Hanna

AU - Park, Joon Sung

AU - Lee, Jong Min

AU - Hong, Chang Hyung

AU - Kim, Sang Yun

AU - Lee, Jae Hong

AU - Kim, Seong Yoon

AU - Park, Kee Hyung

AU - Han, Seol Heui

AU - Cheong, Hae Kwan

AU - Na, Duk L.

N1 - Funding Information: This study was supported by a grant from the Korean Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (no. A102065 and A120798); by the Korean Science and Engineering Foundation National Research Laboratory program grant funded by the Korean government (Ministry of Education, Science and Technology; 2011-0028333); and by the Samsung Medical Center Clinical Research Development Program grant (CRL-108011 and CRS 110-14-1).

PY - 2014/4

Y1 - 2014/4

N2 - The Clinical Research Center for Dementia of South Korea (CREDOS) group developed a new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities (WMHs). In this study, we aimed to evaluate the validity of the CREDOS ischemia classification system. A total of 352 patients with cognitive impairments were included. Their WMH scores were rated using the CREDOS WMH visual rating scale. These patients were divided into 3 groups according to the CREDOS ischemia classification system. The volume of WMH was also automatically measured. The number of lacunes and microbleeds (MBs) were counted. The CREDOS ischemia classification system was revised with factor analysis using vascular risk factors and cerebrovascular disease (CVD) markers (WMH volume, lacunes, and MBs). External validation was performed in another group of patients with cognitive impairment using multinomial logistic regression analysis. The CREDOS WMH visual rating scale showed excellent correlation with the automatically measured volume of WMH. The factor analysis showed that the severe group was expanded to D3P1 and D3P2 in the revised CREDOS ischemia classification system. In the validation group, the presence of vascular risk factors and the severity of CVD markers could be distinguished according to the revised CREDOS ischemia classification. We validated a newly developed classification system for ischemia. This simple visual classification system was capable of providing information on vascular risk factors and CVD markers by simply rating WMH on magnetic resonance imaging.

AB - The Clinical Research Center for Dementia of South Korea (CREDOS) group developed a new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities (WMHs). In this study, we aimed to evaluate the validity of the CREDOS ischemia classification system. A total of 352 patients with cognitive impairments were included. Their WMH scores were rated using the CREDOS WMH visual rating scale. These patients were divided into 3 groups according to the CREDOS ischemia classification system. The volume of WMH was also automatically measured. The number of lacunes and microbleeds (MBs) were counted. The CREDOS ischemia classification system was revised with factor analysis using vascular risk factors and cerebrovascular disease (CVD) markers (WMH volume, lacunes, and MBs). External validation was performed in another group of patients with cognitive impairment using multinomial logistic regression analysis. The CREDOS WMH visual rating scale showed excellent correlation with the automatically measured volume of WMH. The factor analysis showed that the severe group was expanded to D3P1 and D3P2 in the revised CREDOS ischemia classification system. In the validation group, the presence of vascular risk factors and the severity of CVD markers could be distinguished according to the revised CREDOS ischemia classification. We validated a newly developed classification system for ischemia. This simple visual classification system was capable of providing information on vascular risk factors and CVD markers by simply rating WMH on magnetic resonance imaging.

KW - White matter hyperintensities

KW - cerebrovascular disease

KW - classification

KW - ischemia

KW - magnetic resonance imaging

KW - visual rating

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U2 - 10.1016/j.jstrokecerebrovasdis.2013.06.002

DO - 10.1016/j.jstrokecerebrovasdis.2013.06.002

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AN - SCOPUS:84897521158

SN - 1052-3057

VL - 23

SP - 636

EP - 642

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

IS - 4

ER -

A new classification system for ischemia using a combination of deep and periventricular white matter hyperintensities

Abstract

Bibliographical note

Keywords

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