Influence of Mild White Matter Lesions on Voxel-based Morphometry

PURPOSE: The aim of this study was to investigate whether the detectability of brain volume change in voxel-based morphometry (VBM) with gray matter images is affected by mild white matter lesions (MWLs). METHODS: Three-dimensional T(1)-weighted images (3D-T(1)WIs) of 11 healthy subjects were obtained using a 3T MR scanner. We initially created 3D-T(1)WIs with focal cortical atrophy simulated cortical atrophy in left amygdala (type A) and the left medial frontal lobe (type B) from control 3D-T(1)WIs. Next, the following three types of MWL images were created: type A + 1L and type B + 1L images, only one white matter lesion; type A + 4L and type B + 4L images, four white matter lesions at distant positions; and type A + 4L(*) and type B + 4L(*) images, four white matter lesions at clustered positions. Comparisons between the control group and the other groups were performed with VBM using segmented gray matter images. RESULTS: The gray matter volume was significantly lower in the type A group than in the control group, and similar results were observed in the type A + 1L, type A + 4L, and type A + 4L(*) groups. Additionally, the gray matter volume was significantly lower in the type B group than in the control group, and similar results were observed in the type B + 1L, type B + 4L, and type B + 4L(*) groups, but the cluster size in type B + 4L(*) was smaller than that in type B. CONCLUSION: Our study showed that the detectability of brain volume change in VBM with gray matter images was not decreased by MWLs as lacunar infarctions. Therefore, we think that group comparisons with VBM should be analyzed by groups including and excluding subjects with MWLs, respectively.