Published Online
on October 31, 2002

A more recent version of this article appeared on December 1, 2002

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Submitted on June 7, 2002
Accepted on July 4, 2002

Visual Rating Scales for Age-Related White Matter Changes (Leukoaraiosis). Can the Heterogeneity Be Reduced?

Leonardo Pantoni MD, PhD^*; Michela Simoni MD; Giovanni Pracucci MD; Reinhold Schmidt MD; Frederik Barkhof MD, PhD; Domenico Inzitari MD; and for the European Task Force on Age-Related White Matter Changes

From the Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy (L.P., M.S., G.P., D.I.); Department of Neurology, Karl-Franzens University of Graz, Graz, Austria (R.S.); and MR-MS Centre, VU Medical Centre, Amsterdam, the Netherlands (F.B.).

^* To whom correspondence should be addressed. E-mail: pantoni{at}neuro.unifi.it.

Background and Purpose—It has been hypothesized that the use of different visual rating scales partly explains the discordant results of studies investigating risk factors and clinical correlates of age-related cerebral white matter changes (leukoaraiosis). We aimed to compare 6 widely used rating scales for leukoaraiosis and to calculate conversion coefficients of the score of 1 scale in the score of a second scale.

Methods—Two trained raters evaluated 80 pairs of CT and MRI scans using 2 CT and 4 MRI rating scales for white matter changes. Correlations among the scales were evaluated and regression lines were constructed with each of the CT and MRI scale scores as variables.

Results—A high correlation was observed in all the paired comparisons of the 6 scales (Spearman's ranging from 0.85 to 0.96, P<0.0001). Using regression analysis, we determined numeric parameters to transform the score of 1 scale to the corresponding score for each of the remaining scales and relative confidence intervals. The predictive values of these conversions expressed as R² ranged from 0.75 to 0.92.

Conclusions—The present findings support the view that a good correlation exists among the considered visual rating scales for white matter changes. With the limitation that conversion parameters are calculated by applying a linear regression to partly nonlinear scales, their use allows comparison of the results of previous studies that used different scales and to pool data from past and ongoing clinical trials.

Key words: leukoaraiosis • magnetic resonance imaging • tomography, x-ray computed • white matter

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