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A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT
Lars‐Olof Wahlund, Frederik Barkhof, Franz Fazekas, Lena Bronge, Michael Augustin, Magnus J.C. Sjögren, Anders Wallin, H.J. Adèr, Didier Leys, Leonardo Pantoni, Florence Pasquier, Timo Erkinjuntti, Philip Scheltens. Stroke, 2001-06-01
Topic: Risk, prevention and care in population studies
BACKGROUND AND PURPOSE: MRI is more sensitive than CT for detection of age-related white matter changes (ARWMC). Most rating scales estimate the degree and distribution of ARWMC either on CT or on MRI, and they differ in many aspects. This makes it difficult to compare CT and MRI studies. To be able to study the evolution and possible effect of drug treatment on ARWMC in large patient samples, it is necessary to have a rating scale constructed for both MRI and CT. We have developed and evaluated a new scale and studied ARWMC in a large number of patients examined with both MRI and CT. METHODS: Seventy-seven patients with ARWMC on either CT or MRI were recruited and a complementary examination (MRI or CT) performed. The patients came from 4 centers in Europe, and the scans were rated by 4 raters on 1 occasion with the new ARWMC rating scale. The interrater reliability was evaluated by using kappa statistics. The degree and distribution of ARWMC in CT and MRI scans were compared in different brain areas. RESULTS: Interrater reliability was good for MRI (kappa=0.67) and moderate for CT (kappa=0.48). MRI was superior in detection of small ARWMC, whereas larger lesions were detected equally well with both CT and MRI. In the parieto-occipital and infratentorial areas, MRI detected significantly more ARWMC than did CT. In the frontal area and basal ganglia, no differences between modalities were found. When a fluid-attenuated inversion recovery sequence was used, MRI detected significantly more lesions than CT in frontal and parieto-occipital areas. No differences were found in basal ganglia and infratentorial areas. CONCLUSIONS: We present a new ARWMC scale applicable to both CT and MRI that has almost equal sensitivity, except for certain regions. The interrater reliability was slightly better for MRI, as was the detectability of small lesions.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wahlund, L., Barkhof, F., Fazekas, F., Bronge, L., Augustin, M., Sjögren, M. J., et al. (2001). A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT. Stroke. https://doi.org/10.1161/01.str.32.6.1318
Vancouver
Wahlund L, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjögren MJ, et al. A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT. Stroke. 2001. doi:10.1161/01.str.32.6.1318. PMID: 11387493.
BibTeX
@article{wahlund2001-11387493,
author = {Wahlund, Lars‐Olof and Barkhof, Frederik and Fazekas, Franz and Bronge, Lena and Augustin, Michael and Sjögren, Magnus J.C. and Wallin, Anders and Adèr, H.J. and Leys, Didier and Pantoni, Leonardo and Pasquier, Florence and Erkinjuntti, Timo and Scheltens, Philip},
title = {{A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT}},
journal = {Stroke},
year = {2001},
doi = {10.1161/01.str.32.6.1318},
pmid = {11387493},
url = {https://doi.org/10.1161/01.str.32.6.1318}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 13 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Why it matters
Presents a rating scale for age-related white matter changes in the brain that can be used on both MRI and CT scans. In 77 patients from 4 European centers, agreement between raters was good for MRI and moderate for CT, and MRI was better at detecting small changes.
How this study scored 54/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on strength of evidence, so that was left out: it earned 51 of the 95 points we could judge it on, which is 54 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | — / 5 | No evidence rating recorded — left out of this score |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2001 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,805 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 66.9 citations a year over 27 year(s) since 2001 |
| Impact for its field and year | 4 / 6 | Cited 9.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 4 / 4 | Cited 214 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Philip Scheltens: h-index 181 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11387493) |
| Free to read | 2 / 2 | Free to read |
| Points | 51 / 95 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 51 of the 95 points we could judge it on is 54 out of 100. |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
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