1
|
Chang FG, Rost NS, Manson JE, Buring JE, Rist PM. Association between white matter hyperintensity volume and social functioning limitations among stroke survivors. J Stroke Cerebrovasc Dis 2022; 31:106720. [PMID: 36007263 PMCID: PMC9509456 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/10/2022] [Accepted: 08/13/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Existing literature on white matter hyperintensity volume (WMHV) in stroke patients has rarely focused on post-stroke outcomes related to social functioning limitations, such as transportation, social interaction, food preparation, grocery shopping, and housekeeping. Using prospective data from the VITamin D and OmegA-3 TriaL (VITAL) study, we evaluated the association between WMHV and social functioning limitations among 151 ischemic stroke patients. MATERIALS AND METHODS WMHV was ascertained from magnetic resonance imaging (MRI) collected at the time of the stroke event using a validated semiautomated method, and social functioning limitations were assessed using a stroke outcomes questionnaire administered a median of 1.25 years after the date of the MRI scan. Logistic regression was used to explore the association between WMHV and social functioning limitations. RESULTS After adjusting for age and sex, a statistically significant association was found between WMHV and limitations in social interaction (OR=2.82; 95% CI: 1.21-7.55). Increased risks were seen for limitations related to food preparation (OR=2.06; 95% CI: 0.99-4.54), transportation (OR=1.39; 95% CI: 0.85-2.27), and housekeeping (OR=1.37; 95% CI: 0.91-2.11); however, the associations did not reach statistical significance. We observed no association between WMHV and limitations in grocery shopping (OR=1.08; 95% CI: 0.61-1.89). CONCLUSIONS Future studies are needed to further explore the biological mechanisms underlying the relationship with limitations in social interaction and to replicate our findings using a larger and more diverse study sample.
Collapse
Affiliation(s)
- Flora G Chang
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Natalia S Rost
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
| |
Collapse
|
2
|
Hafdi M, Mutsaerts HJMM, Petr J, Richard E, van Dalen JW. Atherosclerotic risk is associated with cerebral perfusion - A cross-sectional study using arterial spin labeling MRI. Neuroimage Clin 2022; 36:103142. [PMID: 35970112 PMCID: PMC9400119 DOI: 10.1016/j.nicl.2022.103142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Arterial spin labeling (ASL) magnetic resonance imaging (MRI) may be a promising technique to evaluate the presence of cerebral atherosclerosis. We tested whether the new and easily calculated ASL MRI parameter for vascular and tissue signal distribution - 'spatial coefficient of variation' (ASL-sCoV) - is a better radiological marker for atherosclerotic risk than the more conventional markers of white matter hyperintensity (WMH) volume and cerebral blood flow (ASL-CBF). METHODS Participants of the preDIVA trial (n = 195), aged 72-80 years with systolic hypertension (>140 mmHg) underwent two MRI scans two to three years apart. WMH volume was derived from 3D FLAIR-MRI; gray matter ASL-CBF and ASL-sCoV from ASL-MRI. Atherosclerotic risk was operationalized as 10-year cardiovascular risk by the Systematic COronary Risk Evaluation Older Persons (SCORE O.P) and calculated at baseline and follow-up. Data were analyzed using linear regression. RESULTS ASL-CBF was associated with atherosclerotic risk scores at baseline (standardized-beta = -0.26, 95 %CI = -0.40 to -0.13, p < 0.001) but not at follow-up (standardized-beta = -0.14, 95 %CI = -0.33 to 0.04, p = 0.12). ASL-sCoV was associated with atherosclerotic risk scores at both time points (baseline standardized-beta = 0.23, 95 %CI = 0.10 to 0.36, p < 0.0001, follow-up standardized beta = 0.20, 95 %CI = 0.03 to 0.36, p = 0.02). WMH volume was not associated with atherosclerotic risk scores at either time-point. There were no longitudinal associations between changes in MRI parameters and baseline atherosclerotic risk scores. CONCLUSIONS Our findings suggest that ASL-sCoV correlates better with atherosclerotic risk than the more conventional markers ASL-CBF and WMH volume. Our data reaffirm that non-invasive imaging with MRI is highly informative and could provide additional information about cerebrovascular damage.
Collapse
Affiliation(s)
- Melanie Hafdi
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands,Corresponding author at: Amsterdam University Medical Centre, Department of Neurology Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, The Netherlands,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Willem van Dalen
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Dercon Q, Nicholas JM, James SN, Schott JM, Richards M. Grip strength from midlife as an indicator of later-life brain health and cognition: evidence from a British birth cohort. BMC Geriatr 2021; 21:475. [PMID: 34465287 PMCID: PMC8406895 DOI: 10.1186/s12877-021-02411-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/10/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Grip strength is an indicator of physical function with potential predictive value for health in ageing populations. We assessed whether trends in grip strength from midlife predicted later-life brain health and cognition. METHODS 446 participants in an ongoing British birth cohort study, the National Survey of Health and Development (NSHD), had their maximum grip strength measured at ages 53, 60-64, and 69, and subsequently underwent neuroimaging as part of a neuroscience sub-study, referred to as "Insight 46", at age 69-71. A group-based trajectory model identified latent groups of individuals in the whole NSHD cohort with below- or above-average grip strength over time, plus a reference group. Group assignment, plus standardised grip strength levels and change from midlife were each related to measures of whole-brain volume (WBV) and white matter hyperintensity volume (WMHV), plus several cognitive tests. Models were adjusted for sex, body size, head size (where appropriate), sociodemographics, and behavioural and vascular risk factors. RESULTS Lower grip strength from midlife was associated with smaller WBV and lower matrix reasoning scores at age 69-71, with findings consistent between analysis of individual time points and analysis of trajectory groups. There was little evidence of an association between grip strength and other cognitive test scores. Although greater declines in grip strength showed a weak association with higher WMHV at age 69-71, trends in the opposite direction were seen at individual time points with higher grip strength at ages 60-64, and 69 associated with higher WMHV. CONCLUSIONS This study provides preliminary evidence that maximum grip strength may have value in predicting brain health. Future work should assess to what extent age-related declines in grip strength from midlife reflect concurrent changes in brain structure.
Collapse
Affiliation(s)
- Quentin Dercon
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom.
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| |
Collapse
|
4
|
Rist PM, Cook NR, Buring JE, Rexrode KM, Rost NS. Prospectively Collected Cardiovascular Biomarkers and White Matter Hyperintensity Volume in Ischemic Stroke Patients. J Stroke Cerebrovasc Dis 2020; 29:104704. [PMID: 32093989 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Few prospective cohort studies collect detailed information on stroke characteristics among individuals who experience ischemic stroke, including white matter hyperintensity volume, and thus cannot explore how prospectively collected biomarkers prior to the stroke influence white matter hyperintensity volume. We explored the association between a large panel of prospectively collected lipid and inflammatory biomarkers and white matter hyperintensity volume among participants in the Women's Health Study with incident ischemic stroke. METHODS Among Women's Health Study participants with first ischemic stroke who had baseline serum biomarkers and available magnetic resonance imaging, we measured white matter hyperintensity volume using a validated semi-automated method. Linear regression was used to explore the associations between biomarkers and log-transformed white matter hyperintensity volume. RESULTS After multivariate adjustment, a 1% increment in HbA1c% was associated with an increase in white matter hyperintensity volume (P value = .05). Evidence of a nonlinear association between high density lipoprotein cholesterol levels and ApoA1 levels with white matter hyperintensity volume was noted (P values for nonlinearity = .01 and .001, respectively). No other biomarkers were significantly associated with white matter hyperintensity volume. CONCLUSIONS Chronic hyperglycemia as evidenced by HbA1c levels measured years prior to stroke is associated with white matter hyperintensity volume at the time of stroke. Additional research is needed to explain why low levels of high density lipoprotein cholesterol levels and ApoA1 may be associated with similar white matter hyperintensity volume as high levels.
Collapse
Affiliation(s)
- Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kathryn M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Natalia S Rost
- Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
5
|
Guo Y, Shen XN, Hou XH, Ou YN, Huang YY, Dong Q, Tan L, Yu JT. Genome-wide association study of white matter hyperintensity volume in elderly persons without dementia. Neuroimage Clin 2020; 26:102209. [PMID: 32062564 PMCID: PMC7021640 DOI: 10.1016/j.nicl.2020.102209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/29/2023]
Abstract
We conducted a GWAS to identify genetic loci linked to WMHV in non-demented elders. Rs7220676 near HS3ST3A1 and MIR548H3 genes was significantly associated with WMHV. Rs7220676 was also correlated with rates of cognitive decline.
Background White matter hyperintensity has been correlated with cognitive disorders and its genetic predictors remain unclear. Here we conducted a genome-wide association study to identify novel genetic determinants that were correlated with white matter hyperintensity volume (WMHV) among non-demented elders. Methods Three hundred and fifty non-Hispanic Caucasian subjects aged 55–80 years were included from the Alzheimer's Disease Neuroimaging Initiative cohort. Associations of WMHV with genetic polymorphisms were explored using multiple linear regression under an additive genetic model. Further studies were conducted to explore the influence of genetic variants on cognition-related phenotypes. Results Rs7220676 near HS3ST3A1 and MIR548H3 genes was associated with WMHV levels at genome-wide significance (P = 2.96 × 10−8). Single nucleotide polymorphisms comprising rs9675262 (near HS3ST3A1 and MIR548H3 genes, P = 1.15 × 10−7), rs9820240 (in DCLK3 gene, P = 2.23 × 10−7), rs10916409 (near ISCA1P2 gene, P = 4.55 × 10−6), and rs540422 (in PICALM gene, P = 9.68 × 10−6) were identified as suggestive loci linked to WMHV levels. The minor allele of rs7220676 (C) showed association with lower log (WMHV) in a dose-dependent manner. Besides, rs7220676 was correlated with rates of cognitive decline assessed by Mini-mental State Examination and memory scores. Conclusions A novel locus near HS3ST3A1 and MIR548H3 genes was associated with WMHV levels and it may be involved in neurodegenerative diseases.
Collapse
Affiliation(s)
- Yu Guo
- Department of Neurology, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, China
| | - Xue-Ning Shen
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai 200040, China
| | - Xiao-He Hou
- Department of Neurology, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, China
| | - Yu-Yuan Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai 200040, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai 200040, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai 200040, China.
| | | |
Collapse
|
6
|
Hawkins KA, Emadi N, Pearlson GD, Winkler AM, Taylor B, Dulipsingh L, King D, Pittman B, Blank K. Hyperinsulinemia and elevated systolic blood pressure independently predict white matter hyperintensities with associated cognitive decrement in the middle-aged offspring of dementia patients. Metab Brain Dis 2017; 32:849-857. [PMID: 28255864 DOI: 10.1007/s11011-017-9980-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 02/23/2017] [Indexed: 12/30/2022]
Abstract
Cerebrovascular disease is an independent risk factor for dementia that may also be synergistic with Alzheimer's disease. In recent years attention has switched from cerebral infarcts to microvascular disease as the primary cause of cerebrovascular cognitive decline, with damage to the white matter the primary mechanism. Uncertainties remain regarding the risks posed by different types vascular threat, the extent to which cerebrovascular damage occurs in middle age, and whether relatively "normal" amounts of white matter damage are accompanied by meaningful degrees of cognitive decline. We explored these issues via laboratory, cardiovascular, cognitive, and magnetic resonance imaging (MRI) data in 67 middle-aged cognitively normal offspring of dementia patients. The sample was enriched for vascular risk. Plasma insulin, 24-h systolic blood pressure, body mass index, age, and % small dense LDL cholesterol were the strongest correlates of MRI white matter hyperintensity (WMH) volume. With shared variance controlled for, 24 h systolic BP, plasma insulin, and age remained as significant predictors of WMH volume. An interaction variable (24 h BP * insulin) did not improve the prediction of WMH. WMH volume correlated negatively with cognition. No evidence for an ApoE ε4 effect emerged for either WMH or cognition. Hypertension and hyperinsulinemia appear to pose independent, consequential threats to the cerebral small vessel vasculature in middle age, reflected in the presence of areas of WMH on MRI scans. Our data show that even modest WMH volumes in middle age are associated with cognitive decrement, underscoring the importance of aggressive treatment and lifestyle modifications to address vascular risk throughout adulthood.
Collapse
Affiliation(s)
- Keith A Hawkins
- Yale University School of Medicine, New Haven, CT, USA.
- Olin Neuropsychiatry Research Center, Hartford, CT, USA.
| | - Nazli Emadi
- Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
| | - Godfrey D Pearlson
- Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
| | - Anderson M Winkler
- Yale University School of Medicine, New Haven, CT, USA
- Oxford Center for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Beth Taylor
- Hartford Hospital, Hartford, CT, USA
- University of Connecticut, Storrs, CT, USA
| | | | - Diana King
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
- Institute of Living, Hartford, CT, 06106, USA
| | - Brian Pittman
- Yale University School of Medicine, New Haven, CT, USA
| | - Karen Blank
- Institute of Living, Hartford, CT, 06106, USA
| |
Collapse
|