Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study.

Manolio, Teri A.; Kronmal, Richard A.; Burke, Gregory L.; Poirier, Virginia C.; O’Leary, Daniel H.; Gardin, Julius M.; Fried, Linda P.; Steinberg, Earl P.; Bryan, R. Nick

doi:10.1161/01.str.25.2.318

Cited by 411 publications

(391 citation statements)

References 45 publications

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“…Furthermore, the increase in these abnormalities within the frontal lobe was more rapid than in the temporal or parietal lobes. These changes have been linked to vascular risk factors [24,26,38]. Attempts to link them to functional impairment in the normal elderly have been mixed.…”

Section: Prevalence Of Signal Hyperintensities Within White Matter Rementioning

confidence: 99%

Effects of age on tissues and regions of the cerebrum and cerebellum

Jernigan

Archibald

Fennema-Notestine

et al. 2001

Neurobiology of Aging

803

624

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Normal volunteers, aged 30 to 99 years, were studied with MRI. Age was related to estimated volumes of: gray matter, white matter, and CSF of the cerebrum and cerebellum; gray matter, white matter, white matter abnormality, and CSF within each cerebral lobe; and gray matter of eight subcortical structures. The results were: 1) Age-related losses in the hippocampus were significantly accelerated relative to gray matter losses elsewhere in the brain. 2) Among the cerebral lobes, the frontal lobes were disproportionately affected by cortical volume loss and increased white matter abnormality. 3) Loss of cerebral and cerebellar white matter occurred later than, but was ultimately greater than, loss of gray matter. It is estimated that between the ages of 30 and 90 volume loss averages 14% in the cerebral cortex, 35% in the hippocampus, and 26% in the cerebral white matter. Separate analyses were conducted in which genetic risk associated with the Apolipoprotein E ⑀4 allele was either overrepresented or underrepresented among elderly participants. Accelerated loss of hippocampal volume was observed with both analyses and thus does not appear to be due to the presence of at-risk subjects. MR signal alterations in the tissues of older individuals pose challenges to the validity of current methods of tissue segmentation, and should be considered in the interpretation of the results.

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Section: Prevalence Of Signal Hyperintensities Within White Matter Rementioning

confidence: 99%

Effects of age on tissues and regions of the cerebrum and cerebellum

Jernigan

Archibald

Fennema-Notestine

et al. 2001

Neurobiology of Aging

803

624

View full text Add to dashboard Cite

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“…1,11 Infarcts by MRI were defined as lesions with abnormal signal in a vascular distribution and no mass effect. Infarcts of the cortical gray matter and deep nuclear regions and capsule were defined as lesions bright on spin density and T 2 -weighted images compared with normal gray matter and isointense or hypointense on T 1 -weighted images.…”

Section: Cerebral Mrimentioning

confidence: 99%

“…[1][2][3] While these findings are related to standard risk factors for cardiovascular disease and are believed to be consequences of ischemia, 4 -6 their relationship to atherosclerosis in the carotid arteries has not been widely explored.…”

mentioning

confidence: 99%

“…Cross-sectional data from these examinations were analyzed (1) to describe prevalences of MRI-defined infarcts, infarctlike lesions, and gray and white matter changes by quintile of common and internal carotid intimal-medial thickness (IMT); degree of carotid stenosis; and characteristics of carotid plaque; (2) to determine independence of carotid atherosclerosis/MRI abnormality associations from known clinical and subclinical cardiovascular disease and cardiovascular disease risk factors; and (3) to define relationships of MRI infarcts and ipsilateral carotid artery disease. tion 4 US communities: Forsyth County, NC; Sacramento County, Calif; Washington County, Md; and Pittsburgh (Allegheny County), Pa.…”

mentioning

confidence: 99%

“…Details of design and methods have been previously published. 1,7,8 The baseline examinations were conducted between June 1989 and May 1990 for 5201 participants of the original cohort and between June 1992 and May 1993 for an additional 687 black participants. Carotid ultrasound was performed at entry for both cohorts and was repeated in the original cohort during the 1992 to 1993 examination.…”

mentioning

confidence: 99%

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Relationships of Cerebral MRI Findings to Ultrasonographic Carotid Atherosclerosis in Older Adults

Manolio

Burke

O’Leary

et al. 1999

ATVB

182

160

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Abstract-Cerebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. While these findings are generally believed to be related to ischemia and atherosclerosis, their relationship to atherosclerosis in the carotid arteries remains to be explored. Study subjects were part of the multicenter Cardiovascular Health Study, a cross-sectional study of 3502 women and men Ն65 years of age undergoing cranial MRI and carotid ultrasonography. MRI infarcts were detected in 1068 participants (29.3%) and measurable carotid plaque in 2745 (75.3%). MRI infarcts, ventricular and sulcal widening, and white matter score were strongly associated with carotid intimal-medial thickness (IMT) and stenosis degree after adjustment for age and sex (all PϽ0.01). Associations with plaque characteristics were less strong and less consistent; MRI infarcts were weakly associated only with surface irregularity, and ventricular size was weakly associated only with lesion density (both PϽ0.04). In contrast, sulcal widening was strongly related to plaque characteristics, with scores being higher in those with heterogeneous and irregular plaque (both PϽ0.009 Key Words: stroke Ⅲ cerebrovascular disorders Ⅲ carotid arteries Ⅲ atherosclerosis Ⅲ aged Ⅲ epidemiology Ⅲ risk factors C erebral magnetic resonance imaging (MRI) has demonstrated a high prevalence of infarct-like lesions, white matter hyperintensities, and evidence of cerebral atrophy in older adults. 1-3 While these findings are related to standard risk factors for cardiovascular disease and are believed to be consequences of ischemia, 4 -6 their relationship to atherosclerosis in the carotid arteries has not been widely explored.Because the carotid arteries provide the majority of the brain's blood supply, detailed information on extent, severity, and characteristics of carotid atherosclerosis can be used to explore its relationships to cerebral MRI findings. Lesion characteristics such as increased density, heterogeneity, and surface irregularity have been shown to relate to prevalent clinically defined transient ischemic attack and stroke, 6 but these associations have not been examined for cerebral MRI findings.The Cardiovascular Health Study (CHS) cohort represents a large, multicenter sample of older men and women examined by both carotid ultrasonography and cerebral MRI. Cross-sectional data from these examinations were analyzed (1) to describe prevalences of MRI-defined infarcts, infarctlike lesions, and gray and white matter changes by quintile of common and internal carotid intimal-medial thickness (IMT); degree of carotid stenosis; and characteristics of carotid plaque; (2) to determine independence of carotid atherosclerosis/MRI abnormality associations from known clinical and subclinical cardiovascular disease and cardiovascular disease risk factors; and (3) to define relationships of MRI infarcts and ipsilateral carotid artery disease. MethodsCHS participants ...

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