Vascular risk factors and longitudinal changes on brain MRI

Knopman, David S.; Penman, Alan D.; Catellier, Diane J.; Coker, Laura H.; Shibata, Dean; Sharrett, A. Richey; Mosley, Thomas H.

doi:10.1212/wnl.0b013e31821d753f

Cited by 160 publications

(173 citation statements)

References 39 publications

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“…Potentially problematic in our patient population is the presence of hypertension and diabetes mellitus, which are closely related confounders known to increase WMH. [26][27][28][29] There is a similar incidence of controlled and uncontrolled hypertension (8 of 11, 73%; 10 of 14, 71%) and diabetes (4 of 11, 36%; 3 of 14, 21%) in the low and high Vit D groups. This is a cross-sectional pilot study with a limited number of subjects and can only establish association but not causation.…”

Section: Discussionmentioning

confidence: 90%

Association of White Matter Hyperintensities with Low Serum 25-Hydroxyvitamin D Levels

Prager

Thomas

Ankenbrandt

et al. 2014

American Journal of Neuroradiology

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Section: Discussionmentioning

confidence: 90%

Association of White Matter Hyperintensities with Low Serum 25-Hydroxyvitamin D Levels

Prager

Thomas

Ankenbrandt

et al. 2014

American Journal of Neuroradiology

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“…12 The few studies reporting on smoking and WMH progression, including our own, suggest an association between current smoking and WMH progression. [13][14][15][16] However, these studies crudely classified smoking (e.g., current/ former/never). Demonstration of a dose-response relationship and declines in risk with smoking cessation would strengthen causal claims.…”

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confidence: 99%

“…17,18 However, it is currently unknown whether this pattern persists for the association between smoking and WMH progression. Our goal was to expand on prior work in ARIC, a biethnic prospective cohort study suggesting an association between baseline current smoking status and WMH progression, 13 to assess whether smoking history, intensity, and cessation are associated with WMH progression overall and by race (black and white).…”

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confidence: 99%

Smoking and white matter hyperintensity progression

et al. 2015

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Objective: Our objective was to examine the link between smoking and smoking history, including smoking intensity and cessation, overall and by race, in a biracial prospective cohort study.Methods: A subset of Atherosclerosis Risk in Communities Study participants (n 5 972, 49% black) completed brain MRI scans twice (1993-1995 and 2004-2006). We defined white matter hyperintensity (WMH) progression as an increase of $2 points on the 9-point Cardiovascular Health Study scale across scans. Participants reported information on smoking behavior at the baseline MRI and at 2 prior study visits, approximately 3 and 6 years before baseline. We used adjusted logistic regression to evaluate the association between smoking variables and WMH progression in the total sample and separately by race (black and white). Results:We found WMH progression in 23% of participants (30% of black participants, 17% of white participants). Overall, being a current smoker 6 years before baseline was associated with WMH progression. In race-stratified analyses, we found adverse associations with smoking status at multiple time points and persistent smoking in white but not in black participants. However, we found no statistical support for effect modification by race for most of these analyses. Increasing pack-years of smoking was associated with greater risk of WMH progression, while time since quitting and age at smoking initiation were not associated with WMH progression, with little indication of differences in these associations by race.Conclusions: Our findings concur with previous studies suggesting a relationship between smoking and WMH progression, and further demonstrate a dose-dependent association.Neurology ® 2015;84:841-848 GLOSSARY ARIC 5 Atherosclerosis Risk in Communities; BMI 5 body mass index; CHD 5 coronary heart disease; CHS 5 Cardiovascular Health Study; IPAW 5 inverse probability of attrition weight; WMH 5 white matter hyperintensity.Smoking may be related to white matter hyperintensities (WMH), also called leukoaraiosis, which reflect subclinical small vessel disease, specifically white matter damage due to hypoperfusion, thrombosis of arterioles, or a leaky blood-brain barrier.1-3 Cross-sectional studies reporting on the association between smoking and WMH severity are mixed. [4][5][6][7][8][9][10][11] Prospective studies of smoking and WMH progression are likely more informative. Associations with progression provide stronger evidence for a causal relation, because studies of within-person change are less susceptible to confounding, and WMH progression may be more strongly associated with clinically relevant outcomes than WMH severity.12 The few studies reporting on smoking and WMH progression, including our own, suggest an association between current smoking and WMH progression. [13][14][15][16] However, these studies crudely classified smoking (e.g., current/ former/never). Demonstration of a dose-response relationship and declines in risk with smoking cessation would strengthen causal claims. Furthermore, ...

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“…Ayrıca, Tip 2 diyabetes mellitus (DM), hipertansiyon (HT), hiperlipidemi, sigara içme ve alkol kullanımı gibi faktörlerin de hastalığın gelişiminde rolü olduğu ileri sü-rülmektedir (4 Hasta sayısının az olması ve araştırmanın kesitsel planda yapılmış olması çalışmamızın kısıtlılıklarıdır. Bu bulgular bir dereceye kadar ileri yaştaki yaşam koşulları ve beslenme alışkanlıkları ile açıklanabilir.…”

Section: Introductionunclassified

Evaluation Of Vascular Risk Factors İn Alzheimer’s Dementia: Clinical Experience

Tiftikçioğlu¹,

Tuncay²,

Korucuk³

et al. 2012

Tepecik Dergisi

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ÖZETAmaç: Alzheimer Hastalığı (AH), hafıza ve bilişsel yetilerin ilerleyici ve geri-dönüşsüz kaybı ile karakterize nörodejeneratif bir hastalıktır ve ileri yaşta demansın en önemli nedenidir. Son yıllarda vasküler risk faktörlerinin de AH patogenezinde önemli rolü olduğu ileri sürülmektedir. Bu çalışmanın amacı kliniğimizdeki Alzheimer hastalarında damarsal risk faktörleri-nin sıklığının ve hastalıkla ilişkisinin araştırılmasıdır. Gereç ve Yöntem:Geriye dönük dosya taraması yöntemi ile AH olan hastaların yaş, cinsiyet, eğitim durumu gibi demografik özellikleri ve vasküler risk faktörü bilgileri ile serum açlık lipid düzeyleri taranmış ve hastalık şiddetinin bir izlem göster-gesi olan Mini Mental Durum Değerlendirme Testi (MMT) ile olan ilişki incelenmiştir. Bulgular: Çalışmaya alınan 111 hastanın gerek demografik özellikleri gerekse de vasküler risk faktörleri ile MMT arasında anlamlı bir ilişki saptanmamıştır (p>0.05). Plazma açlık lipid düzeyleri ile MMT arasındaki korelasyona bakıldığında ise, total kolesterol, LDL ve trigliserid düzeyleri ile MMT arasında anlamlı bir ilişki saptanmazken, HDL kolesterolün artışı ile MMT skorunun istatistiksel olarak anlamlı şekilde azaldığı (t:-2.38, 95%CI: -0.19; -0.02, p: 0.019) izlenmiştir.Sonuç: Bu bulgular HDL kolesterolün AH klinik şiddeti ile ilişkili olduğunu göstermesi bakımından değerlidir ve HDL kolesterolün AH patogenezinde rolü olduğunu desteklemektedir. Alzheimer hastalığının erken tanısı ve risk altındaki bireylerin tanınması için hastalığın risk faktörlerinin ve patogenezinin daha net bir şekilde aydınlatılması gereklidir. Bu nedenle daha geniş hasta grupları üzerinde bu konuda planlanacak ileriye dönük klinik çalışmalara gerek vardır.

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Vascular risk factors and longitudinal changes on brain MRI

Abstract: Both atrophic and ischemic imaging changes were driven by altered glycemic and blood pressure control beginning in midlife.

Cited by 160 publications

References 39 publications

Association of White Matter Hyperintensities with Low Serum 25-Hydroxyvitamin D Levels

Association of White Matter Hyperintensities with Low Serum 25-Hydroxyvitamin D Levels

Smoking and white matter hyperintensity progression

Evaluation Of Vascular Risk Factors İn Alzheimer’s Dementia: Clinical Experience

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