Cortical Atrophy and White Matter Hyperintensities in HIV: The Hawaii Aging with HIV Cohort Study

Abstract Background Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. Methods In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (0.8–3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). Results Patients with T2DM had a higher PWV than controls (8.8 ± 2.2 vs. 7.9 ± 1.4 m/s, p < 0.01). WMH progression were similar in the two groups (p = 0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1–32%], p < 0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p < 0.05). We found no interaction between diabetes and PWV on cWMH progression. Conclusions PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.

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Childhood intelligence and brain white matter hyperintensities predict fluid intelligence age 78–81 years: a 1921 Aberdeen birth cohort study

Age and Ageing ◽

10.1093/ageing/afr065 ◽

2011 ◽

Vol 40 (5) ◽

pp. 562-567 ◽

Cited By ~ 8

Author(s):

Sima Salarirad ◽

Roger T. Staff ◽

Helen C. Fox ◽

Ian J. Deary ◽

Lawrence Whalley ◽

...

Keyword(s):

Cohort Study ◽

White Matter ◽

Birth Cohort ◽

White Matter Hyperintensities ◽

Fluid Intelligence ◽

Birth Cohort Study ◽

Brain White Matter

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Brain White Matter Hyperintensities, Executive Dysfunction, Instability, and Falls in Older People: A Prospective Cohort Study

The Journals of Gerontology Series A ◽

10.1093/gerona/gls063 ◽

2012 ◽

Vol 67 (10) ◽

pp. 1085-1091 ◽

Cited By ~ 46

Author(s):

J. J. J. Zheng ◽

S. R. Lord ◽

J. C. T. Close ◽

P. S. Sachdev ◽

W. Wen ◽

...

Keyword(s):

Cohort Study ◽

White Matter ◽

Older People ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

White Matter Hyperintensities ◽

Executive Dysfunction ◽

Brain White Matter

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Investigating the Contribution of White Matter Hyperintensities and Cortical Thickness to Empathy in Neurodegenerative and Cerebrovascular Diseases

10.1101/2021.08.01.454640 ◽

2021 ◽

Author(s):

Miracle Ozzoude ◽

Brenda Varriano ◽

Derek Beaton ◽

Joel Ramirez ◽

Melissa F Holmes ◽

...

Keyword(s):

White Matter ◽

Cortical Thickness ◽

Brain Atrophy ◽

White Matter Hyperintensities ◽

Automatic Segmentation ◽

Cerebrovascular Diseases ◽

Cortical Atrophy ◽

Reactivity Index ◽

Empathy Deficits ◽

Longitudinal Effects

Introduction: Change in empathy is an increasingly recognised symptom of neurodegenerative diseases and contributes to caregiver burden and patient distress. Empathy impairment has been associated with brain atrophy but its relationship to white matter hyperintensities (WMH) is unknown. We aimed to investigate the relationships amongst WMH, brain atrophy, and empathy deficits in neurodegenerative and cerebrovascular diseases. Methods: 513 participants with Alzheimers Disease/Mild Cognitive Impairment, Amyotrophic Lateral Sclerosis, Frontotemporal Dementia (FTD), Parkinsons Disease, or Cerebrovascular Disease (CVD) were included. Empathy was assessed using the Interpersonal Reactivity Index. WMH were measured using a semi-automatic segmentation and FreeSurfer was used to measure cortical thickness. Results: A heterogeneous pattern of cortical thinning was found between groups, with FTD showing thinning in frontotemporal regions and CVD in left superior parietal, left insula, and left postcentral. Results from both univariate and multivariate analyses revealed that several variables were associated with empathy, particularly cortical thickness in the fronto-insulo-temporal and cingulate regions, sex(female), global cognition, and right parietal and occipital WMH. Conclusions: Our results suggest that cortical atrophy and WMH may be associated with empathy deficits in neurodegenerative and cerebrovascular diseases. Future work should consider investigating the longitudinal effects of WMH and atrophy on empathy deficits in neurodegenerative and cerebrovascular diseases.

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Linking cortical atrophy to white matter hyperintensities of presumed vascular origin

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x20974170 ◽

2020 ◽

pp. 0271678X2097417

Author(s):

Carola Mayer ◽

Benedikt M Frey ◽

Eckhard Schlemm ◽

Marvin Petersen ◽

Kristin Engelke ◽

...

Keyword(s):

White Matter ◽

Cortical Thickness ◽

White Matter Hyperintensities ◽

Small Vessel Disease ◽

Population Based ◽

Vascular Lesions ◽

Cortical Atrophy ◽

Increased Risk ◽

Cortical Regions ◽

The Relationship

We examined the relationship between white matter hyperintensities (WMH) and cortical neurodegeneration in cerebral small vessel disease (CSVD) by investigating whether cortical thickness is a remote effect of WMH through structural fiber tract connectivity in a population at increased risk of CSVD. We measured cortical thickness on T1-weighted images and segmented WMH on FLAIR images in 930 participants of a population-based cohort study at baseline. DWI-derived whole-brain probabilistic tractography was used to define WMH connectivity to cortical regions. Linear mixed-effects models were applied to analyze the relationship between cortical thickness and connectivity to WMH. Factors associated with cortical thickness (age, sex, hemisphere, region, individual differences in cortical thickness) were added as covariates. Median age was 64 [IQR 46–76] years. Visual inspection of surface maps revealed distinct connectivity patterns of cortical regions to WMH. WMH connectivity to the cortex was associated with reduced cortical thickness ( p = 0.009) after controlling for covariates. This association was found for periventricular WMH ( p = 0.001) only. Our results indicate an association between WMH and cortical thickness via connecting fiber tracts. The results imply a mechanism of secondary neurodegeneration in cortical regions distant, yet connected to subcortical vascular lesions, which appears to be driven by periventricular WMH.

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