scholarly journals Regional Microstructural Integrity in Relation to Gait Speed: The Atherosclerosis Risk in Communities Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 72-72
Author(s):  
Kevin Sullivan ◽  
Chad Blackshear ◽  
Timothy Hughes ◽  
Rebecca Gottesman ◽  
Prashanthi Vemuri ◽  
...  

Abstract Brain imaging-based biomarkers of neuropathology are associated with mobility in older adults, but the relation of regional microstructural integrity to gait speed in the context of a broader neuropathological profile is less understood. We examined cross-sectional associations of microstructural integrity with 4-meter usual-pace gait speed (cm/s) in a subsample of ARIC study participants who completed 3T MRI brain scans with diffusion tensor imaging(2011-13; n=1785; mean age=76.2±5.3, 60% Female, 28% Black). We considered total brain and six regional averages of fractional anisotropy (FA; lower=worse microstructural integrity) and mean diffusivity (MD; higher=worse microstructural integrity): frontal, temporal, parietal, occipital, anterior and posterior corpus callosum. Associations were tested in multivariable linear regression models adjusted for demographics, cardiovascular risk factors, and with and without additional neuropathological indices: total brain volume, white matter hyperintensities, infarcts, and microhemorrhages. When modeled separately, all neuropathology indices were associated with slower gait speed. Every standard deviation(SD) higher total brain FA was associated with +2.56 cm/s gait speed (95%CI: 1.64,3.48) and every SD higher MD was associated with -4.27 cm/s gait speed (-5.34,-3.20). All regional estimates were comparable. When adjusted for all other neuropathology indices, only posterior corpus callosum FA (β=1.72; 0.67,2.77), total MD (β=-1.63; -3.02,-0.25), frontal lobe MD (β=-1.76; -3.03,-0.48), and temporal lobe MD (β=-1.40; -2.78,-0.02) remained significantly associated with gait speed. Microstructural integrity is an informative measure of brain pathology in relation to mobility, with regional measures tied to executive, memory, and somatosensory function being more informative when a broader neuropathological profile is considered.

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 989-991 ◽  
Author(s):  
Iris Yuefan Shao ◽  
Melinda C. Power ◽  
Thomas Mosley ◽  
Clifford Jack ◽  
Rebecca F. Gottesman ◽  
...  

Background and Purpose— Evidence suggests that atrial fibrillation (AF) is associated with increased risk of cognitive decline and dementia, even in the absence of stroke. White matter disease (WMD) is a potential mechanism linking AF to cognitive impairment. In this study, we explored the association between prevalent AF and WMD. Methods— We performed a cross-sectional analysis of participants attending the ARIC-NCS (Atherosclerosis Risk in Communities–Neurocognitive Study) in 2011 to 2013 who underwent brain magnetic resonance imaging. AF was ascertained from study visit electrocardiograms or prior hospitalization codes. Extent of WMD was defined by measures of white matter (WM) microstructural integrity and WM hyperintensity volume. Multivariable linear regression models were used to assess the association between AF and WMD. Results— Among 1899 participants (mean age, 76 years; 28% black; 60% women), 133 (7%) had prevalent AF. After multivariable adjustment, differences between participants with and without AF were −0.001 (95% CI, −0.006 to 0.004) for global WM fractional anisotropy, 0.031×10 −4 mm 2 /s (95% CI, −0.075 to 0.137) for global WM mean diffusivity, and 0.08 mm 3 (95% CI, −0.14 to 0.30) for WM hyperintensity volume. Conclusions— The results suggest that there is no association between prevalent AF and WMD.


2021 ◽  
Vol 80 (2) ◽  
pp. 567-576
Author(s):  
Fei Han ◽  
Fei-Fei Zhai ◽  
Ming-Li Li ◽  
Li-Xin Zhou ◽  
Jun Ni ◽  
...  

Background: Mechanisms through which arterial stiffness impacts cognitive function are crucial for devising better strategies to prevent cognitive decline. Objective: To examine the associations of arterial stiffness with white matter integrity and cognition in community dwellings, and to investigate whether white matter injury was the intermediate of the associations between arterial stiffness and cognition. Methods: This study was a cross-sectional analysis on 952 subjects (aged 55.5±9.1 years) who underwent diffusion tensor imaging and measurement of brachial-ankle pulse wave velocity (baPWV). Both linear regression and tract-based spatial statistics were used to investigate the association between baPWV and white matter integrity. The association between baPWV and global cognitive function, measured as the mini-mental state examination (MMSE) was evaluated. Mediation analysis was performed to assess the influence of white matter integrity on the association of baPWV with MMSE. Results: Increased baPWV was significantly associated with lower mean global fractional anisotropy (β= –0.118, p < 0.001), higher mean diffusivity (β= 0.161, p < 0.001), axial diffusivity (β= 0.160, p < 0.001), and radial diffusivity (β= 0.147, p < 0.001) after adjustment of age, sex, and hypertension, which were measures having a direct effect on arterial stiffness and white matter integrity. After adjustment of age, sex, education, apolipoprotein E ɛ4, cardiovascular risk factors, and brain atrophy, we found an association of increased baPWV with worse performance on MMSE (β= –0.093, p = 0.011). White matter disruption partially mediated the effect of baPWV on MMSE. Conclusion: Arterial stiffness is associated with white matter disruption and cognitive decline. Reduced white matter integrity partially explained the effect of arterial stiffness on cognition.


Neurology ◽  
2018 ◽  
Vol 91 (24) ◽  
pp. e2244-e2255 ◽  
Author(s):  
Ian O. Bledsoe ◽  
Glenn T. Stebbins ◽  
Doug Merkitch ◽  
Jennifer G. Goldman

ObjectiveTo evaluate microstructural characteristics of the corpus callosum using diffusion tensor imaging (DTI) and their relationships to cognitive impairment in Parkinson disease (PD).MethodsSeventy-five participants with PD and 24 healthy control (HC) participants underwent structural MRI brain scans including DTI sequences and clinical and neuropsychological evaluations. Using Movement Disorder Society criteria, PD participants were classified as having normal cognition (PD-NC, n = 23), mild cognitive impairment (PD-MCI, n = 35), or dementia (PDD, n = 17). Cognitive domain (attention/working memory, executive function, language, memory, visuospatial function) z scores were calculated. DTI scalar values, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were established for 5 callosal segments on a midsagittal plane, single slice using a topographically derived parcellation method. Scalar values were compared among participant groups. Regression analyses were performed on cognitive domain z scores and DTI metrics.ResultsParticipants with PD showed increased AD values in the anterior 3 callosal segments compared to healthy controls. Participants with PDD had significantly increased AD, MD, and RD in the anterior 2 segments compared to participants with PD-NC and most anterior segment compared to participants with PD-MCI. FA values did not differ significantly between participants with PD and participants with HC or among PD cognitive groups. The strongest associations for the DTI metrics and cognitive performance occurred in the most anterior and most posterior callosal segments, and also reflected fronto-striatal and posterior cortical type cognitive deficits, respectively.ConclusionsMicrostructural white matter abnormalities of the corpus callosum, as measured by DTI, may contribute to PD cognitive impairment by disrupting information transfer across interhemispheric and callosal–cortical projections.


2020 ◽  
Author(s):  
Zhongping Zhang ◽  
Dhanashree Vernekar ◽  
Wenshu Qian ◽  
Mina Kim

Abstract Background: To investigate the effect of using an Rician nonlocal means (NLM) filter on quantification of diffusion tensor (DT)- and diffusion kurtosis (DK)-derived metrics in various anatomical regions of the human brain and the spinal cord, when combined with a constrained linear least squares (CLLS) approach.Methods: Prospective brain data from 9 healthy subjects and retrospective spinal cord data from 5 healthy subjects from a 3T MRI scanner were included in the study. Prior to tensor estimation, registered diffusion weighted images were denoised by an optimized blockwise NLM filter with CLLS. Mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), mean diffusivity (MD), radial diffusivity (RD), axial diffusivity (AD) and fractional anisotropy (FA), were determined in anatomical structures of the brain and the spinal cord. DTI and DKI metrics, signal-to-noise ratio (SNR) and Chi-square values were quantified in distinct anatomical regions for all subjects, with and without Rician denoising. Results: The averaged SNR significantly increased with Rician denoising by a factor of 2 while the averaged Chi-square values significantly decreased up to 61 % in the brain and up to 43% in the spinal cord after Rician NLM filtering. In the brain, the mean MK varied from 0.70 (putamen) to 1.27 (internal capsule) while AK and RK varied from 0.58 (corpus callosum) to 0.92 (cingulum) and from 0.70 (putamen) to 1.98 (corpus callosum), respectively. In the spinal cord, FA varied from 0.78 in lateral column to 0.81 in dorsal column while MD varied from 0.91 × 10−3 mm2/s (lateral) to 0.93 × 10−3 mm2/s (dorsal). RD varied from 0.34 × 10−3 mm2/s (dorsal) to 0.38 × 10−3 mm2/s (lateral) and AD varied from 1.96 × 10−3 mm2/s (lateral) to 2.11 × 10−3 mm2/s (dorsal).Conclusions: Our results show Rician denoising NLM filter incorporated with CLLS significantly increases SNR and reduces estimation errors of DT- and KT-derived metrics, providing the reliable metrics estimation with adequate SNR levels.


2021 ◽  
Author(s):  
Yu Qi ◽  
Yuan-Yuan Wang ◽  
Wei Wang ◽  
Xu-Ze Liu ◽  
Jing Liu ◽  
...  

Abstract Background To investigate the effect of syphilis infection on the microstructure of white matter (WM) in HIV-infected male patients through comparing the differences of WM between HIV-infected male patients with and without syphilitic infection using diffusion tensor imaging (DTI).Methods 27 HIV-infected male patients with current syphilis or a history of syphilis (HIV+/syphilis+) and 29 HIV-infected male patients without syphilis co-infection history (HIV+/syphilis-) were enrolled. All patients received DTI and comprehensive neuropsychological assessment. Clinical data were compared between the two groups with T-test, Mann-Whitney U Test and Chi-square Test. Tract-based spatial statistics (TBSS) was adopted to analyze the DTI metrics. Multiple linear regression analysis was conducted to investigate the relationships between DTI metrics and clinical variables and cognitive performance. Results In the HIV+/syphilis+ group, decreased AD was found in the right superior corona radiata (SCR-R) and body of corpus callosum (BCC); increased RD was found in the bilateral posterior corona radiata (PCR), the right posterior thalamic radiation (PTR-R), the left SCR (SCR-L), splenium of corpus callosum (SCC) and BCC; decreased FA was found in multiple regions. AD in BCC was negatively correlated with CD4/CD8 ratios. AD in SCR-R was positively correlated with CD4/CD8 ratios. Patients in HIV+/syphilis+ group had a lower score in complex motor skills (CMS). RD in SCC and SCR-L was negatively correlated with CMS; RD in PTR-R was positively correlated with CMS. AD in SCR-R was positively correlated with CMS. Conclusions Compared with patients simply infected with HIV, the integrity of WM is more seriously impaired in HIV-infected patients with syphilis co-infection, and it may accelerate the impairment of cognitive function.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Tao ◽  
Yuan Xiao ◽  
Hengyi Cao ◽  
Wenjing Zhang ◽  
Chengmin Yang ◽  
...  

Abstract Background The corpus callosum (CC) deficits have been well documented in chronic schizophrenia. However, the long-term impacts of antipsychotic monotherapies on callosal anatomy remain unclear. This cross-sectional study sought to explore micro- and macro-structural characteristics of the CC in never-treated patients and those with long-term mono-antipsychotic treatment. Methods The study included 23 clozapine-treated schizophrenia patients (CT-SCZ), 19 risperidone-treated schizophrenia patients (RT-SCZ), 23 never-treated schizophrenia patients (NT-SCZ), and 35 healthy controls (HCs). High resolution structural images and diffusion tensor imaging (DTI) data for each participant were obtained via a 3.0 T MR scanner. FreeSurfer was used to examine the volumes and fractional anisotropy (FA) values of the CC for each participant. Results There were significant deficits in the total and sub-regional CC volume and white matter integrity in NT-SCZ in comparison with healthy subjects. Compared with NT-SCZ, both CT-SCZ and RT-SCZ showed significantly increased FA values in the anterior CC region, while only RT-SCZ showed significantly increased volume in the mid-anterior CC region. Moreover, the volume of the mid-anterior CC region was significantly smaller in CT-SCZ compared to HCs. No correlations of clinical symptoms with callosal metrics were observed in schizophrenia patients. Conclusions Our findings provide insight into micro- and macro-structural characteristics of the CC in chronic schizophrenia patients with or without antipsychotics. These results suggest that the pathology itself is responsible for cerebral abnormalities in schizophrenia and that chronic exposure to antipsychotics may have an impact on white matter structure of schizophrenia patients, especially in those with risperidone treatment.


2021 ◽  
pp. 1-9
Author(s):  
Kyosuke Koide ◽  
Atsuhiko Sugiyama ◽  
Hajime Yokota ◽  
Hiroki Mukai ◽  
Jiaqi Wang ◽  
...  

<b><i>Introduction:</i></b> This study assessed the morphological changes and diffusion tensor imaging (DTI)-derived parameters of the brachial plexus using magnetic resonance neurography (MRN) in patients with anti-myelin-associated glycoprotein (anti-MAG) neuropathy. <b><i>Methods:</i></b> Eight patients with anti-MAG neuropathy underwent MRN of the brachial plexus with 3-dimensional (3D) short tau inversion recovery (STIR) and DTI sequences. Two neuroradiologists and a neurologist qualitatively assessed nerve hypertrophy on 3D STIR MRN. The cross-sectional area (CSA) of the nerve roots was measured. Quantitative analyses of fractional anisotropy (FA) and axial, radial, and mean diffusivity (AD, RD, and MD) were obtained after postprocessing on DTI and manual segmentation. <b><i>Results:</i></b> There was nerve hypertrophy in 37.5% of the patients with anti-MAG neuropathy. All patients with anti-MAG neuropathy with nerve hypertrophy were refractory to rituximab therapy. The CSA of the nerve roots was inversely correlated with FA and positively correlated with MD and RD. FA decreased in the nerve roots and inversely correlated with disease duration. <b><i>Conclusions:</i></b> Nerve hypertrophy appears in the proximal portion of peripheral nerves, such as the brachial plexus, in patients with anti-MAG neuropathy. Altered diffusion in the nerve roots might be associated with the loss of myelin integrity due to the demyelination process in anti-MAG neuropathy.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Oluwaseun E Fashanu ◽  
Di Zhao ◽  
Andrea L Schneider ◽  
Andreea M Rawlings ◽  
Richey A Sharrett ◽  
...  

Background: Prior cross-sectional studies among older adults have found associations between low vitamin D (vitD) levels and reduced cognitive performance but were unable to distinguish the temporal order between vitD and the onset of dementia. We examined the association between mid-life vitD levels, assessed by serum 25-hydroxyvitD, with later life performance on neuropsychological testing. Methods: We conducted a non-concurrent cross-sectional analysis of 5,887 white and black participants enrolled in the ARIC Neurocognitive Study. We included participants who had serum vitD concentrations measured at visit 2 (1990-1992; age range 47-69 years) and who had neuropsychological and functional testing at visit 5 (2011-2013; age range 67-91 years). Neuropsychological tests were grouped into memory, language, and executive function domains and were standardized. We categorized vitD using clinical cut points as deficient (<20 ng/mL), intermediate (20-<30 ng/mL), or sufficient (≥ 30 ng/mL). We used Poisson and linear regression models adjusted for demographic and socioeconomic factors to examine the associations between vitD with prevalent dementia and performance on neuropsychological testing. Results: In mid-life, the mean (SD) age of participants was 56 (5) years, 60% were female, and 22% black. Mean (SD) vitD was 24.6 (8.4) ng/mL; 30% had deficient, 46% intermediate, and 24% sufficient vitD levels. Compared to participants with sufficient vitD levels, the prevalence ratios (95% CI) of late-life dementia were 1.35 (0.99, 1.84) and 1.27 (0.90, 1.80) for participants with intermediate and deficient vitD levels, respectively. We found no significant association between mid-life vitD and late-life performance on neuropsychological testing ( Table ). Further adjustments for cardiovascular, genetic, and metabolic factors yielded similar results. Conclusion: In this cohort, mid-life serum vitD levels were not associated with prevalent dementia or with performance on neuropsychological testing 20 years later.


2019 ◽  
Vol 14 (6) ◽  
pp. 2311-2322 ◽  
Author(s):  
Junhong Yu ◽  
◽  
Tatia M. C. Lee

Abstract While strong cross-sectional evidence supported the use of fornix microstructure as a marker for detecting Alzheimer’s disease (AD), longitudinal data remains inconclusive on the sequential nature of fornix microstructure abnormalities and AD progression. An unequivocal longitudinal relationship between fornix microstructure and markers of AD progression –memory impairment and hippocampal atrophy, must be established to validate fornix microstructure as a marker of AD progression. We included 115 participants from the Alzheimer’s Disease Neuroimaging Initiative across the non-demented AD spectrum— defined as those who had at least one AD risk marker at baseline (e.g., mild cognitive impairment (MCI) due to AD diagnosis, amyloid or ApoE4 positivity) and/or ‘cognitively normal individuals who converted to MCI due to AD or AD, with structural and diffusion tensor imaging scans at baseline and two years follow-up. Hippocampal volumes (HV), fractional anisotropy (FA) and mean diffusivity (MD) in the fornix were extracted. Memory was indexed via composite scores of verbal memory tests. Structural equation models tested the bidirectional cross-lagged effects of fornix microstructure, memory, and HV. Impaired memory and smaller HV at baseline significantly predicted worse fornix microstructure (decreased FA and increased MD) two years later. Baseline fornix microstructure was not associated with subsequent changes in memory and HV. Fornix microstructure is compromised likely at a later stage, where significant decline in memory and hippocampal atrophy have occurred. This limits the utility of fornix microstructure in the early detection of AD. Our findings inform the possible pathophysiology and refined the use of AD neural markers.


Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 783-788 ◽  
Author(s):  
Jeremy P. Berman ◽  
Faye L. Norby ◽  
Thomas Mosley ◽  
Elsayed Z. Soliman ◽  
Rebecca F. Gottesman ◽  
...  

Background and Purpose— Atrial fibrillation (AF) is associated with dementia independent of clinical stroke. The mechanisms underlying this association remain unclear. In a community-based cohort, the ARIC study (Atherosclerosis Risk in Communities), we evaluated (1) the longitudinal association of incident AF and (2) the cross-sectional association of prevalent AF with brain magnetic resonance imaging (MRI) abnormalities. Methods— The longitudinal analysis included 963 participants (mean age, 73±4.4 years; 62% women; 51% black) without prevalent stroke or AF who underwent a brain MRI in 1993 to 1995 and a second MRI in 2004 to 2006 (mean, 10.6±0.8 years). Outcomes included subclinical cerebral infarctions, sulcal size, ventricular size, and, for the cross-sectional analysis, white matter hyperintensity volume and total brain volume. Results— In the longitudinal analysis, 29 (3.0%) participants developed AF after the first brain MRI. Those who developed AF had higher odds of increase in subclinical cerebral infarctions (odds ratio [OR], 3.08; 95% CI, 1.39–6.83), worsening sulcal grade (OR, 3.56; 95% CI, 1.04–12.2), and worsening ventricular grade (OR, 9.34; 95% CI, 1.24–70.2). In cross-sectional analysis, of 969 participants, 35 (3.6%) had prevalent AF at the time of the 2004 to 2006 MRI scan. Those with AF had greater odds of higher sulcal (OR, 3.9; 95% CI, 1.7–9.1) and ventricular grade (OR, 2.4; 95% CI, 1.0–5.7) after multivariable adjustment and no difference in white matter hyperintensity or total brain volume. Conclusions— AF is independently associated with increase in subclinical cerebral infarction and worsening sulcal and ventricular grade—morphological changes associated with aging and dementia. More research is needed to define the mechanisms underlying AF-related neurodegeneration.


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