Abstract P120: Racial Differences in Midlife Brain Health and the Role of Cardiometabolic Risk

Introduction: Blacks are at a higher risk for adverse brain-related outcomes, including stroke and dementia. Due to associations of vascular risk factors with brain health, differences in brain health may result from a greater burden of vascular risk factors in blacks, especially in midlife. However, the role of vascular risk factors in midlife racial disparities in brain health have been underexplored. We thus examined racial differences in midlife brain health and tested whether vascular and metabolic risk factors partly explain cross-sectional racial differences. Hypothesis: A composite cardiometabolic risk (CMR) score statistically mediates cross-sectional relationships between race and brain health measures. Methods: 747 adults (20.6% black) aged 30–54, underwent MRI to assess cerebral blood flow (CBF) and morphology. Components of composite CMR were: body mass index, waist circumference, high-density lipoproteins, triglycerides, glucose, insulin, SBP, and DBP. Mediation was tested using the PROCESS v2.14 macro. All models were adjusted for age, sex, income, education, and intracranial volume. Results: Blacks exhibited lower gray matter volume, smaller hippocampi, less cortical surface area, and a thinner cerebral cortex than whites (all p’s<0.05). We observed no significant differences in CBF by race. CMR partially mediated the association of race with gray matter volume (6.94% mediation) and cortical surface area (9.33% mediation). Independent of CMR, there was a direct effect of race on hippocampal volume, cortical surface area, and cortical thickness. The effect was equivalent to: 6.9, 9.59, 13.06, and 9.98 years of aging, respectively. Conclusions: Race differences in some indicators of brain health are evident in midlife. Cardiovascular and metabolic risk factors may partly explain some of these differences. These results have implications for understanding vascular contributions to disparities in brain health prior to the onset of stroke and other clinical outcomes.

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Vascular risk at younger ages most strongly associates with current and future brain volume

Neurology ◽

10.1212/wnl.0000000000006360 ◽

2018 ◽

Vol 91 (16) ◽

pp. e1479-e1486 ◽

Cited By ~ 14

Author(s):

Matthew P. Pase ◽

Kendra Davis-Plourde ◽

Jayandra J. Himali ◽

Claudia L. Satizabal ◽

Hugo Aparicio ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Stroke Risk ◽

Brain Volume ◽

Vascular Risk Factor ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Cross Sectional ◽

Strength Of Association ◽

Risk Factor Burden

ObjectiveGiven the potential therapeutic effect of vascular disease control timing to reduce dementia risk, we investigated the age-related influences of vascular risk factor burden on brain structure throughout the lifespan.MethodsWe studied participants from the community-based prospective Framingham Heart Study. Overall vascular risk factor burden was calculated according to the Framingham Stroke Risk Profile, a validated algorithm that predicts stroke risk. Brain volume was estimated by MRI. We used cross-sectional data to examine how the strength of association between vascular risk factor burden and brain volume changed across each age decade from age 45–54 years through to 85–94 years (N = 2,887). Second, we leveraged up to 40 years of longitudinal data to determine how the strength of association between vascular risk factor burden and brain volume changed when vascular risk factors were examined at progressively earlier ages (N = 7,868).ResultsIn both cross-sectional and longitudinal analyses, higher vascular risk factor burden was associated with lower brain volume across each age decade. In the cross-sectional analysis, the strength of this association decreased with each decade of advancing age (p for trend < 0.0001). In longitudinal analysis, the strength of association between vascular risk factor burden and brain volume was stronger when vascular risk factors were measured at younger ages. For example, vascular risk factor burden was most strongly associated with lower brain volume in later life when vascular risk factors were measured at age 45 years.ConclusionVascular risk factors at younger ages appear to have detrimental effects on current and future brain volume.

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Racial Differences in Vascular Risk Factors and Outcomes of Patients With Intracranial Atherosclerotic Arterial Stenosis

Stroke ◽

10.1161/strokeaha.108.526624 ◽

2009 ◽

Vol 40 (3) ◽

pp. 719-725 ◽

Cited By ~ 30

Author(s):

Salina P. Waddy ◽

George Cotsonis ◽

Michael J. Lynn ◽

Michael R. Frankel ◽

Seemant Chaturvedi ◽

...

Keyword(s):

Risk Factors ◽

Racial Differences ◽

Vascular Risk Factors ◽

Arterial Stenosis ◽

Vascular Risk

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Cross-sectional associations of C-reactive protein with vascular risk factors and vascular complications in the DCCT/EDIC cohort

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2007.02.003 ◽

2008 ◽

Vol 22 (3) ◽

pp. 153-163 ◽

Cited By ~ 16

Author(s):

Alicia J. Jenkins ◽

Michelle Rothen ◽

Richard L. Klein ◽

Karina Moller ◽

Leslie Eldridge ◽

...

Keyword(s):

Risk Factors ◽

Vascular Complications ◽

Vascular Risk Factors ◽

Vascular Risk ◽

C Reactive Protein ◽

Cross Sectional ◽

Reactive Protein

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Prevalence of dementia in African–Caribbean compared with UK-born White older people: two-stage cross-sectional study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.086405 ◽

2011 ◽

Vol 199 (2) ◽

pp. 119-125 ◽

Cited By ~ 34

Author(s):

Simon Adelman ◽

Martin Blanchard ◽

Greta Rait ◽

Gerard Leavey ◽

Gill Livingston

Keyword(s):

Risk Factors ◽

Older People ◽

Vascular Risk Factors ◽

Country Of Birth ◽

Vascular Risk ◽

Cross Sectional ◽

Caribbean Country ◽

African Caribbean ◽

The Uk ◽

Prevalence Of Dementia

BackgroundPreliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African–Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures.AimsTo determine the prevalence of dementia in older people of African–Caribbean country of birth compared with their White UK-born counterparts.MethodA total of 218 people of African–Caribbean country of birth and 218 White UK-born people aged ⩾60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria.ResultsAfrican–Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African–Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3–7.3, P = 0.012).ConclusionsThere is an increased prevalence of dementia in older people of African–Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

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Cortical area and subcortical volume mediate the effect of parental education and adverse experiences on cognitive performance in youth

10.1101/160424 ◽

2017 ◽

Author(s):

Chintan M. Mehta ◽

Jeffrey G. Malins ◽

Kimberly G. Noble ◽

Jeffrey R. Gruen

Keyword(s):

Risk Factors ◽

Surface Area ◽

Cognitive Performance ◽

Parental Education ◽

Cognitive Outcomes ◽

Cognitive Tasks ◽

Cortical Surface ◽

Cortical Surface Area ◽

Adverse Experiences ◽

Subcortical Volume

AbstractEarly adversity and socioeconomic disadvantage are risk factors associated with diminished cognitive outcomes during development. Recent studies also provide evidence that upbringings characterized by stressful experiences and markers of disadvantage during childhood, such as lower parental education or household income, are associated with variation in brain structure. Although disadvantage often confers adversity, these are distinct risk factors whose differential influences on neurodevelopment and neurocognitive outcomes are not well characterized. We examined pathways linking parental education, adverse experiences, brain structure, and cognitive performances through an analysis of 1,413 typically-developing youth, ages 8 through 21, in the Philadelphia Neurodevelopmental Cohort. Parental education and adverse experiences had unique associations with cortical surface area and subcortical volume as well as cognitive performance across several domains. Associations between parental education and several cognitive tasks were explained, in part, by variation in cortical surface area. In contrast, associations between adversity and cognitive tasks were explained primarily by variation in subcortical volume. A composite neurodevelopmental factor derived from principal component analysis of cortical thickness, cortical surface area, and subcortical volume mediated independent associations between both parental education and adverse experiences with reading, geometric reasoning, verbal reasoning, attention, and emotional differentiation tasks. Our analysis provides novel evidence that socioeconomic disadvantage and adversity influence neurodevelopmental pathways associated with cognitive outcomes through independent mechanisms.

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Prevalence of the Frank’s sign by aetiopathogenic stroke subtype: A prospective analysis

PLoS ONE ◽

10.1371/journal.pone.0261080 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261080

Author(s):

Laura Sánchez-Cirera ◽

Saima Bashir ◽

Adina Ciscar ◽

Carla Marco ◽

Verónica Cruz ◽

...

Keyword(s):

Risk Factors ◽

Ischaemic Stroke ◽

Acute Stroke ◽

Haemorrhagic Stroke ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Stroke Subtype ◽

Cross Sectional ◽

Stroke Subtypes ◽

Artery Disease

Background and purpose The Frank’s sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank’s sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Methods Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank’s sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. Results The Frank’s sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank’s sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank’s sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank’s sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. Conclusion The Frank’s sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank’s sign.

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Risk Factors, Lifestyle Behaviors, and Vascular Brain Health

Stroke ◽

10.1161/strokeaha.121.032610 ◽

2022 ◽

Author(s):

Rebecca F. Gottesman ◽

Sudha Seshadri

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Health Outcomes ◽

White Matter Hyperintensities ◽

Genetic Factors ◽

Vascular Risk Factors ◽

Lifestyle Behaviors ◽

Vascular Risk ◽

Brain Health ◽

Reduce Risk

Although a relationship between traditional cardiovascular risk factors and stroke has long been recognized, these risk factors likely play a role in other aspects of brain health. Clinical stroke is only the tip of the iceberg of vascular brain injury that includes covert infarcts, white matter hyperintensities, and microbleeds. Furthermore, an individual’s risk for not only stroke but poor brain health includes not only these traditional vascular risk factors but also lifestyle and genetic factors. The purpose of this narrative review is to summarize the state of the evidence on traditional and nontraditional vascular risk factors and their contributions to brain health. Additionally, we will review important modifiers that interact with these risk factors to increase, or, in some cases, reduce risk of adverse brain health outcomes, with an emphasis on genes and biomarkers associated with Alzheimer disease. Finally, we will consider the importance of social determinants of health in brain health outcomes.

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Asymmetry Map of Human Brain in Young Adults

10.1101/2020.12.03.409805 ◽

2020 ◽

Author(s):

Maryam Malekzadeh ◽

Alireza Kashani

Keyword(s):

Young Adults ◽

White Matter ◽

Human Brain ◽

Surface Area ◽

Gray Matter ◽

Gray Matter Volume ◽

Cortical Surface ◽

Cortical Surface Area ◽

Matter Volume ◽

Cortical Regions

AbstractAlthough, asymmetry is a central organizational aspect of human brain, it has not been clearly described yet. Here, we have studied structural brain asymmetry in 1113 young adults using data obtained from Human Connectome Project. A significant rightward asymmetry in mean global cerebral cortical thickness, surface area and gray matter volume as well as volumes of cerebral white matter, cerebellar cortex and white matter, hippocampus, putamen, caudate nucleus, nucleus accumbens and amygdala was observed. Thalamus showed a leftward asymmetry. Regionally, most cerebral cortical regions show a significant rightward asymmetry in thickness. However, cortical surface area and gray matter volume are more evenly distributed between two hemispheres with almost half of the regions showing a leftward asymmetry. In addition, a strong correlation between cortical surface area and gray matter volume as well as their asymmetry indices was noted which results in concordant asymmetry patterns between cortical surface area and gray matter volume in most cortical regions.

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