Abstract 51: Effects of Vascular Risk Factors on Microstructural White Matter: A Voxel-Based Longitudinal Diffusion Tensor Imaging Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Pauline Maillard ◽  
Evan Fletcher ◽  
Owen Carmichael ◽  
Dan Mungas ◽  
Bruce Reed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Brain Aging ◽  
Diffusion Tensor ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Local Contraction

Background: Diabetes mellitus type II (DMT2) and hypertension (HTN) have been reported as increasing the risk of dementia. Because recent cross-sectional diffusion tensor imaging (DTI) studies have identified association between vascular risk factors (VRF) and microstructural white matter (WM) abnormalities in elderly, longitudinal DTI studies are needed to determine whether VRF may be associated with accelerated WM degeneration over time. Methods: 114 cognitively normal participants from University of California, Davis Alzheimer’s Disease Center, aged 73.9±6.7, received a comprehensive clinical evaluation and brain MRI including T1-weighted and DTI sequences on two dates (mean delay: 3.3 years). Baseline and follow-up FA maps were calculated, aligned, and subtracted to provide FA change ([[Unable to Display Character: ∆]]FA) maps and warped to a common template (MDT). Coregistration of baseline and follow-up T1 maps to MDT enabled computation of Jacobian images (i.e. the local contraction factor). VRF score (VRFS) was computed as the sum of DMT2, HTN and hyperlipidemia (HYP) incidence based on the subject’s medical history. We then used voxel-based linear regressions to relate annual [[Unable to Display Character: ∆]]FA and Jacobian determinants to VRFS, adjusting for potential confounders. Resulting T maps were corrected for multiple comparisons. Results: Poorer VRF score was associated with higher rate of [[Unable to Display Character: ∆]]FA loss and of GM atrophy with regions most heavily implicated including the corpus callosum and the frontal GM (see Figure1). Conclusions: This is one of very few studies of longitudinal DTI change in the elderly. DMT2, HTH and HYP are associated with accelerated WM degeneration and GM atrophy in areas whose integrity is known to be reduced in mild cognitive impairment and dementia. Future work should clarify the independent role of these vascular risk factors in accelerating brain aging.

O2-09-02: Midlife and Late Life Vascular Risk Factors and Microstructural Integrity Assessed Using Diffusion Tensor Imaging: The Aric-NCS Study

2016 ◽  
Vol 12 ◽  
pp. P247-P248
Author(s):  
Melinda C. Power ◽  
Jonathan V. Tingle ◽  
Robert I. Reid ◽  
Juebin Huang ◽  
A Richey Sharrett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Late Life ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Microstructural Integrity

Changes in Vascular Risk Factors from Midlife to Late Life and White Matter Lesions: A 20-Year Follow-Up Study

2011 ◽  
Vol 31 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Miika Vuorinen ◽  
Alina Solomon ◽  
Suvi Rovio ◽  
Lasse Nieminen ◽  
Ingemar Kåreholt ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
White Matter Lesions ◽  
Late Life ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Follow Up Study

scholarly journals White Matter Hyperintensity in Different Migraine Subtypes

2021 ◽  
Author(s):  
Larisa A. Dobrynina ◽  
Anastasia D. Suslina ◽  
Mariia V. Gubanova ◽  
Anastasia V. Belopasova ◽  
Anastasia N. Sergeeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Brain Mri ◽  
Vascular Complications ◽  
Diagnostic Value ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Vascular Risk ◽  
Different Types

Abstract Background: The diagnostic value of white matter hyperintensities (WMH) in different types of migraine are unknown. Objective: To evaluate the WMH pattern of different subtypes in migraine patients with no vascular risk factors.Methods: 92 migraine patients (73 females, mean age 34.6±8.9; 61 episodic migraine, 31 chronic migraine, 36 migraine with aura, 56 migraine without aura) without vascular risk factors underwent brain MRI (3T). We also included a matched healthy control group with no migraine (n=24).Results: The prevalence of WMH in different types of migraine was similar and ranged from 38.7% to 44.4%; the control group showed no WMH at all. Lesions were located within frontal, parietal and temporal lobes (in order of decreasing incidence) in juxtacortical and/or deep white matter. WMH appeared as round or slightly elongated foci with a median size of 2.5 mm [1.5; 3]. Total number, size and prevalence of WMH by lobes and white matter regions were similar between groups, and no interaction with age or sex was found. The number of lesions within the frontal lobe juxtacortical white matter correlated with the age of patients (r= 0.331, p=0.001) and the duration since migraine onset (r=0.264, p=0.012). Conclusion: Patients with different migraine subtypes and without vascular risk factors are characterized by a similar pattern of WMH in the absence of subclinical infarctions or microbleedings. Therefore, WMH have no relevant prognostic value regarding the course of migraine and vascular complications. WMH pattern may be used to differentiate migraine as a primary disorder and other disorders with migraine-like headache and WMH.

scholarly journals White matter hyperintensity in different migraine subtypes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. A. Dobrynina ◽  
A. D. Suslina ◽  
M. V. Gubanova ◽  
A. V. Belopasova ◽  
A. N. Sergeeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Brain Mri ◽  
Vascular Complications ◽  
Diagnostic Value ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Vascular Risk ◽  
Different Types

AbstractThe diagnostic value of white matter hyperintensities (WMH) in different types of migraineare unknown. To evaluate the WMH pattern of different subtypes in migraine patients with no vascular risk factors. 92 migraine patients (73 females, mean age 34.6 ± 8.9; 61 episodic migraine, 31 chronic migraine, 36 migraine with aura, 56 migraine without aura) without vascular risk factors underwent brain MRI (3 T). We also included a matched healthy control group with no migraine (n = 24). The prevalence of WMH in different types of migraine was similar and ranged from 38.7 to 44.4%; the control group showed no WMH at all. Lesions were located within frontal, parietal and temporal lobes (in order of decreasing incidence) in juxtacortical and/or deep white matter. WMH appeared as round or slightly elongated foci with a median size of 2.5 mm [1.5; 3]. Total number, size and prevalence of WMH by lobes and white matter regions were similar between groups, and no interaction with age or sex was found. The number of lesions within the frontal lobe juxtacortical white matter correlated with the age of patients (r = 0.331, p = 0.001) and the duration since migraine onset (r = 0.264, p = 0.012). Patients with different migraine subtypes and without vascular risk factors are characterized by a similar pattern of WMH in the absence of subclinical infarctions or microbleedings. Therefore, WMH have no relevant prognostic value regarding the course of migraine and vascular complications. WMH pattern may be used to differentiate migraine as a primary disorder and other disorders with migraine-like headache and WMH.

Abstract WP244: Applicability of the Compass Trial Criteria Among Stable Outpatients With Established Atherothrombotic Disease or Major Risk Factors

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Carlos Cantu-Brito ◽  
Erwin Chiquete ◽  
Jose L Ruiz-Sandoval ◽  
Fernando Flores-Silva
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Selection Criteria ◽  
Vascular Risk Factors ◽  
Cox Proportional Hazards Model ◽  
Vascular Risk ◽  
Similar Frequency ◽  
History Of ◽  
Atherothrombotic Disease

Background and Purpose: The objective of this study were to describe the proportion of patients eligible for the COMPASS trial among stable outpatients with either established atherothrombotic disease or major vascular risk factors, and to analyze 6-month incident stroke risk according vascular risk factors at baseline. Methods: We prospectively recruited 5,101 stable outpatients in 172 sites, within the Mexican INDAGA cohort study. Inclusion criteria were age >18 years and established atherothrombotic disease [history of either acute coronary syndromes (ACS), acute ischemic stroke (AIS)/transient ischemic attack (TIA) or peripheral artery disease (PAD)] or major vascular risk factors (age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors). Among these patients, we applied the selection criteria of the COMPASS trial for analysis, dividing the population in no COMPASS criteria met and COMPASS criteria met, and this last group subdivided among patients with previous AIS/TIA and without this antecedent, in order to stratify the risk for stroke during 6-month follow-up (incident AIS/TIA). Results: Among 5,101 stable outpatients with either established atherothrombotic disease (n=2,827) or major vascular risk factors (n=2,274), a total of 1,927 (37.8%) met COMPASS trial criteria: 1,054 (54.7%) with established cerebrovascular disease (past history of AIS/TIA) and 873 (45.3%) without. During 6-month follow-up, there were 89 incident AIS/TIA (39 AIS and 54 TIA): 1.7% among the whole population and 2.2% among the COMPASS subgroup. AIS/TIA occurred in a similar frequency among the COMPASS subgroup with established cerebrovascular disease (1.6%) and COMPASS without cerebrovascular disease (0.9%) (P=0.18). After a Cox-proportional hazards model, independent predictors of incident AIS/TIA were age ≥65 years (HR: 1.99, 95% CI: 1.29-3.07) and established cerebrovascular disease at baseline (HR: 1.61, 95% CI: 1.02-2.53). Conclusions: The majority of stable outpatients at vascular risk met COMPASS selection criteria and could be good candidates for low-dose rivaroxaban in addition to aspirin. Short-term predictors of AIS/TIA were old age and history of cerebrovascular disease

Abstract TMP58: Determinants of White Matter Hyperintensity in Acute Ischemic Stroke Patients: The MRI-GENIE Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Anne-Katrin Giese ◽  
Markus D Schirmer ◽  
Adrian V Dalca ◽  
Ramesh Sridharan ◽  
Lisa Cloonan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
White Matter ◽  
Stroke Risk ◽  
Smoking Status ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Vascular Risk ◽  
Prior Stroke

Introduction: White matter hyperintensity (WMH) is a highly heritable trait and a significant contributor to stroke risk and severity. Vascular risk factors contribute to WMH severity; however, knowledge of the determinants of WMH in acute ischemic stroke (AIS) is still limited. Hypothesis: WMH volume (WMHv) varies across AIS subtypes and is modified by vascular risk factors. Methods: We extracted WMHv from the clinical MRI scans of 2683 AIS subjects from the MRI-Genetics Interface Exploration (MRI-GENIE) study using a novel fully-automated, volumetric analysis pipeline. Demographic data, stroke risk factors and stroke subtyping for the Causative Classification of Stroke (CCS) were performed at each of the 12 international study sites. WMHv was natural log-transformed for linear regression analyses. Results: Median WMHv was 5.7cm 3 (interquartile range (IQR): 2.2-12.8cm 3 ). In univariable analysis, age (63.1 ± 14.7 years, β=0.04, SE=0.002), prior stroke (10.2%, β=0.66, SE=0.08), hypertension (65.4%, β=0.75, SE=0.05), diabetes mellitus (23.1%, β=0.35, SE=0.06), coronary artery disease (17.6%, β=0.04, SE=0.002), and atrial fibrillation (14.6%, β=0.48, SE=0.07) were significant predictors of WMHv (all p<0.0001), as well as smoking status (52.2%, β=0.15, SE=0.05, p=0.005), race (16.5% Non-Caucasian, β=0.25, SE=0.07) and ethnicity (8.2% Hispanic, β=0.30, SE=0.11) (all p<0.01). In multivariable analysis, age (β=0.04, SE=0.002), prior stroke (β=0.56, SE=0.08), hypertension (β=0.33, SE=0.05), smoking status (β=0.16, SE=0.05), race (β=0.42, SE=0.06), and ethnicity (β=0.34, SE=0.09) were independent predictors of WMHv (all p<0.0001), as well as diabetes mellitus (β=0.13, SE=0.06, p=0.02). WMHv differed significantly (p<0.0001, unadjusted) across CCS stroke subtypes: cardioembolic stroke (8.0cm 3 , IQR: 4.2-15.4cm 3 ), large-artery stroke (6.9cm 3 , IQR: 3.1-14.7cm 3 ), small-vessel stroke (5.8cm 3 , IQR: 2.5-13.5cm 3 ), stroke of undetermined (4.7cm 3 , IQR: 1.6-11.0cm 3 ) or other (2.55cm 3 , IQR: 0.9-8.8cm 3 ) causes. Conclusion: In this largest-to-date, multicenter hospital-based cohort of AIS patients with automated WMHv analysis, common vascular risk factors contribute significantly to WMH burden and WMHv varies by CCS subtype.

Abstract 224: Increased Total Homocysteine Levels Are Associated With the Risk of Dementia Independently of Cerebral Small-vessel Disease

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Kaori Miwa ◽  
Shuhei Okazaki ◽  
Yoshiki Yagita ◽  
Manabu Sakaguchi ◽  
Hideki Mochizuki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Vessel Disease ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Mri Findings ◽  
Vessel Disease ◽  
Cerebrovascular Events ◽  
Multivariable Analyses ◽  
Total Homocysteine

Objectives: Increased serum total homocysteine (tHcy) levels have been associated with not only vascular injury but also dementia. However, given an association between Hcy and vascular injury, such as cerebral small-vessel disease (SVD) or renal impairment, to what extent Hcy would impact future dementia beyond these confouders is unknown. We assessed the predictive value of tHcy levels with the risk of dementia in patients with vascular risk factors, when controlling for the MRI-findings and renal imapirment. Methods: Within a Japanese cohort of partients with vascular risk factors in an observational study from 2001, we evaluated the association between tHcy levels at baseline, defined as a continuous variable (per 1 μmol/L) and as a categorical variable (the tertile of tHcy), the prevalence of MRI-findings, and incident all-cause dementia during follow-up. Baseline brain MRI was used to determine SVD (lacuna, white matter hyperintensities and cerebral microbleeds [CMBs]) and atrophy (medial-temporal lobe atrophy). Cox proportional hazards analyses were performed for predictors of dementia adjusting for age, sex, APOEε4 allele, educational level, cerebrovascular events, estimated glomerular filtration rate (eGFR), vascular risk factors, and MRI-findings. Results: Of the 643 subjects (mean:67.2±8.4years, male:59%, 12.9±2.6years of schooling), in multivariable analyses adjusted for age, sex, hypertension, cerebrovascular events, eGFR, and intima-media thickness, the highest tHcy tertile (vs lowest) were associated with lacuna, CMBs and strictly deep CMBs, respectively. During the mean 7.3-year follow-up (range:3-13), 47 incident dementia patients (Alzheimer’s disease:24; vascular dementia:18; mixed-type:3; other:2) were diagnosed. In multivariable analyses adjusted for age, sex, cerebrovascular events, eGFR, and MRI-findings, tHcy level or the highest tertile of tHcy for all-cause dementia remained significant, respectively (relative risk [RR]1.09: p=0.02, RR;2.59: p=0.021). Conclusions: Our results provide additional evidence of Hcy that leads to increased susceptibility to the risk of dementia, suggesting that this association may be mediated by independent mechanisms.

Diffusion tensor imaging in multiple sclerosis: a tool for monitoring changes in normal-appearing white matter

2004 ◽  
Vol 10 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Emmanuelle Cassol ◽  
Jean-Philippe Ranjeva ◽  
Danielle Ibarrola ◽  
Claude Mékies ◽  
Claude Manelfe ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Lesion Load ◽  
Normal Appearing White Matter ◽  
Relapsing Remitting ◽  
One Year ◽  
Diffusion Tensor Imaging Dti

Our objectives were to determine the reproducibility of diffusion tensor imaging (DTI) in volunteers and to evaluate the ability of the method to monitor longitudinal changes occurring in the normal-appearing white matter (NAWM) of patients with multiple sclerosis (MS). DTI was performed three-mo nthly for one year in seven MS patients: three relapsing-remitting (RRMS), three secondary progressive (SPMS) and one relapsing SP. They were selected with a limited cerebral lesion load. Seven age- and sex-matched controls also underwent monthly examinations for three months. Diffusivity and anisotropy were quantified over the segmented whole supratentorial white matter, with the indices of trace (Tr) and fractional anisotropy (FA). Results obtained in volunteers show the reproducibility of the method. Patients had higher trace and lower anisotropy than matched controls (P B-0.0001). O ver the follow-up, both Tr and FA indicated a recovery after the acute phase in RRMS and a progressive shift towards abnormal values in SPMS. A lthough this result is not statistically significant, it suggests that DTI is sensitive to microscopic changes occurring in tissue of normal appearance in conventional images and could be useful for monitoring the course of the disease, even though it was unable to clearly distinguish between the various physiopathological processes involved.

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