Development of a cerebrovascular magnetic resonance imaging biomarker for cognitive aging

被引：48

作者：

Vemuri, Prashanthi ^{[1
]}

Lesnick, Timothy G. ^{[2
]}

Przybelski, Scott A. ^{[2
]}

Graff-Radford, Jonathan ^{[3
]}

Reid, Robert I. ^{[4
]}

Lowe, Val J. ^{[1
]}

Zuk, Samantha M. ^{[1
]}

Senjem, Matthew L. ^{[1
,4
]}

Schwarz, Christopher G. ^{[1
]}

Gunter, Jeffrey L. ^{[1
,4
]}

Kantarci, Kejal ^{[1
]}

Machulda, Mary M. ^{[5
]}

Mielke, Michelle M. ^{[2
,3
]}

Petersen, Ronald C. ^{[3
]}

Knopman, David S. ^{[3
]}

Jack, Clifford R., Jr. ^{[1
]}

机构：

[1] Mayo Clin, Dept Radiol, Rochester, MN USA

[2] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA

[3] Mayo Clin, Dept Neurol, Rochester, MN USA

[4] Mayo Clin, Dept Informat Technol, Rochester, MN USA

[5] Mayo Clin, Dept Psychiat Psychol, Rochester, MN USA

来源：

ANNALS OF NEUROLOGY | 2018年 / 84卷 / 05期

关键词：

WHITE-MATTER INTEGRITY; VASCULAR RISK-FACTORS; ALZHEIMER-DISEASE BIOMARKERS; MEDICAL-RECORDS-LINKAGE; CEREBRAL-BLOOD-FLOW; INDEPENDENT PREDICTORS; LONGITUDINAL CHANGES; CORTICAL THICKNESS; BRAIN; DIFFUSION;

D O I：

10.1002/ana.25346

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective Methods Recent availability of amyloid and tau positron emission tomography (PET) has provided us with a unique opportunity to measure the association of systemic vascular health with brain health after accounting for the impact of Alzheimer disease (AD) pathologies. We wanted to quantify early cerebrovascular health-related magnetic resonance imaging brain measures (structure, perfusion, microstructural integrity) and evaluate their utility as a biomarker for cerebrovascular health. We used 2 independent samples (discovery, n = 390; validation, n = 1,035) of individuals, aged >= 60 years, along the cognitive continuum with imaging from the population-based sample of Mayo Clinic Study of Aging. We ascertained vascular health by summing up recently existing cardiovascular and metabolic conditions (CMC) from health care records (hypertension, hyperlipidemia, cardiac arrhythmias, coronary artery disease, congestive heart failure, diabetes mellitus, and stroke). Using multiple regression models, we quantified associations between CMC and brain health after accounting for age, sex, education/occupation, and AD burden (from amyloid and tau PET). Results Interpretation Systemic vascular health was associated with medial temporal lobe thinning, widespread cerebral hypoperfusion, and loss of microstructural integrity in several white matter tracts including the corpus callosum and fornix. Further investigations suggested that microstructural integrity of the genu of the corpus callosum was suitable for assessing prodromal cerebrovascular health, had similar distributions in the discovery and independent validation datasets, and predicted cognitive performance above and beyond amyloid deposition. Systemic vascular health has significant impact on brain structure and function. Quantifying prodromal cerebrovascular health-related brain measures that are independent of AD pathology-related changes has great utility for cognitive aging. Ann Neurol 2018;84:713-724

引用

页码：705 / 716

页数：12

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