Premium
Do cardiovascular risk factors explain the link between white matter hyperintensities and brain volumes in old age? A population‐based study
Author(s) -
Wang R.,
Fratiglioni L.,
Laveskog A.,
Kalpouzos G.,
Ehrenkrona C.H.,
Zhang Y.,
Bronge L.,
Wahlund L.O.,
Bäckman L.,
Qiu C.
Publication year - 2014
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12319
Subject(s) - medicine , hyperintensity , atrophy , dementia , population , cardiology , apolipoprotein e , stroke (engine) , white matter , magnetic resonance imaging , disease , radiology , mechanical engineering , environmental health , engineering
Background and purpose White matter hyperintensities ( WMH s) and brain atrophy frequently coexist in older people. However, it is unclear whether the association between these two brain lesions is dependent on the aging process, a vascular mechanism or genetic susceptibility. It was therefore investigated whether the association between load of WMH s and brain atrophy measures is related to age, vascular risk factors ( VRF s) or the APOE ‐ε4 allele. Methods This population‐based study included 492 participants (age ≥60 years, 59.6% women) free of dementia and stroke. Data on demographics, VRF s and APOE genotypes were collected through interviews, clinical examination and laboratory tests. WMH s on magnetic resonance images were assessed using manual visual rating and automatic volumetric segmentation. Hippocampal and ventricular volumes were manually delineated, whereas total gray matter ( GM ) volume was measured by automatic segmentation. Data were analyzed with multivariate linear regression models. Results More global WMH s, assessed using either a visual rating scale or a volumetric approach, were significantly associated with lower GM volume and higher ventricular volume; the associations remained significant after adjusting for age, VRF s and the APOE ‐ε4 allele. In contrast, the association between global WMH s and hippocampal volume was no longer significant after adjusting for age, whereas adjustment for VRF s and APOE ‐ε4 had no influential effect. Conclusion The association of global WMH s with lower GM volume and higher ventricular volume is independent of age, VRF s and APOE ‐ε4 allele, suggesting that the process of cerebral microvascular disease and neurodegeneration are associated independently of the normal aging process, vascular mechanisms or genetic susceptibility.