TY - JOUR
T1 - White matter and hippocampal volume predict the risk of dementia in patients with cerebral small vessel disease
T2 - The RUN DMC study
AU - Van Uden, Ingeborg W.M.
AU - Van Der Holst, Helena M.
AU - Tuladhar, Anil M.
AU - van Norden, Anouk G.W.
AU - de Laat, Karlijn F.
AU - Rutten-Jacobs, Loes C.A.
AU - Norris, David G.
AU - Claassen, Jurgen A.H.R.
AU - Van DIjk, Ewoud J.
AU - Kessels, Roy P.C.
AU - de Leeuw, Frank-Erik
PY - 2016
Y1 - 2016
N2 - Background: The relationship between cerebral small vessel disease (SVD) and dementia has been studied without considering white matter (WM) volume, the microstructural integrity of the WM surrounding the SVD, and grey matter (GM). Objective: We prospectively investigated the relationship between these structures and the risk of dementia, and formed a prediction model to investigate which characteristics (macro-or microstructural) explained most of the variance. Methods: The RUNDMCstudy is a prospective cohort study among 503 non-demented participants with an age between 50 and 85 years at baseline, with baseline assessment in 2006 and follow-up assessment in 2012. Two were lost to follow-up (yielding a 99.6% response-rate). Cox regression analysis was used, to calculate hazard ratios for dementia, of baseline MRI characteristics. Tract-Based Spatial Statistics (TBSS) analysis was used to assess the added value of microstructural integrity of the WM. Results: Mean age at baselinewas 65.6 years (SD 8.8) and 56.8%was male. 43 participants developed dementia (8.6%), resulting in a 5.5-year cumulative risk of 11.1% (95% CI 7.7-14.6). Low WM and hippocampal volume are significant predictors for dementia. WM, WM hyperintensities, and hippocampal volume explained most of the variance. TBSS analyses showed no additional value of diffusion parameters. Conclusion:WMand hippocampal volume were the main predictors for the development of incident dementia at 5-year followup in elderly with SVD. There was no additional diagnostic value of the diffusion tensor imaging parameters on top of the macrostructural characteristics.
AB - Background: The relationship between cerebral small vessel disease (SVD) and dementia has been studied without considering white matter (WM) volume, the microstructural integrity of the WM surrounding the SVD, and grey matter (GM). Objective: We prospectively investigated the relationship between these structures and the risk of dementia, and formed a prediction model to investigate which characteristics (macro-or microstructural) explained most of the variance. Methods: The RUNDMCstudy is a prospective cohort study among 503 non-demented participants with an age between 50 and 85 years at baseline, with baseline assessment in 2006 and follow-up assessment in 2012. Two were lost to follow-up (yielding a 99.6% response-rate). Cox regression analysis was used, to calculate hazard ratios for dementia, of baseline MRI characteristics. Tract-Based Spatial Statistics (TBSS) analysis was used to assess the added value of microstructural integrity of the WM. Results: Mean age at baselinewas 65.6 years (SD 8.8) and 56.8%was male. 43 participants developed dementia (8.6%), resulting in a 5.5-year cumulative risk of 11.1% (95% CI 7.7-14.6). Low WM and hippocampal volume are significant predictors for dementia. WM, WM hyperintensities, and hippocampal volume explained most of the variance. TBSS analyses showed no additional value of diffusion parameters. Conclusion:WMand hippocampal volume were the main predictors for the development of incident dementia at 5-year followup in elderly with SVD. There was no additional diagnostic value of the diffusion tensor imaging parameters on top of the macrostructural characteristics.
KW - Dementia
KW - Diffusion tensor imaging
KW - Elderly
KW - Hippocampal volume
KW - Magnetic resonance imaging
KW - Small vessel disease
KW - White matter
UR - http://www.scopus.com/inward/record.url?scp=84949935952&partnerID=8YFLogxK
U2 - 10.3233/JAD-150573
DO - 10.3233/JAD-150573
M3 - Article
C2 - 26529206
AN - SCOPUS:84949935952
VL - 49
SP - 863
EP - 873
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 3
ER -