The brain health index: towards a combined measure of neurovascular and neurodegenerative structural brain injury

Dickie, D. A., Valdés Hernández, M. d. C., Makin, S. D., Staals, J., Wiseman, S. J., Bastin, M. E. and Wardlaw, J. M. (2018) The brain health index: towards a combined measure of neurovascular and neurodegenerative structural brain injury. International Journal of Stroke, (doi:10.1177/1747493018770222) (PMID:29672236) (Early Online Publication)

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Abstract

Background: A structural magnetic resonance imaging measure of combined neurovascular and neurodegenerative burden may be useful as these features often coexist in older people, stroke and dementia. Aim: We aimed to develop a new automated approach for quantifying visible brain injury from small vessel disease and brain atrophy in a single measure, the brain health index. Materials and methods: We computed brain health index in N = 288 participants using voxel-based Gaussian mixture model cluster analysis of T1, T2, T2*, and FLAIR magnetic resonance imaging. We tested brain health index against a validated total small vessel disease visual score and white matter hyperintensity volumes in two patient groups (minor stroke, N = 157; lupus, N = 51) and against measures of brain atrophy in healthy participants (N = 80) using multiple regression. We evaluated associations with Addenbrooke’s Cognitive Exam Revised in patients and with reaction time in healthy participants. Results: The brain health index (standard beta = 0.20–0.59, P < 0.05) was significantly and more strongly associated with Addenbrooke’s Cognitive Exam Revised, including at one year follow-up, than white matter hyperintensity volume (standard beta = 0.04–0.08, P > 0.05) and small vessel disease score (standard beta = 0.02–0.27, P > 0.05) alone in both patient groups. Further, the brain health index (standard beta = 0.57–0.59, P < 0.05) was more strongly associated with reaction time than measures of brain atrophy alone (standard beta = 0.04–0.13, P > 0.05) in healthy participants. Conclusions: The brain health index is a new image analysis approach that may usefully capture combined visible brain damage in large-scale studies of ageing, neurovascular and neurodegenerative disease.

Item Type:Articles
Additional Information:Funding from the Stroke Association (DAD), Technology Strategy Board/ Innovate UK (46917-348146), Wellcome Trust (WT088134/Z/09/A), Row Fogo Charitable Trust, Lupus UK, National Institutes of Health (R01 EB004155-03), European Union Horizon 2020 PHC-03-15, project No 666881, SVDs@Target, and Fondation Leducq (Transatlantic Network of Excellence for the Study of Perivascular Spaces in Small Vessel Disease, ref no. 16 CVD 05) is gratefully acknowledged.
Keywords:Neurology.
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dickie, Dr David and Makin, Dr Stephen
Authors: Dickie, D. A., Valdés Hernández, M. d. C., Makin, S. D., Staals, J., Wiseman, S. J., Bastin, M. E., and Wardlaw, J. M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:International Journal of Stroke
Publisher:SAGE
ISSN:1747-4930
ISSN (Online):1747-4949
Published Online:19 April 2018
Copyright Holders:Copyright © 2018 World Stroke Organization
First Published:First published in International Journal of Stroke 2018
Publisher Policy:Reproduced under a Creative Commons License

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