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, 13(8), pp. 849-856. (doi:10.1177/1747493018770222) (PMID:29672236)

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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:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dickie, Dr David Alexander 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 Publications
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 13(8): 849-856
Publisher Policy:Reproduced under a Creative Commons License

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