Associations between vascular risk factors and brain MRI indices in UK Biobank

Cox, S.R. et al. (2019) Associations between vascular risk factors and brain MRI indices in UK Biobank. European Heart Journal, 40(28), pp. 2290-2300. (doi: 10.1093/eurheartj/ehz100) (PMID:30854560) (PMCID:PMC6642726)

Abstract

Aims: Several factors are known to increase risk for cerebrovascular disease and dementia, but there is limited evidence on associations between multiple vascular risk factors (VRFs) and detailed aspects of brain macrostructure and microstructure in large community-dwelling populations across middle and older age. Methods and results: Associations between VRFs (smoking, hypertension, pulse pressure, diabetes, hypercholesterolaemia, body mass index, and waist–hip ratio) and brain structural and diffusion MRI markers were examined in UK Biobank (N = 9722, age range 44–79 years). A larger number of VRFs was associated with greater brain atrophy, lower grey matter volume, and poorer white matter health. Effect sizes were small (brain structural R2 ≤1.8%). Higher aggregate vascular risk was related to multiple regional MRI hallmarks associated with dementia risk: lower frontal and temporal cortical volumes, lower subcortical volumes, higher white matter hyperintensity volumes, and poorer white matter microstructure in association and thalamic pathways. Smoking pack years, hypertension and diabetes showed the most consistent associations across all brain measures. Hypercholesterolaemia was not uniquely associated with any MRI marker. Conclusion: Higher levels of VRFs were associated with poorer brain health across grey and white matter macrostructure and microstructure. Effects are mainly additive, converging upon frontal and temporal cortex, subcortical structures, and specific classes of white matter fibres. Though effect sizes were small, these results emphasize the vulnerability of brain health to vascular factors even in relatively healthy middle and older age, and the potential to partly ameliorate cognitive decline by addressing these malleable risk factors.

• Item Type: Articles
• Additional Information: Funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Medical Research Council (MRC) is gratefully acknowledged. SRC, MEB, JMW, IJD were supported by MRC grants MR/M013111/1 and MR/R024065/1. IJD is additionally supported by the Dementias Platform UK (MR/L015382/1), and he, SRC and SJR by the Age UK-funded Disconnected Mind project ( http://www.disconnectedmind.ed.ac.uk). SRC, SJR, CRB, MEB, IJD and EMT-D were supported by a National Institutes of Health (NIH) research grant R01AG054628. EMT-D was also supported by National Institutes of Health (NIH) research grant RO1HD083613. EMT-D is a member of the Population Research Center at the University of Texas at Austin, which is supported by NIH center grant P2CHD042849. JMW was supported by the Scottish Imaging Network: A Platform for Scientific Excellence (SINAPSE) collaboration (http://www.sinapse.ac.uk). CF-R is supported by Dementias Platform UK (DPUK), funded through the MRC (MR/L023784/2).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pell, Professor Jill and Lyall, Dr Donald
• Authors: Cox, S.R., Lyall, D. M., Ritchie, S.J., Bastin, M.E., Harris, M.A., Buchanan, C.R., Fawns-Ritchie, C., Barbu, M.C., de Nooij, L., Reus, L.M., Alloza, C., Shen, X., Neilson, E., Alderson, H.L., Hunter, S., Liewald, D.C., Whalley, H.C., McIntosh, A.M., Lawrie, S.J., Pell, J. P., Tucker-Drob, E.M., Wardlaw, J.M., Gale, C.R., and Deary, I.J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: European Heart Journal
• Publisher: Oxford University Press
• ISSN: 0195-668X
• ISSN (Online): 1522-9645
• Published Online: 11 March 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in European Heart Journal 40(28):2290-2300
• Publisher Policy: Reproduced under a Creative Commons License