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Cerebral small-vessel disease and progression of brain atrophy: The SMART-MR study.
MedLine Citation:
PMID:  23115210     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To investigate whether severity and progression of periventricular and deep white matter lesions (WML) and lacunar infarcts were associated with progression of brain atrophy. METHODS: Within the SMART-MR study, a prospective cohort on MRI changes in patients with symptomatic atherosclerotic disease, 565 patients (57 ± 9 years) without large infarcts had vascular screening and 1.5 T MRI at baseline and after a mean follow-up of 3.9 years. With automated brain segmentation, total brain, cortical gray matter, ventricular, and WML volumes were estimated and expressed relative to intracranial volume (%). Lacunar infarcts were rated manually. RESULTS: Using linear regression analyses adjusted for demographics and vascular risk factors, periventricular WML volume at baseline was associated with greater decrease in cortical gray matter volume (B = -1.73%, 95% confidence interval [CI] -3.15% to -0.30%, per 1% WML volume increase) and greater increase in ventricular volume (B = 0.12%, 95% CI 0.04% to 0.20%). Progression of periventricular WML volume corresponded with a greater decrease in cortical gray matter volume (B = -0.45%, 95% CI -0.9% to 0%) and greater increase in ventricular volume (B = 0.15%, 95% CI 0.1% to 0.2%). Presence of lacunar infarcts was associated with greater decline in total brain volume (B = -0.25%, 95% CI -0.49% to -0.01%) and progression of lacunar infarcts with a greater decrease of total brain (B = -0.30%, 95% CI -0.59% to 0.01%) and cortical gray matter volume (B = -0.81%, 95% CI -1.43% to -0.20%). CONCLUSIONS: In patients with symptomatic atherosclerotic disease, presence and progression of periventricular WML and lacunar infarcts is associated with greater progression of brain atrophy independent of vascular risk factors.
Authors:
R P Kloppenborg; P J Nederkoorn; A M Grool; K L Vincken; W P T M Mali; M Vermeulen; Y van der Graaf; M I Geerlings;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-31
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-11-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Neurology (R.P.K., P.J.N., M.V.), Academic Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care (R.P.K., A.M.G., Y.v.d.G., M.I.G.), Image Sciences Institute (K.L.V.), and Department of Radiology (W.P.T.M.M.), University Medical Center Utrecht, Utrecht, the Netherlands.
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