Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy

Emily Johnson, Gregory Krauss, Alexandra K. Lee, Andrea L.C. Schneider, Anna M. Kucharska-Newton, Juebin Huang, Clifford R. Jack, Rebecca F Gottesman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy. METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and APOE ε4 allele status. RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95% confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95% CI 1.16-3.02) per age-adjusted SD. CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.

Original languageEnglish (US)
Pages (from-to)e988-e995
JournalNeurology
Volume92
Issue number9
DOIs
StatePublished - Feb 26 2019

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Epilepsy
Atherosclerosis
White Matter
Confidence Intervals
Survival Analysis
Medicare
Blood Vessels
Hospitalization
Logistic Models
Smoking
Alleles
Odds Ratio
Demography
Hypertension
Incidence
Brain

ASJC Scopus subject areas

  • Clinical Neurology

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Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy. / Johnson, Emily; Krauss, Gregory; Lee, Alexandra K.; Schneider, Andrea L.C.; Kucharska-Newton, Anna M.; Huang, Juebin; Jack, Clifford R.; Gottesman, Rebecca F.

In: Neurology, Vol. 92, No. 9, 26.02.2019, p. e988-e995.

Research output: Contribution to journalArticle

Johnson, Emily ; Krauss, Gregory ; Lee, Alexandra K. ; Schneider, Andrea L.C. ; Kucharska-Newton, Anna M. ; Huang, Juebin ; Jack, Clifford R. ; Gottesman, Rebecca F. / Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy. In: Neurology. 2019 ; Vol. 92, No. 9. pp. e988-e995.
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abstract = "OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy. METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9{\%} female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1{\%} female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and APOE ε4 allele status. RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95{\%} confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95{\%} CI 1.16-3.02) per age-adjusted SD. CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.",
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AU - Johnson, Emily

AU - Krauss, Gregory

AU - Lee, Alexandra K.

AU - Schneider, Andrea L.C.

AU - Kucharska-Newton, Anna M.

AU - Huang, Juebin

AU - Jack, Clifford R.

AU - Gottesman, Rebecca F

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N2 - OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy. METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and APOE ε4 allele status. RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95% confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95% CI 1.16-3.02) per age-adjusted SD. CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.

AB - OBJECTIVE: To identify the association between brain vascular changes and cortical volumes on MRI and late-onset epilepsy. METHODS: In 1993-1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011-2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. We identified cases of late-onset epilepsy (starting at age 60 or later) from ARIC hospitalization records and Medicare claims data. Using the 1993-1995 MRI, we evaluated the association between white matter hyperintensities and subsequent epilepsy using survival analysis. We used the 2011-2013 MRI to conduct cross-sectional logistic regression to examine the association of cortical volumes and white matter hyperintensities with late-onset epilepsy. All models were adjusted for demographics, hypertension, diabetes, smoking, and APOE ε4 allele status. RESULTS: Ninety-seven ARIC participants developed epilepsy after having an MRI in 1993-1995 (incidence 3.34 per 1,000 person-years). The degree of white matter hyperintensities measured at ages 49-72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted SD, 95% confidence interval [CI] 1.06-1.54). Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87, 95% CI 1.16-3.02) per age-adjusted SD. CONCLUSIONS: This study demonstrates associations between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy. These findings may help illuminate the causes of late-onset epilepsy.

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