Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia

Eric E. Smith, Svetlana Egorova, Deborah Blacker, Ronald J. Killiany, Alona Muzikansky, Bradford C. Dickerson, Rudolph E. Tanzi, Marilyn Albert, Steven M. Greenberg, Charles R G Guttmann

Research output: Contribution to journalArticle

Abstract

Objective: To determine whether magnetic resonance imaging (MRI) white matter hyperintensities (WMH), whole-brain atrophy, and cardiovascular risk factors predict the development of cognitive decline and dementia. Design: Subjects were recruited into this prospective cohort study and followed for incident cognitive decline for mean (SD) 6.0 (4.1) years. Magnetic resonance imaging dual-echo sequences, obtained at baseline, were used to determine the volume of WMH and the brain parenchymal fraction (BPF), the proportion of the intracranial cavity occupied by brain. White matter hyperintensity volume was analyzed as the percentage of intracranial volume (WMHr); "high WMH"was defined as a WMHr more than 1 SD above the mean. Setting: General community. Patients: Volunteer sample consisting of 67 subjects with normal cognition and 156 subjects with mild cognitive impairment (MCI). Main Outcome Measures: Time to diagnosis of MCI (among those with normal cognition at baseline) or time to diagnosis of dementia, either all-cause or probable Alzheimer disease (AD) (among those with MCI at baseline). Cox proportional hazards models were used for multivariable analysis. Results: High WMH was a predictor of progression from normal to MCI (adjusted hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.33-8.17; P=.01) but not conversion from MCI to all-cause dementia. Conversely, BPF did not predict progression from normal to MCI but did predict conversion to dementia (adjusted HR, 1.10 for each 1% decrease in BPF; 95% CI, 1.02-1.19; P=.02). When conversion to AD dementia was considered as the outcome, BPF was likewise a predictor (adjusted HR, 1.16 for each 1% decrease in BPF; 95% CI, 1.08-1.24; P

Original languageEnglish (US)
Pages (from-to)94-100
Number of pages7
JournalArchives of Neurology
Volume65
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Dementia
Magnetic Resonance Imaging
Brain
Alzheimer Disease
Confidence Intervals
Cognition
Cognitive Dysfunction
White Matter
Mild Cognitive Impairment
Prediction
Proportional Hazards Models
Atrophy
Volunteers
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies
Hazard
Confidence Interval

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Smith, E. E., Egorova, S., Blacker, D., Killiany, R. J., Muzikansky, A., Dickerson, B. C., ... Guttmann, C. R. G. (2008). Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia. Archives of Neurology, 65(1), 94-100. https://doi.org/10.1001/archneurol.2007.23

Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia. / Smith, Eric E.; Egorova, Svetlana; Blacker, Deborah; Killiany, Ronald J.; Muzikansky, Alona; Dickerson, Bradford C.; Tanzi, Rudolph E.; Albert, Marilyn; Greenberg, Steven M.; Guttmann, Charles R G.

In: Archives of Neurology, Vol. 65, No. 1, 01.2008, p. 94-100.

Research output: Contribution to journalArticle

Smith, EE, Egorova, S, Blacker, D, Killiany, RJ, Muzikansky, A, Dickerson, BC, Tanzi, RE, Albert, M, Greenberg, SM & Guttmann, CRG 2008, 'Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia', Archives of Neurology, vol. 65, no. 1, pp. 94-100. https://doi.org/10.1001/archneurol.2007.23
Smith, Eric E. ; Egorova, Svetlana ; Blacker, Deborah ; Killiany, Ronald J. ; Muzikansky, Alona ; Dickerson, Bradford C. ; Tanzi, Rudolph E. ; Albert, Marilyn ; Greenberg, Steven M. ; Guttmann, Charles R G. / Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia. In: Archives of Neurology. 2008 ; Vol. 65, No. 1. pp. 94-100.
@article{1c8e5e9c55a34e2abc13ac02b66e21b3,
title = "Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia",
abstract = "Objective: To determine whether magnetic resonance imaging (MRI) white matter hyperintensities (WMH), whole-brain atrophy, and cardiovascular risk factors predict the development of cognitive decline and dementia. Design: Subjects were recruited into this prospective cohort study and followed for incident cognitive decline for mean (SD) 6.0 (4.1) years. Magnetic resonance imaging dual-echo sequences, obtained at baseline, were used to determine the volume of WMH and the brain parenchymal fraction (BPF), the proportion of the intracranial cavity occupied by brain. White matter hyperintensity volume was analyzed as the percentage of intracranial volume (WMHr); {"}high WMH{"}was defined as a WMHr more than 1 SD above the mean. Setting: General community. Patients: Volunteer sample consisting of 67 subjects with normal cognition and 156 subjects with mild cognitive impairment (MCI). Main Outcome Measures: Time to diagnosis of MCI (among those with normal cognition at baseline) or time to diagnosis of dementia, either all-cause or probable Alzheimer disease (AD) (among those with MCI at baseline). Cox proportional hazards models were used for multivariable analysis. Results: High WMH was a predictor of progression from normal to MCI (adjusted hazard ratio [HR], 3.30; 95{\%} confidence interval [CI], 1.33-8.17; P=.01) but not conversion from MCI to all-cause dementia. Conversely, BPF did not predict progression from normal to MCI but did predict conversion to dementia (adjusted HR, 1.10 for each 1{\%} decrease in BPF; 95{\%} CI, 1.02-1.19; P=.02). When conversion to AD dementia was considered as the outcome, BPF was likewise a predictor (adjusted HR, 1.16 for each 1{\%} decrease in BPF; 95{\%} CI, 1.08-1.24; P",
author = "Smith, {Eric E.} and Svetlana Egorova and Deborah Blacker and Killiany, {Ronald J.} and Alona Muzikansky and Dickerson, {Bradford C.} and Tanzi, {Rudolph E.} and Marilyn Albert and Greenberg, {Steven M.} and Guttmann, {Charles R G}",
year = "2008",
month = "1",
doi = "10.1001/archneurol.2007.23",
language = "English (US)",
volume = "65",
pages = "94--100",
journal = "Archives of Neurology",
issn = "0003-9942",
publisher = "American Medical Association",
number = "1",

}

TY - JOUR

T1 - Magnetic resonance imaging white matter hyperintensities and brain volume in the prediction of mild cognitive impairment and dementia

AU - Smith, Eric E.

AU - Egorova, Svetlana

AU - Blacker, Deborah

AU - Killiany, Ronald J.

AU - Muzikansky, Alona

AU - Dickerson, Bradford C.

AU - Tanzi, Rudolph E.

AU - Albert, Marilyn

AU - Greenberg, Steven M.

AU - Guttmann, Charles R G

PY - 2008/1

Y1 - 2008/1

N2 - Objective: To determine whether magnetic resonance imaging (MRI) white matter hyperintensities (WMH), whole-brain atrophy, and cardiovascular risk factors predict the development of cognitive decline and dementia. Design: Subjects were recruited into this prospective cohort study and followed for incident cognitive decline for mean (SD) 6.0 (4.1) years. Magnetic resonance imaging dual-echo sequences, obtained at baseline, were used to determine the volume of WMH and the brain parenchymal fraction (BPF), the proportion of the intracranial cavity occupied by brain. White matter hyperintensity volume was analyzed as the percentage of intracranial volume (WMHr); "high WMH"was defined as a WMHr more than 1 SD above the mean. Setting: General community. Patients: Volunteer sample consisting of 67 subjects with normal cognition and 156 subjects with mild cognitive impairment (MCI). Main Outcome Measures: Time to diagnosis of MCI (among those with normal cognition at baseline) or time to diagnosis of dementia, either all-cause or probable Alzheimer disease (AD) (among those with MCI at baseline). Cox proportional hazards models were used for multivariable analysis. Results: High WMH was a predictor of progression from normal to MCI (adjusted hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.33-8.17; P=.01) but not conversion from MCI to all-cause dementia. Conversely, BPF did not predict progression from normal to MCI but did predict conversion to dementia (adjusted HR, 1.10 for each 1% decrease in BPF; 95% CI, 1.02-1.19; P=.02). When conversion to AD dementia was considered as the outcome, BPF was likewise a predictor (adjusted HR, 1.16 for each 1% decrease in BPF; 95% CI, 1.08-1.24; P

AB - Objective: To determine whether magnetic resonance imaging (MRI) white matter hyperintensities (WMH), whole-brain atrophy, and cardiovascular risk factors predict the development of cognitive decline and dementia. Design: Subjects were recruited into this prospective cohort study and followed for incident cognitive decline for mean (SD) 6.0 (4.1) years. Magnetic resonance imaging dual-echo sequences, obtained at baseline, were used to determine the volume of WMH and the brain parenchymal fraction (BPF), the proportion of the intracranial cavity occupied by brain. White matter hyperintensity volume was analyzed as the percentage of intracranial volume (WMHr); "high WMH"was defined as a WMHr more than 1 SD above the mean. Setting: General community. Patients: Volunteer sample consisting of 67 subjects with normal cognition and 156 subjects with mild cognitive impairment (MCI). Main Outcome Measures: Time to diagnosis of MCI (among those with normal cognition at baseline) or time to diagnosis of dementia, either all-cause or probable Alzheimer disease (AD) (among those with MCI at baseline). Cox proportional hazards models were used for multivariable analysis. Results: High WMH was a predictor of progression from normal to MCI (adjusted hazard ratio [HR], 3.30; 95% confidence interval [CI], 1.33-8.17; P=.01) but not conversion from MCI to all-cause dementia. Conversely, BPF did not predict progression from normal to MCI but did predict conversion to dementia (adjusted HR, 1.10 for each 1% decrease in BPF; 95% CI, 1.02-1.19; P=.02). When conversion to AD dementia was considered as the outcome, BPF was likewise a predictor (adjusted HR, 1.16 for each 1% decrease in BPF; 95% CI, 1.08-1.24; P

UR - http://www.scopus.com/inward/record.url?scp=38349048522&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38349048522&partnerID=8YFLogxK

U2 - 10.1001/archneurol.2007.23

DO - 10.1001/archneurol.2007.23

M3 - Article

VL - 65

SP - 94

EP - 100

JO - Archives of Neurology

JF - Archives of Neurology

SN - 0003-9942

IS - 1

ER -