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

Simon Cox; Donald Lyall; Stuart James Ritchie; Mark Bastin; Mathew Harris; Colin Buchanan; Chloe Fawns-Ritchie; MC Barbu; L de Nooij; Lianne Reus; Clara Alloza; Xueyi Shen; Emma Neilson; Helen  Alderson; S Hunter; David Liewald; Heather Whalley; Andrew McIntosh; Stephen Lawrie; Jill Pell; Elliot Tucker-Drob; Joanna Wardlaw; Catharine Gale; Ian Deary

doi:10.1093/eurheartj/ehz100

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

Simon Cox, Donald Lyall, Stuart James Ritchie, Mark Bastin, Mathew Harris, Colin Buchanan, Chloe Fawns-Ritchie, MC Barbu, L de Nooij, Lianne Reus, Clara Alloza, Xueyi Shen, Emma Neilson, Helen Alderson, S Hunter, David Liewald, Heather Whalley, Andrew McIntosh, Stephen Lawrie, Jill PellElliot Tucker-Drob, Joanna Wardlaw, Catharine Gale, Ian Deary

Social Genetic & Developmental Psychiatry

University of Edinburgh

Research output: Contribution to journal › Article › peer-review

209 Citations (Scopus)

201 Downloads (Pure)

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 R ² ≤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.

Original language	English
Pages (from-to)	2290-2299
Number of pages	10
Journal	European Heart Journal
Volume	40
Issue number	28
Early online date	11 Mar 2019
DOIs	https://doi.org/10.1093/eurheartj/ehz100
Publication status	Published - Jul 2019

Keywords

Brain
Cortex
Diffusion
MRI
Vascular risk
White matter

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cox_VRF_MRI_UKBiobank_Manuscript_Accepted_PUREAccepted author manuscript, 5.7 MBLicence: CC BY
Associations between vascular_COX_Accepted19Feb2019_GOLD VoRFinal published version, 1.16 MBLicence: CC BY

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Cox, S., Lyall, D., Ritchie, S. J., Bastin, M., Harris, M., Buchanan, C., Fawns-Ritchie, C., Barbu, MC., de Nooij, L., Reus, L., Alloza, C., Shen, X., Neilson, E., Alderson, H., Hunter, S., Liewald, D., Whalley, H., McIntosh, A., Lawrie, S., ... Deary, I. (2019). Associations between vascular risk factors and brain MRI indices in UK Biobank. European Heart Journal, 40(28), 2290-2299. https://doi.org/10.1093/eurheartj/ehz100

@article{e530d6aface6451ea6426b5bc17aa560,

title = "Associations between vascular risk factors and brain MRI indices in UK Biobank",

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 R 2 ≤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. ",

keywords = "Brain, Cortex, Diffusion, MRI, Vascular risk, White matter",

author = "Simon Cox and Donald Lyall and Ritchie, {Stuart James} and Mark Bastin and Mathew Harris and Colin Buchanan and Chloe Fawns-Ritchie and MC Barbu and {de Nooij}, L and Lianne Reus and Clara Alloza and Xueyi Shen and Emma Neilson and Helen Alderson and S Hunter and David Liewald and Heather Whalley and Andrew McIntosh and Stephen Lawrie and Jill Pell and Elliot Tucker-Drob and Joanna Wardlaw and Catharine Gale and Ian Deary",

year = "2019",

month = jul,

doi = "10.1093/eurheartj/ehz100",

language = "English",

volume = "40",

pages = "2290--2299",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "28",

}

Cox, S, Lyall, D, Ritchie, SJ, Bastin, M, Harris, M, Buchanan, C, Fawns-Ritchie, C, Barbu, MC, de Nooij, L, Reus, L, Alloza, C, Shen, X, Neilson, E, Alderson, H, Hunter, S, Liewald, D, Whalley, H, McIntosh, A, Lawrie, S, Pell, J, Tucker-Drob, E, Wardlaw, J, Gale, C & Deary, I 2019, 'Associations between vascular risk factors and brain MRI indices in UK Biobank', European Heart Journal, vol. 40, no. 28, pp. 2290-2299. https://doi.org/10.1093/eurheartj/ehz100

TY - JOUR

T1 - Associations between vascular risk factors and brain MRI indices in UK Biobank

AU - Cox, Simon

AU - Lyall, Donald

AU - Ritchie, Stuart James

AU - Bastin, Mark

AU - Harris, Mathew

AU - Buchanan, Colin

AU - Fawns-Ritchie, Chloe

AU - Barbu, MC

AU - de Nooij, L

AU - Reus, Lianne

AU - Alloza, Clara

AU - Shen, Xueyi

AU - Neilson, Emma

AU - Alderson, Helen

AU - Hunter, S

AU - Liewald, David

AU - Whalley, Heather

AU - McIntosh, Andrew

AU - Lawrie, Stephen

AU - Pell, Jill

AU - Tucker-Drob, Elliot

AU - Wardlaw, Joanna

AU - Gale, Catharine

AU - Deary, Ian

PY - 2019/7

Y1 - 2019/7

N2 - 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 R 2 ≤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.

AB - 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 R 2 ≤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.

KW - Brain

KW - Cortex

KW - Diffusion

KW - MRI

KW - Vascular risk

KW - White matter

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U2 - 10.1093/eurheartj/ehz100

DO - 10.1093/eurheartj/ehz100

M3 - Article

SN - 0195-668X

VL - 40

SP - 2290

EP - 2299

JO - European Heart Journal

JF - European Heart Journal

IS - 28

ER -

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

Abstract

Keywords

UN SDGs

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