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

Simon R Cox, Donald M Lyall, Stuart J Ritchie, Mark E Bastin, Mathew A Harris, Colin R Buchanan, Chloe Fawns-Ritchie, Miruna C Barbu, Laura de Nooij, Lianne M Reus, Clara Alloza, Xueyi Shen, Emma Neilson, Helen L Alderson, Stuart Hunter, David C Liewald, Heather C Whalley, Andrew M McIntosh, Stephen J Lawrie, Jill P Pell & 4 others Elliot M Tucker-Drob, Joanna M Wardlaw, Catharine R Gale, Ian J Deary

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
JournalEuropean Heart Journal
DOIs
Publication statusE-pub ahead of print - 11 Mar 2019

Cite this

Cox, S. R., Lyall, D. M., Ritchie, S. J., Bastin, M. E., Harris, M. A., Buchanan, C. R., ... Deary, I. J. (2019). Associations between vascular risk factors and brain MRI indices in UK Biobank. European Heart Journal. https://doi.org/10.1093/eurheartj/ehz100
Cox, Simon R ; Lyall, Donald M ; Ritchie, Stuart J ; Bastin, Mark E ; Harris, Mathew A ; Buchanan, Colin R ; Fawns-Ritchie, Chloe ; Barbu, Miruna C ; de Nooij, Laura ; Reus, Lianne M ; Alloza, Clara ; Shen, Xueyi ; Neilson, Emma ; Alderson, Helen L ; Hunter, Stuart ; Liewald, David C ; Whalley, Heather C ; McIntosh, Andrew M ; Lawrie, Stephen J ; Pell, Jill P ; Tucker-Drob, Elliot M ; Wardlaw, Joanna M ; Gale, Catharine R ; Deary, Ian J. / Associations between vascular risk factors and brain MRI indices in UK Biobank. In: European Heart Journal. 2019.
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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 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.",
author = "Cox, {Simon R} and Lyall, {Donald M} and Ritchie, {Stuart J} and Bastin, {Mark E} and Harris, {Mathew A} and Buchanan, {Colin R} and Chloe Fawns-Ritchie and Barbu, {Miruna C} and {de Nooij}, Laura and Reus, {Lianne M} and Clara Alloza and Xueyi Shen and Emma Neilson and Alderson, {Helen L} and Stuart Hunter and Liewald, {David C} and Whalley, {Heather C} and McIntosh, {Andrew M} and Lawrie, {Stephen J} and Pell, {Jill P} and Tucker-Drob, {Elliot M} and Wardlaw, {Joanna M} and Gale, {Catharine R} and Deary, {Ian J}",
note = "{\circledC} The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2019",
month = "3",
day = "11",
doi = "10.1093/eurheartj/ehz100",
language = "English",
journal = "European Heart Journal",
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Cox, SR, Lyall, DM, Ritchie, SJ, Bastin, ME, Harris, MA, Buchanan, CR, Fawns-Ritchie, C, Barbu, MC, de Nooij, L, Reus, LM, Alloza, C, Shen, X, Neilson, E, Alderson, HL, Hunter, S, Liewald, DC, Whalley, HC, McIntosh, AM, Lawrie, SJ, Pell, JP, Tucker-Drob, EM, Wardlaw, JM, Gale, CR & Deary, IJ 2019, 'Associations between vascular risk factors and brain MRI indices in UK Biobank' European Heart Journal. https://doi.org/10.1093/eurheartj/ehz100

Associations between vascular risk factors and brain MRI indices in UK Biobank. / Cox, Simon R; Lyall, Donald M; Ritchie, Stuart J; Bastin, Mark E; Harris, Mathew A; Buchanan, Colin R; Fawns-Ritchie, Chloe; Barbu, Miruna C; de Nooij, Laura; Reus, Lianne M; Alloza, Clara; Shen, Xueyi; Neilson, Emma; Alderson, Helen L; Hunter, Stuart; Liewald, David C; Whalley, Heather C; McIntosh, Andrew M; Lawrie, Stephen J; Pell, Jill P; Tucker-Drob, Elliot M; Wardlaw, Joanna M; Gale, Catharine R; Deary, Ian J.

In: European Heart Journal, 11.03.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

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

AU - Cox, Simon R

AU - Lyall, Donald M

AU - Ritchie, Stuart J

AU - Bastin, Mark E

AU - Harris, Mathew A

AU - Buchanan, Colin R

AU - Fawns-Ritchie, Chloe

AU - Barbu, Miruna C

AU - de Nooij, Laura

AU - Reus, Lianne M

AU - Alloza, Clara

AU - Shen, Xueyi

AU - Neilson, Emma

AU - Alderson, Helen L

AU - Hunter, Stuart

AU - Liewald, David C

AU - Whalley, Heather C

AU - McIntosh, Andrew M

AU - Lawrie, Stephen J

AU - Pell, Jill P

AU - Tucker-Drob, Elliot M

AU - Wardlaw, Joanna M

AU - Gale, Catharine R

AU - Deary, Ian J

N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2019/3/11

Y1 - 2019/3/11

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 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.

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 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.

U2 - 10.1093/eurheartj/ehz100

DO - 10.1093/eurheartj/ehz100

M3 - Article

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

ER -