Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter

Rob A R Gons, Anouk G W van Norden, Karlijn F de Laat, Lucas J B van Oudheusden, Inge W M van Uden, Marcel P Zwiers, David G Norris, Frank-Erik de Leeuw

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Cigarette smoking doubles the risk of dementia and Alzheimer's disease. Various pathophysiological pathways have been proposed to cause such a cognitive decline, but the exact mechanisms remain unclear. Smoking may affect the microstructural integrity of cerebral white matter. Diffusion tensor imaging is known to be sensitive for microstructural changes in cerebral white matter. We therefore cross-sectionally studied the relation between smoking behaviour (never, former, current) and diffusion tensor imaging parameters in both normal-appearing white matter and white matter lesions as well as the relation between smoking behaviour and cognitive performance. A structured questionnaire was used to ascertain the amount and duration of smoking in 503 subjects with small-vessel disease, aged between 50 and 85 years. Cognitive function was assessed with a neuropsychological test battery. All subjects underwent 1.5 Tesla magnetic resonance imaging. Using diffusion tensor imaging, fractional anisotropy and mean diffusivity were calculated in both normal-appearing white matter and white matter lesions. A history of smoking was associated with significant higher values of mean diffusivity in normal-appearing white matter and white matter lesions (P-trend for smoking status = 0.02) and with poorer cognitive functioning compared with those who never smoked. Associations with smoking and loss of structural integrity appeared to be strongest in normal-appearing white matter. Furthermore, the duration of smoking cessation was positively related to lower values of mean diffusivity and higher values of fractional anisotropy in normal-appearing white matter [β = -0.004 (95% confidence interval -0.007 to 0.000; P = 0.03) and β = 0.019 (95% confidence interval 0.001-0.038; P = 0.04)]. Fractional anisotropy and mean diffusivity values in normal-appearing white matter of subjects who had quit smoking for >20 years were comparable with subjects who had never smoked. These data suggest that smoking affects the microstructural integrity of cerebral white matter and support previous data that smoking is associated with impaired cognition. Importantly, they suggest that quitting smoking may reverse the impaired structural integrity.

Original languageEnglish
Pages (from-to)2116-24
Number of pages9
JournalBrain : a journal of neurology
Volume134
Issue numberPt 7
DOIs
Publication statusPublished - Jul 2011

Cite this

Gons, R. A. R., van Norden, A. G. W., de Laat, K. F., van Oudheusden, L. J. B., van Uden, I. W. M., Zwiers, M. P., ... de Leeuw, F-E. (2011). Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter. Brain : a journal of neurology, 134(Pt 7), 2116-24. https://doi.org/10.1093/brain/awr145
Gons, Rob A R ; van Norden, Anouk G W ; de Laat, Karlijn F ; van Oudheusden, Lucas J B ; van Uden, Inge W M ; Zwiers, Marcel P ; Norris, David G ; de Leeuw, Frank-Erik. / Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter. In: Brain : a journal of neurology. 2011 ; Vol. 134, No. Pt 7. pp. 2116-24.
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abstract = "Cigarette smoking doubles the risk of dementia and Alzheimer's disease. Various pathophysiological pathways have been proposed to cause such a cognitive decline, but the exact mechanisms remain unclear. Smoking may affect the microstructural integrity of cerebral white matter. Diffusion tensor imaging is known to be sensitive for microstructural changes in cerebral white matter. We therefore cross-sectionally studied the relation between smoking behaviour (never, former, current) and diffusion tensor imaging parameters in both normal-appearing white matter and white matter lesions as well as the relation between smoking behaviour and cognitive performance. A structured questionnaire was used to ascertain the amount and duration of smoking in 503 subjects with small-vessel disease, aged between 50 and 85 years. Cognitive function was assessed with a neuropsychological test battery. All subjects underwent 1.5 Tesla magnetic resonance imaging. Using diffusion tensor imaging, fractional anisotropy and mean diffusivity were calculated in both normal-appearing white matter and white matter lesions. A history of smoking was associated with significant higher values of mean diffusivity in normal-appearing white matter and white matter lesions (P-trend for smoking status = 0.02) and with poorer cognitive functioning compared with those who never smoked. Associations with smoking and loss of structural integrity appeared to be strongest in normal-appearing white matter. Furthermore, the duration of smoking cessation was positively related to lower values of mean diffusivity and higher values of fractional anisotropy in normal-appearing white matter [β = -0.004 (95{\%} confidence interval -0.007 to 0.000; P = 0.03) and β = 0.019 (95{\%} confidence interval 0.001-0.038; P = 0.04)]. Fractional anisotropy and mean diffusivity values in normal-appearing white matter of subjects who had quit smoking for >20 years were comparable with subjects who had never smoked. These data suggest that smoking affects the microstructural integrity of cerebral white matter and support previous data that smoking is associated with impaired cognition. Importantly, they suggest that quitting smoking may reverse the impaired structural integrity.",
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Gons, RAR, van Norden, AGW, de Laat, KF, van Oudheusden, LJB, van Uden, IWM, Zwiers, MP, Norris, DG & de Leeuw, F-E 2011, 'Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter' Brain : a journal of neurology, vol. 134, no. Pt 7, pp. 2116-24. https://doi.org/10.1093/brain/awr145

Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter. / Gons, Rob A R; van Norden, Anouk G W; de Laat, Karlijn F; van Oudheusden, Lucas J B; van Uden, Inge W M; Zwiers, Marcel P; Norris, David G; de Leeuw, Frank-Erik.

In: Brain : a journal of neurology, Vol. 134, No. Pt 7, 07.2011, p. 2116-24.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter

AU - Gons, Rob A R

AU - van Norden, Anouk G W

AU - de Laat, Karlijn F

AU - van Oudheusden, Lucas J B

AU - van Uden, Inge W M

AU - Zwiers, Marcel P

AU - Norris, David G

AU - de Leeuw, Frank-Erik

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N2 - Cigarette smoking doubles the risk of dementia and Alzheimer's disease. Various pathophysiological pathways have been proposed to cause such a cognitive decline, but the exact mechanisms remain unclear. Smoking may affect the microstructural integrity of cerebral white matter. Diffusion tensor imaging is known to be sensitive for microstructural changes in cerebral white matter. We therefore cross-sectionally studied the relation between smoking behaviour (never, former, current) and diffusion tensor imaging parameters in both normal-appearing white matter and white matter lesions as well as the relation between smoking behaviour and cognitive performance. A structured questionnaire was used to ascertain the amount and duration of smoking in 503 subjects with small-vessel disease, aged between 50 and 85 years. Cognitive function was assessed with a neuropsychological test battery. All subjects underwent 1.5 Tesla magnetic resonance imaging. Using diffusion tensor imaging, fractional anisotropy and mean diffusivity were calculated in both normal-appearing white matter and white matter lesions. A history of smoking was associated with significant higher values of mean diffusivity in normal-appearing white matter and white matter lesions (P-trend for smoking status = 0.02) and with poorer cognitive functioning compared with those who never smoked. Associations with smoking and loss of structural integrity appeared to be strongest in normal-appearing white matter. Furthermore, the duration of smoking cessation was positively related to lower values of mean diffusivity and higher values of fractional anisotropy in normal-appearing white matter [β = -0.004 (95% confidence interval -0.007 to 0.000; P = 0.03) and β = 0.019 (95% confidence interval 0.001-0.038; P = 0.04)]. Fractional anisotropy and mean diffusivity values in normal-appearing white matter of subjects who had quit smoking for >20 years were comparable with subjects who had never smoked. These data suggest that smoking affects the microstructural integrity of cerebral white matter and support previous data that smoking is associated with impaired cognition. Importantly, they suggest that quitting smoking may reverse the impaired structural integrity.

AB - Cigarette smoking doubles the risk of dementia and Alzheimer's disease. Various pathophysiological pathways have been proposed to cause such a cognitive decline, but the exact mechanisms remain unclear. Smoking may affect the microstructural integrity of cerebral white matter. Diffusion tensor imaging is known to be sensitive for microstructural changes in cerebral white matter. We therefore cross-sectionally studied the relation between smoking behaviour (never, former, current) and diffusion tensor imaging parameters in both normal-appearing white matter and white matter lesions as well as the relation between smoking behaviour and cognitive performance. A structured questionnaire was used to ascertain the amount and duration of smoking in 503 subjects with small-vessel disease, aged between 50 and 85 years. Cognitive function was assessed with a neuropsychological test battery. All subjects underwent 1.5 Tesla magnetic resonance imaging. Using diffusion tensor imaging, fractional anisotropy and mean diffusivity were calculated in both normal-appearing white matter and white matter lesions. A history of smoking was associated with significant higher values of mean diffusivity in normal-appearing white matter and white matter lesions (P-trend for smoking status = 0.02) and with poorer cognitive functioning compared with those who never smoked. Associations with smoking and loss of structural integrity appeared to be strongest in normal-appearing white matter. Furthermore, the duration of smoking cessation was positively related to lower values of mean diffusivity and higher values of fractional anisotropy in normal-appearing white matter [β = -0.004 (95% confidence interval -0.007 to 0.000; P = 0.03) and β = 0.019 (95% confidence interval 0.001-0.038; P = 0.04)]. Fractional anisotropy and mean diffusivity values in normal-appearing white matter of subjects who had quit smoking for >20 years were comparable with subjects who had never smoked. These data suggest that smoking affects the microstructural integrity of cerebral white matter and support previous data that smoking is associated with impaired cognition. Importantly, they suggest that quitting smoking may reverse the impaired structural integrity.

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KW - Cerebral Cortex/pathology

KW - Cognition Disorders/etiology

KW - Cohort Studies

KW - Diffusion Tensor Imaging/methods

KW - Female

KW - Heart Rate/physiology

KW - Humans

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Middle Aged

KW - Nerve Fibers, Myelinated/pathology

KW - Neuropsychological Tests

KW - Risk Factors

KW - Smoking/pathology

KW - Smoking Cessation/methods

U2 - 10.1093/brain/awr145

DO - 10.1093/brain/awr145

M3 - Article

VL - 134

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JO - Brain : a journal of neurology

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SN - 0006-8950

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