Brain structure and cerebrovascular risk in cognitively impaired patients: Shanghai community brain health initiative-pilot phase

Jing He, Ana Maria Iosif, Dong Young Lee, Oliver Martinez, Shuguang Chu, Owen Carmichael, James A. Mortimer, Qianhua Zhao, Ding Ding, Qihao Guo, Douglas Galasko, David P. Salmon, Qi Dai, Yougui Wu, Ronald Carl Petersen, Zhen Hong, Amy R. Borenstein, Charles DeCarli

Research output: Contribution to journalArticle

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Abstract

Objective: To investigate the associations among brain morphologic changes as seen on magnetic resonance imaging (MRI), cerebrovascular risk (CVR), and clinical diagnosis and cognition in elderly patients with mild cognitive impairment and dementia living in urban Shanghai. Design: Cross-sectional study performed from May 1, 2007, to November 31, 2008. Setting: Memory Disorders Clinic of the Huashan Hospital and the Shanghai community. Participants: Ninety-six older people: 32 with normal cognition (NC), 30 with amnestic mild cognitive impairment (aMCI), and 34 with dementia. Main Outcome Measures: For each patient, we administered a neurologic and physical examination, neuropsychological evaluation, and brain MRI and genotyped the apolipoprotein E-ε4 (APOE-ε4) gene. The volumes determined by MRI were assessed using a semiautomatic method. Results: Brain volume was significantly smaller in the dementia patients compared with the NC (P < .001) and a MCI patients (P = .04). Hippocampal volume (HV) was lower and white matter hyperintensity (WMH) volume was higher in those with aMCI (HV: P = .03; WMH volume: P = .04) and dementia (HV: P < .001; WMH volume: P = .002) compared with NC participants. The presence of APOE-ε4 was significantly associated with reduced HV (P = .02). Systolic blood pressure was positively associated with CVR score (P = .04); diastolic blood pressure (P = .02) and CVR score (P = .04) were positively associated with WMH volume. The WMH volume (P = .03) and CVR score (P = .03) were higher among dementia patients compared with NC participants. Conclusions: Brain structure changes seen on MRI were significantly associated with clinical diagnosis. In addition, blood pressure was highly associated with CVR score and WMH volume. These results suggest that MRI is a valuable measure of brain injury in a Chinese cohort and can serve to assess the effects of various degenerative and cerebrovascular diseases.

Original languageEnglish (US)
Pages (from-to)1231-1237
Number of pages7
JournalArchives of Neurology
Volume67
Issue number10
DOIs
StatePublished - Oct 2010

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Cognition
Dementia
Magnetic Resonance Imaging
Blood Pressure
Health
Brain
Apolipoprotein E4
Cerebrovascular Disorders
Memory Disorders
Neurologic Examination
Brain Injuries
Physical Examination
White Matter
Shanghai
Cross-Sectional Studies
Outcome Assessment (Health Care)
Mild Cognitive Impairment
Genes
Cognitive Dysfunction

ASJC Scopus subject areas

  • Clinical Neurology

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Brain structure and cerebrovascular risk in cognitively impaired patients : Shanghai community brain health initiative-pilot phase. / He, Jing; Iosif, Ana Maria; Lee, Dong Young; Martinez, Oliver; Chu, Shuguang; Carmichael, Owen; Mortimer, James A.; Zhao, Qianhua; Ding, Ding; Guo, Qihao; Galasko, Douglas; Salmon, David P.; Dai, Qi; Wu, Yougui; Petersen, Ronald Carl; Hong, Zhen; Borenstein, Amy R.; DeCarli, Charles.

In: Archives of Neurology, Vol. 67, No. 10, 10.2010, p. 1231-1237.

Research output: Contribution to journalArticle

He, J, Iosif, AM, Lee, DY, Martinez, O, Chu, S, Carmichael, O, Mortimer, JA, Zhao, Q, Ding, D, Guo, Q, Galasko, D, Salmon, DP, Dai, Q, Wu, Y, Petersen, RC, Hong, Z, Borenstein, AR & DeCarli, C 2010, 'Brain structure and cerebrovascular risk in cognitively impaired patients: Shanghai community brain health initiative-pilot phase', Archives of Neurology, vol. 67, no. 10, pp. 1231-1237. https://doi.org/10.1001/archneurol.2010.230
He, Jing ; Iosif, Ana Maria ; Lee, Dong Young ; Martinez, Oliver ; Chu, Shuguang ; Carmichael, Owen ; Mortimer, James A. ; Zhao, Qianhua ; Ding, Ding ; Guo, Qihao ; Galasko, Douglas ; Salmon, David P. ; Dai, Qi ; Wu, Yougui ; Petersen, Ronald Carl ; Hong, Zhen ; Borenstein, Amy R. ; DeCarli, Charles. / Brain structure and cerebrovascular risk in cognitively impaired patients : Shanghai community brain health initiative-pilot phase. In: Archives of Neurology. 2010 ; Vol. 67, No. 10. pp. 1231-1237.
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abstract = "Objective: To investigate the associations among brain morphologic changes as seen on magnetic resonance imaging (MRI), cerebrovascular risk (CVR), and clinical diagnosis and cognition in elderly patients with mild cognitive impairment and dementia living in urban Shanghai. Design: Cross-sectional study performed from May 1, 2007, to November 31, 2008. Setting: Memory Disorders Clinic of the Huashan Hospital and the Shanghai community. Participants: Ninety-six older people: 32 with normal cognition (NC), 30 with amnestic mild cognitive impairment (aMCI), and 34 with dementia. Main Outcome Measures: For each patient, we administered a neurologic and physical examination, neuropsychological evaluation, and brain MRI and genotyped the apolipoprotein E-ε4 (APOE-ε4) gene. The volumes determined by MRI were assessed using a semiautomatic method. Results: Brain volume was significantly smaller in the dementia patients compared with the NC (P < .001) and a MCI patients (P = .04). Hippocampal volume (HV) was lower and white matter hyperintensity (WMH) volume was higher in those with aMCI (HV: P = .03; WMH volume: P = .04) and dementia (HV: P < .001; WMH volume: P = .002) compared with NC participants. The presence of APOE-ε4 was significantly associated with reduced HV (P = .02). Systolic blood pressure was positively associated with CVR score (P = .04); diastolic blood pressure (P = .02) and CVR score (P = .04) were positively associated with WMH volume. The WMH volume (P = .03) and CVR score (P = .03) were higher among dementia patients compared with NC participants. Conclusions: Brain structure changes seen on MRI were significantly associated with clinical diagnosis. In addition, blood pressure was highly associated with CVR score and WMH volume. These results suggest that MRI is a valuable measure of brain injury in a Chinese cohort and can serve to assess the effects of various degenerative and cerebrovascular diseases.",
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AU - He, Jing

AU - Iosif, Ana Maria

AU - Lee, Dong Young

AU - Martinez, Oliver

AU - Chu, Shuguang

AU - Carmichael, Owen

AU - Mortimer, James A.

AU - Zhao, Qianhua

AU - Ding, Ding

AU - Guo, Qihao

AU - Galasko, Douglas

AU - Salmon, David P.

AU - Dai, Qi

AU - Wu, Yougui

AU - Petersen, Ronald Carl

AU - Hong, Zhen

AU - Borenstein, Amy R.

AU - DeCarli, Charles

PY - 2010/10

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N2 - Objective: To investigate the associations among brain morphologic changes as seen on magnetic resonance imaging (MRI), cerebrovascular risk (CVR), and clinical diagnosis and cognition in elderly patients with mild cognitive impairment and dementia living in urban Shanghai. Design: Cross-sectional study performed from May 1, 2007, to November 31, 2008. Setting: Memory Disorders Clinic of the Huashan Hospital and the Shanghai community. Participants: Ninety-six older people: 32 with normal cognition (NC), 30 with amnestic mild cognitive impairment (aMCI), and 34 with dementia. Main Outcome Measures: For each patient, we administered a neurologic and physical examination, neuropsychological evaluation, and brain MRI and genotyped the apolipoprotein E-ε4 (APOE-ε4) gene. The volumes determined by MRI were assessed using a semiautomatic method. Results: Brain volume was significantly smaller in the dementia patients compared with the NC (P < .001) and a MCI patients (P = .04). Hippocampal volume (HV) was lower and white matter hyperintensity (WMH) volume was higher in those with aMCI (HV: P = .03; WMH volume: P = .04) and dementia (HV: P < .001; WMH volume: P = .002) compared with NC participants. The presence of APOE-ε4 was significantly associated with reduced HV (P = .02). Systolic blood pressure was positively associated with CVR score (P = .04); diastolic blood pressure (P = .02) and CVR score (P = .04) were positively associated with WMH volume. The WMH volume (P = .03) and CVR score (P = .03) were higher among dementia patients compared with NC participants. Conclusions: Brain structure changes seen on MRI were significantly associated with clinical diagnosis. In addition, blood pressure was highly associated with CVR score and WMH volume. These results suggest that MRI is a valuable measure of brain injury in a Chinese cohort and can serve to assess the effects of various degenerative and cerebrovascular diseases.

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