TY - JOUR
T1 - Carotid atherosclerosis and progression of brain atrophy
T2 - The SMART-MR Study
AU - Muller, Majon
AU - van der Graaf, Yolanda
AU - Algra, Ale
AU - Hendrikse, Jeroen
AU - Mali, Willem P.
AU - Geerlings, Mirjam I.
AU - Muller, T.H.
PY - 2011/8
Y1 - 2011/8
N2 - Objective: Atherosclerosis has been implicated in the development of brain atrophy. However, support for this association comes from cross-sectional studies. Methods: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, a prospective cohort study among patients with symptomatic atherosclerotic disease (mean age ± standard deviation, 58 ± 10 years; 80% men), magnetic resonance imaging of the brain was performed in 1,232 patients at baseline (2001-2005) and in 663 patients at follow-up (2006-2009). Brain segmentation was used to quantify total brain volume, cortical gray matter volume, and ventricular volume as indicators of global, cortical, and subcortical atrophy. At baseline, measurements of carotid intima-media thickness (CIMT) and carotid stenosis were performed. Carotid stenosis was classified into groups 0 of 50%, 50 of 70% (moderate), and >70% (severe) and into unilateral or bilateral stenosis. Results: Cross-sectional regression analyses showed that both increased CIMT and carotid stenosis were associated with decreased relative total brain and cortical gray matter volume. Our prospective findings showed that after a mean follow-up of 3.9 years (range, 3.0-5.8 years), CIMT and moderate stenosis were not related to progression of brain atrophy. Only severe or bilateral carotid stenosis was related to progression of global atrophy (β [95% confidence interval (CI)], -0.52% [-0.84 to -0.20%], -0.94% [-1.45 to -0.43%]), cortical atrophy (β [95% CI], -0.75% [-1.37 to -0.13%], -1.34% [-2.32 to -0.35%]), and subcortical atrophy (β [95% CI], 0.06% [-0.02 to 0.16%], 0.13% [0.01 to 0.28%]). Interpretation: In a study of patients with atherosclerotic disease with 4 years of follow-up, only severe or bilateral carotid stenosis, and not moderate carotid stenosis and increased CIMT, were associated with progression of brain atrophy. © 2011 American Neurological Association.
AB - Objective: Atherosclerosis has been implicated in the development of brain atrophy. However, support for this association comes from cross-sectional studies. Methods: Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, a prospective cohort study among patients with symptomatic atherosclerotic disease (mean age ± standard deviation, 58 ± 10 years; 80% men), magnetic resonance imaging of the brain was performed in 1,232 patients at baseline (2001-2005) and in 663 patients at follow-up (2006-2009). Brain segmentation was used to quantify total brain volume, cortical gray matter volume, and ventricular volume as indicators of global, cortical, and subcortical atrophy. At baseline, measurements of carotid intima-media thickness (CIMT) and carotid stenosis were performed. Carotid stenosis was classified into groups 0 of 50%, 50 of 70% (moderate), and >70% (severe) and into unilateral or bilateral stenosis. Results: Cross-sectional regression analyses showed that both increased CIMT and carotid stenosis were associated with decreased relative total brain and cortical gray matter volume. Our prospective findings showed that after a mean follow-up of 3.9 years (range, 3.0-5.8 years), CIMT and moderate stenosis were not related to progression of brain atrophy. Only severe or bilateral carotid stenosis was related to progression of global atrophy (β [95% confidence interval (CI)], -0.52% [-0.84 to -0.20%], -0.94% [-1.45 to -0.43%]), cortical atrophy (β [95% CI], -0.75% [-1.37 to -0.13%], -1.34% [-2.32 to -0.35%]), and subcortical atrophy (β [95% CI], 0.06% [-0.02 to 0.16%], 0.13% [0.01 to 0.28%]). Interpretation: In a study of patients with atherosclerotic disease with 4 years of follow-up, only severe or bilateral carotid stenosis, and not moderate carotid stenosis and increased CIMT, were associated with progression of brain atrophy. © 2011 American Neurological Association.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=80051550207&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/21674583
U2 - https://doi.org/10.1002/ana.22392
DO - https://doi.org/10.1002/ana.22392
M3 - Article
C2 - 21674583
SN - 0364-5134
VL - 70
SP - 237
EP - 244
JO - Annals of neurology
JF - Annals of neurology
IS - 2
ER -