TY - JOUR
T1 - MRI phenotypes of the brain are related to future stroke and mortality in patients with manifest arterial disease
T2 - The SMART-MR study
AU - Jaarsma-Coes, Myriam G.
AU - on behalf of the Second Manifestations of ARTerial disease (SMART) Study group
AU - Ghaznawi, Rashid
AU - Hendrikse, Jeroen
AU - Slump, Cornelis
AU - Witkamp, Theo D.
AU - van der Graaf, Yolanda
AU - Geerlings, Mirjam I.
AU - de Bresser, Jeroen
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Neurodegenerative and neurovascular diseases lead to heterogeneous brain abnormalities. A combined analysis of these abnormalities by phenotypes of the brain might give a more accurate representation of the underlying aetiology. We aimed to identify different MRI phenotypes of the brain and assessed the risk of future stroke and mortality within these subgroups. In 1003 patients (59 ± 10 years) from the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, different quantitative 1.5T brain MRI markers were used in a hierarchical clustering analysis to identify 11 distinct subgroups with a different distribution in brain MRI markers and cardiovascular risk factors, and a different risk of stroke (Cox regression: from no increased risk compared to the reference group with relatively few brain abnormalities to HR = 10.34; 95% CI 3.80↔28.12 for the multi-burden subgroup) and mortality (from no increased risk compared to the reference group to HR = 4.00; 95% CI 2.50↔6.40 for the multi-burden subgroup). In conclusion, within a group of patients with manifest arterial disease, we showed that different MRI phenotypes of the brain can be identified and that these were associated with different risks of future stroke and mortality. These MRI phenotypes can possibly classify individual patients and assess their risk of future stroke and mortality.
AB - Neurodegenerative and neurovascular diseases lead to heterogeneous brain abnormalities. A combined analysis of these abnormalities by phenotypes of the brain might give a more accurate representation of the underlying aetiology. We aimed to identify different MRI phenotypes of the brain and assessed the risk of future stroke and mortality within these subgroups. In 1003 patients (59 ± 10 years) from the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, different quantitative 1.5T brain MRI markers were used in a hierarchical clustering analysis to identify 11 distinct subgroups with a different distribution in brain MRI markers and cardiovascular risk factors, and a different risk of stroke (Cox regression: from no increased risk compared to the reference group with relatively few brain abnormalities to HR = 10.34; 95% CI 3.80↔28.12 for the multi-burden subgroup) and mortality (from no increased risk compared to the reference group to HR = 4.00; 95% CI 2.50↔6.40 for the multi-burden subgroup). In conclusion, within a group of patients with manifest arterial disease, we showed that different MRI phenotypes of the brain can be identified and that these were associated with different risks of future stroke and mortality. These MRI phenotypes can possibly classify individual patients and assess their risk of future stroke and mortality.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85060557773&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30547694
U2 - https://doi.org/10.1177/0271678X18818918
DO - https://doi.org/10.1177/0271678X18818918
M3 - Article
C2 - 30547694
SN - 0271-678X
VL - 40
SP - 354
EP - 364
JO - Journal of cerebral blood flow and metabolism
JF - Journal of cerebral blood flow and metabolism
IS - 2
ER -