Dementia and Stroke Risk Associated with Brain Artery Luminal Diameters

Authors

Jesus D. Melgarejo, The University of Texas Rio Grande ValleyFollow
Kursat Gurel, Columbia University Irving
Minghua Liu, Columbia University Irving
Bonnie Levin, University of Miami Miller
Mitchell S.V. Elkind, Columbia University
M. Kamran Ikram, Erasmus University
M. Arfan Ikram
Fabrice Crivello
Christophe Tzourio, University of Bordeaux
Zhen-Yu Zhang, University of Leuven

Document Type

Article

Publication Date

12-25-2023

Abstract

Background: It is unclear whether brain artery diameters measured on conventional T2-weighted brain MRI images relate to dementia and stroke outcomes across distinct populations. We aimed this study to evaluate the association of T2-weighted brain artery luminal diameters with dementia and stroke in three distinct population‑based studies.

Methods: Three longitudinal population-based studies with 8420 adults >40 years old (Northern Manhattan Study [NOMAS] from the United States, and the Rotterdam Study [RS], from the Netherlands, and Three-City, from France) with brain MRI scans obtained between 1999 and 2015. The median follow-up time for clinical events ranged between 7 and 12.5 years. We tested our hypothesis in each cohort separately due to local data‑sharing regulations. The exposure variable was brain carotid and basilar artery luminal diameters measured on MRI axial T2‑weighted scans. Multivariable hazard ratios (HRs) and their 95% confidence intervals (CI) expressed the risk of dementia and stroke (primary outcomes) associated with the lowest (<5^th) and highest (>95^th) percentiles of the rank‑normalized brain artery diameters compared to a reference group defined as the diameters distributed between the 5^th and 95^th percentiles. Secondary outcomes included total and vascular mortality, and fatal and nonfatal cardiovascular and coronary end points.

Results: Among the three cohorts (mean age ranged from 65 to 73 y, ≥57% women), 335 participants developed dementia and 331 strokes. Compared with the reference group, participants with arterial diameters >95^th percentile had a higher risk of dementia (HR range 1.15-4.50) and any stroke (HR range 1.29-2.03). For secondary outcomes, participants with arterial diameters >95^th percentile had a consistent higher risk of coronary outcomes, vascular mortality and a composite of any vascular events. The results were less supportive of a higher risk of events among participants with arterial diameters <5^th percentile except for vascular mortality.

Conclusions: Individuals with dilated brain arteries are at higher risk of dementia and vascular events. Our findings were consistency across distinct populations in spite of using a non-enhanced, conventional T2-weighted MRI sequence. Understanding the underlying physiopathology of the reported associations, particularly with dementia and stroke, might reveal novel vascular contributions to dementia

Comments

© 2023 Alzheimer's Association

Recommended Citation

Melgarejo, J.D., Gurel, K., Compton, C.R., Liu, M., Assuras, S., Levin, B., Sacco, R., Elkind, M.S.V., Rundek, T., Ikram, M.K., Kavousi, M., Ikram, M.A., Wright, C.B., Crivello, F., Laurent, A., Tzourio, C., Vernooij, M.W., Yu Zhang, Z., Bos, D. and Gutierrez, J. (2023), Dementia and Stroke Risk Associated with Brain Artery Luminal Diameters. Alzheimer's Dement., 19: e077653. https://doi.org/10.1002/alz.077653

Publication Title

Alzheimer's & dementia : the journal of the Alzheimer's Association

DOI

10.1002/alz.077653

Academic Level

faculty

Mentor/PI Department

Neuroscience