title: Cardiovascular risk factors cause cortical thinning in cognitively impaired patients: relationships among cardiovascular risk factors, white matter hyperintensities, and cortical atrophy.
abstract: Cardiovascular risk factors are associated with cognitive impairments. However, the effects of cardiovascular risk factors on the topography of cortical thinning have not yet been studied in patients with mild cognitive impairment (MCI) or dementia. Thus, we aimed to evaluate the topography of cortical thinning related to cardiovascular risk factors and the relationships among cardiovascular risk factors, white matter hyperintensities (WMH), and cortical atrophy. Participants included 226 patients with Alzheimer disease or subcortical vascular dementia and 135 patients with amnestic MCI or subcortical vascular MCI. We automatically measured the volume of WMH and cortical thickness. Hypertension was associated with cortical thinning in the frontal and perisylvian regions, and cortical thinning related to diabetes mellitus (DM) occurred in the frontal region. In path analyses, hypertension accounted for 0.04 of the frontal thinning with the mediation of WMH and 0.16 without the mediation of WMH. In case of DM, it accounted for 0.02 of the frontal thinning with the mediation of WMH and 0.13 without the mediation of WMH. Hypertension and DM predominantly affected frontal thinning both with and without the mediation of WMH, where the effects without the mediation of WMH were greater than those with the mediation of WMH.
authors.affiliation: Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Seo
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Kiho
authors.initials: K
authors.lastname: Im
authors.forename: Jun-Sung
authors.initials: JS
authors.lastname: Park
authors.forename: Sook-Hui
authors.initials: SH
authors.lastname: Kim
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Kim
authors.forename: Joong Hyun
authors.initials: JH
authors.lastname: Ahn
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Kim
authors.forename: Geon Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
authors.forename: Jee Hoon
authors.initials: JH
authors.lastname: Roh
authors.forename: Hae-Kwan
authors.initials: HK
authors.lastname: Cheong
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000473:pathology*; D003072:Cognition Disorders / Q000150:complications / Q000473:pathology*; D015140:Dementia, Vascular / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors