title: Atherosclerotic calcification relates to cognitive function and to brain changes on magnetic resonance imaging.
abstract: BACKGROUND
  Increasing evidence suggests a role of atherosclerosis in the pathogenesis of cognitive impairment and dementia. Calcification volume measured with computed tomography (CT) is a valid marker of atherosclerosis. This study investigates associations of atherosclerosis (measured using CT) at four locations with cognition and brain changes on magnetic resonance imaging (MRI).
  
  
  METHODS
  To quantify calcification volume, 2414 nondemented people from the Rotterdam Study underwent CT of the coronary arteries, aortic arch, extracranial carotid arteries, and intracranial carotid arteries. To assess global cognition and performance on memory, executive function, information processing speed, and motor speed, they also underwent neuropsychological tests. In a random subgroup of 844 participants, brain MRI was performed. Automated segmentation and quantification of brain MRI scans yielded brain tissue volumes in milliliters. Diffusion tensor imaging was used to measure the microstructural integrity of the white matter. Relationships of atherosclerotic calcification with cognition, brain tissue volumes, and diffusion tensor imaging measures were assessed with linear regression models and adjusted for relevant confounders.
  
  
  RESULTS
  With larger calcification volumes, lower cognitive scores were observed. When calcification volumes were larger, total brain volumes were also smaller. Specifically, larger coronary artery calcification volumes related to smaller gray matter volumes, and extracranial and intracranial carotid calcification volumes related to smaller white matter volumes. Larger calcification volume in all vessel beds was accompanied by worse microstructural integrity of the white matter.
  
  
  CONCLUSIONS
  Larger calcification volume is associated with worse cognitive performance. It also relates to smaller brain tissue volumes and worse white matter microstructural integrity, revealing possible mechanisms through which atherosclerosis may lead to poorer cognition.
authors.affiliation: Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bos
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.forename: Suzette E
authors.initials: SE
authors.lastname: Elias-Smale
authors.forename: Benjamin F J
authors.initials: BF
authors.lastname: Verhaaren
authors.forename: Henri A
authors.initials: HA
authors.lastname: Vrooman
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D014057:Tomography, X-Ray Computed