title: Longitudinal changes in brain volumes and cerebrovascular lesions on MRI in patients with manifest arterial disease: the SMART-MR study.
abstract: We estimated the progression of brain atrophy and cerebrovascular lesions on MRI in a prospective cohort of patients with various manifestations of arterial disease. Within the SMART-MR study, using brain MRI data from baseline and after on average 3.9 years of follow-up, intracranial volume (ICV), total brain, cortical gray matter, ventricular, white matter lesion volumes and visually rated infarcts were obtained from 663 patients (mean age 57 ± 9 years, 81% men). Global and cortical atrophy increased quadratically with age. Men showed more progression of global and cortical atrophy than women (mean difference in change (95% CI): -0.25 (-0.44; -0.06) and -0.94 (-1.35; -0.52)% ICV) and had an increased risk of new brain infarcts (OR = 2.7, 95% CI 1.2-6.1). Compared with coronary artery disease patients, cerebrovascular disease patients showed more progression of cortical and subcortical atrophy and an increased risk of new brain infarcts, and peripheral arterial disease patients showed more progression of cortical atrophy. These results were independent of cerebrovascular lesions and cardiovascular risk factors. In patients with manifest arterial disease, brain atrophy tended to accelerate with older age and men had more progression of brain atrophy and cerebrovascular lesions than women. Additionally, patients with cerebrovascular and peripheral arterial disease showed the most prominent progression of atrophy and lesions.
authors: Department of Radiology, University Medical Center Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors: Pieternella H
authors: PH
authors: van der Veen
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands; Department of Internal Medicine, VU University Medical Center Amsterdam, The Netherlands.
authors: Majon
authors: M
authors: Muller
authors: Image Sciences Institute, University Medical Center Utrecht, The Netherlands.
authors: Koen L
authors: KL
authors: Vincken
authors: Department of Radiology, University Medical Center Utrecht, The Netherlands.
authors: Theo D
authors: TD
authors: Witkamp
authors: Department of Radiology, University Medical Center Utrecht, The Netherlands.
authors: Willem P T M
authors: WP
authors: Mali
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors: Yolanda
authors: Y
authors: van der Graaf
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. Electronic address: m.geerlings@umcutrecht.nl.
authors: Mirjam I
authors: MI
authors: Geerlings
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy / Q000209:etiology / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000209:etiology / Q000473:pathology; D003327:Coronary Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
keywords: Atherosclerosis; Brain imaging; Cerebrovascular disease; Cohort; Epidemiology; Longitudinal; Magnetic resonance