title: The bidirectional association between reduced cerebral blood flow and brain atrophy in the general population.
abstract: The question remains whether reduced cerebral blood flow (CBF) leads to brain atrophy or vice versa. We studied the longitudinal relation between CBF and brain volume in a community-dwelling population. In the Rotterdam Study, 3011 participants (mean age 59.6 years (s.d. 8.0)) underwent repeat brain magnetic resonance imaging to quantify brain volume and CBF at two time points. Adjusted linear regression models were used to investigate the bidirectional relation between CBF and brain volume. We found that smaller brain volume at baseline was associated with a steeper decrease in CBF in the whole population (standardized change per s.d. increase of total brain volume (TBV)=0.296 (95% confidence interval (CI) 0.200; 0.393)). Only in persons aged ⩾65 years, a lower CBF at baseline was associated with steeper decline of TBV (standardized change per s.d. increase of CBF=0.003 (95% CI -0.004; 0.010) in the whole population and 0.020 (95% CI 0.004; 0.036) in those aged ⩾65 years of age). Our results indicate that brain atrophy causes CBF to decrease over time, rather than vice versa. Only in persons aged >65 years of age did we find lower CBF to also relate to brain atrophy.
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Hazel I
authors.initials: HI
authors.lastname: Zonneveld
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Loehrer
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.|Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000235:genetics; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012307:Risk Factors; D066127:White Matter / Q000473:pathology
chemical_list: D001057:Apolipoproteins E