title: White Matter and Hippocampal Volume Predict the Risk of Dementia in Patients with Cerebral Small Vessel Disease: The RUN DMC Study.
abstract: BACKGROUND
  The relationship between cerebral small vessel disease (SVD) and dementia has been studied without considering white matter (WM) volume, the microstructural integrity of the WM surrounding the SVD, and grey matter (GM).
  
  
  OBJECTIVE
  We prospectively investigated the relationship between these structures and the risk of dementia, and formed a prediction model to investigate which characteristics (macro- or microstructural) explained most of the variance.
  
  
  METHODS
  The RUN DMC study is a prospective cohort study among 503 non-demented participants with an age between 50 and 85 years at baseline, with baseline assessment in 2006 and follow-up assessment in 2012. Two were lost to follow-up (yielding a 99.6% response-rate). Cox regression analysis was used, to calculate hazard ratios for dementia, of baseline MRI characteristics. Tract-Based Spatial Statistics (TBSS) analysis was used to assess the added value of microstructural integrity of the WM.
  
  
  RESULTS
  Mean age at baseline was 65.6 years (SD 8.8) and 56.8% was male. 43 participants developed dementia (8.6%), resulting in a 5.5-year cumulative risk of 11.1% (95% CI 7.7-14.6). Low WM and hippocampal volume are significant predictors for dementia. WM, WM hyperintensities, and hippocampal volume explained most of the variance. TBSS analyses showed no additional value of diffusion parameters.
  
  
  CONCLUSIONS
  WM and hippocampal volume were the main predictors for the development of incident dementia at 5-year follow-up in elderly with SVD. There was no additional diagnostic value of the diffusion tensor imaging parameters on top of the macrostructural characteristics.
authors.affiliation: Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Ingeborg W M
authors.initials: IW
authors.lastname: van Uden
authors.affiliation: Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Helena M
authors.initials: HM
authors.lastname: van der Holst
authors.affiliation: Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Anil M
authors.initials: AM
authors.lastname: Tuladhar
authors.affiliation: Department of Neurology, Amphia ziekenhuis Breda, The Netherlands.
authors.forename: Anouk G W
authors.initials: AG
authors.lastname: van Norden
authors.affiliation: Department of Neurology, HagaZiekenhuis Den Haag, The Netherlands.
authors.forename: Karlijn F
authors.initials: KF
authors.lastname: de Laat
authors.affiliation: University of Cambridge, Department of Clinical Neurosciences, Neurology Unit, Cambridge, UK.
authors.forename: Loes C A
authors.initials: LC
authors.lastname: Rutten-Jacobs
authors.affiliation: Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.|Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany.
authors.forename: David G
authors.initials: DG
authors.lastname: Norris
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Geriatrics, Nijmegen, The Netherlands.
authors.forename: Jurgen A H R
authors.initials: JA
authors.lastname: Claassen
authors.affiliation: Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Ewoud J
authors.initials: EJ
authors.lastname: van Dijk
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Department of Medical Psychology, Nijmegen, The Netherlands.
authors.forename: Roy P C
authors.initials: RP
authors.lastname: Kessels
authors.affiliation: Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands.
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
mesh_terms: D000368:Aged; D059345:Cerebral Small Vessel Diseases / Q000150:complications*; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D018709:Statistics, Nonparametric; D066127:White Matter / Q000473:pathology*
keywords: Dementia; Magnetic resonance imaging; diffusion tensor imaging; elderly; hippocampal volume; small vessel disease; white matter