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James SN, Manning EN, Storey M, Nicholas JM, Coath W, Keuss SE, Cash DM, Lane CA, Parker T, Keshavan A, Buchanan SM, Wagen A, Harris M, Malone I, Lu K, Needham LP, Street R, Thomas D, Dickson J, Murray-Smith H, Wong A, Freiberger T, Crutch SJ, Fox NC, Richards M, Barkhof F, Sudre CH, Barnes J, Schott JM. Neuroimaging, clinical and life course correlates of normal-appearing white matter integrity in 70-year-olds. Brain Commun 2023; 5:fcad225. [PMID: 37680671 PMCID: PMC10481255 DOI: 10.1093/braincomms/fcad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 05/30/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023] Open
Abstract
We investigate associations between normal-appearing white matter microstructural integrity in cognitively normal ∼70-year-olds and concurrently measured brain health and cognition, demographics, genetics and life course cardiovascular health. Participants born in the same week in March 1946 (British 1946 birth cohort) underwent PET-MRI around age 70. Mean standardized normal-appearing white matter integrity metrics (fractional anisotropy, mean diffusivity, neurite density index and orientation dispersion index) were derived from diffusion MRI. Linear regression was used to test associations between normal-appearing white matter metrics and (i) concurrent measures, including whole brain volume, white matter hyperintensity volume, PET amyloid and cognition; (ii) the influence of demographic and genetic predictors, including sex, childhood cognition, education, socio-economic position and genetic risk for Alzheimer's disease (APOE-ɛ4); (iii) systolic and diastolic blood pressure and cardiovascular health (Framingham Heart Study Cardiovascular Risk Score) across adulthood. Sex interactions were tested. Statistical significance included false discovery rate correction (5%). Three hundred and sixty-two participants met inclusion criteria (mean age 70, 49% female). Higher white matter hyperintensity volume was associated with lower fractional anisotropy [b = -0.09 (95% confidence interval: -0.11, -0.06), P < 0.01], neurite density index [b = -0.17 (-0.22, -0.12), P < 0.01] and higher mean diffusivity [b = 0.14 (-0.10, -0.17), P < 0.01]; amyloid (in men) was associated with lower fractional anisotropy [b = -0.04 (-0.08, -0.01), P = 0.03)] and higher mean diffusivity [b = 0.06 (0.01, 0.11), P = 0.02]. Framingham Heart Study Cardiovascular Risk Score in later-life (age 69) was associated with normal-appearing white matter {lower fractional anisotropy [b = -0.06 (-0.09, -0.02) P < 0.01], neurite density index [b = -0.10 (-0.17, -0.03), P < 0.01] and higher mean diffusivity [b = 0.09 (0.04, 0.14), P < 0.01]}. Significant sex interactions (P < 0.05) emerged for midlife cardiovascular health (age 53) and normal-appearing white matter at 70: marginal effect plots demonstrated, in women only, normal-appearing white matter was associated with higher midlife Framingham Heart Study Cardiovascular Risk Score (lower fractional anisotropy and neurite density index), midlife systolic (lower fractional anisotropy, neurite density index and higher mean diffusivity) and diastolic (lower fractional anisotropy and neurite density index) blood pressure and greater blood pressure change between 43 and 53 years (lower fractional anisotropy and neurite density index), independently of white matter hyperintensity volume. In summary, poorer normal-appearing white matter microstructural integrity in ∼70-year-olds was associated with measures of cerebral small vessel disease, amyloid (in males) and later-life cardiovascular health, demonstrating how normal-appearing white matter can provide additional information to overt white matter disease. Our findings further show that greater 'midlife' cardiovascular risk and higher blood pressure were associated with poorer normal-appearing white matter microstructural integrity in females only, suggesting that women's brains may be more susceptible to the effects of midlife blood pressure and cardiovascular health.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emily N Manning
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Mathew Storey
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Aaron Wagen
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Mathew Harris
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ian Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Louisa P Needham
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
| | - Rebecca Street
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - David Thomas
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK
| | - John Dickson
- Institute of Nuclear Medicine, University College London Hospitals Foundation Trust, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
| | - Tamar Freiberger
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
| | - Frederik Barkhof
- Centre for Medical Image Computing, University College London, London, UK
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
- Centre for Medical Image Computing, University College London, London, UK
- School of Biomedical Engineering, King’s College, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
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Storey M, James S, Lane CA, Barnes J, Sudre CH, Parker TD, Lu K, Keshavan A, Buchanan SM, Keuss SE, Wagen A, Cash DM, Malone IB, Coath W, Prosser L, Nicholas JM, Murray‐Smith H, Wong A, Hughes A, Chaturvedi N, Fox NC, Richards M, Schott JM. Mid‐life blood pressure and microstructural white matter: Findings from the 1946 British birth cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.045707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Mathew Storey
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Sarah‐Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | | | - Jo Barnes
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Carole H Sudre
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Thomas D Parker
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Kirsty Lu
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | | | | | - Sarah E Keuss
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Aaron Wagen
- UCL Dementia Research Centre London United Kingdom
| | - David M Cash
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Ian B Malone
- UCL Queen Square Institute of Neurology London United Kingdom
| | - William Coath
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Jennifer M Nicholas
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | | | | | - Nick C Fox
- UK Dementia Research Institute London United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
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3
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Wagen A, Coath W, Keuss SE, Buchanan SM, Storey M, Lu K, Pavisic IM, James S, Street RE, Parker TD, Lane CA, Keshavan A, Murray‐Smith H, Cash DM, Malone IB, Wong A, Henley S, Crutch SJ, Wellington H, Heslegrave AJ, Zetterberg H, Fox NC, Richards M, Cole J, Schott JM. Serum neurofilament light and whole brain volume associate with machine‐learning derived brain‐predicted age in the British 1946 birth cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.045965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Aaron Wagen
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - William Coath
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Sarah E Keuss
- UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Mathew Storey
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Kirsty Lu
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Ivanna M Pavisic
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Sarah‐Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Rebecca E Street
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Thomas D Parker
- UCL Queen Square Institute of Neurology London United Kingdom
| | | | | | | | - David M Cash
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Ian B Malone
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Susie Henley
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Sebastian J Crutch
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry The Sahlgrenska Academy at University of Gothenburg Mölndal Sweden
| | - Nick C Fox
- UK Dementia Research Institute London United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - James Cole
- South London and Maudsley NHS Foundation Trust London United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
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Keuss SE, Poole T, Cash DM, Lane CA, Parker TD, Buchanan SM, Keshavan A, Coath W, Malone IB, Thomas DL, Sudre CH, Barnes J, Lu K, James S, Wagen A, Storey M, Murray‐Smith H, Wong A, Richards M, Fox NC, Schott JM. Cerebral amyloid and white matter hyperintensity volume are independently associated with rates of cerebral atrophy in Insight 46, a sub‐study of the 1946 British birth cohort. Alzheimers Dement 2020. [DOI: 10.1002/alz.044924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sarah E Keuss
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Teresa Poole
- UCL Queen Square Institute of Neurology London United Kingdom
- London School of Hygiene and Tropical Medicine London United Kingdom
| | - David M Cash
- UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Thomas D Parker
- UCL Queen Square Institute of Neurology London United Kingdom
| | | | | | - William Coath
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Ian B Malone
- UCL Queen Square Institute of Neurology London United Kingdom
| | - David L Thomas
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Carole H Sudre
- UCL Queen Square Institute of Neurology London United Kingdom
- School of Biomedical Engineering and Imaging Sciences King’s College London London United Kingdom
| | - Jo Barnes
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Kirsty Lu
- Dementia Research Centre UCL Queen Square Institute of Neurology London United Kingdom
| | - Sarah‐Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Aaron Wagen
- UCL Dementia Research Centre London United Kingdom
| | - Mathew Storey
- UCL Queen Square Institute of Neurology London United Kingdom
| | | | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL London United Kingdom
| | - Nick C Fox
- UCL Queen Square Institute of Neurology London United Kingdom
- UK Dementia Research Institute London United Kingdom
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