1. Nonlinear temporal dynamics of cerebral small vessel disease
- Author
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Valerie Lohner, Anil M. Tuladhar, Loes C.A. Rutten-Jacobs, David G. Norris, Ewoud J. van Dijk, Esther M.C. van Leijsen, Bram Platel, Mohsen Ghafoorian, Eline C. M. Kooijmans, Mayra I. Bergkamp, Helena M. van der Holst, Ingeborg W.M. van Uden, Frank-Erik de Leeuw, Catharina J.M. Klijn, Jacobs, Loes [0000-0003-3223-885X], Apollo - University of Cambridge Repository, and Magnetic Detection and Imaging
- Subjects
Male ,Time Factors ,Medizin ,Junior staff ,Library science ,Article ,150 000 MR Techniques in Brain Function ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Leukoencephalopathies ,Risk Factors ,Image Processing, Computer-Assisted ,Humans ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,Aged ,Aged, 80 and over ,Disease progression ,Data Science ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Magnetic Resonance Imaging ,Cerebral Small Vessel Diseases ,3. Good health ,Women's cancers Radboud Institute for Health Sciences [Radboudumc 17] ,Nonlinear Dynamics ,Disease Progression ,Female ,Neurology (clinical) ,Small vessel ,Psychology ,030217 neurology & neurosurgery - Abstract
Objective:To investigate the temporal dynamics of cerebral small vessel disease (SVD) by 3 consecutive assessments over a period of 9 years, distinguishing progression from regression.Methods:Changes in SVD markers of 276 participants of the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC) cohort were assessed at 3 time points over 9 years. We assessed white matter hyperintensities (WMH) volume by semiautomatic segmentation and rated lacunes and microbleeds manually. We categorized baseline WMH severity as mild, moderate, or severe according to the modified Fazekas scale. We performed mixed-effects regression analysis including a quadratic term for increasing age.Results:Mean WMH progression over 9 years was 4.7 mL (0.54 mL/y; interquartile range 0.95–5.5 mL), 20.3% of patients had incident lacunes (2.3%/y), and 18.9% had incident microbleeds (2.2%/y). WMH volume declined in 9.4% of the participants during the first follow-up interval, but only for 1 participant (0.4%) throughout the whole follow-up. Lacunes disappeared in 3.6% and microbleeds in 5.7% of the participants. WMH progression accelerated over time: including a quadratic term for increasing age during follow-up significantly improved the model (p < 0.001). SVD progression was predominantly seen in participants with moderate to severe WMH at baseline compared to those with mild WMH (odds ratio [OR] 35.5, 95% confidence interval [CI] 15.8–80.0, p < 0.001 for WMH progression; OR 5.7, 95% CI 2.8–11.2, p < 0.001 for incident lacunes; and OR 2.9, 95% CI 1.4–5.9, p = 0.003 for incident microbleeds).Conclusions:SVD progression is nonlinear, accelerating over time, and a highly dynamic process, with progression interrupted by reduction in some, in a population that on average shows progression.
- Published
- 2017