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Simple MRI score aids prediction of dementia in cerebral small vessel disease
- Source :
- Neurology, 94, E1294-E1302, Neurology, 94, 12, pp. E1294-E1302
- Publication Year :
- 2020
-
Abstract
- ObjectiveTo determine whether a simple small vessel disease (SVD) score, which uses information available on rapid visual assessment of clinical MRI scans, predicts risk of cognitive decline and dementia, above that provided by simple clinical measures.MethodsThree prospective longitudinal cohort studies (SCANS [St George's Cognition and Neuroimaging in Stroke], RUN DMC [Radboud University Nijmegen Diffusion Imaging and Magnetic Resonance Imaging Cohort], and the ASPS [Austrian Stroke Prevention Study]), which covered a range of SVD severity from mild and asymptomatic to severe and symptomatic, were included. In all studies, MRI was performed at baseline, cognitive tests repeated during follow-up, and progression to dementia recorded prospectively. Outcome measures were cognitive decline and onset of dementia during follow-up. We determined whether the SVD score predicted risk of cognitive decline and future dementia. We also determined whether using the score to select a group of patients with more severe disease would reduce sample sizes for clinical intervention trials.ResultsIn a pooled analysis of all 3 cohorts, the score improved prediction of dementia (area under the curve [AUC], 0.85; 95% confidence interval [CI], 0.81–0.89) compared with that from clinical risk factors alone (AUC, 0.76; 95% CI, 0.71–0.81). Predictive performance was higher in patients with more severe SVD. Power calculations showed selecting patients with a higher score reduced sample sizes required for hypothetical clinical trials by 40%–66% depending on the outcome measure used.ConclusionsA simple SVD score, easily obtainable from clinical MRI scans and therefore applicable in routine clinical practice, aided prediction of future dementia risk.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Neuroimaging
030204 cardiovascular system & hematology
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
medicine
Dementia
Humans
Prospective Studies
Cognitive decline
Prospective cohort study
Stroke
Aged
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Middle Aged
Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
medicine.disease
Magnetic Resonance Imaging
Confidence interval
Clinical trial
Cerebral Small Vessel Diseases
Cohort
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00283878
- Volume :
- 94
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....6c95eb0989ae0115fec9c13d5607dfb2