Incidental Brain Magnetic Resonance Imaging Findings and the Cognitive and Motor Performance in the Elderly: The Shanghai Changfeng Study

Abstract

BackgroundThe frequently discovered incidental findings (IFs) from imaging observations are increasing. The IFs show the potential clues of structural abnormalities underlying cognitive decline in elders. Detecting brain IFs and their relationship with cognitive and behavioral functions helps provide the information for clinical strategies.MethodsFive hundred and seventy-nine participants were recruited in the Shanghai Changfeng Study. All participants performed the demographic, biochemical, and cognitive functions and gait speed assessment and underwent the high-resolution multimodal magnetic resonance imaging scans. We calculated the detection rate of brain IFs. The association between cardiovascular risk factors and IFs and the associations between IFs and cognitive and motor functions were assessed using regression models. The relationships among gray matter volume, cognitive function, and gait speed were assessed with/without adjusting the IFs to evaluate the effects of potential IFs confounders.ResultsIFs were found in a total of 578 subjects with a detection rate of 99.8%. Age and blood pressure were the most significant cardiovascular risk factors correlated with IFs. IFs were found to be negatively associated with Montreal Cognitive Assessment, Mini-Mental State Examination, and gait speed. The gray matter volume was found to be positively correlated with the cognitive function without adjusting the white matter hyperintensity but not if adjusted.ConclusionIFs are commonly found in the elderly population and related to brain functions. The adequate intervention of IFs related cardiovascular risk factors that may slow down the progression of brain function decline. We also suggest that IFs should be considered as confounding factors that may affect cognitive issues on the structural neuroimaging researches in aging or diseases.

Prevalence of incidental intracranial findings on magnetic resonance imaging: a systematic review and meta-analysis

“…White matter hyperintensities exist on a spectrum from a clinically insignificant finding to pathologic white matter disease [ 24 ], but reporting thresholds are poorly standardised. This issue is exemplified in the findings of Wang et al [ 76 ], who reported the prevalence of hyperintensities stratified into grades in 579 patients. At the lowest threshold, white matter intensities were observed in 566/579 patients (97.8%) [ 76 ].…”

“…This issue is exemplified in the findings of Wang et al [ 76 ], who reported the prevalence of hyperintensities stratified into grades in 579 patients. At the lowest threshold, white matter intensities were observed in 566/579 patients (97.8%) [ 76 ]. Thus, we did not pool these findings.…”

“…Domain-level risk of bias findings is shown in Fig. 2 Study N Location Age Population Design Magnet Sequences Contrast Assessor Risk of bias Serag and Ragab, 2020 [ 68 ] 753 Egypt 49.8 ± 18.7 Healthy volunteers R-NRS 1.5 T T1W1, T2W1, FLAIR Y Radiologist High Wang et al, 2021 [ 76 ] 579 China 67.6 ± 7.6 Healthy volunteers P-NRS 3 T T1W1, T2W1, FLAIR N Radiologist Low Hanna et al, 2020 [ 28 ] 125 USA 43.9 ± 15.2 Healthy volunteers P-NRS 3 T T1W1 N Neuroradiologist High Vázquez-Justes et al, 2020 [ 71 ] 514 Spain 57 Type 2 diabetics R-NRS 1.5 T T1W1, T2W1, FLAIR Y Neuroradiologist High Keuss et al, 2019 [ 42 ] …”

Diagnostic yield of TOF-MRA for detecting incidental vascular lesions in patients with cognitive impairment: observational cohort study

“…1,2 With the wider use of brain MRI in clinical practice, the cases of incidental imaging ndings in patients with cognitive impairment have been increasing. 3,4 Studies have demonstrated that majority of these incidental ndings do not indicate the requirement of any treatment, although positive ndings have been more frequently observed in patients with cognitive impairment compared to healthy elderly. 3 However, incidental vascular ndings such as aneurysm or stenosis are not well documented in the literature.…”

Diagnostic yield of TOF-MRA for detecting incidental vascular lesions in patients with cognitive impairment: An observational cohort study

“…Brain magnetic resonance imaging (MRI) plays a crucial role in the diagnostic work-up and follow-up of patients with cognitive impairment ( 1 , 2 ). With the wider use of brain MRI in clinical practice, the cases of incidental imaging findings in patients with cognitive impairment have been increasing ( 3 , 4 ). Studies have indicated that positive findings have been more frequently observed in patients with a cognitive impairment compared to healthy elderly, although majority of these incidental findings do not indicate the requirement of any treatment ( 3 ).…”