Links Between Physical Frailty and Regional Gray Matter Volumes in Older Adults: A Voxel-Based Morphometry Study

Nishita, Yukiko; Nakamura, Akinori; Kato, Takashi; Otsuka, Rei; Iwata, Koichi; Tange, Chikako; Ando, Fujiko; Ito, Kengo; Shimokata, Hiroshi; Arai, Hidenori

doi:10.1016/j.jamda.2019.09.001

Cited by 44 publications

(30 citation statements)

References 34 publications

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“…We are the first to demonstrate microstructural characteristics of gray matter underlying frailty. Our findings concerning the spatial distribution of gray matter microstructure with frailty are in line with previous brain volumetric and β-amyloid findings (6,12,15,34). Specifically, the medial frontal cortex is an identified area important for motor function and associated with lower extremity performance, perhaps due to its key role in executive function.…”

Section: Discussionsupporting

confidence: 91%

“…Notably, the thalamus has an important role in motor control and coordination and also has a strong structural and functional connection to the striatum of putamen and caudate. We did not observe any association in the temporal lobe or specifically the hippocampus, which has been reported in previous brain volumetric studies by MRI and CT (6,15,34). This inconsistency may be due to differences in characteristics of study participants, imaging analytical approaches (voxel-based morphometry vs. ROIs), or frailty assessment.…”

Section: Discussioncontrasting

confidence: 68%

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Microstructural Neuroimaging of Frailty in Cognitively Normal Older Adults

et al. 2020

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Physical frailty is an age-related clinical syndrome that is associated with multiple adverse health outcomes, including cognitive impairment and dementia. Recent studies have shown that frailty is associated with specific volumetric neuroimaging characteristics. Whether brain microstructural characteristics, particularly gray matter, associated with frailty exist and what their spatial distribution is have not been explored. We identified 670 participants of the Baltimore Longitudinal Study of Aging who were aged 60 and older and cognitively normal and who had concurrent data on frailty and regional microstructural neuroimaging markers by diffusion tensor imaging (DTI), including mean diffusivity (MD) of gray matter and fractional anisotropy (FA) of white matter. We identified neuroimaging markers that were associated with frailty status (non-frail, pre-frail, frail) and further examined differences between three groups using multivariate linear regression (non-frail = reference). Models were adjusted for age, sex, race, years of education, body mass index, scanner type, and Apolipoprotein E e4 carrier status. Compared to the non-frail participants, those who were frail had higher MD in the medial frontal cortex, several subcortical regions (putamen, caudate, thalamus), anterior cingulate cortex, and a trend of lower FA in the body of the corpus callosum. Those who were pre-frail also had higher MD in the putamen and a trend of lower FA in the body of the corpus callosum. Our study demonstrates for the first time that the microstructure of both gray and white matter differs by frailty status in cognitively normal older adults. Brain areas were not widespread but mostly localized in frontal and subcortical motor areas and the body of the corpus callosum. Whether changes in brain microstructure precede future frailty development warrants further investigation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 68%

Microstructural Neuroimaging of Frailty in Cognitively Normal Older Adults

et al. 2020

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“…In the present study, global brain volume and multiple regional GMV showed significant negative correlations with the EFS. This was consistent with the results of several previous studies, which showed that reduced global and regional brain volume changes were found in frailty (22)(23)(24), despite differing frailty assessment tools. Such results demonstrate the progressive brain atrophy during the development of frailty.…”

Section: Discussionsupporting

confidence: 93%

Associations between brain volumetry and relaxometry signatures and the Edmonton Frail Scale in frailty

Li¹,

Chen²,

Wu³

et al. 2021

Quant Imaging Med Surg

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Background: Frailty is a geriatric condition characterized by a decreased reserve. The Edmonton frailty scale (EFS) has been widely used as an assessment tool in clinical practice. However, the brain's underlying pathophysiological changes in frailty and their associations with the EFS remain unclear. This study aimed to explore the associations between brain volumetry and relaxometry signatures and the EFS (and each domain score of the EFS) in frailty.Methods: A total of 40 non-demented subjects were enrolled in this prospective study. Frailty assessment was performed for each subject according to the EFS. All subjects underwent synthetic magnetic resonance imaging (MRI) (MAGnetic resonance image Compilation, MAGiC) and three-dimensional fast spoiled gradient-recalled echo (3D-FSPGR) T1-weighted structural image acquisitions on a 3.0 T MR scanner.Brain segmentation was performed based on quantitative values obtained from the MAGiC and 3D-FSPGR images. Volumetry and relaxometry of the global brain and regional gray matter (GM) were also obtained.The associations between the total EFS score (and the score of each domain) and the brain's volumetry and relaxometry were investigated by partial correlation while eliminating the effects of age. Multiple comparisons of regional GM volumetry and relaxometry analyses were controlled by false discovery rate (FDR) correction. All data were analyzed using the SPSS 13.0 statistical package (IBM, Armonk, NY, USA) and MATLAB (MathWorks, Natick, MA, USA).Results: For global volumetry, significant correlations were found between multiple global volumetry parameters and the EFS, as well as the cognition score, functional independence score, nutrition score, and functional performance score (P<0.05). For global relaxometry, notable positive correlations were found between the T2 values of gray and white matter (WM) and the EFS (r=0.357, P=0.026; r=0.357, P=0.026, respectively). Significant correlations were also identified between the T2 value of GM, the T1, T2, and

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“…[11][12][13][14] Furthermore, in AIS patients undergoing MT, cerebral atrophy has been linked to inferior functional outcome. [15] Moreover, brain atrophy is associated with physical frailty, [16,17] and in our previous study we showed that sarcopenia, represented by masseter muscle area and 3 density, is associated with poor three-month survival after MT. [18] The potential predictive value of BAI and its dependence on sarcopenia as well as other risk factors in AIS patients treated with MT remains poorly defined.…”

Section: Introductionmentioning

confidence: 94%

Brain atrophy predicts mortality after mechanical thrombectomy of proximal anterior circulation occlusion

Lauksio

Lindström

Khan

et al. 2020

J NeuroIntervent Surg

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BackgroundBrain atrophy is associated with an inferior functional outcome in patients undergoing mechanical thrombectomy (MT) for acute ischemic stroke. We hypothesized that brain atrophy determined from pre-interventional non-contrast-enhanced CT scans would also be linked to increased mortality in this cohort.MethodsA total of 204 patients treated with MT for acute occlusions of the internal carotid artery (ICA) or the M1 segment of the middle cerebral artery (M1) at Tampere University Hospital, Finland between 2013 and 2017 were retrospectively studied. Brain atrophy index (BAI), masseter muscle surface area and density, chronic ischemic lesions, and white matter lesions were evaluated from pre-interventional CT studies. Logistic regression was applied in analyzing the association of BAI with 3-month mortality.ResultsMedian age at baseline was 69.9 years (IQR 15.6) and mortality at 3 months was 13.2% (n=27). BAI, measured with excellent reproducibility (intraclass correlation coefficient ≥0.894, p<0.001), was significantly associated with age (r=0.54), white matter lesions (r=0.43), dental status (r=−0.31), masseter area (r=−0.24), masseter density (r=−0.28), and chronic ischemic lesions (r=0.24) (p≤0.001 for all). In univariable analysis, BAI demonstrated a strong association with mortality (OR 2.02, 95% CI 1.34 to 3.05, per 1 SD increase), and none of the other factors associated with mortality remained as significant when included in the same multivariable model. The results remained similar when extending the follow-up up to 2.5 years.ConclusionsBrain atrophy predicts 3-month mortality after MT of the ICA or the M1 independent of age, masseter sarcopenia, chronic ischemic lesions, or white matter lesions.

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Links Between Physical Frailty and Regional Gray Matter Volumes in Older Adults: A Voxel-Based Morphometry Study

Cited by 44 publications

References 34 publications

Microstructural Neuroimaging of Frailty in Cognitively Normal Older Adults

Microstructural Neuroimaging of Frailty in Cognitively Normal Older Adults

Associations between brain volumetry and relaxometry signatures and the Edmonton Frail Scale in frailty

Brain atrophy predicts mortality after mechanical thrombectomy of proximal anterior circulation occlusion

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