Risk Factors and Consequences of Cortical Thickness in an Asian Population

Hilal, Saima; Xu, Xiaoyan; Ang, Seow Li; Tan, Chuen Seng; Venketasubramanian, Narayanaswamy; Niessen, Wiro J.; Vrooman, Henri A.; Wong, Tien Yin; Chen, Christopher; Ikram, M. Kamran

doi:10.1097/md.0000000000000852

Cited by 21 publications

(15 citation statements)

References 46 publications

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“…However, close monitoring of kidney function during earlier lifespan was important since the accumulation of Aβ could start from middle age 5 . Secondly, women tended to have a greater cortical thickness than their age-matched counterpart 45,46 , and our results were in line with these findings (women vs men: + 47.7 μm, 95% CI = 21.4-74.1 μm in age-adjusted global cortical thickness). Interestingly, we found that kidney dysfunction had more prominent effects on global CTh in women (equivalent to an aging effect of 20.5 years).…”

Section: Discussionsupporting

confidence: 81%

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Effect of kidney dysfunction on cerebral cortical thinning in elderly population

Chen

Tsai

et al. 2017

Journal of the Neurological Sciences

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Chronic kidney disease has been linked to cognitive impairment and morphological brain change. However, less is known about the impact of kidney functions on cerebral cortical thickness. This study investigated the relationship between kidney functions and global or lobar cerebral cortical thickness (CTh) in 259 non-demented elderly persons. Forty-three participants (16.7%) had kidney dysfunction, which was defined as either a glomerular filtration rate (GFR) of <60 ml/min/1.73 m 2 or presence of proteinuria. Kidney dysfunction was associated with lower global (β = −0.05, 95% CI = −0.08 to −0.01) as well as frontal, parietal, temporal, occipital, and insular lobar CTh. In the stratified analysis, the associations were more pronounced in women, APOEε4 non-carriers, and participants with a lower cognitive score. Besides, kidney dysfunction significantly increased the risk of cortical thinning, defined as being the lowest CTh tertile, in the insular lobe (adjusted odds ratio = 2.74, 95% CI = 1.31−5.74). Our results suggested that kidney dysfunction should be closely monitored and managed in elderly population to prevent neurodegeneration.The worldwide incidence and prevalence of dementia is increasing rapidly in persons of advanced age, which results in a huge global disease burden 1 . Currently, it is estimated that 46.8 million people worldwide are living with dementia, although in some developed countries the prevalence is gradually lowering possibly due to higher education levels and better control of cardiovascular risk factors 2, 3 . Long before clinically evident dementia-related functional impairment, generalized brain atrophy progresses gradually and asymptomatically with age, beginning at middle age 4 . Therefore, it is important to identify potentially preventable factors related to brain atrophy during the subclinical phase. Consequently, the structural neuroimaging, among various potential biomarkers for dementia, serves most closely temporal relationship with the onset of clinically detectable cognitive impairment 5 . The most commonly applied structural neuroimaging technique is magnetic resonance imaging (MRI). In various MRI imaging sequences, physicians can use three-dimensional T1-weighted images that clearly delineate the volume, shape, and thickness of the respective cerebral cortex. Specifically, the volume of cortical regions is a composite measure related to both thickness and surface area. In these two morphometric parameters, cortical thickness more closely reflects pathological changes related to dementia, such as laminar thinning and neuronal loss, while volume loss is largely the result of a reduction in surface area during normal aging 6 . Several factors have been linked to dementia, such as age, sex, education, apolipoprotein E (APOE) ε4 status, and various cardiovascular risk factors such as hypertension, diabetes mellitus, metabolic syndrome, and stroke 7 . In recent years, brain-kidney interaction is increasingly emphasized. Chronic kidney disease (CKD) and

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Section: Discussionsupporting

confidence: 81%

“…Increasing age was generally associated with less cortical thickness 4,45,46 . In our subgroup analysis, we found that in the young-old group (65-74 years-old), kidney dysfunction was significantly related to a lower global CTh, while the old-old group (≥75 years-old) also demonstrated a non-significant relationship.…”

Section: Discussionmentioning

confidence: 99%

Effect of kidney dysfunction on cerebral cortical thinning in elderly population

Chen

Tsai

et al. 2017

Journal of the Neurological Sciences

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“…Across these studies the effect of cortical thickness varies, with some reporting relationships with executive function, processing speed, memory (59,64), whilst others reporting relationships with memory and attention (60,63). A study by Hilal et al (2015) demonstrated that WMH and microbleeds were associated with thinning in the temporal and insular regions and associated multi-domain cognitive dysfunction. The insula is an important structure with extensive connections to cortical and subcortical regions, and is involved in various processes, such as empathy, emotion, body sensation, and other aspects of social cognition (66,67).…”

Section: Discussionmentioning

confidence: 99%

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Ozzoude

Ramirez

Raamana³

et al. 2020

Preprint

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BackgroundRegional changes to cortical thickness in individuals with neurodegenerative and cerebrovascular diseases can be estimated using specialised neuroimaging software. However, the presence of cerebral small vessel disease, focal atrophy, and cortico-subcortical stroke lesions, pose significant challenges that increase the likelihood of misclassification errors and segmentation failures.PurposeThe main goal of this study was to examine a correction procedure developed for enhancing FreeSurfer’s cortical thickness estimation tool, particularly when applied to the most challenging MRI obtained from participants with chronic stroke and cerebrovascular disease, with varying degrees of neuro-vascular lesions and brain atrophy.MethodsIn 155 cerebrovascular disease patients enrolled in the Ontario Neurodegenerative Disease Research Initiative (ONDRI), FreeSurfer outputs were compared between a fully automated, unmodified procedure and a corrected procedure that accounted for potential sources of error due to atrophy and neurovascular lesions. Quality control (QC) measures were obtained from both procedures. Association between cortical thickness and global cognitive status as assessed by the Montreal Cognitive Assessment (MoCA) score was also investigated from both procedures.ResultsCorrected procedures increased ‘Acceptable’ QC ratings from 18% to 76% for the cortical ribbon and from 38% to 92% for tissue segmentation. Corrected procedures reduced ‘Fail’ ratings from 11% to 0% for the cortical ribbon and 62% to 8% for tissue segmentation. FreeSurfer-based segmentation of T1-weighted white matter hypointensities were significantly greater in the corrected procedure (5.8mL vs. 15.9mL, p<0.001). The unmodified procedure yielded no significant associations with global cognitive status, whereas the corrected procedure yielded positive associations between MoCA total score and clusters of cortical thickness in the left superior parietal (p=0.018) and left insula (p=0.04) regions. Further analyses with the corrected cortical thickness results and MoCA subscores showed a positive association between left superior parietal cortical thickness and Attention (p<0.001).ConclusionsThese findings suggest that correction procedures that account for brain atrophy and neurovascular lesions can significantly improve FreeSurfer’s segmentation results, reduce failure rates, and potentially increase sensitivity to examine brain-behaviour relationships. Future work will examine relationships between cortical thickness, cerebral small vessel disease, and neurodegenerative disease in the ONDRI study.

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“…Out of 957 subjects, 30 were diagnosed with dementia and hence were excluded from the analysis. The details of the study methodology have been described elsewhere 11. Recruitment took place from August 8, 2010 to July 24, 2015.…”

Section: Methodsmentioning

confidence: 99%

Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries

Hilal

Mok

Youn

et al. 2017

J Neurol Neurosurg Psychiatry

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Risk Factors and Consequences of Cortical Thickness in an Asian Population

Abstract: Supplemental Digital Content is available in the text

Cited by 21 publications

References 46 publications

Effect of kidney dysfunction on cerebral cortical thinning in elderly population

Effect of kidney dysfunction on cerebral cortical thinning in elderly population

Cortical thickness estimation in individuals with cerebral small vessel disease, focal atrophy, and chronic stroke lesions

Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries

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