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Extreme deep white matter hyperintensity volumes are associated with African American race.
Wednesday,2015-03-04 13:55 America/Los_Angeles — zdrager
| Title | Extreme deep white matter hyperintensity volumes are associated with African American race. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Nyquist, PA, Bilgel, MS, Gottesman, R, Yanek, LR, Moy, TF, Becker, LC, Cuzzocreo, J, Prince, J, Yousem, DM, Becker, DM, Kral, BG, Vaidya, D |
| Journal | Cerebrovasc Dis |
| Volume | 37 |
| Issue | 4 |
| Pagination | 244-50 |
| Date Published | 2014 |
| ISSN | 1421-9786 |
| Keywords | Adult, African Americans, Age Factors, Aged, Cerebrovascular Disorders, European Continental Ancestry Group, Female, Humans, Hypertension, Magnetic Resonance Imaging, Male, Middle Aged, Prevalence, Risk Factors, White Matter |
| Abstract | <p><b>BACKGROUND: </b>African Americans (AAs) have a higher prevalence of extreme ischemic white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) than do European Americans (EAs) based on the Cardiovascular Health Study (CHS) score. Ischemic white matter disease, limited to the deep white matter, may be biologically distinct from disease in other regions and may reflect a previously observed trend toward an increased risk of subcortical lacunar infarcts in AAs. We hypothesized that extreme deep WMH volume (DWMV) or periventricular volume (PV) may also have a higher prevalence in AAs. Thus, we studied extreme CHS scores and extreme DWMV and PV in a healthy population enriched for cardiovascular disease risk factors.</p><p><b>METHODS: </b>We imaged the brains of 593 subjects who were first-degree relatives of probands with early onset coronary disease prior to 60 years of age. WMHs were manually delineated on 3-tesla cranial MRI by a trained radiology reader; the location and volume of lesions were characterized using automated software. DWMV and PV were measured directly with automated software, and the CHS score was determined by a neuroradiologist. Volumes were characterized as being in the upper 25% versus lower 75% of total lesion volume. Volumes in the upper versus the remaining quartiles were examined for AA versus EA race using multiple logistic regression (generalized estimating equations adjusted for family relatedness) and adjusted for major vascular disease risk factors including age ≥55 years versus <55, sex, current smoking, obesity, hypertension, diabetes and low-density lipoprotein >160 mg/dl.</p><p><b>RESULTS: </b>Participants were 58% women and 37% AAs, with a mean age of 51.5 ± 11.0 years (range, 29-74 years). AAs had significantly higher odds of having extreme DWMVs (odds ratio, OR, 1.8; 95% confidence interval, CI, 1.2-2.9; p = 0.0076) independently of age, sex, hypertension and all other risk factors. AAs also had significantly higher odds of having extreme CHS scores ≥3 (OR, 1.3; 95% CI, 1.1-3.6; p = 0.025). Extreme PV was not significantly associated with AA race (OR, 1.3; 95% CI, 0.81-2.1; p = 0.26).</p><p><b>CONCLUSIONS: </b>AAs from families with early-onset cardiovascular disease are more likely to have extreme DWMVs (a subclinical form of cerebrovascular disease) and an extreme CHS score, but not extreme PV, independently of age and other cardiovascular disease risk factors. These findings suggest that this AA population is at an increased risk for DWMV and may be at an increased risk for future subcortical stroke. Longitudinal studies are required to see if DWMV is predictive of symptomatic subcortical strokes in this population.</p> |
| DOI | 10.1159/000358117 |
| Alternate Journal | Cerebrovasc. Dis. |
| PubMed ID | 24686322 |
| PubMed Central ID | PMC4054819 |
| Grant List | M01 RR000052 / RR / NCRR NIH HHS / United States R01 NS062059 / NS / NINDS NIH HHS / United States R01NS062059 / NS / NINDS NIH HHS / United States |