White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment.
White matter hyperintensity progression is associated with incident probable dementia or mild cognitive impairment.
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DOI：
10.1136/svn-2021-001357
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发表时间：
2022-04-29
影响因子：
5.9
通讯作者：
中科院分区：
文献类型：
--
作者：
脑MRI上的白色高信号（WMH）与痴呆或轻度认知障碍（MCI）的发生相关，但WMH随时间的进展尚未作为独立的风险因素进行充分研究。我们进行了一个事后分析的symptoms血压干预试验-记忆和认知降低高血压（SPRINT MIND）试验。主要结局是在入组后48个月随访MRI前发生可能的痴呆或MCI（痴呆/MCI）。主要预测因素是WMH进展，定义为随访和基线WMH体积之间的Z评分差异。次要预测因子是二元WMH进展阈值（≥1.4 mL vs <1.4 mL）。在纳入的433例患者中，33例（7.6%）发生痴呆/MCI。有156例（36.0%）患者达到WMH进展阈值≥1.4 mL，其中痴呆/MCI的发生率为12.8%（20/156），而WMH进展<1.4 mL的患者为4.7%（13/277）（p=0.002）。在多变量logistic回归分析中，WMH进展的Z评分与痴呆/MCI相关（OR 1.51，95% CI 1.12至2.04，p=0.007），WMH进展阈值≥1.4 mL也是如此（OR 2.89，95% CI 1.23至6.81，p=0.015）。在SPRINT MIND的事后分析中，超过48个月的WMH进展与可能的痴呆或MCI的发展相关。
White matter hyperintensity (WMH) on brain MRI is associated with developing dementia or mild cognitive impairment (MCI), but WMH progression over time has not been fully investigated as an independent risk factor. We performed a post hoc analysis of the Systolic Blood Pressure Intervention Trial - Memory and Cognition in Decreased Hypertension (SPRINT MIND) trial. The primary outcome was incident probable dementia or MCI (dementia/MCI) before the follow-up MRI at 48 months from enrolment. The primary predictor was WMH progression, defined as the Z score difference between the follow-up and baseline WMH volumes. The secondary predictor was a binary WMH progression threshold (≥1.4 mL vs <1.4 mL). Among the 433 included patients, 33 (7.6%) developed dementia/MCI. There were 156 (36.0%) patients who met the WMH progression threshold of ≥1.4 mL, in whom the rate of dementia/MCI was 12.8% (20/156) vs 4.7% (13/277) of patients with <1.4 mL WMH progression (p=0.002). In multivariable logistic regression, the Z score of WMH progression was associated with dementia/MCI (OR 1.51, 95% CI 1.12 to 2.04, p=0.007) as was the WMH progression threshold of ≥1.4 mL (OR 2.89, 95% CI 1.23 to 6.81, p=0.015). In this post hoc analysis of SPRINT MIND, WMH progression over 48 months was associated with the development of probable dementia or MCI.
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影响因子：
9.9
作者：
de Havenon, Adam;Majersik, Jennifer J.;Rost, Natalia S.
通讯作者：
Rost, Natalia S.
影响因子：
5.8
作者：
de Havenon A;Meyer C;McNally JS;Alexander M;Chung L
通讯作者：
Chung L
影响因子：
120.7
作者：
Williamson, Jeff D.;Pajewski, Nicholas M.;Wright, Clinton B.
通讯作者：
Wright, Clinton B.
影响因子：
8.3
作者：
Gorelick PB;Scuteri A;Black SE;Decarli C;Greenberg SM;Iadecola C;Launer LJ;Laurent S;Lopez OL;Nyenhuis D;Petersen RC;Schneider JA;Tzourio C;Arnett DK;Bennett DA;Chui HC;Higashida RT;Lindquist R;Nilsson PM;Roman GC;Sellke FW;Seshadri S;American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia
通讯作者：
American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia
影响因子：
120.7
作者：
Nasrallah, Ilya M.;Pajewski, Nicholas M.;Bryan, R. Nick
通讯作者：
Bryan, R. Nick