CARDIA Year 35 Brain MRI Renewal

CARDIA Y35脑MRI更新辅助研究摘要 许多研究已经建立了脑血管疾病（CEVD）、形态学和病理学之间的密切关系。 生理性大脑变化，包括中风，认知能力下降和痴呆，包括阿尔茨海默病 疾病及相关病症（ADRD）。新的生理和功能磁共振成像（fMRI）方法允许非- 局部脑血流量、血管反应性和生理脑连接的侵入性测量。 这些技术提供了评价形态学、病理生理学和脑功能障碍的手段 与CEVD和ADRD有关。 CARDIA第25年和第30年脑MRI子研究旨在纳入最先进的MRI 将MRI技术应用于相对年轻的CARDIA人群，以确定CVD风险的MRI相关性 并检测早期CEVD。这些研究记录了CEVD的早期MRI变化， 与CVD危险因素的相关性，特别是高血压。CARDIA 35年MRI辅助研究是 旨在将这些早期研究扩展到CARDIA的中年晚期人群。 CEVD和ADRD的大多数生物标志物在大约55岁之前都是弱表达的，当他们开始他们的活动时， 在生命的第六和第七个十年里明显的陡峭的斜坡。相应地，亚临床 疾病在临床上变得明显，反映为增加的生理变化和认知缺陷。 然而，年龄、生活方式和合并症（包括ADRD）是CEVD影响的混杂因素。心脏， 凭借其冗长而丰富的历史数据，很好地剖析了CEVD的复杂性， 从中年到老年的过渡期与ADRD的关系，从几乎没有合并症的年龄开始， 药物使用率低。 大约1044名参与者将从四个参与的现场中心入组辅助研究。 MRI受试者将从之前的CARDIA脑MRI受试者中招募，并接受脑MRI扫描 以及Y25和Y30所定义的认知测试。将报告MRI数据的计算机分析 通过感兴趣的解剖区域定量地进行。 主要目标是：1）提高统计能力，以更好地记录以前描述的和新的 定义人口统计学指标、风险因素和脑MRI结果之间的关联，2）定义MRI 与临床事件和认知变化最密切相关的参数，以及3）识别早期MRI 生物标志物模式，其在个体水平上告知疾病病理生理学和进展。

CARDIA Y35 Brain MRI Renewal Ancillary Study Abstract Many studies have established strong relationships between cerebrovascular disease (CEVD), morphological and physiological brain changes, including stroke, and cognitive decline and dementia, including Alzheimer disease and related disorders (ADRD). New physiological and functional MRI (fMRI) methods allow non- invasive measurement of regional cerebral blood flow, vascular reactivity and physiological brain connectivity. These techniques provide the means to evaluate the morphology, pathophysiology, and brain dysfunction related to CEVD and ADRD. The CARDIA Year 25 and Year 30 Brain MRI Substudies were designed to incorporate state-of-the-art MRI technology into the relatively younger population of CARDIA in order to determine MRI correlates of CVD risk factors and detect early CEVD. These studies documented early MRI changes of CEVD with strong correlations to CVD risk factors, particularly hypertension. The CARDIA Year 35 MRI Ancillary Study is intended to extend these earlier studies into the late middle age population of CARDIA. Most biomarkers of CEVD and ADRD are weakly expressed until approximately age 55, when they begin their precipitous rise to the steep slope evident in the 6th and 7th decades of life. Correspondingly, subclinical disease becomes clinically evident, reflected by increasing physiological changes and cognitive deficits. However, confounding the effects of CEVD are age, lifestyle, and co-morbidities, including ADRD. CARDIA, with its lengthy and rich historical data, is well-positioned to dissect the intricacies of CEVD and putative relationship to ADRD in the transition from middle age to seniority, starting at ages with few comorbidities and low medication use. Approximately 1044 participants will be enrolled in the Ancillary Study from the four participating Field Centers. MRI participants will be recruited from previous CARDIA Brain MRI participants and receive brain MRI scans and cognitive testing as defined for Y25 and Y30. Computer analysis of MRI data will be reported quantitatively by anatomic regions-of-interest. The primary objectives are to: 1) enhance statistical power to better document previously described and newly defined associations between demographic measures, risk factors and brain MRI findings, 2) define MRI parameters most strongly associated with clinical events and cognitive changes, and 3) identify early MRI biomarker patterns that inform disease pathophysiology and progression at an individual level.