APRISE Dementia (Assessing Population-based Radiological brain health in Stroke Epidemiology-Dementia)

说明/摘要： 痴呆症是一个主要负担，其成本超过癌症和心脏病，预计到2060年将翻一番。 在非裔美国人中不成比例。在导致卒中后痴呆(PSD)的参数中，血管 原因，包括小血管疾病，代表了一种需要进一步定性的无声流行病。 从流行病学上讲。在发病率和特征方面进一步开展以人群为基础的PSD研究， 在美国需要进行国家预测和公共卫生规划。目前，我们还 缺乏对PSD的既定预测工具。一个类似于Framingham的“中风后痴呆的风险函数工具” 尤其是融合了现代成像参数的全色域，在不同种族的 可能会确定高危患者进行有针对性的干预。此外，它还可能揭示新的因果关系。 未来调查的途径和风险因素。我们建议对NIH资助的评估进行一项辅助研究 卒中流行病学中基于人群的放射脑健康(APRISE)研究，APRISE-痴呆。 我们的目标是建立在GCNKSS和APRISE基础设施的基础上，这些基础设施将具有辐射特征 从2015年开始，大辛辛那提/北肯塔基州的全部中风/短暂性脑缺血发作人口，创造了第一个现代， 主要基于MRI的当代中风/短暂性脑缺血发作人群的脑健康特征，并确定 以人群为基础的发病率、临床和人口学特征以及PSD的预测因素 卒中/短暂性脑缺血发作后。我们的具体目标是创建一个结合成像的PSD预测模型 使用最先进的建模技术在双系缺血性卒中/出血性卒中/短暂性脑缺血发作人群中的参数 接近了。我们假设PSD的诊断(从指标性卒中事件开始的五年内)会更好 与传统的血管危险因素相比，通过结合成像参数进行预测。我们会 通过利用广泛的成像，以显著的成本和时间高效的方式实现这些目标， 目前已在收集2015年来卒中/短暂性脑缺血发作患者的临床和人口学数据 资助APRISE和GCKNSS赠款。我们的项目不仅将提供首个人群水平的发病率 PSD在全国范围内进行预测，并创新性地利用大脑健康的整个成像光谱进行预测，但它 还将为NINDS/NIA未来的前瞻性验证和改进产生新的假设- 资助了U19发现队列。在基础设施已经到位的情况下，我们可以独一无二地满足 这些紧迫的问题。

DESCRIPTION/ABSTRACT: Dementia is a major burden, costing more than cancer and heart disease, and expected to double by 2060, and disproportionately in African-Americans. Among the parameters leading to post stroke dementia (PSD), vascular causes, including small vessel disease, represent a silent epidemic in need of further characterization epidemiologically. Further population-based studies of PSD, both in terms of incidence and characterization, are needed in the United States to allow for national projections and public health planning. Currently, we also lack an established prediction tool for PSD. A Framingham-like “Risk Function Tool for Post-Stroke Dementia,” especially one incorporating the full gamut of modern imaging parameters developed in a racially diverse population, would likely identify high-risk patients for targeted interventions. Moreover, it may reveal novel causal pathways and risk factors for future investigation. We propose an ancillary study to the NIH-funded Assessing Population-based Radiological brain health in Stroke Epidemiology (APRISE) study entitled, APRISE-Dementia. Our objective is to build on the GCNKSS and APRISE infrastructures which will have radiologically characterized the full stroke/TIA population of Greater Cincinnati/Northern Kentucky from 2015 and created the first modern, largely MRI-based characterization of brain health in a contemporary stroke/TIA population, and determine the population-based incidence, clinical and demographic features, and predictors of PSD up to five years after the incident stroke/TIA. Our specific aim is to create a prediction model of PSD incorporating imaging parameters in a biracial ischemic stroke/hemorrhagic stroke/TIA population using state-of-the-art modeling approaches. We hypothesize that diagnosis of PSD (within five years from index stroke event) will be better predicted by incorporating imaging parameters compared to traditional vascular risk factors alone. We will achieve these goals in a remarkably cost- and time-efficient manner by leveraging the extensive imaging, clinical and demographic data of stroke/TIA patients from 2015 already being collected in the currently funded APRISE and GCKNSS grants. Our project will not only provide the first population-level incidence of PSD projected nationally and innovatively utilize the entire imaging spectrum of brain health for prediction, but it will also generate novel hypotheses for prospective validation and refinement in the prospective NINDS/NIA- funded U19 DISCOVERY cohort. With the infrastructures already in place, we are uniquely ready to address these urgent questions.