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Stroke risk profile predicts white matter hyperintensity volume: the Framingham Study
Tom Jeerakathil1, Philip A Wolf, Alexa Beiser
1Division of Neurology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Stroke
|June 26, 2004
Summary
The Framingham Stroke Risk Profile (FSRP) and its risk factors are linked to white matter hyperintensity (WMH) volume in individuals without stroke or dementia, suggesting a vascular basis for WMH.
Area of Science:
- Neuroimaging
- Cardiovascular Epidemiology
- Cerebrovascular Health
Background:
- Previous studies on cardiovascular risk factors and white matter hyperintensity (WMH) were limited by excluding symptomatic cerebrovascular disease and dementia.
- Semiquantitative methods for measuring WMH volume (WMHV) were often used instead of quantitative approaches.
Purpose of the Study:
- To examine the relationship between the Framingham Stroke Risk Profile (FSRP) and quantitatively measured WMHV.
- To investigate this relationship in a stroke and dementia-free subset of the Framingham Offspring Cohort.
Main Methods:
- Brain MRI was conducted on 1814 participants from the Framingham Offspring Cohort.
- Pixel-based quantitative WMHV measures, corrected for head size, were obtained using a semiautomated algorithm and log-transformed (LWMHV).
- FSRP and its components, measured 7.5 years prior to MRI, were analyzed against continuous LWMHV and large LWMHV (LWMHV-large), adjusting for age and sex.
Main Results:
- The FSRP demonstrated a strong association with both LWMHV and LWMHV-large.
- Significant relationships were found between LWMHV/LWMHV-large and age, smoking, history of cardiovascular disease, hypertension, and electrocardiogram-defined left ventricular hypertrophy.
Conclusions:
- The FSRP and several cardiovascular risk factors are associated with both continuous and categorical measures of WMHV.
- These findings strongly support a vascular etiology for white matter hyperintensities.