The brain health index: Towards a combined measure of neurovascular and neurodegenerative structural brain injury

David Alexander Dickie (Corresponding Author), Maria del C Valdes Hernandez, Stephen D Makin, Julie Staals, Stewart J Wiseman, Mark E Bastin, Joanna M Wardlaw

Research output: Contribution to journalArticle

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Abstract

Background A structural magnetic resonance imaging measure of combined neurovascular and neurodegenerative burden may be useful as these features often coexist in older people, stroke and dementia. Aim We aimed to develop a new automated approach for quantifying visible brain injury from small vessel disease and brain atrophy in a single measure, the brain health index. Materials and methods We computed brain health index in N = 288 participants using voxel-based Gaussian mixture model cluster analysis of T1, T2, T2*, and FLAIR magnetic resonance imaging. We tested brain health index against a validated total small vessel disease visual score and white matter hyperintensity volumes in two patient groups (minor stroke, N = 157; lupus, N = 51) and against measures of brain atrophy in healthy participants (N = 80) using multiple regression. We evaluated associations with Addenbrooke's Cognitive Exam Revised in patients and with reaction time in healthy participants. Results The brain health index (standard beta = 0.20-0.59, P <0.05) was significantly and more strongly associated with Addenbrooke's Cognitive Exam Revised, including at one year follow-up, than white matter hyperintensity volume (standard beta = 0.04-0.08, P > 0.05) and small vessel disease score (standard beta = 0.02-0.27, P > 0.05) alone in both patient groups. Further, the brain health index (standard beta = 0.57-0.59, P <0.05) was more strongly associated with reaction time than measures of brain atrophy alone (standard beta = 0.04-0.13, P > 0.05) in healthy participants. Conclusions The brain health index is a new image analysis approach that may usefully capture combined visible brain damage in large-scale studies of ageing, neurovascular and neurodegenerative disease.
Original languageEnglish
Pages (from-to)849-856
Number of pages8
JournalInternational Journal of Stroke
Volume13
Issue number8
Early online date19 Apr 2018
DOIs
Publication statusPublished - 1 Oct 2018

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Brain Injuries
Health
Brain
Healthy Volunteers
Atrophy
Stroke
Magnetic Resonance Imaging
Brain Diseases
Neurodegenerative Diseases
Cluster Analysis
Dementia

Keywords

  • Atrophy
  • cerebral small vessel diseases
  • cognition
  • computer-assisted image processing
  • stroke
  • magnetic resonance imaging

Cite this

The brain health index : Towards a combined measure of neurovascular and neurodegenerative structural brain injury. / Dickie, David Alexander (Corresponding Author); Valdes Hernandez, Maria del C; Makin, Stephen D; Staals, Julie ; Wiseman, Stewart J; Bastin, Mark E; Wardlaw, Joanna M.

In: International Journal of Stroke, Vol. 13, No. 8, 01.10.2018, p. 849-856.

Research output: Contribution to journalArticle

Dickie, David Alexander ; Valdes Hernandez, Maria del C ; Makin, Stephen D ; Staals, Julie ; Wiseman, Stewart J ; Bastin, Mark E ; Wardlaw, Joanna M. / The brain health index : Towards a combined measure of neurovascular and neurodegenerative structural brain injury. In: International Journal of Stroke. 2018 ; Vol. 13, No. 8. pp. 849-856.
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title = "The brain health index: Towards a combined measure of neurovascular and neurodegenerative structural brain injury",
abstract = "Background A structural magnetic resonance imaging measure of combined neurovascular and neurodegenerative burden may be useful as these features often coexist in older people, stroke and dementia. Aim We aimed to develop a new automated approach for quantifying visible brain injury from small vessel disease and brain atrophy in a single measure, the brain health index. Materials and methods We computed brain health index in N = 288 participants using voxel-based Gaussian mixture model cluster analysis of T1, T2, T2*, and FLAIR magnetic resonance imaging. We tested brain health index against a validated total small vessel disease visual score and white matter hyperintensity volumes in two patient groups (minor stroke, N = 157; lupus, N = 51) and against measures of brain atrophy in healthy participants (N = 80) using multiple regression. We evaluated associations with Addenbrooke's Cognitive Exam Revised in patients and with reaction time in healthy participants. Results The brain health index (standard beta = 0.20-0.59, P <0.05) was significantly and more strongly associated with Addenbrooke's Cognitive Exam Revised, including at one year follow-up, than white matter hyperintensity volume (standard beta = 0.04-0.08, P > 0.05) and small vessel disease score (standard beta = 0.02-0.27, P > 0.05) alone in both patient groups. Further, the brain health index (standard beta = 0.57-0.59, P <0.05) was more strongly associated with reaction time than measures of brain atrophy alone (standard beta = 0.04-0.13, P > 0.05) in healthy participants. Conclusions The brain health index is a new image analysis approach that may usefully capture combined visible brain damage in large-scale studies of ageing, neurovascular and neurodegenerative disease.",
keywords = "Atrophy, cerebral small vessel diseases, cognition, computer-assisted image processing, stroke, magnetic resonance imaging",
author = "Dickie, {David Alexander} and {Valdes Hernandez}, {Maria del C} and Makin, {Stephen D} and Julie Staals and Wiseman, {Stewart J} and Bastin, {Mark E} and Wardlaw, {Joanna M}",
note = "The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding from the Stroke Association (DAD), Technology Strategy Board/ Innovate UK (46917-348146), Wellcome Trust (WT088134/Z/09/A), Row Fogo Charitable Trust, Lupus UK, National Institutes of Health (R01 EB004155-03), European Union Horizon 2020 PHC-03-15, project No 666881, SVDs@Target, and Fondation Leducq (Transatlantic Network of Excellence for the Study of Perivascular Spaces in Small Vessel Disease, ref no. 16 CVD 05) is gratefully acknowledged.",
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T1 - The brain health index

T2 - Towards a combined measure of neurovascular and neurodegenerative structural brain injury

AU - Dickie, David Alexander

AU - Valdes Hernandez, Maria del C

AU - Makin, Stephen D

AU - Staals, Julie

AU - Wiseman, Stewart J

AU - Bastin, Mark E

AU - Wardlaw, Joanna M

N1 - The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding from the Stroke Association (DAD), Technology Strategy Board/ Innovate UK (46917-348146), Wellcome Trust (WT088134/Z/09/A), Row Fogo Charitable Trust, Lupus UK, National Institutes of Health (R01 EB004155-03), European Union Horizon 2020 PHC-03-15, project No 666881, SVDs@Target, and Fondation Leducq (Transatlantic Network of Excellence for the Study of Perivascular Spaces in Small Vessel Disease, ref no. 16 CVD 05) is gratefully acknowledged.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background A structural magnetic resonance imaging measure of combined neurovascular and neurodegenerative burden may be useful as these features often coexist in older people, stroke and dementia. Aim We aimed to develop a new automated approach for quantifying visible brain injury from small vessel disease and brain atrophy in a single measure, the brain health index. Materials and methods We computed brain health index in N = 288 participants using voxel-based Gaussian mixture model cluster analysis of T1, T2, T2*, and FLAIR magnetic resonance imaging. We tested brain health index against a validated total small vessel disease visual score and white matter hyperintensity volumes in two patient groups (minor stroke, N = 157; lupus, N = 51) and against measures of brain atrophy in healthy participants (N = 80) using multiple regression. We evaluated associations with Addenbrooke's Cognitive Exam Revised in patients and with reaction time in healthy participants. Results The brain health index (standard beta = 0.20-0.59, P <0.05) was significantly and more strongly associated with Addenbrooke's Cognitive Exam Revised, including at one year follow-up, than white matter hyperintensity volume (standard beta = 0.04-0.08, P > 0.05) and small vessel disease score (standard beta = 0.02-0.27, P > 0.05) alone in both patient groups. Further, the brain health index (standard beta = 0.57-0.59, P <0.05) was more strongly associated with reaction time than measures of brain atrophy alone (standard beta = 0.04-0.13, P > 0.05) in healthy participants. Conclusions The brain health index is a new image analysis approach that may usefully capture combined visible brain damage in large-scale studies of ageing, neurovascular and neurodegenerative disease.

AB - Background A structural magnetic resonance imaging measure of combined neurovascular and neurodegenerative burden may be useful as these features often coexist in older people, stroke and dementia. Aim We aimed to develop a new automated approach for quantifying visible brain injury from small vessel disease and brain atrophy in a single measure, the brain health index. Materials and methods We computed brain health index in N = 288 participants using voxel-based Gaussian mixture model cluster analysis of T1, T2, T2*, and FLAIR magnetic resonance imaging. We tested brain health index against a validated total small vessel disease visual score and white matter hyperintensity volumes in two patient groups (minor stroke, N = 157; lupus, N = 51) and against measures of brain atrophy in healthy participants (N = 80) using multiple regression. We evaluated associations with Addenbrooke's Cognitive Exam Revised in patients and with reaction time in healthy participants. Results The brain health index (standard beta = 0.20-0.59, P <0.05) was significantly and more strongly associated with Addenbrooke's Cognitive Exam Revised, including at one year follow-up, than white matter hyperintensity volume (standard beta = 0.04-0.08, P > 0.05) and small vessel disease score (standard beta = 0.02-0.27, P > 0.05) alone in both patient groups. Further, the brain health index (standard beta = 0.57-0.59, P <0.05) was more strongly associated with reaction time than measures of brain atrophy alone (standard beta = 0.04-0.13, P > 0.05) in healthy participants. Conclusions The brain health index is a new image analysis approach that may usefully capture combined visible brain damage in large-scale studies of ageing, neurovascular and neurodegenerative disease.

KW - Atrophy

KW - cerebral small vessel diseases

KW - cognition

KW - computer-assisted image processing

KW - stroke

KW - magnetic resonance imaging

U2 - 10.1177/1747493018770222

DO - 10.1177/1747493018770222

M3 - Article

C2 - 29672236

VL - 13

SP - 849

EP - 856

JO - International Journal of Stroke

JF - International Journal of Stroke

SN - 1747-4930

IS - 8

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