Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study
Asymmetry of brain dysfunction may disrupt brain network efficiency. We hypothesized that greater left-right white matter hyperintensity volume (WMHV) asymmetry was associated with functional trajectories.Methods: In the Northern Manhattan Study, participants underwent brain MRI with axial T1, T2, a...
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| Format: | Article |
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Frontiers Media S.A.
2017-09-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fnagi.2017.00305/full |
| _version_ | 1819181356638273536 |
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| author | Mandip S. Dhamoon Mandip S. Dhamoon Ying-Kuen Cheung Ahmet Bagci Noam Alperin Ralph L. Sacco Ralph L. Sacco Mitchell S. V. Elkind Mitchell S. V. Elkind Clinton B. Wright |
| author_facet | Mandip S. Dhamoon Mandip S. Dhamoon Ying-Kuen Cheung Ahmet Bagci Noam Alperin Ralph L. Sacco Ralph L. Sacco Mitchell S. V. Elkind Mitchell S. V. Elkind Clinton B. Wright |
| author_sort | Mandip S. Dhamoon |
| collection | DOAJ |
| description | Asymmetry of brain dysfunction may disrupt brain network efficiency. We hypothesized that greater left-right white matter hyperintensity volume (WMHV) asymmetry was associated with functional trajectories.Methods: In the Northern Manhattan Study, participants underwent brain MRI with axial T1, T2, and fluid attenuated inversion recovery sequences, with baseline interview and examination. Volumetric WMHV distribution across 14 brain regions was determined separately by combining bimodal image intensity distribution and atlas based methods. Participants had annual functional assessments with the Barthel index (BI, range 0–100) over a mean of 7.3 years. Generalized estimating equations (GEE) models estimated associations of regional WMHV and regional left-right asymmetry with baseline BI and change over time, adjusted for baseline medical risk factors, sociodemographics, and cognition, and stroke and myocardial infarction during follow-up.Results: Among 1,195 participants, greater WMHV asymmetry in the parietal lobes (−8.46 BI points per unit greater WMHV on the right compared to left, 95% CI −3.07, −13.86) and temporal lobes (−2.48 BI points, 95% CI −1.04, −3.93) was associated with lower overall function. Greater WMHV asymmetry in the parietal lobes (−1.09 additional BI points per year per unit greater WMHV on the left compared to right, 95% CI −1.89, −0.28) was independently associated with accelerated functional decline.Conclusions: In this large population-based study with long-term repeated measures of function, greater regional WMHV asymmetry was associated with lower function and functional decline. In addition to global WMHV, WHMV asymmetry may be an important predictor of long-term functional status. |
| first_indexed | 2024-12-22T22:28:56Z |
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| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-12-22T22:28:56Z |
| publishDate | 2017-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-f59541b112904425a837a88c5d5951df2022-12-21T18:10:29ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652017-09-01910.3389/fnagi.2017.00305286276Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan StudyMandip S. Dhamoon0Mandip S. Dhamoon1Ying-Kuen Cheung2Ahmet Bagci3Noam Alperin4Ralph L. Sacco5Ralph L. Sacco6Mitchell S. V. Elkind7Mitchell S. V. Elkind8Clinton B. Wright9Department of Neurology, Icahn School of Medicine at Mount SinaiNew York, NY, United StatesDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityNew York, NY, United StatesDepartment of Biostatistics, Mailman School of Public Health, Columbia UniversityNew York, NY, United StatesEvelyn F. McKnight Brain Institute, Miller School of Medicine, University of MiamiMiami, FL, United StatesEvelyn F. McKnight Brain Institute, Miller School of Medicine, University of MiamiMiami, FL, United StatesEvelyn F. McKnight Brain Institute, Miller School of Medicine, University of MiamiMiami, FL, United StatesDepartments of Public Health Sciences and Human Genetics, Miller School of Medicine, University of MiamiMiami, FL, United StatesDepartment of Epidemiology, Mailman School of Public Health, Columbia UniversityNew York, NY, United StatesDepartment of Neurology, College of Physicians and Surgeons, Columbia UniversityNew York, NY, United StatesNational Institutes of HealthBethesda, MD, United StatesAsymmetry of brain dysfunction may disrupt brain network efficiency. We hypothesized that greater left-right white matter hyperintensity volume (WMHV) asymmetry was associated with functional trajectories.Methods: In the Northern Manhattan Study, participants underwent brain MRI with axial T1, T2, and fluid attenuated inversion recovery sequences, with baseline interview and examination. Volumetric WMHV distribution across 14 brain regions was determined separately by combining bimodal image intensity distribution and atlas based methods. Participants had annual functional assessments with the Barthel index (BI, range 0–100) over a mean of 7.3 years. Generalized estimating equations (GEE) models estimated associations of regional WMHV and regional left-right asymmetry with baseline BI and change over time, adjusted for baseline medical risk factors, sociodemographics, and cognition, and stroke and myocardial infarction during follow-up.Results: Among 1,195 participants, greater WMHV asymmetry in the parietal lobes (−8.46 BI points per unit greater WMHV on the right compared to left, 95% CI −3.07, −13.86) and temporal lobes (−2.48 BI points, 95% CI −1.04, −3.93) was associated with lower overall function. Greater WMHV asymmetry in the parietal lobes (−1.09 additional BI points per year per unit greater WMHV on the left compared to right, 95% CI −1.89, −0.28) was independently associated with accelerated functional decline.Conclusions: In this large population-based study with long-term repeated measures of function, greater regional WMHV asymmetry was associated with lower function and functional decline. In addition to global WMHV, WHMV asymmetry may be an important predictor of long-term functional status.http://journal.frontiersin.org/article/10.3389/fnagi.2017.00305/fullwhite matter hyperintensitiesdisabilitytrajectoryMRI and fMRIsubclinical ischemia |
| spellingShingle | Mandip S. Dhamoon Mandip S. Dhamoon Ying-Kuen Cheung Ahmet Bagci Noam Alperin Ralph L. Sacco Ralph L. Sacco Mitchell S. V. Elkind Mitchell S. V. Elkind Clinton B. Wright Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study Frontiers in Aging Neuroscience white matter hyperintensities disability trajectory MRI and fMRI subclinical ischemia |
| title | Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study |
| title_full | Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study |
| title_fullStr | Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study |
| title_full_unstemmed | Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study |
| title_short | Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study |
| title_sort | differential effect of left vs right white matter hyperintensity burden on functional decline the northern manhattan study |
| topic | white matter hyperintensities disability trajectory MRI and fMRI subclinical ischemia |
| url | http://journal.frontiersin.org/article/10.3389/fnagi.2017.00305/full |
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