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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,...

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Autores principales: Dhamoon, Mandip S., Cheung, Ying-Kuen, Bagci, Ahmet, Alperin, Noam, Sacco, Ralph L., Elkind, Mitchell S. V., Wright, Clinton B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609109/
https://www.ncbi.nlm.nih.gov/pubmed/28970793
http://dx.doi.org/10.3389/fnagi.2017.00305
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author Dhamoon, Mandip S.
Cheung, Ying-Kuen
Bagci, Ahmet
Alperin, Noam
Sacco, Ralph L.
Elkind, Mitchell S. V.
Wright, Clinton B.
author_facet Dhamoon, Mandip S.
Cheung, Ying-Kuen
Bagci, Ahmet
Alperin, Noam
Sacco, Ralph L.
Elkind, Mitchell S. V.
Wright, Clinton B.
author_sort Dhamoon, Mandip S.
collection PubMed
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.
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spelling pubmed-56091092017-10-02 Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study Dhamoon, Mandip S. Cheung, Ying-Kuen Bagci, Ahmet Alperin, Noam Sacco, Ralph L. Elkind, Mitchell S. V. Wright, Clinton B. Front Aging Neurosci Neuroscience 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. Frontiers Media S.A. 2017-09-20 /pmc/articles/PMC5609109/ /pubmed/28970793 http://dx.doi.org/10.3389/fnagi.2017.00305 Text en Copyright © 2017 Dhamoon, Cheung, Bagci, Alperin, Sacco, Elkind and Wright. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Dhamoon, Mandip S.
Cheung, Ying-Kuen
Bagci, Ahmet
Alperin, Noam
Sacco, Ralph L.
Elkind, Mitchell S. V.
Wright, Clinton B.
Differential Effect of Left vs. Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study
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 Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609109/
https://www.ncbi.nlm.nih.gov/pubmed/28970793
http://dx.doi.org/10.3389/fnagi.2017.00305
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