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Research ArticleAdult Brain
Open Access

Effects of Arterial Stiffness on Cerebral WM Integrity in Older Adults: A Neurite Orientation Dispersion and Density Imaging and Magnetization Transfer Saturation Imaging Study

J. Kikuta, K. Kamagata, M. Abe, C. Andica, Y. Saito, K. Takabayashi, W. Uchida, H. Naito, H. Tabata, A. Wada, Y. Tamura, R. Kawamori, H. Watada and S. Aoki
American Journal of Neuroradiology December 2022, 43 (12) 1706-1712; DOI: https://doi.org/10.3174/ajnr.A7709
J. Kikuta
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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K. Kamagata
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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M. Abe
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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C. Andica
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
dFaculty of Health Data Science (C.A.), Juntendo University, Chiba, Japan
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Y. Saito
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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K. Takabayashi
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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W. Uchida
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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H. Naito
bMetabolism and Endocrinology (H.N., Y.T., R.K., H.W.)
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H. Tabata
cSportology Center (H.T., Y.T., R.K., H.W.), Juntendo University Graduate School of Medicine, Tokyo, Japan
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A. Wada
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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Y. Tamura
bMetabolism and Endocrinology (H.N., Y.T., R.K., H.W.)
cSportology Center (H.T., Y.T., R.K., H.W.), Juntendo University Graduate School of Medicine, Tokyo, Japan
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R. Kawamori
bMetabolism and Endocrinology (H.N., Y.T., R.K., H.W.)
cSportology Center (H.T., Y.T., R.K., H.W.), Juntendo University Graduate School of Medicine, Tokyo, Japan
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H. Watada
bMetabolism and Endocrinology (H.N., Y.T., R.K., H.W.)
cSportology Center (H.T., Y.T., R.K., H.W.), Juntendo University Graduate School of Medicine, Tokyo, Japan
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S. Aoki
aFrom the Departments of Radiology (J.K., K.K., M.A., C.A., Y.S., K.T., W.U., A.W., S.A.)
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    FIGURE.

    Comparison between the high- and low-CAVI groups. For TBSS, the low- and high-CAVI groups were compared (family-wise error–corrected P < .05, adjusting for age, sex, antihypertensive therapy use, intracranial volume, and systolic blood pressure). Red–yellow voxels demonstrate significantly higher RD and ISOVF values in the high-CAVI group than in the low-CAVI group. Blue–light blue voxels illustrate a significantly lower MVF value in the high-CAVI group than in the low-CAVI group.

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    Table 1:

    Demographic characteristics of the participantsa

    All Participants(n = 110)High-CAVI (n = 60)Low-CAVI (n = 50)High- vs Low-CAVI (P Value)
    Sex (men/female)66:4437:2329:21.70
    Age (yr)72.65 (SD, 4.90)72.72 (SD, 5.00)72.58 (SD, 4.82).96
    Mean CAVI9.12 (SD, 0.84)9.71 (SD, 0.57)8.41 (SD, 0.46)<.001
    Antihypertensive therapy714328.09
    Education (yr)14.31 (SD, 2.11)14.30 (SD, 2.09)14.32 (SD, 2.15).96
    Body mass index22.54 (SD, 2.84)22.79 (SD, 2.54)22.24 (SD, 3.16).31
    Systolic blood pressure137.47 (SD, 15.67)139.60 (SD, 15.21)134.92 (SD, 16.00).12
    Diastolic blood pressure86.05 (SD, 9.35)86.52 (SD, 8.49)85.48 (SD, 10.34).56
    Heart rate65.70 (SD, 23.73)66.16 (SD, 33.88)65.31 (SD, 9.85).85
    Montreal Cognitive Assessment (Japanese version)25.19 (SD, 2.87)25.31 (SD, 2.95)25.04 (SD, 2.66).61
    Mini-Mental State Examination27.93 (SD, 1.68)28.07 (SD, 1.59)27.76 (SD, 1.78).34
    TMT A42.51 (SD, 13.90)43.32 (SD, 14.24)41.54 (SD, 13.56).51
    TMT B115.82 (SD, 50.38)116.78 (SD, 40.22)114.66 (SD, 60.80).83
    TMT B minus A73.31 (SD, 44.11)73.47 (SD, 36.01)73.12 (SD, 52.60).97
    Periventricular hyperintensity1.14 (SD, 0.39)1.17 (SD, 0.42)1.10 (SD, 0.36).372
    Deep and subcortical WM hyperintensity1.25 (SD, 0.53)1.31 (SD, 0.60)1.18 (SD, 0.48).135
    • ↵a Data are means.

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    Table 2:

    Summary of WM metrics

    Diffusion MR ImagingParameterExplanation
    DTIFAOverall direction of water diffusion in brain tissue
    Mean diffusivityThe magnitude of isotropic diffusion in brain tissue
    Axial diffusivityThe coefficient of diffusion across the long axis of the ellipsoid
    RDThe coefficient of diffusion perpendicular to the long axis
    NODDIIntracellular volume fractionNeurite density based on intracellular diffusion
    Orientation dispersion indexDispersion of neurites in the intracellular compartment
    ISOVFThe measure of extracellular water diffusion
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    Table 3:

    Univariate and multivariate linear regression analyses adjusted for age, sex, antihypertensive therapy, systolic blood pressure, and intracranial volume for the association of mean CAVI with WM metrics in specific regions

    Univariate Linear RegressionMultivariate Linear Regression
    PβPβ
    RD
     ATR.1210.149.0151.549
     CC.0750.171
     CR.0790.168.004−0.737
     FMi.010.245.0610.296
     IC.2790.104
     IFOF.1630.134
    ISOVF
     ATR.160.135.014−1.531
     CC.0360.2
     CR.0310.206.0050.596
     FMi.0370.2
     IC.2710.106
     IFOF.1230.148
    MVF
     ATR.005−0.265
     CC.174−0.13
     CR.015−0.231
     FMi.028−0.21
     IC.009−0.249
     IFOF.019−0.224
     SLF.015−0.231.036−0.218
    • View popup
    Table 4:

    Partial correlation coefficients between WM metrics and TMT B, adjusted for age, sex, and educationa

    All ParticipantsHigh-CAVI GroupLow-CAVI Group
    Corrected P ValuerCorrected P ValuerCorrected P Valuer
    RD
     ATR.8180.023.898−0.017.5450.090
     CC.1210.160.6580.078.2910.174
     CR.0460.220.6580.080.1070.307
     FMi.0160.288.6500.135.0130.436
     IC.0460.221.6500.152.2760.197
     IFOF.0500.206.6500.121.2460.228
    ISOVF
     ATR.866−0.016.983−0.008.8650.025
     CC.6690.094.9830.003.4370.183
     CR.4640.139.9830.055.2720.250
     FMi.4640.147.9830.044.2560.297
     IC.8220.059.9830.058.8650.047
     IFOF.861−0.035.983−0.108.7880.095
    MVF
     ATR.042−0.200.549−0.116.054−0.283
     CC.042−0.200.659−0.060.051−0.324
     CR.022−0.275.549−0.145.027−0.414
     FMi.026−0.235.614−0.086.051−0.306
     IC.033−0.219.549−0.134.054−0.283
     ISOF.022−0.250.549−0.121.051−0.331
     SLF.022−0.250.549−0.205.051−0.312
    • ↵a False discovery rate–corrected P value <.05.

    • View popup
    Table 5:

    Partial correlation coefficients between WM metrics and TMT B minus A, adjusted for age, sex, and educationa

    All ParticipantsHigh-CAVI GroupLow-CAVI Group
    Corrected P ValuerCorrected P ValuerCorrected P Valuer
    RD
     ATR.2860.104.2800.172.8460.029
     CC.0600.199.2700.191.5080.127
     CR.0190.262.2700.200.1620.283
     FMi.0060.315.2700.265.1430.329
     IC.0460.219.2700.203.5080.120
     IFOF.1360.154.4190.109.5080.164
    ISOVF
     ATR.5060.065.3330.187.774−0.053
     CC.2330.153.3440.156.7740.099
     CR.2010.178.3330.178.7740.156
     FMi.1200.225.3330.230.7740.176
     IC.3950.095.3330.176.774−0.043
     IFOF.386−0.110.526−0.102.774−0.051
    MVF
     ATR.038−0.232.817−0.207.082−0.256
     CC.088−0.166.8550.025.017−0.390
     CR.038−0.265.817−0.114.008−0.460
     FMi.038−0.232.817−0.074.019−0.363
     IC.057−0.192.817−0.083.037−0.314
     IFOF.051−0.211.847−0.048.017−0.388
     SLF.057−0.1910.817−0.088.019−0.358
    • ↵a False discovery rate–corrected P value <.05.

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J. Kikuta, K. Kamagata, M. Abe, C. Andica, Y. Saito, K. Takabayashi, W. Uchida, H. Naito, H. Tabata, A. Wada, Y. Tamura, R. Kawamori, H. Watada, S. Aoki
Effects of Arterial Stiffness on Cerebral WM Integrity in Older Adults: A Neurite Orientation Dispersion and Density Imaging and Magnetization Transfer Saturation Imaging Study
American Journal of Neuroradiology Dec 2022, 43 (12) 1706-1712; DOI: 10.3174/ajnr.A7709

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Arterial Stiffness & White Matter in Older Adults
J. Kikuta, K. Kamagata, M. Abe, C. Andica, Y. Saito, K. Takabayashi, W. Uchida, H. Naito, H. Tabata, A. Wada, Y. Tamura, R. Kawamori, H. Watada, S. Aoki
American Journal of Neuroradiology Dec 2022, 43 (12) 1706-1712; DOI: 10.3174/ajnr.A7709
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