Abstract Details

Title Ultrasound Imaging Markers of Carotid Atherosclerosis are Associated with Cognition Through Cerebral Small Vessel Disease on MRI

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S15 - Innovative Diagnostics in Dementia (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background Atherosclerosis is a risk factor for cognitive decline. Ultrasonographic measures of carotid atherosclerosis (plaque and intima-media thickness) and MRI measures of small vessel disease (white matter hyperintensity volume) are subclinical markers of cerebrovascular disease that are associated with cognitive dysfunction.

Objective Determine whether markers of carotid atherosclerosis are associated with cognitive function through the burden of white matter disease.

Design/Methods We included 1290 subjects from the racially and ethnically diverse Northern Manhattan Study (age 64+/-8years, 60% women, 67% Hispanic, 18% Black, 15% White, education 10+/-5years). We assessed total plaque area (TPA) and intima-media thickness (cIMT) measures on carotid ultrasound and measures of white matter hyperintensity volume (WMHV) on MRI. Participants underwent neurocognitive evaluation to estimate global cognitive performance and domains of episodic memory, executive function, semantic memory, and processing speed. Associative mediation models were employed to determine if WMHV mediates the association of TPA and cIMT on global and domain-specific cognitive performance adjusting for age, sex, race, ethnicity, education, ApoE4 status, hypertension, hypercholesteremia, diabetes, and smoking.

Results Of the 1290 participants, 675 had carotid plaque (TPA 21+/-22mm², cIMT 0.95+/-0.09mm, and WMHV 0.77+/-0.93%TIV). WMHV(log) mediated the association of TPA on global cognition [b(indirect-effect)=-0.001, p<0.05], episodic memory [b(indirect-effect)=-0.001, p<0.05], and processing speed [b(indirect-effect)=-0.001, p<0.05)] after adjustment. WMHV(log) volume mediated the association of cIMT on global cognition [b(indirect-effect)=-0.073, p<0.05], episodic memory [b(indirect-effect)=-0.112, p<0.05], and processing speed [b(indirect-effect)=-0.097, p<0.05] after adjustment. No associations were present for executive function and semantic memory.

Conclusions Ultrasound measures of extracranial carotid arteriosclerosis are related to intracranial MRI measures of small vessel disease and associated with cognitive performance. White matter hyperintensity volume may be an important factor in understanding the biological link between atherosclerosis and cognitive dysfunction in middle to older age population. More research is needed to better understand vascular imaging biomarkers of age-related cognitive dysfunction.

Authors/Disclosures
Taylor Ariko PRESENTER	Ms. Ariko has nothing to disclose.
Botagoz Aimagambetova, MD	Ms. Aimagambetova has nothing to disclose.
Hannah Gardener, ScD (University of Miami)	Ms. Gardener has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intersocietal Accreditation Commission. Ms. Gardener has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ellipse Analytics. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Baum Hedlund. Ms. Gardener has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant with A Green Slate Consulting.
Bonnie E. Levin, PhD	No disclosure on file
Xiaoyan Sun, MD, PhD (University of Miami Miller School of Medicine)	The institution of Dr. Sun has received research support from NIH. The institution of Dr. Sun has received research support from Dr. M. Lee Pearce Foundation.
	No disclosure on file
Carolina Gutierrez	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy. The institution of Dr. Elkind has received research support from BMS-Pfizer Alliance for Eliquis. The institution of Dr. Elkind has received research support from Roche. Dr. Elkind has received publishing royalties from a publication relating to health care. Dr. Elkind has a non-compensated relationship as a Officer with American Heart Association that is relevant to AAN interests or activities.
Jose Gutierrez, MD (Columbia University)	Dr. Gutierrez has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Roetzel & Andress, JOHN ASTUNO, JR. L.L.C.. The institution of Dr. Gutierrez has received research support from NIH. Dr. Gutierrez has received publishing royalties from a publication relating to health care. Dr. Gutierrez has received publishing royalties from a publication relating to health care.
Clinton B. Wright, MD, FAAN (NINDS)	An immediate family member of Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. An immediate family member of Dr. Wright has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MARSHALL DENNEHY. The institution of an immediate family member of Dr. Wright has received research support from Oncospace. Dr. Wright has received publishing royalties from a publication relating to health care. An immediate family member of Dr. Wright has received personal compensation in the range of $500-$4,999 for serving as a surveyor with ASTRO.
Ralph L. Sacco, MD, MS, FAHA	Dr. Sacco has received personal compensation in the range of $100,000-$499,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Sacco has received research support from NIH, NINDS, NCATS, NIMHD. The institution of Dr. Sacco has received research support from FL Department of Health. Dr. Sacco has received research support from University of Washington, Seattle. Dr. Sacco has received publishing royalties from a publication relating to health care.
Tatjana Rundek, MD, PhD	The institution of Dr. Rundek has received research support from NIH.