Association of fractal dimension and other retinal vascular network parameters with cognitive performance and neuroimaging biomarkers: The Multi-Ethnic Study of Atherosclerosis (MESA)

Sally S Ong; Jeremy J Peavey; Kevin D Hiatt; Christopher T Whitlow; Rebecca M Sappington; Atalie C Thompson; Samuel N Lockhart; Haiying Chen; Suzanne Craft; Stephen R Rapp; Annette L Fitzpatrick; Susan R Heckbert; José A Luchsinger; Barbara E K Klein; Stacy M Meuer; Mary Frances Cotch; Tien Y Wong; Timothy M Hughes

doi:10.1002/alz.13498

Association of fractal dimension and other retinal vascular network parameters with cognitive performance and neuroimaging biomarkers: The Multi-Ethnic Study of Atherosclerosis (MESA)

Alzheimers Dement. 2024 Feb;20(2):941-953. doi: 10.1002/alz.13498. Epub 2023 Oct 12.

Authors

Sally S Ong¹, Jeremy J Peavey², Kevin D Hiatt³, Christopher T Whitlow³, Rebecca M Sappington^{1

4}, Atalie C Thompson¹, Samuel N Lockhart², Haiying Chen⁵, Suzanne Craft², Stephen R Rapp⁶, Annette L Fitzpatrick⁷, Susan R Heckbert⁷, José A Luchsinger⁸, Barbara E K Klein⁹, Stacy M Meuer⁹, Mary Frances Cotch¹⁰, Tien Y Wong^{11

12}, Timothy M Hughes²

Affiliations

¹ Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
² Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
³ Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁴ Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁶ Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
⁷ Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA.
⁸ Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, New York, USA.
⁹ Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA.
¹⁰ National Eye Institute, National Institute of Health, Bethesda, Maryland, USA.
¹¹ Singapore Eye Research Institute, Singapore National Eye Center, Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.
¹² Tsinghua Medicine, Tsinghua University, Beijing, China.

Abstract

Introduction: Retinal vascular network changes may reflect the integrity of the cerebral microcirculation, and may be associated with cognitive impairment.

Methods: Associations of retinal vascular measures with cognitive function and MRI biomarkers were examined amongst Multi-Ethnic Study of Atherosclerosis (MESA) participants in North Carolina who had gradable retinal photographs at Exams 2 (2002 to 2004, n = 313) and 5 (2010 to 2012, n = 306), and detailed cognitive testing and MRI at Exam 6 (2016 to 2018).

Results: After adjustment for covariates and multiple comparisons, greater arteriolar fractal dimension (FD) at Exam 2 was associated with less isotropic free water of gray matter regions (β = -0.0005, SE = 0.0024, p = 0.01) at Exam 6, while greater arteriolar FD at Exam 5 was associated with greater gray matter cortical volume (in mm³ , β = 5458, SE = 20.17, p = 0.04) at Exam 6.

Conclusion: Greater arteriolar FD, reflecting greater complexity of the branching pattern of the retinal arteries, is associated with MRI biomarkers indicative of less neuroinflammation and neurodegeneration.

Keywords: Alzheimer's disease; MRI biomarkers; branching angle; curvature tortuosity; dementia; fractal dimension; retinal vascular network parameter.

MeSH terms

Atherosclerosis* / diagnostic imaging
Biomarkers
Cognition
Fractals*
Humans
Neuroimaging
Retinal Vessels / diagnostic imaging

Substances

Biomarkers

Abstract

MeSH terms

Substances

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