Normative values of the brain health index in UK biobank

Background: The Brain Health Index (BHI) is an automated approach to quantifying brain integrity, combining different types of structural magnetic resonance imaging (MRI). Normative values derived from generally healthy individuals provide a vital baseline for understanding neurodegenerative change....

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Main Authors: Jodi K. Watt, David Alexander Dickie, Donald M. Lyall, Joey Ward, Frederick K. Ho, Jesse Dawson, Terence J. Quinn
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:NeuroImage: Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666956023000211
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author Jodi K. Watt
David Alexander Dickie
Donald M. Lyall
Joey Ward
Frederick K. Ho
Jesse Dawson
Terence J. Quinn
author_facet Jodi K. Watt
David Alexander Dickie
Donald M. Lyall
Joey Ward
Frederick K. Ho
Jesse Dawson
Terence J. Quinn
author_sort Jodi K. Watt
collection DOAJ
description Background: The Brain Health Index (BHI) is an automated approach to quantifying brain integrity, combining different types of structural magnetic resonance imaging (MRI). Normative values derived from generally healthy individuals provide a vital baseline for understanding neurodegenerative change. Although commonplace in other areas of medicine, these are not always established when proposing new analytical approaches using MRI. The scale and quality of the UK Biobank imaging cohort (approximately N = 50k, as of 2022) allows for derivation of such values, and the wealth of additional lifestyle, physiological and demographic data enables validation of BHI through comparison with more established variables which may affect brain health. Aim: This study aimed to: 1) establish normative BHI values in a cohort of ‘healthy’ participants, and 2) explore associations between BHI and risk factors for brain health. Methods: The BHI was computed using voxel-based Gaussian mixture model cluster analysis of T1 and T2 FLAIR MRI in a sub-cohort of UK Biobank participants. From these data, normative score curves – with bounds described as 1, 2 and 3 standard deviations from the mean – were produced for males and females, using regression analyses to measure the scale of the BHI values as a function of age. Additional Pearson’s correlation testing was used to examine known risk factors to brain health and their relationship to BHI scores, with t-tests and ANOVAs used to determine between-group differences in BHI scoring. Results: Data from 2,990 participants (50.07% male, 97.05% Caucasian, 43.6% with degree-level education) were used to derive normative BHI curves from 48 to 77 years old. BHI scores were higher in female than male participants (95% CI: 0.0103 to 0.0162, p <0.001, Cohen’s d = 0.0416), males with a degree (95% CI: 0.000 to 0.009; p < 0.05; Cohen’s d = 0.044), and lower in people with type 2 diabetes mellitus (95% CI: 0.018 to 0.033; p <0.001; Cohen’s d = 0.0417), hypertension (95% CI: 0.008 to 0.018; p <0.001; Cohen’s d = 0.0419), and regular smokers (95% CI: 0.009 to 0.017, p <0.001, Cohen’s d = 0.041). BHI scores were higher in those with lower waist-to-hip ratios (WHR; males: R2 = 0.02121, F(1, 1466) = 31.77, p <0.001; females: R2 = 0.02201, F(1, 1454) = 32.72, p <0.001), and lower pulse pressure (males: R2 = 0.06261, F(1, 1215) = 81.16, p <0.001; females: R2 = 0.07616, F(1, 1205) = 99.34, p <0.001). Conclusions: BHI score curves may provide useful reference values for future clinical research. More work is required to determine normative values in more diverse populations.
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spelling doaj-art-bb8ac90be7524ce195b9ac17d4e03e372025-08-20T03:22:50ZengElsevierNeuroImage: Reports2666-95602023-09-013310017610.1016/j.ynirp.2023.100176Normative values of the brain health index in UK biobankJodi K. Watt0David Alexander Dickie1Donald M. Lyall2Joey Ward3Frederick K. Ho4Jesse Dawson5Terence J. Quinn6School of Cardiovascular and Metabolic Health, University of Glasgow, UK; Corresponding author. School of Cardiovascular &amp; Metabolic Health, New Lister Building, University of Glasgow, Glasgow Royal Infirmary, 84 Castle Street, G4 0SF, UK.School of Cardiovascular and Metabolic Health, University of Glasgow, UKSchool of Health and Wellbeing, University of Glasgow, UKSchool of Health and Wellbeing, University of Glasgow, UKSchool of Health and Wellbeing, University of Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, UKBackground: The Brain Health Index (BHI) is an automated approach to quantifying brain integrity, combining different types of structural magnetic resonance imaging (MRI). Normative values derived from generally healthy individuals provide a vital baseline for understanding neurodegenerative change. Although commonplace in other areas of medicine, these are not always established when proposing new analytical approaches using MRI. The scale and quality of the UK Biobank imaging cohort (approximately N = 50k, as of 2022) allows for derivation of such values, and the wealth of additional lifestyle, physiological and demographic data enables validation of BHI through comparison with more established variables which may affect brain health. Aim: This study aimed to: 1) establish normative BHI values in a cohort of ‘healthy’ participants, and 2) explore associations between BHI and risk factors for brain health. Methods: The BHI was computed using voxel-based Gaussian mixture model cluster analysis of T1 and T2 FLAIR MRI in a sub-cohort of UK Biobank participants. From these data, normative score curves – with bounds described as 1, 2 and 3 standard deviations from the mean – were produced for males and females, using regression analyses to measure the scale of the BHI values as a function of age. Additional Pearson’s correlation testing was used to examine known risk factors to brain health and their relationship to BHI scores, with t-tests and ANOVAs used to determine between-group differences in BHI scoring. Results: Data from 2,990 participants (50.07% male, 97.05% Caucasian, 43.6% with degree-level education) were used to derive normative BHI curves from 48 to 77 years old. BHI scores were higher in female than male participants (95% CI: 0.0103 to 0.0162, p <0.001, Cohen’s d = 0.0416), males with a degree (95% CI: 0.000 to 0.009; p < 0.05; Cohen’s d = 0.044), and lower in people with type 2 diabetes mellitus (95% CI: 0.018 to 0.033; p <0.001; Cohen’s d = 0.0417), hypertension (95% CI: 0.008 to 0.018; p <0.001; Cohen’s d = 0.0419), and regular smokers (95% CI: 0.009 to 0.017, p <0.001, Cohen’s d = 0.041). BHI scores were higher in those with lower waist-to-hip ratios (WHR; males: R2 = 0.02121, F(1, 1466) = 31.77, p <0.001; females: R2 = 0.02201, F(1, 1454) = 32.72, p <0.001), and lower pulse pressure (males: R2 = 0.06261, F(1, 1215) = 81.16, p <0.001; females: R2 = 0.07616, F(1, 1205) = 99.34, p <0.001). Conclusions: BHI score curves may provide useful reference values for future clinical research. More work is required to determine normative values in more diverse populations.http://www.sciencedirect.com/science/article/pii/S2666956023000211UK BiobankImage processingMagnetic resonance imagingAgeing
spellingShingle Jodi K. Watt
David Alexander Dickie
Donald M. Lyall
Joey Ward
Frederick K. Ho
Jesse Dawson
Terence J. Quinn
Normative values of the brain health index in UK biobank
NeuroImage: Reports
UK Biobank
Image processing
Magnetic resonance imaging
Ageing
title Normative values of the brain health index in UK biobank
title_full Normative values of the brain health index in UK biobank
title_fullStr Normative values of the brain health index in UK biobank
title_full_unstemmed Normative values of the brain health index in UK biobank
title_short Normative values of the brain health index in UK biobank
title_sort normative values of the brain health index in uk biobank
topic UK Biobank
Image processing
Magnetic resonance imaging
Ageing
url http://www.sciencedirect.com/science/article/pii/S2666956023000211
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