Evidence map›Paper›PMID 25563642›Full record

Trial reportStroke2015

Vascular imaging abnormalities and cognition: mediation by cortical volume in nondemented individuals: atherosclerosis risk in communities-neurocognitive study.

David S Knopman, Michael E Griswold, Seth T Lirette, Rebecca F Gottesman, Kejal Kantarci, A Richey Sharrett, Clifford R Jack, Jonathan Graff-Radford, Andrea L C Schneider, B Gwen Windham and 4 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 131 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
131citing papers in PubMed, 3 pooled it
9.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

131 citing papers in PubMed, 3 syntheses or guidelines pooled it, 159 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Traumatic brain injury, changes in plasma amyloid, tau, and neurodegenerative biomarkers, and dementia risk.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

71 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

David S KnopmanFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.). knopman@mayo.edu.
Michael E GriswoldFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Seth T LiretteFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Rebecca F GottesmanFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Kejal KantarciFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
A Richey SharrettFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Clifford R JackFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Jonathan Graff-RadfordFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Andrea L C SchneiderFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
B Gwen WindhamFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Laura H CokerFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Marilyn S AlbertFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
Thomas H MosleyFrom the Departments of Neurology (D.S.K., J.G.-R.) and Radiology (K.K., C.R.J.), Mayo Clinic, Rochester, MN; Departments of Biostatistics (M.E.G., S.T.L.) and Medicine (B.G.W., T.H.M.), University of Mississippi Medical Center, Jackson, MS; Departments of Neurology (R.F.G., M.S.A.) and Epidemiology (A.R.S., A.L.C.S.), Johns Hopkins University, Baltimore, MD; and Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC (L.H.C.).
ARIC Neurocognitive Investigators
Johns Hopkins University · USMayo Clinic · USMayo Clinic in Arizona · USWinnMed · US

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5U01HL096899 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J · 2010 to 2018
$7.5M
ARIC Neurocognitive Study (ARIC-NCS)U01HL096902 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2010 to 2018
$7.4M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5U01HL096814 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUGHES, TIMOTHY M., WAGENKNECHT, LYNNE E · 2010 to 2018
$6.5M
The ARIC and Neurocognitive Longitudinal StudyR01HL070825 · NHLBI · UNIVERSITY OF MISSISSIPPI MEDICAL CENTER · PI MOSLEY, THOMAS H · 2002 to 2004
$5.1M
NHLBI NIH HHS HL096814NHLBI NIH HHS HL096899NHLBI NIH HHS HL096902NHLBI NIH HHS HL096917NHLBI NIH HHS R01 HL070825NHLBI NIH HHS R01-HL70825NHLBI NIH HHS U01 HL096812NHLBI NIH HHS U01 HL096814NHLBI NIH HHS U01 HL096899NHLBI NIH HHS U01 HL096902NHLBI NIH HHS U01 HL096917
6 · The paper itself

Abstract

background and purposeThe relationships between cerebrovascular lesions visible on imaging and cognition are complex. We explored the possibility that the cerebral cortical volume mediated these relationships.

methodsTotal of 1906 nondemented participants (59% women; 25% African-American; mean age, 76.6 years) in the Atherosclerosis Risk in Communities (ARIC) study underwent cognitive assessments, risk factor assessments, and quantitative MRI for white matter hyperintensities (WMH) and infarcts. The Freesurfer imaging analysis pipeline was used to determine regional cerebral volumes. We examined the associations of cognitive domain outcomes with cerebral volumes (hippocampus and separate groups of posterior and frontal cortical regions of interest) and cerebrovascular imaging features (presence of large or small cortical/subcortical infarcts and WMH volume). We performed mediation pathway analyses to assess the hypothesis that hippocampal and cortical volumes mediated the associations between cerebrovascular imaging features and cognition.

resultsIn unmediated analyses, WMH and infarcts were both associated with worse psychomotor speed/executive function. In mediation analyses, WMH and infarct associations on psychomotor speed/executive function were significantly attenuated, but not abolished, by the inclusion of the posterior cortical regions of interest volume in the models, and the infarcts on psychomotor speed/executive function association were attenuated, but not abolished, by inclusion of the frontal cortical regions of interest volume.

conclusionsBoth WMH and infarcts were associated with cortical volume, and both lesions were also associated with cognitive performance, implying shared pathophysiological mechanisms. Although cross-sectional, our findings suggest that WMH and infarcts could be proxies for clinically covert processes that directly damage cortical regions. Microinfarcts are 1 candidate for such a clinically covert process.

Indexed as

Neuropsychological TestsResidence CharacteristicsAgedAged, 80 and overAtherosclerosisCerebrovascular DisordersCognition DisordersCohort StudiesFemaleHumansMaleRisk Factorscerebral infarctioncerebral small vessel diseasescognitionmagnetic resonance imaging

Identifiers

PMID25563642
PMCPMC4308430
OpenAlexW2171477682

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.