Periodontitis as risk factor of cerebral small vessel disease and silent stroke
Clinical Neurology; Neurosurgery and Neuroradiology
Final Report Abstract
With the PAROBRAIN study, we examined the association of cerebral small vessel disease (CSVD), microstructural white matter damage and periodontal disease. We used white matter hyperintensity load (WMH) as marker of CSVD and peak width of skeletonized mean diffusivity (PSMD) as a novel imaging marker of microstructural white matter integrity. Periodontal disease was quantified with clinical attachment level (CAL), decayed / missing / filled teeth (DMFT) index and plaque index. In univariate linear regression analysis controlling for age and sex, WMH correlated significantly with all dental parameters. An increased WMH load was associated with more CAL, higher plaque index and higher DMFT index. These associations were attenuated in the fully adjusted model. For PSMD, model 1 revealed a significant association of PSMD with plaque index and with DMFT. Controlling for cardiovascular risk factors and education in model 2 did not alter the associations, with a higher PSMD (lower white matter integrity) to be associated with worse measures on the DMFT and plaque index. The results imply that parameters of oral health are associated with markers of CSVD and with subtle alterations in the microstructural white matter integrity. Previous literature already revealed an association between periodontal disease with dementia, Alzheimer’s Disease and stroke. Put together, the results of previous studies and the results from our analysis build a foundation for future research. For example, randomized controlled trials studying if treatment of periodontal disease reduces the long-term risk for stroke and dementia are currently missing but of major clinical relevance in the prevention of major neurological diseases. Moreover, based on our results showing that periodontal health has influence on subtle changes in the brain microstructure, successful treatment of periodontal disease might also impact cognitive performance positively beyond patient cohorts.
Publications
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Linking cortical atrophy to white matter hyperintensities of presumed vascular origin. Journal of Cerebral Blood Flow & Metabolism, 41(7), 1682-1691.
Mayer, Carola; Frey, Benedikt M; Schlemm, Eckhard; Petersen, Marvin; Engelke, Kristin; Hanning, Uta; Jagodzinski, Annika; Borof, Katrin; Fiehler, Jens; Gerloff, Christian; Thomalla, Götz & Cheng, Bastian
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Network Localisation of White Matter Damage in Cerebral Small Vessel Disease. Scientific Reports, 10(1).
Petersen, Marvin; Frey, Benedikt M.; Schlemm, Eckhard; Mayer, Carola; Hanning, Uta; Engelke, Kristin; Fiehler, Jens; Borof, Katrin; Jagodzinski, Annika; Gerloff, Christian; Thomalla, Götz & Cheng, Bastian
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White matter integrity and structural brain network topology in cerebral small vessel disease: The Hamburg city health study. Human Brain Mapping, 42(5), 1406-1415.
Frey, Benedikt M.; Petersen, Marvin; Schlemm, Eckhard; Mayer, Carola; Hanning, Uta; Engelke, Kristin; Fiehler, Jens; Borof, Katrin; Jagodzinski, Annika; Gerloff, Christian; Thomalla, Götz & Cheng, Bastian
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Periodontitis as potential risk factor for Alzheimer’s disease. Dtsch Zahnärztl Z Int 3, 121-128
Aarabi G, Thomalla G, Walther C, Mayer C, Beikler T, Heydecke G, Seedorf U.
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Cross‐sectional analysis of the association of periodontitis with carotid intima media thickness and atherosclerotic plaque in the Hamburg City health study. Journal of Periodontal Research, 57(4), 824-834.
Lamprecht, Ragna; Rimmele, David Leander; Schnabel, Renate B.; Heydecke, Guido; Seedorf, Udo; Walther, Carolin; Mayer, Carola; Struppek, Julia; Borof, Katrin; Behrendt, Christian‐Alexander; Cheng, Bastian; Gerloff, Christian; Debus, Sebastian; Smeets, Ralf; Beikler, Thomas; Blankenberg, Stefan; Zeller, Tanja; Karakas, Mahir; Thomalla, Götz & Aarabi, Ghazal
