Original ArticlesCerebral Ventricular Changes Associated With Transitions Between Normal Cognitive Function, Mild Cognitive Impairment, and DementiaCarmichael, Owen T. PhD*; Kuller, Lewis H. MD†; Lopez, Oscar L. MD‡; Thompson, Paul M. PhD§; Dutton, Rebecca A. BS§; Lu, Allen MS§; Lee, Sharon E. BS§; Lee, Jessica Y. BS§; Aizenstein, Howard J. MD, PhD∥; Meltzer, Carolyn C. MD‡ ∥ ¶; Liu, Yanxi PhD♯ ** ††; Toga, Arthur W. PhD§; Becker, James T. PhD‡ ∥ ‡‡Author Information *Neurology and Computer Science Departments, University of California, Davis, CA †Department of Epidemiology ‡Neurology Department ∥Psychiatry Department **Radiology Department ‡‡Psychology Department, University of Pittsburgh ♯The Robotics Institute, Carnegie Mellon University, Pittsburgh, PA §Neurology Department, University of California, Los Angeles, CA ¶Radiology, Neurology, and Psychiatry Departments, Emory University, Atlanta, GA ††Departments of Computer Science and Engineering and Electrical Engineering, The Pennsylvania State University, State College, PA Supported by National Heart, Lung, and Blood Institute contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, and U01 HL080295; NIH grants NS07391, MH064625, AG05133, DA015900-01, MH01077, EB001561, RR019771, RR021813, AG016570, AG20098, and AG15928; and additional contribution from the National Institute of Neurological Disorders and Stroke. Reprints: Owen T. Carmichael, PhD, Center For Neuroscience, 1544 Newton Court, Davis, CA, 95616 (e-mail: firstname.lastname@example.org). Received for publication June 16, 2006; accepted December 27, 2006 Disclosure: The authors have reported no conflicts of interest. Alzheimer Disease & Associated Disorders: January-March 2007 - Volume 21 - Issue 1 - p 14-24 doi: 10.1097/WAD.0b013e318032d2b1 Buy Metrics Abstract Expansion of the cerebral ventricles may occur at an accelerated rate in subjects with dementia, but the time course of expansion during transitions between normal cognitive function, mild cognitive impairment (MCI), and dementia is not well understood. Furthermore, the effects of cardiovascular risk factors on rate of ventricular expansion are unclear. We used a fully automated segmentation technique to measure change rate in lateral ventricle-to-brain ratio (VBR) on 145 longitudinal pairs of magnetic resonance images of subjects in the Cardiovascular Health Study Cognition Study from the Pittsburgh Center. A multivariate model analyzed VBR change rate, accounting for dementia statuses at both imaging times (normal, MCI, or dementia), age, sex, education, race, magnetic resonance-defined infarcts, Center for Epidemiology Studies Depression Scale, baseline ventricular volume, and cardiovascular risk factors. VBR change was faster in subjects who were demented or transitioned from MCI to dementia, compared with subjects normal at both images and subjects who transitioned from normal to MCI or dementia. Patients with diabetes had faster VBR change. Ventricular expansion may accelerate late in the progression from normal cognitive function to dementia, and may be modulated by diabetes. © 2007 Lippincott Williams & Wilkins, Inc.