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Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Feb 05, 2025;

Association between vertebral fractures and brain volume: insights from a community cohort study.

Koji Nakajima, Chiaki Horii, Hiroyasu Kodama, Tomohiko Shirokoshi, Akitoshi Ogawa, Takahiro Osada, Seiki Konishi, Yasushi Oshima, Toshiko Iidaka, Shigeyuki Muraki, Hiroyuki Oka, Hiroshi Kawaguchi, Toru Akune, Hiroshi Hashizume, Hiroshi Yamada, Munehito Yoshida, Kozo Nakamura, Masaaki Shojima, Sakae Tanaka, Noriko Yoshimura
Author Information
  1. Koji Nakajima: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  2. Chiaki Horii: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  3. Hiroyasu Kodama: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  4. Tomohiko Shirokoshi: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  5. Akitoshi Ogawa: Department of Neurophysiology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-Ku, Tokyo, 113-8421, Japan.
  6. Takahiro Osada: Department of Neurophysiology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-Ku, Tokyo, 113-8421, Japan.
  7. Seiki Konishi: Department of Neurophysiology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-Ku, Tokyo, 113-8421, Japan.
  8. Yasushi Oshima: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  9. Toshiko Iidaka: Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  10. Shigeyuki Muraki: Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  11. Hiroyuki Oka: Division of Musculoskeletal AI System Development, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, Japan.
  12. Hiroshi Kawaguchi: Tokyo Neurological Center, Toranomon 4-1-17, Minato-Ku, Tokyo, 105-0001, Japan.
  13. Toru Akune: National Rehabilitation Center for Persons With Disabilities, Namiki 4-1, Tokorozawa, Saitama, 359-0042, Japan.
  14. Hiroshi Hashizume: Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan.
  15. Hiroshi Yamada: Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan.
  16. Munehito Yoshida: Department of Orthopedic Surgery, Wakayama Medical University School of Medicine, Kimiidera 811-1, Wakayama, 641-8509, Japan.
  17. Kozo Nakamura: Towa Hospital, Towa 4-7-10, Adachi-Ku, Tokyo, 120-0003, Japan.
  18. Masaaki Shojima: Department of Neurosurgery, Teikyo University Hospital, Kaga 2-11-1, Itabashi-Ku, Tokyo, 173-8606, Japan.
  19. Sakae Tanaka: Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan.
  20. Noriko Yoshimura: Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, Faculty of Medicine, the University of Tokyo, Hongo 7-3-1, Bunkyo-Ku, Tokyo, 113-8655, Japan. noripu2yoshi@gmail.com. ORCID
PMID: 39907787 DOI: 10.1007/s00198-025-07403-6

Abstract

Investigating vertebral fractures and brain structure, we found significant gray matter volume reductions in the right hippocampus, amygdala, and parahippocampal gyrus, especially in males. These findings emphasize the importance of integrating skeletal and neural health in osteoporosis management.
PURPOSE: Vertebral fractures (VF) due to osteoporosis impact morbidity and quality of life in the elderly. The relationship between VF and changes in brain structure remains underexplored. This study aimed to investigate the association between VF and gray matter volume (GMV) reductions in specific brain regions and to explore potential sex differences.
METHODS: Data from 1,751 participants (571 males, 1,180 females; mean age 64.9, range 18-97) in the fourth survey of the population-based Research on Osteoarthritis/Osteoporosis Against Disability study (2015-2016) were used. Participants were classified into those with and without VF (VF���+���and VF���-���groups) based on Genant's semiquantitative method, assessed by spine radiographs. Voxel-based morphometry was applied to MRI images to measure GMV, and a general linear model analysis was performed to compare GMV between groups, adjusting for age, sex, total brain volume, and Mini-Mental State Examination scores as covariates. Additionally, a two-way analysis of variance was conducted on the significant GMV cluster, with sex and VF presence as independent variables, to explore interaction effects.
RESULTS: The VF+ group consisted of 113 participants, while the VF- group included 1,638 participants. The analysis identified a significant cluster with reduced GMV in the VF���+���group compared to the VF���-���group. This cluster included the right hippocampus, right amygdala, and right parahippocampal gyrus. Further analysis revealed that males in the VF���+���group exhibited more pronounced GMV reductions in the significant cluster compared to females.
CONCLUSION: These findings suggest that VF is associated with significant reductions in brain regions critical for memory, emotional processing, and visuospatial memory, with more severe effects observed in males.

Keywords

Brain volume Gray matter volume Magnetic resonance imaging Vertebral fracture Voxel-based morphometry

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  31. 2015/Japan Osteoporosis Foundation
  32. 2014-1/Japanese Orthopaedic Association
  33. 2015/Japanese Society for Musculoskeletal Medicine
  34. 2017/Japanese Society for Musculoskeletal Medicine
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Journal Article

Word Cloud

Created with Highcharts 10.0.0brainVFGMVsignificantvolumereductionsrightmalesanalysisclusterfracturesmatterstudysex1participantsvertebralstructuregrayhippocampusamygdalaparahippocampalgyrusfindingsosteoporosisVertebralregionsexplorefemalesageVoxel-basedmorphometryeffectsgroupincludedVF���+���groupcomparedmemoryInvestigatingfoundespeciallyemphasizeimportanceintegratingskeletalneuralhealthmanagementPURPOSE:dueimpactmorbidityqualitylifeelderlyrelationshipchangesremainsunderexploredaimedinvestigateassociationspecificpotentialdifferencesMETHODS:Data751571180mean649range18-97fourthsurveypopulation-basedResearchOsteoarthritis/OsteoporosisDisability2015-2016usedParticipantsclassifiedwithoutVF���+���andVF���-���groupsbasedGenant'ssemiquantitativemethodassessedspineradiographsappliedMRIimagesmeasuregenerallinearmodelperformedcomparegroupsadjustingtotalMini-MentalStateExaminationscorescovariatesAdditionallytwo-wayvarianceconductedpresenceindependentvariablesinteractionRESULTS:VF+consisted113VF-638 TheidentifiedreducedVF���-���grouprevealedexhibitedpronouncedCONCLUSION:suggestassociatedcriticalemotionalprocessingvisuospatialsevereobservedAssociationvolume:insightscommunitycohortBrainGrayMagneticresonanceimagingfracture

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