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Yano Y, Reis JP, Levine DA, Bryan RN, Viera AJ, Shimbo D, Tedla YG, Allen NB, Schreiner PJ, Bancks MP, Sidney S, Pletcher MJ, Liu K, Greenland P, Lloyd-Jones DM, Launer LJ. Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults). Hypertension 2017; 70:1091-1098. [PMID: 28993449 PMCID: PMC5680098 DOI: 10.1161/hypertensionaha.117.10144] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/15/2017] [Accepted: 09/16/2017] [Indexed: 01/15/2023]
Abstract
The aims of this study are to assess the relationships of visit-to-visit blood pressure (BP) variability in young adulthood to hippocampal volume and integrity at middle age. We used data over 8 examinations spanning 25 years collected in the CARDIA study (Coronary Artery Risk Development in Young Adults) of black and white adults (age, 18-30 years) started in 1985 to 1986. Visit-to-visit BP variability was defined as by SDBP and average real variability (ARVBP, defined as the absolute differences of BP between successive BP measurements). Hippocampal tissue volume standardized by intracranial volume (%) and integrity assessed by fractional anisotropy were measured by 3-Tesla magnetic resonance imaging at the year-25 examination (n=545; mean age, 51 years; 54% women and 34% African Americans). Mean systolic BP (SBP)/diastolic BP levels were 110/69 mm Hg at year 0 (baseline), 117/73 mm Hg at year 25, and ARVSBP and SDSBP were 7.7 and 7.9 mm Hg, respectively. In multivariable-adjusted linear models, higher ARVSBP was associated with lower hippocampal volume (unstandardized regression coefficient [standard error] with 1-SD higher ARVSBP: -0.006 [0.003]), and higher SDSBP with lower hippocampal fractional anisotropy (-0.02 [0.01]; all P<0.05), independent of cumulative exposure to SBP during follow-up. Conversely, cumulative exposure to SBP and diastolic BP was not associated with hippocampal volume. There was no interaction by sex or race between ARVSBP or SDSBP with hippocampal volume or integrity. In conclusion, visit-to-visit BP variability during young adulthood may be useful in assessing the potential risk for reductions in hippocampal volume and integrity in midlife.
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Affiliation(s)
- Yuichiro Yano
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.).
| | - Jared P Reis
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Deborah A Levine
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - R Nick Bryan
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Anthony J Viera
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Daichi Shimbo
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Yacob G Tedla
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Norrina B Allen
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Pamela J Schreiner
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Michael P Bancks
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Stephen Sidney
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Mark J Pletcher
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Kiang Liu
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Philip Greenland
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Donald M Lloyd-Jones
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Lenore J Launer
- From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.)
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Elbejjani M, Schreiner PJ, Siscovick DS, Sidney S, Lewis CE, Bryan NR, Launer LJ. Sex hormones and brain volumes in a longitudinal study of middle-aged men in the CARDIA study. Brain Behav 2017; 7:e00765. [PMID: 29075555 PMCID: PMC5651379 DOI: 10.1002/brb3.765] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/02/2017] [Accepted: 06/03/2017] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Several findings suggest that testosterone (T) is neuroprotective and that declining T levels during aging are associated with cognitive and brain pathologies; however, little is known on T and brain health in middle-age. We examined the relationships of total T, bioavailable T, and sex hormone binding globulin (SHBG) levels with total and regional gray matter (GM) and white matter (WM) volumes in middle-aged men. We also evaluated the association of sex hormone levels with cognitive function. METHODS Analysis included 267 community-dwelling men participating in the Coronary Artery Risk Development in Young Adults (CARDIA) brain magnetic resonance imaging (MRI) substudy. Total T, bioavailable T, and SHBG levels were measured at three times from the 2nd to 4th decade of life; brain volumes were measured at the ages of 42-56. Associations were estimated using linear regression models, adjusted for several potential confounders. RESULTS Higher SHBG levels were associated with greater total WM volume (+3.15 cm3 [95% confidence interval [CI] = 0.01, 6.28] per one standard deviation higher SHBG). Higher SHBG levels were associated with lower total and regional GM volumes overall and significantly with smaller parietal GM volume (-0.96 cm3 [95%CI = -1.71, -0.21]). T levels were not related to brain volumes. Neither T nor SHBG levels were associated with cognitive function. CONCLUSION Results suggest a role for SHBG in structural brain outcomes in men and emphasize the value of investigating SHBG levels as modulators of sex hormone and metabolic pathways regulating brain and behavioral characteristics in men.
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Affiliation(s)
- Martine Elbejjani
- Laboratory of Epidemiology and Population ScienceNational Institute on AgingBethesdaMDUSA
| | - Pamela J. Schreiner
- Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisMNUSA
| | - David S. Siscovick
- School of Public HealthUniversity of WashingtonSeattleWAUSA
- The New York Academy of MedicineNew York, NYUSA
| | - Stephen Sidney
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCAUSA
| | - Cora E. Lewis
- Division of Preventive MedicineUniversity of Alabama at BirminghamBirmingham, ALUSA
| | - Nick R. Bryan
- Department of RadiologyUniversity of Pennsylvania Health SystemPhiladelphiaPAUSA
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population ScienceNational Institute on AgingBethesdaMDUSA
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Schwarz NF, Nordstrom LK, Pagen LHG, Palombo DJ, Salat DH, Milberg WP, McGlinchey RE, Leritz EC. Differential associations of metabolic risk factors on cortical thickness in metabolic syndrome. NEUROIMAGE-CLINICAL 2017; 17:98-108. [PMID: 29062686 PMCID: PMC5641920 DOI: 10.1016/j.nicl.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/31/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Objective Metabolic syndrome (MetS) refers to a cluster of risk factors for cardiovascular disease, including obesity, hypertension, dyslipidemia, and hyperglycemia. While sizable prior literature has examined associations between individual risk factors and quantitative measures of cortical thickness (CT), only very limited research has investigated such measures in MetS. Furthermore, the relative contributions of these risk factors to MetS-related effects on brain morphology have not yet been studied. The primary goal of this investigation was to examine how MetS may affect CT. A secondary goal was to explore the relative contributions of individual risk factors to regional alterations in CT, with the potential to identify risk factor combinations that may underlie structural changes. Methods Eighteen participants with MetS (mean age = 59.78 years) were age-matched with 18 healthy control participants (mean age = 60.50 years). CT measures were generated from T1-weighted images and groups were contrasted using whole-brain general linear modeling. A follow-up multivariate partial least squares correlation (PLS) analysis, including the full study sample with complete risk factor measurements (N = 53), was employed to examine which risk factors account for variance in group structural differences. Results Participants with MetS demonstrated significantly reduced CT in left hemisphere inferior parietal, rostral middle frontal, and lateral occipital clusters and in a right hemisphere precentral cluster. The PLS analysis revealed that waist circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose were significant contributors to reduced CT in these clusters. In contrast, diastolic blood pressure showed a significantly positive association with CT while systolic blood pressure did not emerge as a significant contributor. Age was not associated with CT. Conclusion These results indicate that MetS can be associated with regionally specific reductions in CT. Importantly, a novel link between a risk factor profile comprising indices of obesity, hyperglycemia, dyslipidemia and diastolic BP and localized alterations in CT emerged. While the pathophysiological mechanisms underlying these associations remain incompletely understood, these findings may be relevant for future investigations of MetS and might have implications for treatment approaches that focus on specific risk factor profiles with the aim to reduce negative consequences on the structural integrity of the brain. Cortical thickness is reduced bilaterally in metabolic syndrome. Five out of six risk factor components contribute to altered cortical thickness. Particular risk factor combination may be an important target for intervention.
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Affiliation(s)
- Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leslie K Nordstrom
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Linda H G Pagen
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daniela J Palombo
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Abstract
Purpose of Review In this review, we summarise the evidence on the association between cardiovascular disease (CVD) and cognitive impairment and explore the role of the nitric oxide (NO) pathway as a causal mechanism. Recent Findings Evidence from epidemiological studies suggests that the presence of CVD and its risk factors in midlife is associated with an increased risk of later life cognitive impairment and dementia. It is unclear what is driving this association but risk may be conveyed via an increase in neurodegeneration (e.g. amyloid deposition), vascular changes (e.g. small vessel disease) and mechanistically due to increased levels of oxidative stress and inflammation as well as changes in NO bioavailability. Summary CVDs and dementia are major challenges to global health worldwide. The NO pathway may be a promising biological candidate for future studies focused on reducing not only CVD but also risk of cognitive decline and dementia.
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The diabetic brain and cognition. J Neural Transm (Vienna) 2017; 124:1431-1454. [PMID: 28766040 DOI: 10.1007/s00702-017-1763-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/13/2017] [Indexed: 12/20/2022]
Abstract
The prevalence of both Alzheimer's disease (AD) and vascular dementia (VaD) is increasing with the aging of the population. Studies from the last several years have shown that people with diabetes have an increased risk for dementia and cognitive impairment. Therefore, the authors of this consensus review tried to elaborate on the role of diabetes, especially diabetes type 2 (T2DM) in both AD and VaD. Based on the clinical and experimental work of scientists from 18 countries participating in the International Congress on Vascular Disorders and on literature search using PUBMED, it can be concluded that T2DM is a risk factor for both, AD and VaD, based on a pathology of glucose utilization. This pathology is the consequence of a disturbance of insulin-related mechanisms leading to brain insulin resistance. Although the underlying pathological mechanisms for AD and VaD are different in many aspects, the contribution of T2DM and insulin resistant brain state (IRBS) to cerebrovascular disturbances in both disorders cannot be neglected. Therefore, early diagnosis of metabolic parameters including those relevant for T2DM is required. Moreover, it is possible that therapeutic options utilized today for diabetes treatment may also have an effect on the risk for dementia. T2DM/IRBS contribute to pathological processes in AD and VaD.
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Bora E, Akdede BB, Alptekin K. The relationship between cognitive impairment in schizophrenia and metabolic syndrome: a systematic review and meta-analysis. Psychol Med 2017; 47:1030-1040. [PMID: 28032535 DOI: 10.1017/s0033291716003366] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Individuals with schizophrenia are at greater risk for metabolic syndrome (MetS) which is associated with cognitive deficits in the general population. MetS might be potentially an important contributing factor to cognitive impairment in schizophrenia. METHOD In the current systematic review and meta-analysis, the findings of 18 studies investigating the association between MetS (and its components) with cognitive impairment in schizophrenia are reviewed. RESULTS Co-morbidity of MetS (d = 0.28) and diabetes mellitus (d = 0.28) were both associated with more severe cognitive deficits in schizophrenia. There was also evidence for a significant relationship between cognitive impairment in schizophrenia and each of the components of MetS including hypertension, dyslipidemia, abdominal obesity and diabetes. CONCLUSIONS MetS is significantly associated with cognitive impairment in schizophrenia and can potentially contribute to functional decline observed in some patients with schizophrenia throughout the course of illness.
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Affiliation(s)
- E Bora
- Department of Psychiatry,Melbourne Neuropsychiatry Centre,University of Melbourne and Melbourne Health,Carlton South,Victoria,Australia
| | - B B Akdede
- Department of Psychiatry,Dokuz Eylul University School of Medicine,Izmir,Turkey
| | - K Alptekin
- Department of Psychiatry,Dokuz Eylul University School of Medicine,Izmir,Turkey
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57
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VanWagner LB, Terry JG, Chow LS, Alman AC, Kang H, Ingram KH, Shay C, Lewis CE, Bryan RN, Launer LJ, Carr JJ. Nonalcoholic fatty liver disease and measures of early brain health in middle-aged adults: The CARDIA study. Obesity (Silver Spring) 2017; 25:642-651. [PMID: 28169509 PMCID: PMC5323279 DOI: 10.1002/oby.21767] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/08/2016] [Accepted: 12/19/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess associations between nonalcoholic fatty liver disease (NAFLD) and measures of brain health in a population-based sample of adults. METHODS Participants from the CARDIA study (Y25 exam; age 43-55 years) with concurrent computed tomography quantification of liver fat, visceral adipose tissue (VAT), and brain magnetic resonance (MR) images were included (n = 505). NAFLD was identified after exclusion of other causes of liver fat. Total tissue volume (TTV) and gray matter cerebral blood flow (GM-CBF) were estimated using 3T brain MR images. RESULTS NAFLD prevalence was 18%. NAFLD was associated with lower TTV and GM-CBF after adjusting for intracranial volume, demographics, and health behaviors (P < 0.04 for all). In models with additional adjustment for cardiovascular risk factors, the association of NAFLD with GM-CBF remained significant (P = 0.04) but was attenuated after adjustment for VAT (P = 0.06) and eliminated with BMI (P = 0.20). NAFLD was not associated with TTV after adjustment for cardiovascular risk factors (P = 0.10) or additional adjustment for VAT (P = 0.14) or BMI (P = 0.05). CONCLUSIONS NAFLD is negatively associated with early brain health as assessed by MR measures of structure (TTV) and perfusion (GM-CBF). BMI and VAT attenuated this relationship, providing insight into the potential metabolic role of liver fat in brain health and disease.
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Affiliation(s)
- Lisa B. VanWagner
- Departments of Medicine-Gastroenterology & Hepatology and Preventive Medicine, Northwestern University, Chicago, IL USA
| | - James G. Terry
- Department of Radiology, Vanderbilt University, Nashville, TN USA
| | - Lisa S. Chow
- Division of Diabetes, Endocrinology & Metabolism, University of Minnesota, Minneapolis, MN USA
| | - Amy C. Alman
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University, Nashville, TN USA
| | - Katherine H. Ingram
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA USA
| | - Christina Shay
- Center for Health Metrics and Evaluation, American Heart Association, Dallas, TX, USA
| | - Cora E. Lewis
- Division of Preventive Medicine, University of Alabama Birmingham, Birmingham AL USA
| | - R. Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA USA
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - J. Jeffrey Carr
- Department of Radiology, Vanderbilt University, Nashville, TN USA
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58
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Lao Y, Nguyen B, Tsao S, Gajawelli N, Law M, Chui H, Weiner M, Wang Y, Leporé N. A T1 and DTI fused 3D corpus callosum analysis in MCI subjects with high and low cardiovascular risk profile. Neuroimage Clin 2016; 14:298-307. [PMID: 28210541 PMCID: PMC5299209 DOI: 10.1016/j.nicl.2016.12.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 12/13/2016] [Accepted: 12/20/2016] [Indexed: 01/08/2023]
Abstract
Understanding the extent to which vascular disease and its risk factors are associated with prodromal dementia, notably Alzheimer's disease (AD), may enhance predictive accuracy as well as guide early interventions. One promising avenue to determine this relationship consists of looking for reliable and sensitive in-vivo imaging methods capable of characterizing the subtle brain alterations before the clinical manifestations. However, little is known from the imaging perspective about how risk factors such as vascular disease influence AD progression. Here, for the first time, we apply an innovative T1 and DTI fusion analysis of 3D corpus callosum (CC) on mild cognitive impairment (MCI) populations with different levels of vascular profile, aiming to de-couple the vascular factor in the prodromal AD stage. Our new fusion method successfully increases the detection power for differentiating MCI subjects with high from low vascular risk profiles, as well as from healthy controls. MCI subjects with high and low vascular risk profiles showed differed alteration patterns in the anterior CC, which may help to elucidate the inter-wired relationship between MCI and vascular risk factors.
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Affiliation(s)
- Yi Lao
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
| | - Binh Nguyen
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
| | - Sinchai Tsao
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
| | - Niharika Gajawelli
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
| | - Meng Law
- Department of Biomedical Engineering, University of Southern California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, USA
| | - Helena Chui
- Department of Biomedical Engineering, University of Southern California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, USA
| | - Michael Weiner
- Department of Radiology, University of California, San Francisco, USA
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, USA
| | - Natasha Leporé
- CIBORG Laboratory, Department of Radiology, Children's Hospital Los Angeles, USA
- Department of Biomedical Engineering, University of Southern California, USA
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Evans TE, O’Sullivan MJ, de Groot M, Niessen WJ, Hofman A, Krestin GP, van der Lugt A, Portegies ML, Koudstaal PJ, Bos D, Vernooij MW, Ikram MA. White Matter Microstructure Improves Stroke Risk Prediction in the General Population. Stroke 2016; 47:2756-2762. [DOI: 10.1161/strokeaha.116.014651] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/26/2016] [Indexed: 01/01/2023]
Abstract
Background and Purpose—
The presence of subclinical vascular brain disease, including white matter lesions and lacunar infarcts, substantially increases the risk of clinical stroke. White matter microstructural integrity is considered an earlier, potentially better, marker of the total burden of vascular brain disease. Its association with risk of stroke, a focal event, remains unknown.
Methods—
From the population-based Rotterdam Study, 4259 stroke-free participants (mean age: 63.6 years, 55.6% women) underwent brain magnetic resonance imaging, including diffusion magnetic resonance imaging, between 2006 and 2011. All participants were followed up for incident stroke until 2013. Cox proportional hazards models were used to associate markers of the microstructure of normal-appearing white matter with risk of stroke, adjusting for age, sex, white matter lesion volume, lacunar infarcts, and additionally for cardiovascular risk factors. Finally, we assessed the predictive value of white matter microstructural integrity for stroke beyond the Framingham Stroke Risk Profile.
Results—
During 18 476 person-years of follow-up, 58 people experienced a stroke. Both lower fractional anisotropy and higher MD increased risk of stroke, independent of age, sex, cardiovascular risk factors, white matter lesion volume, and lacunar infarcts (hazard ratio per SD increase in: fractional anisotropy: 0.75 [95% confidence interval, 0.57–0.98] and MD: 1.50 [95% confidence interval, 1.08–2.09]). MD improved stroke prediction beyond the Framingham Stroke Risk Profile (continuous net reclassification improvement: 0.52 [95% confidence interval, 0.24–0.81]).
Conclusions—
Future stroke is predicted not only by prevalent vascular lesions but also by subtle alterations in the microstructure of normal-appearing white matter. Inclusion of this effect in risk prediction models produces a significant advantage in stroke prediction compared with the existing Framingham Stroke Risk Profile.
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Affiliation(s)
- Tavia E. Evans
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Michael J. O’Sullivan
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Marius de Groot
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Wiro J. Niessen
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Albert Hofman
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Gabriel P. Krestin
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Aad van der Lugt
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Marileen L.P. Portegies
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Peter J. Koudstaal
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Daniel Bos
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - Meike W. Vernooij
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
| | - M. Arfan Ikram
- From the Department of Epidemiology (T.E.E., M.d.G., A.H., M.L.P.P., D.B., M.W.V., M.A.I.), Department of Radiology and Nuclear Medicine (T.E.E., M.d.G., W.J.N., G.P.K., A.v.d.L., D.B., M.W.V., M.A.I.), Department of Medical Informatics (M.d.G., W.J.N.), and Department of Neurology (M.L.P.P., P.J.K., M.A.I.), Erasmus MC, Rotterdam, The Netherlands; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom (T.E.E., M.J.O
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Sauvé M, Hui SK, Dinh DD, Foltz WD, Momen A, Nedospasov SA, Offermanns S, Husain M, Kroetsch JT, Lidington D, Bolz SS. Tumor Necrosis Factor/Sphingosine-1-Phosphate Signaling Augments Resistance Artery Myogenic Tone in Diabetes. Diabetes 2016; 65:1916-28. [PMID: 27207546 DOI: 10.2337/db15-1450] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/23/2016] [Indexed: 11/13/2022]
Abstract
Diabetes strongly associates with microvascular complications that ultimately promote multiorgan failure. Altered myogenic responsiveness compromises tissue perfusion, aggravates hypertension, and sets the stage for later permanent structural changes to the microcirculation. We demonstrate that skeletal muscle resistance arteries isolated from patients with diabetes have augmented myogenic tone, despite reasonable blood glucose control. To understand the mechanisms, we titrated a standard diabetes mouse model (high-fat diet plus streptozotocin [HFD/STZ]) to induce a mild increase in blood glucose levels. HFD/STZ treatment induced a progressive myogenic tone augmentation in mesenteric and olfactory cerebral arteries; neither HFD nor STZ alone had an effect on blood glucose or resistance artery myogenic tone. Using gene deletion models that eliminate tumor necrosis factor (TNF) or sphingosine kinase 1, we demonstrate that vascular smooth muscle cell TNF drives the elevation of myogenic tone via enhanced sphingosine-1-phosphate (S1P) signaling. Therapeutically antagonizing TNF (etanercept) or S1P (JTE013) signaling corrects this defect. Our investigation concludes that vascular smooth muscle cell TNF augments resistance artery myogenic vasoconstriction in a diabetes model that induces a small elevation of blood glucose. Our data demonstrate that microvascular reactivity is an early disease marker and advocate establishing therapies that strategically target the microcirculation.
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Affiliation(s)
- Meghan Sauvé
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Sonya K Hui
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada Toronto Centre for Microvascular Medicine, University of Toronto at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Danny D Dinh
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Warren D Foltz
- Spatio-Temporal Targeting and Amplification of Radiation Response Innovation Centre, Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Abdul Momen
- Division of Cell and Molecular Biology, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Sergei A Nedospasov
- Engelhardt Institute of Molecular Biology and Lomonosov Moscow State University, Moscow, Russia
| | - Stefan Offermanns
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Mansoor Husain
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada Division of Cell and Molecular Biology, Toronto General Hospital Research Institute, Toronto, Ontario, Canada Department of Medicine, University of Toronto, Toronto, Ontario, Canada Heart and Stroke/Richard Lewar Centre of Excellence for Cardiovascular Research, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey T Kroetsch
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Darcy Lidington
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada Toronto Centre for Microvascular Medicine, University of Toronto at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Steffen-Sebastian Bolz
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada Toronto Centre for Microvascular Medicine, University of Toronto at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada Heart and Stroke/Richard Lewar Centre of Excellence for Cardiovascular Research, University of Toronto, Toronto, Ontario, Canada Keenan Research Centre at the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
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das Neves MF, Dos Reis MCR, de Andrade EAF, Lima FPS, Nicolau RA, Arisawa EÂL, Andrade AO, Lima MO. Effects of low-level laser therapy (LLLT 808 nm) on lower limb spastic muscle activity in chronic stroke patients. Lasers Med Sci 2016; 31:1293-300. [PMID: 27299571 DOI: 10.1007/s10103-016-1968-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
A cerebrovascular accident (CVA) may affect basic motor functions, including spasticity that may be present in the upper extremity and/or the lower extremity, post-stroke. Spasticity causes pain, muscle force reduction, and decreases the time to onset of muscle fatigue. Several therapeutic resources have been employed to treat CVA to promote functional recovery. The clinical use of low-level laser therapy (LLLT) for rehabilitation of muscular disorders has provided better muscle responses. Thus, the aim of this study was to evaluate the effect of the application of LLLT in spastic muscles in patients with spasticity post-CVA. A double-blind clinical trial was conducted with 15 volunteer stroke patients who presented with post-stroke spasticity. Both males and females were treated; the average age was 51.5 ± 11.8 years old; the participants entered the study ranging from 11 to 48 months post-stroke onset. The patients participated in three consecutive phases (control, placebo, and real LLLT), in which all tests of isometric endurance of their hemiparetic lower limb were performed. LLLT (diode laser, 100 mW 808 nm, beam spot area 0.0314 cm(2), 127.39 J/cm(2)/point, 40 s) was applied before isometric endurance. After the real LLLT intervention, we observed significant reduction in the visual analogue scale for pain intensity (p = 0.0038), increased time to onset of muscle fatigue (p = 0.0063), and increased torque peak (p = 0.0076), but no significant change in the root mean square (RMS) value (electric signal in the motor unit during contraction, as obtained with surface electromyography). Our results suggest that the application of LLLT may contribute to increased recruitment of muscle fibers and, hence, to increase the onset time of the spastic muscle fatigue, reducing pain intensity in stroke patients with spasticity, as has been observed in healthy subjects and athletes.
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Affiliation(s)
- Marcele Florêncio das Neves
- Universidade do Vale do Paraíba - Laboratório de Engenharia de Reabilotação Sensório Motora, Instituto de Pesquisa e Desenvolvimento, Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, SP, Brasil.
| | - Mariana César Ribeiro Dos Reis
- Universidade do Vale do Paraíba - Laboratório de Engenharia de Reabilotação Sensório Motora, Instituto de Pesquisa e Desenvolvimento, Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, SP, Brasil
| | - Eliana Aparecida Fonseca de Andrade
- Universidade do Vale do Paraíba - Laboratório de Engenharia de Reabilotação Sensório Motora, Instituto de Pesquisa e Desenvolvimento, Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, SP, Brasil
| | - Fernanda Pupio Silva Lima
- Universidade do Vale do Paraíba - Laboratório de Engenharia de Reabilotação Sensório Motora, Instituto de Pesquisa e Desenvolvimento, Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, SP, Brasil
| | - Renata Amadei Nicolau
- Universidade do Vale do Paraíba, Centro de Laserterapia e Fotobiologia, Instituto de Pesquisa e Desenvolvimento, São José dos Campos, SP, Brasil
| | - Emília Ângela Loschiavo Arisawa
- Universidade do Vale do Paraíba, Laboratório de Espectroscopia Vibracional Biomédica, Instituto de Pesquisa e Desenvolvimento, São José dos Campos, SP, Brasil
| | | | - Mário Oliveira Lima
- Universidade do Vale do Paraíba - Laboratório de Engenharia de Reabilotação Sensório Motora, Instituto de Pesquisa e Desenvolvimento, Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, SP, Brasil
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Kharabian Masouleh S, Arélin K, Horstmann A, Lampe L, Kipping JA, Luck T, Riedel-Heller SG, Schroeter ML, Stumvoll M, Villringer A, Witte AV. Higher body mass index in older adults is associated with lower gray matter volume: implications for memory performance. Neurobiol Aging 2016; 40:1-10. [DOI: 10.1016/j.neurobiolaging.2015.12.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 12/28/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
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63
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Damoiseaux JS, Viviano RP, Yuan P, Raz N. Differential effect of age on posterior and anterior hippocampal functional connectivity. Neuroimage 2016; 133:468-476. [PMID: 27034025 DOI: 10.1016/j.neuroimage.2016.03.047] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/17/2016] [Accepted: 03/18/2016] [Indexed: 01/27/2023] Open
Abstract
Aging is associated with declines in cognitive performance and multiple changes in the brain, including reduced default mode functional connectivity (FC). However, conflicting results have been reported regarding age differences in FC between hippocampal and default mode regions. This discrepancy may stem from the variation in selection of hippocampal regions. We therefore examined the effect of age on resting state FC of anterior and posterior hippocampal regions in an adult life-span sample. Advanced age was associated with lower FC between the posterior hippocampus and three regions: the posterior cingulate cortex, medial prefrontal cortex, and lateral parietal cortex. In addition, age-related reductions of FC between the left and right posterior hippocampus, and bilaterally along the posterior to anterior hippocampal axis were noted. Age differences in medial prefrontal and inter-hemispheric FC significantly differed between anterior and posterior hippocampus. Older age was associated with lower performance in all cognitive domains, but we observed no associations between FC and cognitive performance after controlling for age. We observed a significant effect of gender and a linear effect of COMT val158met polymorphism on hippocampal FC. Females showed higher FC of anterior and posterior hippocampus and medial prefrontal cortex than males, and the dose of val allele was associated with lower posterior hippocampus - posterior cingulate FC, independent of age. Vascular and metabolic factors showed no significant effects on FC. These results suggest differential age-related reduction in the posterior hippocampal FC compared to the anterior hippocampus, and an age-independent effect of gender and COMT on hippocampal FC.
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Affiliation(s)
- Jessica S Damoiseaux
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA.
| | - Raymond P Viviano
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Peng Yuan
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Naftali Raz
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI, USA
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Kuller LH, Lopez OL, Mackey RH, Rosano C, Edmundowicz D, Becker JT, Newman AB. Subclinical Cardiovascular Disease and Death, Dementia, and Coronary Heart Disease in Patients 80+ Years. J Am Coll Cardiol 2016; 67:1013-1022. [PMID: 26940919 PMCID: PMC5502352 DOI: 10.1016/j.jacc.2015.12.034] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/24/2015] [Accepted: 12/14/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The successful prevention and treatment of coronary heart disease (CHD) and stroke has resulted in a substantial increase in longevity, with subsequent growth in the population of older people at risk for dementia. OBJECTIVES The authors evaluated the relationship of coronary and other peripheral atherosclerosis to risk of death, dementia, and CHD in the very elderly. Because the extent of vascular disease differs substantially between men and women, sex- and race-specific analyses were included, with a specific focus on women with low coronary artery calcium (CAC) Agatston scores. METHODS We evaluated the relationship between measures of subclinical cardiovascular disease (CAC, carotid intimal medial thickness, stenosis, and ankle brachial index) and risk of dementia, CHD, and total mortality in 532 participants of the Cardiovascular Health Study-Cognition Study from 1998/1999 (mean age, 80 years) to 2012/2013 (mean age, 93 years). RESULTS Thirty-six percent of participants had CAC scores >400. Women and African-Americans had lower CAC scores. Few men had low CAC scores. CAC score and number of coronary calcifications were directly related to age-adjusted total mortality and CHD. The age-specific incidence of dementia was higher than for CHD. Only about 25% of deaths were caused by CHD and 16% by dementia. Approximately 64% of those who died had a prior diagnosis of dementia. White women with low CAC scores had a significantly decreased incidence of dementia. CONCLUSIONS In subjects 80+ years of age, there is a greater incidence of dementia than of CHD. CAC, as a marker of atherosclerosis, is a determinant of mortality, and risk of CHD and myocardial infarction. White women with low CAC scores had a significantly decreased risk of dementia. A very important unanswered question, especially in the very elderly, is whether prevention of atherosclerosis and its complications is associated with less Alzheimer disease pathology and dementia. (Cardiovascular Health Study [CHS]; NCT00005133).
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Affiliation(s)
- Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rachel H Mackey
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daniel Edmundowicz
- Department of Medicine, Section of Cardiology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - James T Becker
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Chou PS, Chen CH, Wu MN, Lin YH, Lai CL, Lin RT, Yang YH. Determinants of cerebral white matter changes in patients with stroke. Intern Med J 2016; 45:390-5. [PMID: 25644475 DOI: 10.1111/imj.12704] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/28/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIM Cerebral white matter changes (WMC) are commonly observed in magnetic resonance imaging (MRI) scans of elderly people. Information about the prevalence of WMC is limited, and little is known about site-specific risk factors for the subcortical and periventricular regions in patients with ischaemic stroke. The study aims to analyse the prevalence and severity of WMC and investigate the risk factors of periventricular WMC (PVWMC) and deep WMC (DWMC) separately in patients with ischaemic stroke. METHODS The data were collected between January and December 2013 from a medical centre in southern Taiwan. Every patient underwent a cerebral MRI scan, and WMC was separately rated as PVWMC and DWMC by using the modified Fazekas scale. RESULTS In total, 527 patients who had experienced ischaemic stroke were included. The mean age of the patients was 67.0 ± 12.5 years (range: 31-94) and 62% of them were men. The mean age was significantly different among the four grades of severity in both the PVWMC (P < 0.001) and DWMC (P < 0.001) groups after adjustments for sex and vascular risk factors. Hypertension was independently correlated with severity of DWMC (P = 0.032) but not with PVWMC (P = 0.222). In multiple logistic regressions model, hypertension was a significant independent indicator of DWMC (odds ratio = 4.30; 95% confidence interval = 1.70-10.89). CONCLUSION Our results suggest a region-specific pathogenesis of cerebral white matter in Asian patients with ischaemic stroke that may differ from those in the general population.
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Affiliation(s)
- P-S Chou
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Anazodo UC, Shoemaker JK, Suskin N, Ssali T, Wang DJJ, St Lawrence KS. Impaired Cerebrovascular Function in Coronary Artery Disease Patients and Recovery Following Cardiac Rehabilitation. Front Aging Neurosci 2016; 7:224. [PMID: 26779011 PMCID: PMC4700211 DOI: 10.3389/fnagi.2015.00224] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/19/2015] [Indexed: 01/01/2023] Open
Abstract
Coronary artery disease (CAD) poses a risk to the cerebrovascular function of older adults and has been linked to impaired cognitive abilities. Using magnetic resonance perfusion imaging, we investigated changes in resting cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) to hypercapnia in 34 CAD patients and 21 age-matched controls. Gray matter volume (GMV) images were acquired and used as a confounding variable to separate changes in structure from function. Compared to healthy controls, CAD patients demonstrated reduced CBF in the superior frontal, anterior cingulate (AC), insular, pre- and post-central gyri, middle temporal, and superior temporal regions. Subsequent analysis of these regions demonstrated decreased CVR in the AC, insula, post-central and superior frontal regions. Except in the superior frontal and precentral regions, regional reductions in CBF and CVR were identified in brain areas where no detectable reductions in GMV were observed, demonstrating that these vascular changes were independent of brain atrophy. Because aerobic fitness training can improve brain function, potential changes in regional CBF were investigated in the CAD patients after completion of a 6-months exercise-based cardiac rehabilitation program. Increased CBF was observed in the bilateral AC, as well as recovery of CBF in the dorsal aspect of the right AC, where the magnitude of increased CBF was roughly equal to the reduction in CBF at baseline compared to controls. These exercise-related improvements in CBF in the AC is intriguing given the role of this area in cognitive processing and regulation of cardiovascular autonomic control.
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Affiliation(s)
- Udunna C Anazodo
- Lawson Health Research Institute, LondonON, Canada; Department of Medical Biophysics, Western University, LondonON, Canada; Laboratory for Brain and Heart Health, School of Kinesiology, Western University, LondonON, Canada
| | - J K Shoemaker
- Department of Medical Biophysics, Western University, LondonON, Canada; Laboratory for Brain and Heart Health, School of Kinesiology, Western University, LondonON, Canada
| | - Neville Suskin
- London Health Sciences Cardiology Rehabilitation Program, London ON, Canada
| | - Tracy Ssali
- Lawson Health Research Institute, LondonON, Canada; Department of Medical Biophysics, Western University, LondonON, Canada
| | - Danny J J Wang
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles CA, USA
| | - Keith S St Lawrence
- Lawson Health Research Institute, LondonON, Canada; Department of Medical Biophysics, Western University, LondonON, Canada
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Effects of Cardiac Rehabilitation on Executive Function in Sedentary Older Adults. ACTA ACUST UNITED AC 2016. [DOI: 10.14391/ajhs.11.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) negatively affects brain structure and function. Meta-analytical data show that relative to age and sex matched non-psychiatric controls, patients with bipolar disorders have double the risk of T2DM. We review the evidence for association between T2DM and adverse clinical and brain imaging changes in bipolar disorders and summarize studies investigating effects of diabetes treatment on psychiatric and brain outcomes. RECENT FINDINGS Participants with bipolar disorders and T2DM or insulin resistance demonstrate greater morbidity, chronicity and disability, and lower treatment response to Li. Bipolar disorders complicated by insulin resistance/T2DM are associated with smaller hippocampal and cortical gray matter volumes and lower prefrontal N-acetyl aspartate (neuronal marker). Treatment of T2DM yields preservation of brain gray matter and insulin sensitizers, such as pioglitazone, improve symptoms of depression in unipolar or bipolar disorders. SUMMARY T2DM or insulin resistance frequently cooccur with bipolar disorders and are associated with negative psychiatric clinical outcomes and compromised brain health. This is clinically concerning, as patients with bipolar disorders have an increased risk of metabolic syndrome and yet often receive suboptimal medical care. At the same time treatment of T2DM and insulin resistance has positive effects on psychiatric and brain outcomes. These findings create a rich agenda for future research, which could enhance psychiatric pharmacopeia and directly impact patient care.
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Rai ABS, Tauqir N, Attique HB, Hasan Virk HU. Asymptomatic cardiovascular risk assessment: the road less traveled. JACC Cardiovasc Imaging 2015; 8:498. [PMID: 25882577 DOI: 10.1016/j.jcmg.2014.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/22/2014] [Indexed: 11/25/2022]
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Friedman JI, Tang CY, Fayad ZA, Fuster V, Narula J. Reply: Asymptomatic cardiovascular risk assessment: the road less traveled. JACC Cardiovasc Imaging 2015; 8:498. [PMID: 25882578 DOI: 10.1016/j.jcmg.2014.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 11/14/2014] [Indexed: 10/23/2022]
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Launer LJ, Lewis CE, Schreiner PJ, Sidney S, Battapady H, Jacobs DR, Lim KO, D’Esposito M, Zhang Q, Reis J, Davatzikos C, Bryan RN. Vascular factors and multiple measures of early brain health: CARDIA brain MRI study. PLoS One 2015; 10:e0122138. [PMID: 25812012 PMCID: PMC4374951 DOI: 10.1371/journal.pone.0122138] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 02/08/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To identify early changes in brain structure and function that are associated with cardiovascular risk factors (CVRF). DESIGN Cross-sectional brain Magnetic Resonance I (MRI) study. SETTING Community based cohort in three U.S. sites. PARTICIPANTS A Caucasian and African-American sub-sample (n= 680; mean age 50.3 yrs) attending the 25 year follow-up exam of the Coronary Artery Risk Development in Young Adults Study. PRIMARY AND SECONDARY OUTCOMES 3T brain MR images processed for quantitative estimates of: total brain (TBV) and abnormal white matter (AWM) volume; white matter fractional anisotropy (WM-FA); and gray matter cerebral blood flow (GM-CBF). Total intracranial volume is TBV plus cerebral spinal fluid (TICV). A Global Cognitive Function (GCF) score was derived from tests of speed, memory and executive function. RESULTS Adjusting for TICV and demographic factors, current smoking was significantly associated with lower GM-CBF and TBV, and more AWM (all <0.05); SA with lower GM-CBF, WM-FA and TBV (p=0.01); increasing BMI with decreasing GM-CBF (p<0003); hypertension with lower GM-CBF, WM-FA, and TBV and higher AWM (all <0.05); and diabetes with lower TBV (p=0.007). The GCS was lower as TBV decreased, AWM increased, and WM-FA (all p<0.01). CONCLUSION In middle age adults, CVRF are associated with brain health, reflected in MRI measures of structure and perfusion, and cognitive functioning. These findings suggest markers of mid-life cardiovascular and brain health should be considered as indication for early intervention and future risk of late-life cerebrovascular disease and dementia.
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Affiliation(s)
- Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, United States of America
| | - Cora E. Lewis
- University of Alabama, Birmingham, AL, United States of America
| | - Pamela J. Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Steve Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Harsha Battapady
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - David R. Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Kelvin O. Lim
- Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
| | - Mark D’Esposito
- Department of Radiology, University of California, Berkeley, Berkeley, CA, United States of America
| | - Qian Zhang
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, United States of America
| | - Jared Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - R. Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
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