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Pase MP, Satizabal CL, Seshadri S. Role of Improved Vascular Health in the Declining Incidence of Dementia. Stroke 2017; 48:2013-2020. [PMID: 28596460 DOI: 10.1161/strokeaha.117.013369] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/10/2017] [Accepted: 04/18/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Matthew P Pase
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., C.L.S., S.S.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia (M.P.P.)
| | - Claudia L Satizabal
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., C.L.S., S.S.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia (M.P.P.)
| | - Sudha Seshadri
- From the Department of Neurology, Boston University School of Medicine, MA (M.P.P., C.L.S., S.S.); Framingham Heart Study, MA (M.P.P., C.L.S., S.S.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia (M.P.P.).
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152
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Hawkins KA, Emadi N, Pearlson GD, Winkler AM, Taylor B, Dulipsingh L, King D, Pittman B, Blank K. Hyperinsulinemia and elevated systolic blood pressure independently predict white matter hyperintensities with associated cognitive decrement in the middle-aged offspring of dementia patients. Metab Brain Dis 2017; 32:849-857. [PMID: 28255864 DOI: 10.1007/s11011-017-9980-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 02/23/2017] [Indexed: 12/30/2022]
Abstract
Cerebrovascular disease is an independent risk factor for dementia that may also be synergistic with Alzheimer's disease. In recent years attention has switched from cerebral infarcts to microvascular disease as the primary cause of cerebrovascular cognitive decline, with damage to the white matter the primary mechanism. Uncertainties remain regarding the risks posed by different types vascular threat, the extent to which cerebrovascular damage occurs in middle age, and whether relatively "normal" amounts of white matter damage are accompanied by meaningful degrees of cognitive decline. We explored these issues via laboratory, cardiovascular, cognitive, and magnetic resonance imaging (MRI) data in 67 middle-aged cognitively normal offspring of dementia patients. The sample was enriched for vascular risk. Plasma insulin, 24-h systolic blood pressure, body mass index, age, and % small dense LDL cholesterol were the strongest correlates of MRI white matter hyperintensity (WMH) volume. With shared variance controlled for, 24 h systolic BP, plasma insulin, and age remained as significant predictors of WMH volume. An interaction variable (24 h BP * insulin) did not improve the prediction of WMH. WMH volume correlated negatively with cognition. No evidence for an ApoE ε4 effect emerged for either WMH or cognition. Hypertension and hyperinsulinemia appear to pose independent, consequential threats to the cerebral small vessel vasculature in middle age, reflected in the presence of areas of WMH on MRI scans. Our data show that even modest WMH volumes in middle age are associated with cognitive decrement, underscoring the importance of aggressive treatment and lifestyle modifications to address vascular risk throughout adulthood.
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Affiliation(s)
- Keith A Hawkins
- Yale University School of Medicine, New Haven, CT, USA.
- Olin Neuropsychiatry Research Center, Hartford, CT, USA.
| | - Nazli Emadi
- Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
| | - Godfrey D Pearlson
- Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
| | - Anderson M Winkler
- Yale University School of Medicine, New Haven, CT, USA
- Oxford Center for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Beth Taylor
- Hartford Hospital, Hartford, CT, USA
- University of Connecticut, Storrs, CT, USA
| | | | - Diana King
- Olin Neuropsychiatry Research Center, Hartford, CT, USA
- Institute of Living, Hartford, CT, 06106, USA
| | - Brian Pittman
- Yale University School of Medicine, New Haven, CT, USA
| | - Karen Blank
- Institute of Living, Hartford, CT, 06106, USA
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153
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Power MC, Tingle JV, Reid RI, Huang J, Sharrett AR, Coresh J, Griswold M, Kantarci K, Jack CR, Knopman D, Gottesman RF, Mosley TH. Midlife and Late-Life Vascular Risk Factors and White Matter Microstructural Integrity: The Atherosclerosis Risk in Communities Neurocognitive Study. J Am Heart Assoc 2017; 6:JAHA.117.005608. [PMID: 28522676 PMCID: PMC5524102 DOI: 10.1161/jaha.117.005608] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Diffusion tensor imaging measures of white matter (WM) microstructural integrity appear to provide earlier indication of WM injury than WM hyperintensities; however, risk factors for poor WM microstructural integrity have not been established. Our study quantifies the association between vascular risk factors in midlife and late life with measures of late‐life WM microstructural integrity. Methods and Results We used data from 1851 participants in ARIC (Atherosclerosis Risk in Communities Study) who completed 3‐T magnetic resonance imaging, including diffusion tensor imaging, as part of the ARIC Neurocognitive Study (ARIC‐NCS). We quantified the association among lipids, glucose, and blood pressure from the baseline ARIC visit (1987–1989, ages 44–65, midlife) and visit 5 of ARIC (2011–2013, ages 67–90, late life, concurrent with ARIC‐NCS) with regional and overall WM mean diffusivity and fractional anisotropy obtained at ARIC visit 5 for ARIC participants. We also considered whether these associations were independent of or modified by WM hyperintensity volumes. We found that elevated blood pressure in midlife and late life and elevated glucose in midlife, but not late life, were associated with worse late‐life WM microstructural integrity. These associations were independent of the degree of WM hyperintensity, and the association between glucose and WM microstructural integrity appeared stronger for those with the least WM hyperintensity. There was little support for an adverse association between lipids and WM microstructural integrity. Conclusions Hypertension in both midlife and late life and elevated glucose in midlife are related to worse WM microstructural integrity in late life.
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Affiliation(s)
- Melinda C Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Jonathan V Tingle
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS
| | | | - Juebin Huang
- Department of Neurology, University of Mississippi Medical Center, Jackson, MS
| | | | - Josef Coresh
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Michael Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS
| | | | | | | | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD.,Department of Neurology, Johns Hopkins University, Baltimore, MD
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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154
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Wong NML, Ma EPW, Lee TMC. The Integrity of the Corpus Callosum Mitigates the Impact of Blood Pressure on the Ventral Attention Network and Information Processing Speed in Healthy Adults. Front Aging Neurosci 2017; 9:108. [PMID: 28484386 PMCID: PMC5402183 DOI: 10.3389/fnagi.2017.00108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/04/2017] [Indexed: 11/23/2022] Open
Abstract
Hypertension is a risk factor for cognitive impairment in older age. However, evidence of the neural basis of the relationship between the deterioration of cognitive function and elevated blood pressure is sparse. Based on previous research, we speculate that variations in brain connectivity are closely related to elevated blood pressure even before the onset of clinical conditions and apparent cognitive decline in individuals over 60 years of age. Forty cognitively healthy adults were recruited. Each received a blood pressure test before and after the cognitive assessment in various domains. Diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rsfMRI) data were collected. Our findings confirm that elevated blood pressure is associated with brain connectivity variations in cognitively healthy individuals. The integrity of the splenium of the corpus callosum is closely related to individual differences in systolic blood pressure. In particular, elevated systolic blood pressure is related to resting-state ventral attention network (VAN) and information processing speed. Serial mediation analyses have further revealed that lower integrity of the splenium statistically predicts elevated systolic blood pressure, which in turn predicts weakened functional connectivity (FC) within the VAN and eventually poorer processing speed. The current study sheds light on how neural correlates are involved in the impact of elevated blood pressure on cognitive functioning.
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Affiliation(s)
- Nichol M L Wong
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong
| | - Ernie Po-Wing Ma
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Science, The University of Hong KongHong Kong, Hong Kong
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155
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Siepmann T, Boardman H, Bilderbeck A, Griffanti L, Kenworthy Y, Zwager C, McKean D, Francis J, Neubauer S, Yu GZ, Lewandowski AJ, Sverrisdottir YB, Leeson P. Long-term cerebral white and gray matter changes after preeclampsia. Neurology 2017; 88:1256-1264. [PMID: 28235810 PMCID: PMC5373775 DOI: 10.1212/wnl.0000000000003765] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/22/2016] [Indexed: 01/03/2023] Open
Abstract
Objective: To determine whether changes in cerebral structure are present after preeclampsia that may explain increased cerebrovascular risk in these women. Methods: We conducted a case control study in women between 5 and 15 years after either a preeclamptic or normotensive pregnancy. Brain MRI was performed. Analysis of white matter structure was undertaken using voxel-based segmentation of fluid-attenuation inversion recovery sequences to assess white matter lesion volume and diffusion tensor imaging to measure microstructural integrity. Voxel-based analysis of gray matter volumes was performed with adjustment for skull size. Results: Thirty-four previously preeclamptic women (aged 42.8 ± 5.1 years) and 49 controls were included. Previously preeclamptic women had reduced cortical gray matter volume (523.2 ± 30.1 vs 544.4 ± 44.7 mL, p < 0.05) and, although both groups displayed white matter lesions, changes were more extensive in previously preeclamptic women. They displayed increased temporal lobe white matter disease (lesion volume: 23.2 ± 24.9 vs 10.9 ± 15.0 μL, p < 0.05) and altered microstructural integrity (radial diffusivity: 538 ± 19 vs 526 ± 18 × 10−6 mm2/s, p < 0.01), which also extended to occipital and parietal lobes. The degree of temporal lobe white matter change in previously preeclamptic women was independent of their current cardiovascular risk profile (p < 0.05) and increased with time from index pregnancy (p < 0.05). Conclusion: A history of preeclampsia is associated with temporal lobe white matter changes and reduced cortical volume in young women, which is out of proportion to their classic cardiovascular risk profile. The severity of changes is proportional to time since pregnancy, which would be consistent with continued accumulation of damage after pregnancy.
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Affiliation(s)
- Timo Siepmann
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Henry Boardman
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Amy Bilderbeck
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ludovica Griffanti
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yvonne Kenworthy
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Zwager
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - David McKean
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jane Francis
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan Neubauer
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Grace Z Yu
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Adam J Lewandowski
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yrsa Bergmann Sverrisdottir
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Paul Leeson
- From the Radcliffe Department of Medicine (T.S., H.B., Y.K., C.Z., J.F., S.N., A.J.L., P.L.), Department of Psychiatry (A.B.), Nuffield Department of Clinical Neurosciences (L.G.), Nuffield Department of Surgical Sciences (Y.B.S.), and Department of Cardiology (G.Z.Y.), University of Oxford; Department of Radiology (D.M.), Stoke Mandeville Hospital, Aylesbury, UK; and Department of Neurology (T.S.), University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
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156
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Tan CH, Low KA, Kong T, Fletcher MA, Zimmerman B, Maclin EL, Chiarelli AM, Gratton G, Fabiani M. Mapping cerebral pulse pressure and arterial compliance over the adult lifespan with optical imaging. PLoS One 2017; 12:e0171305. [PMID: 28234912 PMCID: PMC5325189 DOI: 10.1371/journal.pone.0171305] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 01/19/2017] [Indexed: 12/22/2022] Open
Abstract
Cerebrovascular health is important for maintaining a high level of cognitive performance, not only in old age, but also throughout the lifespan. Recently, it was first demonstrated that diffuse optical imaging measures of pulse amplitude and arterial compliance can provide estimates of cerebral arterial health throughout the cortex, and were associated with age, estimated cardiorespiratory fitness (eCRF), neuroanatomy and cognitive function in older adults (aged 55-87). The current study replicates and extends the original findings using a broader age range (a new adult sample aged 18-75), longer recording periods (360 s), and a more extensive optical montage (1536 channels). These methodological improvements represent a 5-fold increase in recording time and a 4-fold increase in coverage compared to the initial study. Results show that reliability for both pulse amplitude and compliance measures across recording blocks was very high (r(45) = .99 and .75, respectively). Pulse amplitude and pulse pressure were shown to correlate with age across the broader age range. We also found correlations between arterial health and both cortical and subcortical gray matter volumes. Additionally, we replicated the correlations between arterial compliance and age, eCRF, global brain atrophy, and cognitive flexibility. New regional analyses revealed that higher performance on the operation span (OSPAN) working memory task was associated with greater localized arterial compliance in frontoparietal cortex, but not with global arterial compliance. Further, greater arterial compliance in frontoparietal regions was associated with younger age and higher eCRF. These associations were not present in the visual cortex. The current study not only replicates the initial one in a sample including a much wider age range, but also provides new evidence showing that frontoparietal regions may be especially vulnerable to vascular degeneration during brain aging, with potential functional consequences in cognition.
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Affiliation(s)
- Chin Hong Tan
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Kathy A. Low
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Tania Kong
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Mark A. Fletcher
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Benjamin Zimmerman
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Edward L. Maclin
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Antonio M. Chiarelli
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Gabriele Gratton
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
| | - Monica Fabiani
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of America
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157
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Wang Y, Santerre M, Tempera I, Martin K, Mukerjee R, Sawaya BE. HIV-1 Vpr disrupts mitochondria axonal transport and accelerates neuronal aging. Neuropharmacology 2017; 117:364-375. [PMID: 28212984 PMCID: PMC5397298 DOI: 10.1016/j.neuropharm.2017.02.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 12/24/2022]
Abstract
Disruption of mitochondria axonal transport, essential for the maintenance of synaptic and neuronal integrity and function, has been identified in neurodegenerative diseases. Whether HIV-1 viral proteins affect mitochondria axonal transport is unknown, albeit HIV-associated neurocognitive disorders occur in around half of the patients living with HIV. Therefore, we sought to examine the effect of HIV-1 viral protein R (Vpr) on mitochondria axonal transport. Using mice primary neuronal cultures, we demonstrated that 4-day Vpr treatment reduced the ratio of moving mitochondria associated with (i) less energy (ATP) supply, (ii) reduction in Miro-1 and (iii) increase of α-synuclein which led to loss of microtubule stability as demonstrated by inconsecutive distribution of acetylated α-tubulin along the axons. Interestingly, the effect of Vpr on mitochondria axonal transport was partially restored in the presence of bongkrekic acid, a compound that negatively affected the Vpr-adenine nucleotide translocator (ANT) interaction and totally restored the ATP level in neurons. This indicated Vpr impaired mitochondria axonal transport partially related to its interaction with ANT. The above effect of Vpr was similar to the data obtained from hippocampal tissues isolated from 18-month-old aging mice compared to 5-month-old mice. In accord with previous clinical findings that HIV infection prematurely ages the brain and increases the susceptibility to HAND, we found that Vpr induced aging markers in neurons. Thus, we concluded that instead of causing cell death, low concentration of HIV-1 Vpr altered neuronal function related with inhibition of mitochondria axonal transport which might contribute to the accelerated neuronal aging.
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Affiliation(s)
- Ying Wang
- Molecular Studies of Neurodegenerative Diseases Lab, United States; Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States.
| | - Maryline Santerre
- Molecular Studies of Neurodegenerative Diseases Lab, United States; Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States
| | - Italo Tempera
- Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States
| | - Kayla Martin
- Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States
| | - Ruma Mukerjee
- Molecular Studies of Neurodegenerative Diseases Lab, United States; Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States
| | - Bassel E Sawaya
- Molecular Studies of Neurodegenerative Diseases Lab, United States; Department of Neurology, The Fels Institute for Cancer Research & Molecular Biology, United States; Temple University School of Medicine, Philadelphia, PA 19140, United States.
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158
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Muñoz Maniega S, Chappell FM, Valdés Hernández MC, Armitage PA, Makin SD, Heye AK, Thrippleton MJ, Sakka E, Shuler K, Dennis MS, Wardlaw JM. Integrity of normal-appearing white matter: Influence of age, visible lesion burden and hypertension in patients with small-vessel disease. J Cereb Blood Flow Metab 2017; 37:644-656. [PMID: 26933133 PMCID: PMC5381455 DOI: 10.1177/0271678x16635657] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
White matter hyperintensities accumulate with age and occur in patients with stroke, but their pathogenesis is poorly understood. We measured multiple magnetic resonance imaging biomarkers of tissue integrity in normal-appearing white matter and white matter hyperintensities in patients with mild stroke, to improve understanding of white matter hyperintensities origins. We classified white matter into white matter hyperintensities and normal-appearing white matter and measured fractional anisotropy, mean diffusivity, water content (T1-relaxation time) and blood-brain barrier leakage (signal enhancement slope from dynamic contrast-enhanced magnetic resonance imaging). We studied the effects of age, white matter hyperintensities burden (Fazekas score) and vascular risk factors on each biomarker, in normal-appearing white matter and white matter hyperintensities, and performed receiver-operator characteristic curve analysis. Amongst 204 patients (34.3-90.9 years), all biomarkers differed between normal-appearing white matter and white matter hyperintensities ( P < 0.001). In normal-appearing white matter and white matter hyperintensities, mean diffusivity and T1 increased with age ( P < 0.001), all biomarkers varied with white matter hyperintensities burden ( P < 0.001; P = 0.02 signal enhancement slope), but only signal enhancement slope increased with hypertension ( P = 0.028). Fractional anisotropy showed complex age-white matter hyperintensities-tissue interactions; enhancement slope showed white matter hyperintensities-tissue interactions. Mean diffusivity distinguished white matter hyperintensities from normal-appearing white matter best at all ages. Blood-brain barrier leakage increases with hypertension and white matter hyperintensities burden at all ages in normal-appearing white matter and white matter hyperintensities, whereas water mobility and content increase as tissue damage accrues, suggesting that blood-brain barrier leakage mediates small vessel disease-related brain damage.
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Affiliation(s)
| | | | | | - Paul A Armitage
- 2 Department of Cardiovascular Science, University of Sheffield, Sheffield, UK
| | - Stephen D Makin
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
| | - Anna K Heye
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Eleni Sakka
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
| | - Kirsten Shuler
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
| | - Martin S Dennis
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- 1 Division of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK
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Santos PP, Silveira PSD, Souza-Duran FL, Tamashiro-Duran JH, Scazufca M, Menezes PR, Leite CDC, Lotufo PA, Vallada H, Wajngarten M, De Toledo Ferraz Alves TC, Rzezak P, Busatto GF. Prefrontal-Parietal White Matter Volumes in Healthy Elderlies Are Decreased in Proportion to the Degree of Cardiovascular Risk and Related to Inhibitory Control Deficits. Front Psychol 2017; 8:57. [PMID: 28184203 PMCID: PMC5266720 DOI: 10.3389/fpsyg.2017.00057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/10/2017] [Indexed: 01/05/2023] Open
Abstract
Cardiovascular risk (CVR) factors may be associated with poor cognitive functioning in elderlies and impairments in brain structure. Using MRI and voxel-based morphometry (VBM), we assessed regional white matter (WM) volumes in a population-based sample of individuals aged 65–75 years (n = 156), subdivided in three CVR subgroups using the Framingham Risk Score. Cognition was assessed using the Short Cognitive Performance Test. In high-risk subjects, we detected significantly reduced WM volume in the right juxtacortical dorsolateral prefrontal region compared to both low and intermediate CVR subgroups. Findings remained significant after accounting for the presence of the APOEε4 allele. Inhibitory control performance was negatively related to right prefrontal WM volume, proportionally to the degree of CVR. Significantly reduced deep parietal WM was also detected bilaterally in the high CVR subgroup. This is the first large study documenting the topography of CVR-related WM brain volume deficits. The significant association regarding poor response inhibition indicates that prefrontal WM deficits related to CVR are clinically meaningful, since inhibitory control is known to rely on prefrontal integrity.
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Affiliation(s)
- Pedro P Santos
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Paula S Da Silveira
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Fabio L Souza-Duran
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Jaqueline H Tamashiro-Duran
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Márcia Scazufca
- Department and Institute of Psychiatry, University of São Paulo São Paulo, Brazil
| | - Paulo R Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São PauloSão Paulo, Brazil; Center of Research in Mental Health Population, University of São PauloSão Paulo, Brazil
| | - Claudia Da Costa Leite
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Laboratory of Magnetic Resonance in Neuroradiology, Institute and Department of Radiology, University of São PauloSão Paulo, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, Center for Clinical and Epidemiologic Research, University of São Paulo São Paulo, Brazil
| | - Homero Vallada
- Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Department and Institute of Psychiatry, University of São PauloSão Paulo, Brazil
| | - Maurício Wajngarten
- Department of Cardiopneumology, Heart Institute, General Hospital of University of São Paulo Medical School São Paulo, Brazil
| | - Tânia C De Toledo Ferraz Alves
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
| | - Patricia Rzezak
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil; Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP)São Paulo, Brazil
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, Universidade de São PauloSão Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São PauloSão Paulo, Brazil
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160
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Zostawa J, Adamczyk J, Sowa P, Adamczyk-Sowa M. The influence of sodium on pathophysiology of multiple sclerosis. Neurol Sci 2017; 38:389-398. [PMID: 28078565 PMCID: PMC5331099 DOI: 10.1007/s10072-016-2802-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 12/19/2016] [Indexed: 01/06/2023]
Abstract
Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system, and is an important cause of disability in young adults. In genetically susceptible individuals, several environmental factors may play a partial role in the pathogenesis of MS. Some studies suggests that high-salt diet (>5 g/day) may contribute to the MS and other autoimmune disease development through the induction of pathogenic Th17 cells and pro-inflammatory cytokines in both humans and mice. However, the precise mechanisms of pro-inflammatory effect of sodium chloride intake are not yet explained. The purpose of this review was to discuss the present state of knowledge on the potential role of environmental and dietary factors, particularly sodium chloride on the development and course of MS.
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Affiliation(s)
- Jacek Zostawa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
| | - Jowita Adamczyk
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland.
| | - Paweł Sowa
- Department of Otorhinolaryngology and Oncological Laryngology, Medical University of Silesia, ul. C. Skłodowskiej 10, 41-800, Zabrze, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland
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161
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Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, Damasceno A, Delles C, Gimenez-Roqueplo AP, Hering D, López-Jaramillo P, Martinez F, Perkovic V, Rietzschel ER, Schillaci G, Schutte AE, Scuteri A, Sharman JE, Wachtell K, Wang JG. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension. Lancet 2016; 388:2665-2712. [PMID: 27671667 DOI: 10.1016/s0140-6736(16)31134-5] [Citation(s) in RCA: 586] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Michael H Olsen
- Department of Internal Medicine, Holbæk Hospital and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark; Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
| | - Sonia Y Angell
- Division of Prevention and Primary Care, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Samira Asma
- Global NCD Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Boutouyrie
- Department of Pharmacology and INSERM U 970, Georges Pompidou Hospital, Paris Descartes University, Paris, France
| | - Dylan Burger
- Kidney Research Centre, Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, ON, Canada
| | - Julio A Chirinos
- Department of Medicine at University Hospital of Pennsylvania and Veteran's Administration, PA, USA
| | | | - Christian Delles
- Christian Delles: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anne-Paule Gimenez-Roqueplo
- INSERM, UMR970, Paris-Cardiovascular Research Center, F-75015, Paris, France; Paris Descartes University, F-75006, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Department of Genetics, F-75015, Paris, France
| | - Dagmara Hering
- The University of Western Australia-Royal Perth Hospital, Perth, WA, Australia
| | - Patricio López-Jaramillo
- Direccion de Investigaciones, FOSCAL and Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander, Bucaramanga, Colombia
| | - Fernando Martinez
- Hypertension Clinic, Internal Medicine, Hospital Clinico, University of Valencia, Valencia, Spain
| | - Vlado Perkovic
- The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - Ernst R Rietzschel
- Department of Cardiology, Ghent University and Biobanking & Cardiovascular Epidemiology, Ghent University Hospital, Ghent, Belgium
| | - Giuseppe Schillaci
- Department of Internal Medicine, University of Perugia, Terni University Hospital, Terni, Italy
| | - Aletta E Schutte
- Medical Research Council Unit on Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Angelo Scuteri
- Hypertension Center, Hypertension and Nephrology Unit, Department of Medicien, Policlinico Tor Vergata, Rome, Italy
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Kristian Wachtell
- Department of Cardiology, Division of Cardiovascular and Pulmonary Diseases Oslo University Hospital, Oslo, Norway
| | - Ji Guang Wang
- The Shanghai Institute of Hypertension, RuiJin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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162
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Wardlaw JM, Makin SJ, Valdés Hernández MC, Armitage PA, Heye AK, Chappell FM, Muñoz‐Maniega S, Sakka E, Shuler K, Dennis MS, Thrippleton MJ. Blood‐brain barrier failure as a core mechanism in cerebral small vessel disease and dementia: evidence from a cohort study. Alzheimers Dement 2016. [PMCID: PMC5472180 DOI: 10.1016/j.jalz.2016.09.006] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction Methods Results Discussion In 201 patients with non-disabling stroke and white matter hyperintensities (WMH), we measured blood-brain barrier (BBB) leakage with contrast-enhanced MRI. BBB leakage was higher in WMH than in normal appearing white matter. BBB leakage increased in both WMH and normal appearing white matter with the burden of small vessel disease, hypertension, and age. BBB leakage predicted cognitive decline one year later. The leakage pattern supported the hypothesis that BBB leak was pathogenic of diffuse brain damage in cerebral small vessel disease.
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Affiliation(s)
- Joanna M. Wardlaw
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - Stephen J. Makin
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | | | - Paul A. Armitage
- Academic Unit of Radiology, Department of Cardiovascular Science University of Sheffield, Royal Hallamshire Hospital Sheffield UK
| | - Anna K. Heye
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | | | | | - Eleni Sakka
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - Kirsten Shuler
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
| | - Martin S. Dennis
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh UK
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Iadecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB, Gulati M, Kamel H, Knopman DS, Launer LJ, Saczynski JS, Seshadri S, Zeki Al Hazzouri A. Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association. Hypertension 2016; 68:e67-e94. [PMID: 27977393 DOI: 10.1161/hyp.0000000000000053] [Citation(s) in RCA: 431] [Impact Index Per Article: 53.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions. METHODS Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data. RESULTS Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive. CONCLUSIONS After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.
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164
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Allen B, Muldoon MF, Gianaros PJ, Jennings JR. Higher Blood Pressure Partially Links Greater Adiposity to Reduced Brain White Matter Integrity. Am J Hypertens 2016; 29:1029-37. [PMID: 26970287 DOI: 10.1093/ajh/hpw026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 02/18/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Adiposity and elevated blood pressure (BP) are associated with brain structure abnormalities, but whether these effects are independent is unknown. We tested whether associations between adiposity and white matter integrity were explained by elevated BP. METHODS A sample of 209 middle-aged adults underwent diffusion tensor imaging to quantify indirect metrics of white matter structural integrity. These included putative markers of global white matter integrity (fractional anisotropy (FA)), axonal integrity (axial diffusivity), and myelin integrity (radial diffusivity). Participants were either normotensive or prehypertensive. RESULTS After adjusting for age and sex, regression analyses showed that waist circumference was associated with FA (β = -0.15, P < 0.05) and axial diffusivity (β = -0.24, P < 0.001), and mean arterial pressure (MAP) was associated with FA (β = -0.21, P < 0.05). Direct and indirect effect analyses showed that waist circumference was indirectly associated with whole brain FA through MAP (β = -0.06), and directly related to whole brain axial diffusivity, independent of MAP (β = -0.24). Examination of specific white matter tracts yielded similar results; waist circumference was indirectly related to FA through MAP and radial diffusivity, and directly related to axial diffusivity, independent of MAP. Supplemental analyses using body mass index, systolic BP, and diastolic BP also yielded similar results. CONCLUSION These findings suggest at least 2 mechanisms explain the adiposity and white matter association: one pathway through elevated BP impacting global white matter integrity and reducing integrity of the myelin sheath, and at least one other adiposity-specific pathway decreasing axonal integrity.
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Affiliation(s)
- Ben Allen
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA. (
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165
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Arntz RM, van den Broek SMA, van Uden IWM, Ghafoorian M, Platel B, Rutten-Jacobs LCA, Maaijwee NAM, Schaapsmeerders P, Schoonderwaldt HC, van Dijk EJ, de Leeuw FE. Accelerated development of cerebral small vessel disease in young stroke patients. Neurology 2016; 87:1212-9. [PMID: 27521431 PMCID: PMC5035980 DOI: 10.1212/wnl.0000000000003123] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/08/2016] [Indexed: 01/30/2023] Open
Abstract
Objective: To study the long-term prevalence of small vessel disease after young stroke and to compare this to healthy controls. Methods: This prospective cohort study comprises 337 patients with an ischemic stroke or TIA, aged 18–50 years, without a history of TIA or stroke. In addition, 90 age- and sex-matched controls were included. At follow-up, lacunes, microbleeds, and white matter hyperintensity (WMH) volume were assessed using MRI. To investigate the relation between risk factors and small vessel disease, logistic and linear regression were used. Results: After mean follow-up of 9.9 (SD 8.1) years, 337 patients were included (227 with an ischemic stroke and 110 with a TIA). Mean age of patients was 49.8 years (SD 10.3) and 45.4% were men; for controls, mean age was 49.4 years (SD 11.9) and 45.6% were men. Compared with controls, patients more often had at least 1 lacune (24.0% vs 4.5%, p < 0.0001). In addition, they had a higher WMH volume (median 1.5 mL [interquartile range (IQR) 0.5–3.7] vs 0.4 mL [IQR 0.0–1.0], p < 0.001). Compared with controls, patients had the same volume WMHs on average 10–20 years earlier. In the patient group, age at stroke (β = 0.03, 95% confidence interval [CI] 0.02–0.04) hypertension (β = 0.22, 95% CI 0.04–0.39), and smoking (β = 0.18, 95% CI 0.01–0.34) at baseline were associated with WMH volume. Conclusions: Patients with a young stroke have a higher burden of small vessel disease than controls adjusted for confounders. Cerebral aging seems accelerated by 10–20 years in these patients, which may suggest an increased vulnerability to vascular risk factors.
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Affiliation(s)
- Renate M Arntz
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Steffen M A van den Broek
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Inge W M van Uden
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Mohsen Ghafoorian
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Bram Platel
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Loes C A Rutten-Jacobs
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Noortje A M Maaijwee
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Pauline Schaapsmeerders
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Hennie C Schoonderwaldt
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Ewoud J van Dijk
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK
| | - Frank-Erik de Leeuw
- From Donders Institute for Brain, Cognition and Behaviour, Department of Neurology (R.M.A., S.M.A.v.d.B., I.W.M.v.U., L.C.A.R.-J., N.A.M.M., P.S., H.C.S., E.J.v.D., F.-E.d.L.), and Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine (M.G., B.P.), Radboudumc; Institute for Computing and Information Sciences (M.G.), Radboud University, Nijmegen, the Netherlands; and Department of Clinical Neurosciences, Neurology Unit (L.C.A.R.-J.), University of Cambridge, UK.
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Scott BM, Maye J, Jones J, Thomas K, Mangal PC, Trifilio E, Hass C, Marsiske M, Bowers D. Post-exercise pulse pressure is a better predictor of executive function than pre-exercise pulse pressure in cognitively normal older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2016; 23:464-76. [PMID: 26629911 PMCID: PMC4856549 DOI: 10.1080/13825585.2015.1118007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Exercise "stress tests" are widely used to assess cardiovascular function and to detect abnormalities. In line with the view of exercise as a stressor, the present study examined the relationship between cognitive function and cardiovascular activity before and after light physical exercise in a sample of 84 non-demented community-dwelling older adults. Based on known relationships between hypertension, executive function and cerebral white matter changes, we hypothesized that greater post-exercise reactivity, as indexed by higher pulse pressure, would be more related to worse performance on frontal-executive tasks than pre-exercise physiologic measures. All participants were administered a comprehensive neuropsychological battery and underwent a Six Minute Walk Test (6MWT), with blood pressure (BP) measures obtained immediately before and after the walk. Pulse pressure (PP) was derived from BP as an indicator of vascular auto-regulation and composite scores were computed for each cognitive domain assessed. As predicted, worse executive function scores exhibited a stronger relationship with post-exercise PP than pre-exercise PP. Results suggest that PP following system stress in the form of walking may be more reflective of the state of vascular integrity and associated executive dysfunction in older adults than baseline physiologic measures.
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Affiliation(s)
- Bonnie M. Scott
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Jacqueline Maye
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Jacob Jones
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Kelsey Thomas
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Paul C. Mangal
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Erin Trifilio
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Chris Hass
- University of Florida, Department of Applied Physiology and Kinesiology, P.O. Box 118205, Gainesville, Florida, 32611
| | - Michael Marsiske
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
| | - Dawn Bowers
- University of Florida, Department of Clinical and Health Psychology, P.O. Box 100165, Gainesville, Florida, 32610
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Preventive geriatrics the cross-talk between arterial and brain aging: A lifelong condition. Exp Gerontol 2016; 87:148-150. [PMID: 27311517 DOI: 10.1016/j.exger.2016.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 05/11/2016] [Accepted: 06/06/2016] [Indexed: 11/23/2022]
Abstract
Arterial aging - clinically evaluable noninvasively as carotid-femoral Pulse Wave Velocity (PWV), an index of arterial stiffness - has emerged as a risky condition for cardiovascular events and cognitive decline. With advancing age, arterial aging is less and less dependent on blood pressure levels. We propose a life-course approach to the cross-talking between arterial and brain aging aimed at preventing disabling conditions at older ages. This vision is supported by growing evidence that "silent" alteration in large artery as well as in brain structure and function are already detectable at young ages.
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168
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Sala M, van den Berg-Huysmans A, van der Grond J, Huisman M, Brandts A, Westenberg JJ, de Roos A. Aortic Arch Stiffness Is Associated With Incipient Brain Injury in Patients With Hypertension. Am J Hypertens 2016; 29:705-12. [PMID: 26404903 DOI: 10.1093/ajh/hpv161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/27/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It has been shown that microstructural brain tissue damage can be detected in hypertension patients, while the underlying mechanisms are not fully understood. We aim to explore the association between diffusion tensor imaging (DTI) measures of brain injury and aortic arch pulse wave velocity (PWV) in hypertensive patients without clinically manifest cerebrovascular disease. METHODS Sixty-six hypertension patients (30 men, mean age 46±14 years) were prospectively included. Aortic arch PWV was assessed using velocity-encoded magnetic resonance imaging (VE-MRI). Brain tissue integrity was assessed by using DTI. Multivariable linear regression analysis was performed to assess the association between aortic arch PWV and fractional anisotropy (FA), axial diffusivity (AxD), and radial diffusivity (RD). RESULTS Increased aortic arch PWV was associated with decreased white matter FA (β = -0.30, P = 0.018), increased gray matter AxD (β = 0.28, P = 0.016), and increased gray and white matter RD (β = 0.30, P = 0.008 and β = 0.35, P = 0.003, respectively). These effects were independent of age, sex, body mass index, smoking, and white matter hyperintensity (WMH) volume. CONCLUSIONS Aortic arch stiffness relates to incipient brain injury before overt brain abnormalities may become apparent in patients with hypertension.
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Affiliation(s)
- Michiel Sala
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands;
| | | | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Menno Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne Brandts
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jos J Westenberg
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Shan ZY, Kwiatek R, Burnet R, Del Fante P, Staines DR, Marshall-Gradisnik SM, Barnden LR. Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study. J Magn Reson Imaging 2016; 44:1301-1311. [PMID: 27123773 PMCID: PMC5111735 DOI: 10.1002/jmri.25283] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose To examine progressive brain changes associated with chronic fatigue syndrome (CFS). Materials and Methods We investigated progressive brain changes with longitudinal MRI in 15 CFS and 10 normal controls (NCs) scanned twice 6 years apart on the same 1.5 Tesla (T) scanner. MR images yielded gray matter (GM) volumes, white matter (WM) volumes, and T1‐ and T2‐weighted signal intensities (T1w and T2w). Each participant was characterized with Bell disability scores, and somatic and neurological symptom scores. We tested for differences in longitudinal changes between CFS and NC groups, inter group differences between pooled CFS and pooled NC populations, and correlations between MRI and symptom scores using voxel based morphometry. The analysis methodologies were first optimized using simulated atrophy. Results We found a significant decrease in WM volumes in the left inferior fronto‐occipital fasciculus (IFOF) in CFS while in NCs it was unchanged (family wise error adjusted cluster level P value, PFWE < 0.05). This longitudinal finding was consolidated by the group comparisons which detected significantly decreased regional WM volumes in adjacent regions (PFWE < 0.05) and decreased GM and blood volumes in contralateral regions (PFWE < 0.05). Moreover, the regional GM and WM volumes and T2w in those areas showed significant correlations with CFS symptom scores (PFWE < 0.05). Conclusion The results suggested that CFS is associated with IFOF WM deficits which continue to deteriorate at an abnormal rate. J. Magn. Reson. Imaging 2016;44:1301–1311.
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Affiliation(s)
- Zack Y Shan
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia.
| | - Richard Kwiatek
- Division of Medical Subspecialities, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Richard Burnet
- Endocrinology department, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Donald R Staines
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Sonya M Marshall-Gradisnik
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Leighton R Barnden
- National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Southport, Australia
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Maillard P, Mitchell GF, Himali JJ, Beiser A, Tsao CW, Pase MP, Satizabal CL, Vasan RS, Seshadri S, DeCarli C. Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study. Stroke 2016; 47:1030-6. [PMID: 26965846 DOI: 10.1161/strokeaha.116.012949] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/22/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Previous work from the Framingham Heart Study suggests that brain changes because of arterial aging may begin in young adulthood and that such changes precede cognitive deficits. The objective of this study was to determine the association of arterial stiffness with measures of white matter and gray matter (GM) integrity in young adults. METHODS One thousand nine hundred three participants from the Framingham Heart Study Third Generation (mean age, 46±8.7 years) had complete tonometry measurements and brain magnetic resonance imaging (T1-weighted and diffusion tensor imaging). Tonometry measures included carotid-femoral pulse wave velocity, augmentation index, carotid-brachial pressure amplification, and central pulse pressure. Fractional anisotropy and GM density images were computed from diffusion tensor imaging and T1 images. Registration to a common anatomic template enabled voxel-based linear regressions relating measures of fractional anisotropy and GM to tonometry measures, adjusting for relevant covariables. RESULTS Higher carotid-femoral pulse wave velocity was associated with lower regional fractional anisotropy, including the corpus callosum and the corona radiata (8.7 and 8.6 cc, respectively, P<0.001), as well as lower GM density in the thalamus region (0.9 cc, P<0.001). Analyses did not reveal significant associations between other tonometry measures and fractional anisotropy or GM. CONCLUSIONS Among young healthy adults, higher aortic stiffness was associated with measures of reduced white matter and GM integrity in areas implicated in cognitive decline and Alzheimer's disease. Greater aortic stiffness may result in subclinical vascular brain injury at ages much younger than previously described.
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Affiliation(s)
- Pauline Maillard
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.).
| | - Gary F Mitchell
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Jayandra J Himali
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Alexa Beiser
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Connie W Tsao
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Matthew P Pase
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Claudia L Satizabal
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Ramachandran S Vasan
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Sudha Seshadri
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
| | - Charles DeCarli
- From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.)
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171
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Rosenberg GA. Matrix Metalloproteinase-Mediated Neuroinflammation in Vascular Cognitive Impairment of the Binswanger Type. Cell Mol Neurobiol 2016; 36:195-202. [PMID: 26993507 PMCID: PMC4861651 DOI: 10.1007/s10571-015-0277-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/28/2015] [Indexed: 01/05/2023]
Abstract
Vascular cognitive impairment (VCI) is a heterogeneous group of diseases linked together by cerebrovascular disease. Treatment of VCI has been hindered by the lack of a coherent pathophysiological process that could provide molecular targets. Of the several forms of VCI, the small vessel disease form is both the most prevalent and generally has a progressive course. Binswanger's disease (BD) is the small vessel form of VCI that involves extensive injury to the deep white matter. Growing evidence suggests that there is disruption of the blood-brain barrier (BBB) secondary to an inflammatory state. Matrix metalloproteinases (MMPs) are increased in the brain and CSF of patients with BD, and have been shown to disrupt the BBB in animal studies, suggesting that they may be biomarkers and therapeutic targets. Multimodal biomarkers derived from clinical, neuropsychological, imaging, and biochemical data can be used to narrow the VCI population to the progressive inflammatory form that will be optimal for treatment trials. This review describes the role of the MMPs in pathophysiology and their use as biomarkers.
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Affiliation(s)
- Gary A Rosenberg
- Departments of Neurology, Neurosciences, Cell Biology and Physiology, and Mathematics and Statistics, Health Sciences Center, University of New Mexico, Albuquerque, NM, 87107, USA.
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172
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Lu D, Ren S, Zhang J, Sun D. Vascular risk factors aggravate cognitive impairment in first-ever young ischaemic stroke patients. Eur J Neurol 2016; 23:940-7. [PMID: 26917058 DOI: 10.1111/ene.12967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Young ischaemic stroke patients often suffer from cognitive impairment after stroke. However, the risk factors of cognitive impairment are still unclear. This study examined the impact of vascular risk factors (VRFs) on cognitive impairment in first-ever young ischaemic stroke patients. METHODS Subjects were divided into low (0-1 VRF, n = 27), medium (2-3 VRFs, n = 45) and high-risk (≥4 VRFs, n = 12) groups according to their number of VRFs. The following VRFs were collected: hypertension, diabetes mellitus, dyslipidaemia, atrial fibrillation, obesity, smoking, excess alcohol consumption, coronary heart disease and hyperhomocysteinaemia. A battery of cognitive assessments was executed 2 weeks after stroke. Differences of cognitive performances between groups were compared. The correlation between VRFs and cognitive function was investigated with an emphasis on discovering the main VRFs. RESULTS Eighty-four patients were enrolled in this study eventually. Compared with the low-risk group, the high-risk group had significantly worse performance in most of the cognitive domains. VRFs had a correlation with general cognition, executive function, attention and verbal fluency. After adjusting the covariates, VRFs showed a linear correlation with global cognitive function (R = 0.640, P = 0.000), verbal fluency (R = 0.372, P = 0.000), delayed memory (R = 0.327, P = 0.002), visual attention (R = 0.290, P = 0.007) and executive function (R = 0.266, P = 0.015). Amongst all the VRFs, hypertension, hyperlipidaemia, smoking and hyperhomocysteinaemia were the main influencing VRFs. CONCLUSION Vascular risk factors aggravate cognitive impairment after young ischaemic stroke. Effective management of VRFs in young adults is urgent and this may reduce the cognitive impairment.
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Affiliation(s)
- D Lu
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - S Ren
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - J Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - D Sun
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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173
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González-Quevedo A, González-García S, Hernández-Díaz Z, Fernández Concepción O, Quevedo Sotolongo L, Peña-Sánchez M, Márquez Rosales B, Santiesteban Freixas R, Fernández-Almirall I, Menéndez-Sainz MC, Fernández-Carriera R. Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension. J Neurol Sci 2016; 363:158-63. [PMID: 27000243 DOI: 10.1016/j.jns.2016.02.052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/19/2016] [Accepted: 02/20/2016] [Indexed: 11/30/2022]
Abstract
The object of this work was to explore if blood based biomarkers of brain damage could predict subclinical brain lesions and clinical outcome during follow-up in asymptomatic hypertensive patients. This was a cross-sectional study including 101 patients with essential hypertension and no clinical evidence of neurological disease and 53 healthy controls, followed by a longitudinal study of 62 hypertensive patients for an average of 33 months. Serum concentrations of two brain specific proteins (S100B and neuron specific enolase - NSE) were determined at inclusion. Fundoscopic exploration, brain MRI and echocardiographic studies were also performed. Clinical outcome at follow-up was registered: transient ischemic attack (TIA), stroke, vascular headache or migraine, cardiovascular events and death. Higher serum NSE and S100B concentrations were observed in hypertensive patients; and multiple regression analysis revealed independent associations of clinical variables and more severe white matter lesions only with NSE concentration. A panel combining two clinical variables (blood pressure>140/90 and years of hypertension>10) and serum NSE>13 μg/L predicted more severe white matter lesions with 80% sensitivity and 94.4% specificity. Higher NSE levels at inclusion were associated not only with the occurrence of vascular events related with the CNS (stroke, TIA and vascular headache), but also with an earlier presentation of these events during the follow-up period. Serum NSE concentration could be a useful biomarker to predict subclinical brain damage and future vascular events related with the CNS in hypertension. Blood based biomarkers could aid in filtering hypertensive patients with a higher risk of cerebrovascular disease for brain MRI scanning.
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174
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Krishna V, Sammartino F, Yee P, Mikulis D, Walker M, Elias G, Hodaie M. Diffusion tensor imaging assessment of microstructural brainstem integrity in Chiari malformation Type I. J Neurosurg 2016; 125:1112-1119. [PMID: 26848913 DOI: 10.3171/2015.9.jns151196] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The diagnosis of Chiari malformation Type I (CM-I) is primarily based on the degree of cerebellar tonsillar herniation even though it does not always correlate with symptoms. Neurological dysfunction in CM-I presumably results from brainstem compression. With the premise that conventional MRI does not reveal brain microstructural changes, this study examined both structural and microstructural neuroimaging metrics to distinguish patients with CM-I from age- and sex-matched healthy control subjects. METHODS Eight patients with CM-I and 16 controls were analyzed. Image postprocessing involved coregistration of anatomical T1-weighted with diffusion tensor images using 3D Slicer software. The structural parameters included volumes of the posterior fossa, fourth ventricle, and tentorial angle. Fractional anisotropy (FA) was calculated separately in the anterior and posterior compartments of the lower brainstem. RESULTS The mean age of patients in the CM-I cohort was 42.6 ± 10.4 years with mean tonsillar herniation of 12 mm (SD 0.7 mm). There were no significant differences in the posterior fossa volume (p = 0.06) or fourth ventricular volume between the 2 groups (p = 0.11). However, the FA in the anterior brainstem compartment was significantly higher in patients with CM-I preoperatively (p = 0.001). The FA values normalized after Chiari decompression except for persistently elevated FA in the posterior brainstem compartment in patients with CM-I and syrinx. CONCLUSIONS In this case-control study, microstructural alterations appear to be reliably associated with the diagnosis of CM-I, with a significantly elevated FA in the lower brainstem in patients with CM-I compared with controls. More importantly, the FA values normalized after decompressive surgery. These findings should be validated in future studies to determine the significance of diffusion tensor imaging-based assessment of brainstem microstructural integrity as an adjunct to the clinical assessment in patients with CM-I.
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Affiliation(s)
- Vibhor Krishna
- 1Division of Neurosurgery, Department of Surgery.,2Center for Neuromodulation, Department of Neurosurgery, Ohio State University, Columbus, Ohio
| | | | - Philip Yee
- 1Division of Neurosurgery, Department of Surgery
| | - David Mikulis
- 1Division of Neurosurgery, Department of Surgery.,3Division of Brain Imaging, Behaviour Systems Neuroscience, Toronto Western Research Institute; and.,4Institute of Medical Science, and.,5Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada; and.,6Department of Medical Imaging, University of Toronto
| | - Matthew Walker
- 3Division of Brain Imaging, Behaviour Systems Neuroscience, Toronto Western Research Institute; and
| | - Gavin Elias
- 1Division of Neurosurgery, Department of Surgery
| | - Mojgan Hodaie
- 1Division of Neurosurgery, Department of Surgery.,3Division of Brain Imaging, Behaviour Systems Neuroscience, Toronto Western Research Institute; and.,4Institute of Medical Science, and.,5Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada; and
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175
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Pelletier A, Periot O, Dilharreguy B, Hiba B, Bordessoules M, Chanraud S, Pérès K, Amieva H, Dartigues JF, Allard M, Catheline G. Age-Related Modifications of Diffusion Tensor Imaging Parameters and White Matter Hyperintensities as Inter-Dependent Processes. Front Aging Neurosci 2016; 7:255. [PMID: 26834625 PMCID: PMC4718031 DOI: 10.3389/fnagi.2015.00255] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 12/22/2015] [Indexed: 11/13/2022] Open
Abstract
Microstructural changes of White Matter (WM) associated with aging have been widely described through Diffusion Tensor Imaging (DTI) parameters. In parallel, White Matter Hyperintensities (WMH) as observed on a T2-weighted MRI are extremely common in older individuals. However, few studies have investigated both phenomena conjointly. The present study investigates aging effects on DTI parameters in absence and in presence of WMH. Diffusion maps were constructed based on 21 directions DTI scans of young adults (n = 19, mean age = 33 SD = 7.4) and two age-matched groups of older adults, one presenting low-level-WMH (n = 20, mean age = 78, SD = 3.2) and one presenting high-level-WMH (n = 20, mean age = 79, SD = 5.4). Older subjects with low-level-WMH presented modifications of DTI parameters in comparison to younger subjects, fitting with the DTI pattern classically described in aging, i.e., Fractional Anisotropy (FA) decrease/Radial Diffusivity (RD) increase. Furthermore, older subjects with high-level-WMH showed higher DTI modifications in Normal Appearing White Matter (NAWM) in comparison to those with low-level-WMH. Finally, in older subjects with high-level-WMH, FA, and RD values of NAWM were associated with to WMH burden. Therefore, our findings suggest that DTI modifications and the presence of WMH would be two inter-dependent processes but occurring within different temporal windows. DTI changes would reflect the early phase of white matter changes and WMH would appear as a consequence of those changes.
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Affiliation(s)
- Amandine Pelletier
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; ISPED, Centre ISPED, Institut National de la Santé et de la Recherche Médicale U 1219, Université de BordeauxBordeaux, France
| | - Olivier Periot
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; CHU de BordeauxBordeaux, France
| | - Bixente Dilharreguy
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France
| | | | - Martine Bordessoules
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; CHU de BordeauxBordeaux, France
| | - Sandra Chanraud
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; EPHEBordeaux, France
| | - Karine Pérès
- ISPED, Centre ISPED, Institut National de la Santé et de la Recherche Médicale U 1219, Université de Bordeaux Bordeaux, France
| | - Hélène Amieva
- ISPED, Centre ISPED, Institut National de la Santé et de la Recherche Médicale U 1219, Université de Bordeaux Bordeaux, France
| | - Jean-François Dartigues
- ISPED, Centre ISPED, Institut National de la Santé et de la Recherche Médicale U 1219, Université de Bordeaux Bordeaux, France
| | - Michèle Allard
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; CHU de BordeauxBordeaux, France; EPHEBordeaux, France
| | - Gwénaëlle Catheline
- INCIA, UMR 5287, Université de BordeauxTalence, France; Centre National de la Recherche Scientifique, INCIA, UMR 5287Talence, France; EPHEBordeaux, France
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Abstract
Vascular cognitive impairment (VCI) is the diagnostic term used to describe a heterogeneous group of sporadic and hereditary diseases of the large and small blood vessels. Subcortical small vessel disease (SVD) leads to lacunar infarcts and progressive damage to the white matter. Patients with progressive damage to the white matter, referred to as Binswanger's disease (BD), constitute a spectrum from pure vascular disease to a mixture with neurodegenerative changes. Binswanger's disease patients are a relatively homogeneous subgroup with hypoxic hypoperfusion, lacunar infarcts, and inflammation that act synergistically to disrupt the blood-brain barrier (BBB) and break down myelin. Identification of this subgroup can be facilitated by multimodal disease markers obtained from clinical, cerebrospinal fluid, neuropsychological, and imaging studies. This consensus statement identifies a potential set of biomarkers based on underlying pathologic changes that could facilitate diagnosis and aid patient selection for future collaborative treatment trials.
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177
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Vascular Dementia and Cognitive Impairment. Stroke 2016. [DOI: 10.1016/b978-0-323-29544-4.00017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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178
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Zimering MB, Knight J, Ge L, Bahn G. Predictors of Cognitive Decline in Older Adult Type 2 Diabetes from the Veterans Affairs Diabetes Trial. Front Endocrinol (Lausanne) 2016; 7:123. [PMID: 27660621 PMCID: PMC5015004 DOI: 10.3389/fendo.2016.00123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/24/2016] [Indexed: 12/27/2022] Open
Abstract
AIMS Cognitive decline disproportionately affects older adult type 2 diabetes. We tested whether randomized intensive (INT) glucose-lowering reduces the rate(s) of cognitive decline in adults with advanced type 2 diabetes (mean: age, 60 years; diabetes duration, 11 years) from the Veterans Affairs Diabetes Trial. METHODS A battery of neuropsychological tests [digit span, digit symbol substitution (DSym), and Trails-making Test-Part B (TMT-B)] was administered at baseline in ~1700 participants and repeated at year 5. Thirty-seven risk factors were evaluated as predictors of cognitive decline in multivariable regression analyses. RESULTS The mean age-adjusted DSym or TMT-B declined significantly in all study participants (P < 0.001). Randomized INT glucose-lowering did not significantly alter the rate of cognitive decline. The final model of risk factors associated with 5-year decline in age-adjusted TMT-B included as significant predictors: longer baseline diabetes duration (beta = -0.028; P = 0.0057), lower baseline diastolic blood pressure (BP; beta = 0.028; P = 0.002), and baseline calcium channel blocker medication use (beta = -0.639; P < 0.001). Higher baseline pulse pressure was significantly associated with decline in age-adjusted TMT-B suggesting a role for both higher systolic and lower diastolic BPs. Baseline thiazide diuretic use (beta = -0.549; P = 0.015) was an additional significant predictor of 5-year decline in age-adjusted digit symbol score. Post-baseline systolic BP-lowering was significantly associated (P < 0.001) with decline in TMT-B performance. There was a significant inverse association between post-baseline plasma triglyceride-lowering (P = 0.045) and decline in digit symbol substitution task performance. CONCLUSION A 5-year period of randomized INT glucose-lowering did not significantly reduce the rate of cognitive decline in older-aged adults with type 2 diabetes. Systolic and diastolic BPs as well as plasma triglycerides appeared as modifiable risk factors of the rate of cognitive decline in older adult type 2 diabetes.
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Affiliation(s)
- Mark B. Zimering
- Medical Service, Department of Veterans Affairs New Jersey Health Care System, Lyons, NJ, USA
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- *Correspondence: Mark B. Zimering,
| | - Jeffrey Knight
- National Center for PTSD, VA Boston Healthcare System, Boston MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Ling Ge
- Hines Veterans Affairs Hospital, Hines, IL, USA
| | - Gideon Bahn
- Hines Veterans Affairs Hospital, Hines, IL, USA
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179
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Disrupted white matter structure underlies cognitive deficit in hypertensive patients. Eur Radiol 2015; 26:2899-907. [PMID: 26615558 DOI: 10.1007/s00330-015-4116-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/19/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Hypertension is considered a risk factor of cognitive impairments and could result in white matter changes. Current studies on hypertension-related white matter (WM) changes focus only on regional changes, and the information about global changes in WM structure network is limited. METHODS We assessed the cognitive function in 39 hypertensive patients and 37 healthy controls with a battery of neuropsychological tests. The WM structural networks were constructed by utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. The direct and indirect correlations among cognitive impairments, brain WM network disruptions and hypertension were analyzed with structural equation modelling (SEM). RESULTS Hypertensive patients showed deficits in executive function, memory and attention compared with controls. An aberrant connectivity of WM networks was found in the hypertensive patients (P Eglob = 0.005, P Lp = 0.005), especially in the frontal and parietal regions. Importantly, SEM analysis showed that the decline of executive function resulted from aberrant WM networks in hypertensive patients (p = 0.3788, CFI = 0.99). CONCLUSIONS These results suggest that the cognitive decline in hypertensive patients was due to frontal and parietal WM disconnections. Our findings highlight the importance of brain protection in hypertension patients. KEY POINTS • Hypertension has a negative effect on the performance of the cognitive domains • Reduced efficiencies of white matter networks were shown in hypertension • Disrupted white matter networks are responsible for poor cognitive function in hypertension.
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180
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Pase MP, Beiser A, Aparicio H, DeCarli C, Vasan RS, Murabito J, Seshadri S. Interarm differences in systolic blood pressure and the risk of dementia and subclinical brain injury. Alzheimers Dement 2015; 12:438-45. [PMID: 26542262 DOI: 10.1016/j.jalz.2015.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/27/2015] [Accepted: 09/19/2015] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This study examined whether interarm differences in systolic blood pressure (IDSBP) ≥10 mm Hg were associated with the risk of incident dementia and subclinical brain injury. METHODS Between 1992 and 1998, 2063 participants of the Framingham Heart Study underwent assessment of IDSBP with results related to the 10-year risk of incident dementia including clinically characterized Alzheimer's disease. Secondary outcomes included markers of subclinical brain injury on magnetic resonance imaging. RESULTS High IDSBP were associated with a greater risk of incident dementia (hazard ratio [HR] 1.92; 95% confidence interval [CI], 1.09-3.40) and Alzheimer's disease (HR, 2.32; 95% CI, 1.29-4.18), but only in those who carried an apolipoprotein E (APOE) ε4 allele. IDSBP also predicted lower total brain volumes and more prevalent silent brain infarcts in those who were APOE ε4 positive. DISCUSSION High IDSBP were associated with an increased risk of dementia, including clinical Alzheimer's disease, and subclinical brain injury in those who were APOE ε4 positive.
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Affiliation(s)
- Matthew P Pase
- Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia.
| | - Alexa Beiser
- Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA; Boston University School of Public Health, Boston, MA, USA
| | - Hugo Aparicio
- Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA
| | - Charles DeCarli
- Department of Neurology, School of Medicine & Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California Davis, Sacramento, CA, USA
| | | | - Joanne Murabito
- Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA
| | - Sudha Seshadri
- Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA
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Adams HHH, Hilal S, Schwingenschuh P, Wittfeld K, van der Lee SJ, DeCarli C, Vernooij MW, Katschnig-Winter P, Habes M, Chen C, Seshadri S, van Duijn CM, Ikram MK, Grabe HJ, Schmidt R, Ikram MA. A priori collaboration in population imaging: The Uniform Neuro-Imaging of Virchow-Robin Spaces Enlargement consortium. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:513-20. [PMID: 27239529 PMCID: PMC4879491 DOI: 10.1016/j.dadm.2015.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction Virchow-Robin spaces (VRS), or perivascular spaces, are compartments of interstitial fluid enclosing cerebral blood vessels and are potential imaging markers of various underlying brain pathologies. Despite a growing interest in the study of enlarged VRS, the heterogeneity in rating and quantification methods combined with small sample sizes have so far hampered advancement in the field. Methods The Uniform Neuro-Imaging of Virchow-Robin Spaces Enlargement (UNIVRSE) consortium was established with primary aims to harmonize rating and analysis (www.uconsortium.org). The UNIVRSE consortium brings together 13 (sub)cohorts from five countries, totaling 16,000 subjects and over 25,000 scans. Eight different magnetic resonance imaging protocols were used in the consortium. Results VRS rating was harmonized using a validated protocol that was developed by the two founding members, with high reliability independent of scanner type, rater experience, or concomitant brain pathology. Initial analyses revealed risk factors for enlarged VRS including increased age, sex, high blood pressure, brain infarcts, and white matter lesions, but this varied by brain region. Discussion Early collaborative efforts between cohort studies with respect to data harmonization and joint analyses can advance the field of population (neuro)imaging. The UNIVRSE consortium will focus efforts on other potential correlates of enlarged VRS, including genetics, cognition, stroke, and dementia.
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Affiliation(s)
- Hieab H H Adams
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Saima Hilal
- Department of Ophthalmology, National University of Singapore, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore
| | | | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Greifswald, Germany
| | - Sven J van der Lee
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Charles DeCarli
- Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology and Center for Neuroscience, University of California at Davis, Davis, CA, USA
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Mohamad Habes
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher Chen
- Memory Aging and Cognition Center, National University Health System, Singapore
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA; Framingham Heart Study, Framingham, MA, USA
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Ophthalmology, National University of Singapore, Singapore; Memory Aging and Cognition Center, National University Health System, Singapore
| | - Hans J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
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182
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Jolly TAD, Cooper PS, Wan Ahmadul Badwi SA, Phillips NA, Rennie JL, Levi CR, Drysdale KA, Parsons MW, Michie PT, Karayanidis F. Microstructural white matter changes mediate age-related cognitive decline on the Montreal Cognitive Assessment (MoCA). Psychophysiology 2015; 53:258-67. [DOI: 10.1111/psyp.12565] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 09/10/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Todd A. D. Jolly
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Patrick S. Cooper
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Syarifah Azizah Wan Ahmadul Badwi
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Department of Psychology, Kulliyyah of IRKHS; International Islamic University Malaysia; Kuala Lumpur Malaysia
| | - Natalie A. Phillips
- Centre for Research in Human Development, Department of Psychology; Concordia University; Montreal Quebec Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
| | - Jaime L. Rennie
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Christopher R. Levi
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Newcastle Australia
| | - Karen A. Drysdale
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Mark W. Parsons
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Newcastle Australia
| | - Patricia T. Michie
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
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183
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Yano Y, Ning H, Muntner P, Reis JP, Calhoun DA, Viera AJ, Levine DA, Jacobs DR, Shimbo D, Liu K, Greenland P, Lloyd-Jones D. Nocturnal Blood Pressure in Young Adults and Cognitive Function in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Hypertens 2015; 28:1240-7. [PMID: 25783740 PMCID: PMC4580541 DOI: 10.1093/ajh/hpv028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 02/02/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study, including 224 participants (mean age 30 years, 45% men, 63% African Americans). At the 20-year follow-up, the Stroop test (executive function), Digit Symbol Substitution Test (psychomotor speed), and Rey Auditory Verbal Learning Test (verbal memory) were assessed. RESULTS Baseline mean office, daytime, and nocturnal BP were 109/73, 120/74, and 107/59 mm Hg, respectively. Nocturnal BP dipping, calculated as (nocturnal systolic BP [SBP]--daytime SBP) × 100/daytime SBP, was divided into quartiles (Q1: -39.3% to -16.9%; Q2: -16.8% to -13.2%, Q3 [reference]: -13.1% to -7.8%, and Q4: -7.7% to +56.4%). In multiple regression analyses, the least nocturnal SBP dipping (Q4 vs. reference) and higher nocturnal diastolic BP level were associated with worse Stroop scores, with adjustments for demographic and clinical characteristics, and cumulative exposure to office BP during follow-up (β [standard error]: 0.37 [0.18] and 0.19 [0.07], respectively; all P < 0.05). Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test were not significantly associated with nocturnal SBP dipping or nocturnal SBP/diastolic BP levels. CONCLUSIONS Among healthy young adults, less nocturnal SBP dipping and higher nocturnal diastolic BP levels were associated with lower executive function in midlife, independent of multiple measures of office BP during long-term follow-up.
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Affiliation(s)
- Yuichiro Yano
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;
| | - Hongyan Ning
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alaska, USA
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - David A Calhoun
- Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alaska, USA
| | - Anthony J Viera
- Hypertension Research Program and Department of Family Medicine, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Deborah A Levine
- Departments of Internal Medicine and Neurology and Stroke Program, University of Michigan Health System, Veterans Affairs Health Services Research and Development Center of Excellence, Ann Arbor, Michigan, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Daichi Shimbo
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University, New York, USA
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Disrupted Frontoparietal Network Mediates White Matter Structure Dysfunction Associated with Cognitive Decline in Hypertension Patients. J Neurosci 2015; 35:10015-24. [PMID: 26157001 DOI: 10.1523/jneurosci.5113-14.2015] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
UNLABELLED Some previous reports have suggested that hypertension is a risk factor for dementia and cognitive impairments. Using behavioral data from 1007 elderly human subjects (405 hypertensive patients) of Han ethnicity from Beijing, China, the present study aimed to assess the effects of hypertension on cognitive performance and explore related neuronal changes via advanced resting-state functional magnetic resonance imaging and diffusion tensor imaging data from 84 of these subjects (44 hypertensive patients). Cognitively, we found that patients with hypertension showed decreased executive functions and attention compared with those with normotension in the large sample. In magnetic resonance imaging scan sample, using independent component analysis to examine the functional connectivity difference between the two groups, we found that the frontoparietal networks in the hypertensive group exhibited altered patterns compared with the control group, mainly in the inferior parietal lobe, left inferior frontal lobe, and precuneus. Using tract-based spatial statistics to investigate the between-group structural difference, we found that the hypertensive group showed significantly reduced integrity of white matter in the bilateral superior longitudinal fasciculus. Importantly, using the mediation analysis, we found that the functional connectivity of the frontoparietal networks mediates the impact of white matter on executive function in the hypertensive group. The results demonstrate that hypertension targets a specific pattern of cognitive decline, possibly due to deficits in the white matter and functional connectivity in frontal and parietal lobes. Our findings highlight the importance of brain protection in hypertension. SIGNIFICANCE STATEMENT Hypertension is a risk factor for cognitive decline and dementia. However, the neural mechanism underlying cognitive decline in hypertension is largely unknown. We studied the relationship among cognitive decline, brain functional, and structural changes in hypertensive patients via advanced resting-state functional magnetic resonance imaging and diffusion tensor imaging data in a Chinese cohort. Hypertensive patients showed executive dysfunction, along with disrupted functional connectivity in frontoparietal (FP) networks and reduced integrity of white matter in the bilateral superior longitudinal fasciculus. Importantly, the functional connectivity changes mediate the impact of white matter alterations on cognitive decline in the hypertensive group. Our findings provide a better understanding of the mechanism of cognitive decline in hypertension and highlight the importance of brain protection in hypertension.
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185
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DeCarli C. A call for new thoughts about what might influence human brain aging: aging, apolipoprotein E, and amyloid. JAMA Neurol 2015; 72:500-2. [PMID: 25775040 DOI: 10.1001/jamaneurol.2015.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento
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186
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Foster‐Dingley JC, Moonen JE, van den Berg‐Huijsmans AA, de Craen AJ, de Ruijter W, van der Grond J, van der Mast RC. Lower Blood Pressure and Gray Matter Integrity Loss in Older Persons. J Clin Hypertens (Greenwich) 2015; 17:630-7. [PMID: 25867921 PMCID: PMC8031938 DOI: 10.1111/jch.12550] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/03/2015] [Accepted: 03/08/2015] [Indexed: 01/23/2023]
Abstract
In contrast to middle age, it is unclear whether blood pressure (BP) in older persons is associated with cerebral small vessel disease (cSVD). The authors evaluated the association of BP with signs of cSVD as well as gray and white matter integrity in older persons. In 220 participants aged 75 years and older from the Discontinuation of Antihypertensive Treatment in the Elderly (DANTE) study, cSVD was assessed with conventional magnetic resonance imaging, and microstructural integrity with diffusion tensor and magnetization transfer (MT) imaging. BP measures were not associated with cSVD. However, lower systolic and diastolic BP and mean arterial pressure were associated with decreased gray matter MT ratio peak height and MT ratio in cortical gray matter. Mean arterial pressure was also associated with increased gray matter diffusivity. A lower level of BP was especially associated with worse gray matter integrity. Results suggest that not only upper but preferably lower thresholds of BP values should be observed in older persons.
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Affiliation(s)
| | - Justine E.F. Moonen
- Department of PsychiatryLeiden University Medical CenterLeidenthe Netherlands
| | | | - Anton J.M. de Craen
- Department of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
| | - Wouter de Ruijter
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenthe Netherlands
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Pelletier A, Barul C, Féart C, Helmer C, Bernard C, Periot O, Dilharreguy B, Dartigues J, Allard M, Barberger‐Gateau P, Catheline G, Samieri C. Mediterranean diet and preserved brain structural connectivity in older subjects. Alzheimers Dement 2015; 11:1023-31. [DOI: 10.1016/j.jalz.2015.06.1888] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/27/2015] [Accepted: 06/02/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Amandine Pelletier
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Christine Barul
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Catherine Féart
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Catherine Helmer
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Charlotte Bernard
- Univ. Bordeaux, INCIA, UMR 5287 F‐33076 Bordeaux France
- CNRS, INCIA, UMR 5287 F‐33076 Bordeaux France
| | - Olivier Periot
- Univ. Bordeaux, INCIA, UMR 5287 F‐33076 Bordeaux France
- CNRS, INCIA, UMR 5287 F‐33076 Bordeaux France
- CHU de Bordeaux F‐33076 Bordeaux France
| | - Bixente Dilharreguy
- Univ. Bordeaux, INCIA, UMR 5287 F‐33076 Bordeaux France
- CNRS, INCIA, UMR 5287 F‐33076 Bordeaux France
| | - Jean‐François Dartigues
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Michèle Allard
- Univ. Bordeaux, INCIA, UMR 5287 F‐33076 Bordeaux France
- CNRS, INCIA, UMR 5287 F‐33076 Bordeaux France
- CHU de Bordeaux F‐33076 Bordeaux France
- EPHE Laboratoire Neurobiologie Intégrative et Adaptative F‐33076 Bordeaux France
| | - Pascale Barberger‐Gateau
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
| | - Gwénaëlle Catheline
- Univ. Bordeaux, INCIA, UMR 5287 F‐33076 Bordeaux France
- CNRS, INCIA, UMR 5287 F‐33076 Bordeaux France
- EPHE Laboratoire Neurobiologie Intégrative et Adaptative F‐33076 Bordeaux France
| | - Cécilia Samieri
- Univ. Bordeaux ISPED, Centre INSERM U897 F‐33076 Bordeaux France
- INSERM, ISPED Centre INSERM U897 F‐33076 Bordeaux France
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Pistoia F, Sacco S, Degan D, Tiseo C, Ornello R, Carolei A. Hypertension and Stroke: Epidemiological Aspects and Clinical Evaluation. High Blood Press Cardiovasc Prev 2015; 23:9-18. [DOI: 10.1007/s40292-015-0115-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/01/2015] [Indexed: 11/28/2022] Open
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Santiago C, Herrmann N, Swardfager W, Saleem M, Oh PI, Black SE, Lanctôt KL. White Matter Microstructural Integrity Is Associated with Executive Function and Processing Speed in Older Adults with Coronary Artery Disease. Am J Geriatr Psychiatry 2015; 23:754-63. [PMID: 25499674 DOI: 10.1016/j.jagp.2014.09.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/16/2014] [Accepted: 09/22/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Coronary artery disease (CAD) is associated with an increased risk of cognitive decline. Although cerebral white matter (WM) damage predicts cognitive function in CAD, conventional neuroimaging measures only partially explain the effect of CAD on cognition. The purpose of this study was to determine if WM microstructural integrity and CAD using diffusion tensor imaging (DTI) correlates with cognitive function in older adults with CAD. METHODS Forty-nine CAD patients (66 ± 7 years old, 86% male) underwent neurocognitive assessments using the cognitive battery recommended by the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network for the study of vascular cognitive impairment. Composite scores for each cognitive domain were calculated. Microstructural integrity in normal-appearing WM was quantified as fractional anisotropy (FA) using DTI in nine bilateral and two interhemispheric WM tracts from the Johns Hopkins University WM Tractography Atlas. Linear regression models examined associations between FA and cognitive performance, controlling for age, sex, and education, with correction for multiple comparisons using a false discovery rate of 5%. RESULTS Executive function was most significantly associated with FA in the left parahippocampal cingulum (β = 0.471, t = 3.381, df = 44, p = 0.002) and left inferior fronto-occipital fasciculus (β = 0.430, t = 2.984, df = 44, p = 0.005). FA was not associated with memory in any of the WM tracts examined. CONCLUSION These results suggest that WM microstructural integrity may be an important neural correlate of executive function even in cognitively intact CAD patients. This study suggests WM damage may be relevant to subtle cognitive decline in a population that may have early neural risk for dementia.
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Affiliation(s)
- Calvin Santiago
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Walter Swardfager
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Mahwesh Saleem
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Paul I Oh
- Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, and University of Toronto, Toronto, Ontario, Canada; Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, and University of Toronto, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Neuropsychopharmacology Research Group, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, and University of Toronto, Toronto, Ontario, Canada.
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190
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George MG, Hong Y, Bowman BA. Improving Population Blood Pressure Control for Brain and Heart Health. Public Health Rep 2015; 130:302-6. [PMID: 26345373 PMCID: PMC4547583 DOI: 10.1177/003335491513000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mary G. George
- Mary G. George is Deputy Associate Director for Science and Senior Medical Officer, Yuling Hong is Associate Director for Science, and Barbara A. Bowman is Director, all with the Division for Heart Disease and Stroke Prevention at CDC
| | - Yuling Hong
- Mary G. George is Deputy Associate Director for Science and Senior Medical Officer, Yuling Hong is Associate Director for Science, and Barbara A. Bowman is Director, all with the Division for Heart Disease and Stroke Prevention at CDC
| | - Barbara A. Bowman
- Mary G. George is Deputy Associate Director for Science and Senior Medical Officer, Yuling Hong is Associate Director for Science, and Barbara A. Bowman is Director, all with the Division for Heart Disease and Stroke Prevention at CDC
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191
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Wardlaw JM, Valdés Hernández MC, Muñoz-Maniega S. What are white matter hyperintensities made of? Relevance to vascular cognitive impairment. J Am Heart Assoc 2015; 4:001140. [PMID: 26104658 PMCID: PMC4599520 DOI: 10.1161/jaha.114.001140] [Citation(s) in RCA: 521] [Impact Index Per Article: 57.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Joanna M Wardlaw
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Maria C Valdés Hernández
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
| | - Susana Muñoz-Maniega
- Division of Neuroimaging Sciences and Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.M.W., M.C.V.H., S.M.M.)
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Ihle-Hansen H, Thommessen B, Fagerland MW, Øksengård AR, Wyller TB, Engedal K, Fure B. Blood pressure control to prevent decline in cognition after stroke. Vasc Health Risk Manag 2015; 11:311-6. [PMID: 26089677 PMCID: PMC4467749 DOI: 10.2147/vhrm.s82839] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Treatment of hypertension post-stroke preserves cognition through prevention of recurrent stroke, but it is not clear whether it prevents cognitive decline through other mechanisms. We aimed to describe changes in blood pressure from baseline to 1 year post-stroke and to evaluate the association between achieved blood pressure targets and cognitive function, mild cognitive impairment (MCI), and dementia. Methods We included patients with first-ever stroke, and defined achieved blood pressure goals as systolic blood pressure (SBP) in the categories ≤125 mmHg, ≤140 mmHg, and ≤160 mmHg, SBP reduction of ≥10 mmHg, and diastolic blood pressure (DBP) reduction of ≥5 mmHg. The main outcome variables were cognitive assessments 1 year post stroke. Secondary outcomes were diagnoses of MCI or dementia. Results Forty-one of 166 patients (25%) reached SBP ≤125 mmHg after 1 year, 92/166 (55%) reached SBP ≤140 mmHg, and 150/166 (90%) reached SBP ≤160 mmHg. SBP was reduced by ≥10 mmHg in 44/150 (29%) and DBP by ≥5 mmHg in 57/150 (38%). We did not find any statistically significant associations between cognitive test performances and different blood pressure goals (P=0.070–1.0). Nor was there any significant association between achieved goal blood pressure or blood pressure reduction after 1 year and the diagnoses of MCI or dementia (P=0.32–0.56). Conclusion Treatment of hypertension is important for primary and secondary prevention of stroke. Showing a potential beneficial effect of blood pressure control on cognitive function, however, probably needs longer follow-up.
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Affiliation(s)
- Hege Ihle-Hansen
- Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Morten W Fagerland
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Norway
| | - Anne R Øksengård
- Department of Internal medicine, Vestre Viken Hospital Trust, Bærum Hospital, Bærum, Norway
| | - Torgeir B Wyller
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Knut Engedal
- Norwegian Centre for Dementia Research, Oslo University Hospital, Oslo, Norway
| | - Brynjar Fure
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
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193
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McEvoy LK, Fennema-Notestine C, Eyler LT, Franz CE, Hagler DJ, Lyons MJ, Panizzon MS, Rinker DA, Dale AM, Kremen WS. Hypertension-related alterations in white matter microstructure detectable in middle age. Hypertension 2015; 66:317-23. [PMID: 26056337 DOI: 10.1161/hypertensionaha.115.05336] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/13/2015] [Indexed: 12/21/2022]
Abstract
Most studies examining associations between hypertension and brain white matter microstructure have focused on older adults or on cohorts with a large age range. Because hypertension effects on the brain may vary with age, it is important to focus on middle age, when hypertension becomes more prevalent. We used linear mixed-effect models to examine differences in white matter diffusion metrics as a function of hypertension in a well-characterized cohort of middle-aged men (n=316; mean, 61.8 years; range, 56.7-65.6). Diffusion metrics were examined in 9 tracts reported to be sensitive to hypertension in older adults. Relative to normotensive individuals, individuals with long-standing hypertension (>5.6 years) showed reduced fractional anisotropy or increased diffusivity in most tracts. Effects were stronger among carriers than among noncarriers of the apolipoprotein E ε4 allele for 2 tracts connecting frontal regions with other brain areas. Significant differences were observed even after adjustment for potentially related lifestyle and cardiovascular risk factors. Shorter duration of hypertension or better blood pressure control among hypertensive individuals did not lessen the adverse effects. These findings suggest that microstructural white matter alterations appear early in the course of hypertension and may persist despite adequate treatment. Although longitudinal studies are needed to confirm these findings, the results suggest that prevention-rather than management-of hypertension may be vital to preserving brain health in aging.
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Affiliation(s)
- Linda K McEvoy
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.).
| | - Christine Fennema-Notestine
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Lisa T Eyler
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Carol E Franz
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Donald J Hagler
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Michael J Lyons
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Matthew S Panizzon
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Daniel A Rinker
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - Anders M Dale
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
| | - William S Kremen
- From the Departments of Radiology (L.K.M., C.F.-N., D.J.H., A.M.D.), Psychiatry (C.F.-N., L.T.E., C.E.F., M.S.P., W.S.K.), and Neurosciences (A.M.D.), University of California, San Diego; Mental Illness Research, Education, and Clinical Center (L.T.E.) and Center of Excellence for Stress and Mental Health (W.S.K.), VA San Diego Healthcare System; Department of Psychiatry and Brain Sciences, Boston University, Boston, MA (M.J.L.); and Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles (D.A.R.)
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194
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Affiliation(s)
- Charles DeCarli
- Department of Neurology, University of California, Davis, Sacramento
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195
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Weinstein G, Maillard P, Himali JJ, Beiser AS, Au R, Wolf PA, Seshadri S, DeCarli C. Glucose indices are associated with cognitive and structural brain measures in young adults. Neurology 2015; 84:2329-37. [PMID: 25948725 DOI: 10.1212/wnl.0000000000001655] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 01/20/2015] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To evaluate the possible early consequences of impaired glucose metabolism on the brain by assessing the relationship of diabetes, fasting blood glucose (FBG) levels, and insulin resistance with cognitive performance and brain integrity in healthy young and middle-aged adults. METHODS The sample included dementia-free participants (mean age 40 ± 9 years; 53% women) of the Framingham Heart Study third-generation cohort with cognitive testing of memory, abstract reasoning, visual perception, attention, and executive function (n = 2,126). In addition, brain MRI examination (n = 1,597) was used to determine white matter, gray matter, and white matter hyperintensity (WMH) volumes and fractional anisotropy measures. We used linear regression models to assess relationships between diabetes, FBG, and insulin resistance with cognition, lobar gray matter, and WMH volumes as well as voxel-based microstructural white matter integrity and gray matter density, adjusting for potential confounders. Mediating effect of brain lesions on the association of diabetes with cognitive performance was also tested. RESULTS Diabetes was associated with worse memory, visual perception, and attention performance; increased WMH; and decreased total cerebral brain and occipital lobar gray matter volumes. The link of diabetes with attention and memory was mediated through occipital and frontal atrophy, and the latter also through hippocampal atrophy. Both diabetes and increased FBG were associated with large areas of reductions in gray matter density and fractional anisotropy on voxel-based analyses. CONCLUSIONS We found that hyperglycemia is associated with subtle brain injury and impaired attention and memory even in young adults, indicating that brain injury is an early manifestation of impaired glucose metabolism.
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Affiliation(s)
- Galit Weinstein
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA.
| | - Pauline Maillard
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Jayandra J Himali
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Alexa S Beiser
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Rhoda Au
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Philip A Wolf
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Sudha Seshadri
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
| | - Charles DeCarli
- From the Department of Neurology (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), Boston University School of Medicine, MA; The Framingham Heart Study (G.W., J.J.H., A.S.B., R.A., P.A.W., S.S.), MA; the Department of Neurology (P.M., C.D.), The University of California at Davis, Sacramento; and the Department of Biostatistics (A.S.B.), Boston University School of Public Health, MA
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Allan CL, Zsoldos E, Filippini N, Sexton CE, Topiwala A, Valkanova V, Singh-Manoux A, Tabák AG, Shipley MJ, Mackay C, Ebmeier KP, Kivimäki M. Lifetime hypertension as a predictor of brain structure in older adults: cohort study with a 28-year follow-up. Br J Psychiatry 2015; 206:308-15. [PMID: 25497301 PMCID: PMC4381190 DOI: 10.1192/bjp.bp.114.153536] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/23/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hypertension is associated with an increased risk of dementia and depression with uncertain longitudinal associations with brain structure. AIMS To examine lifetime blood pressure as a predictor of brain structure in old age. METHOD A total of 190 participants (mean age 69.3 years) from the Whitehall II study were screened for hypertension six times (1985-2013). In 2012-2013, participants had a 3T-magnetic resonance imaging (MRI) brain scan. Data from the MRI were analysed using automated and visual measures of global atrophy, hippocampal atrophy and white matter hyperintensities. RESULTS Longitudinally, higher mean arterial pressure predicted increased automated white matter hyperintensities (P<0.002). Cross-sectionally, hypertensive participants had increased automated white matter hyperintensities and visually rated deep white matter hyperintensities. There was no significant association with global or hippocampal atrophy. CONCLUSIONS Long-term exposure to high blood pressure predicts hyperintensities, particularly in deep white matter. The greatest changes are seen in those with severe forms of hypertension, suggesting a dose-response pattern.
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197
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Kullmann S, Schweizer F, Veit R, Fritsche A, Preissl H. Compromised white matter integrity in obesity. Obes Rev 2015; 16:273-81. [PMID: 25676886 DOI: 10.1111/obr.12248] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 11/14/2014] [Accepted: 12/01/2014] [Indexed: 12/13/2022]
Abstract
Obesity is associated with both structural and functional changes of the central nervous system. While gray matter alterations in obesity point to a consistent reduction with increasing body mass index (BMI), volumetric changes in white matter are more complex and less conclusive. Hence, more recently, diffusion tensor imaging (DTI) has been employed as a highly sensitive tool to investigate microstructural changes in white matter structure. Parameters of diffusivity and anisotropy are used to evaluate white matter and fibre integrity as well as axonal and myelin degeneration. Fractional anisotropy (FA) is the most commonly used parameter as it is the best estimate of fibre integrity. The focus of this review was on the relationship between obesity and brain alterations assessed by DTI. Altogether, these studies have shown a loss of white matter integrity with obesity-related factors, especially in tracts within the limbic system and those connecting the temporal and frontal lobe. More specifically, multiple studies found an inverse association between BMI and FA in the corpus callosum, fornix, cingulum and corona radiata in elderly and young adults as well as children. Furthermore, significant interactions were observed between BMI and age, pointing to accelerated ageing of white matter structure in obese.
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Affiliation(s)
- S Kullmann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, University of Tübingen, Tübingen, Germany; German Center for Diabetes Research, Neuherberg, Germany; Institute of Medical Psychology and Behavioral Neurobiology, fMEG Center, University of Tübingen, Tübingen, Germany
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Meurs M, Groenewold NA, Roest AM, van der Wee NJA, Veltman DJ, van Tol MJ, de Jonge P. The associations of depression and hypertension with brain volumes: Independent or interactive? NEUROIMAGE-CLINICAL 2015; 8:79-86. [PMID: 26106530 PMCID: PMC4473298 DOI: 10.1016/j.nicl.2015.03.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/12/2015] [Accepted: 03/26/2015] [Indexed: 12/29/2022]
Abstract
Independent studies on major depressive disorder (MDD) and hypertension, suggest overlapping abnormalities in brain regions associated with emotional and autonomic processing. However, the unique and interactive effects of MDD and hypertension have never been studied in a single sample. Brain volume in these areas may be an explanatory link in the comorbidity between MDD and hypertension. Voxel-based morphometry was used to test for main effects of MDD (N = 152) and hypertension (N = 82) and their interactions on gray and white matter volumes. Voxel-wise results are reported at p < .05 FWE corrected for the spatial extent of the whole brain and a-priori regions of interest (ROIs: hippocampus, anterior cingulate cortex (ACC) and inferior frontal gyrus (IFG)). In addition, analyses on the extracted total volumes of our ROIs were performed. Interactive effects in the mid-cingulate cortex (MCC) (p FWE = .01), cerebellum (p FWE = .01) and in the ACC total ROI volume (p = .02) were found. MDD in the presence, but not in the absence of hypertension was associated with lower volumes in the ACC and MCC, and with a trend towards larger gray matter volume in the cerebellum. No associations with white matter volumes were observed. Results suggest that the combination of MDD and hypertension has a unique effect on brain volumes in areas implicated in the regulation of emotional and autonomic functions. Brain volume in these regulatory areas may be an explanatory link in the comorbidity between hypertension and MDD.
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Affiliation(s)
- Maaike Meurs
- University of Groningen, University Medical Center, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Hanzeplein 1, Groningen, Groningen 9713 GZ, The Netherlands
| | - Nynke A Groenewold
- University of Groningen, University Medical Center, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Hanzeplein 1, Groningen, Groningen 9713 GZ, The Netherlands
| | - Annelieke M Roest
- University of Groningen, University Medical Center, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Hanzeplein 1, Groningen, Groningen 9713 GZ, The Netherlands
| | - Nic J A van der Wee
- University of Leiden, Leiden University Medical Center, Department of Psychiatry and Leiden Institute for Brain and Cognition, Postbus 9600, Leiden 2300 RC, The Netherlands
| | - Dick J Veltman
- University of Amsterdam, VU University Medical Center, Department of Psychiatry, A.J. Ernststraat 1187, Amsterdam 1081 HL, The Netherlands
| | - Marie-José van Tol
- Neuroimaging Center, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Peter de Jonge
- University of Groningen, University Medical Center, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Hanzeplein 1, Groningen, Groningen 9713 GZ, The Netherlands
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Smith EE, O'Donnell M, Dagenais G, Lear SA, Wielgosz A, Sharma M, Poirier P, Stotts G, Black SE, Strother S, Noseworthy MD, Benavente O, Modi J, Goyal M, Batool S, Sanchez K, Hill V, McCreary CR, Frayne R, Islam S, DeJesus J, Rangarajan S, Teo K, Yusuf S. Early cerebral small vessel disease and brain volume, cognition, and gait. Ann Neurol 2015; 77:251-61. [PMID: 25428654 PMCID: PMC4338762 DOI: 10.1002/ana.24320] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 10/25/2014] [Accepted: 11/22/2014] [Indexed: 11/20/2022]
Abstract
Objective Decline in cognitive function begins by the 40s, and may be related to future dementia risk. We used data from a community-representative study to determine whether there are age-related differences in simple cognitive and gait tests by the 40s, and whether these differences were associated with covert cerebrovascular disease on magnetic resonance imaging (MRI). Methods Between 2010 and 2012, 803 participants aged 40 to 75 years in the Prospective Urban Rural Epidemiological (PURE) study, recruited from prespecified postal code regions centered on 4 Canadian cities, underwent brain MRI and simple tests of cognition and gait as part of a substudy (PURE-MIND). Results Mean age was 58 ± 8 years. Linear decreases in performance on the Montreal Cognitive Assessment, Digit Symbol Substitution Test (DSST), and Timed Up and Go test of gait were seen with each age decade from the 40s to the 70s. Silent brain infarcts were observed in 3% of 40- to 49-year-olds, with increasing prevalence up to 18.9% in 70-year-olds. Silent brain infarcts were associated with slower timed gait and lower volume of supratentorial white matter. Higher volume of supratentorial MRI white matter hyperintensity was associated with slower timed gait and worse performance on DSST, and lower volumes of the supratentorial cortex and white matter, and cerebellum. Interpretation Covert cerebrovascular disease and its consequences on cognitive and gait performance and brain atrophy are manifest in some clinically asymptomatic persons as early as the 5th decade of life. Ann Neurol 2015;77:251–261
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Affiliation(s)
- Eric E Smith
- Hotchkiss Brain Institute; Department of Clinical Neurosciences; Department of Radiology; Seaman Family Centre, University of Calgary, Calgary, Alberta
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Tau proteins in the temporal and frontal cortices in patients with vascular dementia. J Neuropathol Exp Neurol 2015; 74:148-57. [PMID: 25575131 DOI: 10.1097/nen.0000000000000157] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
We previously reported that, in the brains of older patients with vascular dementia (VaD), there is a distinctive accumulation of detergent-extractable soluble amyloid-β, with a predominance of Aβ42 species. It is unclear, however, if tau proteins also accumulate in the brains of older VaD subjects. Using antibody-specific immunoassays, we assessed concentrations of total tau (t-tau) and phosphorylated tau protein, measured at 3 phosphorylated sites (i.e. Thr181, Ser202/Thr205, and Ser262), as well as synaptophysin in the temporal and frontal cortices of 18 VaD, 16 Alzheimer disease (AD), and 16 normal age-matched control subjects. There was selective loss of t-tau protein in VaD compared with controls and AD subjects (p < 0.021 and p < 0.001, respectively). In contrast, phosphorylated tau levels were similar to controls in VaD in both regions, but they were increased in the temporal lobes of patients with AD (p < 0.01 and p < 0.0001 for Ser202/Thr205 and Ser262 phosphorylated sites, respectively). The reduced t-tau in the VaD group was unrelated to any low-level neurofibrillary or amyloid pathology or age at death. These findings suggest that breaches of microvascular or microstructural tissue integrity subsequent to ischemic injury in older age may modify tau protein metabolism or phosphorylation and have effects on the burden of neurofibrillary pathology characteristic of AD.
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