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Li Z, Wang W, Sang F, Zhang Z, Li X. White matter changes underlie hypertension-related cognitive decline in older adults. Neuroimage Clin 2023; 38:103389. [PMID: 37004321 PMCID: PMC10102561 DOI: 10.1016/j.nicl.2023.103389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
Hypertension has been well recognized as a risk factor for cognitive impairment and dementia. Although the underlying mechanisms of hypertension-affected cognitive deterioration are not fully understood, white matter changes (WMCs) seem to play an important role. WMCs include low microstructural integrity and subsequent white matter macrostructural lesions, which are common on brain imaging in hypertensive patients and are critical for multiple cognitive domains. This article provides an overview of the impact of hypertension on white matter microstructural and macrostructural changes and its link to cognitive dysfunction. Hypertension may induce microstructural changes in white matter, especially for the long-range fibers such as anterior thalamic radiation (ATR) and inferior fronto-occipital fasciculus (IFOF), and then macrostructural abnormalities affecting different lobes, especially the periventricular area. Different regions' WMCs would further exert different effects to specific cognitive domains and accelerate brain aging. As a modifiable risk factor, hypertension might provide a new perspective for alleviating and delaying cognitive impairment.
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Affiliation(s)
- Zilin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Wenxiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
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Sexual dimorphism in the relationship between brain complexity, volume and general intelligence (g): a cross-cohort study. Sci Rep 2022; 12:11025. [PMID: 35773463 PMCID: PMC9247090 DOI: 10.1038/s41598-022-15208-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/20/2022] [Indexed: 01/20/2023] Open
Abstract
Changes in brain morphology have been reported during development, ageing and in relation to different pathologies. Brain morphology described by the shape complexity of gyri and sulci can be captured and quantified using fractal dimension (FD). This measure of brain structural complexity, as well as brain volume, are associated with intelligence, but less is known about the sexual dimorphism of these relationships. In this paper, sex differences in the relationship between brain structural complexity and general intelligence (g) in two diverse geographic and cultural populations (UK and Indian) are investigated. 3D T1-weighted magnetic resonance imaging (MRI) data and a battery of cognitive tests were acquired from participants belonging to three different cohorts: Mysore Parthenon Cohort (MPC); Aberdeen Children of the 1950s (ACONF) and UK Biobank. We computed MRI derived structural brain complexity and g estimated from a battery of cognitive tests for each group. Brain complexity and volume were both positively corelated with intelligence, with the correlations being significant in women but not always in men. This relationship is seen across populations of differing ages and geographical locations and improves understanding of neurobiological sex-differences.
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Lin Z, Chen X. Adverse childhood circumstances and cognitive function in middle-aged and older Chinese adults: Lower level or faster decline? SSM Popul Health 2021; 14:100767. [PMID: 33855158 PMCID: PMC8025052 DOI: 10.1016/j.ssmph.2021.100767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/04/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022] Open
Abstract
We examine the long-term relationship between childhood circumstances and cognitive aging. In particular, we differentiate the level of cognitive deficit from the rate of cognitive decline. Applying a linear mixed-effect model to three waves of China Health and Retirement Longitudinal Surveys (CHARLS 2011, 2013, 2015) and matching cognitive outcomes to CHARLS Life History Survey (2014), we find that key domains of childhood circumstances, including family socioeconomic status (SES), neighborhood cohesion, friendship, and health conditions, are significantly associated with both the level of cognitive deficit and the rate of decline. In contrast, childhood neighborhood safety only affects the level of cognitive deficit. Childhood relationship with mother only affects the rate of cognitive decline. The effects of adverse childhood circumstances are generally larger on level of cognitive deficit than on rate of cognitive decline. Moreover, education plays a more important role in mediating the relationships compared to other later-life factors. These findings suggest that exposure to disadvantaged childhood circumstances can exacerbate cognitive deficit as well as cognitive decline over time, which may be partially ameliorated by educational attainment.
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Affiliation(s)
- Zhuoer Lin
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Department of Economics, Yale University, New Haven, CT, USA
- Alzheimer's Disease Research Center, New Haven, CT, USA
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Lorgen-Ritchie M, Murray AD, Staff R, Ferguson-Smith AC, Richards M, Horgan GW, Phillips LH, Hoad G, McNeil C, Ribeiro A, Haggarty P. Imprinting methylation predicts hippocampal volumes and hyperintensities and the change with age in later life. Sci Rep 2021; 11:943. [PMID: 33441584 PMCID: PMC7806645 DOI: 10.1038/s41598-020-78062-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/16/2020] [Indexed: 12/29/2022] Open
Abstract
Epigenetic imprinting is important for neurogenesis and brain function. Hippocampal volumes and brain hyperintensities in late life have been associated with early life circumstances. Epigenetic imprinting may underpin these associations. Methylation was measured at 982 sites in 13 imprinted locations in blood samples from a longitudinal cohort by bisulphite amplicon sequencing. Hippocampal volumes and hyperintensities were determined at age 64y and 72y using MRI. Hyperintensities were determined in white matter, grey matter and infratentorial regions. Permutation methods were used to adjust for multiple testing. At 64y, H19/IGF2 and NESPAS methylation predicted hippocampal volumes. PEG3 predicted hyperintensities in hippocampal grey matter, and white matter. GNASXL predicted grey matter hyperintensities. Changes with age were predicted for hippocampal volume (MEST1, KvDMR, L3MBTL, GNASXL), white matter (MEST1, PEG3) and hippocampal grey matter hyperintensities (MCTS2, GNASXL, NESPAS, L3MBTL, MCTS2, SNRPN, MEST1). Including childhood cognitive ability, years in education, or socioeconomic status as additional explanatory variables in regression analyses did not change the overall findings. Imprinting methylation in multiple genes predicts brain structures, and their change over time. These findings are potentially relevant to the development of novel tests of brain structure and function across the life-course, strategies to improve cognitive outcomes, and our understanding of early influences on brain development and function.
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Affiliation(s)
- Marlene Lorgen-Ritchie
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | | | | | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Graham W Horgan
- Biomathematics and Statistics Scotland, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Louise H Phillips
- School of Psychology, University of Aberdeen, Aberdeen, AB24 3FX, UK
| | - Gwen Hoad
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Chris McNeil
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Antonio Ribeiro
- Centre for Genome-Enabled Biology and Medicine, University of Aberdeen, Aberdeen, AB24 3UU, UK
| | - Paul Haggarty
- Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
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Malden DE, Mangoni AA, Woodman RJ, Thies F, McNeil C, Murray AD, Soiza RL. Circulating asymmetric dimethylarginine and cognitive decline: A 4-year follow-up study of the 1936 Aberdeen Birth Cohort. Int J Geriatr Psychiatry 2020; 35:1181-1188. [PMID: 32452069 DOI: 10.1002/gps.5355] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/27/2020] [Accepted: 05/17/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The underlying mechanisms leading to dementia and Alzheimer's disease (AD) are unclear. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may be associated with cognitive decline, but population-based evidence is lacking. METHODS Change in cognitive performance was assessed in participants of the Aberdeen Birth Cohort of 1936 using longitudinal Raven's progressive matrices (RPM) between 2000 and 2004. Multiple linear regression was used to estimate the association between ADMA concentrations in 2000 and change in cognitive performance after adjustment for potential confounders. RESULTS A total of 93 participants had complete information on cognitive performance between 2000 and 2004. Mean plasma ADMA concentrations were approximately 0.4 μmol/L lower in those participants with stable or improved RPM scores over follow-up compared with participants whose cognitive performance worsened. In confounder-adjusted analysis, one SD (0.06 μmol/L) increase in ADMA at 63 years of age was associated with an average reduction in RPM of 1.26 points (95% CI 0.14-2.26) after 4 years. CONCLUSION Raised plasma ADMA concentrations predicted worsening cognitive performance after approximately 4 years in this cohort of adults in late-middle age. These findings have implications for future research, including presymptomatic diagnosis or novel therapeutic targets for dementia and AD.
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Affiliation(s)
- Deborah E Malden
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia.,Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Frank Thies
- Rowett institute, University of Aberdeen, Aberdeen, UK
| | - Chris McNeil
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK
| | - Roy L Soiza
- Ageing Clinical & Experimental Research (ACER), University of Aberdeen, Aberdeen, UK
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de Oliveira FF, Berretta JM, de Almeida Junior GV, de Almeida SS, Chen ES, Smith MC, Bertolucci PHF. Pharmacogenetic analyses of variations of measures of cardiovascular risk in Alzheimer's dementia. Indian J Med Res 2020; 150:261-271. [PMID: 31719297 PMCID: PMC6886147 DOI: 10.4103/ijmr.ijmr_1209_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background & objectives: Neurodegeneration affects blood pressure variations, while renal function and cerebral perfusion are impaired by vascular risk factors. This study was aimed to estimate variations of measures of cardiovascular risk in Alzheimer's dementia by pharmacogenetic analyses of the effects of angiotensin-converting enzyme (ACE) inhibitors and statins. Methods: Consecutive patients were prospectively followed to study variations of creatinine clearance and blood pressure for one year, estimated by correlating the effects of ACE inhibitors with the ACE Alu I/D polymorphism and genotypes or haplotypes of rs1800764 or rs4291, and the effects of statins with LDLR (low-density lipoprotein receptor) genotypes or haplotypes of rs11669576 (exon 8) or rs5930 (exon 10), or genotypes of rs2695121 (liver X receptor β gene). Variations of the coronary heart disease (CHD) risk according to these cardiovascular measures were also explored. Results: All polymorphisms of the 193 patients were in Hardy-Weinberg equilibrium. Genetic determinants of cardiovascular effects affected the individual variability of the response to ACE inhibitors and statins. ACE inhibitors, but not statins, reduced blood pressure for all patients. ACE inhibitors protected carriers of alleles that supposedly decrease serum ACE levels (rs1800764-T, rs4291-A, Alu II) regarding creatinine clearance variations (P<0.005), but carriers of Alu DD (P<0.02), rs1800764-C (P<0.05), or rs4291-AT (P<0.04) showed better blood pressure lowering effects. The presence of rs2695121-T (P=0.007) or rs5930-A (P=0.039) was associated with systolic blood pressure lowering, whereas rs5930-AA was protective against decrease in creatinine clearance (P=0.019). Statins lowered creatinine clearance for carriers of rs2695121-CT (P=0.026). Interpretation & conclusions: Pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins may be genetically mediated.
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Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Neurology & Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Juliana Marília Berretta
- Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | | | - Sandro Soares de Almeida
- Department of Biophysics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Elizabeth Suchi Chen
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
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Khezrian M, Waymont JMJ, Myint PK, McNeil CJ, Whalley LJ, Staff R, Murray AD. Aspirin moderates the association between cardiovascular risk, brain white matter hyperintensity total lesion volume and processing speed in normal ageing. Maturitas 2020; 133:49-53. [PMID: 32005423 DOI: 10.1016/j.maturitas.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/09/2019] [Accepted: 01/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Cardiovascular risk is associated with cognitive decline and this effect is attributed to brain pathology, including white matter hyperintensity (WMH) burden. Low-dose aspirin is frequently recommended for reducing vascular events. We investigated the effect of taking aspirin on the association between cardiovascular risk, WMH burden and cognitive function. STUDY DESIGN The study sample was drawn from 318 dementia-free adults aged 67-71 years. Brain magnetic resonance imaging (MRI) scans were acquired from 239 participants. MAIN OUTCOME MEASURES WMH total lesion volumes (TLV) were extracted using the automated lesion segmentation algorithm. We measured cardiovascular risk by calculating ASSIGN score. Cognitive ability was measured using a test of processing speed. We developed structural equation models to test our hypothesis. RESULTS Sixty-eight participants (47.1 % male, mean age = 68.8 years) reported that they took aspirin. The demographic measures did not differ significantly by aspirin use. Among aspirin users, there was a strong negative association between WMH TLV and cognition (β = -0.43, p-value < 0.001), while in non-users of aspirin the only significant predictor of poorer cognition was cardiovascular risk (β = -0.17, p-value = 0.001). CONCLUSIONS Aspirin use moderates the negative effect of WMH burden on cognition. Considering WMH burden in addition to cardiovascular risk could improve the prediction of cognitive decline in older adults with aspirin use.
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Affiliation(s)
- Mina Khezrian
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
| | - Jennifer M J Waymont
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Phyo K Myint
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Christopher J McNeil
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Lawrence J Whalley
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Roger Staff
- Aberdeen Royal Infirmary, NHS Grampian, Foresterhill, Aberdeen, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
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Walhovd KB, Howell GR, Ritchie SJ, Staff RT, Cotman CW. What are the earlier life contributions to reserve and resilience? Neurobiol Aging 2019; 83:135-139. [PMID: 31307838 DOI: 10.1016/j.neurobiolaging.2019.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/30/2022]
Abstract
The brain's structures and functions arise from a combination of developmental processes and interaction with environmental experiences, beginning in utero and continuing throughout the lifespan. Broadly, the process that we think of as "successful aging" likely has its foundation in early life and is continuously shaped as life experiences are programmed into the brain in response to a changing environment. Thus, individual lifestyle choices and interventions aimed at increasing cognitive reserve and resilience could change the course of cognitive aging. To determine the relative efficacy of these approaches, we will need to understand how the timing of these interventions (e.g., age, duration, frequency) influences cognitive capacity through the lifespan. Although analysis of age-related changes in cognitive function reveals a general decline at the population level, it has become clear that there is great individual variance in the extent to which cognitive function changes with advanced age. The factors responsible for the individual differences in cognitive decline are unclear, but uncovering them with new analytical tools, epigenetic approaches, and subpopulation studies will provide a roadmap toward enhancing reserve and resilience in the population at large and preserving cognitive function in a greater number of aging individuals.
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Affiliation(s)
- Kristine B Walhovd
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | | | - Stuart J Ritchie
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Roger T Staff
- Aberdeen Royal Infirmary, NHS Grampian, Scotland, UK
| | - Carl W Cotman
- Institute for Brain Aging and Dementia, University of California, Irvine, CA, USA.
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Guàrdia-Olmos J, Peró-Cebollero M, Gudayol-Ferré E. Meta-Analysis of the Structural Equation Models' Parameters for the Estimation of Brain Connectivity with fMRI. Front Behav Neurosci 2018; 12:19. [PMID: 29497368 PMCID: PMC5818469 DOI: 10.3389/fnbeh.2018.00019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 01/22/2018] [Indexed: 11/26/2022] Open
Abstract
Structural Equation Models (SEM) is among of the most extensively applied statistical techniques in the study of human behavior in the fields of Neuroscience and Cognitive Neuroscience. This paper reviews the application of SEM to estimate functional and effective connectivity models in work published since 2001. The articles analyzed were compiled from Journal Citation Reports, PsycInfo, Pubmed, and Scopus, after searching with the following keywords: fMRI, SEMs, and Connectivity. Results: A 100 papers were found, of which 25 were rejected due to a lack of sufficient data on basic aspects of the construction of SEM. The other 75 were included and contained a total of 160 models to analyze, since most papers included more than one model. The analysis of the explained variance (R2) of each model yields an effect of the type of design used, the type of population studied, the type of study, the existence of recursive effects in the model, and the number of paths defined in the model. Along with these comments, a series of recommendations are included for the use of SEM to estimate of functional and effective connectivity models.
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Affiliation(s)
- Joan Guàrdia-Olmos
- Department of Social Psychology and Quantitative Psychology, School of Psychology, Institute of Neuroscience, Institute of Complexity, University of Barcelona, Barcelona, Spain
| | - Maribel Peró-Cebollero
- Department of Social Psychology and Quantitative Psychology, School of Psychology, Institute of Neuroscience, Institute of Complexity, University of Barcelona, Barcelona, Spain
| | - Esteve Gudayol-Ferré
- School of Psychology, Universidad Michoacana de San Nicolás de Hidalgo de Morelia, Morelia, Mexico
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McNeil CJ, Myint PK, Sandu AL, Potter JF, Staff R, Whalley LJ, Murray AD. Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing. Age Ageing 2018; 47:95-100. [PMID: 29106439 DOI: 10.1093/ageing/afx102] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/12/2017] [Indexed: 11/12/2022] Open
Abstract
Background hypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer's disease pathology. Objective to examine relationships between blood pressure (BP) components and brain pathology in older adults. Subjects two hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years. Methods BP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships. Results higher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = -0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = -0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011). Conclusion increased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer's diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.
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Affiliation(s)
- Christopher J McNeil
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Phyo Kyaw Myint
- AGEING: Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Medicine for the Elderly, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - John F Potter
- Norwich Medical School, Norwich Research Park Cardiovascular Research Group, University of East Anglia, Norwich, UK
| | - Roger Staff
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
- NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Lawrence J Whalley
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
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Compensatory functional reorganization may precede hypertension-related brain damage and cognitive decline: a functional magnetic resonance imaging study. J Hypertens 2017; 35:1252-1262. [PMID: 28169883 PMCID: PMC5404398 DOI: 10.1097/hjh.0000000000001293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Supplemental Digital Content is available in the text Objectives: Our study aimed at exploring structural and functional differences in the brain during higher cognitive processing between middle-aged hypertensive patients and controls matched for sex, age and years of education. Methods: Two groups of 20 patients took part in MRI examinations. This article reports the results of functional MRI during a Stroop color interference task and structural evaluations based on a modified Fazekas scale. Results: No intergroup differences were found in regards to the severity of white matter lesions (Mann–Whitney U test = 150.5, P > 0.1), nor from the task performance in the scanner (t(35) = 0.2, P > 0.1). However, brain activation patterns between patients and controls varied. Hypertensive patients involved significantly more cerebral areas during the processing, regardless of the task difficulty. Differences were found in 26 diverse regions of both primary and associative cortices (with a peak voxel located in the cuneus, Z = 6.94, P < 0.05 family-wise error corrected at voxel level). Conclusion: Our findings provide an insight into the brain mechanisms related to essential hypertension and suggest a functional reorganization (neuroplasticity) early in the course of the disease.
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12
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Cerebral Venous Collagen Remodeling in a Modified White Matter Lesions Animal Model. Neuroscience 2017; 367:72-84. [PMID: 29111361 DOI: 10.1016/j.neuroscience.2017.10.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 01/12/2023]
Abstract
To mimic the expected pathological changes of white matter lesions (WMLs) and increase the stability, we applied modified two-vessel occlusion (modified 2VO) (1-week interval bilateral carotid artery occlusion) in stroke-prone renovascular hypertensive rats (RHRSP) and established a modified WMLs model (RHRSP/modified 2VO) that compared their phenotypes with RHRSP and sham-operated rats. In addition, we tried to differentiate small veins from small arteries through the presence of smooth muscle to study the pathological changes of small veins detailed in the model. RHRSP/modified 2VO rats showed higher stability and more extensive white matter damage without an obvious increase in mortality rate at 12 weeks after the modified 2VO operation compared to RHRSP rats. RHRSP/modified 2VO rats showed more severe small venous collagen deposition than RHRSP rats, and the majority of the deposition was collagen I and IV rather than collagen III. In addition, RHRSP/modified 2VO rats possessed cognitive impairment, mild wall thickness and blood-brain barrier disruption. Our findings suggest that the modified WMLs model (RHRSP/modified 2VO) mimics cognitive impairment and small vessel pathological changes similar to WMLs in humans. Differentiating small veins from small arteries through smooth muscle is feasible, and marked small venous deposition may play an important role in the hypertensive white matter lesions.
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Peng Y, Li S, Zhuang Y, Liu X, Wu L, Gong H, Liu D, Zhou F. Density abnormalities in normal-appearing gray matter in the middle-aged brain with white matter hyperintense lesions: a DARTEL-enhanced voxel-based morphometry study. Clin Interv Aging 2016; 11:615-22. [PMID: 27274211 PMCID: PMC4869624 DOI: 10.2147/cia.s98409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background and purpose Little is known about the structural alterations within gray matter (GM) in middle-aged subjects with white matter hyperintense (WMH) lesions. Here, we aimed to examine the anatomical changes within the GM and their relationship to WMH lesion loads in middle-aged subjects. Participants and methods Twenty-three middle-aged subjects with WMH lesions (WMH group) and 23 demographically matched healthy control subjects participated in the study. A Diffeomorphic Anatomical Registration Through Exponentiated Liealgebra-enhanced voxel-based morphometry was used to measure the GM density, and the correlations between WMH lesion volume and extracted GM values in abnormal regions were identified by voxel-based morphometry analysis. Results Compared with the healthy control subjects, the WMH group had a significantly decreased GM density in the left middle frontal gyrus, bilateral anterior cingulate cortex, left and right premotor cortex, and left and right middle cingulate cortex and an increased GM density in the bilateral cerebellum anterior lobe, left middle temporal gyrus, right temporoparietal junction, left and right prefrontal cortex (PFC), and left inferior parietal lobule. A relationship was observed between the normalized WMH lesion volume and the decreased GM density, including the left middle frontal gyrus (ρ=−0.629, P=0.002), bilateral anterior cingulate cortex (ρ=−0.507, P=0.019), right middle cingulate cortex (ρ=−0.484, P=0.026), and right premotor cortex (ρ=−0.438, P=0.047). The WMH lesion loads also negatively correlated with increased GM density in the right temporoparietal junction (ρ=−0.484, P=0.026), left PFC (ρ=−0.469, P=0.032), and right PFC (ρ=−0.438, P=0.047). Conclusion We observed that lesion load-associated structural plasticity corresponds to bidirectional changes in regional GM density in the WMH group.
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Affiliation(s)
- Yan Peng
- Burn Center, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Shenhong Li
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Ying Zhuang
- Department of Oncology, The Second Hospital of Nanchang, Nanchang, Jiangxi Province, People's Republic of China
| | - Xiaojia Liu
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, People's Republic of China
| | - Lin Wu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Dewu Liu
- Burn Center, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China
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Life course socioeconomic status and the decline in information processing speed in late life. Soc Sci Med 2016; 151:130-8. [PMID: 26802369 DOI: 10.1016/j.socscimed.2016.01.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/08/2016] [Accepted: 01/11/2016] [Indexed: 11/23/2022]
Abstract
Low socio-economic status is a recognised composite measure made up of income, education and occupational social class, which is a risk factor for poor physical and mental health and late life dementia. Here, we distinguish between components of childhood socioeconomic status to explore their separate influences of childhood and adult occupational social class (OSC), childhood mental ability and education on late life cognitive ability and change trajectories. Cognitive data were collected longitudinally from a sub-sample (N = 478) of the Aberdeen 1936 birth cohort tested on up to 5 occasions between ages 63 and 78 years. Age 11 mental ability scores were available for all participants. We used longitudinal multi-level linear modelling to explore models of cognitive change that distinguished between the possible influences of parental occupation, participants' own occupation as adults, duration of formal education, childhood mental ability and the participants' own occupation. We showed that parental occupation and the participants' own occupation are independently associated with cognition in late life, but do not influence the trajectory of cognitive change. However, when models include childhood mental ability and education the influence of parental and participant occupation is no longer significant. The association in these data between parental occupation and late life cognitive variation is accounted for by childhood mental ability and duration of formal education. However, we cannot exclude the possibility that parental occupation in early life influences early life mental ability and duration of education. The trajectory of change with age is similar across all models, with none of the life course factors (education, parental and participant occupational social class and childhood ability) significantly co-varying with the trajectory of cognitive variation.
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15
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Fan Y, Lan L, Zheng L, Ji X, Lin J, Zeng J, Huang R, Sun J. Spontaneous white matter lesion in brain of stroke-prone renovascular hypertensive rats: a study from MRI, pathology and behavior. Metab Brain Dis 2015; 30:1479-86. [PMID: 26387009 DOI: 10.1007/s11011-015-9722-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
Hypertension is considered one of the most important controllable risk factors for white matter lesion (WML). Our previous work found that stroke-prone renovascular hypertensive rats (RHRSP) displayed a high rate of WML. This study aimed to investigate the WML in RHRSP from MRI, pathology and behavior. RHRSP model was established by two-kidney, two-clipmethod and kept for 20 weeks. WML was decteted by magnetic resonance imaging (MRI) and loyez staining. Cognition was tested by morris water maze (MWM). Vascular changes were observed by HE staining on brain and carotid sections. Ultrastucture of blood brain barrier (BBB) were observed by transmission electron microscope. Immunofluorescence was used to detect albumin leakage and cell proliferation. T(2)-weighted MRI scans of RHRSP displayed diffuse, confluent white-matter hyperintensities. Pathological examination of the same rat showed marked vacuoles, disappearence of myelin and nerve fibers in white matter, supporting the neuroimaging findings. Spatial learning and memory impairment were observed in RHRSP. The small arteries in brain exhibited fibrinoid necrosis, hyalinosis and vascular remodeling. BBB disruption and plasma albumin leakage into vascular wall was observed in RHRSP. Increased cell proliferation in subventricular zone was seen in RHRSP. RHRSP demonstrated spontaneous WML and cognitive impairment. Hypertensive small vessel lesions and BBB disruption might paly causative factors for the onset and development of WML. The characteristic features of WML in RHRSP suggested it a valid animal model for WML.
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Affiliation(s)
- Yuhua Fan
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China.
| | - Linfang Lan
- Department of Medicine and Therapeutics, Chinese University of Hongkong, Hongkong, China
| | - Lu Zheng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Xiaotan Ji
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jing Lin
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jinsheng Zeng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Ruxun Huang
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jian Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
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16
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Deckers K, van Boxtel MPJ, Schiepers OJG, de Vugt M, Muñoz Sánchez JL, Anstey KJ, Brayne C, Dartigues JF, Engedal K, Kivipelto M, Ritchie K, Starr JM, Yaffe K, Irving K, Verhey FRJ, Köhler S. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry 2015; 30:234-46. [PMID: 25504093 DOI: 10.1002/gps.4245] [Citation(s) in RCA: 304] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 10/17/2014] [Accepted: 11/05/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Dementia has a multifactorial etiology, but the importance of individual health and lifestyle related risk factors is often uncertain or based on few studies. The goal of this paper is to identify the major modifiable risk factors for dementia as a first step in developing an effective preventive strategy and promoting healthy late life cognitive functioning. METHODS A mixed-method approach combined findings from a systematic literature review and a Delphi consensus study. The literature search was conducted in PubMed and updated an earlier review by the United States National Institutes of Health from 2010. We reviewed the available evidence from observational epidemiological studies. The online Delphi study asked eight international experts to rank and weigh each risk factor for its importance for dementia prevention. RESULTS Out of 3127 abstracts, 291 were included in the review. There was good agreement between modifiable risk factors identified in the literature review and risk factors named spontaneously by experts. After triangulation of both methods and re-weighting by experts, strongest support was found for depression, (midlife) hypertension, physical inactivity, diabetes, (midlife) obesity, hyperlipidemia, and smoking, while more research is needed for coronary heart disease, renal dysfunction, diet, and cognitive activity. CONCLUSIONS Findings provide good support for several somatic and lifestyle factors and will be used to inform the design of a new multicenter trial into dementia prevention.
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Affiliation(s)
- Kay Deckers
- Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht, The Netherlands
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17
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Cherbuin N, Mortby ME, Janke AL, Sachdev PS, Abhayaratna WP, Anstey KJ. Blood pressure, brain structure, and cognition: opposite associations in men and women. Am J Hypertens 2015; 28:225-31. [PMID: 25159080 DOI: 10.1093/ajh/hpu120] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Research on associations between blood pressure, brain structure, and cognitive function has produced somewhat inconsistent results. In part, this may be due to differences in age ranges studied and because of sex differences in physiology and/or exposure to risk factors, which may lead to different time course or patterns in cardiovascular disease progression. The aim of this study was to investigate the impact of sex on associations between blood pressure, regional cerebral volumes, and cognitive function in older individuals. METHODS In this cohort study, brachial blood pressure was measured twice at rest in 266 community-based individuals free of dementia aged 68-73 years who had also undergone a brain scan and a neuropsychological assessment. Associations between mean blood pressure (MAP), regional brain volumes, and cognition were investigated with voxel-wise regression analyses. RESULTS Positive associations between MAP and regional volumes were detected in men, whereas negative associations were found in women. Similarly, there were sex differences in the brain-volume cognition relationship, with a positive relationship between regional brain volumes associated with MAP in men and a negative relationship in women. CONCLUSIONS In this cohort of older individuals, higher MAP was associated with larger regional volume and better cognition in men, whereas opposite findings were demonstrated in women. These effects may be due to different lifetime risk exposure or because of physiological differences between men and women. Future studies investigating the relationship between blood pressure and brain structure or cognitive function should evaluate the potential for differential sex effects.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia;
| | - Moyra E Mortby
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia
| | - Andrew L Janke
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | | | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia
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18
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Lan LF, Zheng L, Yang X, Ji XT, Fan YH, Zeng JS. Peroxisome proliferator-activated receptor-γ agonist pioglitazone ameliorates white matter lesion and cognitive impairment in hypertensive rats. CNS Neurosci Ther 2015; 21:410-6. [PMID: 25611692 DOI: 10.1111/cns.12374] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/10/2014] [Accepted: 12/06/2014] [Indexed: 12/13/2022] Open
Abstract
AIMS Cerebrovascular white matter lesion (WML) is a major subtype of cerebral small vessel disease. Clinical drugs are not available for WML. We investigated whether peroxisome proliferator-activated receptor-γ agonist pioglitazone, with properties of vascular protection and antiinflammation, exerts beneficial effect in hypertensive WML rats. METHODS Stroke-prone renovascular hypertensive rats (RHRSP) were treated with pioglitazone for 12 weeks. Morris water maze experiment was conducted to assess cognition. WML was observed by Luxol fast blue staining. Smooth muscle actin-alpha, collagen I, collagen IV, glial fibrillary acidic protein, and ionized calcium-binding adaptor molecule-1 were evaluated by immunohistochemistry. Interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) in brain and soluble intercellular adhesion molecule-1 (sICAM-1) in serum were detected. RESULTS Pioglitazone significantly attenuated WML in corpus callosum, caudate putamen, external capsule, and internal capsule. Cognitive impairment in RHRSP was ameliorated by pioglitazone. Pioglitazone attenuated arteriolar remodeling and reduced sICAM-1 level in serum. Pioglitazone decreased the proliferation of microglia and astrocyte and lowered the expression of proinflammatory cytokines IL-1β and TNF-α in the white matter. CONCLUSIONS Long-term treatment of pioglitazone has beneficial effect on hypertension-induced WML and cognition decline, which may partly through its effect on attenuation of arteriolar remodeling, endothelial activation, and brain inflammation.
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Affiliation(s)
- Lin-Fang Lan
- Department of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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19
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Narayanan L, Murray AD. What is the role of neuroimaging in dementia? A review. IMAGING 2014. [DOI: 10.1259/img.20120015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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20
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Gąsecki D, Kwarciany M, Nyka W, Narkiewicz K. Hypertension, brain damage and cognitive decline. Curr Hypertens Rep 2014; 15:547-58. [PMID: 24146223 PMCID: PMC3838597 DOI: 10.1007/s11906-013-0398-4] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Loss of cognitive function is one the most devastating manifestations of ageing and vascular disease. Cognitive decline is rapidly becoming an important cause of disability worldwide and contributes significantly to increased mortality. There is growing evidence that hypertension is the most important modifiable vascular risk factor for development and progression of both cognitive decline and dementia. High blood pressure contributes to cerebral small and large vessel disease resulting in brain damage and dementia. A decline in cerebrovascular reserve capacity and emerging degenerative vascular wall changes underlie complete and incomplete brain infarcts, haemorrhages and white matter hyperintensities. This review discusses the complexity of factors linking hypertension to brain functional and structural changes, and to cognitive decline and dementia. The evidence for possible clinical markers useful for prevention of decreased cognitive ability, as well as recent data on vascular mechanism in the pathogenesis of cognitive decline, and the role of antihypertensive therapies in long-term prevention of late-life cognitive decline will be reviewed.
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Affiliation(s)
- Dariusz Gąsecki
- Department of Neurology of Adults, Medical University of Gdańsk, Gdańsk, Poland
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21
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Murray AD, McNeil CJ, Salarirad S, Whalley LJ, Staff RT. Early life socioeconomic circumstance and late life brain hyperintensities--a population based cohort study. PLoS One 2014; 9:e88969. [PMID: 24558456 PMCID: PMC3928340 DOI: 10.1371/journal.pone.0088969] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/14/2014] [Indexed: 11/28/2022] Open
Abstract
CONTEXT There have been many reports confirming the association between lower childhood socioeconomic circumstance and cardiovascular disease but evidence for links with cerebrovascular disease is contradictory. Hyperintensities on brain magnetic resonance imaging are associated with vascular risk factors, cognitive decline, dementia and death. However, the relationship between childhood socioeconomic circumstance and these lesions is unclear. OBJECTIVE To test the hypothesis that childhood socioeconomic circumstance is associated with late life hyperintensity burden and that neither adult socioeconomic circumstance nor change in socioeconomic circumstance during life influence this effect. DESIGN Cohort study. SETTING Community. PARTICIPANTS 227 community dwelling members of the 1936 Aberdeen Birth Cohort aged 68 years, who were free from dementia. MAIN OUTCOME MEASURES Relationship between early life socioeconomic circumstance (paternal occupation) and abundance of late life brain hyperintensities. RESULTS We find significant negative correlations between childhood socioeconomic circumstance and white matter hyperintensities (ρ = -0.18, P<0.01), and periventricular hyperintensities (ρ = -0.15, P<0.05), between educational attainment and white matter hyperintensities (ρ = -0.15, P<0.05) and periventricular hyperintensities (ρ = -0.17, P<0.05), and between childhood intelligence and periventricular hyperintensities (ρ = -0.14, P<0.05). The relationship is strongest for childhood socioeconomic circumstance and regional white matter hyperintensities, where there is a step change in increased burden from paternal occupation grades equivalent to a shift from "white collar" to "blue collar" paternal occupation. Significant correlations were also found between hypertension and hyperintensity burden in all brain regions (ρ = 0.15-0.24, P<0.05). In models that include hypertension, the magnitude of the effect of childhood socioeconomic circumstance is similar to and independent from that of hypertension. CONCLUSIONS Childhood socioeconomic circumstance predicts the burden of brain white matter hyperintensities aged 68 years. The mechanism underlying this effect is unknown, but may act through fetal and/or early life programming of cerebrovascular disease. Future work to understand this vulnerability will inform strategies to reduce dementia and stroke.
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Affiliation(s)
- Alison D. Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Christopher J. McNeil
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Sima Salarirad
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Lawrence J. Whalley
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
| | - Roger T. Staff
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom
- Department of Nuclear Medicine, NHS Grampian, Aberdeen, United Kingdom
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22
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Valdés Hernández MDC, Booth T, Murray C, Gow AJ, Penke L, Morris Z, Maniega SM, Royle NA, Aribisala BS, Bastin ME, Starr JM, Deary IJ, Wardlaw JM. Brain white matter damage in aging and cognitive ability in youth and older age. Neurobiol Aging 2013; 34:2740-7. [PMID: 23850341 PMCID: PMC3898072 DOI: 10.1016/j.neurobiolaging.2013.05.032] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 05/23/2013] [Accepted: 05/30/2013] [Indexed: 11/14/2022]
Abstract
Cerebral white matter hyperintensities (WMH) reflect accumulating white matter damage with aging and impair cognition. The role of childhood intelligence is rarely considered in associations between cognitive impairment and WMH. We studied community-dwelling older people all born in 1936, in whom IQ had been assessed at age 11 years. We assessed medical histories, current cognitive ability and quantified WMH on MR imaging. Among 634 participants, mean age 72.7 (SD 0.7), age 11 IQ was the strongest predictor of late life cognitive ability. After accounting for age 11 IQ, greater WMH load was significantly associated with lower late life general cognitive ability (β = −0.14, p < 0.01) and processing speed (β = −0.19, p < 0.001). WMH were also associated independently with lower age 11 IQ (β = −0.08, p < 0.05) and hypertension. In conclusion, having more WMH is significantly associated with lower cognitive ability, after accounting for prior ability, age 11IQ. Early-life IQ also influenced WMH in later life. Determining how lower IQ in youth leads to increasing brain damage with aging is important for future successful cognitive aging.
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Affiliation(s)
- Maria Del C Valdés Hernández
- Brain Research Imaging Centre, Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
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Abstract
Brain imaging has progressed from exclusion of rare treatable mass lesions to a specific antemortem diagnosis. MR imaging-derived hippocampal atrophy and WMH are regarded as imaging biomarkers of AD and CVD respectively. Abnormal FP-CIT SPECT or cardiac iodobenzamide SPECT is a useful supportive imaging feature in the diagnosis of DLB. Frontal and/or anterior temporal atrophy and anterior defects on molecular imaging with FDG-PET or perfusion SPECT are characteristic of FTDs. Whole-body FDG-PET may be helpful in patients with rapidly progressing "autoimmune dementias," and FLAIR and DWI are indicated in suspected CJD. A major role of imaging is in the development of new drugs and less costly biomarkers.
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Affiliation(s)
- A D Murray
- Aberdeen Biomedical Imaging Centre, Division of Applied Medicine, University of Aberdeen, Aberdeen, UK.
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