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Allison EY, Al-Khazraji BK. Association of Arterial Stiffness Index and Brain Structure in the UK Biobank: A 10-Year Retrospective Analysis. Aging Dis 2024; 15:1872-1884. [PMID: 37307821 PMCID: PMC11272205 DOI: 10.14336/ad.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/19/2023] [Indexed: 06/14/2023] Open
Abstract
Arterial stiffening and changes in brain structure both occur with normal aging and can be exacerbated via acquired health conditions. While cross-sectional associations exist, the longitudinal relationship between arterial stiffness and brain structure remains unclear. In this study, we investigated 1) associations between baseline arterial stiffness index (ASI) and brain structure (global and regional grey matter volumes (GMV), white matter hyperintensities (WMH)) 10-years post-baseline (10.4±0.8 years) and 2) associations between the 10-year change in ASI from baseline and brain structure 10-years post-baseline in 650 healthy middle- to older-aged adults (53.4±7.5 years) from the UK Biobank. We observed significant associations between baseline ASI and GMV (p<0.001) and WMH (p=0.0036) 10-years post-baseline. No significant associations between 10-year change in ASI and brain structure (global GMV p=0.24; WMH volume p=0.87) were observed. There were significant associations of baseline ASI in 2 of 60 regional brain volumes analyzed (right posterior superior temporal gyrus p=0.001; left superior lateral occipital cortex p<0.001). Strong associations with baseline ASI, but not changes in ASI over 10-years, suggest arterial stiffness at the entry point of older adulthood is more impactful on brain structure 10-years later compared to age-related stiffening. Based on these associations, we suggest clinical monitoring and potential intervention for reducing arterial stiffness should occur in midlife to reduce vascular contributions to structural changes in the brain, supporting a healthy trajectory of brain aging. Our findings also support use of ASI as a surrogate for gold standard measures in showing overall relationships between arterial stiffness and brain structure.
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Affiliation(s)
- Elric Y Allison
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Baraa K Al-Khazraji
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
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Durazzo TC, Kraybill EP, Stephens LH, May AC, Meyerhoff DJ. Pro-atherogenic medical conditions are associated with widespread regional brain metabolite abnormalities in those with alcohol use disorder. Alcohol Alcohol 2024; 59:agae055. [PMID: 39127890 DOI: 10.1093/alcalc/agae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/24/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
AIMS Widespread brain metabolite abnormalities in those with alcohol use disorder (AUD) were reported in numerous studies, but the effects of the pro-atherogenic conditions of hypertension, type 2 diabetes mellitus, hepatitis C seropositivity, and hyperlipidemia on metabolite levels were not considered. These conditions were associated with brain metabolite abnormalities in those without AUD. We predicted treatment-seeking individuals with AUD and pro-atherogenic conditions (Atherogenic+) demonstrate lower regional metabolite markers of neuronal viability [N-acetylaspartate (NAA)] and cell membrane turnover/synthesis [choline-containing compounds (Cho)], compared with those with AUD without pro-atherogenic conditions (Atherogenic-) and healthy controls (CON). METHODS Atherogenic+ (n = 59) and Atherogenic- (n = 51) and CON (n = 49) completed a 1.5 T proton magnetic resonance spectroscopic imaging study. Groups were compared on NAA, Cho, total creatine, and myoinositol in cortical gray matter (GM), white matter (WM), and select subcortical regions. RESULTS Atherogenic+ had lower frontal GM and temporal WM NAA than CON. Atherogenic+ showed lower parietal GM, frontal, parietal and occipital WM and lenticular nuclei NAA level than Atherogenic- and CON. Atherogenic- showed lower frontal GM and WM NAA than CON. Atherogenic+ had lower Cho level than CON in the frontal GM, parietal WM, and thalamus. Atherogenic+ showed lower frontal WM and cerebellar vermis Cho than Atherogenic- and CON. CONCLUSIONS Findings suggest proatherogenic conditions in those with AUD were associated with increased compromise of neuronal integrity and cell membrane turnover/synthesis. The greater metabolite abnormalities observed in Atherogenic+ may relate to increased oxidative stress-related compromise of neuronal and glial cell structure and/or impaired arterial vasoreactivity/lumen viability.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - Eric P Kraybill
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
| | - Lauren H Stephens
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - April C May
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, 3801 Miranda Ave. (151Y), Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, 4150 Clement St. (114M) San Francisco, CA 94121, United States
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus St., San Francisco, CA 94143, United States
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Del Mauro G, Wang Z. Associations of Brain Entropy Estimated by Resting State fMRI With Physiological Indices, Body Mass Index, and Cognition. J Magn Reson Imaging 2024; 59:1697-1707. [PMID: 37578314 PMCID: PMC10864678 DOI: 10.1002/jmri.28948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND In recent years, resting-state fMRI (rsfMRI)-based brain entropy (BEN) has gained increasing interest as a tool to characterize brain activity. While previous studies indicate that BEN is correlated with cognition, it remains unclear whether BEN is influenced by other factors that typically affect brain activity measured by fMRI. PURPOSE To investigate the relationship between BEN and physiological indices, including respiratory rate (RR), heart rate (HR), systolic blood pressure (s-BP), and body mass index (BMI), and to investigate whether and to what extent the relationship between BEN and cognition is influenced by physiological variables. STUDY TYPE Retrospective. SUBJECTS One thousand two hundred six healthy subjects (mean age: 28.83 ± 3.69 years; 550 male) with rsfMRI datasets selected from the Human Connectome Project (HCP). FIELD STRENGTH/SEQUENCE Multiband echo planar imaging (EPI) sequence at 3.0 Tesla. ASSESSMENT Neurocognitive, physical health (RR, HR, s-BP, BMI), and rsfMRI data were retrieved from the HCP datasets. Neurocognition was measured through the total cognition composite (TCC) score provided by HCP. BEN maps were calculated from rsfMRI data. STATISTICAL TESTS Multiple regression models, pheight-family wise error (FWE) < 0.05 and pcluster-FWE < 0.05 were considered statistically significant. RESULTS BEN was negatively associated with RR (T-thresholds ranging from 4.75 to 4.8; r-threshold = |0.15|) and positively associated with s-BP and BMI (T-thresholds ranging from 4.75 to 4.8; r-threshold = |0.15|) in areas overlapping with the default mode network. After controlling the physiological effects, BEN still showed regional associations with TCC, including negative associations (T-thresholds = 3.09; r-threshold = |0.1|) in the fronto-parietal cortex and positive associations (T-thresholds = 3.09; r-threshold = |0.1|) in the sensorimotor system (motor network and the limbic system). DATA CONCLUSIONS RR negatively affects rsfMRI-derived BEN, while s-BP and BMI positively affect BEN. The positive associations between BEN and cognition in the motor network and the limbic system might indicate a facilitation of information processing in the sensorimotor system. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Gianpaolo Del Mauro
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Ye Z, Zeng Q, Ning L, Huang W, Su Q. Systolic blood pressure is associated with abnormal alterations in brain cortical structure: Evidence from a Mendelian randomization study. Eur J Intern Med 2024; 120:92-98. [PMID: 37852841 DOI: 10.1016/j.ejim.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/09/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Hypertension has been recognized as a significant risk factor for cerebrovascular diseases and cognitive decline. However, the specific impact of hypertension, systolic/diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) on brain cortical structure remains unclear. Mendelian randomization (MR) provides a robust approach to investigate the causal relationship between blood pressure components and brain cortical changes. METHODS In this MR study, data from large-scale genome-wide association studies for blood pressure components and neuroimaging were utilized to conduct our analyses. We leveraged genetic variants associated specifically with hypertension (122,620 cases and 332,683 controls), systolic (469,767 individuals), diastolic (490,469 individuals) blood pressure, PP (810,865 individuals) and MAP (over 1 million individuals) to evaluate their effects on brain cortex surficial area (51,665 individuals) and cortex thickness (51,665 individuals). RESULTS Our findings revealed a significant correlation between systolic blood pressure and abnormal reduction in brain cortex surficial area (β=-1330.69, 95% confident interval [CI]: -2655.35 to -6.02, p = 0.0489); however, no significant relationship was found between systolic blood pressure and brain cortex thickness (β=-0.0078, 95% CI: -0.0178 to 0.0022, p = 0.1287). Additionally, no significant associations were observed between hypertension (β=-200.05, p = 0.6884; β=-0.0051, p = 0.1179, respectively), diastolic blood pressure (β=-460.63, p = 0.5160; β=0.0047, p = 0.2448, respectively), PP (β=1041.84, p = 0.3725; β=-0.0112, p = 0.2212, respectively), MAP (β=-18.84, p = 0.8841; β=0.0002, p = 0.7654, respectively) and both brain cortex surficial area and brain cortex thickness. CONCLUSION Our MR study provides evidence supporting the hypothesis that systolic blood pressure, rather than diastolic blood pressure, PP or MAP, is associated with abnormal changes in brain cortical structure.
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Affiliation(s)
- Ziliang Ye
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Qing Zeng
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Limeng Ning
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Wanzhong Huang
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Qiang Su
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China.
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Durazzo TC, Stephens LH, Meyerhoff DJ. Regional cortical thickness recovery with extended abstinence after treatment in those with alcohol use disorder. Alcohol 2024; 114:51-60. [PMID: 37657667 PMCID: PMC10902196 DOI: 10.1016/j.alcohol.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/31/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
Several cross-sectional investigations reported widespread cortical thinning in those with alcohol use disorder (AUD). The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety. Consequently, cortical thickness changes during extended abstinence in those with AUD is unclear. In this study, AUD participants were studied at approximately 1 week (n = 68), 1 month (n = 88), and 7.3 months (n = 40) of abstinence. Forty-five never-smoking controls (CON) completed a baseline study, and 15 were reassessed after approximately 9.6 months. Participants completed magnetic resonance imaging studies at 1.5T, and cortical thickness for 34 bilateral regions of interest (ROI) was quantitated with FreeSurfer. AUD participants demonstrated significant linear thickness increases in 25/34 ROI over 7.3 months of abstinence. The rate of change from 1 week to 1 month was greater than 1 month to 7.3 months in 19/34 ROIs. Proatherogenic conditions were associated with lower thickness recovery in anterior frontal, inferior parietal, and lateral/mesial temporal regions. After 7.3 months of abstinence, AUD participants were statistically equivalent to CON on cortical thickness in 24/34 ROIs; the cortical thickness differences between AUD and CON in the banks superior temporal gyrus, post central, posterior cingulate, superior parietal, supramarginal, and superior frontal cortices were driven by thinner cortices in AUD with proatherogenic conditions relative to CON. In actively smoking AUD, increasing pack-years was associated with decreasing thickness recovery primarily in the anterior frontal ROIs. Widespread bilateral cortical thickness recovery over 7.3 months of abstinence was the central finding for this AUD cohort. The longitudinal and cross-sectional findings for AUD with proatherogenic suggests alterations in perfusion or vascular integrity may relate to structural recovery in those with AUD. These results support the adaptive and beneficial effects of sustained sobriety on brain structural recovery in people with AUD.
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Affiliation(s)
- Timothy C Durazzo
- Sierra-Pacific Mental Illness Research and Education Clinical Centers, Veterans Administration Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Lauren H Stephens
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco Veterans Administration Medical Center, San Francisco, CA, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States
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Norling AM, Gerstenecker A, Bolding MS, Hoef LV, Buford T, Walden R, An H, Ying C, Myers T, Jones BS, Del Bene V, Lazar RM. Effects of a brief HIIT intervention on cognitive performance in older women. GeroScience 2024; 46:1371-1384. [PMID: 37581755 PMCID: PMC10828265 DOI: 10.1007/s11357-023-00893-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023] Open
Abstract
Cardiorespiratory fitness (CRF) mitigates age-related decline in cognition and brain volume. Little is known, however, about the effects of high-intensity interval training (HIIT) on cognitive aging and the relationship between HIIT, cognition, hippocampal subfield volumes, and cerebral oxygen extraction fraction (OEF). Older sedentary women participated in an 8-week HIIT intervention. We conducted cognitive assessments, fitness assessments (VO2max), MRI scans: asymmetric spin echo oxygen extraction fraction (ASE-OEF), high-resolution multiple image co-registration and averaging (HR-MICRA) imaging, and transcranial Doppler ultrasonography before and after the intervention. VO2max increased from baseline (M = 19.36, SD = 2.84) to follow-up (M = 23.25, SD = 3.61), Z = - 2.93, p < .001, r = 0.63. Composite cognitive (Z = - 2.05, p = 0.041), language (Z = - 2.19, p = 0.028), and visuospatial memory (Z = - 2.22, p = 0.026), z-scores increased significantly. Hippocampal subfield volumes CA1 and CA3 dentate gyrus and subiculum decreased non-significantly (all p > 0.05); whereas a significant decrease in CA2 (Z = - 2.045, p = 0.041, r = 0.436) from baseline (M = 29.51; SD = 24.50) to follow-up (M = 24.50; SD = 13.38) was observed. Right hemisphere gray matter was correlated with language z-scores (p = 0.025; r = 0.679). The subiculum was correlated with attention (p = 0.047; r = 0.618) and verbal memory (p = 0.020; r = 0.700). The OEF and CBF were unchanged at follow-up (all p > .05). Although we observed cognitive improvements following 8 weeks of our HIIT intervention, they were not explained by hippocampal, OEF, or CBF changes.
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Affiliation(s)
- Amani M Norling
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA.
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mark S Bolding
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lawrence Ver Hoef
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
| | - Thomas Buford
- Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Randall Walden
- School of Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hongyu An
- Mallinckrodt Institute of Radiology, Washington University of Medicine in St. Louis, St. Louis, MO, USA
| | - Chunwei Ying
- Mallinckrodt Institute of Radiology, Washington University of Medicine in St. Louis, St. Louis, MO, USA
| | - Terina Myers
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Benjamin S Jones
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
| | - Victor Del Bene
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald M Lazar
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
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Woodward OB, Driver I, Hart E, Wise R. In search of a marker of altered cerebrovascular function in hypertension: Analysis of the fractional amplitude of low-frequency fluctuations in UK Biobank resting state fMRI data. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 6:100196. [PMID: 38179182 PMCID: PMC10765253 DOI: 10.1016/j.cccb.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/07/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
The selfish brain mechanism proposes that in some patients with impaired cerebral blood flow (CBF) or cerebrovascular function, hypertension may develop as a compensatory mechanism that aims to maintain CBF by increasing systemic blood pressure through an increase in cardiovascular sympathetic tone. The amplitude of low frequency fluctuations (ALFF) in the resting state blood oxygenation level dependent (BOLD) functional MRI signal has been previously posited as an index of cerebrovascular reactivity. We investigated whether regional fractional ALFF (fALFF) differs between 2054 hypertensives and 1724 normotensives using data from the UK Biobank dataset. Our primary hypothesis was that cerebrovascular function in the medulla and other regions involved in sympathetic regulation differs between hypertensives and normotensives, and that this is reflected by regional variations in fALFF. There is a significant regional variation in fALFF (F(14) =1126.17, p < 2 × 10-16, partial η2 = 0.22), but this regional variation does not differ between hypertensives and normotensives (F(14) = 0.23, p = 0.99, partial η2 = 8 × 10-5). Prospective longitudinal studies of cerebral haemodynamics in hypertensives and normotensives are required to further investigate the selfish brain mechanism.
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Affiliation(s)
| | - Ian Driver
- Cardiff University Brain Research Imaging Centre, Cardiff, Wales, United Kingdom
| | - Emma Hart
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, United Kingdom
| | - Richard Wise
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
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8
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Luckhoff HK, du Plessis S, Leigh van den H, Emsley R, Seedat S. Independent effects of posttraumatic stress disorder diagnosis and metabolic syndrome status on prefrontal cortical thickness and subcortical gray matter volumes. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:64-74. [PMID: 37497602 PMCID: PMC10375918 DOI: 10.1080/19585969.2023.2237525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/05/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION Posttraumatic stress disorder (PTSD) and metabolic syndrome (MetS) are associated with overlapping brain structural differences. These often involve brain structures involved in the regulation of appetite, food intake, satiety, and reward processing. We examined the individual and interactive effects of PTSD diagnosis and MetS on cortical thickness and subcortical gray matter volumes in patients with PTSD (n = 104) compared to trauma-exposed controls (n = 97). METHODS Multivariate models were constructed for FreeSurfer-generated prefrontal cortical thickness and subcortical gray matter regions-of-interest (ROIs) to explore the effects of PTSD diagnosis and MetS as predictors, adjusting for relevant socio-demographic and clinical covariates. Individual prefrontal cortical and subcortical limbic ROIs were also selected based on a priori evidence of their involvement in both PTSD and MetS. RESULTS The mean age of the sample (n = 201; 78% female) was 41.6 (SD, 13.1) years. PTSD and MetS status showed independent associations with prefrontal cortical thickness and subcortical gray matter volumes across multiple ROIs, adjusting for age, sex, scanner sequence, alcohol, and tobacco use. CONCLUSIONS PTSD and MetS are independently associated with brain structural differences, including thinner prefrontal cortical thickness and smaller subcortical gray matter volumes, across multiple ROIs implicated in the hedonic and homeostatic regulation of food intake.
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Affiliation(s)
- Hilmar Klaus Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Stefan du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Heuvel Leigh van den
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- SAMRC Genomics and Brain Disorders Unit, Department of Psychiatry. Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robin Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Franco R, Serrano-Marín J, Navarro G, Rivas-Santisteban R. The NADPH Link between the Renin Angiotensin System and the Antioxidant Mechanisms in Dopaminergic Neurons. Antioxidants (Basel) 2023; 12:1869. [PMID: 37891948 PMCID: PMC10604245 DOI: 10.3390/antiox12101869] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
The renin angiotensin system (RAS) has several components including signaling peptides, enzymes, and membrane receptors. The effort in characterizing this system in the periphery has led to the approval of a class of antihypertensives. Much less is known about RAS in the central nervous system. The production of RAS peptides and the expression of several RAS enzymes and receptors in dopaminergic neurons of the substantia nigra has raised expectations in the therapy of Parkinson's disease, a neurodegenerative condition characterized by lack of dopamine in the striatum, the motor control region of the mammalian brain. On the one hand, dopamine production requires reducing power. On the other hand, reducing power is required by mechanisms involved in REDOX homeostasis. This review focuses on the potential role of RAS in the regulation of neuronal/glial expression of glucose-6-phosphate dehydrogenase, which produces the NADPH required for dopamine synthesis and for reactive oxygen species (ROS) detoxification. It is known that transgenic expression of the gene coding for glucose-6-phosphate dehydrogenase prevents the death of dopaminergic nigral neurons. Signaling via angiotensin II G protein-coupled receptors, AT1 or AT2, leads to the activation of protein kinase A and/or protein kinase C that in turn can regulate glucose-6- phosphate dehydrogenase activity, by Ser/Thr phosphorylation/dephosphorylation events. Long-term effects of AT1 or AT2 receptor activation may also impact on the concentration of the enzyme via activation of transcription factors that participate in the regulation of gene expression in neurons (or glia). Future research is needed to determine how the system can be pharmacologically manipulated to increase the availability of NADPH to neurons degenerating in Parkinson's disease and to neuroprotective glia.
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Affiliation(s)
- Rafael Franco
- Department of Biochemistry and Molecular Biomedicine, School of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
- CiberNed, Network Center for Neurodegenerative Diseases, Spanish National Health Institute Carlos III, 28029 Madrid, Spain;
- School of Chemistry, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Joan Serrano-Marín
- Department of Biochemistry and Molecular Biomedicine, School of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Gemma Navarro
- CiberNed, Network Center for Neurodegenerative Diseases, Spanish National Health Institute Carlos III, 28029 Madrid, Spain;
- Department of Biochemistry and Physiology, School of Pharmacy and Food Science, Universitat de Barcelona, 08028 Barcelona, Spain
- Institute of Neurosciences, Universitat de Barcelona, 08007 Barcelona, Spain
| | - Rafael Rivas-Santisteban
- CiberNed, Network Center for Neurodegenerative Diseases, Spanish National Health Institute Carlos III, 28029 Madrid, Spain;
- Campus Bellaterra, Autonomous University of Barcelona, Cerdanyola del Vallés, 08193 Barcelona, Spain
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Truter N, Malan L, Essop MF. Glial cell activity in cardiovascular diseases and risk of acute myocardial infarction. Am J Physiol Heart Circ Physiol 2023; 324:H373-H390. [PMID: 36662577 DOI: 10.1152/ajpheart.00332.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Growing evidence indicates that the pathophysiological link between the brain and heart underlies cardiovascular diseases, specifically acute myocardial infarction (AMI). Astrocytes are the most abundant glial cells in the central nervous system and provide support/protection for neurons. Astrocytes and peripheral glial cells are emerging as key modulators of the brain-heart axis in AMI, by affecting sympathetic nervous system activity (centrally and peripherally). This review, therefore, aimed to gain an improved understanding of glial cell activity and AMI risk. This includes discussions on the potential role of contributing factors in AMI risk, i.e., autonomic nervous system dysfunction, glial-neurotrophic and ischemic risk markers [glial cell line-derived neurotrophic factor (GDNF), astrocytic S100 calcium-binding protein B (S100B), silent myocardial ischemia, and cardiac troponin T (cTnT)]. Consideration of glial cell activity and related contributing factors in certain brain-heart disorders, namely, blood-brain barrier dysfunction, myocardial ischemia, and chronic psychological stress, may improve our understanding regarding the pathological role that glial dysfunction can play in the development/onset of AMI. Here, findings demonstrated perturbations in glial cell activity and contributing factors (especially sympathetic activity). Moreover, emerging AMI risk included sympathovagal imbalance, low GDNF levels reflecting prothrombic risk, hypertension, and increased ischemia due to perfusion deficits (indicated by S100B and cTnT levels). Such perturbations impacted blood-barrier function and perfusion that were exacerbated during psychological stress. Thus, greater insights and consideration regarding such biomarkers may help drive future studies investigating brain-heart axis pathologies to gain a deeper understanding of astrocytic glial cell contributions and unlock potential novel therapies for AMI.
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Affiliation(s)
- Nina Truter
- Centre for Cardio-metabolic Research in Africa, Department of Physiological Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leoné Malan
- Technology Transfer and Innovation-Support Office, North-West University, Potchefstroom, South Africa
| | - M Faadiel Essop
- Centre for Cardio-metabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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11
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Rashid T, Li K, Toledo JB, Nasrallah I, Pajewski NM, Dolui S, Detre J, Wolk DA, Liu H, Heckbert SR, Bryan RN, Williamson J, Davatzikos C, Seshadri S, Launer LJ, Habes M. Association of Intensive vs Standard Blood Pressure Control With Regional Changes in Cerebral Small Vessel Disease Biomarkers: Post Hoc Secondary Analysis of the SPRINT MIND Randomized Clinical Trial. JAMA Netw Open 2023; 6:e231055. [PMID: 36857053 PMCID: PMC9978954 DOI: 10.1001/jamanetworkopen.2023.1055] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
IMPORTANCE Little is known about the associations of strict blood pressure (BP) control with microstructural changes in small vessel disease markers. OBJECTIVE To investigate the regional associations of intensive vs standard BP control with small vessel disease biomarkers, such as white matter lesions (WMLs), fractional anisotropy (FA), mean diffusivity (MD), and cerebral blood flow (CBF). DESIGN, SETTING, AND PARTICIPANTS The Systolic Blood Pressure Intervention Trial (SPRINT) is a multicenter randomized clinical trial that compared intensive systolic BP (SBP) control (SBP target <120 mm Hg) vs standard control (SBP target <140 mm Hg) among participants aged 50 years or older with hypertension and without diabetes or a history of stroke. The study began randomization on November 8, 2010, and stopped July 1, 2016, with a follow-up duration of approximately 4 years. A total of 670 and 458 participants completed brain magnetic resonance imaging at baseline and follow-up, respectively, and comprise the cohort for this post hoc analysis. Statistical analyses for this post hoc analysis were performed between August 2020 and October 2022. INTERVENTIONS At baseline, 355 participants received intensive SBP treatment and 315 participants received standard SBP treatment. MAIN OUTCOMES AND MEASURES The main outcomes were regional changes in WMLs, FA, MD (in white matter regions of interest), and CBF (in gray matter regions of interest). RESULTS At baseline, 355 participants (mean [SD] age, 67.7 [8.0] years; 200 men [56.3%]) received intensive BP treatment and 315 participants (mean [SD] age, 67.0 [8.4] years; 199 men [63.2%]) received standard BP treatment. Intensive treatment was associated with smaller mean increases in WML volume compared with standard treatment (644.5 mm3 vs 1258.1 mm3). The smaller mean increases were observed specifically in the deep white matter regions of the left anterior corona radiata (intensive treatment, 30.3 mm3 [95% CI, 16.0-44.5 mm3]; standard treatment, 80.5 mm3 [95% CI, 53.8-107.2 mm3]), left tapetum (intensive treatment, 11.8 mm3 [95% CI, 4.4-19.2 mm3]; standard treatment, 27.2 mm3 [95% CI, 19.4-35.0 mm3]), left superior fronto-occipital fasciculus (intensive treatment, 3.2 mm3 [95% CI, 0.7-5.8 mm3]; standard treatment, 9.4 mm3 [95% CI, 5.5-13.4 mm3]), left posterior corona radiata (intensive treatment, 26.0 mm3 [95% CI, 12.9-39.1 mm3]; standard treatment, 52.3 mm3 [95% CI, 34.8-69.8 mm3]), left splenium of the corpus callosum (intensive treatment, 45.4 mm3 [95% CI, 25.1-65.7 mm3]; standard treatment, 83.0 mm3 [95% CI, 58.7-107.2 mm3]), left posterior thalamic radiation (intensive treatment, 53.0 mm3 [95% CI, 29.8-76.2 mm3]; standard treatment, 106.9 mm3 [95% CI, 73.4-140.3 mm3]), and right posterior thalamic radiation (intensive treatment, 49.5 mm3 [95% CI, 24.3-74.7 mm3]; standard treatment, 102.6 mm3 [95% CI, 71.0-134.2 mm3]). CONCLUSIONS AND RELEVANCE This study suggests that intensive BP treatment, compared with standard treatment, was associated with a slower increase of WMLs, improved diffusion tensor imaging, and FA and CBF changes in several brain regions that represent vulnerable areas that may benefit from more strict BP control. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01206062.
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Affiliation(s)
- Tanweer Rashid
- Neuroimage Analytics Laboratory and the Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
| | - Karl Li
- Neuroimage Analytics Laboratory and the Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
| | - Jon B. Toledo
- Department of Neurology, University of Florida, Gainesville
- Department of Neurology, Houston Methodist Hospital, Houston, Texas
| | - Ilya Nasrallah
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Nicholas M. Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sudipto Dolui
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
| | - John Detre
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Hangfan Liu
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | | | - R. Nick Bryan
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
| | - Jeff Williamson
- Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Christos Davatzikos
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Sudha Seshadri
- Neuroimage Analytics Laboratory and the Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
| | - Lenore J. Launer
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
| | - Mohamad Habes
- Neuroimage Analytics Laboratory and the Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
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12
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Windham BG, Griswold ME, Ranadive R, Sullivan KJ, Mosley TH, Mielke MM, Jack CR, Knopman D, Petersen R, Vemuri P. Relationships of Cerebral Perfusion With Gait Speed Across Systolic Blood Pressure Levels and Age: A Cohort Study. J Gerontol A Biol Sci Med Sci 2023; 78:514-520. [PMID: 35640170 PMCID: PMC9977228 DOI: 10.1093/gerona/glac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study aimed to examine if the association of cerebral perfusion with gait speed differs across systolic blood pressure (SBP) and age. METHODS Cerebral perfusion was measured via arterial spin labeled (ASL)-MRI among community-dwelling adults aged 31-94 years in the population-based Mayo Clinic Study of Aging. Usual gait speed was assessed over 5.6 meters on an electronic mat. Sex- and body mass index (BMI)-adjusted linear regression models estimated cross-sectional gait speed associations with ASL and modifying effects of age and SBP using 3-way and 2-way interaction terms between continuous age, SBP, and ASL. Results report estimated differences in gait speed per standard deviation (SD) lower ASL for exemplar SBPs and ages. RESULTS Among 479 participants (mean age 67.6 years; 44% women; mean gait speed 1.17 m/s), ASL relations to gait speed varied by age (ASL-x-age interaction: p = .001) and SBP (ASL-x-SBP interaction: p = .009). At an SBP of 120 mmHg, each SD lower ASL was associated with a 0.04 m/s (95% confidence interval [CI]: 0.01, 0.07) slower gait speed at 65 years, 0.07 m/s (0.04, 0.10) at 75 years, and 0.09 m/s (0.05, 0.13) at 85 years. At an SBP of 140 mmHg, ASL associations with gait speed were attenuated to 0.01 (-0.01, 0.04), 0.04 (0.02, 0.06), and 0.06 (0.04, 0.09) m/s slower gait speed at ages 65, 75, and 85, respectively. CONCLUSION Poorer cerebral perfusion is associated with clinically meaningful slower gait speeds, particularly with older age, while higher perfusion markedly attenuates age differences in gait speed.
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Affiliation(s)
- B Gwen Windham
- Address correspondence to: B. Gwen Windham, MD, MHS, Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA. E-mail:
| | - Michael E Griswold
- Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Radhikesh Ranadive
- Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kevin J Sullivan
- Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Thomas H Mosley
- Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Michelle M Mielke
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Clifford R Jack
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dave Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ron Petersen
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Prashanthi Vemuri
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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13
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Woldstad C, Rusinek H, Sweeney E, Butler T, Li Y, Tanzi E, Mardy C, Harvey P, de Leon MJ, Glodzik L. Quadratic relationship between systolic blood pressure and white matter lesions in individuals with hypertension. J Hypertens 2023; 41:35-43. [PMID: 36204999 PMCID: PMC9794123 DOI: 10.1097/hjh.0000000000003292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/07/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is a well documented relationship between cardiovascular risk factors and the development of brain injury, which can lead to cognitive dysfunction. Hypertension (HTN) is a condition increasing the risk of silent and symptomatic ischemic brain lesions. Although benefits of hypertension treatment are indisputable, the target blood pressure value where the possibility of tissue damage is most reduced remains under debate. METHOD Our group performed a cross-sectional ( n = 376) and longitudinal ( n = 188) study of individuals without dementia or stroke (60% women n = 228, age 68.5 ± 7.4 years; men n = 148, age 70.7 ± 6.9 years). Participants were split into hypertensive ( n = 169) and normotensive ( n = 207) groups. MR images were obtained on a 3T system. Linear modeling was performed in hypertensive and normotensive cohorts to investigate the relationship between systolic (SBP) and diastolic (DBP) blood pressure, white matter lesion (WML), and brain volumes. RESULTS Participants in the hypertensive cohort showed a quadratic relationship between SBP and WML, with the lowest amounts of WML being measured in participants with readings at approximately 124 mmHg. Additionally, the hypertensive cohort also exhibited a quadratic relationship between DBP and mean hippocampal volume; participants with readings at approximately 77 mmHg showing the largest volumes. Longitudinally, all groups experienced WML growth, despite different BP trajectories, further suggesting that WML expansion may occur despite or because of BP reduction in individuals with compromised vascular system. CONCLUSION Overall, our study suggests that in the hypertensive group there is a valley of mid-range blood pressures displaying less pathology in the brain.
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Affiliation(s)
| | | | - Elizabeth Sweeney
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine
| | - Tracy Butler
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Yi Li
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Emily Tanzi
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Christopher Mardy
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Patrick Harvey
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Mony J. de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
| | - Lidia Glodzik
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
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14
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Park JH, Park KI, Kim D, Lee M, Kang S, Kang SJ, Yoon DH. Improving performance robustness of subject-based brain segmentation software. ENCEPHALITIS 2023; 3:24-33. [PMID: 37469714 PMCID: PMC10295817 DOI: 10.47936/encephalitis.2022.00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 07/21/2023] Open
Abstract
Purpose Artificial intelligence (AI)-based image analysis tools to quantify the brain have become commercialized. However, insufficient data for learning and scanner specificity is a limitation for achieving high quality. In the present study, the performance of personalized brain segmentation software when applied to multicenter data using an AI model trained on data from a single institution was improved. Methods Preindicators of brain white matter (WM) information from the training dataset were utilized for preprocessing. During learning, data of cognitively normal (CN) individuals from a single center were utilized, and data of CN individuals and Alzheimer disease (AD) patients enrolled in multiple centers were considered the test set. Results The preprocessing based on the preindicator (dice similarity coefficient [DSC], 0.8567) resulted in a better performance than without (DSC, 0.7921). The standard deviation (SD) of the WM region intensity (DSC, 0.8303) had a more substantial influence on the performance than the average intensity (DSC, 0.6591). When the SD of the test data WM intensity was smaller than the learning data, the performance improved (0.03 increase in lower SD, 0.05 decrease in higher SD). Furthermore, preindicator-based pretreatment increased the correlation of mean cortical thickness of the entire gray matter between Atroscan and FreeSurfer, and data augmentation without preprocessing did not.Both preindicator processing and data augmentation improved the correlation coefficient from 0.7584 to 0.8165. Conclusion Data augmentation and preindicator-based preprocessing of training data can improve the performance of AI-based brain segmentation software, both increasing the generalizability and stability of brain segmentation software.
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Affiliation(s)
| | - Kyung-Il Park
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Division of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | | | | | | | - Seung Joo Kang
- Division of Gastroenterology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Dae Hyun Yoon
- Division of Psychiatry, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
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15
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Wan C, Zong RY, Chen XS. The new mechanism of cognitive decline induced by hypertension: High homocysteine-mediated aberrant DNA methylation. Front Cardiovasc Med 2022; 9:928701. [PMID: 36352848 PMCID: PMC9637555 DOI: 10.3389/fcvm.2022.928701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
The prevalence and severity of hypertension-induced cognitive impairment increase with the prolonging of hypertension. The mechanisms of cognitive impairment induced by hypertension primarily include cerebral blood flow perfusion imbalance, white and gray matter injury with blood–brain barrier disruption, neuroinflammation and amyloid-beta deposition, genetic polymorphisms and variants, and instability of blood pressure. High homocysteine (HHcy) is an independent risk factor for hypertension that also increases the risk of developing early cognitive impairment. Homocysteine (Hcy) levels increase in patients with cognitive impairment induced by hypertension. This review summarizes a new mechanism whereby HHcy-mediated aberrant DNA methylation and exacerbate hypertension. It involves changes in Hcy-dependent DNA methylation products, such as methionine adenosyltransferase, DNA methyltransferases, S-adenosylmethionine, S-adenosylhomocysteine, and methylenetetrahydrofolate reductase (MTHFR). The mechanism also involves DNA methylation changes in the genes of hypertension patients, such as brain-derived neurotrophic factor, apolipoprotein E4, and estrogen receptor alpha, which contribute to learning, memory, and attention deficits. Studies have shown that methionine (Met) induces hypertension in mice. Moreover, DNA hypermethylation leads to cognitive behavioral changes alongside oligodendroglial and/or myelin deficits in Met-induced mice. Taken together, these studies demonstrate that DNA methylation regulates cognitive dysfunction in patients with hypertension. A better understanding of the function and mechanism underlying the effect of Hcy-dependent DNA methylation on hypertension-induced cognitive impairment will be valuable for early diagnosis, interventions, and prevention of further cognitive defects induced by hypertension.
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Affiliation(s)
- Chong Wan
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- College of Basic Medicine, Army Medical University, Chongqing, China
| | - Rui-Yi Zong
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- NCO School, Army Medical University, Shijiazhuang, China
| | - Xing-Shu Chen
- Department of Military Medical Geography, Army Medical Training Base, Army Medical University (Third Military Medical University), Chongqing, China
- *Correspondence: Xing-Shu Chen,
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16
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Wu S, Tyler LK, Henson RN, Rowe JB, Cam-CAN, Tsvetanov KA. Cerebral blood flow predicts multiple demand network activity and fluid intelligence across the adult lifespan. Neurobiol Aging 2022; 121:1-14. [PMID: 36306687 PMCID: PMC7613814 DOI: 10.1016/j.neurobiolaging.2022.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022]
Abstract
The preservation of cognitive function in old age is a public health priority. Cerebral hypoperfusion is a hallmark of dementia but its impact on maintaining cognitive ability across the lifespan is less clear. We investigated the relationship between baseline cerebral blood flow (CBF) and blood oxygenation level-dependent (BOLD) response during a fluid reasoning task in a population-based adult lifespan cohort. As age differences in CBF could lead to non-neuronal contributions to the BOLD signal, we introduced commonality analysis to neuroimaging to dissociate performance-related CBF effects from the physiological confounding effects of CBF on the BOLD response. Accounting for CBF, we confirmed that performance- and age-related differences in BOLD responses in the multiple-demand network were implicated in fluid reasoning. Age differences in CBF explained not only performance-related BOLD responses but also performance-independent BOLD responses. Our results suggest that CBF is important for maintaining cognitive function, while its non-neuronal contributions to BOLD signals reflect an age-related confound. Maintaining perfusion into old age may serve to support brain function and preserve cognitive performance.
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Affiliation(s)
- Shuyi Wu
- Centre for Speech, Language and the Brain, Department of Psychology, University of Cambridge, Cambridge, UK,Department of Management, School of Business, Hong Kong Baptist University, Hong Kong, China
| | - Lorraine K. Tyler
- Centre for Speech, Language and the Brain, Department of Psychology, University of Cambridge, Cambridge, UK
| | - Richard N.A. Henson
- Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, Cambridge, UK
| | - James B. Rowe
- Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, Cambridge, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Cam-CAN
- Centre for Speech, Language and the Brain, Department of Psychology, University of Cambridge, Cambridge, UK,Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, Cambridge, UK
| | - Kamen A. Tsvetanov
- Centre for Speech, Language and the Brain, Department of Psychology, University of Cambridge, Cambridge, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK,Corresponding author (, +44 1223 766 556)
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17
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Kennedy KG, Grigorian A, Mitchell RHB, McCrindle BW, MacIntosh BJ, Goldstein BI. Association of blood pressure with brain structure in youth with and without bipolar disorder. J Affect Disord 2022; 299:666-674. [PMID: 34920038 DOI: 10.1016/j.jad.2021.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/25/2021] [Accepted: 12/12/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND We previously found that blood pressure (BP) is elevated, and associated with poorer neurocognition, in youth with bipolar disorder (BD). While higher BP is associated with smaller brain structure in adults, studies have not examined this topic in BD or youth. METHODS Participants were 154 youth, ages 13-20 (n = 81 BD, n = 73 HC). Structural magnetic resonance imaging and diastolic (DBP), and systolic (SBP) pressure were obtained. Region of interest (ROI; anterior cingulate cortex [ACC], insular cortex, hippocampus) and vertex-wise analyses controlling for age, sex, body-mass-index, and intracranial volume investigated BP-neurostructural associations; a group-by-BP interaction was also assessed. RESULTS In ROI analyses, higher DBP in the overall sample was associated with smaller insular cortex area (β=-0.18 p = 0.007) and was associated with smaller ACC area to a significantly greater extent in HC vs. BD (β=-0.14 p = 0.015). In vertex-wise analyses, higher DBP and SBP were associated with smaller area and volume in the insular cortex, frontal, parietal, and temporal regions in the overall sample. Additionally, higher SBP was associated with greater thickness in temporal and parietal regions. Finally, higher SBP was associated with smaller area and volume in frontal, parietal, and temporal regions to a significantly greater extent in BD vs. HC. LIMITATIONS Cross-sectional design, single assessment of BP. CONCLUSION BP is associated with brain structure in youth, with variability related to structural phenotype (volume vs. thickness) and psychiatric diagnosis (BD vs. HC). Future studies evaluating temporality of these findings, and the association of BP changes on brain structure in youth, are warranted.
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Affiliation(s)
- Kody G Kennedy
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Rm 4326, 100 stokes street Way, Toronto, ON M6J 1H4, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Rm 4326, 100 stokes street Way, Toronto, ON M6J 1H4, Canada
| | - Rachel H B Mitchell
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Brian W McCrindle
- Division of Pediatric Cardiology, Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Brain Sciences, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Rm 4326, 100 stokes street Way, Toronto, ON M6J 1H4, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada.
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18
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Villa RF, Gorini A, Ferrari F. Clonidine and Brain Mitochondrial Energy Metabolism: Pharmacodynamic Insights Beyond Receptorial Effects. Neurochem Res 2022; 47:1429-1441. [DOI: 10.1007/s11064-022-03541-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/27/2022]
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19
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Paradela RS, Ferreira NV, Nucci MP, Cabella B, Martino LM, Torres LA, Costa DID, Consolim-Colombo FM, Suemoto CK, Irigoyen MC. Relation of a Socioeconomic Index with Cognitive Function and Neuroimaging in Hypertensive Individuals. J Alzheimers Dis 2021; 82:815-826. [PMID: 34092639 DOI: 10.3233/jad-210143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Socioeconomic factors are important contributors to brain health. However, data from developing countries (where social inequalities are the most prominent) are still scarce, particularly about hypertensive individuals. OBJECTIVE To evaluate the relationship between socioeconomic index, cognitive function, and cortical brain volume, as well as determine whether white matter hyperintensities are mediators of the association of the socioeconomic index with cognitive function in hypertensive individuals. METHODS We assessed 92 hypertensive participants (mean age = 58±8.6 years, 65.2%female). Cognitive evaluation and neuroimaging were performed and clinical and sociodemographic data were collected using questionnaires. A socioeconomic index was created using education, income, occupation (manual or non-manual work), and race. The associations of the socioeconomic index with cognitive performance and brain volume were investigated using linear regression models adjusted for age, sex, time of hypertension since diagnosis, and comorbidities. A causal mediation analysis was also conducted. RESULTS Better socioeconomic status was associated with better visuospatial ability, executive function, and global cognition. We found associations between a better socioeconomic index and a higher parietal lobe volume. White matter hyperintensities were also not mediators in the relationship between the socioeconomic index and cognitive performance. CONCLUSION Socioeconomic disadvantages are associated with worse cognitive performance and brain volume in individuals with hypertension.
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Affiliation(s)
- Regina Silva Paradela
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Naomi Vidal Ferreira
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.,Adventist University of São Paulo, Engenheiro Coelho, SP, Brazil
| | - Mariana Penteado Nucci
- Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Brenno Cabella
- Institute of Theoretical Physics, São Paulo State University (IFT-UNESP), São Paulo, SP, Brazil
| | - Luiza Menoni Martino
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Laura Aló Torres
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Danielle Irigoyen da Costa
- Brain Institute (InsCer), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | | | - Claudia Kimie Suemoto
- Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Claudia Irigoyen
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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20
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Min KD, Kim JS, Park YH, Shin HY, Kim C, Seo SW, Kim SY. New assessment for residential greenness and the association with cortical thickness in cognitively healthy adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 778:146129. [PMID: 33714817 DOI: 10.1016/j.scitotenv.2021.146129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/26/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Recent evidence suggests that neurological health could be improved with the intervention of local green space. A few studies adopted cortical thickness, as an effective biomarker for neurodegenerative disorder, to investigate the association with residential greenness. However, they relied on limited data sources, definitions or applications to assess residential greenness. Our cross-sectional study assessed individual residential greenness using an alternative measure, which provides a more realistic definition of local impact and application based on the type of area, and investigated the association with cortical thickness. METHODS The study population included 2542 subjects who participated in the medical check-up program at the Health Promotion Center of the Samsung Medical Center in Seoul, Korea, from 2008 to 2014. The cortical thickness was calculated by each of the four and global lobes from brain MRI. For greenness, we used the enhanced vegetation index (EVI) that detects canopy structural variation by adjusting background noise based on satellite imagery data. To assess individual exposure to residential greenness, we computed the maximum annual EVI before the date of a medical check-up and averaged it within 750 m from subjects' homes to represent an average walking distance. Finally, we assessed the association with cortical thickness by urban and non-urban populations using multiple linear regression adjusting for individual characteristics. RESULTS The average global cortical thickness and EVI were 3.05 mm (standard deviation = 0.1 mm) and 0.31 (0.1), respectively. An interquartile range increase in EVI was associated with 11 μm (95% confidence interval = 3-20) and 9 μm (1-16) increases in cortical thickness of the parietal and occipital regions among the urban population. We did not find associations in non-urban subjects. CONCLUSIONS Our findings confirm the association between residential greenness and neurological health using alternative exposure assessments, indicating that high exposure to residential greenness can prevent neurological disorders.
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Affiliation(s)
- Kyung-Duk Min
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Ji Sun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yu Hyun Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hee Young Shin
- Health Promotion Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
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21
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Effects of different acupuncture manipulations on protein expression in the parietal cortex of spontaneously hypertensive rats. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2021. [DOI: 10.1016/j.jtcms.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Uddin MN, Tivarus M, Adams H, Little E, Schifitto G, Lande MB. Magnetic Resonance Imaging in Childhood Primary Hypertension: Potential in the Study of Cognitive Outcomes. Hypertension 2021; 77:751-758. [PMID: 33566685 DOI: 10.1161/hypertensionaha.120.15242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary hypertension in youth and young adulthood is associated with decreased neurocognitive test performance both in midlife and during youth itself, leading to concern of subsequent cognitive decline and dementia in later life. The early vascular effects of hypertension in youth are likely involved in the pathogenesis of hypertensive target organ damage to the brain, but the potential impact of antihypertensive treatment from youth on subsequent cognitive health is not known. This review will highlight the need to answer the question of whether treatment of hypertension from early in life would slow cognitive decline in adulthood, and will then outline, for the nonneurologist, magnetic resonance imaging techniques potentially useful in the study of the pathogenesis of decreased cognition in hypertensive youth and for use as potential biomarkers for early antihypertensive treatment interventions.
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Affiliation(s)
- Md Nasir Uddin
- From the Department of Neurology (M.N.U., H.A., G.S.), University of Rochester, NY
| | - Madalina Tivarus
- Department of Imaging Sciences (M.T., G.S.), University of Rochester, NY.,Department of Neuroscience (M.T.), University of Rochester, NY
| | - Heather Adams
- From the Department of Neurology (M.N.U., H.A., G.S.), University of Rochester, NY.,Department of Pediatrics (H.A., E.L., M.B.L.), University of Rochester, NY
| | - Erika Little
- Department of Pediatrics (H.A., E.L., M.B.L.), University of Rochester, NY
| | - Giovanni Schifitto
- From the Department of Neurology (M.N.U., H.A., G.S.), University of Rochester, NY.,Department of Imaging Sciences (M.T., G.S.), University of Rochester, NY
| | - Marc B Lande
- Department of Pediatrics (H.A., E.L., M.B.L.), University of Rochester, NY
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23
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Arterial hypertension and cerebral hemodynamics: impact of head-down tilt on cerebral blood flow (arterial spin-labeling-MRI) in healthy and hypertensive patients. J Hypertens 2020; 39:979-986. [PMID: 33306520 DOI: 10.1097/hjh.0000000000002709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hypertension affects cerebrovascular autoregulation and increases the risk of cerebrovascular events and dementia. Notably, it is associated with cerebrovascular remodeling and lower resting cerebral blood flow (CBF). We wanted to determine, using arterial spin-labeling-MRI, the impact of a head-down tilt (HDT) dynamic maneuver on CBF in hypertensive patients. METHODS The current prospective study measured 36 patients' CBFs (18 normotensive individuals; 18 hypertensive patients) on 1.5T arterial spin-labeling-MRI in the supine position and after 4 min at -15° HDT. We reconstructed CBF maps of left and right subcortical nuclear gray matter, cortical gray matter and white matter (16 structures) to explore cerebrovascular autoregulation modification under dynamic conditions. RESULTS Normotensive and hypertensive participants had no significant CBF differences in the supine position. After HDT, CBF mean variations (CBF-mVs) across all structures declined (mean -5.8%) for the whole population (n = 36), with -6.6 and -7.6% decreases, respectively, in white matter and gray matter (P < 0.001). Left and right accumbens nuclei had the largest changes (-9.6 and -9.2%, respectively; P < 0.001). No CBF-mV difference (0/16) was found in hypertensive patients after HDT, whereas normotensive participants' CBF-mVs changed significantly in four structures (left and right accumbens, putamen and left caudate nucleus) and gray matter. Hypertensive patients exhibited fewer CBF-mVs in left caudate nuclei (P = 0.039) and cortical gray matter (P = 0.013). Among hypertensive patients, people with diabetes had smaller CBF-mVs than people without diabetes. CONCLUSION Our results highlight the significantly different CBF reactions to HDT of normotensive and hypertensive participants. They support the hypothesis that hypertension is responsible for deficient cerebrovascular autoregulation.
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24
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Ostroumova TM, Ostroumova OD, Parfenov VA, Perepelova EM, Perepelov VA, Kochetkov AI. Effect of Perindopril/Indapamide on Cerebral Blood Flow in Middle-Aged, Treatment-Naïve Patients with Hypertension. Adv Ther 2020; 37:4930-4943. [PMID: 33026579 DOI: 10.1007/s12325-020-01515-7] [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: 08/14/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The relationship between blood pressure (BP) and cerebral blood flow (CBF) is not fully understood. This study evaluated the impact of a perindopril arginine/indapamide (Pa/I) single-pill combination (SPC) on CBF in middle-aged patients. METHODS A total of 22 treatment-naïve patients with essential hypertension and at least one hypertension-mediated organ damage and 41 healthy controls were enrolled. At baseline, all participants underwent brain magnetic resonance imaging (MRI); patients with hypertension underwent an additional MRI at end of follow-up. Arterial spin labeling (ASL) was used to calculate CBF in the frontal lobe cortical plate. Patients with hypertension received once-daily Pa/I 5 mg/1.25 mg SPC, which could be increased to Pa/I 10 mg/2.5 mg at 2 weeks if necessary. Patients with hypertension underwent 24-h ambulatory BP monitoring (ABPM) at baseline and end of follow-up. RESULTS Mean baseline BP values were 146.2/93.1 and 119.1/76.1 mmHg in the hypertension and control groups, respectively. Patients with hypertension had significantly (p < 0.001) lower CBF in the cortical plate of both left (36.2 ± 8.3 vs. 45.3 ± 3.5 ml/100 g/min) and right (37.9 ± 7.9 vs. 45.8 ± 3.2 ml/100 g/min) frontal lobes compared to normotensive controls. At the end of follow-up, there was a statistically significant (p < 0.001) increase in CBF in the cortical plate of both left (from 36.2 ± 8.3 to 47.5 ± 9.8 ml/100 g/min) and right frontal lobes (from 37.9 ± 7.9 to 47.4 ± 10.1 ml/100 g/min) compared to baseline. No significant difference was found between end of follow-up CBF levels in frontal lobes of patients with hypertension and those of healthy controls at baseline. Office BP decreased by 24.2/15.5 mmHg and 24-h ABPM from 145.5/95.3 to 120.8/79.3 mmHg. CONCLUSION In middle-aged, treatment-naïve patients with hypertension, Pa/I SPC was associated with increased CBF in the cortical plate of the frontal lobes, which achieved levels of normotensive controls. The increase in CBF had no clear association with observed BP changes. REGISTRATION NUMBER ISRCTN67799751.
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Affiliation(s)
- Tatiana M Ostroumova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
| | - Olga D Ostroumova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
- Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Vladimir A Parfenov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Elena M Perepelova
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Vsevolod A Perepelov
- Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Alexey I Kochetkov
- Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
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25
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Presa JL, Saravia F, Bagi Z, Filosa JA. Vasculo-Neuronal Coupling and Neurovascular Coupling at the Neurovascular Unit: Impact of Hypertension. Front Physiol 2020; 11:584135. [PMID: 33101063 PMCID: PMC7546852 DOI: 10.3389/fphys.2020.584135] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/04/2020] [Indexed: 12/18/2022] Open
Abstract
Components of the neurovascular unit (NVU) establish dynamic crosstalk that regulates cerebral blood flow and maintain brain homeostasis. Here, we describe accumulating evidence for cellular elements of the NVU contributing to critical physiological processes such as cerebral autoregulation, neurovascular coupling, and vasculo-neuronal coupling. We discuss how alterations in the cellular mechanisms governing NVU homeostasis can lead to pathological changes in which vascular endothelial and smooth muscle cell, pericyte and astrocyte function may play a key role. Because hypertension is a modifiable risk factor for stroke and accelerated cognitive decline in aging, we focus on hypertension-associated changes on cerebral arteriole function and structure, and the molecular mechanisms through which these may contribute to cognitive decline. We gather recent emerging evidence concerning cognitive loss in hypertension and the link with vascular dementia and Alzheimer’s disease. Collectively, we summarize how vascular dysfunction, chronic hypoperfusion, oxidative stress, and inflammatory processes can uncouple communication at the NVU impairing cerebral perfusion and contributing to neurodegeneration.
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Affiliation(s)
- Jessica L Presa
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, United States.,Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and Instituto de Biología y Medicina Experimental, CONICET, Buenos Aires, Argentina
| | - Flavia Saravia
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and Instituto de Biología y Medicina Experimental, CONICET, Buenos Aires, Argentina
| | - Zsolt Bagi
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Jessica A Filosa
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, United States
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26
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Jennings JR, Muldoon MF, Allen B, Ginty AT, Gianaros PJ. Cerebrovascular function in hypertension: Does high blood pressure make you old? Psychophysiology 2020; 58:e13654. [PMID: 32830869 DOI: 10.1111/psyp.13654] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 12/22/2022]
Abstract
The majority of individuals over an age of 60 have hypertension. Elevated blood pressure and older age are associated with very similar changes in brain structure and function. We review the parallel brain changes associated with increasing age and blood pressure. This review focuses on joint associations of aging and elevated blood pressure with neuropsychological function, regional cerebral blood flow responses to cognitive and metabolic challenges, white matter disruptions, grey matter volume, cortical thinning, and neurovascular coupling. Treatment of hypertension ameliorates many of these changes but fails to reverse them. Treatment of hypertension itself appears more successful with better initial brain function. We show evidence that sympathetic and renal influences known to increase blood pressure also impact brain integrity. Possible central mechanisms contributing to the course of hypertension and aging are then suggested. An emphasis is placed on psychologically relevant factors: stress, cardiovascular reactions to stress, and diet/obesity. The contribution of some of these factors to biological aging remains unclear and may provide a starting point for defining the independent and interacting effects of aging and increasing blood pressure on the brain.
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Affiliation(s)
- J Richard Jennings
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew F Muldoon
- Department of Medicine, Heart and Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ben Allen
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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27
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Elliott ML. MRI-based biomarkers of accelerated aging and dementia risk in midlife: how close are we? Ageing Res Rev 2020; 61:101075. [PMID: 32325150 DOI: 10.1016/j.arr.2020.101075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/10/2020] [Accepted: 04/15/2020] [Indexed: 01/18/2023]
Abstract
The global population is aging, leading to an increasing burden of age-related neurodegenerative disease. Efforts to intervene against age-related dementias in older adults have generally proven ineffective. These failures suggest that a lifetime of brain aging may be difficult to reverse once widespread deterioration has occurred. To test interventions in younger populations, biomarkers of brain aging are needed that index subtle signs of accelerated brain deterioration that are part of the putative pathway to dementia. Here I review potential MRI-based biomarkers that could connect midlife brain aging to later life dementia. I survey the literature with three questions in mind, 1) Does the biomarker index age-related changes across the lifespan? 2) Does the biomarker index cognitive ability and cognitive decline? 3) Is the biomarker sensitive to known risk factors for dementia? I find that while there is preliminary support for some midlife MRI-based biomarkers for accelerated aging, the longitudinal research that would best answer these questions is still in its infancy and needs to be further developed. I conclude with suggestions for future research.
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Affiliation(s)
- Maxwell L Elliott
- Department of Psychology and Neuroscience, Duke University, 2020 West Main Street, Suite 030, Durham, NC, 27701, USA.
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28
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Durazzo TC, Nguyen LC, Meyerhoff DJ. Medical Conditions Linked to Atherosclerosis Are Associated With Magnified Cortical Thinning in Individuals With Alcohol Use Disorders. Alcohol Alcohol 2020; 55:382-390. [PMID: 32445335 PMCID: PMC7307314 DOI: 10.1093/alcalc/agaa034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/19/2020] [Accepted: 04/09/2020] [Indexed: 01/21/2023] Open
Abstract
AIMS Magnetic resonance imaging (MRI) studies report widespread cortical thinning in individuals with alcohol use disorder (AUD), but did not consider potential effects of pro-atherogenic conditions such as hypertension, type 2 diabetes mellitus, hepatitis C seropositivity and hyperlipidemia on cortical thickness. The conditions are associated with regional cortical thinning in those without AUD. We predicted that individuals with concurrent AUD and pro-atherogenic conditions demonstrate the greatest regional cortical thinning in areas most vulnerable to decreased perfusion. METHODS Treatment-seeking individuals with AUD (n = 126) and healthy controls (CON; n = 49) completed a 1.5 T MRI study. Regional cortical thickness was quantitated via FreeSurfer. Individuals with AUD and pro-atherogenic conditions (Atherogenic+), AUD without pro-atherogenic conditions (Atherogenic-) and CON were compared on regional cortical thickness. RESULTS Individuals with AUD showed significant bilateral cortical thinning compared to CON, but Atherogenic+ demonstrated the most widespread and greatest magnitude of regional thinning, while Atherogenic- had reduced thickness primarily in anterior frontal and posterior parietal lobes. Atherogenic+ also showed a thinner cortex than Atherogenic- in lateral orbitofrontal and dorso/dorsolateral frontal cortex, mesial and lateral temporal and inferior parietal regions. CONCLUSIONS Our results demonstrate significant bilateral cortical thinning in individuals with AUD relative to CON, but the distribution and magnitude were influenced by comorbid pro-atherogenic conditions. The magnitude of cortical thinning in Atherogenic+ strongly corresponded to cortical watershed areas susceptible to decreased perfusion, which may result in morphometric abnormalities. The findings indicate that pro-atherogenic conditions may contribute to cortical thinning in those seeking treatment for AUD.
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Affiliation(s)
- Timothy C Durazzo
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Linh-Chi Nguyen
- Mental Illness Research and Education Clinical Centers, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Dieter J Meyerhoff
- Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Silbert LC, Lahna D, Promjunyakul NO, Boespflug E, Ohya Y, Higashiuesato Y, Nishihira J, Katsumata Y, Tokashiki T, Dodge HH. Risk Factors Associated with Cortical Thickness and White Matter Hyperintensities in Dementia Free Okinawan Elderly. J Alzheimers Dis 2019; 63:365-372. [PMID: 29578488 PMCID: PMC5900560 DOI: 10.3233/jad-171153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Cortical gray matter (GM) and white matter (WM) deterioration are signals of neurodegeneration and increased dementia risk; however, their specific etiologies in dementia-free aging is unclear. Objective: The objective of this study was to examine potentially modifiable risk factors of GM and WM degeneration in a well-characterized cohort of dementia-free elderly. Methods: 96 Okinawan elderly participants (age 83.6) from the Keys to Optimal Cognitive Aging Project (KOCOA) underwent MRI and cognitive evaluation. Serum markers of inflammation (interleukin-6 (IL-6), high sensitivity C-reactive protein), cerebrovascular disease (systolic blood pressure (SBP) 140+, hemoglobin A1C (HgbA1C), total cholesterol), and essential minerals (copper (Cu), magnesium, and calcium) were examined in relation to mean cortical thickness (MCT) and white matter hyperintensities (WMH), adjusting for age and gender. Voxel-based morphometry (VBM) analyses identified relationships between regional GM density and the above markers. Results: Decreased MCT was associated with SBP 140 + (p = 0.029) and increased serum IL-6 (p = 0.036), HgbA1C (p = 0.002), and Cu (p = 0.025). In VBM analyses, increased IL-6, HgbA1C, and Cu were associated with decreased GM density in temporal lobe regions. HgbA1C (p = 0.004) was associated with greater WMH volume. Conclusions: Peripheral markers of Cu, CVD risk, and inflammation are associated with MRI-markers of decreased brain health in dementia-free Okinawan elderly, with regional cortical thinning in areas involved in early accumulation of Alzheimer’s disease pathology. Results identify potentially modifiable biomarkers as targets in the prevention of dementia in older individuals.
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Affiliation(s)
- Lisa C Silbert
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.,Portland Veterans Affairs Health Care System, Portland, OR, USA
| | - David Lahna
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Nutta-On Promjunyakul
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Erin Boespflug
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | | | - Junko Nishihira
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Yuriko Katsumata
- Department of Biostatistics, University of Kentucky, Lexington, KY, USA
| | - Takashi Tokashiki
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Hiroko H Dodge
- Department of Neurology, NIA-Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.,Department of Neurology, Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA
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30
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Kim SE, Lee JS, Woo S, Kim S, Kim HJ, Park S, Lee BI, Park J, Kim Y, Jang H, Kim SJ, Cho SH, Lee B, Lockhart SN, Na DL, Seo SW. Sex-specific relationship of cardiometabolic syndrome with lower cortical thickness. Neurology 2019; 93:e1045-e1057. [PMID: 31444241 DOI: 10.1212/wnl.0000000000008084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/10/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate whether cardiometabolic factors were associated with age-related differences in cortical thickness in relation to sex. METHODS In this cross-sectional study, we enrolled 1,322 cognitively normal elderly (≥65 years old) individuals (774 [58.5%] men, 548 [41.5%] women). We measured cortical thickness using a surface-based analysis. We analyzed the associations of cardiometabolic risk factors with cortical thickness using multivariate linear regression models after adjusting for possible confounders and interactions with age. RESULT Among women, hypertension (β = -1.119 to -0.024, p < 0.05) and diabetes mellitus (β = -0.920, p = 0.03) were independently associated with lower mean cortical thickness. In addition, there was an interaction effect between obesity (body mass index [BMI] ≥27.5 kg/m2) and age on cortical thickness in women (β = -0.324 to -0.010, p < 0.05), suggesting that age-related differences in cortical thickness were more prominent in obese women compared to women with normal weight. Moreover, low education level (<6 years) was correlated with lower mean cortical thickness (β = -0.053 to -0.046, p < 0.05). Conversely, among men, only being underweight (BMI ≤18.5 kg/m2, β = -2.656 to -0.073, p < 0.05) was associated with lower cortical thickness. CONCLUSIONS Our findings suggest that cortical thickness is more vulnerable to cardiometabolic risk factors in women than in men. Therefore, sex-specific prevention strategies may be needed to protect against accelerated brain aging.
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Affiliation(s)
- Si Eun Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jin San Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sookyoung Woo
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seonwoo Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Hee Jin Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seongbeom Park
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Byung In Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jinse Park
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Yeshin Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Hyemin Jang
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Seung Joo Kim
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Soo Hyun Cho
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Byungju Lee
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Samuel N Lockhart
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Duk L Na
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sang Won Seo
- From the Departments of Neurology (S.E.K., H.J.K., S.P., H.J., S.J.K., S.H.C., D.L.N., S.W.S.), Clinical Research Design and Evaluation (S.W.S.), and Health Sciences and Technology (D.L.N.), SAIHST, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul; Department of Neurology (S.E.K., B.I.L., J.P.), Inje University College of Medicine, Haeundae Paik Hospital, Busan; Department of Neurology (J.S.L.), Kyung Hee University Hospital; Statistics and Data Center (S.W., S.K.), Center for Clinical Epidemiology (S.W.S.), and Samsung Alzheimer Research Center, Neuroscience Center (H.J.K., S.P., H.J., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (Y.K.), Kangwon National University College of Medicine, Chuncheon-si, Gangwon-do; Department of Neurology (S.J.K.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital; Department of Neurology (S.H.C.), Chonnam National University Hospital, Gwangju; Department of Neurology (B.L.), Yuseong Geriatric Rehabilitation Hospital, Pohang, Korea; and Department of Internal Medicine (S.N.L.), Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
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Lamar M, Durazo-Arvizu RA, Sachdeva S, Pirzada A, Perreira KM, Rundek T, Gallo LC, Grober E, DeCarli C, Lipton RB, Tarraf W, González HM, Daviglus ML. Cardiovascular disease risk factor burden and cognition: Implications of ethnic diversity within the Hispanic Community Health Study/Study of Latinos. PLoS One 2019; 14:e0215378. [PMID: 31009492 PMCID: PMC6476505 DOI: 10.1371/journal.pone.0215378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/01/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hispanics/Latinos have some of the highest prevalence rates for cardiovascular disease risk factors, but stark differences exist by self-reported background. Cardiovascular disease risk factors negatively impact cognition in Hispanics/Latinos; less is known about these relationships by Hispanic/Latino backgrounds. We investigated cognitive associations with cardiovascular disease risk factor burden in a diverse cohort, the Hispanic Community Health Study/Study of Latinos. METHODS Baseline data from this observational study of cardiovascular disease and its antecedents was collected from 2008-2011. We included 7,121 participants 45-74 years old from Central American, Cuban, Dominican, Mexican, Puerto Rican, or South American backgrounds. Dichotomous indicators for hypertension, diabetes, hypercholesterolemia, obesity, and smoking were evaluated and totaled, with participants grouped by lowest (0-2), middle (3) or highest (4-5) burden. Cognitive testing included the Brief Spanish English Verbal Learning Test, letter fluency, and digit symbol substitution. RESULTS In separate fully-adjusted linear regression models, lower fluency and digit symbol substitution performance were restricted to the highest compared to the lowest burden group; whereas the middle burden group displayed impaired memory performance compared to the lowest burden group (p-values≤0.05). Background interacted with burden for learning and memory performance. That is, the association of burden level (i.e., lowest, middle, or highest) with cognitive performance was modified by background (e.g., Mexicans vs Cuban). CONCLUSIONS Hispanics/Latinos with higher levels of cardiovascular disease risk factor burden displayed lower levels of cognitive performance, with learning and memory performance modified by background.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center and the Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Public Health Sciences, Loyola University, Chicago, Illinois, United States of America
| | - Shruti Sachdeva
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Krista M. Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tatjana Rundek
- Department of Neurology, University of Miami Health System, Miami, Florida, United States of America
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Charles DeCarli
- Department of Neurology, University of California Davis Health System, Sacramento, California, United States of America
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, New York, United States of America
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, United States of America
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, California, United States of America
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
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刘 颖, 曾 祥, 王 筝, 张 函, 王 希, 袁 慧. [Cerebral blood flow measurements in patients with comorbid hypertension and depression using 3D arterial spin labeling]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:260-264. [PMID: 30996364 PMCID: PMC7441213 DOI: 10.19723/j.issn.1671-167x.2019.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate cerebral blood flow (CBF) in patients with comorbid hypertension in depression using 3D pseudocontinuous arterial spin labeling (3D pcASL) and to compare the differences of CBF values in depression, hypertension, and comorbid hypertension between depression and healthy control groups. To investigate the correlation between CBF values and degrees of depression. METHODS Sixteen patients with depression (depression group, 3 males and 13 females, age range of 42-72 years old), sixteen patients with hypertension (hypertension group, 3 males and 13 females, age range of 41-68 years old), sixteen patients with comorbid hypertension in depression (comorbidity group, 3 males and 13 females, age range of 45-74 years old), and sixteen healthy controls (control group, 3 males and 13 females, age range of 43-68 years old) were recruited. 3D pcASL sequence was performed by GE 3.0T magnetic resonance scanner and CBF map was generated automatically. Statistical parametric mapping (SPM8) was performed to preprocess the CBF map, which was spatially normalized and smoothed. Comparison of the CBF values among the four groups was conducted by ANOVA. Correlation between the average CBF values in areas of decreased CBF and Hamilton depression scale (HAMD-17) was investigated. RESULTS The patients with comorbid hypertension in depression demonstrated lower CBF in bilateral superior frontal gyri, middle frontal gyri, inferior frontal gyri, right superior parietal gyrus, right inferior parietal gyrus, right supramarginal gyrus, left caudate nucleus and left insula lobe in comparison with the controls. Compared with control group, CBF values decreased in bilateral frontal lobes, but did not reach statistical significance. There were no significant differences of CBF values between the patients with hypertension and control subjects. Compared with depression, the patients with comorbid hypertension in depression showed lower CBF values in bilateral frontal lobes and right supramarginal gyrus. Compared with hypertension, lower CBF values in left middle frontal gyrus in the patients with comorbid hypertension in depression were shown. Correlation analysis indicated that no correlation between CBF values and scores of HAMD-17 was shown. CONCLUSION Although there were no significant decreases of CBF values in patients with depression and hypertension, regional hypoperfusions were observed in patients with comorbid hypertension in depression. Hypertension might play a synergistic action on cerebral hypoperfusion in patients with comorbid hypertension in depression.
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Affiliation(s)
- 颖 刘
- 北京大学第三医院放射科, 北京 100191Department of Radiology, Peking University Third Hospital, Beijing 100191, China
| | - 祥柱 曾
- 北京大学第三医院放射科, 北京 100191Department of Radiology, Peking University Third Hospital, Beijing 100191, China
| | - 筝 王
- 北京大学第三医院放射科, 北京 100191Department of Radiology, Peking University Third Hospital, Beijing 100191, China
| | - 函 张
- 北京大学第六医院联络会诊科, 北京 100191Department of Consultation Liaison, Peking University Sixth Hospital, Beijing 100191, China
| | - 希林 王
- 北京大学第六医院联络会诊科, 北京 100191Department of Consultation Liaison, Peking University Sixth Hospital, Beijing 100191, China
| | - 慧书 袁
- 北京大学第三医院放射科, 北京 100191Department of Radiology, Peking University Third Hospital, Beijing 100191, China
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Olesen ND, Nielsen HB, Olsen NV, Secher NH. The age-related reduction in cerebral blood flow affects vertebral artery more than internal carotid artery blood flow. Clin Physiol Funct Imaging 2019; 39:255-260. [PMID: 30897269 DOI: 10.1111/cpf.12568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
Ageing reduces cerebral blood flow (CBF), while mean arterial pressure (MAP) becomes elevated. According to 'the selfish brain' hypothesis of hypertension, a reduction in vertebral artery blood flow (VA) leads to increased sympathetic activity and thus increases MAP. In twenty-two young (24 ± 3 years; mean ± SD) and eleven elderly (70 ± 5 years) normotensive men, duplex ultrasound evaluated whether the age-related reduction in CBF affects VA more than internal carotid artery (ICA) blood flow. Pulse-contour analysis evaluated MAP while near-infrared spectroscopy determined frontal lobe oxygenation and transcranial Doppler middle cerebral artery mean blood velocity (MCA Vmean ). During supine rest, MAP (90 ± 13 versus 78 ± 9 mmHg; P<0·001) was elevated in the older subjects while their frontal lobe oxygenation (68 ± 7% versus 77 ± 7%; P<0·001), MCA Vmean (49 ± 9 versus 60 ± 12 cm s-1 ; P = 0·016) and CBF (754 ± 112 versus 900 ± 144 ml min-1 ; P = 0·004) were low reflected in VA (138 ± 48 versus 219 ± 50 ml min-1 ; P<0·001) rather than in ICA flow (616 ± 96 versus 680 ± 120 ml min-1 ; P = 0·099). In conclusion, blood supply to the brain and its oxygenation are affected by ageing and the age-related decline in VA flow appears to be four times as large as that in ICA and could be important for the age-related increase in MAP.
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Affiliation(s)
- Niels D Olesen
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henning B Nielsen
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels V Olsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels H Secher
- Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Norling AM, Marshall RS, Pavol MA, Howard G, Howard V, Liebeskind D, Huston J, Lal BK, Brott TG, Lazar RM. Is Hemispheric Hypoperfusion a Treatable Cause of Cognitive Impairment? Curr Cardiol Rep 2019; 21:4. [PMID: 30661122 DOI: 10.1007/s11886-019-1089-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To review the current literature that supports the notion that cerebral hemodynamic compromise from internal carotid artery stenosis may be a cause of vascular cognitive impairment that is amenable to treatment by revascularization. RECENT FINDINGS Converging evidence suggests that successful carotid endarterectomy and carotid artery stenting are associated with reversal of cognitive decline in many patients with severe but asymptomatic carotid artery stenosis. Most of these findings have been derived from cohort studies and comparisons with either normal or surgical controls. Failure to find treatment benefit in a number of studies appears to have been the result of patient heterogeneity or confounding from concomitant conditions independently associated with cognitive decline, such as heart failure and other cardiovascular risk factors, or failure to establish pre-procedure hemodynamic failure. Patients with severe carotid artery stenosis causing cerebral hemodynamic impairment may have a reversible cause of cognitive decline. None of the prior studies, however, were done in the context of a randomized clinical trial with large numbers of participants. The ongoing CREST-2 trial comparing revascularization with medical therapy versus medical therapy alone, and its associated CREST-H study determining whether cognitive decline is reversible among those with hemodynamic compromise may address this question.
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Affiliation(s)
- Amani M Norling
- Department of Neurology, University of Alabama at Birmingham, 1720 7th Ave S-SC 650, Birmingham, AL, 35294, USA
| | - Randolph S Marshall
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Marykay A Pavol
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - George Howard
- Department of Biostatistics (GH), University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia Howard
- Department of Epidemiology (VH), University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Liebeskind
- Department of Neurology, University of California, Los Angeles, CA, USA
| | - John Huston
- Department of Neuroradiology (JH), Mayo Clinic, Rochester, MN, USA
| | - Brajesh K Lal
- Department of Vascular Surgery (BKL), University of Maryland, Baltimore, MD, USA
| | - Thomas G Brott
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ronald M Lazar
- Department of Neurology, University of Alabama at Birmingham, 1720 7th Ave S-SC 650, Birmingham, AL, 35294, USA.
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Morrison HW, Filosa JA. Stroke and the neurovascular unit: glial cells, sex differences, and hypertension. Am J Physiol Cell Physiol 2019; 316:C325-C339. [PMID: 30601672 DOI: 10.1152/ajpcell.00333.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A functional neurovascular unit (NVU) is central to meeting the brain's dynamic metabolic needs. Poststroke damage to the NVU within the ipsilateral hemisphere ranges from cell dysfunction to complete cell loss. Thus, understanding poststroke cell-cell communication within the NVU is of critical importance. Loss of coordinated NVU function exacerbates ischemic injury. However, particular cells of the NVU (e.g., astrocytes) and those with ancillary roles (e.g., microglia) also contribute to repair mechanisms. Epidemiological studies support the notion that infarct size and recovery outcomes are heterogeneous and greatly influenced by modifiable and nonmodifiable factors such as sex and the co-morbid condition common to stroke: hypertension. The mechanisms whereby sex and hypertension modulate NVU function are explored, to some extent, in preclinical laboratory studies. We present a review of the NVU in the context of ischemic stroke with a focus on glial contributions to NVU function and dysfunction. We explore the impact of sex and hypertension as modifiable and nonmodifiable risk factors and the underlying cellular mechanisms that may underlie heterogeneous stroke outcomes. Most of the preclinical investigative studies of poststroke NVU dysfunction are carried out primarily in male stroke models lacking underlying co-morbid conditions, which is very different from the human condition. As such, the evolution of translational medicine to target the NVU for improved stroke outcomes remains elusive; however, it is attainable with further research.
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Gjerde PB, Jørgensen KN, Steen NE, Melle I, Andreassen OA, Steen VM, Agartz I. Association between olanzapine treatment and brain cortical thickness and gray/white matter contrast is moderated by cholesterol in psychotic disorders. Psychiatry Res Neuroimaging 2018; 282:55-63. [PMID: 30415175 DOI: 10.1016/j.pscychresns.2018.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/09/2018] [Accepted: 10/09/2018] [Indexed: 01/21/2023]
Abstract
Altered cortical brain morphology is observed in psychotic disorders. Despite the importance of lipid homeostasis for healthy brain functioning, knowledge about its role in cortical alterations in psychosis is limited. In a sample of patients with psychotic disorders, we investigated the relationship between treatment with olanzapine (OLZ), and cortical thickness and gray/white matter intensity contrast, and the association between these measures and serum lipid levels. We included 33 OLZ users, 19 unmedicated psychotic patients and 76 healthy controls (HC). Data on serum lipids and cortical measures based on MR brain images processed with FreeSurfer were analyzed with General Linear Models. We found that intensity contrast was similar in OLZ users as compared to HC and that the cortex (frontal, orbitofrontal, medial temporal) was thinner in OLZ users (p < 0.05, Bonferroni corrected). An OLZ-specific HDL interaction effect was further found for the pericentral cortical thickness measure (p < 0.05, Bonferroni corrected). Additionally, nominally significant findings indicated similar OLZ-specific interaction effects for cortical thickness in several regions, and an OLZ-specific interaction with LDL for occipital lobe contrast (p < 0.05, uncorrected). Our findings may suggest a drug-related lipid-effect on brain myelination. Experimental studies and replications in different study samples are needed to clarify these complex relationships further.
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Affiliation(s)
- Priyanthi B Gjerde
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
| | - Kjetil N Jørgensen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Vinderen, 0373 Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Nils E Steen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Vidar M Steen
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Vinderen, 0373 Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden.
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Yuan JQ, Lv YB, Chen HS, Gao X, Yin ZX, Wang WT, Kraus VB, Luo JS, Wang JN, Zeng Y, Mao C, Shi XM. Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study. J Am Med Dir Assoc 2018; 20:177-182.e2. [PMID: 30017702 DOI: 10.1016/j.jamda.2018.05.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/25/2018] [Accepted: 05/30/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults. DESIGN Prospective cohort study. SETTING Community-living older adults from 22 provinces in China. PARTICIPANTS We included 12,281 cognitively normal [Mini-Mental State Examination (MMSE) ≥ 24] older adults (median age: 81 years) from the Chinese Longitudinal Healthy Longevity Survey. Eligible participants must have baseline blood pressure data and have 1 or more follow-up cognitive assessments. MEASUREMENTS Baseline systolic (SBP) and diastolic blood pressure (DBP) were measured by trained internists. Cognitive function was evaluated by MMSE. We considered mild/moderate/severe cognitive impairment (MMSE <24, and MMSE decline ≥3) as the primary outcome. RESULTS The participants with hypertension had a significantly higher risk of mild/moderate/severe cognitive impairment (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.10-1.24). Overall, the associations with cognitive impairment seem to be hockey stick-shaped for SBP and linear for DBP, though the estimated effects for low SBP/DBP were less precise. High SBP was associated with a gradual increase in the risk of mild/moderate/severe cognitive impairment (P trend < .001). Compared with SBP 120 to 129 mmHg, the adjusted HR was 1.17 (95% CI 1.07-1.29) for SBP 130 to 139 mmHg, increased to 1.54 (95% CI 1.35-1.75) for SBP ≥180 mmHg. Analyses for high DBP showed the same increasing pattern, with an adjusted HR of 1.09 (95% CI 1.01-1.18) for DBP 90 to 99 mmHg and 1.19 (95% CI 1.02-1.38) for DBP ≥110 mmHg, as compared with DBP 70 to 79 mmHg. CONCLUSION Late-life high blood pressure was independently associated with cognitive impairment in cognitively normal Chinese older adults. Prevention and management of high blood pressure may have substantial benefits for cognition among older adults in view of the high prevalence of hypertension in this rapidly growing population.
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Affiliation(s)
- Jin-Qiu Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Shuai Chen
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, Philadelphia, PA
| | - Zhao-Xue Yin
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Wen-Tao Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Jie-Si Luo
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao-Nan Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zeng
- Center for the Study of Aging and Human Development and the Geriatric Division of School of Medicine, Duke University, Durham, NC; Center for Study of Healthy Aging and Development Studies, Peking University, Beijing, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Should you stop wearing neckties?-wearing a tight necktie reduces cerebral blood flow. Neuroradiology 2018; 60:861-864. [PMID: 29961088 DOI: 10.1007/s00234-018-2048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Negative cerebrovascular effects can be expected by compressing jugular veins and carotids by a necktie. It was already demonstrated that a necktie increases intraocular pressure. In many professions, a special dress code including a necktie and a collared shirt is mandatory although little is known about the effect of this "socially desirable strangulation." METHODS In this study, the effect of wearing a necktie concerning cerebral blood flow and jugular venous flow by magnetic resonance imaging. Thirty volunteers were divided in two groups. One underwent MRI with necktie, the other without. RESULTS The examination resulted in a statistically significant decrease of CBF after tightening the necktie (p < 0.001) while the venous flow did not show any significant changes. CONCLUSION It appears that wearing a necktie leads to a reduction in CBF.
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Rast P, Kennedy KM, Rodrigue KM, Robinson PRAW, Gross AL, McLaren DG, Grabowski T, Schaie KW, Willis SL. APOEε4 Genotype and Hypertension Modify 8-year Cortical Thinning: Five Occasion Evidence from the Seattle Longitudinal Study. Cereb Cortex 2018; 28:1934-1945. [PMID: 28444388 PMCID: PMC6019039 DOI: 10.1093/cercor/bhx099] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/30/2017] [Accepted: 04/04/2017] [Indexed: 01/08/2023] Open
Abstract
We investigated individual differences in longitudinal trajectories of brain aging in cognitively normal healthy adults from the Seattle Longitudinal Study covering 8 years of longitudinal change (across 5 occasions) in cortical thickness in 249 midlife and older adults (52-95 years old). We aimed to understand true brain change; examine the influence of salient risk factors that modify an individual's rate of cortical thinning; and compare cross-sectional age-related differences in cortical thickness to longitudinal within-person cortical thinning. We used Multivariate Multilevel Modeling to simultaneously model dependencies among 5 lobar composites (Frontal, Parietal, Temporal, Occipital, and Cingulate [CING]) and account for the longitudinal nature of the data. Results indicate (1) all 5 lobar composites significantly atrophied across 8 years, showing nonlinear longitudinal rate of cortical thinning decelerated over time, (2) longitudinal thinning was significantly altered by hypertension and Apolipoprotein-E ε4 (APOEε4), varying by location: Frontal and CING thinned more rapidly in APOEε4 carriers. Notably, thinning of parietal and occipital cortex showed synergistic effect of combined risk factors, where individuals who were both APOEε4 carriers and hypertensive had significantly greater 8-year thinning than those with either risk factor alone or neither risk factor, (3) longitudinal thinning was 3 times greater than cross-sectional estimates of age-related differences in thickness in parietal and occipital cortices.
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Affiliation(s)
- Philippe Rast
- Department of Psychology, University of California, Davis, 1 Shields Avenue, Davis, CA 95616, USA
| | - Kristen M Kennedy
- School of Behavioral and Brain Sciences, Center for Vital Longevity, The University of Texas at Dallas, 1600 Viceroy Drive, Suite 800, Dallas, TX 75235, USA
| | - Karen M Rodrigue
- School of Behavioral and Brain Sciences, Center for Vital Longevity, The University of Texas at Dallas, 1600 Viceroy Drive, Suite 800, Dallas, TX 75235, USA
| | - Paul R A W Robinson
- Department of Radiology, Integrated Brain Imaging Center (IBIC), University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg, School of Public Health, Baltimore, MD, USA
| | | | - Tom Grabowski
- Department of Radiology, Integrated Brain Imaging Center (IBIC), University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - K Warner Schaie
- Department of Radiology, Integrated Brain Imaging Center (IBIC), University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
- Seattle Longitudinal Study, Department of Psychiatry and Behavioral Sciences, University of Washington, 2500 Sixth Ave N., Seattle, WA, USA
| | - Sherry L Willis
- Department of Radiology, Integrated Brain Imaging Center (IBIC), University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
- Seattle Longitudinal Study, Department of Psychiatry and Behavioral Sciences, University of Washington, 2500 Sixth Ave N., Seattle, WA, USA
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Reddan JM, White DJ, Macpherson H, Scholey A, Pipingas A. Glycerophospholipid Supplementation as a Potential Intervention for Supporting Cerebral Structure in Older Adults. Front Aging Neurosci 2018; 10:49. [PMID: 29563868 PMCID: PMC5845902 DOI: 10.3389/fnagi.2018.00049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/15/2018] [Indexed: 01/13/2023] Open
Abstract
Modifying nutritional intake through supplementation may be efficacious for altering the trajectory of cerebral structural decline evident with increasing age. To date, there have been a number of clinical trials in older adults whereby chronic supplementation with B vitamins, omega-3 fatty acids, or resveratrol, has been observed to either slow the rate of decline or repair cerebral tissue. There is also some evidence from animal studies indicating that supplementation with glycerophospholipids (GPL) may benefit cerebral structure, though these effects have not yet been investigated in adult humans. Despite this paucity of research, there are a number of factors predicting poorer cerebral structure in older humans, which GPL supplementation appears to beneficially modify or protect against. These include elevated concentrations of homocysteine, unbalanced activity of reactive oxygen species both increasing the risk of oxidative stress, increased concentrations of pro-inflammatory messengers, as well as poorer cardio- and cerebrovascular function. As such, it is hypothesized that GPL supplementation will support cerebral structure in older adults. These cerebral effects may influence cognitive function. The current review aims to provide a theoretical basis for future clinical trials investigating the effects of GPL supplementation on cerebral structural integrity in older adults.
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Affiliation(s)
- Jeffery M Reddan
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
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Yoo HJ, Thayer JF, Greening S, Lee TH, Ponzio A, Min J, Sakaki M, Nga L, Mather M, Koenig J. Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples. Brain Struct Funct 2018; 223:727-737. [PMID: 28921167 PMCID: PMC5828882 DOI: 10.1007/s00429-017-1519-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 09/10/2017] [Indexed: 12/18/2022]
Abstract
Previous research has shown associations between brain structure and resting state high-frequency heart rate variability (HF HRV). Age affects both brain structure and HF HRV. Therefore, we sought to examine the relationship between brain structure and HF HRV as a function of age. Data from two independent studies were used for the present analysis. Study 1 included 19 older adults (10 males, age range 62-78 years) and 19 younger adults (12 males, age range 19-37). Study 2 included 23 older adults (12 males; age range 55-75) and 27 younger adults (17 males; age range 18-34). The root-mean-square of successive R-R-interval differences (RMSSD) from ECG recordings was used as time-domain measure of HF HRV. MRI scans were performed on a 3.0-T Siemens Magnetom Trio scanner. Cortical reconstruction and volumetric segmentation were performed with the Freesurfer image analysis suite, including 12 regions as regions of interests (ROI). Zero-order and partial correlations were used to assess the correlation of RMSSD with cortical thickness in selected ROIs. Lateral orbitofrontal cortex (OFC) cortical thickness was significantly associated with RMSSD. Further, both studies, in line with previous research, showed correlations between RMSSD and anterior cingulate cortex (ACC) cortical thickness. Meta-analysis on adjusted correlation coefficients from individual studies confirmed an association of RMSSD with the left rostral ACC and the left lateral OFC. Future longitudinal studies are necessary to trace individual trajectories in the association of HRV and brain structure across aging.
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Affiliation(s)
- Hyun Joo Yoo
- Emotion and Cognition Lab, University of Southern California, Los Angeles, CA, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Steven Greening
- Department of Psychology, Cognitive and Brain Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - Tae-Ho Lee
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Allison Ponzio
- Emotion and Cognition Lab, University of Southern California, Los Angeles, CA, USA
| | - Jungwon Min
- Emotion and Cognition Lab, University of Southern California, Los Angeles, CA, USA
| | - Michiko Sakaki
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Lin Nga
- Emotion and Cognition Lab, University of Southern California, Los Angeles, CA, USA
| | - Mara Mather
- Emotion and Cognition Lab, University of Southern California, Los Angeles, CA, USA.
| | - Julian Koenig
- Department of Psychology, The Ohio State University, Columbus, OH, USA
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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Kaczmarz S, Griese V, Preibisch C, Kallmayer M, Helle M, Wustrow I, Petersen ET, Eckstein HH, Zimmer C, Sorg C, Göttler J. Increased variability of watershed areas in patients with high-grade carotid stenosis. Neuroradiology 2018; 60:311-323. [PMID: 29299616 DOI: 10.1007/s00234-017-1970-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/19/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Watershed areas (WSAs) of the brain are most susceptible to acute hypoperfusion due to their peripheral location between vascular territories. Additionally, chronic WSA-related vascular processes underlie cognitive decline especially in patients with cerebral hemodynamic compromise. Despite of high relevance for both clinical diagnostics and research, individual in vivo WSA definition is fairly limited to date. Thus, this study proposes a standardized segmentation approach to delineate individual WSAs by use of time-to-peak (TTP) maps and investigates spatial variability of individual WSAs. METHODS We defined individual watershed masks based on relative TTP increases in 30 healthy elderly persons and 28 patients with unilateral, high-grade carotid stenosis, being at risk for watershed-related hemodynamic impairment. Determined WSA location was confirmed by an arterial transit time atlas and individual super-selective arterial spin labeling. We compared spatial variability of WSA probability maps between groups and assessed TTP differences between hemispheres in individual and group-average watershed locations. RESULTS Patients showed significantly higher spatial variability of WSAs than healthy controls. Perfusion on the side of the stenosis was delayed within individual watershed masks as compared to a watershed template derived from controls, being independent from the grade of the stenosis and collateralization status of the circle of Willis. CONCLUSION Results demonstrate feasibility of individual WSA delineation by TTP maps in healthy elderly and carotid stenosis patients. Data indicate necessity of individual segmentation approaches especially in patients with hemodynamic compromise to detect critical regions of impaired hemodynamics.
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Affiliation(s)
- Stephan Kaczmarz
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Vanessa Griese
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- Clinic for Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Kallmayer
- Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Helle
- Research Laboratories, Philips GmbH Innovative Technologies, Hamburg, Germany
| | - Isabel Wustrow
- I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Esben Thade Petersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
- Center for Magnetic Resonance, Department of Electrical Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Hans-Henning Eckstein
- Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Christian Sorg
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jens Göttler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
- TUM Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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Hart EC. Human hypertension, sympathetic activity and the selfish brain. Exp Physiol 2018; 101:1451-1462. [PMID: 27519960 DOI: 10.1113/ep085775] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/10/2016] [Indexed: 12/19/2022]
Abstract
NEW FINDINGS What is the topic of this review? This review article revisits an historical hypothesis that cerebral hypoperfusion, caused by elevated cerebral vascular resistances, causes the onset of high sympathetic nerve activity and hypertension in humans. What advances does it highlight? The review article highlights new evidence indicating that congenital cerebrovascular abnormalities, namely vertebral artery hypoplasia and an incomplete posterior circle of Willis, may play a role in the onset of hypertension. Despite the harmful consequences of high blood pressure (hypertension; e.g. stroke, renal failure, dementia and even death), the underlying physiological mechanisms that cause the onset of hypertension are poorly understood. The most established finding is that hypertension occurs alongside activation of the sympathetic nervous system, yet exactly what triggers this in humans is ambiguous. This review discusses evidence for elevated sympathetic nerve activity, particularly in human hypertension, and revisits an historical theory regarding the aetiology underlying human hypertension that was proposed by Seymour Kety and John Dickinson in the 1940s-1950s. My research group hypothesizes that elevated sympathetic nerve activity and hypertension develop as a fundamental mechanism to maintain adequate cerebral blood flow, which is now termed Cushing's mechanism or the selfish brain hypothesis. Moreover, it goes against the traditional belief that high cerebrovascular resistance is a consequence of hypertension; we propose that this elevated resistance drives hypertension. This review discusses historical and new evidence in animals and humans supporting this hypothesis. In particular, unique human data indicating a higher prevalence of congenital cerebral vascular abnormalities in hypertension are considered.
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Affiliation(s)
- Emma C Hart
- School of Physiology, Pharmacology and Neuroscience, Clinical Research and Imaging Centre, University of Bristol, Bristol, UK
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Altered cerebral hemodyamics and cortical thinning in asymptomatic carotid artery stenosis. PLoS One 2017; 12:e0189727. [PMID: 29240808 PMCID: PMC5730122 DOI: 10.1371/journal.pone.0189727] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/30/2017] [Indexed: 11/19/2022] Open
Abstract
Cortical thinning is a potentially important biomarker, but the pathophysiology in cerebrovascular disease is unknown. We investigated the association between regional cortical blood flow and regional cortical thickness in patients with asymptomatic unilateral high-grade internal carotid artery disease without stroke. Twenty-nine patients underwent high resolution anatomical and single-delay, pseudocontinuous arterial spin labeling magnetic resonance imaging with partial volume correction to assess gray matter baseline flow. Cortical thickness was estimated using Freesurfer software, followed by co-registration onto each patient's cerebral blood flow image space. Paired t-tests assessed regional cerebral blood flow in motor cortex (supplied by the carotid artery) and visual cortex (indirectly supplied by the carotid) on the occluded and unoccluded side. Pearson correlations were calculated between cortical thickness and regional cerebral blood flow, along with age, hypertension, diabetes and white matter hyperintensity volume. Multiple regression and generalized estimating equation were used to predict cortical thickness bilaterally and in each hemisphere separately. Cortical blood flow correlated with thickness in motor cortex bilaterally (p = 0.0002), and in the occluded and unoccluded sides individually; age (p = 0.002) was also a predictor of cortical thickness in the motor cortex. None of the variables predicted cortical thickness in visual cortex. Blood flow was significantly lower on the occluded versus unoccluded side in the motor cortex (p<0.0001) and in the visual cortex (p = 0.018). On average, cortex was thinner on the side of occlusion in motor but not in visual cortex. The association between cortical blood flow and cortical thickness in carotid arterial territory with greater thinning on the side of the carotid occlusion suggests that altered cerebral hemodynamics is a factor in cortical thinning.
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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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Schwarz NF, Nordstrom LK, Pagen LHG, Palombo DJ, Salat DH, Milberg WP, McGlinchey RE, Leritz EC. Differential associations of metabolic risk factors on cortical thickness in metabolic syndrome. NEUROIMAGE-CLINICAL 2017; 17:98-108. [PMID: 29062686 PMCID: PMC5641920 DOI: 10.1016/j.nicl.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/31/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Objective Metabolic syndrome (MetS) refers to a cluster of risk factors for cardiovascular disease, including obesity, hypertension, dyslipidemia, and hyperglycemia. While sizable prior literature has examined associations between individual risk factors and quantitative measures of cortical thickness (CT), only very limited research has investigated such measures in MetS. Furthermore, the relative contributions of these risk factors to MetS-related effects on brain morphology have not yet been studied. The primary goal of this investigation was to examine how MetS may affect CT. A secondary goal was to explore the relative contributions of individual risk factors to regional alterations in CT, with the potential to identify risk factor combinations that may underlie structural changes. Methods Eighteen participants with MetS (mean age = 59.78 years) were age-matched with 18 healthy control participants (mean age = 60.50 years). CT measures were generated from T1-weighted images and groups were contrasted using whole-brain general linear modeling. A follow-up multivariate partial least squares correlation (PLS) analysis, including the full study sample with complete risk factor measurements (N = 53), was employed to examine which risk factors account for variance in group structural differences. Results Participants with MetS demonstrated significantly reduced CT in left hemisphere inferior parietal, rostral middle frontal, and lateral occipital clusters and in a right hemisphere precentral cluster. The PLS analysis revealed that waist circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose were significant contributors to reduced CT in these clusters. In contrast, diastolic blood pressure showed a significantly positive association with CT while systolic blood pressure did not emerge as a significant contributor. Age was not associated with CT. Conclusion These results indicate that MetS can be associated with regionally specific reductions in CT. Importantly, a novel link between a risk factor profile comprising indices of obesity, hyperglycemia, dyslipidemia and diastolic BP and localized alterations in CT emerged. While the pathophysiological mechanisms underlying these associations remain incompletely understood, these findings may be relevant for future investigations of MetS and might have implications for treatment approaches that focus on specific risk factor profiles with the aim to reduce negative consequences on the structural integrity of the brain. Cortical thickness is reduced bilaterally in metabolic syndrome. Five out of six risk factor components contribute to altered cortical thickness. Particular risk factor combination may be an important target for intervention.
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Affiliation(s)
- Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leslie K Nordstrom
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Linda H G Pagen
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daniela J Palombo
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden. BMC Cardiovasc Disord 2016; 16:208. [PMID: 27809779 PMCID: PMC5093934 DOI: 10.1186/s12872-016-0386-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 10/26/2016] [Indexed: 12/17/2022] Open
Abstract
Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer’s disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established. Cognition has improved following the use of at least one representative agent of the major drug classes with further neuroprotection with renin angiotensin inhibitors and calcium channel blockers in the hypertensive elderly. However, a reduction in BP may worsen cerebral perfusion causing an increased risk of CV complications due to the J-curve phenomenon. Given the uncertainties and conflicting results from randomized trials regarding the hypertension management in the elderly, particularly octogenarians, antihypertensive approaches are primarily based on expert opinion. Herein, we summarize available data linking arterial hypertension to cognitive decline and antihypertensive approach with potential benefits in improving cognitive function in elderly hypertensive patients.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Centre "Dr. Dragisa Misovic", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036, Meda, Italy
| | - Dagmara Hering
- Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth, Hospital Unit, The University of Western Australia, Rear 50 Murray Street, 6000, Perth, Australia
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Posttraumatic Stress Disorder as a Catalyst for the Association Between Metabolic Syndrome and Reduced Cortical Thickness. Biol Psychiatry 2016; 80:363-71. [PMID: 26826875 PMCID: PMC4899313 DOI: 10.1016/j.biopsych.2015.11.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/24/2015] [Accepted: 11/25/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS), defined by a constellation of cardiometabolic pathologies, is highly prevalent among veterans, especially veterans with posttraumatic stress disorder (PTSD), and poses a major risk for adverse health outcomes, including neurodegeneration and mortality. Given this, we evaluated 1) the association between MetS and neural integrity, indexed by cortical thickness; 2) the relationship between PTSD and MetS; and 3) whether PTSD was associated with cortical thickness indirectly through MetS. METHODS The sample consisted of 346 U.S. military veterans (89.3% male; 71.4% white) who deployed to Iraq, Afghanistan, or both. Neuroimaging data were available for 274 participants. RESULTS In whole-brain analyses, MetS was negatively associated with cortical thickness in two left and four right hemisphere regions, as follows: bilateral temporal lobe, including temporal pole, fusiform gyrus, and insula, and extending into occipital cortex (left hemisphere) and orbitofrontal cortex (right hemisphere); bilateral precuneus, posterior cingulate, calcarine, and occipital-parietal cortex; and right rostral anterior cingulate cortex and central sulcus/postcentral gyrus. Path models showed that PTSD predicted MetS (β = .19, p < .001), which was associated with reduced cortical thickness (β = -.29 to -.43, all p < .001). CONCLUSIONS Results from this young veteran sample provide evidence that PTSD confers risk for cardiometabolic pathology and neurodegeneration and raise concern that this cohort may be aging prematurely and at risk for substantial medical and cognitive decline. This study highlights the need to identify the molecular mechanisms linking PTSD to MetS and effective interventions to reduce PTSD-related health comorbidities.
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Summative effects of vascular risk factors on cortical thickness in mild cognitive impairment. Neurobiol Aging 2016; 45:98-106. [DOI: 10.1016/j.neurobiolaging.2016.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 05/11/2016] [Accepted: 05/11/2016] [Indexed: 01/09/2023]
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