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Tomoto T, Zhang R. Arterial Aging and Cerebrovascular Function: Impact of Aerobic Exercise Training in Older Adults. Aging Dis 2024; 15:1672-1687. [PMID: 38270114 PMCID: PMC11272215 DOI: 10.14336/ad.2023.1109-1] [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: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 01/26/2024] Open
Abstract
Advanced age is the major risk factor for dementia including Alzheimer's disease. The clinical effects of recently developed anti-amyloid therapy for Alzheimer's disease were modest and the long-term outcome is unknown. Thus, an in-depth understanding of the mechanisms of brain aging is essential to develop preventive interventions to maintain cognitive health in late life. Mounting evidence suggests that arterial aging manifested as increases in central arterial stiffness is associated closely with cerebrovascular dysfunction and brain aging while improvement of cerebrovascular function with aerobic exercise training contributes to brain health in older adults. We summarized evidence in this brief review that 1) increases in central arterial stiffness and arterial pulsation with age are associated with increases in cerebrovascular resistance, reduction in cerebral blood flow, and cerebrovascular dysfunction, 2) aerobic exercise training improves cerebral blood flow by modifying arterial aging as indicated by reductions in cerebrovascular resistance, central arterial stiffness, arterial pulsation, and improvement in cerebrovascular function, and 3) improvement in cerebral blood flow and cerebrovascular function with aerobic exercise training may lead to improvement in cognitive function. These findings highlight the associations between arterial aging and cerebrovascular function and the importance of aerobic exercise in maintaining brain health in older adults.
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Affiliation(s)
- Tsubasa Tomoto
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan.
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA.
- Departments of Neurology,
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA.
- Departments of Neurology,
- Internal Medicine, and
- Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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2
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Wang M, Wang Z, Wang Y, Zhou Q, Wang J. Causal relationships involving brain imaging-derived phenotypes based on UKB imaging cohort: a review of Mendelian randomization studies. Front Neurosci 2024; 18:1436223. [PMID: 39050670 PMCID: PMC11266110 DOI: 10.3389/fnins.2024.1436223] [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: 05/21/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
The UK Biobank (UKB) has the largest adult brain imaging dataset, which encompasses over 40,000 participants. A significant number of Mendelian randomization (MR) studies based on UKB neuroimaging data have been published to validate potential causal relationships identified in observational studies. Relevant articles published before December 2023 were identified following the PRISMA protocol. Included studies (n = 34) revealed that there were causal relationships between various lifestyles, diseases, biomarkers, and brain image-derived phenotypes (BIDPs). In terms of lifestyle habits and environmental factors, there were causal relationships between alcohol consumption, tea intake, coffee consumption, smoking, educational attainment, and certain BIDPs. Additionally, some BIDPs could serve as mediators between leisure/physical inactivity and major depressive disorder. Regarding diseases, BIDPs have been found to have causal relationships not only with Alzheimer's disease, stroke, psychiatric disorders, and migraine, but also with cardiovascular diseases, diabetes, poor oral health, osteoporosis, and ankle sprain. In addition, there were causal relationships between certain biological markers and BIDPs, such as blood pressure, LDL-C, IL-6, telomere length, and more.
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Affiliation(s)
- Mengdong Wang
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Zirui Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaoyi Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Quan Zhou
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Junping Wang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
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3
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Cai X, Zhou D, Wang P, Zhang Z, Fan Y, Lin L, Geng Y, Mossa-Basha M, Zhu C, Zhang S. Precranial artery calcification burden: a potential indicator of the clinical outcome of reperfusion in patients with acute large artery occlusion. J Int Med Res 2024; 52:3000605241260364. [PMID: 39068525 PMCID: PMC11287721 DOI: 10.1177/03000605241260364] [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: 02/13/2024] [Accepted: 05/21/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE With mechanical thrombectomy (MT), we investigated the prognostic importance of aortic arch calcification (AoAC) and carotid sinus calcification (CaSC) for symptomatic intracerebral hemorrhage (sICH) and poor outcome in acute large artery occlusion (LAO). METHODS In this retrospective observational study, we calculated pre-cranial artery calcification burden (PACB) scores (burden score of AoAC and CaSC) using the AoAC grading scale score plus Woodcock visual score. The outcome measure was sICH per the European Cooperative Acute Stroke Study III definition. A 3-month modified Rankin scale score 3-6 was designated as poor outcome. RESULTS Compared with patients who had PACB <3, those with PACB ≥3 showed substantially higher risks of sICH (odds ratio [OR] = 2.567, 95% confidence interval [CI] = 1.187-5.550) and poor outcome (OR = 4.777, 95% CI = 1.659-13.756). According to receiver operating characteristic (ROC) curves, adding PACB to the regression model enhanced the predictive value for poor outcome (area under the ROC curve [AUC]: 0.718 vs. 0.519, Z = 2.340) and in patients receiving MT (AUC: 0.714 vs. 0.584, Z = 2.021), independently. CONCLUSIONS Factors related to PACB were consistent with common risk factors of systemic atherosclerosis. Low PACB scores indicated better prognosis. In patients with LAO following MT, PACB was useful in predicting sICH and poor clinical outcome.
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Affiliation(s)
- Xiaofeng Cai
- Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Dengfeng Zhou
- Key Laboratory of Bioorganic Synthesis of Zhejiang Province, College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Peng Wang
- Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Zheyu Zhang
- Department of Neurology, Ningbo First Hospital, Ningbo, China
| | - Yongmei Fan
- Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Longting Lin
- School of Medicine and Public Health, University of Newcastle, Australia
| | - Yu Geng
- Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, United States
| | - Sheng Zhang
- Centre for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
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4
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Hao P, Feng S, Suo M, Wang S, Zheng K, Wu X. Estimated Pulse Wave Velocity and Cognitive Outcomes: A Post hoc Analysis of SPRINT-MIND. Am J Hypertens 2024; 37:485-492. [PMID: 38488616 DOI: 10.1093/ajh/hpae032] [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: 01/17/2024] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Arterial stiffness has been confirmed to be associated with cognitive impairment. Carotid-femoral pulse wave velocity (cfPWV) is widely regarded as the gold standard for assessing arterial stiffness, yet it is not readily accessible. In response, the use of estimated pulse wave velocity (ePWV) has been proposed as a more accessible and cost-effective alternative. ePWV not only offers ease of calculation but also covers a broader spectrum of vascular aging processes, some of which may be distinct from those detected by cfPWV. The aim of our study was to investigate the association between ePWV and cognitive outcomes in SPRINT-MIND (Systolic Blood Pressure Intervention Trial Memory and Cognition in Decreased Hypertension). METHODS This study was a post hoc analysis of the SPRINT-MIND. The primary endpoint was a composite outcome including probable dementia and mild cognitive impairment (MCI). The calculation of ePWV was based on age and mean blood pressure. The association between ePWV and cognitive outcomes was assessed Using Cox regression analysis. The response of ePWV to antihypertensive treatment at 12 months was used to define treatment efficacy. RESULTS 8,563 patients were enrolled. The ePWV was found to be independently associated with risk of probable dementia (Tertile 3 vs. Tertile 1: HR, 95% CI: 1.70, 1.08-2.68, P = 0.023, P for trend = 0.013), MCI (Tertile 3 vs. Tertile 1: HR, 95% CI: 2.35, 1.71-3.23, P < 0.001, P for trend < 0.001), and the composite outcome of probable dementia or MCI (Tertile 3 vs. Tertile 1: HR, 95% CI: 2.17, 1.65-2.86, P < 0.001, P for trend < 0.001). The combined effect of treatment allocation and the response of ePWV to treatment exhibited that intensive/ePWV responders had the lowest risk of the primary outcome (Log-rank P = 0.002). CONCLUSIONS EPWV demonstrated independent predictive value for cognitive outcomes in SPRINT-MIND.
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Affiliation(s)
- Peng Hao
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Siting Feng
- Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Min Suo
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Shen Wang
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Keyang Zheng
- Center of Hypertension, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xiaofan Wu
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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5
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Menon NJ, Sun C, Chhina J, Halvorson BD, Frisbee JC, Frisbee SJ. Cerebrovascular dysfunction and depressive symptoms in preclinical models: insights from a scoping review. J Appl Physiol (1985) 2024; 136:1352-1363. [PMID: 38601994 DOI: 10.1152/japplphysiol.00031.2024] [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: 01/11/2024] [Revised: 03/11/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024] Open
Abstract
Although existing literature supports associations between cerebrovascular dysfunction and the emergence of depression and depressive symptoms, relatively little is known about underlying mechanistic pathways that may explain potential relationships. As such, an integrated understanding of these relationships in preclinical models could provide insight into the nature of the relationship, basic mechanistic linkages, and areas in which additional investment should be targeted. This scoping review was conducted in MEDLINE, EMBASE, and Scopus to outline the relationship between depressive symptoms and cerebrovascular dysfunction in preclinical animal models with an additional focus on the areas above. From 3,438 articles initially identified, 15 studies met the inclusion criteria and were included in the review. All studies reported a positive association between the severity of markers for cerebrovascular dysfunction and that for depressive symptoms in rodent models and this spanned all models for either pathology. Specific mechanistic links between the two such as chronic inflammation, elevated vascular oxidant stress, and altered serotonergic signaling were highlighted. Notably, almost all studies addressed outcomes in male animals, with a near complete lack of data from females, and there was little consistency in terms of how cerebrovascular dysfunction was assessed. Across nearly all studies was a lack of clarity for any "cause and effect" relationship between depressive symptoms and cerebrovascular dysfunction. At this time, it is reasonable to conclude that a correlative relationship clearly exists between the two, and future investigation will be required to parse out more specific aspects of this relationship.NEW & NOTEWORTHY This scoping review presents a structured evaluation of all relevant existing literature linking cerebral vasculopathy to depressive symptom emergence in preclinical models. Results support a definite connection between vascular dysfunction and depressive symptoms, highlighting the importance of chronic elevations in inflammation and oxidant stress, and impaired serotonergic signaling. The review also identified significant knowledge gaps addressing male versus female differences and limited clear mechanistic links between cerebral vasculopathy and depressive symptoms.
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Affiliation(s)
- Nithin J Menon
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Clara Sun
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jashnoor Chhina
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Brayden D Halvorson
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Stephanie J Frisbee
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
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Pacholko A, Iadecola C. Hypertension, Neurodegeneration, and Cognitive Decline. Hypertension 2024; 81:991-1007. [PMID: 38426329 PMCID: PMC11023809 DOI: 10.1161/hypertensionaha.123.21356] [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] [Indexed: 03/02/2024]
Abstract
Elevated blood pressure is a well-established risk factor for age-related cognitive decline. Long linked to cognitive impairment on vascular bases, increasing evidence suggests a potential association of hypertension with the neurodegenerative pathology underlying Alzheimer disease. Hypertension is well known to disrupt the structural and functional integrity of the cerebral vasculature. However, the mechanisms by which these alterations lead to brain damage, enhance Alzheimer pathology, and promote cognitive impairment remain to be established. Furthermore, critical questions concerning whether lowering blood pressure by antihypertensive medications prevents cognitive impairment have not been answered. Recent developments in neurovascular biology, brain imaging, and epidemiology, as well as new clinical trials, have provided insights into these critical issues. In particular, clinical and basic findings on the link between neurovascular dysfunction and the pathobiology of neurodegeneration have shed new light on the overlap between vascular and Alzheimer pathology. In this review, we will examine the progress made in the relationship between hypertension and cognitive impairment and, after a critical evaluation of the evidence, attempt to identify remaining knowledge gaps and future research directions that may advance our understanding of one of the leading health challenges of our time.
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Affiliation(s)
- Anthony Pacholko
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
| | - Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
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7
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Huang WQ, Lin Q, Tzeng CM. Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities. J Stroke 2024; 26:131-163. [PMID: 38836265 PMCID: PMC11164597 DOI: 10.5853/jos.2023.02719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/15/2024] [Indexed: 06/06/2024] Open
Abstract
Leukoaraiosis (LA) manifests as cerebral white matter hyperintensities on T2-weighted magnetic resonance imaging scans and corresponds to white matter lesions or abnormalities in brain tissue. Clinically, it is generally detected in the early 40s and is highly prevalent globally in individuals aged >60 years. From the imaging perspective, LA can present as several heterogeneous forms, including punctate and patchy lesions in deep or subcortical white matter; lesions with periventricular caps, a pencil-thin lining, and smooth halo; as well as irregular lesions, which are not always benign. Given its potential of having deleterious effects on normal brain function and the resulting increase in public health burden, considerable effort has been focused on investigating the associations between various risk factors and LA risk, and developing its associated clinical interventions. However, study results have been inconsistent, most likely due to potential differences in study designs, neuroimaging methods, and sample sizes as well as the inherent neuroimaging heterogeneity and multi-factorial nature of LA. In this article, we provided an overview of LA and summarized the current knowledge regarding its epidemiology, neuroimaging classification, pathological characteristics, risk factors, and potential intervention strategies.
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Affiliation(s)
- Wen-Qing Huang
- Department of Central Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Lin
- Department of Neurology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Clinical Research Center for Neurological Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Clinical Research Center for Brain Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- The Third Clinical College, Fujian Medical University, Fuzhou, Fujian, China
| | - Chi-Meng Tzeng
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, China
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8
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Gusmão WDP, Silva VM, Paiva AMG, Mota-Gomes MA, Nadruz W, Moreno CRC. Association Between Augmentation Index and Total Sleep Time in Night Shift Workers. J Biol Rhythms 2024; 39:200-207. [PMID: 38433444 DOI: 10.1177/07487304241229180] [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] [Indexed: 03/05/2024]
Abstract
Augmentation index and pulse wave velocity are markers of vascular compromise and independent predictors of cardiovascular risk and mortality. While the link between shift work and heightened cardiovascular risk is established, the intricate genesis of early cardiovascular outcomes in shift workers remains incompletely understood. However, there is evidence that sleep duration plays a role in this regard. Here we evaluate the association of total sleep time with pulse wave velocity, augmentation index, and central blood pressure in night shift workers. This study cross-sectionally evaluated the association of total sleep time evaluated by 10-day monitoring actigraphy with augmentation index, pulse wave velocity, and brachial and central blood pressure evaluated by oscillometry in nursing professionals, 63 shift workers (89% women; age = 45.0 ± 10.5 years), and 17 (100% women; age = 41.8 ± 15.6) day workers. There were no differences in the studied variables between shift workers and day workers. Results of correlation analysis demonstrated that pulse wave velocity, central systolic blood pressure, central diastolic blood pressure, brachial systolic blood pressure, and brachial diastolic blood pressure tended to have significant correlation with each other, while these measures did not have a significant relationship with augmentation index in both groups. However, results of adjusted restricted cubic spline analysis showed a U-shaped-curve association between total sleep time and augmentation index (p < 0.001 for trend) with a nadir at 300-360 min of total sleep time in shift workers. The present study showed that total sleep time, assessed by actigraphy, had a U-shaped association with augmentation index in shift workers, which indicated better characteristics of vascular functionality when sleep time was 5-6 h in the workers studied.
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Affiliation(s)
- Waléria D P Gusmão
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Alagoas State University of Health Sciences, Maceió, Brazil
| | - Victor M Silva
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Annelise M G Paiva
- University Center Clinical Research Center - Cesmac/Alagoas Heart Hospital, Maceió, Brazil
| | | | - Wilson Nadruz
- Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Sao Paulo, Brazil
| | - Claudia R C Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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Kobayashi R, Negoro H. Acute effects of the 4-4-8 breathing technique on arterial stiffness in healthy young men. Cardiol J 2024; 31:418-426. [PMID: 38348911 PMCID: PMC11229811 DOI: 10.5603/cj.96299] [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: 07/01/2023] [Revised: 12/01/2023] [Accepted: 12/23/2023] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Increased arterial stiffness is a risk factor for cardiovascular disease. Slow, deep breathing decreases blood pressure related to arterial stiffness. The objective of the present study was to determine the acute effects of a single session of slow breathing on arterial stiffness, blood pressure, and cardiac autonomic function. METHODS Fifteen healthy men (20 ± 0 years) were administered (a) a slow breathing condition (12 consecutive breaths of 4 s of inhalation, 4 s of pause, and 8 s of exhalation through the nose, approximately 5 min per breath) and (b) a control, two-condition crossover design. Carotid-femoral artery pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), brachial blood pressure, high frequency (HF) and low frequency (LF) were measured at baseline, 30 min, 60 min and 24 h after respiratory control. RESULTS Brachial-ankle PWV and brachial systolic pressure on the 4-4-8 breathing trial decreased after 30 min of respiratory control compared to baseline (p < 0.05), but did not change on the CON trial. Carotid-femoral PWV on both trials was unchanged; HF on the 4-4-8 breathing trial increased (p < 0.05) and LF decreased (p < 0.05) after 30 min of respiratory control compared to baseline, but was unchanged on the CON trial. CONCLUSIONS These results suggest that slow breathing techniques may be effective in modulating autonomic function and improving arterial stiffness in healthy young adults.
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Affiliation(s)
- Ryota Kobayashi
- Department of Natural and Environmental Science, Teikyo University of Science, Tokyo, Japan.
| | - Hideyuki Negoro
- Department of Medicine, Nara Medical University, Nara, Japan
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10
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Delli Pizzi S, Gambi F, Di Pietro M, Caulo M, Sensi SL, Ferretti A. BOLD cardiorespiratory pulsatility in the brain: from noise to signal of interest. Front Hum Neurosci 2024; 17:1327276. [PMID: 38259340 PMCID: PMC10800549 DOI: 10.3389/fnhum.2023.1327276] [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: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Functional magnetic resonance imaging (fMRI) based on the Blood Oxygen Level Dependent (BOLD) contrast has been extensively used to map brain activity and connectivity in health and disease. Standard fMRI preprocessing includes different steps to remove confounds unrelated to neuronal activity. First, this narrative review explores how signal fluctuations due to cardiac and respiratory activity, usually considered as "physiological noise" and regressed out from fMRI time series. However, these signal components bear useful information about some mechanisms of brain functioning (e.g., glymphatic clearance) or cerebrovascular compliance in response to arterial pressure waves. Aging and chronic diseases can cause stiffening of the aorta and other main arteries, with a reduced dampening effect resulting in greater transmission of pressure impulses to the brain. Importantly, the continuous hammering of cardiac pulsations can produce local alterations of the mechanical properties of the small cerebral vessels, with a progressive deterioration that ultimately affects neuronal functionality. Second, the review emphasizes how fMRI can study the brain patterns most affected by cardiac pulsations in health and disease with high spatiotemporal resolution, offering the opportunity to identify much more specific risk markers than systemic factors based on measurements of the vascular compliance of large arteries or other global risk factors. In this regard, modern fast fMRI acquisition techniques allow a better characterization of these pulsatile signal components due to reduced aliasing effects, turning what has been traditionally considered as noise in a signal of interest that can be used to develop novel non-invasive biomarkers in different clinical contexts.
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Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | | | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
| | - Stefano L. Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
- UdA-TechLab, Research Center, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
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11
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Kim HL. The Value of Serial Measurement of Arterial Stiffness in Cardiovascular Disease. Rev Cardiovasc Med 2024; 25:7. [PMID: 39077652 PMCID: PMC11262365 DOI: 10.31083/j.rcm2501007] [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: 08/24/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 07/31/2024] Open
Abstract
Clinically assessing arterial stiffness is valuable because it aids in predicting future cardiovascular events. There are several methods for measuring arterial stiffness, including pulse wave velocity (PWV), augmentation index, and pulse pressure. Numerous studies have shown that these indicators of arterial stiffness possess prognostic value for various patient groups as well as the general population. In cross-sectional studies, arterial stiffness was also linked to organ damage indices. However, most studies related to arterial stiffness have relied on a single measurement. Taking multiple serial measurements of arterial stiffness offers several advantages. Through repeated assessments, one can confirm the variability of arterial stiffness and observe changes over time, which is beneficial for understanding its pathophysiology. Such repeated measurements are also invaluable in evaluating the efficacy of interventions aimed at improving arterial stiffness. However, caution is needed, as there is no standardized method for measuring arterial stiffness. For instance, with PWV, the values can be influenced by numerous external factors. Therefore, the external conditions during the measurement must be noted. It's essential to recognize the pros and cons of repeated arterial stiffness measurements and integrate them effectively into clinical practice.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 07061 Seoul, Republic of Korea
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12
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Xu M, Wang W, Chen R, Zhou L, Hu H, Qiao G, Wang L, Liu X, Wang Q, Ai Y, Ren H, Hu P. Individual and combined associations of estimated pulse wave velocity and systemic inflammation response index with risk of stroke in middle-aged and older Chinese adults: a prospective cohort study. Front Cardiovasc Med 2023; 10:1158098. [PMID: 38028467 PMCID: PMC10655141 DOI: 10.3389/fcvm.2023.1158098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background and aims Estimated pulse wave velocity (ePWV) and systemic inflammatory response index (SIRI) have been recently investigated as a marker of arterial stiffness and a novel systemic inflammatory indicator. This study aims to examine the independent and combined association of ePWV and SIRI with incident stroke and its subtypes. Methods Data of the Dongfeng-Tongji cohort study was analyzed for 9,154 middle-aged and older adults, who were free of cardiovascular disease and cancer and were followed up to document incident stroke. But their association with incident stroke events and its subtypes have not been well studied. Multivariable adjusted Cox regression models were used to determine the independent and combined association of ePWV and SIRI with incident stroke events. Results Over a 7.22-year follow-up, the cohort documented 491 stroke cases (387 ischemic stroke and 104 hemorrhagic stroke). The multivariate adjusted model showed that with each one-unit increase in the level of ePWV, the corresponding hazard ratios (HRs) (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.53 (95% CI, 1.23-1.90), 1.42 (95% CI, 1.11-1.83), and 1.92 (95% CI, 1.21-3.03), respectively. Similarly, with each one-unit increase in log-transformed levels of SIRI, the corresponding HRs (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.23 (95% CI,1.04-1.47), 1.16 (95% CI, 0.96-1.41), and 1.52 (95% CI, 1.05-2.20), respectively. There appeared to be a combined effect of ePWV and SIRI on stroke; Participants with high levels of both ePWV and SIRI had a higher risk of total stroke and hemorrhagic stroke, with multiple adjusted HR of 2.43 (95% CI, 1.09-5.42). Additionally, the incorporation of ePWV in addition to traditional cardiovascular risk factors significantly improved the predictive accuracy for total stroke with C statistic increased from 0.684 (95% CI, 0.661-0.707) to 0.687 (95% CI, 0.664-0.710; x2 = 6.65; p for difference = 0.010), and (suggestively) for ischemic stroke with C statistic increased from 0.684 (95% CI, 0.659-0.71) to 0.691(95% CI, 0.666-0.717; x2 = 3.13, p for difference = 0.077), respectively. Conclusions The presence of both high ePWV and SIRI individually, as well as together, was found to be associated with an increased incidence of stroke. The combined stroke risk assessment using these two indicators could potentially improve non-invasive assessment and treatment strategies for high-risk patients, as these indicators are easily accessible in clinical practice.
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Affiliation(s)
- Man Xu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqiang Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Li Zhou
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ling Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | | | - Qiuhong Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ping Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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13
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Aghilinejad A, Amlani F, Mazandarani SP, King KS, Pahlevan NM. Mechanistic insights on age-related changes in heart-aorta-brain hemodynamic coupling using a pulse wave model of the entire circulatory system. Am J Physiol Heart Circ Physiol 2023; 325:H1193-H1209. [PMID: 37712923 PMCID: PMC10908406 DOI: 10.1152/ajpheart.00314.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
Age-related changes in aortic biomechanics can impact the brain by reducing blood flow and increasing pulsatile energy transmission. Clinical studies have shown that impaired cardiac function in patients with heart failure is associated with cognitive impairment. Although previous studies have attempted to elucidate the complex relationship between age-associated aortic stiffening and pulsatility transmission to the cerebral network, they have not adequately addressed the effect of interactions between aortic stiffness and left ventricle (LV) contractility (neither on energy transmission nor on brain perfusion). In this study, we use a well-established and validated one-dimensional blood flow and pulse wave computational model of the circulatory system to address how age-related changes in cardiac function and vasculature affect the underlying mechanisms involved in the LV-aorta-brain hemodynamic coupling. Our results reveal how LV contractility affects pulsatile energy transmission to the brain, even with preserved cardiac output. Our model demonstrates the existence of an optimal heart rate (near the normal human heart rate) that minimizes pulsatile energy transmission to the brain at different contractility levels. Our findings further suggest that the reduction in cerebral blood flow at low levels of LV contractility is more prominent in the setting of age-related aortic stiffening. Maintaining optimal blood flow to the brain requires either an increase in contractility or an increase in heart rate. The former consistently leads to higher pulsatile power transmission, and the latter can either increase or decrease subsequent pulsatile power transmission to the brain.NEW & NOTEWORTHY We investigated the impact of major aging mechanisms of the arterial system and cardiac function on brain hemodynamics. Our findings suggest that aging has a significant impact on heart-aorta-brain coupling through changes in both arterial stiffening and left ventricle (LV) contractility. Understanding the underlying physical mechanisms involved here can potentially be a key step for developing more effective therapeutic strategies that can mitigate the contributions of abnormal LV-arterial coupling toward neurodegenerative diseases and dementia.
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Affiliation(s)
- Arian Aghilinejad
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States
| | - Faisal Amlani
- Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Paris, France
| | - Sohrab P Mazandarani
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Kevin S King
- Barrow Neurological Institute, Phoenix, Arizona, United States
| | - Niema M Pahlevan
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States
- Division of Cardiovascular Medicine, Department of Medicine, University of Southern California, Los Angeles, California, United States
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14
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Nihei S, Ogawa M, Hashimoto Y, Kikuchi N, Nakazato K, Okamoto T. Arterial stiffness and physical fitness on cognitive function in community-dwelling middle-aged and older adults. Aging Clin Exp Res 2023; 35:1845-1854. [PMID: 37329475 DOI: 10.1007/s40520-023-02470-3] [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: 07/19/2022] [Accepted: 06/05/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This study examined whether decline in cognitive function is related to arterial stiffness and reduction in physical fitness in middle-aged and older adults. METHODS A total of 1554 healthy middle-aged and older adults participated in this study. The trail making test parts-A (TMT-A) and B (TMT-B), brachial-ankle pulse wave velocity (baPWV), grip strength, the 30-s chair stand (CS-30) test, the 6-min walk (6MW) test, the 8-foot up-and-go (8UG) test and gait assessment were performed. Participants were classified into a middle-aged group (40-64 years; mean, 50.4 ± 0.2 years) or an older group (≥ 65 years; mean, 73.1 ± 0.5 years), as well as into three cognition (COG) groups (high, moderate, and low) based on median TMT-A and -B scores (high scores on both, either, or neither TMT-A and -B, respectively). RESULTS The results revealed that baPWV was significantly lower in the high-than in the moderate- and low-COG groups in both middle-aged and older adults (P < 0.05). In addition, except for a few parameters (e.g., 6MW test in middle-aged adults), physical fitness was significantly higher in the high-than in the moderate- and low-COG groups in both middle-aged and older adults (P < 0.05). Multivariate regression analysis revealed that baPWV (P < 0.05) and some physical fitness indicators (grip strength, CS-30, and 8UG) were significantly independently associated with both TMT-A and -B in the middle-aged and older groups (P < 0.05). CONCLUSION These results suggest that increased arterial stiffness and reduced physical fitness are associated with impaired cognitive function in middle-aged and older adults.
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Affiliation(s)
| | - Madoka Ogawa
- Research Institute of Sports Science, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
- Department of Sport Science and Research, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Yuto Hashimoto
- Research Institute of Sports Science, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Naoki Kikuchi
- Research Institute of Sports Science, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Koichi Nakazato
- Research Institute of Sports Science, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Takanobu Okamoto
- Research Institute of Sports Science, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan.
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15
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Hunt RD, Sedighi O, Clark WM, Doiron AL, Cipolla M. Differential effect of gold nanoparticles on cerebrovascular function and biomechanical properties. Physiol Rep 2023; 11:e15789. [PMID: 37604668 PMCID: PMC10442527 DOI: 10.14814/phy2.15789] [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: 03/29/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/23/2023] Open
Abstract
Human stroke serum (HSS) has been shown to impair cerebrovascular function, likely by factors released into the circulation after ischemia. 20 nm gold nanoparticles (GNPs) have demonstrated anti-inflammatory properties, with evidence that they decrease pathologic markers of ischemic severity. Whether GNPs affect cerebrovascular function, and potentially protect against the damaging effects of HSS on the cerebral circulation remains unclear. HSS obtained 24 h poststroke was perfused through the lumen of isolated and pressurized third-order posterior cerebral arteries (PCAs) from male Wistar rats with and without GNPs (~2 × 109 GNP/ml), or GNPs in vehicle, in an arteriograph chamber (n = 8/group). All vessels were myogenically reactive ≥60 mmHg intravascular pressure; however, vessels containing GNPs had significantly less myogenic tone. GNPs increased vasoreactivity to small and intermediate conductance calcium activated potassium channel activation via NS309; however, reduced vasoconstriction to nitric oxide synthase inhibition. Hydraulic conductivity and transvascular filtration, were decreased by GNPs, suggesting a protective effect on the blood-brain barrier. The stress-strain curves of PCAs exposed to GNPs were shifted leftward, indicating increased vessel stiffness. This study provides the first evidence that GNPs affect the structure and function of the cerebrovasculature, which may be important for their development and use in biomedical applications.
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Affiliation(s)
- Ryan D. Hunt
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Omid Sedighi
- Department of Electrical and Biomedical EngineeringUniversity of Vermont College of Engineering and Mathematical SciencesBurlingtonVermontUSA
| | - Wayne M. Clark
- Oregon Stroke Center, Department of NeurologyOregon Health, and Science UniversityPortlandUSA
| | - Amber L. Doiron
- Department of Electrical and Biomedical EngineeringUniversity of Vermont College of Engineering and Mathematical SciencesBurlingtonVermontUSA
| | - Marilyn J. Cipolla
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
- Department of Electrical and Biomedical EngineeringUniversity of Vermont College of Engineering and Mathematical SciencesBurlingtonVermontUSA
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
- Department of PharmacologyUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
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16
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Haidegger M, Lindenbeck S, Hofer E, Rodler C, Zweiker R, Perl S, Pirpamer L, Kneihsl M, Fandler-Höfler S, Gattringer T, Enzinger C, Schmidt R. Arterial stiffness and its influence on cerebral morphology and cognitive function. Ther Adv Neurol Disord 2023; 16:17562864231180715. [PMID: 37363185 PMCID: PMC10285591 DOI: 10.1177/17562864231180715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/03/2023] [Indexed: 06/28/2023] Open
Abstract
Background Recently, arterial stiffness has been associated with cerebral small vessel disease (SVD), brain atrophy and vascular dementia. Arterial stiffness is assessed via pulse wave velocity (PWV) measurement and is strongly dependent on arterial blood pressure. While circadian blood pressure fluctuations are important determinants of end-organ damage, the role of 24-h PWV variability is yet unclear. Objectives We here investigated the association between PWV and its circadian changes on brain morphology and cognitive function in community-dwelling individuals. Design Single-centre, prospective, community-based follow-up study. Methods The study cohort comprised elderly community-based participants of the Austrian Stroke Prevention Family Study which was started in 2006. Patients with any history of cerebrovascular disease or dementia were excluded. The study consists of 84 participants who underwent ambulatory 24-h PWV measurement. White matter hyperintensity volume and brain volume were evaluated by 3-Tesla magnetic resonance imaging (MRI). A subgroup of patients was evaluated for cognitive function using an extensive neuropsychological test battery. Results PWV was significantly related to reduced total brain volume (p = 0.013), which was independent of blood pressure and blood pressure variability. We found no association between PWV with markers of cerebral SVD or impaired cognitive functioning. Only night-time PWV values were associated with global brain atrophy (p = 0.005). Conclusions This study shows a relationship of arterial stiffness and reduced total brain volume. Elevations in PWV during night-time are of greater importance than day-time measures.
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Affiliation(s)
| | - Simon Lindenbeck
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Edith Hofer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Christina Rodler
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Robert Zweiker
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Sabine Perl
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Lukas Pirpamer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
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17
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Tomoto T, Tarumi T, Zhang R. Central arterial stiffness, brain white matter hyperintensity and total brain volume across the adult lifespan. J Hypertens 2023; 41:819-829. [PMID: 36883450 PMCID: PMC10079586 DOI: 10.1097/hjh.0000000000003404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVES Mounting evidence suggests that central arterial stiffening is associated with brain ageing in older adults. The purpose of this study was to determine the associations of age with carotid arterial stiffness and carotid-femoral pulse wave velocity (cfPWV), both measurements of central arterial stiffness, the relationship between age-related arterial stiffness, brain white matter hyperintensity (WMH) and total brain volume (TBV), and whether effects of central arterial stiffness on WMH volume and TBV are mediated by pulsatile cerebral blood flow (CBF). METHODS One hundred and seventy-eight healthy adults (21-80 years) underwent measurements of central arterial stiffness using tonometry and ultrasonography, WMH and TBV via MRI, and pulsatile CBF at the middle cerebral artery via transcranial Doppler. RESULTS Advanced age was associated with increases in both carotid arterial stiffness and cfPWV, increases in WMH volume and decreases in TBV (all P < 0.01). Multiple linear regression analysis showed that carotid β-stiffness was positively associated with WMH volume (B = 0.015, P = 0.017) and cfPWV negatively with TBV (B = -0.558, P < 0.001) after adjustment for age, sex and arterial pressure. Pulsatile CBF mediates the associations between carotid β-stiffness and WMH (95% confidence interval: 0.0001-0.0079). CONCLUSION These findings suggest that age-related central arterial stiffness is associated with increased WMH volume and decreased TBV, which is likely mediated by increased arterial pulsation.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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18
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Ellström K, Abul-Kasim K, Siennicki-Lantz A, Elmståhl S. Associations of carotid artery flow parameters with MRI markers of cerebral small vessel disease and patterns of brain atrophy. J Stroke Cerebrovasc Dis 2023; 32:106981. [PMID: 36657270 DOI: 10.1016/j.jstrokecerebrovasdis.2023.106981] [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: 09/26/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES A growing body of evidence links age related brain pathologies to systemic vascular processes. We aimed to study the prevalence and interrelations between magnetic resonance imaging (MRI) markers of cerebral small vessel disease and patterns of brain atrophy, and their association to carotid duplex ultrasound flow parameters. MATERIALS AND METHODS We investigated a population based randomised cohort of older adults (n=391) aged 70-87, part of the Swedish Good Aging in Skåne Study. Peak systolic and end diastolic velocities of the carotid arteries were measured by ultrasound, and resistivity- and pulsatility indexes were calculated. Subjects with increased peak systolic velocity indicating carotid stenosis were excluded from analysis. Nine MRI findings were rated by visual scales: white matter changes, pontine white matter changes, microbleeds, lacunar infarctions, medial temporal lobe atrophy, global cortical atrophy, parietal atrophy, precuneus atrophy and central atrophy. RESULTS MRI pathologies were found in 80% of subjects. Mean end diastolic velocity in common carotid arteries was inversely associated with white matter hyperintensities (OR=0.92; p=0.004), parietal lobe atrophy (OR=0.94; p=0.039), global cortical atrophy (OR=0.90; p=0.013), precuneus atrophy (OR=0.94; p=0.022), "number of CSV pathologies" (β=-0.07; p<0.001) and "MRI-burden score" (β=-0.11; p<0.001), after adjustment for age and sex. The latter three were also associated with pulsatility and resistivity indexes. CONCLUSIONS Low carotid end diastolic velocity, as well as increased carotid resistivity and pulsatility, were associated with signs of cerebral small vessel disease and patterns of brain atrophy, indicating a vascular component in the process of brain aging.
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Affiliation(s)
- Katarina Ellström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden.
| | - Kasim Abul-Kasim
- Department of Clinical Sciences Lund, Division of Diagnostic Radiology, Lund University, Sweden
| | - Arkadiusz Siennicki-Lantz
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
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19
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Tomoto T, Verma A, Kostroske K, Tarumi T, Patel NR, Pasha EP, Riley J, Tinajero CD, Hynan LS, Rodrigue KM, Kennedy KM, Park DC, Zhang R. One-year aerobic exercise increases cerebral blood flow in cognitively normal older adults. J Cereb Blood Flow Metab 2023; 43:404-418. [PMID: 36250505 PMCID: PMC9941859 DOI: 10.1177/0271678x221133861] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/04/2022] [Accepted: 09/04/2022] [Indexed: 02/16/2023]
Abstract
The impact of aerobic exercise training (AET) on cerebral blood flow (CBF) regulation remains inconclusive. This study investigated the effects of one-year progressive, moderate-to-vigorous AET on CBF, central arterial stiffness, and cognitive performance in cognitively normal older adults. Seventy-three older adults were randomly assigned to AET or stretching-and-toning (SAT, active control) intervention. CBF was measured with 2D duplex ultrasonography. Central arterial stiffness, measured by carotid β-stiffness index, was assessed with the ultrasonography and applanation tonometry. Cerebrovascular resistance (CVR) was calculated as mean arterial pressure divided by CBF. A cognitive battery was administered with a focus on memory and executive function. Cardiorespiratory fitness was measured by peak oxygen consumption (V ˙ O2peak). One-year AET increased V ˙ O2peak and CBF and decreased CVR and carotid β-stiffness index. In the AET group, improved V ˙ O2peak was correlated with increased CBF (r = 0.621, p = 0.001) and decreased CVR (r = -0.412, p = 0.037) and carotid β-stiffness index (r = -0.478, p = 0.011). Further, increased Woodcock-Johnson recall score was associated with decreased CVR (r = -0.483, p = 0.012) and carotid β-stiffness index (r = -0.498, p = 0.008) in AET group (not in SAT group). In conclusion, one-year progressive, moderate-to-vigorous aerobic exercise training increased CBF and decreased carotid arterial stiffness and CVR which were associated with improved memory function in cognitively normal older adults.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National
Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki,
Japan
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Aryan Verma
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Kayla Kostroske
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National
Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki,
Japan
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Graduate School of Comprehensive Human Sciences, University of
Tsukuba, Tsukuba, Ibaraki, Japan
| | - Neena R Patel
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Evan P Pasha
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Jonathan Riley
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Cynthia D Tinajero
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Linda S Hynan
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Department of Population and Data Sciences, University of Texas
Southwestern Medical Center, Dallas, Texas, USA
| | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Kristen M Kennedy
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Denise C Park
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas
Southwestern Medical Center, Dallas, Texas, USA
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20
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Paré M, Obeid H, Labrecque L, Drapeau A, Brassard P, Agharazii M. Cerebral blood flow pulsatility and cerebral artery stiffness acutely decrease during hemodialysis. Physiol Rep 2023; 11:e15595. [PMID: 36808481 PMCID: PMC9937783 DOI: 10.14814/phy2.15595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 02/19/2023] Open
Abstract
End-stage kidney disease (ESKD) is associated with increased arterial stiffness and cognitive impairment. Cognitive decline is accelerated in ESKD patients on hemodialysis and may result from repeatedly inappropriate cerebral blood flow (CBF). The aim of this study was to examine the acute effect of hemodialysis on pulsatile components of CBF and their relation to acute changes in arterial stiffness. In eight participants (age: 63 ± 18 years, men: 5), CBF was estimated using middle cerebral artery blood velocity (MCAv) assessed with transcranial Doppler ultrasound before, during, and after a single hemodialysis session. Brachial and central blood pressure, along with estimated aortic stiffness (eAoPWV) were measured using an oscillometric device. Arterial stiffness from heart to MCA was measured as the pulse arrival time (PAT) between electrocardiogram (ECG) and transcranial Doppler ultrasound waveforms (cerebral PAT). During hemodialysis, there was a significant reduction in mean MCAv (-3.2 cm/s, p < 0.001), and systolic MCAv (-13.0 cm/s, p < 0.001). While baseline eAoPWV (9.25 ± 0.80 m/s) did not significantly change during hemodialysis, cerebral PAT increased significantly (+0.027 , p < 0.001) and was associated with reduced pulsatile components of MCAv. This study shows that hemodialysis acutely reduces stiffness of arteries perfusing the brain along with pulsatile components of blood velocity.
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Affiliation(s)
- Mathilde Paré
- CHU de Québec Research Center, L'Hôtel‐Dieu de Québec HospitalQuébec CityQuebecCanada,Research Center of the Institute Universitaire de Cardiologie et de Pneumologie de QuébecQuébec CityQuebecCanada,Department of Kinesiology, Faculty of MedicineUniversité LavalQuébec CityQuebecCanada
| | - Hasan Obeid
- CHU de Québec Research Center, L'Hôtel‐Dieu de Québec HospitalQuébec CityQuebecCanada
| | - Lawrence Labrecque
- Research Center of the Institute Universitaire de Cardiologie et de Pneumologie de QuébecQuébec CityQuebecCanada,Department of Kinesiology, Faculty of MedicineUniversité LavalQuébec CityQuebecCanada
| | - Audrey Drapeau
- Research Center of the Institute Universitaire de Cardiologie et de Pneumologie de QuébecQuébec CityQuebecCanada,Department of Kinesiology, Faculty of MedicineUniversité LavalQuébec CityQuebecCanada
| | - Patrice Brassard
- Research Center of the Institute Universitaire de Cardiologie et de Pneumologie de QuébecQuébec CityQuebecCanada,Department of Kinesiology, Faculty of MedicineUniversité LavalQuébec CityQuebecCanada
| | - Mohsen Agharazii
- CHU de Québec Research Center, L'Hôtel‐Dieu de Québec HospitalQuébec CityQuebecCanada,Division of Nephrology, Faculty of MedicineUniversité Laval, QuébecQuébec CityQuebecCanada
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21
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Reeve EH, Kronquist EK, Wolf JR, Lee B, Khurana A, Pham H, Cullen AE, Peterson JA, Meza A, Colton Bramwell R, Villasana L, Machin DR, Henson GD, Walker AE. Pyridoxamine treatment ameliorates large artery stiffening and cerebral artery endothelial dysfunction in old mice. J Cereb Blood Flow Metab 2023; 43:281-295. [PMID: 36189840 PMCID: PMC9903220 DOI: 10.1177/0271678x221130124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Age-related increases in large artery stiffness are associated with cerebrovascular dysfunction and cognitive impairment. Pyridoxamine treatment prevents large artery stiffening with advancing age, but the effects of pyridoxamine treatment on the cerebral vasculature or cognition is unknown. The purpose of this study was to investigate the effects of pyridoxamine on blood pressure, large artery stiffness, cerebral artery function, and cognitive function in old mice. Old male C57BL/6 mice consumed either pyridoxamine (2 g/L) or vehicle control in drinking water for ∼7.5 months and were compared with young male C57BL/6 mice. From pre- to post-treatment, systolic blood pressure increased in old control mice, but was maintained in pyridoxamine treated mice. Large artery stiffness decreased in pyridoxamine-treated mice but was unaffected in control mice. Pyridoxamine-treated mice had greater cerebral artery endothelium-dependent dilation compared with old control mice, and not different from young mice. Old control mice had impaired cognitive function; however, pyridoxamine only partially preserved cognitive function in old mice. In summary, pyridoxamine treatment in old mice prevented age-related increases in blood pressure, reduced large artery stiffness, preserved cerebral artery endothelial function, and partially preserved cognitive function. Taken together, these results suggest that pyridoxamine treatment may limit vascular aging.
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Affiliation(s)
- Emily H Reeve
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Elise K Kronquist
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Julia R Wolf
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Byron Lee
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Aleena Khurana
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Hanson Pham
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Abigail E Cullen
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Jessica A Peterson
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Antonio Meza
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - R Colton Bramwell
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Daniel R Machin
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Nutrition and Integrative Physiology, 7823, Florida State University, Tallahassee, FL, USA
| | - Grant D Henson
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
| | - Ashley E Walker
- Department of Human Physiology, 3265, University of Oregon, Eugene, OR, USA
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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22
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Yu J, Zhu H, Kindy MS, Taheri S. The impact of a high-sodium diet regimen on cerebrovascular morphology and cerebral perfusion in Alzheimer's disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 4:100161. [PMID: 36741272 PMCID: PMC9895990 DOI: 10.1016/j.cccb.2023.100161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/05/2022] [Accepted: 01/27/2023] [Indexed: 01/30/2023]
Abstract
Introduction Various lifestyle factors such as chronic hypertension and a high-sodium diet regimen are shown to impact cerebrovascular morphology and structure. Unusual cerebrovascular morphological and structural changes may contribute to cerebral hypoperfusion in Alzheimer's disease (AD). The objective of this study was to examine whether a high-sodium diet mediates cerebrovascular morphology and cerebral perfusion alterations in AD. Methods Double transgenic mice harboring Aβ precursor protein (APPswe) and presenilin-1 (PSEN1) along with wild-type controls were divided into four groups. Group A (APP/PS1) and B (controls) were both fed a high-sodium (4.00%), while group C (APP/PS1) and D (controls) were both fed a low-sodium (0.08% a regular chow diet) for three months. Then, changes in regional cerebral perfusion and diffusion, cerebrovascular morphology, and structure were quantified. Results A 3-month high-sodium diet causes pyknosis and deep staining in hippocampal neurons and reduced vascular density in both hippocampal and cortical areas (p <0.001) of APP/PS1. Despite vascular density changes, cerebral perfusion was not increased markedly (p = 0.3) in this group, though it was increased more in wild-type controls (p = 0.022). Conclusion A high-sodium diet regimen causes cerebrovascular morphology alteration in APP/PS1 mouse model of AD.
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Affiliation(s)
- Jin Yu
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Hong Zhu
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Mark S. Kindy
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA,James A. Haley VA Medical Center, Tampa, FL 33612, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, University of South Florida, Tampa, FL 33612, USA,USF Heart Institute, Tampa, FL 33612, USA,Corresponding author at: Department of Pharmaceutical Sciences, USF Heart Institute, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 30, Tampa, FL 33612, USA.
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23
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Abstract
Hypertension affects a significant proportion of the adult and aging population and represents an important risk factor for vascular cognitive impairment and late-life dementia. Chronic high blood pressure continuously challenges the structural and functional integrity of the cerebral vasculature, leading to microvascular rarefaction and dysfunction, and neurovascular uncoupling that typically impairs cerebral blood supply. Hypertension disrupts blood-brain barrier integrity, promotes neuroinflammation, and may contribute to amyloid deposition and Alzheimer pathology. The mechanisms underlying these harmful effects are still a focus of investigation, but studies in animal models have provided significant molecular and cellular mechanistic insights. Remaining questions relate to whether adequate treatment of hypertension may prevent deterioration of cognitive function, the threshold for blood pressure treatment, and the most effective antihypertensive drugs. Recent advances in neurovascular biology, advanced brain imaging, and detection of subtle behavioral phenotypes have begun to provide insights into these critical issues. Importantly, a parallel analysis of these parameters in animal models and humans is feasible, making it possible to foster translational advancements. In this review, we provide a critical evaluation of the evidence available in experimental models and humans to examine the progress made and identify remaining gaps in knowledge.
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Affiliation(s)
| | - Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
| | - Daniela Carnevale
- Department of Molecular Medicine, “Sapienza” University of Rome, Italy
- Research Unit of Neuro and Cardiovascular Pathophysiology, IRCCS Neuromed, Pozzilli, Italy
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24
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Robert C, Ling L, Tan ESJ, Gyanwali B, Venketasubramanian N, Lim SL, Gong L, Berboso JL, Richards AM, Chen C, Hilal S. Effects of Carotid Artery Stiffness on Cerebral Small-Vessel Disease and Cognition. J Am Heart Assoc 2022; 11:e027295. [PMID: 36444832 PMCID: PMC9851463 DOI: 10.1161/jaha.122.027295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Carotid artery stiffness is associated with cognitive impairment and dementia, but the underlying mechanisms remain unknown. We examined the associations of carotid artery stiffness with cerebral small-vessel disease markers, cognition, and dementia subtypes in a memory clinic cohort. Methods and Results A total of 272 participants underwent carotid ultrasonography, 3 Tesla brain magnetic resonance imaging, and neuropsychological assessment. Carotid ultrasonography was used to assess β-index, pressure-strain elastic modulus, and pulse-wave velocity-β. Brain magnetic resonance images were graded for cerebral small-vessel disease markers, including white matter hyperintensities, lacunes, and cerebral microbleeds. Participants were classified as having no cognitive impairment, cognitive impairment and no dementia, or dementia subtyped as Alzheimer disease and vascular dementia. Cognition was assessed using National Institute of Neurological Disorders and Stroke-Canadian Stroke Network harmonization battery. After adjusting for age, sex, cardiovascular risk factors, and diseases, multivariable models showed that β-index (β=0.69; P=0.002), elastic modulus (β=0.78; P<0.001), and pulse-wave velocity-β (β=0.80; P<0.001) were associated with white matter hyperintensities, and elastic modulus (odds ratio [OR], 1.39 [95% CI, 1.04-1.85]) and pulse-wave velocity-β (OR, 1.47 [95% CI, 1.10-1.98]) were independently associated with lacunes. Similarly, β-index (OR, 2.04 [95% CI, 1.14-4.13]), elastic modulus (OR, 2.22 [95% CI, 1.25-4.42]), and pulse-wave velocity-β (OR, 2.50 [95% CI, 1.36-5.18]) were independently associated with vascular dementia. Carotid stiffness measures were independently associated with worse performance in global cognition, visuomotor speed, visuospatial function, and executive function. These associations became largely nonsignificant after further adjusting for cerebral small-vessel disease markers. Conclusions In memory clinic patients, carotid artery stiffness was associated with white matter hyperintensities and lacunes, impairment in global and domain-specific cognition, and causative subtypes of dementia, particularly vascular. The effects of carotid stiffness on cognition were not independent of, and were partially mediated by, cerebral small-vessel disease.
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Affiliation(s)
- Caroline Robert
- Department of Pharmacology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore,Memory Aging and Cognition CentreNational University Health SystemSingapore CitySingapore
| | - Lieng‐Hsi Ling
- Department of CardiologyNational University Heart CentreSingapore CitySingapore,Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
| | - Eugene S. J. Tan
- Department of CardiologyNational University Heart CentreSingapore CitySingapore
| | - Bibek Gyanwali
- Memory Aging and Cognition CentreNational University Health SystemSingapore CitySingapore,Department of BiochemistryYong Loo Lin School of MedicineSingapore CitySingapore
| | | | - Shir Lynn Lim
- Department of CardiologyNational University Heart CentreSingapore CitySingapore
| | - Lingli Gong
- Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
| | - Josephine Lunaria Berboso
- Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore
| | - Arthur Mark Richards
- Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore,Cardiovascular Research InstituteNational University Health SystemSingapore CitySingapore,Christchurch Heart InstituteUniversity of OtagoSingapore CitySingapore
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore,Memory Aging and Cognition CentreNational University Health SystemSingapore CitySingapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore CitySingapore,Memory Aging and Cognition CentreNational University Health SystemSingapore CitySingapore,Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore CitySingapore
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25
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Tsentidou G, Moraitou D, Tsolaki M, Masoura E, Papaliagkas V. Trajectories of Cognitive Impairment in Adults Bearing Vascular Risk Factors, with or without Diagnosis of Mild Cognitive Impairment: Findings from a Longitudinal Study Assessing Executive Functions, Memory, and Social Cognition. Diagnostics (Basel) 2022; 12:diagnostics12123017. [PMID: 36553024 PMCID: PMC9777412 DOI: 10.3390/diagnostics12123017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
With the aging of the population, a key concern of both societies and health services is to keep the population cognitively healthy until the maximum age limit. It is a well-known fact that vascular aging has a negative effect on the cognitive skills of adults, putting them at greater risk of developing dementia. The present longitudinal study aimed to evaluate the main dimensions of cognition in two pathological groups with different health profiles: a group of adults with vascular risk factors (VRF) (n = 35) and a group of adults with vascular risk factors and mild cognitive impairment (VRF + MCI) (n = 35). The two groups were matched in age, education, and gender. They were assessed with extensive neuropsychological testing at three different times with a distance of about 8 months between them; the assessment regarded executive functions, memory capacity, and Theory of Mind abilities. The analyses carried out were (a) mixed-measures ANOVA, (b) repeated measures ANOVA, and (c) ANOVA. The findings showed that global cognitive status and short-term memory are the main cognitive abilities that decline in community dwelling people bearing VRF. Hence, this group of adults should be examined at least every 2 years for this decline. As regards people with both VRF and MCI, it seems that the assessment of Theory of Mind abilities can better capture their further impairment. Global cognitive status, task/rule switching function, and long-term memory (delayed verbal recall) were revealed as the abilities that clearly and steadily differentiate VRF people with and without MCI.
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Affiliation(s)
- Glykeria Tsentidou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6983140302
| | - Despina Moraitou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Elvira Masoura
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 574 00 Sindos, Greece
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26
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Gusmão WDP, Pureza IROM, Moreno CRC. Shift Work and Early Arterial Stiffness: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14569. [PMID: 36361448 PMCID: PMC9654495 DOI: 10.3390/ijerph192114569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Shift work is a way of organizing rotating schedules throughout the day. This can include 1-3 shifts for the same person on a rotational basis with other workers. Schedules that include night work have been associated with cardiovascular risk, mainly due to circadian misalignment. This systematic review sought to determine whether shift work is a risk factor for increased arterial stiffness. A systematic review of different databases was performed, using the following keywords: work shift, night work, arteriosclerosis, vascular stiffness, arterial stiffness, pulse wave velocity, and their Medical Subject Headings. We selected and analyzed 11 articles regarding pulse wave velocity as an indicator of arterial stiffness. Two studies identified higher levels of arterial stiffness in shift workers compared to day workers, while two studies found the opposite. In addition, four studies found no differences in arterial stiffness between shifts, two studies associated shorter sleep duration with arterial stiffness, and one study observed that physical activity could prevent adverse cardiovascular outcomes in shift workers. The findings are heterogeneous and preclude any robust conclusions. However, the present review points to the need for further studies to investigate arterial stiffness in shift workers, with greater control for confounding factors and longitudinal design.
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Affiliation(s)
- Waléria D. P. Gusmão
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
| | - Isabele R. O. M. Pureza
- Department of Nutrition, Campus I—Prof. Eduardo Almeida, Centro Universitário Cesmac, Maceió 57051-160, Brazil
| | - Claudia R. C. Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil
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27
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Prediction of long-term outcomes by arterial stiffness and pressure wave reflections in patients with acute stroke: the Athens Stroke Registry. J Hypertens 2022; 40:2192-2199. [DOI: 10.1097/hjh.0000000000003244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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28
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Imahori Y, Vetrano DL, Xia X, Grande G, Ljungman P, Fratiglioni L, Qiu C. Association of resting heart rate with cognitive decline and dementia in older adults: A population-based cohort study. Alzheimers Dement 2022; 18:1779-1787. [PMID: 34859936 DOI: 10.1002/alz.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Resting heart rate (RHR) predicts future risk for cardiovascular disease (CVD). However, longitudinal studies investigating the relationship of RHR with cognitive decline are scarce. METHODS This population-based cohort study included 2147 participants (age≥60) in SNAC-K who were free of dementia and regularly followed from 2001-2004 to 2013-2016. RHR was assessed with electrocardiogram. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders 4th Revision criteria. Global cognitive function was assessed using Mini-Mental State Examination (MMSE). Data were analyzed using Cox and linear mixed-effects models. RESULTS RHR≥80 (vs. 60-69) bpm was associated with a multi-adjusted hazard ratio of 1.55 (95% confidence interval 1.06-2.27) for dementia. The association remained significant after excluding participants with prevalent and incident CVDs. Similarly, RHR≥80 bpm was associated with a multi-adjusted β-coefficient of -0.13 (-0.21 to -0.04) for MMSE score. DISCUSSION Higher RHR is associated with increased risk for dementia and faster cognitive decline independent of CVDs in a general population of elderly people.
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Affiliation(s)
- Yume Imahori
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centro Medicina dell'Invecchiamento, Fondazione Policlinico "A- Gemelli" IRCCS and Catholic University of Rome, Rome, Italy
| | - Xin Xia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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29
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Hirasawa A, Nagai K, Miyazawa T, Koshiba H, Tamada M, Shibata S, Kozaki K. Relationship between arterial stiffness and cognitive function in outpatients with dementia and mild cognitive impairment compared with community residents without dementia. J Geriatr Cardiol 2022; 19:594-602. [PMID: 36339473 PMCID: PMC9630006 DOI: 10.11909/j.issn.1671-5411.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND It is unclear whether the dementia patients with Alzheimer's disease (AD) and vascular dementia (VaD) and mixed dementia (MIX, including AD and VaD) would have more developed arterial stiffness as compared with local residents without dementia. The aim of this study was to assess arterial stiffness and cognitive function in different types of dementia patients [AD, VaD, MIX and mild cognitive impairment (MCI)] and community residents without dementia. METHODS This was a single-center, cross-sectional observational study. We studied a cohort of 600 elderly outpatients with a complaint of memory loss, who were divided into four groups (AD, VaD, MIX and MCI). In addition, they were compared with 55 age-matched local residents without dementia (Controls). We assessed arterial stiffness by brachial-ankle pulse wave velocity (baPWV) and the global cognitive function by the Mini-Mental State Examination (MMSE). RESULTS The baPWV was higher in AD, VaD and MIX than in MCI and in Controls (P < 0.05). The baPWV was higher in MCI than in Controls (P = 0.021), while MMSE were compatible between them (P = 0.119). The higher baPWV predicted the presence of AD, VaD, MIX and MCI with the odds ratio of 6.46, 8.74, 6.16 and 6.19, respectively. In contrast, there were no difference in baPWV among three different types of dementia (P = 0.191). The linear relationship between baPWV and MMSE was observed in the elderly with MMSE ≥ 23 (R = 0.452, P = 0.033), while it was not in dementia patients (MMSE < 23). CONCLUSIONS The findings suggest that MCI and dementia patients have stiffer arteries as compared with age-matched local residents, although global cognitive function may be comparable between MCI and the local residents.
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Affiliation(s)
- Ai Hirasawa
- Department of Health and Welfare, Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - Kumiko Nagai
- Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Taiki Miyazawa
- Department of Health and Sports Science, Faculty of Wellness, Shigakkan University, Aichi, Japan
| | - Hitomi Koshiba
- Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Mami Tamada
- Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Shigeki Shibata
- Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Tokyo, Japan
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30
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Decreases in Arterial Stiffness and Wave Reflection after Isometric Handgrip Training Are Associated with Improvements in Cognitive Function in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159585. [PMID: 35954942 PMCID: PMC9368421 DOI: 10.3390/ijerph19159585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to investigate whether decreases in arterial stiffness and wave reflection after isometric handgrip (IHG) training improve cognitive function in older adults. Twenty-two older adults (mean age ± standard error: 75 ± 2 years) were randomly assigned to either a group that performed IHG training (IHG group, n = 11) or a sedentary control group (CON group, n = 11). The IHG exercise comprised four unilateral 2-minute isometric contractions at 30% of maximal voluntary contraction using a programmed handgrip dynamometer with 1-minute rest periods, performed 5 days per week for 8 weeks. Carotid pulse wave velocity (cPWV) and carotid augmentation index (cAIx) were measured, and the trail-making test (TMT) parts A (TMT-A) and B (TMT-B) were performed before (baseline) and after 8 weeks of training in both groups. After 8 weeks of training, cPWV, cAIx, TMT-A, and TMT-B were significantly reduced in the IHG group (p < 0.05). Significant positive correlations were found between the amount of change in cPWV and cAIx and that in TMT-A (p < 0.05 each). In addition, positive correlation trends were observed between the amount of change in cPWV and cAIx and that in TMT-B (p = 0.06, p = 0.05, respectively). The results of the present study suggest that IHG training-induced decreases in arterial stiffness and wave reflection are associated with improvements in cognitive function in older adults.
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31
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Genome-wide associations of aortic distensibility suggest causality for aortic aneurysms and brain white matter hyperintensities. Nat Commun 2022; 13:4505. [PMID: 35922433 PMCID: PMC9349177 DOI: 10.1038/s41467-022-32219-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 07/20/2022] [Indexed: 12/13/2022] Open
Abstract
Aortic dimensions and distensibility are key risk factors for aortic aneurysms and dissections, as well as for other cardiovascular and cerebrovascular diseases. We present genome-wide associations of ascending and descending aortic distensibility and area derived from cardiac magnetic resonance imaging (MRI) data of up to 32,590 Caucasian individuals in UK Biobank. We identify 102 loci (including 27 novel associations) tagging genes related to cardiovascular development, extracellular matrix production, smooth muscle cell contraction and heritable aortic diseases. Functional analyses highlight four signalling pathways associated with aortic distensibility (TGF-β, IGF, VEGF and PDGF). We identify distinct sex-specific associations with aortic traits. We develop co-expression networks associated with aortic traits and apply phenome-wide Mendelian randomization (MR-PheWAS), generating evidence for a causal role for aortic distensibility in development of aortic aneurysms. Multivariable MR suggests a causal relationship between aortic distensibility and cerebral white matter hyperintensities, mechanistically linking aortic traits and brain small vessel disease.
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32
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Cipolla MJ, Tremble S, DeLance N, Allison D, Johnson AC. Treatment with apocynin selectively restores hippocampal arteriole function and seizure-induced hyperemia in a model of preeclampsia. J Cereb Blood Flow Metab 2022; 42:1425-1436. [PMID: 35137612 PMCID: PMC9274854 DOI: 10.1177/0271678x221080092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/06/2022] [Accepted: 01/21/2022] [Indexed: 12/31/2022]
Abstract
Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with neurovascular dysfunction, cognitive impairment and increased seizure susceptibility. Here, we sought to determine if treatment of experimental PE (ePE) rats with apocynin could prevent hippocampal arteriolar (HA) dysfunction and impaired seizure-induced hyperemia within the hippocampus, a brain region central to cognition and seizure generation. Isolated and pressurized HAs from Sprague Dawley rats that were normal pregnant (Preg; n = 8), ePE (n = 8) or ePE treated with apocynin for 2 weeks of gestation (ePE + apo; n = 8) were compared. Hippocampal blood flow (n = 6/group) was measured using hydrogen clearance before and during seizure. Aorta elastin was quantified using histochemistry. ePE was associated with HA dysfunction including reduced contraction to endothelin-1 and diminished dilation to the endothelium-dependent vasodilator NS309 that was prevented by apocynin. However, apocynin had no effect on ePE-induced impairment of dilation to the nitric oxide donor sodium nitroprusside, but increased myogenic tone and substantially increased HA distensibility. Seizure-induced hyperemia was impaired in ePE rats that was restored by apocynin. Aorta from ePE rats had reduced elastin content, suggesting large artery stiffness, that was unaffected by apocynin. Thus, while apocynin partially prevented HA dysfunction, its restoration of functional hyperemia may be protective of seizure-induced injury during eclampsia.
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Affiliation(s)
- Marilyn J Cipolla
- Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA
- Department of Pharmacology, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Sarah Tremble
- Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Nicole DeLance
- Department of Pathology, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Dana Allison
- Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Abbie C Johnson
- Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA
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Proteomic Assessment of C57BL/6 Hippocampi after Non-Selective Pharmacological Inhibition of Nitric Oxide Synthase Activity: Implications of Seizure-like Neuronal Hyperexcitability Followed by Tauopathy. Biomedicines 2022; 10:biomedicines10081772. [PMID: 35892672 PMCID: PMC9331517 DOI: 10.3390/biomedicines10081772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
Nitric oxide (NO) is a small gaseous signaling molecule responsible for maintaining homeostasis in a myriad of tissues and molecular pathways in neurology and the cardiovasculature. In recent years, there has been increasing interest in the potential interaction between arterial stiffness (AS), an independent cardiovascular risk factor, and neurodegenerative syndromes given increasingly epidemiological study reports. For this reason, we previously investigated the mechanistic convergence between AS and neurodegeneration via the progressive non-selective inhibition of all nitric oxide synthase (NOS) isoforms with N(G)-nitro-L-arginine methyl ester (L-NAME) in C57BL/6 mice. Our previous results showed progressively increased AS in vivo and impaired visuospatial learning and memory in L-NAME-treated C57BL/6 mice. In the current study, we sought to further investigate the progressive molecular signatures in hippocampal tissue via LC–MS/MS proteomic analysis. Our data implicate mitochondrial dysfunction due to progressive L-NAME treatment. Two weeks of L-NAME treatment implicates altered G-protein-coupled-receptor signaling in the nerve synapse and associated presence of seizures and altered emotional behavior. Furthermore, molecular signatures implicate the cerebral presence of seizure-related hyperexcitability after short-term (8 weeks) treatment followed by ribosomal dysfunction and tauopathy after long-term (16 weeks) treatment.
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Aminuddin N, Achuthan A, Ruhaiyem NIR, Che Mohd Nassir CMN, Idris NS, Mustapha M. Reduced cerebral vascular fractal dimension among asymptomatic individuals as a potential biomarker for cerebral small vessel disease. Sci Rep 2022; 12:11780. [PMID: 35821514 PMCID: PMC9276662 DOI: 10.1038/s41598-022-15710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
Cerebral small vessel disease is a neurological disease frequently found in the elderly and detected on neuroimaging, often as an incidental finding. White matter hyperintensity is one of the most commonly reported neuroimaging markers of CSVD and is linked with an increased risk of future stroke and vascular dementia. Recent attention has focused on the search of CSVD biomarkers. The objective of this study is to explore the potential of fractal dimension as a vascular neuroimaging marker in asymptomatic CSVD with low WMH burden. Df is an index that measures the complexity of a self-similar and irregular structure such as circle of Willis and its tributaries. This exploratory cross-sectional study involved 22 neurologically asymptomatic adult subjects (42 ± 12 years old; 68% female) with low to moderate 10-year cardiovascular disease risk prediction score (QRISK2 score) who underwent magnetic resonance imaging/angiography (MRI/MRA) brain scan. Based on the MRI findings, subjects were divided into two groups: subjects with low WMH burden and no WMH burden, (WMH+; n = 8) and (WMH−; n = 14) respectively. Maximum intensity projection image was constructed from the 3D time-of-flight (TOF) MRA. The complexity of the CoW and its tributaries observed in the MIP image was characterised using Df. The Df of the CoW and its tributaries, i.e., Df (w) was significantly lower in the WMH+ group (1.5172 ± 0.0248) as compared to WMH− (1.5653 ± 0.0304, p = 0.001). There was a significant inverse relationship between the QRISK2 risk score and Df (w), (rs = − .656, p = 0.001). Df (w) is a promising, non-invasive vascular neuroimaging marker for asymptomatic CSVD with WMH. Further study with multi-centre and long-term follow-up is warranted to explore its potential as a biomarker in CSVD and correlation with clinical sequalae of CSVD.
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Affiliation(s)
- Niferiti Aminuddin
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.,Department of Basic Medical Sciences, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Anusha Achuthan
- School of Computer Sciences, Universiti Sains Malaysia, 11800, USM, Pulau Pinang, Malaysia
| | | | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Nur Suhaila Idris
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, 16150, Kubang Kerian, Kelantan, Malaysia.,Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia. .,Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, 16150, Kubang Kerian, Kelantan, Malaysia.
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Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment. Eur J Appl Physiol 2022; 122:1843-1856. [PMID: 35522276 PMCID: PMC9287231 DOI: 10.1007/s00421-022-04956-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/15/2022] [Indexed: 01/23/2023]
Abstract
PURPOSE Our aim was to compare cerebrovascular and systemic vascular function between older adults with and without mild cognitive impairment (MCI), and to determine which measures of vascular function best predict the presence of MCI. METHODS In 41 adults with MCI and 33 adults without MCI (control) we compared middle cerebral artery velocity (MCAv) and cerebrovascular pulsatility index (PI) at rest, cerebrovascular reactivity to CO2, and responsiveness to changes in blood pressure (%∆MCAv/%∆MAP). Systemic vascular function was assessed by flow-mediated dilation (FMD) and stiffness by pulse wave velocity (PWV). RESULTS Cerebrovascular PI was higher in MCI compared with control (mean ± SD: 1.17 ± 0.27 vs. 1.04 ± 0.21), and MCI exhibited a lower %∆MCAv/%∆MAP (1.26 ± 0.44 vs. 1.50 ± 0.55%). Absolute (p = 0.76) and relative cerebrovascular reactivity to CO2 (p = 0.34) was similar between MCI and control. When age was included as a covariate the significant difference in cerebral PI between groups was lost. PWV was higher (13.2 ± 2.2 vs. 11.3 ± 2.5 m s-1) and FMD% (4.41 ± 1.70 vs. 5.43 ± 2.15%) was lower in MCI compared with control. FMD% was positively associated with PI across the cohort. Logistic regression analysis indicated that FMD and PWV significantly discriminated between MCI and controls, independent of age, whereas the inclusion of cerebrovascular measures did not improve the predictive accuracy of the model. CONCLUSION These findings raise the possibility that early changes in systemic vascular stiffness and endothelial function may contribute to altered cerebrovascular haemodynamics and impaired cognitive function, and present potential targets for prevention and treatment strategies in people with MCI.
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Cerebral small vessel disease alters neurovascular unit regulation of microcirculation integrity involved in vascular cognitive impairment. Neurobiol Dis 2022; 170:105750. [DOI: 10.1016/j.nbd.2022.105750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/09/2022] [Accepted: 05/08/2022] [Indexed: 12/25/2022] Open
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Baradaran H, Gupta A. Carotid Artery Stiffness: Imaging Techniques and Impact on Cerebrovascular Disease. Front Cardiovasc Med 2022; 9:852173. [PMID: 35369341 PMCID: PMC8964780 DOI: 10.3389/fcvm.2022.852173] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
Arterial stiffness is an important measure of vascular aging and atherosclerosis. Though it is measured in many well-known epidemiologic cohort studies, arterial stiffness is often overlooked in routine clinical practice for a number of reasons including difficulties in measurement, variations in definition, and uncertainties surrounding treatment. Central arterial stiffness, a surrogate for aortic stiffness, is the most commonly measured marker of arterial stiffness. In addition to central stiffness, there are also a number of ultrasound based techniques to measure local vascular stiffness, including carotid stiffness. There is evidence that both local carotid stiffness and central arterial stiffness measures are associated with multiple cerebrovascular processes, including stroke and cognitive dysfunction. Mechanistic explanations supporting this association include increased flow load experienced by the cerebral microvasculature leading to cerebral parenchymal damage. In this article, we review definitions of carotid artery stiffness measures and pathophysiologic mechanisms underpinning its association with plaque development and downstream cerebral pathology. We will review the evidence surrounding the association of carotid stiffness measures with downstream manifestations including stroke, cerebral small vessel disease detected on brain MR such as white matter hyperintensities and covert brain infarctions, brain atrophy, and cognitive dysfunction. With consistent definitions, measurement methods, and further scientific support, carotid stiffness may have potential as an imaging-based risk factor for stroke and cognitive decline.
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Affiliation(s)
- Hediyeh Baradaran
- Department of Radiology, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Hediyeh Baradaran
| | - Ajay Gupta
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
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Rouch L, Hoang T, Xia F, Sidney S, Lima JAC, Yaffe K. Twenty-Five-Year Change in Cardiac Structure and Function and Midlife Cognition: The CARDIA Study. Neurology 2022; 98:e1040-e1049. [PMID: 35082172 PMCID: PMC8967387 DOI: 10.1212/wnl.0000000000013249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The goal of this work was to determine whether midlife cardiac structure and function and their 25-year change from early to middle adulthood are associated with lower midlife cognition. METHODS We studied 2,653 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study (57% women, 46% Black). Echocardiograms were obtained at year 5, 25, and 30 visits (participant mean age 30, 50, and 55 years) to assess left ventricular (LV) mass (LVM), LV systolic function with LV ejection fraction (LVEF), and LV diastolic function with left atrial volume (LAV) and early peak mitral velocity (E)/early peak mitral annular velocity (e') ratio. LVM and LAV were indexed to body surface area (LVMi and LAVi). At year 30, 5 cognitive domains were measured: global cognition, processing speed, executive function, delayed verbal memory, and verbal fluency. We investigated the association between midlife (year 30) and 25-year change in cardiac structure and function on midlife cognition using linear regressions. RESULTS Over 25 years, LVMi and LAVi increased with mean change (SD) per year of 0.27 (0.28) g/m2 and 0.42 (0.15) mL/m2, while LVEF decreased by 0.11% (0.02%). After adjustment for demographics and education, 25-year increase (≥1 SD) in LVMi was associated with lower cognition on most tests (p ≤ 0.02); 25-year increase in LAVi was associated with lower global cognition (p = 0.04), but 25-year decrease in LVEF was not associated with cognition. Further adjustment for cardiovascular risk factors led to similar results. In addition, unlike year 30 E/e' ratio and LVEF, higher year 30 LVMi and LAVi were significantly associated with worse cognition on most cognitive tests. DISCUSSION Midlife cardiac structure and its change from early to middle adulthood are associated with lower midlife cognition even after accounting for confounders. Unlike systolic function, midlife LV diastolic function and its 25-year change were also linked to cognition. Our results provide information linking early to midlife cardiac structure and function to cognition.
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Affiliation(s)
- Laure Rouch
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA.
| | - Tina Hoang
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA
| | - Feng Xia
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA
| | - Stephen Sidney
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA
| | - Joao A C Lima
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA
| | - Kristine Yaffe
- From the Departments of Psychiatry (L.R., K.Y.), Neurology (K.Y.), and Epidemiology (K.Y.), University of California, San Francisco; Northern California Institute for Research and Education (T.H., F.X.), San Francisco; Kaiser Permanente Northern California (S.S.), Division of Research, Oakland; Johns Hopkins University School of Medicine (J.A.C.L.), Baltimore, MD; and San Francisco VA Medical Center (K.Y.), CA
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Wang Y, Chen W, Zhou J, Wang Y, Wang H, Wang Y. Nitrate Metabolism and Ischemic Cerebrovascular Disease: A Narrative Review. Front Neurol 2022; 13:735181. [PMID: 35309590 PMCID: PMC8927699 DOI: 10.3389/fneur.2022.735181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
Inorganic and organic nitrates are present in vivo and in vitro. Inorganic nitrate is considered a pool of nitric oxide (NO), but it can be converted into nitrite and NO through various mechanisms. It plays an important role in the regulation of complex physiological and biochemical reactions, such as anti-inflammatory processes and the inhibition of platelet aggregation, which are closely related to the pathology and treatment of cerebrovascular disease. Ischemic cerebrovascular disease is characterized by high incidence, recurrence, and disability rates. Nitrate, nitrite, and NO were recently found to be involved in cerebrovascular disease. In this review, we describe the relationship between cerebrovascular disease and nitrate metabolism to provide a basis for further advances in laboratory and clinical medicine.
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Affiliation(s)
- Yicong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
| | - Weiqi Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
| | - Jian Zhou
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- School of Stomatology, Capital Medical University, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Wang
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Hao Wang
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Laboratory for Oral and General Health Integration and Translation, Beijing, China
- Yilong Wang
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Qu F, Yang X, Yang J, Zhou Q, Yang X, Chen M, Xiong Y, Hu Y. Interaction between arteriosclerosis and the APOE4 gene in cognitive decline in older adults: a cross-sectional study in rural minority areas in western China. Psychogeriatrics 2022; 22:243-251. [PMID: 35048467 DOI: 10.1111/psyg.12808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/14/2021] [Accepted: 12/28/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Numerous studies have confirmed that the apolipoprotein E4 allele (APOE4) gene and arteriosclerosis (AS) have a combined effect on the occurrence of cognitive function impairment, and dyslipidaemia levels are significantly correlated with APOE4 levels and AS. Few studies have focused on the combined effect of the APOE4 gene and AS on cognitive function. Therefore, this study aimed to investigate the effect of APOE4 gene and AS acting together on cognitive function through dyslipidaemia levels, which could provide certain scientific research value for future studies. METHODS A multi-stage cluster sampling method was used to investigate older adults aged 60 years and above in rural areas of Guizhou, China. The demographic sociological characteristics were collected, and laboratory tests, blood lipid measurements, and physical examinations were performed. Mini-Mental State Examination (MMSE) was used to determine cognitive function. Analysis of variance with two-factor factorial design was used to analyse the interaction between the APOE4 gene and AS on cognitive function and its domains. RESULTS A total of 549 elderly subjects were eligible for this study. The result of the factorial design analysis revealed there was a significant interaction between the APOE4 gene and AS in terms of attention and numeracy (F = 6.878, P = 0.009). CONCLUSIONS The combination of the APOE4 gene and AS leads to a decrease in the level of attention and numeracy domains, and certain attention should be focused on such populations in the future.
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Affiliation(s)
- Fang Qu
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Xing Yang
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
| | - Jingyuan Yang
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Quanxiang Zhou
- Department of Medicine, Qiannan Medical College for Nationalities, Duyun, China
| | - Xi Yang
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Mingyan Chen
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Yan Xiong
- School of Public Health, Guizhou Medical University, Guiyang, China
| | - Yuxin Hu
- School of Public Health, Guizhou Medical University, Guiyang, China
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Birch AA, El-Bouri WK, Marchbanks RJ, Moore LA, Campbell-Bell CM, Kipps CM, Bulters DO. Pulsatile tympanic membrane displacement is associated with cognitive score in healthy subjects. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100132. [PMID: 36324393 PMCID: PMC9616339 DOI: 10.1016/j.cccb.2022.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 06/16/2023]
Abstract
To test the hypothesis that pulsing of intracranial pressure has an association with cognition, we measured cognitive score and pulsing of the tympanic membrane in 290 healthy subjects. This hypothesis was formed on the assumptions that large intracranial pressure pulses impair cognitive performance and tympanic membrane pulses reflect intracranial pressure pulses. 290 healthy subjects, aged 20-80 years, completed the Montreal Cognitive Assessment Test. Spontaneous tympanic membrane displacement during a heart cycle was measured from both ears in the sitting and supine position. We applied multiple linear regression, correcting for age, heart rate, and height, to test for an association between cognitive score and spontaneous tympanic membrane displacement. Significance was set at P < 0.0125 (Bonferroni correction.) A significant association was seen in the left supine position (p = 0.0076.) The association was not significant in the right ear supine (p = 0.28) or in either ear while sitting. Sub-domains of the cognitive assessment revealed that executive function, language and memory have been primarily responsible for this association. In conclusion, we have found that spontaneous pulses of the tympanic membrane are associated with cognitive performance and believe this reflects an association between cognitive performance and intracranial pressure pulses.
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Affiliation(s)
- Anthony A. Birch
- Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- University of Southampton, Faculty of Medicine, Southampton, SO17 1BJ, UK
| | - Wahbi K. El-Bouri
- Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- University of Southampton, Faculty of Engineering and Physical Sciences, Southampton, SO17 1BJ, UK
- Liverpool Centre for Cardiovascular Sciences, Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
| | - Robert J. Marchbanks
- Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- University of Southampton, Faculty of Medicine, Southampton, SO17 1BJ, UK
| | - Laura A. Moore
- Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Cherith M. Campbell-Bell
- Neurological Physics Group, Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Christopher M. Kipps
- University of Southampton, Faculty of Medicine, Southampton, SO17 1BJ, UK
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Diederik O. Bulters
- University of Southampton, Faculty of Medicine, Southampton, SO17 1BJ, UK
- Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
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Wardlaw JM, Benveniste H, Williams A. Cerebral Vascular Dysfunctions Detected in Human Small Vessel Disease and Implications for Preclinical Studies. Annu Rev Physiol 2022; 84:409-434. [PMID: 34699267 DOI: 10.1146/annurev-physiol-060821-014521] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cerebral small vessel disease (SVD) is highly prevalent and a common cause of ischemic and hemorrhagic stroke and dementia, yet the pathophysiology is poorly understood. Its clinical expression is highly varied, and prognostic implications are frequently overlooked in clinics; thus, treatment is currently confined to vascular risk factor management. Traditionally, SVD is considered the small vessel equivalent of large artery stroke (occlusion, rupture), but data emerging from human neuroimaging and genetic studies refute this, instead showing microvessel endothelial dysfunction impacting on cell-cell interactions and leading to brain damage. These dysfunctions reflect defects that appear to be inherited and secondary to environmental exposures, including vascular risk factors. Interrogation in preclinical models shows consistent and converging molecular and cellular interactions across the endothelial-glial-neural unit that increasingly explain the human macroscopic observations and identify common patterns of pathology despite different triggers. Importantly, these insights may offer new targets for therapeutic intervention focused on restoring endothelial-glial physiology.
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Affiliation(s)
- Joanna M Wardlaw
- Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences; UK Dementia Research Institute; and Edinburgh Imaging, University of Edinburgh, Edinburgh, United Kingdom;
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Anna Williams
- Centre for Regenerative Medicine, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
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Lee ATC, Fung AWT, Richards M, Chan WC, Chiu HFK, Lee RSY, Lam LCW. Late-life longitudinal blood pressure trajectories as predictor of dementia. Sci Rep 2022; 12:1630. [PMID: 35102219 PMCID: PMC8803958 DOI: 10.1038/s41598-022-05680-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
While hypertension is widely recognized as a risk factor for dementia, few observational studies and clinical trials fully accounted for the effect of age on blood pressure (BP) changes prior to dementia onset. In this territory-wide population-based longitudinal study of 16,591 community-living dementia-free older adults, we followed their BP and cognitive status and tested if loss of longitudinal increase in BP in late life was associated with higher dementia risk in 6 years, with consideration of the confounding effects of hypertension, hypotension, BP variability, and other health problems and behaviours and, in the data analysis, exclusion of individuals who developed dementia within 3 years after baseline to minimize risk of reverse causality. Over 72,997 person-years of follow-up, 1429 participants developed dementia. We found that loss of longitudinal increase in systolic BP (defined as SBP increased by either < 10 mmHg or 10%) from baseline to Year 3 was independently associated with higher risk of incident dementia at Years 4 to 6 (adjusted OR 1.22, 95% CI 1.02-1.45, p = 0.03; adjusted OR 1.24, 95% CI 1.03-1.50, p = 0.02; respectively). Our findings suggest that late-life SBP trajectory changes might independently predict dementia onset and highlight the importance of including longitudinal BP monitoring in dementia risk assessment.
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Affiliation(s)
- Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ada W T Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Wai C Chan
- Department of Psychiatry, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Helen F K Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Long-Term Pharmacological Inhibition of the Activity of All NOS Isoforms Rather Than Genetic Knock-Out of Endothelial NOS Leads to Impaired Spatial Learning and Memory in C57BL/6 Mice. Biomedicines 2021; 9:biomedicines9121905. [PMID: 34944725 PMCID: PMC8698888 DOI: 10.3390/biomedicines9121905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
Increasing epidemiological and experimental evidence points to a link between arterial stiffness and rapid cognitive decline. However, the underlying mechanism linking the two diseases is still unknown. The importance of nitric oxide synthases in both diseases is well-defined. In this study, we introduced arterial stiffness in both genetic (eNOS−/−, endothelial nitric oxide synthase knockout) and pharmacological (N(G)-nitro-L-arginine methyl ester (L-NAME) treatment) NO dysfunction models to study their association with cognitive decline. Our findings demonstrate that the non-selective inhibition of NOS activity with L-NAME induces cardiac dysfunction, arterial stiffness, and a decline in hippocampal-dependent learning and memory. This outcome demonstrates the importance of neuronal NOS (nNOS) in both cardiovascular and neurological pathophysiology and its potential contribution in the convergence between arterial stiffness and cognitive decline.
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45
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Eriksson MD, Eriksson JG, Kautiainen H, Salonen MK, Mikkola TM, Kajantie E, Wasenius N, von Bonsdorff M, Korhonen P, Laine MK. Higher carotid-radial pulse wave velocity is associated with non-melancholic depressive symptoms in men - findings from Helsinki Birth Cohort Study. Ann Med 2021; 53:531-540. [PMID: 33769182 PMCID: PMC8011688 DOI: 10.1080/07853890.2021.1904277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Depression and cardiovascular disease (CVD) are major causes of global disease burden that are interrelated through mostly unknown mechanisms. We studied the relationship of melancholic and non-melancholic depressive symptoms with arterial stiffness, an important underlying mechanism of CVD. METHODS The Helsinki Birth Cohort Study recruited 683 previously extensively phenotyped subjects for this sub-study. Cross-sectional data along with responses regarding depressive symptoms were obtained for each participant. For evaluation of depressive symptoms, the Beck Depression Inventory (BDI)and subscales were used to measure melancholic and non-melancholic depressive symptoms. Arterial stiffness was assessed as pulse wave velocity (PWV) that was measured between the carotid and radial artery, and carotid and femoral artery. RESULTS Of the participants, 532 scored <10 on the BDI and were classified as not having depressive symptoms. Of the 151 participants that scored ≥10 on the BDI, 122 were classified as having non-melancholic depressive symptoms and 29 as having melancholic depressive symptoms. Men had higher carotid-radial PWV (crPWV) values than women (p < .001). A positive relationship between BDI scores and crPWV (p < .001) was found in men. We also found higher crPWV in men with non-melancholic depressive symptoms compared to all others. No such differences were found in women. DISCUSSION Arterial stiffness has a relationship with depressive symptoms and subtypes of depressive symptoms, at least in men. There is a significant relationship between higher PWV and non-melancholic depressive symptoms in men. Due to the intricate nature of the disease causality or directionality is impossible to infer solely based on this study. Further studies into the subtypes of depressive symptoms may be of benefit to understanding depression.KEY MESSAGESIt is known that arterial stiffness contributes to cardiovascular disease, and is associated with depression.Higher Beck Depression Inventory scores are associated with higher carotid-radial pulse wave velocity in men.Non-melancholic depressive symptoms are associated with higher carotid-radial pulse wave velocity in men.
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Affiliation(s)
- Mia D Eriksson
- Primary Health Care Unit, Helsinki University Hospital (HUS), Helsinki, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Obstetrics & Gynecology and Human Potential Translational Research Programme Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niko Wasenius
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mikaela von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Korhonen
- Department of General Practice, Turku University Hospital and University of Turku, Turku, Finland
| | - Merja K Laine
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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46
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Hendrickx JO, De Moudt S, Van Dam D, De Deyn PP, Fransen P, De Meyer GRY. Altered stress hormone levels affect in vivo vascular function in the hAPP23 +/- overexpressing mouse model of Alzheimer's disease. Am J Physiol Heart Circ Physiol 2021; 321:H905-H919. [PMID: 34506227 DOI: 10.1152/ajpheart.00254.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/02/2021] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease (AD) has long been considered a brain-specific dementia syndrome. However, in recent decades, the occurrence of cardiovascular (CV) disease in the progression of AD has been confirmed by increasing epidemiological evidence. In this study, we conducted an in-depth cardiovascular characterization of a humanized amyloid precursor protein (APP) overexpressing mouse model (hAPP23+/-), which overexpresses the Swedish mutation (KM670/671NL). At the age of 6 mo, hAPP23+/- mice had a lower survival, lower body weight, and increased corticosterone and VMA levels compared with C57BL/6 littermates. Systolic blood pressure was increased in hAPP23+/- animals compared with C57BL/6 littermates, but diastolic blood pressure was not statistically different. Pulse pressure remained unchanged but abdominal and carotid pulse-wave velocity (aPWV and cPWV) were increased in hAPP23+/- compared with C57BL/6 mice. Echocardiography showed no differences in systolic or diastolic cardiac function. Ex vivo evaluation of vascular function showed decreased adreno receptor dependent vasoconstriction of hAPP23+/- aortic segments, although the isobaric biomechanics of the aortic wall were similar to C57BL/6 aortic segments. In conclusion, hAPP23+/- mice exhibited high serum corticosterone levels, elevated systolic blood pressure, and increased arterial stiffness in vivo. However, ex vivo aortic stiffness of hAPP23+/- aortic segments was not changed and vascular reactivity to α1-adrenoceptor stimulation was attenuated. These findings highlight the need for more frequent assessment of circulating stress hormone levels and PWV measurements in daily clinical practice for people at risk of AD.NEW & NOTEWORTHY We showed that male amyloid precursor protein (APP) transgenic mice have higher circulating stress hormone levels. As a result, higher systolic blood pressure and pulse-wave velocity were measured in vivo in addition to a smaller α-adrenergic receptor-dependent contraction upon ex vivo stimulation with phenylephrine. Our findings highlight the need for more frequent assessment of circulating stress hormone levels and PWV measurements in daily clinical practice for people at risk of Alzheimer's disease.
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Affiliation(s)
- Jhana O Hendrickx
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Sofie De Moudt
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Debby Van Dam
- Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, Antwerp, Belgium
- Department of Neurology and Alzheimer Center, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Paul De Deyn
- Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, Antwerp, Belgium
- Department of Neurology and Alzheimer Center, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Paul Fransen
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Guido R Y De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
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47
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Dao E, Barha CK, Santos M, Welch M, Liu-Ambrose T. Sex Differences in the Relationship Between Arterial Stiffness and Cognitive Function in Older Adults. J Stroke Cerebrovasc Dis 2021; 31:106175. [PMID: 34715522 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106175] [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: 06/22/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To examine potential sex differences in the relationship between arterial stiffness and global cognitive function and executive functions. METHODS Baseline data from 80 older adults were included from two randomized controlled trials (NCT02669394 and NCT02737878). Arterial stiffness was measured by carotid-femoral pulse wave velocity (cf-PWV). Cognitive function assessment included global cognition (Mini-Mental State Examination [MMSE]) and executive functions (set shifting [Trail Making Test Part B minus A], inhibition [Stroop Test], and working memory [Verbal Digit Span Backwards Test]). Separate statistical models were constructed to assess the effect of cf-PWV on each cognitive outcome for females and males. Each statistical model controlled for Framingham cardiovascular disease risk score and education. RESULTS Higher cf-PWV was associated with impaired MMSE performance in males (β = -0.48; p = 0.018), but not females (p ≥ 0.389). For executive processes, higher cf-PWV was associated with impaired Trail Making Test Part B minus A (β = 0.56; p = 0.005) and Stroop Test (β = 0.59; p = 0.004) in males, but not in females (ps ≥ 0.108). cf-PWV was not significantly associated with Verbal Digit Span Forward minus Backward Test in males or females (ps ≥ 0.108). CONCLUSIONS Arterial stiffness is more strongly associated with cognitive impairment in males than females. These results further elucidate the interplay between vascular health and cognitive function by providing support for sex-specific mechanisms.
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Affiliation(s)
- Elizabeth Dao
- Department of Radiology, University of British Columbia (UBC), 2775 Laurel St., Vancouver V5Z 1M9, Canada; Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada.
| | - Cindy K Barha
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
| | - Mij Santos
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada.
| | - Madison Welch
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver V6T 1Z3, Canada; Department of Physical Therapy, Aging, Mobility, and Cognitive Health Lab, UBC, 109-828 West 10th Ave., Vancouver V5Z 1M9, Canada; Centre for Hip Health and Mobility, Robert H.N. Ho Research Centre, 2635 Laurel St., Vancouver V5Z 1M9, Canada.
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48
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Hu H, Fukunaga A, Yokoya T, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Miyamoto T, Sasaki N, Ogasawara T, Gonmori N, Yamamoto K, Hori A, Tomita K, Nagahama S, Konishi M, Katayama N, Morioka H, Kabe I, Mizoue T, Dohi S. Non-High-Density Lipoprotein Cholesterol and Risk of Cardiovascular disease: the Japan Epidemiology Collaboration on Occupational Health Study. J Atheroscler Thromb 2021; 29:1295-1306. [PMID: 34690212 PMCID: PMC9444673 DOI: 10.5551/jat.63118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS We aimed to investigate the association between non-high-density lipoprotein cholesterol (non-HDL-C) levels and the risk of cardiovascular disease (CVD) and its subtypes. METHODS In this contemporary cohort study, we analyzed the data of 63,814 Japanese employees aged ≥ 30 years, without known CVD in 2012 and who were followed up for up to 8 years. The non-HDL-C level was divided into 5 groups: <110, 110-129, 130-149, 150-169, and ≥ 170 mg/dL. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) for CVD and its subtypes associated with each non-HDL-C group, considering 130-149 mg/dL as the reference group. RESULTS During the study period, 271 participants developed CVD, including 78 myocardial infarctions and 193 strokes (102 ischemic strokes, 89 hemorrhagic strokes, and 2 unknowns). A U-shaped association between non-HDL-C and stroke was observed. In the analysis of stroke subtypes, the multivariable-adjusted HR (95% CI) for hemorrhagic stroke was 2.61 (1.19-5.72), 2.02 (0.95-4.29), 2.10 (1.01-4.36), and 1.98 (0.96-4.08), while that for ischemic stroke was 1.54 (0.77-3.07), 0.91 (0.46-1.80), 0.73 (0.38-1.41), and 1.50 (0.87-2.56) in the <110, 110-129, 150-169, and ≥ 170 mg/dL groups, respectively. Individuals with elevated non-HDL-C levels had a higher risk of myocardial infarction. CONCLUSIONS High non-HDL-C levels were associated with an increased risk of myocardial infarction. Moreover, high and low non-HDL-C levels were associated with a high risk of stroke and its subtypes among Japanese workers.
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Affiliation(s)
- Huan Hu
- Department of Public Health, Tokushima University Graduate School of Biomedical Sciences.,Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | - Ami Fukunaga
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | | | | | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd
| | | | | | | | | | | | | | - Kenya Yamamoto
- Division of Chemical Information, National Institute of Occupational Safety and Health
| | - Ai Hori
- Department of Global Public Health, Faculty of Medicine, University of Tsukuba
| | | | | | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | - Nobumi Katayama
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
| | - Hisayoshi Morioka
- Department of Public Health, Tokushima University Graduate School of Biomedical Sciences
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine
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Lefferts WK, Rosenberg AJ, Schroeder EC, Grigoriadis G, Sandroff BM, Motl RW, Baynard T. Assessment of Cerebrovascular Dynamics and Cognitive Function with Acute Aerobic Exercise in Persons with Multiple Sclerosis. Int J MS Care 2021; 23:162-169. [PMID: 34483755 DOI: 10.7224/1537-2073.2020-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Cognitive dysfunction in multiple sclerosis (MS) may partially stem from inadequate cerebral blood flow. Cerebral blood flow and cognitive function improve with aerobic exercise in healthy adults. The effect of aerobic exercise on cerebrovascular hemodynamics and cognitive performance in persons with MS is unclear. The acute effect of aerobic exercise versus quiet rest on cerebrovascular hemodynamics and cognitive performance in relapsing-remitting MS was examined. Methods Sixteen adults with relapsing-remitting MS underwent cerebrovascular hemodynamics and cognitive performance testing before, 2 minutes after, and 30 minutes after aerobic exercise (20-minute treadmill walking, 60% peak oxygen consumption) and a time-matched seated control. Brachial blood pressure was obtained via an oscillometric cuff. Right middle cerebral artery (MCA) blood velocity was measured via transcranial Doppler and used to calculate mean velocity, pulsatility index (PI), and conductance. Carotid artery stiffness was measured via ultrasonography and tonometry. Cognitive performance (accuracy, reaction time) was assessed using a modified flanker task. Results Exercise elicited significant increases in mean pressure and carotid artery stiffness and decreases in MCA conductance at 2 minutes after exercise, which subsided by 30 minutes (P < .05). Exercise did not significantly alter MCA PI. Flanker reaction time decreased during posttesting in both conditions (P < .05). There were no condition × time interactions for cognitive performance. Conclusions Persons with MS seem resilient to exercise-induced acute changes in MCA PI despite transient carotid stiffening, potentially via reductions in MCA conductance. These data suggest that changes in cognitive performance after acute aerobic exercise are not directly related to transient cerebrovascular responses in persons with MS.
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50
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Tomoto T, Liu J, Tseng BY, Pasha EP, Cardim D, Tarumi T, Hynan LS, Munro Cullum C, Zhang R. One-Year Aerobic Exercise Reduced Carotid Arterial Stiffness and Increased Cerebral Blood Flow in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2021; 80:841-853. [PMID: 33579857 DOI: 10.3233/jad-201456] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Central arterial stiffness and brain hypoperfusion are emerging risk factors of Alzheimer's disease (AD). Aerobic exercise training (AET) may improve central arterial stiffness and brain perfusion. OBJECTIVE To investigate the effects of AET on central arterial stiffness and cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (MCI), a prodromal stage of AD. METHODS This is a proof-of-concept, randomized controlled trial that assigned 70 amnestic MCI patients into a 12-month program of moderate-to-vigorous AET or stretching-and-toning (SAT) intervention. Carotid β-stiffness index and CBF were measured by color-coded duplex ultrasonography and applanation tonometry. Total CBF was measured as the sum of CBF from both the internal carotid and vertebral arteries, and divided by total brain tissue mass assessed with MRI to obtain normalized CBF (nCBF). Episodic memory and executive function were assessed using standard neuropsychological tests (CVLT-II and D-KEFS). Changes in cardiorespiratory fitness were measured by peak oxygen uptake (VO2peak). RESULTS Total 48 patients (29 in SAT and 19 in AET) were completed one-year training. AET improved VO2peak, decreased carotid β-stiffness index and CBF pulsatility, and increased nCBF. Changes in VO2peak were associated positively with changes in nCBF (r = 0.388, p = 0.034) and negatively with carotid β-stiffness index (r = -0.418, p = 0.007) and CBF pulsatility (r = -0.400, p = 0.014). Decreases in carotid β-stiffness were associated with increases in cerebral perfusion (r = -0.494, p = 0.003). AET effects on cognitive performance were minimal compared with SAT. CONCLUSION AET reduced central arterial stiffness and increased CBF which may precede its effects on neurocognitive function in patients with MCI.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jie Liu
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University, Newark, NJ, USA
| | - Benjamin Y Tseng
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX, USA
| | - Evan P Pasha
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
| | - Danilo Cardim
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
| | - Linda S Hynan
- Department of psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Internal Medicine University of Texas Southwestern Medical Center, Dallas, TX, USA
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