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Van Etten EJ, Knoff AA, Colaizzi TA, Knight AR, Milberg WP, Fortier CB, Leritz EC, Salat DH. Association between metabolic syndrome and white matter integrity in young and mid-age post-9/11 adult Veterans. Cereb Cortex 2024; 34:bhae340. [PMID: 39152671 DOI: 10.1093/cercor/bhae340] [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: 03/25/2024] [Revised: 07/26/2024] [Accepted: 08/01/2024] [Indexed: 08/19/2024] Open
Abstract
Metabolic syndrome has been associated with reduced brain white matter integrity in older individuals. However, less is known about how metabolic syndrome might impact white matter integrity in younger populations. This study examined metabolic syndrome-related global and regional white matter integrity differences in a sample of 537 post-9/11 Veterans. Metabolic syndrome was defined as ≥3 factors of: increased waist circumference, hypertriglyceridemia, low high-density lipoprotein cholesterol, hypertension, and high fasting glucose. T1 and diffusion weighted 3 T MRI scans were processed using the FreeSurfer image analysis suite and FSL Diffusion Toolbox. Atlas-based regions of interest were determined from a combination of the Johns Hopkins University atlas and a Tract-Based Spatial Statistics-based FreeSurfer WMPARC white matter skeleton atlas. Analyses revealed individuals with metabolic syndrome (n = 132) had significantly lower global fractional anisotropy than those without metabolic syndrome (n = 405), and lower high-density lipoprotein cholesterol levels was the only metabolic syndrome factor significantly related to lower global fractional anisotropy levels. Lobe-specific analyses revealed individuals with metabolic syndrome had decreased fractional anisotropy in frontal white matter regions compared with those without metabolic syndrome. These findings indicate metabolic syndrome is prevalent in this sample of younger Veterans and is related to reduced frontal white matter integrity. Early intervention for metabolic syndrome may help alleviate adverse metabolic syndrome-related brain and cognitive effects with age.
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Affiliation(s)
- Emily J Van Etten
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States
| | - Aubrey A Knoff
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
- Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, United States
| | - Tristan A Colaizzi
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
| | - Arielle R Knight
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, United States
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, United States
| | - Elizabeth C Leritz
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, United States
- VA Boston Healthcare System, Boston, MA 02130, United States
| | - David H Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, United States
- Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, United States
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA 02130, United States
- Anthinoula A. Martinos Center for Biomedical Imaging, Boston, MA 02129, United States
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2
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Ye Z, Mo C, Liu S, Gao S, Feng L, Zhao B, Canida T, Wu YC, Hatch KS, Ma Y, Mitchell BD, Hong L, Kochunov P, Chen C, Zhao B, Chen S, Ma T. Deciphering the causal relationship between blood pressure and regional white matter integrity: A two-sample Mendelian randomization study. J Neurosci Res 2023; 101:1471-1483. [PMID: 37330925 PMCID: PMC10444533 DOI: 10.1002/jnr.25205] [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] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/30/2023] [Accepted: 05/10/2023] [Indexed: 06/20/2023]
Abstract
Elevated arterial blood pressure (BP) is a common risk factor for cerebrovascular and cardiovascular diseases, but no causal relationship has been established between BP and cerebral white matter (WM) integrity. In this study, we performed a two-sample Mendelian randomization (MR) analysis with individual-level data by defining two nonoverlapping sets of European ancestry individuals (genetics-exposure set: N = 203,111; mean age = 56.71 years, genetics-outcome set: N = 16,156; mean age = 54.61 years) from UK Biobank to evaluate the causal effects of BP on regional WM integrity, measured by fractional anisotropy of diffusion tensor imaging. Two BP traits: systolic and diastolic blood pressure were used as exposures. Genetic variant was carefully selected as instrumental variable (IV) under the MR analysis assumptions. We existing large-scale genome-wide association study summary data for validation. The main method used was a generalized version of inverse-variance weight method while other MR methods were also applied for consistent findings. Two additional MR analyses were performed to exclude the possibility of reverse causality. We found significantly negative causal effects (FDR-adjusted p < .05; every 10 mmHg increase in BP leads to a decrease in FA value by .4% ~ 2%) of BP traits on a union set of 17 WM tracts, including brain regions related to cognitive function and memory. Our study extended the previous findings of association to causation for regional WM integrity, providing insights into the pathological processes of elevated BP that might chronically alter the brain microstructure in different regions.
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Affiliation(s)
- Zhenyao Ye
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Chen Mo
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Song Liu
- School of Computer Science and Technology, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong, China
| | - Si Gao
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Li Feng
- Department of Nutrition and Food Science, College of Agriculture & Natural Resources, University of Maryland, College Park, Maryland, United States of America
| | - Boao Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Travis Canida
- Department of Mathematics, The college of Computer, Mathematical, and Natural Sciences, University of Maryland, College Park, Maryland, United States of America
| | - Yu-Chia Wu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Kathryn S Hatch
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Yizhou Ma
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Braxton D. Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - L.Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Chixiang Chen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Bingxin Zhao
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States of America
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Tianzhou Ma
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland, United States of America
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3
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de Heus RA, Tzourio C, Lee EJL, Opozda M, Vincent AD, Anstey KJ, Hofman A, Kario K, Lattanzi S, Launer LJ, Ma Y, Mahajan R, Mooijaart SP, Nagai M, Peters R, Turnbull D, Yano Y, Claassen JA, Tully PJ. Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis. Hypertension 2021; 78:1478-1489. [PMID: 34538105 PMCID: PMC8516811 DOI: 10.1161/hypertensionaha.121.17797] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/04/2021] [Indexed: 01/20/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Rianne A.A. de Heus
- Radboud University Medical Center, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., J.A.H.R.C.)
| | - Christophe Tzourio
- Bordeaux Population Health, Univeristy of Bordeaux, Inserm, Team Healthy, UMR 1219, CHU Bordeaux, France (C.T.)
| | - Emily Jo Lynn Lee
- Adelaide Medical School (E.J.L.L., M.O., A.D.V., P.J.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
| | - Melissa Opozda
- Adelaide Medical School (E.J.L.L., M.O., A.D.V., P.J.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
- Centre for Nutrition and Gastrointestinal Research (M.O.), South Australian Health and Medical Research Institute, Australia
| | - Andrew D. Vincent
- Adelaide Medical School (E.J.L.L., M.O., A.D.V., P.J.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
| | - Kaarin J. Anstey
- School of Psychology (K.J.A.), University of New South Wales, Sydney, Australia
- Neuroscience Research Australia (K.J.A.), University of New South Wales, Sydney, Australia
| | - Albert Hofman
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (A.H., Y.M.)
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K.)
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy (S.L.)
| | - Lenore J. Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L.)
| | - Yuan Ma
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (A.H., Y.M.)
| | - Rajiv Mahajan
- Radboud University Medical Center, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., J.A.H.R.C.)
- Bordeaux Population Health, Univeristy of Bordeaux, Inserm, Team Healthy, UMR 1219, CHU Bordeaux, France (C.T.)
- Adelaide Medical School (E.J.L.L., M.O., A.D.V., P.J.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
- School of Psychology (D.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
- Centre for Nutrition and Gastrointestinal Research (M.O.), South Australian Health and Medical Research Institute, Australia
- University of Adelaide, Lyell McEwin Hospital (R.M.), South Australian Health and Medical Research Institute, Australia
- School of Psychology (K.J.A.), University of New South Wales, Sydney, Australia
- Neuroscience Research Australia (K.J.A.), University of New South Wales, Sydney, Australia
- Neuroscience Research Australia (R.P.), University of New South Wales, Sydney, Australia
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA (A.H., Y.M.)
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan (K.K.)
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy (S.L.)
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD (L.J.L.)
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Institute for Evidence-Based Medicine in Old Age, the Netherlands (S.P.M.)
- Department of Cardiology, Hiroshima City Asa Hospital, Japan (M.N.)
- Imperial College London, United Kingdom (R.P.)
- Yokohama City University Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Japan (Y.Y.)
- The Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.)
| | - Simon P. Mooijaart
- University of Adelaide, Lyell McEwin Hospital (R.M.), South Australian Health and Medical Research Institute, Australia
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Institute for Evidence-Based Medicine in Old Age, the Netherlands (S.P.M.)
| | - Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, Japan (M.N.)
| | - Ruth Peters
- Neuroscience Research Australia (R.P.), University of New South Wales, Sydney, Australia
- Imperial College London, United Kingdom (R.P.)
| | - Deborah Turnbull
- School of Psychology (D.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
| | - Yuichiro Yano
- Yokohama City University Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Japan (Y.Y.)
- The Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.)
| | - Jurgen A.H.R. Claassen
- Radboud University Medical Center, Department of Geriatric Medicine, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., J.A.H.R.C.)
| | - Phillip J. Tully
- Adelaide Medical School (E.J.L.L., M.O., A.D.V., P.J.T.), Freemasons Centre for Male Health and Wellbeing, The University of Adelaide, Australia
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Iriondo A, García-Sebastian M, Arrospide A, Arriba M, Aurtenetxe S, Barandiaran M, Clerigue M, Ecay-Torres M, Estanga A, Gabilondo A, Izagirre A, Saldias J, Tainta M, Villanua J, Mar J, Goñi FM, Martínez-Lage P. Plasma lipids are associated with white matter microstructural changes and axonal degeneration. Brain Imaging Behav 2021; 15:1043-1057. [PMID: 32748320 DOI: 10.1007/s11682-020-00311-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Dislipidemia is a risk factor for cognitive impairment. We studied the association between interindividual variability of plasma lipids and white matter (WM) microstructure, using diffusion tensor imaging (DTI) in 273 healthy adults. Special focus was placed on 7 regions of interest (ROI) which are structural components of cognitive neurocircuitry. We also investigated the effect of plasma lipids on cerebrospinal fluid (CSF) neurofilament light chain (NfL), an axonal degeneration marker. Low density lipoprotein (LDL) and triglyceride (TG) levels showed a negative association with axial diffusivity (AxD) in multiple regions. High density lipoproteins (HDL) showed a positive correlation. The association was independent of Apolipoprotein E (APOE) genotype, blood pressure or use of statins. LDL moderated the relation between NfL and AxD in the body of the corpus callosum (p = 0.041), right cingulum gyrus (p = 0.041), right fornix/stria terminalis (p = 0.025) and right superior longitudinal fasciculus (p = 0.020) and TG in the right inferior longitudinal fasciculus (p = 0.004) and left fornix/stria terminalis (p = 0.001). We conclude that plasma lipids are associated to WM microstructural changes and axonal degeneration and might represent a risk factor in the transition from healthy aging to disease.
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Affiliation(s)
- Ane Iriondo
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Maite García-Sebastian
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Arantzazu Arrospide
- Gipuzkoa Primary Care - Integrated Health Care Organizations Research Unit. Alto Deba Integrated Health Care Organisation, Arrasate, Spain.,Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Maria Arriba
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Sara Aurtenetxe
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Myriam Barandiaran
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Montserrat Clerigue
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Mirian Ecay-Torres
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Ainara Estanga
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Alazne Gabilondo
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Andrea Izagirre
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain.,Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jon Saldias
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Mikel Tainta
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Jorge Villanua
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Javier Mar
- Gipuzkoa Primary Care - Integrated Health Care Organizations Research Unit. Alto Deba Integrated Health Care Organisation, Arrasate, Spain.,Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | - Felix M Goñi
- Departamento de Bioquímica, University of the Basque Country (UPV/EHU) and Instituto Biofisika (CSIC, UPV/EHU), Leioa, Spain
| | - Pablo Martínez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain.
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Luo DH, Tseng WYI, Chang YL. White matter microstructure disruptions mediate the adverse relationships between hypertension and multiple cognitive functions in cognitively intact older adults. Neuroimage 2019; 197:109-119. [PMID: 31029871 DOI: 10.1016/j.neuroimage.2019.04.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Although hypertension is a prominent vascular risk factor for late-life cognitive decline, the underlying pathophysiological mechanism remains unclear. Accordingly, the aim of this study was to examine the role of white matter microstructural integrity in hypertension-related cognitive detriments. We recruited 66 cognitively normal older adults, comprising 41 hypertensive patients and 25 normotensive controls. All participants underwent a comprehensive neuropsychological battery. White matter microstructural integrity was assessed using a tract-based automatic analysis approach derived from diffusion spectrum imaging. Mediating effects of white matter integrity were evaluated using structural equation modeling analyses. The results revealed that hypertensive older adults displayed poorer processing speed, executive function, and memory encoding. Lower white matter microstructural integrity was observed in the hypertensive elderly patients, primarily in long-range association fiber bundles. In particular, low microstructural integrity in specific tract bundles connecting frontal and posterior cerebral regions was found to underlie the adverse relationships between hypertension and multiple cognitive domains, including processing speed, executive function, memory encoding, and memory retention. Our findings suggest that hypertension may impair multiple cognitive functions by undermining white matter microstructures, even in cognitively intact older adults, thus further highlighting the necessity of monitoring vascular health to prevent cognitive decline.
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Affiliation(s)
- Di-Hua Luo
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan
| | - Wen-Yih Isaac Tseng
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, 10617, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan.
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6
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The Lifespan Human Connectome Project in Aging: An overview. Neuroimage 2018; 185:335-348. [PMID: 30332613 DOI: 10.1016/j.neuroimage.2018.10.009] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/21/2018] [Accepted: 10/04/2018] [Indexed: 12/31/2022] Open
Abstract
The original Human Connectome Project yielded a rich data set on structural and functional connectivity in a large sample of healthy young adults using improved methods of data acquisition, analysis, and sharing. More recent efforts are extending this approach to include infants, children, older adults, and brain disorders. This paper introduces and describes the Human Connectome Project in Aging (HCP-A), which is currently recruiting 1200 + healthy adults aged 36 to 100+, with a subset of 600 + participants returning for longitudinal assessment. Four acquisition sites using matched Siemens Prisma 3T MRI scanners with centralized quality control and data analysis are enrolling participants. Data are acquired across multimodal imaging and behavioral domains with a focus on factors known to be altered in advanced aging. MRI acquisitions include structural (whole brain and high resolution hippocampal) plus multiband resting state functional (rfMRI), task fMRI (tfMRI), diffusion MRI (dMRI), and arterial spin labeling (ASL). Behavioral characterization includes cognitive (such as processing speed and episodic memory), psychiatric, metabolic, and socioeconomic measures as well as assessment of systemic health (with a focus on menopause via hormonal assays). This dataset will provide a unique resource for examining how brain organization and connectivity changes across typical aging, and how these differences relate to key characteristics of aging including alterations in hormonal status and declining memory and general cognition. A primary goal of the HCP-A is to make these data freely available to the scientific community, supported by the Connectome Coordination Facility (CCF) platform for data quality assurance, preprocessing and basic analysis, and shared via the NIMH Data Archive (NDA). Here we provide the rationale for our study design and sufficient details of the resource for scientists to plan future analyses of these data. A companion paper describes the related Human Connectome Project in Development (HCP-D, Somerville et al., 2018), and the image acquisition protocol common to both studies (Harms et al., 2018).
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Reddan JM, White DJ, Macpherson H, Scholey A, Pipingas A. Glycerophospholipid Supplementation as a Potential Intervention for Supporting Cerebral Structure in Older Adults. Front Aging Neurosci 2018; 10:49. [PMID: 29563868 PMCID: PMC5845902 DOI: 10.3389/fnagi.2018.00049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/15/2018] [Indexed: 01/13/2023] Open
Abstract
Modifying nutritional intake through supplementation may be efficacious for altering the trajectory of cerebral structural decline evident with increasing age. To date, there have been a number of clinical trials in older adults whereby chronic supplementation with B vitamins, omega-3 fatty acids, or resveratrol, has been observed to either slow the rate of decline or repair cerebral tissue. There is also some evidence from animal studies indicating that supplementation with glycerophospholipids (GPL) may benefit cerebral structure, though these effects have not yet been investigated in adult humans. Despite this paucity of research, there are a number of factors predicting poorer cerebral structure in older humans, which GPL supplementation appears to beneficially modify or protect against. These include elevated concentrations of homocysteine, unbalanced activity of reactive oxygen species both increasing the risk of oxidative stress, increased concentrations of pro-inflammatory messengers, as well as poorer cardio- and cerebrovascular function. As such, it is hypothesized that GPL supplementation will support cerebral structure in older adults. These cerebral effects may influence cognitive function. The current review aims to provide a theoretical basis for future clinical trials investigating the effects of GPL supplementation on cerebral structural integrity in older adults.
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Affiliation(s)
- Jeffery M Reddan
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
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8
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Suzuki H, Gao H, Bai W, Evangelou E, Glocker B, O’Regan DP, Elliott P, Matthews PM. Abnormal brain white matter microstructure is associated with both pre-hypertension and hypertension. PLoS One 2017; 12:e0187600. [PMID: 29145428 PMCID: PMC5690584 DOI: 10.1371/journal.pone.0187600] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 10/23/2017] [Indexed: 12/31/2022] Open
Abstract
Objectives To characterize effects of chronically elevated blood pressure on the brain, we tested for brain white matter microstructural differences associated with normotension, pre-hypertension and hypertension in recently available brain magnetic resonance imaging data from 4659 participants without known neurological or psychiatric disease (62.3±7.4 yrs, 47.0% male) in UK Biobank. Methods For assessment of white matter microstructure, we used measures derived from neurite orientation dispersion and density imaging (NODDI) including the intracellular volume fraction (an estimate of neurite density) and isotropic volume fraction (an index of the relative extra-cellular water diffusion). To estimate differences associated specifically with blood pressure, we applied propensity score matching based on age, sex, educational level, body mass index, and history of smoking, diabetes mellitus and cardiovascular disease to perform separate contrasts of non-hypertensive (normotensive or pre-hypertensive, N = 2332) and hypertensive (N = 2337) individuals and of normotensive (N = 741) and pre-hypertensive (N = 1581) individuals (p<0.05 after Bonferroni correction). Results The brain white matter intracellular volume fraction was significantly lower, and isotropic volume fraction was higher in hypertensive relative to non-hypertensive individuals (N = 1559, each). The white matter isotropic volume fraction also was higher in pre-hypertensive than in normotensive individuals (N = 694, each) in the right superior longitudinal fasciculus and the right superior thalamic radiation, where the lower intracellular volume fraction was observed in the hypertensives relative to the non-hypertensive group. Significance Pathological processes associated with chronically elevated blood pressure are associated with imaging differences suggesting chronic alterations of white matter axonal structure that may affect cognitive functions even with pre-hypertension.
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Affiliation(s)
- Hideaki Suzuki
- Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
- * E-mail:
| | - He Gao
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Wenjia Bai
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, United Kingdom
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Ben Glocker
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, United Kingdom
| | - Declan P. O’Regan
- Medical Research Council London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, United Kingdom
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Paul M. Matthews
- Division of Brain Sciences, Department of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
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9
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Ryu CW, Coutu JP, Greka A, Rosas HD, Jahng GH, Rosen BR, Salat DH. Differential associations between systemic markers of disease and white matter tissue health in middle-aged and older adults. J Cereb Blood Flow Metab 2017; 37:3568-3579. [PMID: 27298238 PMCID: PMC5669337 DOI: 10.1177/0271678x16653613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Age-associated cerebrovascular disease impacts brain tissue integrity, but other factors, including normal variation in blood markers of systemic health, may also influence the structural integrity of the brain. This cross-sectional study included 139 individuals between 40 to 86 years old who were physically healthy and cognitively intact. Eleven markers (total-cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride, insulin, fasting glucose, glycated hemoglobin, creatinine, blood urea nitrogen, albumin, total protein) and five derived indicators (estimated glomerular filtration rate, creatinine clearance rate, insulin-resistance, average glucose, and cholesterol/high-density lipoprotein ratio) were obtained from blood sampling. Diffusion tensor imaging was used to evaluate white matter tissue health. Blood markers were clustered into five factors. The first factor (defined as insulin/high-density lipoprotein factor) was associated with markers of integrity in the deep white matter and projection fiber systems, while the third factor (defined as kidney function factor) was associated with different markers of integrity in the periventricular and watershed white matter regions. Differential segregated associations for insulin and high-density lipoprotein levels and serum markers of kidney function may provide information about distinct mechanisms of brain changes across the lifespan. These results emphasize the need to determine whether therapeutic modulation of systemic health and organ function may prevent decline in brain structural integrity.
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Affiliation(s)
- Chang-Woo Ryu
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,2 Department of Radiology, School of Medicine, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jean-Philippe Coutu
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,3 Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Anna Greka
- 4 Renal Division, Department of Medicine, Glom-NExT Center, Brigham and Women's Hospital, Boston MA, USA.,5 Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - H Diana Rosas
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,6 Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Geon-Ho Jahng
- 2 Department of Radiology, School of Medicine, Kyung Hee University, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Bruce R Rosen
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,7 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David H Salat
- 1 MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,7 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,8 Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
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10
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Khan A, Akhtar N, Kamran S, Ponirakis G, Petropoulos IN, Tunio NA, Dargham SR, Imam Y, Sartaj F, Parray A, Bourke P, Khan R, Santos M, Joseph S, Shuaib A, Malik RA. Corneal Confocal Microscopy Detects Corneal Nerve Damage in Patients Admitted With Acute Ischemic Stroke. Stroke 2017; 48:3012-3018. [PMID: 29018135 DOI: 10.1161/strokeaha.117.018289] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. METHODS One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. RESULTS There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance (P<0.001, P<0.001, P<0.001), impaired glucose tolerance (P=0.004, P<0.001, P=0.002), and type 2 diabetes mellitus (P<0.001, P<0.001, P<0.001) compared with controls. HbA1c and triglycerides correlated with corneal nerve fiber density (r=-0.187, P=0.03; r=-0.229 P=0.01), corneal nerve fiber length (r=-0.228, P=0.009; r=-0.285; P=0.001), and corneal nerve branch density (r=-0.187, P=0.033; r=-0.229, P=0.01). Multiple linear regression showed no independent associations between corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length and relevant risk factors for stroke. CONCLUSIONS Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke.
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Affiliation(s)
- Adnan Khan
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Naveed Akhtar
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Saadat Kamran
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Georgios Ponirakis
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Ioannis N Petropoulos
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Nahel A Tunio
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Soha R Dargham
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Yahia Imam
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Faheem Sartaj
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Aijaz Parray
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Paula Bourke
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Rabia Khan
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Mark Santos
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Sujatha Joseph
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Ashfaq Shuaib
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.)
| | - Rayaz A Malik
- From the Department of Medicine (A.K., G.P., I.N.P., N.A.T., R.A.M.) and Biostatistics, Epidemiology, and Biomathematics Research Core (S.R.D.), Weill Cornell Medicine-Qatar, Doha; Department of Neurology, Institute of Neurosciences, Hamad Medical Corporation, Doha, Qatar (N.A., S.K., Y.I., F.S., A.P., P.B., R.K., M.S., S.J., A.S.); and Stroke Program, Department of Neurology, University of Alberta, Edmonton, Canada (A.S.).
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11
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Power MC, Tingle JV, Reid RI, Huang J, Sharrett AR, Coresh J, Griswold M, Kantarci K, Jack CR, Knopman D, Gottesman RF, Mosley TH. Midlife and Late-Life Vascular Risk Factors and White Matter Microstructural Integrity: The Atherosclerosis Risk in Communities Neurocognitive Study. J Am Heart Assoc 2017; 6:JAHA.117.005608. [PMID: 28522676 PMCID: PMC5524102 DOI: 10.1161/jaha.117.005608] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Diffusion tensor imaging measures of white matter (WM) microstructural integrity appear to provide earlier indication of WM injury than WM hyperintensities; however, risk factors for poor WM microstructural integrity have not been established. Our study quantifies the association between vascular risk factors in midlife and late life with measures of late‐life WM microstructural integrity. Methods and Results We used data from 1851 participants in ARIC (Atherosclerosis Risk in Communities Study) who completed 3‐T magnetic resonance imaging, including diffusion tensor imaging, as part of the ARIC Neurocognitive Study (ARIC‐NCS). We quantified the association among lipids, glucose, and blood pressure from the baseline ARIC visit (1987–1989, ages 44–65, midlife) and visit 5 of ARIC (2011–2013, ages 67–90, late life, concurrent with ARIC‐NCS) with regional and overall WM mean diffusivity and fractional anisotropy obtained at ARIC visit 5 for ARIC participants. We also considered whether these associations were independent of or modified by WM hyperintensity volumes. We found that elevated blood pressure in midlife and late life and elevated glucose in midlife, but not late life, were associated with worse late‐life WM microstructural integrity. These associations were independent of the degree of WM hyperintensity, and the association between glucose and WM microstructural integrity appeared stronger for those with the least WM hyperintensity. There was little support for an adverse association between lipids and WM microstructural integrity. Conclusions Hypertension in both midlife and late life and elevated glucose in midlife are related to worse WM microstructural integrity in late life.
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Affiliation(s)
- Melinda C Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Jonathan V Tingle
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS
| | | | - Juebin Huang
- Department of Neurology, University of Mississippi Medical Center, Jackson, MS
| | | | - Josef Coresh
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Michael Griswold
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS
| | | | | | | | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD.,Department of Neurology, Johns Hopkins University, Baltimore, MD
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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12
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Wong NML, Ma EPW, Lee TMC. The Integrity of the Corpus Callosum Mitigates the Impact of Blood Pressure on the Ventral Attention Network and Information Processing Speed in Healthy Adults. Front Aging Neurosci 2017; 9:108. [PMID: 28484386 PMCID: PMC5402183 DOI: 10.3389/fnagi.2017.00108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/04/2017] [Indexed: 11/23/2022] Open
Abstract
Hypertension is a risk factor for cognitive impairment in older age. However, evidence of the neural basis of the relationship between the deterioration of cognitive function and elevated blood pressure is sparse. Based on previous research, we speculate that variations in brain connectivity are closely related to elevated blood pressure even before the onset of clinical conditions and apparent cognitive decline in individuals over 60 years of age. Forty cognitively healthy adults were recruited. Each received a blood pressure test before and after the cognitive assessment in various domains. Diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rsfMRI) data were collected. Our findings confirm that elevated blood pressure is associated with brain connectivity variations in cognitively healthy individuals. The integrity of the splenium of the corpus callosum is closely related to individual differences in systolic blood pressure. In particular, elevated systolic blood pressure is related to resting-state ventral attention network (VAN) and information processing speed. Serial mediation analyses have further revealed that lower integrity of the splenium statistically predicts elevated systolic blood pressure, which in turn predicts weakened functional connectivity (FC) within the VAN and eventually poorer processing speed. The current study sheds light on how neural correlates are involved in the impact of elevated blood pressure on cognitive functioning.
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Affiliation(s)
- Nichol M L Wong
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong
| | - Ernie Po-Wing Ma
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,Laboratory of Social Cognitive Affective Neuroscience, The University of Hong KongHong Kong, Hong Kong.,Institute of Clinical Neuropsychology, The University of Hong KongHong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Science, The University of Hong KongHong Kong, Hong Kong
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13
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Jolly TA, Cooper PS, Rennie JL, Levi CR, Lenroot R, Parsons MW, Michie PT, Karayanidis F. Age-related decline in task switching is linked to both global and tract-specific changes in white matter microstructure. Hum Brain Mapp 2017; 38:1588-1603. [PMID: 27879030 PMCID: PMC6866847 DOI: 10.1002/hbm.23473] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/08/2016] [Accepted: 11/08/2016] [Indexed: 11/11/2022] Open
Abstract
Task-switching performance relies on a broadly distributed frontoparietal network and declines in older adults. In this study, they investigated whether this age-related decline in task switching performance was mediated by variability in global or regional white matter microstructural health. Seventy cognitively intact adults (43-87 years) completed a cued-trials task switching paradigm. Microstructural white matter measures were derived using diffusion tensor imaging (DTI) analyses on the diffusion-weighted imaging (DWI) sequence. Task switching performance decreased with increasing age and radial diffusivity (RaD), a measure of white matter microstructure that is sensitive to myelin structure. RaD mediated the relationship between age and task switching performance. However, the relationship between RaD and task switching performance remained significant when controlling for age and was stronger in the presence of cardiovascular risk factors. Variability in error and RT mixing cost were associated with RaD in global white matter and in frontoparietal white matter tracts, respectively. These findings suggest that age-related increase in mixing cost may result from both global and tract-specific disruption of cerebral white matter linked to the increased incidence of cardiovascular risks in older adults. Hum Brain Mapp 38:1588-1603, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Todd A.D. Jolly
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Patrick S. Cooper
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Jaime L. Rennie
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Christopher R. Levi
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
| | - Rhoshel Lenroot
- Neuroscience Research Australia, University of New South WalesSydneyAustralia
| | - Mark W. Parsons
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
| | - Patricia T. Michie
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
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14
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Iadecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB, Gulati M, Kamel H, Knopman DS, Launer LJ, Saczynski JS, Seshadri S, Zeki Al Hazzouri A. Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association. Hypertension 2016; 68:e67-e94. [PMID: 27977393 DOI: 10.1161/hyp.0000000000000053] [Citation(s) in RCA: 437] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions. METHODS Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data. RESULTS Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive. CONCLUSIONS After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.
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15
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Leritz EC, McGlinchey RE, Salat DH, Milberg WP. Elevated levels of serum cholesterol are associated with better performance on tasks of episodic memory. Metab Brain Dis 2016; 31:465-73. [PMID: 26873100 PMCID: PMC4913474 DOI: 10.1007/s11011-016-9797-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 01/18/2016] [Indexed: 01/14/2023]
Abstract
We examined how serum cholesterol, an established risk factor for cerebrovascular disease (CVD), relates to cognitive function in healthy middle-older aged individuals with no neurologic or CVD history. A complete lipid panel was obtained from a cohort of one hundred twenty individuals, ages 43-85, who also underwent a comprehensive neuropsychological examination. In order to reduce the number of variables and empirically identify broad cognitive domains, scores from neuropsychological tests were submitted into a factor analysis. This analysis revealed three explainable factors: Memory, Executive Function and Memory/Language. Three separate hierarchical multiple regression analyses were conducted using individual cholesterol metrics (total cholesterol, low density lipoprotein; LDL, high density lipoprotein; HDL, and triglycerides), as well as age, education, medication status (lipid lowering agents), ApoE status, and additional risk factors for CVD to predict neuropsychological function. The Memory Factor was predicted by a combination of age, LDL, and triglyceride levels; both age and triglycerides were negatively associated with factor score, while LDL levels revealed a positive relationship. Both the Executive and Memory/Language factor were only explained by education, whereby more years were associated with better performance. These results provide evidence that individual cholesterol lipoproteins and triglycerides may differentially impact cognitive function, over and above other common CVD risk factors and ApoE status. Our findings demonstrate the importance of consideration of vascular risk factors, such as cholesterol, in studies of cognitive aging.
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Affiliation(s)
- Elizabeth C Leritz
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA.
- Neuroimaging Research for Veterans Center (NERVE), VA Boston Healthcare System, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Regina E McGlinchey
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
- Neuroimaging Research for Veterans Center (NERVE), VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - David H Salat
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
- Neuroimaging Research for Veterans Center (NERVE), VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - William P Milberg
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
- Neuroimaging Research for Veterans Center (NERVE), VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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16
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Stricker NH, Salat DH, Kuhn TP, Foley JM, Price JS, Westlye LT, Esterman MS, McGlinchey RE, Milberg WP, Leritz EC. Mild Cognitive Impairment is Associated With White Matter Integrity Changes in Late-Myelinating Regions Within the Corpus Callosum. Am J Alzheimers Dis Other Demen 2016; 31:68-75. [PMID: 25904759 PMCID: PMC4913466 DOI: 10.1177/1533317515578257] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Degenerative brain changes in Alzheimer's disease may occur in reverse order of normal brain development based on the retrogenesis model. This study tested whether evidence of reverse myelination was observed in mild cognitive impairment (MCI) using a data-driven analytic approach based on life span developmental data. Whole-brain high-resolution diffusion tensor imaging scans were obtained for 31 patients with MCI and 79 demographically matched healthy older adults. Comparisons across corpus callosum (CC) regions of interest (ROIs) showed decreased fractional anisotropy (FA) in the body but not in the genu or splenium; early-, middle-, and late-myelinating ROIs restricted to the CC revealed decreased FA in late- but not early- or middle-myelinating ROIs. Voxelwise group differences revealed areas of lower FA in MCI, but whole-brain differences were equally distributed across early-, middle-, and late-myelinating regions. Overall, results within the CC support the retrogenesis model, although caution is needed when generalizing these results beyond the CC.
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Affiliation(s)
- Nikki H Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA Department of Radiology, Harvard Medical School, Boston, MA, USA Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Taylor P Kuhn
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
| | - Jessica M Foley
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jenessa S Price
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA McLean Hospital, Belmont, MA, USA
| | - Lars T Westlye
- Division of Mental Health and Addiction, KG Jebsen Centre for Psychosis Research, Norwegian Centre for Mental Disorder Research (NORMENT), Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway Department of Psychology, University of Oslo, Oslo, Norway
| | - Michael S Esterman
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA
| | - Regina E McGlinchey
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
| | - William P Milberg
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA Department of Medicine, Harvard Medical School, Boston, MA, USA
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Foley JM, Salat DH, Stricker NH, McGlinchey RE, Milberg WP, Grande LJ, Leritz EC. Glucose Dysregulation Interacts With APOE-∊4 to Potentiate Temporoparietal Cortical Thinning. Am J Alzheimers Dis Other Demen 2016; 31:76-86. [PMID: 26006791 PMCID: PMC4913470 DOI: 10.1177/1533317515587084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We examined the interactive effects of apolipoprotein ∊4 (APOE-∊4), a risk factor for Alzheimer's disease (AD), and diabetes risk on cortical thickness among 107 healthy elderly participants; in particular, participants included 27 APOE-∊4+ and 80 APOE-∊4- controls using T1-weighted structural magnetic resonance imaging. Regions of interests included select frontal, temporal, and parietal cortical regions. Among APOE-∊4, glucose abnormalities independently predicted reduced cortical thickness among temporoparietal regions but failed to predict changes for noncarriers. However, among noncarriers, age independently predicted reduced cortical thickness among temporoparietal and frontal regions. Diabetes risk is particularly important for the integrity of cortical gray matter in APOE-∊4 and demonstrates a pattern of thinning that is expected in preclinical AD. However, in the absence of this genetic factor, age confers risk for reduced cortical thickness among regions of expected compromise. This study supports aggressive management of cerebrovascular factors and earlier preclinical detection of AD among individuals presenting with genetic and metabolic risks.
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Affiliation(s)
- Jessica M Foley
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - David H Salat
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Nikki H Stricker
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Regina E McGlinchey
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P Milberg
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Laura J Grande
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth C Leritz
- Department of Psychiatry, VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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18
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Disrupted white matter structure underlies cognitive deficit in hypertensive patients. Eur Radiol 2015; 26:2899-907. [PMID: 26615558 DOI: 10.1007/s00330-015-4116-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/19/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Hypertension is considered a risk factor of cognitive impairments and could result in white matter changes. Current studies on hypertension-related white matter (WM) changes focus only on regional changes, and the information about global changes in WM structure network is limited. METHODS We assessed the cognitive function in 39 hypertensive patients and 37 healthy controls with a battery of neuropsychological tests. The WM structural networks were constructed by utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. The direct and indirect correlations among cognitive impairments, brain WM network disruptions and hypertension were analyzed with structural equation modelling (SEM). RESULTS Hypertensive patients showed deficits in executive function, memory and attention compared with controls. An aberrant connectivity of WM networks was found in the hypertensive patients (P Eglob = 0.005, P Lp = 0.005), especially in the frontal and parietal regions. Importantly, SEM analysis showed that the decline of executive function resulted from aberrant WM networks in hypertensive patients (p = 0.3788, CFI = 0.99). CONCLUSIONS These results suggest that the cognitive decline in hypertensive patients was due to frontal and parietal WM disconnections. Our findings highlight the importance of brain protection in hypertension patients. KEY POINTS • Hypertension has a negative effect on the performance of the cognitive domains • Reduced efficiencies of white matter networks were shown in hypertension • Disrupted white matter networks are responsible for poor cognitive function in hypertension.
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19
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Salminen LE, Schofield PR, Pierce KD, Zhao Y, Luo X, Wang Y, Laidlaw DH, Cabeen RP, Conturo TE, Tate DF, Akbudak E, Lane EM, Heaps JM, Bolzenius JD, Baker LM, Cagle LM, Paul RH. Neuromarkers of the common angiotensinogen polymorphism in healthy older adults: A comprehensive assessment of white matter integrity and cognition. Behav Brain Res 2015; 296:85-93. [PMID: 26318936 DOI: 10.1016/j.bbr.2015.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
The common angiotensinogen (AGT) M268T polymorphism (rs699; historically referred to as M235T) has been identified as a significant risk factor for cerebrovascular pathologies, yet it is unclear if healthy older adults carrying the threonine amino acid variant have a greater risk for white matter damage in specific fiber tracts. Further, the impact of the threonine variant on cognitive function remains unknown. The present study utilized multiple indices of diffusion tensor imaging (DTI) and neuropsychological assessment to examine the integrity of specific white matter tracts and cognition between individuals with homozygous genotypes of M268T (MetMet n=27, ThrThr n=27). Differences in subcortical hyperintensity (SH) volume were also examined between groups. Results indicated that the threonine variant was associated with significantly reduced integrity in the superior longitudinal fasciculus (SLF) and the cingulate gyrus segment of the cingulum bundle (cingulum CG) compared to those with the methionine variant, and poorer cognitive performance on tests of attention/processing speed and language. Despite these associations, integrity of these tracts did not significantly mediate relationships between cognition and genetic status, and SH did not differ significantly between groups. Collectively our results suggest that the threonine variant of M268T is a significant risk factor for abnormalities in specific white matter tracts and cognitive domains in healthy older adults, independent of SH burden.
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Affiliation(s)
- Lauren E Salminen
- University of Missouri-St. Louis, Department of Psychological Sciences, 1 University Blvd., Stadler Hall 442A, St. Louis, MO 63121, USA.
| | - Peter R Schofield
- Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kerrie D Pierce
- Neuroscience Research Australia, Barker Street Randwick, Sydney, NSW 2031, Australia
| | - Yi Zhao
- Brown University, Department of Biostatistics and Center for Statistical Sciences, Providence, RI 02912, USA
| | - Xi Luo
- Brown University, Department of Biostatistics and Center for Statistical Sciences, Providence, RI 02912, USA
| | - Youdan Wang
- Brown University, Department of Biostatistics and Center for Statistical Sciences, Providence, RI 02912, USA
| | - David H Laidlaw
- Brown University, Computer Science Department, Providence, RI 02912, USA
| | - Ryan P Cabeen
- Brown University, Computer Science Department, Providence, RI 02912, USA
| | - Thomas E Conturo
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 S. Kingshighway, St. Louis, MO 63110, USA
| | - David F Tate
- Missouri Institute of Mental Health,4633 World Parkway Circle, Berkeley, MO 63134-3115, USA
| | - Erbil Akbudak
- Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 S. Kingshighway, St. Louis, MO 63110, USA
| | - Elizabeth M Lane
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA
| | - Jodi M Heaps
- Missouri Institute of Mental Health,4633 World Parkway Circle, Berkeley, MO 63134-3115, USA
| | - Jacob D Bolzenius
- University of Missouri-St. Louis, Department of Psychological Sciences, 1 University Blvd., Stadler Hall 442A, St. Louis, MO 63121, USA
| | - Laurie M Baker
- University of Missouri-St. Louis, Department of Psychological Sciences, 1 University Blvd., Stadler Hall 442A, St. Louis, MO 63121, USA
| | - Lee M Cagle
- University of Missouri-St. Louis, Department of Psychological Sciences, 1 University Blvd., Stadler Hall 442A, St. Louis, MO 63121, USA
| | - Robert H Paul
- University of Missouri-St. Louis, Department of Psychological Sciences, 1 University Blvd., Stadler Hall 442A, St. Louis, MO 63121, USA; Missouri Institute of Mental Health,4633 World Parkway Circle, Berkeley, MO 63134-3115, USA
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20
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Pasha EP, Kaur SS, Gonzales MM, Machin DR, Kasischke K, Tanaka H, Haley AP. Vascular function, cerebral cortical thickness, and cognitive performance in middle-aged Hispanic and non-Hispanic Caucasian adults. J Clin Hypertens (Greenwich) 2015; 17:306-12. [PMID: 25720950 PMCID: PMC4390456 DOI: 10.1111/jch.12512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/05/2015] [Accepted: 01/07/2015] [Indexed: 11/26/2022]
Abstract
Hispanics are at increased risk for acquiring cardiovascular risk factors that contribute to cognitive dysfunction. To compare indices of vascular health with measures of cerebral gray matter integrity, 60 middle-aged Hispanic and non-Hispanic Caucasian participants were matched across age, sex, years of education, and mental status. Arterial stiffness was characterized by β-stiffness index and carotid-femoral pulse wave velocity, and magnetic resonance imaging estimated cortical thickness in a priori regions of interest known to be susceptible to vascular risk factors. Measures of arterial stiffness were significantly higher in Hispanics than in non-Hispanic Caucasians. Hispanics exhibited thinner left inferior frontal gyrus (LIFG) cortical thickness (P=.04) with concurrently lower language (P=.02), memory (P=.03), and attention-executive functioning (P=.02). These results suggest that compromised vascular health may occur simultaneously with cortical thinning of the LIFG as an early neuropathological alteration in Hispanics.
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Affiliation(s)
- Evan P Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX
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21
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Oberlin LE, Manuck SB, Gianaros PJ, Ferrell RE, Muldoon MF, Jennings JR, Flory JD, Erickson KI. Blood pressure interacts with APOE ε4 to predict memory performance in a midlife sample. Neuropsychology 2015; 29:693-702. [PMID: 25730733 DOI: 10.1037/neu0000177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Elevated blood pressure and the Apolipoprotein ε4 allele (APOE ε4) are independent risk factors for Alzheimer's disease. We sought to determine whether the combined presence of the APOE ε4 allele and elevated blood pressure is associated with lower cognitive performance in cognitively healthy middle-aged adults. METHODS A total of 975 participants aged 30-54 (mean age = 44.47) were genotyped for APOE. Cardiometabolic risk factors including blood pressure, lipids, and glucose were assessed and cognitive function was measured using the Trail Making Test and the Visual Reproduction and Logical Memory subtests from the Wechsler Memory Scale. RESULTS Multivariable regression analysis showed that the association between APOE ε4 and episodic memory performance varied as a function of systolic blood pressure (SBP), such that elevated SBP was predictive of poorer episodic memory performance only in APOE ε4 carriers (β = -.092; t = -2.614; p = .009). Notably, this association was apparent at prehypertensive levels (≥130 mmHg), even after adjusting for physical activity, depression, smoking, and other cardiometabolic risk factors. CONCLUSIONS The joint presence of APOE ε4 and elevated SBP, even at prehypertensive levels, is associated with lower cognitive performance in healthy, middle-aged adults. Results of this study suggest that the combination of APOE ε4 and elevated SBP may synergistically compromise memory function well before the appearance of clinically significant impairments. Interventions targeting blood pressure control in APOE ε4 carriers during midlife should be studied as a possible means to reduce the risk of cognitive decline in genetically susceptible samples.
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Affiliation(s)
| | | | | | | | - Matthew F Muldoon
- Heart and Vascular Institute, University of Pittsburgh School of Medicine
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22
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Abstract
This study explored effects of the metabolic syndrome (MetS) on language in aging. MetS is a constellation of five vascular and metabolic risk factors associated with the development of chronic diseases and increased risk of mortality, as well as brain and cognitive impairments. We tested 281 English-speaking older adults aged 55-84, free of stroke and dementia. Presence of MetS was based on the harmonized criteria (Alberti et al., 2009). Language performance was assessed by measures of accuracy and reaction time on two tasks of lexical retrieval and two tasks of sentence processing. Regression analyses, adjusted for age, education, gender, diabetes, hypertension, and heart disease, demonstrated that participants with MetS had significantly lower accuracy on measures of lexical retrieval (action naming) and sentence processing (embedded sentences, both subject and object relative clauses). Reaction time was slightly faster on the test of embedded sentences among those with MetS. MetS adversely affects the language performance of older adults, impairing accuracy of both lexical retrieval and sentence processing. This finding reinforces and extends results of earlier research documenting the negative influence of potentially treatable medical conditions (diabetes, hypertension) on language performance in aging. The unanticipated finding that persons with MetS were faster in processing embedded sentences may represent an impairment of timing functions among older individuals with MetS.
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23
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Foley JM, Salat DH, Stricker NH, Zink TA, Grande LJ, McGlinchey RE, Milberg WP, Leritz EC. Interactive effects of apolipoprotein E4 and diabetes risk on later myelinating white matter regions in neurologically healthy older aged adults. Am J Alzheimers Dis Other Demen 2014; 29:222-35. [PMID: 24381137 PMCID: PMC4356251 DOI: 10.1177/1533317513517045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Possession of the apolipoprotein E4 (APOE4) allele and diabetes risk are independently related to reduced white matter (WM) integrity that may contribute to the development of Alzheimer's disease (AD). The purpose of this study is to examine the interactive effects of APOE4 and diabetes risk on later myelinating WM regions among healthy elderly individuals at risk of AD. A sample of 107 healthy elderly (80 APOE4-/27 APOE4+) individuals underwent structural magnetic resonance imaging/diffusion tensor imaging (DTI). Data were prepared using Tract-Based Spatial Statistics, and a priori regions of interest (ROIs) were extracted from T1-based WM parcellations. Regions of interest included later myelinating frontal/temporal/parietal WM regions and control regions measured by fractional anisotropy (FA). There were no APOE group differences in DTI for any ROI. Within the APOE4 group, we found negative relationships between hemoglobin A1c/fasting glucose and APOE4 on FA for all later myelinating WM regions but not for early/middle myelinating control regions. Results also showed APOE4/diabetes risk interactions for WM underlying supramarginal, superior temporal, precuneus, superior parietal, and superior frontal regions. Results suggest interactive effects of APOE4 and diabetes risk on later myelinating WM regions, which supports preclinical detection of AD among this particularly susceptible subgroup.
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Affiliation(s)
- Jessica M. Foley
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David H. Salat
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Nikki H. Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Tyler A. Zink
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Laura J. Grande
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Regina E. McGlinchey
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - William P. Milberg
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elizabeth C. Leritz
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Division of Aging, Brigham & Women’s Hospital, Boston, MA, USA
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24
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Dacosta-Aguayo R, Graña M, Fernández-Andújar M, López-Cancio E, Cáceres C, Bargalló N, Barrios M, Clemente I, Monserrat PT, Sas MA, Dávalos A, Auer T, Mataró M. Structural integrity of the contralesional hemisphere predicts cognitive impairment in ischemic stroke at three months. PLoS One 2014; 9:e86119. [PMID: 24475078 PMCID: PMC3901679 DOI: 10.1371/journal.pone.0086119] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/10/2013] [Indexed: 02/06/2023] Open
Abstract
After stroke, white matter integrity can be affected both locally and distally to the primary lesion location. It has been shown that tract disruption in mirror's regions of the contralateral hemisphere is associated with degree of functional impairment. Fourteen patients suffering right hemispheric focal stroke (S) and eighteen healthy controls (HC) underwent Diffusion Weighted Imaging (DWI) and neuropsychological assessment. The stroke patient group was divided into poor (SP; n = 8) and good (SG; n = 6) cognitive recovery groups according to their cognitive improvement from the acute phase (72 hours after stroke) to the subacute phase (3 months post-stroke). Whole-brain DWI data analysis was performed by computing Diffusion Tensor Imaging (DTI) followed by Tract Based Spatial Statistics (TBSS). Assessment of effects was obtained computing the correlation of the projections on TBSS skeleton of Fractional Anisotropy (FA) and Radial Diffusivity (RD) with cognitive test results. Significant decrease of FA was found only in right brain anatomical areas for the S group when compared to the HC group. Analyzed separately, stroke patients with poor cognitive recovery showed additional significant FA decrease in several left hemisphere regions; whereas SG patients showed significant decrease only in the left genu of corpus callosum when compared to the HC. For the SG group, whole brain analysis revealed significant correlation between the performance in the Semantic Fluency test and the FA in the right hemisphere as well as between the performance in the Grooved Pegboard Test (GPT) and the Trail Making Test-part A and the FA in the left hemisphere. For the SP group, correlation analysis revealed significant correlation between the performance in the GPT and the FA in the right hemisphere.
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Affiliation(s)
- Rosalia Dacosta-Aguayo
- Group of Computational Intelligence, University of the Basque Country UPV/EHU, San Sebastian, Spain
| | - Manuel Graña
- Group of Computational Intelligence, University of the Basque Country UPV/EHU, San Sebastian, Spain
| | - Marina Fernández-Andújar
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behaviour (IR3C), Barcelona, Spain
| | - Elena López-Cancio
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Núria Bargalló
- Diagnostic Center for Image, Clinic Hospital, Barcelona, Spain
- Imatge Platform of IDIBAPS, Barcelona, Spain
| | - Maite Barrios
- Department of Methodology of Behavioral Sciences, University of Barcelona, Spain
| | - Immaculada Clemente
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behaviour (IR3C), Barcelona, Spain
| | - Pere Toran Monserrat
- Primary Healthcare Research Support Unit Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària (−IDIAP) Jordi Gol, Santa Coloma de Gramenet, Spain
| | - Maite Alzamora Sas
- Primary Healthcare Research Support Unit Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària (−IDIAP) Jordi Gol, Santa Coloma de Gramenet, Spain
| | - Antoni Dávalos
- Department of Neurosciences, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tibor Auer
- MRC Cognition and Brain Sciences Unit, Cambridge, England
| | - Maria Mataró
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Institute for Brain, Cognition and Behaviour (IR3C), Barcelona, Spain
- * E-mail:
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25
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Salat DH. Imaging small vessel-associated white matter changes in aging. Neuroscience 2013; 276:174-86. [PMID: 24316059 DOI: 10.1016/j.neuroscience.2013.11.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 11/21/2013] [Accepted: 11/21/2013] [Indexed: 01/18/2023]
Abstract
Alterations in cerebrovascular structure and function may underlie the most common age-associated cognitive, psychiatric, and neurological conditions presented by older adults. Although much remains to understand, existing research suggests several age-associated detrimental conditions may be mediated through sometimes subtle small vessel-induced damage to the cerebral white matter. Here we review a selected portion of the vast work that demonstrates links between changes in vascular and neural health as a function of advancing age, and how even changes in low-to-moderate risk individuals, potentially beginning early in the adult age-span, may have an important impact on functional status in late life.
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Affiliation(s)
- D H Salat
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Department of Radiology, Charlestown, MA, USA; Neuroimaging Research for Veterans Center, Boston VA Healthcare System, Boston, MA, USA.
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26
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Decreased white matter integrity in neuropsychologically defined mild cognitive impairment is independent of cortical thinning. J Int Neuropsychol Soc 2013; 19:925-37. [PMID: 23809097 PMCID: PMC4356249 DOI: 10.1017/s1355617713000660] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer’s disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for corticalthic kness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes.
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27
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Chen JJ, Rosas HD, Salat DH. The relationship between cortical blood flow and sub-cortical white-matter health across the adult age span. PLoS One 2013; 8:e56733. [PMID: 23437228 PMCID: PMC3578934 DOI: 10.1371/journal.pone.0056733] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/14/2013] [Indexed: 11/18/2022] Open
Abstract
Degeneration of cerebral white matter is commonly observed in aging, and the associated degradation in neural connectivity contributes to cognitive decline in older adults. Vascular dysfunction has been implicated as a potential mechanism for general age-related neural tissue deterioration; however, no prior study has examined the direct relationship between cortical vascular health and subcortical white-matter integrity. In this work, we aimed to determine whether blood supply to the brain is associated with microstructural integrity of connective tissue, and whether such associations are regionally specific and mainly accounted for by aging. We examined the association between cerebral blood flow (CBF) in the cortical mantle, measured using arterial spin labeling (ASL), and subcortical white-matter integrity, measured using diffusion tensor imaging (DTI), in a group of healthy adults spanning early to late adulthood. We found cortical CBF to be significantly associated with white-matter integrity throughout the brain. In addition, these associations were only partially tied to aging, as they remained even when statistically controlling for age, and when restricting the analyses to a young subset of the sample. Furthermore, vascular risk was not a prominent determinant of these effects. These findings suggest that the overall blood supply to the brain is an important indicator of white-matter health in the normal range of variations amongst adults, and that the decline in CBF with advancing age may potentially exacerbate deterioration of the connective anatomy of the brain.
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Affiliation(s)
- J Jean Chen
- Rotman Research Institute, Baycrest Centre for Geriatric Care, University of Toronto, Toronto, Canada.
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Leritz EC, Shepel J, Williams VJ, Lipsitz LA, McGlinchey RE, Milberg WP, Salat DH. Associations between T1 white matter lesion volume and regional white matter microstructure in aging. Hum Brain Mapp 2013; 35:1085-100. [PMID: 23362153 DOI: 10.1002/hbm.22236] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 10/16/2012] [Accepted: 11/11/2012] [Indexed: 01/18/2023] Open
Abstract
White matter lesions, typically manifesting as regions of signal intensity abnormality (WMSA) on MRI, increase in frequency with age. However, the role of this damage in cognitive decline and disease is still not clear, as lesion volume has only loosely been associated with clinical status. Diffusion tensor imaging (DTI) has been used to examine the quantitative microstructural integrity of white matter, and has applications in the examination of subtle changes to tissue that appear visually normal on conventional imaging. The primary goal of this study was to determine whether major macrostructural white matter damage, (total WMSA volume), is associated with microstructural integrity of normal appearing white matter, and if these macrostructural changes fully account for microstructural changes. Imaging was performed in 126 nondemented individuals, ages 43-85 years, with no history of cerebrovascular disease. Controlling for age, greater WMSA volume was associated with decreased fractional anisotropy (FA) in widespread brain regions. Patterns were similar for FA and radial diffusivity but in contrast, WMSA was associated with axial diffusivity in fewer areas. Age was associated with FA in several regions, and many of these effects remained even when controlling for WMSA volume, suggesting the etiology of WMSAs does not fully account for all age-associated white matter deterioration. These results provide evidence that WMSA volume is associated with the integrity of normal-appearing white matter. In addition, our results suggest that overt lesions may not account for the association of increasing age with decreased white matter tissue integrity.
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Affiliation(s)
- Elizabeth C Leritz
- Geriatric Research, Education and Clinical Center (GRECC) and Neuroimaging Research for Veterans Center (NeRVe), VA Boston Healthcare System, Boston, Massachusetts; Division of Aging, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts
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Abstract
Great effort has been dedicated to mapping the functional architecture of the brain in health and disease. The neural centers that support cognition and behavior are the "hubs" defining the salient geographic landmarks of the cerebral topography. Similar to urban cartography, however, the functionality of these hubs is critically dependent on the infrastructure permitting the transfer of relevant information from site to site, and this infrastructure is susceptible to deterioration. The groundwork of the brain lies in the form of the complexly organized myelinated nerve fibers responsible for the inter-regional transmission of electrical impulses among distinct neural areas. Damage to the myelin sheath and reduction in the total number of nerve fibers with aging are thought to result in a degradation in the efficiency of communication among neural regions and to contribute to the decline of function in older adults. This article describes selected studies that are relevant to understanding the deterioration in structural connectivity of the aging brain with a focus on potential consequences to functional network activity. First, the neural substrates of connectivity and techniques used in the study of connectivity are described with a focus on neuroimaging methodologies. This is followed with discussion of the negative effects of age on connective integrity, and the possible mechanisms and neural and cognitive consequences of this progressive disconnection. Given the potential for natural repair of certain elements of the connective network, understanding the basis of age-associated decline in connectivity could have important implications with regard to the amelioration of neural dysfunction and the restoration of the infrastructure necessary for optimal function in older adults.
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Affiliation(s)
- David H Salat
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
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Maillard P, Seshadri S, Beiser A, Himali JJ, Au R, Fletcher E, Carmichael O, Wolf PA, DeCarli C. Effects of systolic blood pressure on white-matter integrity in young adults in the Framingham Heart Study: a cross-sectional study. Lancet Neurol 2012; 11:1039-47. [PMID: 23122892 DOI: 10.1016/s1474-4422(12)70241-7] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Previous studies have identified effects of age and vascular risk factors on brain injury in elderly individuals. We aimed to establish whether the effects of high blood pressure in the brain are evident as early as the fifth decade of life. METHODS In an investigation of the third generation of the Framingham Heart Study, we approached all participants in 2009 to ask whether they would be willing to undergo MRI. Consenting patients underwent clinical assessment and cerebral MRI that included T1-weighted and diffusion tensor imaging to obtain estimates of fractional anisotropy, mean diffusivity, and grey-matter volumes. All images were coregistered to a common minimum deformation template for voxel-based linear regressions relating fractional anisotropy, mean diffusivity, and grey-matter volumes to age and systolic blood pressure, with adjustment for potential confounders. FINDINGS 579 (14·1%) of 4095 participants in the third-generation cohort (mean age 39·2 years, SD 8·4) underwent brain MRI between June, 2009 and June, 2010. Age was associated with decreased fractional anisotropy and increased mean diffusivity in almost all cerebral white-matter voxels. Age was also independently associated with reduced grey-matter volumes. Increased systolic blood pressure was linearly associated with decreased regional fractional anisotropy and increased mean diffusivity, especially in the anterior corpus callosum, the inferior fronto-occipital fasciculi, and the fibres that project from the thalamus to the superior frontal gyrus. It was also strongly associated with reduced grey-matter volumes, particularly in Brodmann's area 48 on the medial surface of the temporal lobe and Brodmann's area 21 of the middle temporal gyrus. INTERPRETATION Our results suggest that subtle vascular brain injury develops insidiously during life, with discernible effects even in young adults. These findings emphasise the need for early and optimum control of blood pressure. FUNDING National Institutes of Health and National Heart, Lung, and Blood Institute; National Institute on Aging; and National Institute of Neurological Disorders and Stroke.
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Affiliation(s)
- Pauline Maillard
- Imaging of Dementia and Aging Laboratory, Center for Neuroscience, Sacramento CA, USA
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Increased body mass index is associated with a global and distributed decrease in white matter microstructural integrity. Psychosom Med 2012; 74:682-90. [PMID: 22879428 PMCID: PMC3586991 DOI: 10.1097/psy.0b013e318261909c] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Obesity and decreased physical health are linked to deficits in several cognitive domains. The broad range of cognitive problems linked to obesity suggests a global mechanism that may interfere with multiple neural systems. We examined how variation in body mass index (BMI) is associated with the microstructural integrity of fiber connections in the human brain. METHODS White matter structure was measured using diffusion tensor imaging in 28 participants (mean age = 30 years) with BMI scores ranging from normal weight to obese (19.5-45.7 kg/m(2)) based on standard BMI criteria. RESULTS Using a whole-brain voxelwise analysis, we found that, across participants, the fractional anisotropy of white matter voxels parametrically decreased with increasing BMI (63% of white matter voxels). Midbrain and brainstem tracts were among the pathways most strongly associated with obesity (r = -0.18 to -0.33, df = 27, all p values < .05). We also observed a weaker overall diffusion signal in individuals with higher BMI than controls with normal weight (r = -0.14 to -0.71, df = 27, for 67% of fiber pathways tested, all p values < .05). After controlling for this decrease in general diffusivity, we found that decreases in fractional anisotropy stemmed from both a decrease in axial diffusivity (p < .05) and an increase in radial diffusivity (p < .05). CONCLUSIONS Our results show that increased BMI is globally associated with a reduction in white matter integrity throughout the brain, elucidating a potential mechanism by which changes in physical health may influence cognitive health.
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Williams VJ, Leritz EC, Shepel J, McGlinchey RE, Milberg WP, Rudolph JL, Lipsitz LA, Salat DH. Interindividual variation in serum cholesterol is associated with regional white matter tissue integrity in older adults. Hum Brain Mapp 2012; 34:1826-41. [PMID: 22438182 DOI: 10.1002/hbm.22030] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 12/06/2011] [Accepted: 12/07/2011] [Indexed: 01/24/2023] Open
Abstract
Prior research has demonstrated links among vascular health and the occurrence of stroke, mild cognitive decline, and dementia in older adults. However, little is known about whether normal variation in vascular indicators may be related to changes in neural tissue integrity. Even less is known about how the brain is affected by cholesterol levels in the normal to moderate risk range, leading up to overt disease pathology. This study examined associations between serum lipid levels and DTI indicators of white matter (WM) structural integrity in a sample of 125 generally healthy older adults aged 43-87 years. Whole-brain voxelwise analysis, controlling for age and gender, revealed low density lipoprotein levels (LDL) as the most robust correlate of regional WM structural integrity of the measured lipids. Higher LDL was associated with decreased WM integrity in right frontal and temporal regions, the superior longitudinal fasciculus and internal/external capsules. Increasing LDL was associated with increased radial and axial diffusivity; however, more widespread statistical effects were found for radial diffusivity. These findings suggest that normal interindividual variation in lipid levels is associated with compromised regional WM integrity, even in individuals below clinical thresholds for hyperlipidemia. Given the prevalence of cholesterol-associated sequelae in older adults, and mounting evidence suggesting a vascular role in the etiology of dementia, the current data suggest that understanding the relationship between cholesterol and brain tissue microstructure may have important clinical implications for early detection of vascular-related cognitive disorders and optimal regulation of serum lipids to maintain neural health in older adults.
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Affiliation(s)
- Victoria J Williams
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts, USA
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Jacobs HIL, Leritz EC, Williams VJ, Van Boxtel MPJ, van der Elst W, Jolles J, Verhey FRJ, McGlinchey RE, Milberg WP, Salat DH. Association between white matter microstructure, executive functions, and processing speed in older adults: the impact of vascular health. Hum Brain Mapp 2011; 34:77-95. [PMID: 21954054 DOI: 10.1002/hbm.21412] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/08/2011] [Accepted: 07/01/2011] [Indexed: 11/12/2022] Open
Abstract
Cerebral white matter damage is not only a commonly reported consequence of healthy aging, but is also associated with cognitive decline and dementia. The aetiology of this damage is unclear; however, individuals with hypertension have a greater burden of white matter signal abnormalities (WMSA) on MR imaging than those without hypertension. It is therefore possible that elevated blood pressure (BP) impacts white matter tissue structure which in turn has a negative impact on cognition. However, little information exists about whether vascular health indexed by BP mediates the relationship between cognition and white matter tissue structure. We used diffusion tensor imaging to examine the impact of vascular health on regional associations between white matter integrity and cognition in healthy older adults spanning the normotensive to moderate-severe hypertensive BP range (43-87 years; N = 128). We examined how white matter structure was associated with performance on tests of two cognitive domains, executive functioning (EF) and processing speed (PS), and how patterns of regional associations were modified by BP and WMSA. Multiple linear regression and structural equation models demonstrated associations between tissue structure, EF and PS in frontal, temporal, parietal, and occipital white matter regions. Radial diffusivity was more prominently associated with performance than axial diffusivity. BP only minimally influenced the relationship between white matter integrity, EF and PS. However, WMSA volume had a major impact on neurocognitive associations. This suggests that, although BP and WMSA are causally related, these differential metrics of vascular health may act via independent pathways to influence brain structure, EF and PS.
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Affiliation(s)
- Heidi I L Jacobs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, University Maastricht, 6200 MD Maastricht, The Netherlands.
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Tang CY, Friedman JI, Carpenter DM, Novakovic V, Eaves E, Ng J, Wu YW, Gottlieb S, Wallenstein S, Moshier E, Parrella M, White L, Bowler S, McGinn TG, Flanagan L, Davis KL. The effects of hypertension and body mass index on diffusion tensor imaging in schizophrenia. Schizophr Res 2011; 130:94-100. [PMID: 21641187 DOI: 10.1016/j.schres.2011.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 05/03/2011] [Accepted: 05/04/2011] [Indexed: 11/30/2022]
Abstract
Recently, the negative effects of hypertension and elevated body mass index on cognitive functioning in schizophrenia have been reported (Friedman et al., 2010). Data suggests that cognitive changes in hypertensive patients from the general population may be mediated, in part, by white matter damage. Therefore, we performed diffusion tensor imaging (DTI) in the same subjects studied by Friedman et al. (2010) to investigate the effects of hypertension and elevated body mass index on the fractional anisotropy (FA) of several major white matter tracts. Significant interactions between a diagnosis of schizophrenia and hypertension on FA in several white matter regions were detected. Hypertension was associated with lower FA in the schizophrenic group and higher FA in the same tracts in the non-schizophrenic subjects. These results suggest hypertension-induced compensatory mechanisms in the brains of non-schizophrenic patients with hypertension which may be impaired in persons with schizophrenia.
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Affiliation(s)
- Cheuk Ying Tang
- Department of Radiology, Mount Sinai School of Medicine, New York, NY 10029, United States.
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Salat DH, Williams VJ, Leritz EC, Schnyer DM, Rudolph JL, Lipsitz LA, McGlinchey RE, Milberg WP. Inter-individual variation in blood pressure is associated with regional white matter integrity in generally healthy older adults. Neuroimage 2011; 59:181-92. [PMID: 21820060 DOI: 10.1016/j.neuroimage.2011.07.033] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 05/30/2011] [Accepted: 07/12/2011] [Indexed: 11/16/2022] Open
Abstract
Prior studies have documented a range of brain changes that occur as a result of healthy aging as well as neural alterations due to profound dysregulation in vascular health such as extreme hypertension, cerebrovascular disease and stroke. In contrast, little information exists about the more transitionary state between the normal and abnormal physiology that contributes to vascular disease and cognitive decline. Specifically, little information exists with regard to the influence of systemic vascular physiology on brain tissue structure in older individuals with low risk for cerebrovascular disease and with no evidence of cognitive impairment. We examined the association between resting blood pressure and diffusion tensor imaging (DTI) indices of white matter microstructure in 128 healthy older adults (43-87 years) spanning the normotensive to moderate-severe hypertensive range. Mean arterial blood pressure (MABP) was related to diffusion measures in several regions of the brain with greatest associations in the anterior corpus callosum and lateral frontal, precentral, superior frontal, lateral parietal and precuneus white matter. Associations between white matter integrity and blood pressure remained when controlling for age, when controlling for white matter lesions, and when limiting the analyses to only normotensive, pharmacologically controlled and pre-hypertensive individuals. Of the diffusion measures examined, associations were strongest between MABP and radial diffusivity which may indicate that blood pressure has an influence on myelin structure. Associations between MABP and white matter integrity followed spatial patterns resembling those often attributed to the effects of chronological age, suggesting that systemic cerebrovascular health may play a role in neural tissue degeneration classically ascribed to aging. These results demonstrate the importance of the consideration of vascular physiology in studies of cognitive and neural aging, and that this significance extends to even the normotensive and medically controlled population. These data additionally suggest that optimal management of blood pressure may require consideration of the more subtle influence of vascular health on neural health in addition to the primary goal of prevention of a major cerebrovascular event.
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Affiliation(s)
- David H Salat
- Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, MA, USA.
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Leritz EC, McGlinchey RE, Kellison I, Rudolph JL, Milberg WP. Cardiovascular Disease Risk Factors and Cognition in the Elderly. CURRENT CARDIOVASCULAR RISK REPORTS 2011; 5:407-412. [PMID: 22199992 DOI: 10.1007/s12170-011-0189-x] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
While it is relatively widely known that cardiovascular disease (CVD) can result in cognitive decline, it is becoming increasingly clearer that actual risk factors for CVD, such as high blood pressure, diabetes, and obesity are also associated with alterations to brain structure and cognition. The prevalence of CVD risk factors increase exponentially with age and are often overlooked as a source of cognitive changes that are otherwise thought to be part of the 'normal' aging process. Associated cognitive changes are observed even at levels of risk that would be considered subclinical by current diagnostic convention, and are often significant enough to interfere with daily functional abilities. More importantly, if not controlled, CVD risk can lead to further decline, including cerebrovacsular disease and dementia. Thus, it is critically important to consider these factors in the elderly and we recommend more routine cognitive screenings, particularly when CVD risk factors are involved.
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Leritz EC, Salat DH, Williams VJ, Schnyer DM, Rudolph JL, Lipsitz L, Fischl B, McGlinchey RE, Milberg WP. Thickness of the human cerebral cortex is associated with metrics of cerebrovascular health in a normative sample of community dwelling older adults. Neuroimage 2011; 54:2659-71. [PMID: 21035552 PMCID: PMC3026290 DOI: 10.1016/j.neuroimage.2010.10.050] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 09/21/2010] [Accepted: 10/13/2010] [Indexed: 11/19/2022] Open
Abstract
We examined how wide ranges in levels of risk factors for cerebrovascular disease are associated with thickness of the human cerebral cortex in 115 individuals ages 43-83 with no cerebrovascular or neurologic history. Cerebrovascular risk factors included blood pressure, cholesterol, body mass index, creatinine, and diabetes-related factors. Variables were submitted into a principal components analysis that confirmed four orthogonal factors (blood pressure, cholesterol, cholesterol/metabolic and glucose). T1-weighted MRI was used to create models of the cortex for calculation of regional cortical thickness. Increasing blood pressure factor scores were associated with numerous regions of reduced thickness. Increasing glucose scores were modestly associated with areas of regionally decreased thickness. Increasing cholesterol scores, in contrast, were associated with thicker cortex across the whole brain. All findings were primarily independent of age. These results provide evidence that normal and moderately abnormal levels of parameters used to assess cerebrovascular health may impact brain structure, even in the absence of cerebrovascular disease. Our data have important implications for the clinical management of vascular health, as well as for what is currently conceptualized as "normal aging" as they suggest that subclinical levels of risk may impact cortical gray matter before a disease process is evident.
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Affiliation(s)
- Elizabeth C Leritz
- Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA.
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