The physiologic complexity of beat-to-beat blood pressure is associated with age-related alterations in blood pressure regulation

The Physiologic Complexity of Prefrontal Oxygenation Dynamics Is Associated With Age and Executive Function: An Exploratory Study

BACKGROUND

The hemodynamics of prefrontal cortex (PFC) oxygenation are regulated by numerous processes operating over multiple temporal scales, producing complex patterns in its output fluctuations. Age may alter this multiscale regulation of PFC oxygenation, leading to diminished physiologic complexity of this important regulatory process. We aimed to characterize the effects of age on such complexity and its relationship to performance of an executive n-back task.

METHODS

Twenty-four younger (aged 28 ± 3 years) and 27 older (aged 78 ± 6 years) adults completed this study. Continuous oxygenation (HbO2) and deoxygenation (HHb) signals of PFC were recorded using functional near-infrared spectroscopy (fNIRS) while participants stood and watched a blank screen (blank), clicked a mouse when an X appeared (IdX), or when a letter was repeated from "2-back" in a sequence shown on a screen (2-back). We used multiscale entropy to quantify the HbO2 and HHb complexity of fNIRS signals.

RESULTS

Older adults exhibited lower HbO2 and HHb complexity compared to younger adults, regardless of task (p = .0005-.002). Both groups exhibited greater complexity during the IdX and 2-back than blank task (p = .02-.04). Across all participants, those with greater HbO2 and/or HHb complexity during the blank task exhibited faster IdX and 2-back reaction time (β = -0.56 to -0.6, p = .009-.02). Those demonstrating greater increase in HbO2 and/or HHb complexity from IdX to 2-back task had lower percent increase in reaction time from IdX to 2-back task (β = -0.41 to -0.37, p = .005-.01).

CONCLUSIONS

The complexity of fNIRS-measured PFC oxygenation fluctuations may capture the influence of aging on the regulation of prefrontal hemodynamics involved in executive-function-based task performance.

Clinical and physiological risk factors contributing to the restricted mobility in older adults: a longitudinal analysis

BACKGROUND

Mobility limitations (e.g., using wheelchair) have been closely linked to diminished functional independence and quality of life in older adults. The regulation of mobility is pertaining to multiple neurophysiologic and sociodemographic factors. We here aimed to characterize the relationships of these factors to the risk of restricted mobility in older adults.

METHODS

In this longitudinal study, 668 older adults with intact mobility at baseline completed the baseline assessments of clinical characteristics, cognitive function, sleep quality, activities of daily living (ADL), walking performance, beat-to-beat blood pressure, and structural MRI of the brain. Then 506 of them (mean age = 70.7 ± 7.5 years) responded to the follow-up interview on the mobility limitation (as defined by if using wheelchair, cane, or walkers, or being disabled and lying on the bed) after 18 ± 3.5 months. Logistic regression analyses were performed to examine the relationships between the baseline characteristics and the follow-up mobility restriction.

RESULTS

At baseline, compared to intact-mobility group (n = 475), restricted-mobility group (n = 31) were older, with lower score of ADL and the Montreal Cognitive Assessment (MoCA), greater score of Pittsburgh Sleep Quality Index (PSQI), poorer cardio- and cerebral vascular function, and slower walking speeds (ps < 0.05). The logistic regression analysis demonstrated that participants who were with history of falls, uncontrolled-hypertension, and/or greater Fazekas scale (odds ratios (ORs):1.3 ~ 13.9, 95% confidence intervals (CIs) = 1.1 ~ 328.2), walked slower, and/or with lower ADL score (ORs: 0.0026 ~ 0.9; 95%CI: 0.0001 ~ 0.99) at baseline, would have significantly greater risk of restricted mobility (p < 0.05; VIFs = 1.2 ~ 1.9).

CONCLUSIONS

These findings provide novel profile of potential risk factors, including vascular characteristics, psycho-cognitive and motor performance, for the development of restricted mobility in near future in older adults, ultimately helping the design of appropriate clinical and rehabilitative programs for mobility in this population.

Hypotension with neurovascular changes and cognitive dysfunction: An epidemiological, pathobiological, and treatment review

ABSTRACT

Hypotension is a leading cause of age-related cognitive impairment. The available literature evidences that vascular factors are associated with dementia and that hypotension alters cerebral perfusion flow and can aggravate the neurodegeneration of Alzheimer's disease (AD). Despite the discovery of biomarkers and the recent progress made in neurovascular biology, epidemiology, and brain imaging, some key issues remain largely unresolved: the potential mechanisms underlying the neural deterioration observed in AD, the effect of cerebrovascular alterations on cognitive deficits, and the positive effects of hypotension treatment on cognition. Therefore, further well-designed studies are needed to unravel the potential association between hypotension and cognitive dysfunction and reveal the potential benefits of hypotension treatment for AD patients. Here, we review the current epidemiological, pathobiological, and treatment-related literature on neurovascular changes and hypotension-related cognitive dysfunction and highlight the unsettled but imminent issues that warrant future research endeavors.

The physiologic complexity of beat-to-beat blood pressure is associated with age-related alterations in blood pressure regulation

The fluctuations in resting-state beat-to-beat blood pressure (BP) are physiologically complex, and the degree of such BP complexity is believed to reflect the multiscale regulation of this critical physiologic process. Hypertension (HTN), one common age-related condition, is associated with altered BP regulation and diminished system responsiveness to perturbations such as orthostatic change. We thus aimed to characterize the impact of HTN on resting-state BP complexity, as well as the relationship between BP complexity and both adaptive capacity and underlying vascular characteristics. We recruited 392 participants (age: 60-91 years), including 144 that were normotensive and 248 with HTN (140 controlled- and 108 uncontrolled-HTN). Participants completed a 10-min continuous finger BP recording during supine rest, then underwent measures of lying-to-standing BP change, arterial stiffness (i.e., brachial-ankle pulse wave velocity), and endothelial function (i.e., flow-mediated vasodilation). The complexity of supine beat-to-beat systolic (SBP) and diastolic (DBP) BP was quantified using multiscale entropy. Thirty participants with HTN (16 controlled-HTN and 14 uncontrolled-HTN) exhibited orthostatic hypotension. SBP and DBP complexity was greatest in normotensive participants, lower in those with controlled-HTN, and lowest in those in uncontrolled-HTN (p < 0.0005). Lower SBP and DBP complexity correlated with greater lying-to-standing decrease in SBP and DBP level (β = -0.33 to -0.19, p < 0.01), greater arterial stiffness (β = -0.35 to -0.18, p < 0.01), and worse endothelial function (β = 0.17-0.22, p < 0.01), both across all participants and within the control- and uncontrolled-HTN groups. These results suggest that in older adults, BP complexity may capture the integrity of multiple interacting physiologic mechanisms that regulate BP and are important to cardiovascular health.

Healthy aging: Linking causal mechanisms with holistic outcomes

Identifying and understanding the impact of differing exposures over the lifecourse necessitates contextualizing different levels of influence ranging from genetics, epigenetics, geography, and psychosocial networks.

Effects of endurance exercise on physiologic complexity of the hemodynamics in prefrontal cortex

Significance

Prefrontal cortex (PFC) hemodynamics are regulated by numerous underlying neurophysiological components over multiple temporal scales. The pattern of output signals, such as functional near-infrared spectroscopy fluctuations (i.e., fNIRS), is thus complex. We demonstrate first-of-its-kind evidence that this fNIRS complexity is a marker that captures the influence of endurance capacity and the effects of hydrogen gas (H 2 ) on PFC regulation.

Aim

We aim to explore the effects of different physical loads of exercise as well as the intaking of hydrogen gas on the fNIRS complexity of the PFC.

Approach

Twenty-four healthy young men completed endurance cycling exercise from 0 (i.e., baseline) to 100% of their physical loads after intaking 20 min of either H 2 or placebo gas (i.e., control) on each of two separate visits. The fNIRS measuring the PFC hemodynamics and heart rate (HR) was continuously recorded throughout the exercise. The fNIRS complexity was quantified using multiscale entropy.

Results

The fNIRS complexity was significantly greater in the conditions from 25% to 100% of the physical load (p < 0.0005 ) compared with the baseline and after intaking H 2 before exercise; this increase of fNIRS complexity was significantly greater compared with the control (p = 0.001 ∼ 0.01 ). At the baseline, participants with a greater fNIRS complexity had a lower HR (β = - 0.35 ∼ - 0.33 , p = 0.008 ∼ 0.02 ). Those with a greater increase of complexity had a lower increase of the HR (β = - 0.30 ∼ - 0.28 , p = 0.001 ∼ 0.002 ) during exercise.

Conclusions

These observations suggest that fNIRS complexity would be a marker that captures the adaptive capacity of PFC to endurance exercise and to the effects of interventions on PFC hemodynamics.