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Darling AM, Richey RE, Akins JD, Saunders EFH, Matthew Brothers R, Greaney JL. Cerebrovascular reactivity is blunted in young adults with major depressive disorder: The influence of current depressive symptomology. J Affect Disord 2021; 295:513-521. [PMID: 34509066 PMCID: PMC8667006 DOI: 10.1016/j.jad.2021.08.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND In middle-aged adults with depression, cerebral vasodilatory reactivity is blunted; however, this has not been examined in treatment-naïve young adults with major depressive disorder (MDD). We tested the hypothesis that cerebrovascular reactivity would be blunted in young adults (18-30 yrs) with MDD compared to healthy non-depressed adults (HA) and would be attenuated to a greater extent in adults with symptomatic MDD (sMDD) compared to adults with MDD in remission (euthymic MDD; eMDD). METHODS Sixteen adults with MDD [21±3yrs; n = 8 sMDD (6 women); n = 8 eMDD (5 women)] and 14 HA (22±3yrs; 9 women) participated. End-tidal carbon dioxide concentration (PETCO2; capnograph), beat-to-beat mean arterial pressure (MAP; finger photoplethysmography), middle cerebral artery blood velocity (MCAv; transcranial Doppler ultrasound), and internal carotid artery (ICA) diameter and blood velocity (Doppler ultrasound) were continuously measured during baseline and rebreathing-induced hypercapnia. Cerebrovascular reactivity was calculated as the relative increase in vascular conductance during hypercapnia. RESULTS In adults with MDD, cerebrovascular reactivity in the MCA (∆39±9 HA vs. ∆31±13% MDD, p = 0.04), but not the ICA (∆36±24 HA vs. ∆34±18% MDD, p = 0.84), was blunted compared to HA. In the MCA, cerebrovascular reactivity was reduced in adults with sMDD compared to adults with eMDD (∆36±11 eMDD vs. ∆25±13% sMDD, p = 0.02). LIMITATIONS The cross-sectional nature approach limits conclusions regarding the temporal nature of this link. CONCLUSION These data indicate that MCA cerebrovascular reactivity is blunted in young adults with MDD and further modulated by current depressive symptomology, suggesting that the management of depressive symptomology may secondarily improve cerebrovascular health.
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Affiliation(s)
- Ashley M Darling
- Department of Kinesiology, The University of Texas at Arlington, 655W. Mitchell Street, Arlington, TX 76010, United States
| | - Rauchelle E Richey
- Department of Kinesiology, The University of Texas at Arlington, 655W. Mitchell Street, Arlington, TX 76010, United States; Department of Integrative Physiology, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - John D Akins
- Department of Kinesiology, The University of Texas at Arlington, 655W. Mitchell Street, Arlington, TX 76010, United States
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, United States
| | - R Matthew Brothers
- Department of Kinesiology, The University of Texas at Arlington, 655W. Mitchell Street, Arlington, TX 76010, United States
| | - Jody L Greaney
- Department of Kinesiology, The University of Texas at Arlington, 655W. Mitchell Street, Arlington, TX 76010, United States.
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2
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Nandadeva D, Young BE, Stephens BY, Grotle AK, Skow RJ, Middleton AJ, Haseltine FP, Fadel PJ. Blunted peripheral but not cerebral vasodilator function in young otherwise healthy adults with persistent symptoms following COVID-19. Am J Physiol Heart Circ Physiol 2021; 321:H479-H484. [PMID: 34296966 PMCID: PMC8384473 DOI: 10.1152/ajpheart.00368.2021] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Recent findings suggest that COVID-19 causes vascular dysfunction during the acute phase of the illness in otherwise healthy young adults. To date, to our knowledge, no studies have investigated the longer-term effects of COVID-19 on vascular function. Herein, we hypothesized that young, otherwise healthy adults who are past the acute phase of COVID-19 would exhibit blunted peripheral [brachial artery flow-mediated dilation (FMD) and reactive hyperemia] and cerebral vasodilator function (cerebral vasomotor reactivity to hypercapnia; CVMR) and increased central arterial stiffness. Sixteen young adults who were at least 4 wk past a COVID-19 diagnosis and 12 controls who never had COVID-19 were studied. Eight subjects with COVID-19 were symptomatic (SYM) and eight were asymptomatic (ASYM) at the time of testing. FMD and reactive hyperemia were not different between COVID and control groups. However, FMD was lower in SYM (3.8 ± 0.6%) compared with ASYM (6.8 ± 0.9%; P = 0.007) and control (6.8 ± 0.6%; P = 0.003) with no difference between ASYM and control. Similarly, peak blood velocity following cuff release was lower in SYM (47 ± 8 cm/s) compared with ASYM (64 ± 19 cm/s; P = 0.025) and control (61 ± 14 cm/s; P = 0.036). CVMR and arterial stiffness were not different between any groups. In summary, peripheral macrovascular and microvascular function, but not cerebral vascular function or central arterial stiffness were blunted in young adults symptomatic beyond the acute phase of COVID-19. In contrast, those who were asymptomatic had similar vascular function compared with controls who never had COVID-19. NEW & NOTEWORTHY This study was the first to investigate the persistent effects of COVID-19 on vascular function in otherwise healthy young adults. We demonstrated that peripheral macrovascular and microvascular vasodilation was significantly blunted in young adults still symptomatic from COVID-19 beyond the acute phase (>4 wk from diagnosis), whereas those who become asymptomatic have similar vascular function compared with controls who never had COVID-19. In contrast, cerebral vascular function and central arterial stiffness were unaffected irrespective of COVID-19 symptomology.
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Affiliation(s)
- Damsara Nandadeva
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Benjamin E Young
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Brandi Y Stephens
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Ann-Katrin Grotle
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Rachel J Skow
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | | | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
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3
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Daoust J, Schaffer J, Zeighami Y, Dagher A, García-García I, Michaud A. White matter integrity differences in obesity: A meta-analysis of diffusion tensor imaging studies. Neurosci Biobehav Rev 2021; 129:133-141. [PMID: 34284063 DOI: 10.1016/j.neubiorev.2021.07.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/07/2021] [Accepted: 07/15/2021] [Indexed: 01/17/2023]
Abstract
Some Diffusion Tensor Imaging studies have shown a loss of white matter (WM) integrity linked to impaired cognitive function in obese individuals. However, inconsistent WM integrity changes have been reported. We aimed to identify which WM tracts show consistent changes with obesity. We conducted a systematic search to find studies examining the association between obesity-related measures and Fractional Anisotropy (FA) or Mean Diffusivity. We performed a meta-analysis with FA datasets using Anisotropic Effect Size-Signed Differential Mapping software. The meta-analysis showed that increased obesity measurements were related to reduced FA in the genu of the corpus callosum. We validated our findings using an independent sample from the Human Connectome Project dataset, which supports lower FA in this region in individuals with obesity compared to those with normal weight (p = 0.028). Our findings provide evidence that obesity is associated with reduced WM integrity in the genu of the corpus callosum, a tract linking frontal areas involved in executive function. Future studies are needed on the mechanisms linking obesity with loss of WM integrity.
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Affiliation(s)
- Justine Daoust
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada
| | - Joelle Schaffer
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Yashar Zeighami
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Montreal, Québec, H3A 2B4, Canada
| | - Isabel García-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Gran Via de les Corts Catalanes, 585, 08007, Barcelona, Spain
| | - Andréanne Michaud
- Research Center of the Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, 2725 chemin Sainte-Foy, Québec, Québec, G1V 4G5, Canada; School of Nutrition, Université Laval, 2325 rue de l'Université, Québec, Québec, G1V 0A6, Canada.
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4
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Balasubramanian P, Kiss T, Tarantini S, Nyúl-Tóth Á, Ahire C, Yabluchanskiy A, Csipo T, Lipecz A, Tabak A, Institoris A, Csiszar A, Ungvari Z. Obesity-induced cognitive impairment in older adults: a microvascular perspective. Am J Physiol Heart Circ Physiol 2021; 320:H740-H761. [PMID: 33337961 PMCID: PMC8091942 DOI: 10.1152/ajpheart.00736.2020] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over two-thirds of individuals aged 65 and older are obese or overweight in the United States. Epidemiological data show an association between the degree of adiposity and cognitive dysfunction in the elderly. In this review, the pathophysiological roles of microvascular mechanisms, including impaired endothelial function and neurovascular coupling responses, microvascular rarefaction, and blood-brain barrier disruption in the genesis of cognitive impairment in geriatric obesity are considered. The potential contribution of adipose-derived factors and fundamental cellular and molecular mechanisms of senescence to exacerbated obesity-induced cerebromicrovascular impairment and cognitive decline in aging are discussed.
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Affiliation(s)
- Priya Balasubramanian
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Kiss
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Stefano Tarantini
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,4Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ádám Nyúl-Tóth
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,5International Training Program in Geroscience, Institute of Biophysics, Biological Research Centre, Szeged, Hungary
| | - Chetan Ahire
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andriy Yabluchanskiy
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Csipo
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,6International Training Program in Geroscience, Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Agnes Lipecz
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Adam Tabak
- 3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,7Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary,8Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Adam Institoris
- 9Hotchkiss Brain Institute, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anna Csiszar
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Zoltan Ungvari
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,4Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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5
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Tengeler AC, Gart E, Wiesmann M, Arnoldussen IAC, van Duyvenvoorde W, Hoogstad M, Dederen PJ, Verweij V, Geenen B, Kozicz T, Kleemann R, Morrison MC, Kiliaan AJ. Propionic acid and not caproic acid, attenuates nonalcoholic steatohepatitis and improves (cerebro) vascular functions in obese Ldlr -/- .Leiden mice. FASEB J 2020; 34:9575-9593. [PMID: 32472598 DOI: 10.1096/fj.202000455r] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
The obesity epidemic increases the interest to elucidate impact of short-chain fatty acids on metabolism, obesity, and the brain. We investigated the effects of propionic acid (PA) and caproic acid (CA) on metabolic risk factors, liver and adipose tissue pathology, brain function, structure (by MRI), and gene expression, during obesity development in Ldlr-/- .Leiden mice. Ldlr-/- .Leiden mice received 16 weeks either a high-fat diet (HFD) to induce obesity, or chow as reference group. Next, obese HFD-fed mice were treated 12 weeks with (a) HFD + CA (CA), (b) HFD + PA (PA), or (c) a HFD-control group. PA reduced the body weight and systolic blood pressure, lowered fasting insulin levels, and reduced HFD-induced liver macrovesicular steatosis, hypertrophy, inflammation, and collagen content. PA increased the amount of glucose transporter type 1-positive cerebral blood vessels, reverted cerebral vasoreactivity, and HFD-induced effects in microstructural gray and white matter integrity of optic tract, and somatosensory and visual cortex. PA and CA also reverted HFD-induced effects in functional connectivity between visual and auditory cortex. However, PA mice were more anxious in open field, and showed reduced activity of synaptogenesis and glutamate regulators in hippocampus. Therefore, PA treatment should be used with caution even though positive metabolic, (cerebro) vascular, and brain structural and functional effects were observed.
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Affiliation(s)
- Anouk C Tengeler
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eveline Gart
- Department of Metabolic Health Research, The Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands.,Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Maximilian Wiesmann
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ilse A C Arnoldussen
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Wim van Duyvenvoorde
- Department of Metabolic Health Research, The Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Marloes Hoogstad
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Pieter J Dederen
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Vivienne Verweij
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bram Geenen
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tamas Kozicz
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Robert Kleemann
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Vascular Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Martine C Morrison
- Department of Metabolic Health Research, The Netherlands Organisation for Applied Scientific Research (TNO), Leiden, the Netherlands.,Human and Animal Physiology, Wageningen University, Wageningen, the Netherlands
| | - Amanda J Kiliaan
- Department of Anatomy, Donders Institute for Brain, Cognition and Behavior, Preclinical Imaging Centre, Radboud University Medical Center, Nijmegen, the Netherlands
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6
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Doneddu A, Roberto S, Pinna V, Magnani S, Ghiani G, Sainas G, Mulliri G, Serra S, Kakhak SAH, Milia R, Lecis R, Guicciardi M, Crisafulli A. Effect of Combined Mental Task and Metaboreflex Activation on Hemodynamics and Cerebral Oxygenation in Patients With Metabolic Syndrome. Front Physiol 2020; 11:397. [PMID: 32477157 PMCID: PMC7241117 DOI: 10.3389/fphys.2020.00397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/02/2020] [Indexed: 01/26/2023] Open
Abstract
Objective: The hemodynamic response to muscle metaboreflex has been reported to be significantly altered by metabolic syndrome (MS), with exaggerated systemic vascular resistance (SVR) increments and reduced cardiac output (CO) in comparison to healthy controls (CTLs). Moreover, patients with metabolic disorders, such as type 2 diabetes, have proven to have impaired cerebral blood flow in response to exercise. Thus, we hypothesized that contemporary mental task (MT) and metaboreflex would result in reduced cerebral oxygenation (COX) in these patients. Methods: Thirteen MS patients (five women) and 14 normal age-matched CTLs (six women) were enrolled in this study. All the participants underwent five different tests, each lasting 12 min: post-exercise muscle ischemia (PEMI) to activate the metaboreflex, control exercise recovery (CER), PEMI + MT, CER + MT, and MT alone. Cerebral oxygenation was evaluated using near-infrared spectroscopy with sensors applied to the forehead. Hemodynamics were measured using impedance cardiography. Results: The main results show that MS patients had higher SVR and lower CO levels compared to the CTL group during metaboreflex activation. Stroke volume and ventricular filling and emptying rates were also significantly reduced. Moreover, when MT was added to PEMI, COX was significantly increased in the CTL group with respect to the baseline (103.46 ± 3.14%), whereas this capacity was reduced in MS patients (102.37 ± 2.46%). Conclusion: It was concluded that (1) patients with MS showed hemodynamic dysregulation during the metaboreflex, with exaggerated vasoconstriction and that (2) as compared to CTL, MS patients had reduced capacity to enhance COX when an MT superimposed the metaboreflex.
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Affiliation(s)
- Azzurrra Doneddu
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Silvana Roberto
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Virginia Pinna
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Sara Magnani
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Giovanna Ghiani
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Gianmarco Sainas
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Gabriele Mulliri
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Stefano Serra
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | | | - Raffaele Milia
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Romina Lecis
- Department of Pedagogy, Psychology, and Philosophy, University of Cagliari, Cagliari, Italy
| | - Marco Guicciardi
- Department of Pedagogy, Psychology, and Philosophy, University of Cagliari, Cagliari, Italy
| | - Antonio Crisafulli
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
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7
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Tucker WJ, Thomas BP, Puzziferri N, Samuel TJ, Zaha VG, Lingvay I, Almandoz J, Wang J, Gonzales EA, Brothers RM, Nelson MD. Impact of bariatric surgery on cerebral vascular reactivity and cognitive function: a non-randomized pilot study. Pilot Feasibility Stud 2020; 6:21. [PMID: 32082607 PMCID: PMC7017515 DOI: 10.1186/s40814-020-00569-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/06/2020] [Indexed: 01/03/2023] Open
Abstract
Background Bariatric surgery is an effective long-term weight loss strategy yielding improvements in neurocognitive function; however, the mechanism(s) responsible for these improvements remains unclear. Here, we assessed the feasibility of using magnetic resonance imaging (MRI) to evaluate whether cerebral vascular reactivity (CVR) is impaired in severely obese bariatric surgery candidates compared with normal weight healthy controls and whether CVR improves following bariatric surgery. We also investigated whether changes in CVR were associated with changes in cognitive function. Methods Bariatric surgery candidates (n = 6) were compared with normal weight healthy controls of a similar age (n = 10) at baseline, and then reassessed 2 weeks and 14 weeks following sleeve gastrectomy bariatric surgery. Young reference controls (n = 7) were also studied at baseline to establish the range of normal for each outcome measure. Microvascular and macrovascular CVR to hypercapnia (5% CO2) were assessed using blood-oxygen-level-dependent (BOLD) MRI, and changes in the middle cerebral artery (MCA) cross-sectional area, respectively. Cognitive function was assessed using a validated neurocognitive software. Results Compliance with the CVR protocol was high. Both macro- and micro-cerebrovascular function were highest in the young reference controls. Cognitive function was lower in obese bariatric surgery candidates compared with normal weight controls, and improved by 17% at 2 weeks and 21% by 14 weeks following bariatric surgery. To our surprise, whole-brain CVR BOLD did not differ between obese bariatric surgery candidates and normal weight controls of similar age (0.184 ± 0.101 vs. 0.192 ± 0.034 %BOLD/mmHgCO2), and did not change after bariatric surgery. In contrast, we observed vasoconstriction of the MCA during hypercapnia in 60% of the obese patients prior to surgery, which appeared to be abolished following bariatric surgery. Improvements in cognitive function were not associated with improvements in either CVR BOLD or MCA vasodilation after bariatric surgery. Conclusions Assessing CVR responses to a hypercapnic challenge with MRI was feasible in severely obese bariatric patients. However, no changes in whole-brain BOLD CVR were observed following bariatric surgery despite improvements in cognitive function. We recommend that future large trials assess CVR responses to cognitive tasks (rather than hypercapnia) to better define the mechanisms responsible for cognitive function improvements following bariatric surgery.
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Affiliation(s)
- Wesley J Tucker
- 1Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Science & Engineering Innovation & Research Building, 701 S. Nedderman Drive, Room 105, Arlington, TX 76019 USA.,2Department of Nutrition & Food Sciences, Texas Woman's University, Houston, TX USA
| | - Binu P Thomas
- 3Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX USA.,4Department of Bioengineering, University of Texas at Arlington, Arlington, TX USA
| | - Nancy Puzziferri
- 5Department of Surgery, Oregon Health & Science University, Portland, OR USA
| | - T Jake Samuel
- 1Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Science & Engineering Innovation & Research Building, 701 S. Nedderman Drive, Room 105, Arlington, TX 76019 USA
| | - Vlad G Zaha
- 3Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX USA.,6Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ildiko Lingvay
- 7Division of Endocrinology, Diabetes, and Metabolism, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Jaime Almandoz
- 7Division of Endocrinology, Diabetes, and Metabolism, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Jing Wang
- 8College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX USA
| | - Edward A Gonzales
- 1Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Science & Engineering Innovation & Research Building, 701 S. Nedderman Drive, Room 105, Arlington, TX 76019 USA.,8College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX USA
| | - R Matthew Brothers
- 1Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Science & Engineering Innovation & Research Building, 701 S. Nedderman Drive, Room 105, Arlington, TX 76019 USA
| | - Michael D Nelson
- 1Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Science & Engineering Innovation & Research Building, 701 S. Nedderman Drive, Room 105, Arlington, TX 76019 USA.,4Department of Bioengineering, University of Texas at Arlington, Arlington, TX USA
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8
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Vianna LC. Is obesity mechanistically linked to the greater risk of cerebral vascular disease? Exp Physiol 2017; 102:1263. [PMID: 28776803 DOI: 10.1113/ep086596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lauro C Vianna
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brasilia, Brazil
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