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Sayah DN, Descovich D, Costantino S, Lesk MR. The Association between the Pulsatile Choroidal Volume Change and Ocular Rigidity. OPHTHALMOLOGY SCIENCE 2024; 4:100576. [PMID: 39253552 PMCID: PMC11381872 DOI: 10.1016/j.xops.2024.100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/09/2024] [Accepted: 06/18/2024] [Indexed: 09/11/2024]
Abstract
Purpose To assess the relationship between the pulsatile choroidal volume change (ΔV) and ocular rigidity (OR), an important biomechanical property of the eye. Design This is a prospective cross-sectional study. Subjects Two hundred seventeen participants (235 eyes) were included in this study. Of those, 18 eyes (18 participants) had exudative retinal disease, and 217 eyes (199 participants) had open-angle glaucoma (39.2%), suspect discs (12.4%), ocular hypertension (14.3%), or healthy eyes (34.1%). Methods Pulsatile choroidal volume change was measured using dynamic OCT, which detects the change in choroidal thickness during the cardiac cycle. Ocular rigidity was measured using an invasive procedure as well as using a validated optical method. Correlations between ΔV and OR were assessed in subjects with healthy eyes, eyes with glaucoma, or eyes with exudative retinal disease. Main Outcome Measures Ocular rigidity and pulsatile ocular volume change. Results In 18 eyes where OR was obtained invasively and ΔV was obtained noninvasively, a significant correlation was found between ΔV and OR (rs = -0.664, P = 0.003). Similarly, a strong inverse correlation was found between the noninvasive measurements of both ΔV and OR (rs = -0.748, P < 0.001) in a large cohort and maintained its significance across diagnostic groups (a more compliant eye is associated with greater ΔV). No correlation was found between ΔV and age, blood pressure, intraocular pressure, axial length, or diagnosis (P ≥ 0.05). Mean ΔV was 7.3 ± 3.4 μL for all groups combined with a range of 3.0 to 20.8 μL. Conclusions These results suggest an association between the biomechanics of the corneoscleral shell and pulsatile ocular blood flow, which may indicate that a more rigid eye exerts more resistance to pulsatile choroidal expansion. This highlights the dynamic nature of both blood flow and biomechanics in the eye, as well as how they may interact, leading to a greater understanding of the pathophysiology of ocular disease. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Diane N Sayah
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec H1T 2M4, Canada
- University of Houston College of Optometry, Houston, Texas, 77204
| | - Denise Descovich
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec H1T 2M4, Canada
| | - Santiago Costantino
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
| | - Mark R Lesk
- Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec H1T 2M4, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, Quebec H3T 1J4, Canada
- Centre Universitaire d'ophtalmologie de l'Université de Montréal at l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Quebec H1T 2M4, Canada
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Yang ES, Jung JY, Kang CK. Effects of low-pressure Valsalva maneuver on changes in cerebral arterial stiffness and pulse wave velocity. PLoS One 2024; 19:e0308866. [PMID: 39331633 PMCID: PMC11432835 DOI: 10.1371/journal.pone.0308866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/30/2024] [Indexed: 09/29/2024] Open
Abstract
The Valsalva maneuver (VM), commonly used to assess cardiovascular and autonomic nervous system functions, can induce changes in hemodynamic function that may affect cerebral vascular functionality, such as arterial elasticity. This study aimed to investigate the effects of low-pressure VM on cerebral arterial stiffness and cerebral vascular dynamics. Thirty-one healthy young participants (average age 21.58±1.72 years) were recruited for this study. These participants were instructed to maintain an expiratory pressure of 30-35 mmHg for 15 seconds. We measured the vasoconstriction and vasodilation diameters (VCD and VDD) of the common carotid artery (CCA), as well as systolic and diastolic blood pressures (SBP and DBP), before and after VM (PRE_VM and POST_VM). Additionally, we assessed mean arterial pressure (MAP), pulse pressure (PP), pulse wave velocity (PWV), and arterial stiffness. Our findings revealed significant increases in both the VCD and VDD of the CCA (2.15%, p = 0.039 and 4.55%, p<0.001, respectively), MAP (1.67%, p = 0.049), and DBP (1.10%, p = 0.029) following low-pressure VM. SBP showed an increasing trend, but this was not statistically significant (p = 0.108). Interestingly, we observed significant decreases in arterial stiffness and PWV in POST_VM when comparing with PRE_VM (p<0.001 and p<0.001, respectively). In conclusion, our study demonstrated the effectiveness of low-pressure VM in reducing the PWV and stiffness of the CCA. This suggests that low-pressure VM can be a simple and cost-effective method to reduce cerebrovascular stiffness in a brief interval, without the need for specific environmental conditions.
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Affiliation(s)
- Eun-Seon Yang
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences & Technology (GAIHST), Gachon University, Incheon, Republic of Korea
| | - Ju-Yeon Jung
- Institute for Human Health and Science Convergence, Gachon University, Incheon, Republic of Korea
| | - Chang-Ki Kang
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences & Technology (GAIHST), Gachon University, Incheon, Republic of Korea
- Institute for Human Health and Science Convergence, Gachon University, Incheon, Republic of Korea
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
- Department of Radiological Science, College of Medical Science, Gachon University, Incheon, Republic of Korea
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Feron J, Segaert K, Rahman F, Fosstveit SH, Joyce KE, Gilani A, Lohne-Seiler H, Berntsen S, Mullinger KJ, Lucas SJE. Determinants of cerebral blood flow and arterial transit time in healthy older adults. Aging (Albany NY) 2024; null:206112. [PMID: 39302230 DOI: 10.18632/aging.206112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/02/2024] [Indexed: 09/22/2024]
Abstract
Cerebral blood flow (CBF) and arterial transit time (ATT), markers of brain vascular health, worsen with age. The primary aim of this cross-sectional study was to identify modifiable determinants of CBF and ATT in healthy older adults (n = 78, aged 60-81 years). Associations between cardiorespiratory fitness and CBF or ATT were of particular interest because the impact of cardiorespiratory fitness is not clear within existing literature. Secondly, this study assessed whether CBF or ATT relate to cognitive function in older adults. Multiple post-labelling delay pseudo-continuous arterial spin labelling estimated resting CBF and ATT in grey matter. Results from multiple linear regressions found higher BMI was associated with lower global CBF (β = -0.35, P = 0.008) and a longer global ATT (β = 0.30, P = 0.017), global ATT lengthened with increasing age (β = 0.43, P = 0.004), and higher cardiorespiratory fitness was associated with longer ATT in parietal (β = 0.44, P = 0.004) and occipital (β = 0.45, P = 0.003) regions. Global or regional CBF or ATT were not associated with processing speed, working memory, or attention. In conclusion, preventing excessive weight gain may help attenuate age-related declines in brain vascular health. ATT may be more sensitive to age-related decline than CBF, and therefore useful for early detection and management of cerebrovascular impairment. Finally, cardiorespiratory fitness appears to have little effect on CBF but may induce longer ATT in specific regions.
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Affiliation(s)
- Jack Feron
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Katrien Segaert
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Foyzul Rahman
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
- College of Psychology, Birmingham City University, Birmingham, UK
| | - Sindre H Fosstveit
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Kelsey E Joyce
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Ahmed Gilani
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Hilde Lohne-Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Karen J Mullinger
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- School of Psychology, University of Birmingham, Birmingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Samuel J E Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK
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Robert C, Ling LH, Tan ES, Venketasubramanian N, Lim SL, Gong L, Berboso JL, Richards AM, Chen C, Hilal S. The relative associations of aortic and carotid artery stiffness with CeVD and cognition. J Cereb Blood Flow Metab 2024:271678X241281137. [PMID: 39253823 DOI: 10.1177/0271678x241281137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
We examined the relative associations of aortic and carotid artery stiffness with cerebrovascular disease (CeVD), cognition, and dementia subtypes in a memory clinic cohort of 272 participants (mean age = 75.4, SD = 6.8). We hypothesized that carotid artery stiffness would have greater effects on outcomes, given its proximate relationship to the brain. Aortic and carotid artery stiffness were assessed with applanation tonometry and carotid ultrasonography, respectively. CeVD markers included white matter hyperintensities (WMH), lacunes, cerebral microbleeds, cortical infarcts, and intracranial stenosis. Cognition was assessed by the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a neuropsychological battery. Multivariable linear regression was conducted to determine associations of arterial stiffness with WMH and cognition, while logistic regression analysed associations with CeVD markers and dementia subtypes. Carotid artery stiffness z-score was associated with WMH, cortical infarcts, vascular cognitive impairment, and MMSE, independent of age, sex, education, vascular risk factors, and aortic stiffness z-score. Although aortic stiffness z-score was independently associated with cortical infarcts, this became non-significant after further adjusting for carotid artery stiffness z-score. We found that carotid artery stiffness had greater effects on CeVD, cognitive function and impairment in memory clinic patients compared to aortic stiffness.
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Affiliation(s)
- Caroline Robert
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Lieng-Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eugene Sj Tan
- Department of Cardiology, National University Heart Centre, Singapore
| | | | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre, Singapore
| | - Lingli Gong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Josephine Lunaria Berboso
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Arthur Mark Richards
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Cardiovascular Research Institute, National University Health System, Singapore
- Christchurch Heart Institute, University of Otago, Dunedin, New Zealand
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Chen F, Zhao J, Meng F, He F, Ni J, Fu Y. The vascular contribution of apolipoprotein E to Alzheimer's disease. Brain 2024; 147:2946-2965. [PMID: 38748848 DOI: 10.1093/brain/awae156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/23/2024] [Accepted: 04/21/2024] [Indexed: 09/04/2024] Open
Abstract
Alzheimer's disease, the most prevalent form of dementia, imposes a substantial societal burden. The persistent inadequacy of disease-modifying drugs targeting amyloid plaques and neurofibrillary tangles suggests the contribution of alternative pathogenic mechanisms. A frequently overlooked aspect is cerebrovascular dysfunction, which may manifest early in the progression of Alzheimer's disease pathology. Mounting evidence underscores the pivotal role of the apolipoprotein E gene, particularly the apolipoprotein ε4 allele as the strongest genetic risk factor for late-onset Alzheimer's disease, in the cerebrovascular pathology associated with Alzheimer's disease. In this review, we examine the evidence elucidating the cerebrovascular impact of both central and peripheral apolipoprotein E on the pathogenesis of Alzheimer's disease. We present a novel three-hit hypothesis, outlining potential mechanisms that shed light on the intricate relationship among different pathogenic events. Finally, we discuss prospective therapeutics targeting the cerebrovascular pathology associated with apolipoprotein E and explore their implications for future research endeavours.
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Affiliation(s)
- Feng Chen
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jing Zhao
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou 215123, China
| | - Fanxia Meng
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Fangping He
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jie Ni
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Yuan Fu
- Department of Neurology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Lin Y, Song E, Jin H, Jin Y. Reproductive hormones and sex differences in relation to brachial-ankle pulse wave velocity in obese subjects: a retrospective case-control study. Endocr Connect 2024; 13:e240190. [PMID: 39072509 PMCID: PMC11378129 DOI: 10.1530/ec-24-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/29/2024] [Indexed: 07/30/2024]
Abstract
Background Reproductive hormones may be a risk factor for cardiovascular disease (CVD), but their influence is often underestimated. Obesity can exacerbate the progression of CVD. Arterial stiffness (AS) is correlated with the risk of CVD. Brachial-ankle pulse wave velocity (baPWV) has served as a practical tool for assessing AS with broad clinical applications. This study aimed to investigate the association between reproductive hormones and baPWV in obese male and female subjects. Methods A retrospective case-control design was designed. AS was assessed using baPWV, with a baPWV ≥ 1400 cm/s indicating increased AS. Between September 2018 and October 2022, 241 obese subjects with increased AS were recruited from Ningbo Yinzhou No. 2 Hospital. The control group consisted of 241 obese subjects without increased AS. A 1:1 propensity score matching was performed to correct potential confounders by age and sex. We additionally performed a sex-based sub-analysis. Results Correlation analysis demonstrated that luteinizing hormone (LH) (r = 0.214, P = 0.001) and follicle-stimulating hormone (FSH) (r = 0.328, P < 0.001) were positively correlated with baPWV in obese male subjects. In the multivariate conditional logistic regression analysis, FSH (OR = 1.407, 95% CI = 1.040-1.902, P = 0.027) rather than LH (OR = 1.210, 95% CI = 0.908-1.612, P = 0.194) was independently and positively associated with increased AS in obese male subjects. However, there was no significant correlation between reproductive hormones and baPWV in women. Conclusions Our study identified FSH as a potential risk factor for arteriosclerosis in obese male subjects. This provides a novel and intriguing perspective on the pathogenesis of CVD in obese subjects.
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Affiliation(s)
- Yunting Lin
- Department of Surgical Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Endi Song
- Department of Internal Medicine, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, China
| | - Han Jin
- Department of Medicine, Ningbo University, Ningbo, Zhejiang, China
| | - Yong Jin
- Department of Internal Medicine, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, China
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Li X, Xing J, Hui Y, Shi H, Li R, Zhang S, Chen S, Li J, Liang X, Wu Y, Zhao P, Wu S, Wang Z. Hippocampal volume mediates the association of arterial stiffness with cognitive impairment in adult population. J Hypertens 2024; 42:1566-1572. [PMID: 38747362 PMCID: PMC11296271 DOI: 10.1097/hjh.0000000000003760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/06/2024] [Accepted: 04/16/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVES To investigate the association of arterial stiffness with brain perfusion, brain tissue volume and cognitive impairment in the general adult population. MATERIALS AND METHODS This prospective study included 1488 adult participants (age range: 22.8-83.9 years) from the Kailuan study. All participants underwent brachial-ankle pulse wave velocity (PWV) measurement, brain MRI, and Montreal Cognitive Assessment (MoCA). The association of PWV with cerebral blood flow (CBF), brain tissue volume and MoCA score was investigated. Mediation analysis was used to determine whether CBF and brain tissue volume changes mediated the associations between PWV and MoCA score. RESULTS A 1 standard deviation (SD) increase in PWV was associated with lower total brain CBF [ β (95% CI) -0.67 (-1.2 to -0.14)], total gray matter CBF [β (95% CI) -0.7 [-1.27 to -0.13)], frontal lobe CBF [ β (95% CI) -0.59 (-1.17 to -0.01)], parietal lobe CBF [ β (95% CI) -0.8 (-1.43 to -0.18)], and temporal lobe CBF [ β (95% CI) -0.68 (-1.24 to -0.12)]. Negative associations were found for PWV and total brain volume [ β (95% CI) -4.8 (-7.61 to -1.99)] and hippocampus volume [ β (95% CI) -0.08 (-0.13 to -0.04)]. A 1 SD increase PWV was significantly associated with elevated odds of developing cognitive impairment [odds ratio (95% CI) 1.21 (1.01-1.45)]. Mediation analysis showed that hippocampal volume partially mediated the negative association between PWV and MoCA scores (proportion: 14.173%). CONCLUSION High arterial stiffness was associated with decreased total and regional CBF, brain tissue volume, and cognitive impairment. Hippocampal volume partially mediated the effects of arterial stiffness on cognitive impairment.
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Affiliation(s)
- Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Jie Xing
- Department of Ultrasound, Beijing Aerospace General Hospital, Beijing
| | | | - Huijing Shi
- Department of Rheumatology and Immunology, Kailuan General Hospital
| | - Rui Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Shun Zhang
- Department of Psychiatry, Kailuan Mental Health Center
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Jing Li
- Department of Radiology, Beijing Tsinghua Changgung Hospital, Tsinghua University
| | | | - Yuntao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei Province, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University
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Davies A, Gurung D, Ladthavorlaphatt K, Mankoo A, Panerai RB, Robinson TG, Minhas JS, Beishon LC. The effect of CO 2 on the age dependence of neurovascular coupling. J Appl Physiol (1985) 2024; 137:445-459. [PMID: 38961823 DOI: 10.1152/japplphysiol.00695.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024] Open
Abstract
Prior studies have identified variable effects of aging on neurovascular coupling (NVC). Carbon dioxide (CO2) affects both cerebral blood velocity (CBv) and NVC, but the effects of age on NVC under different CO2 conditions are unknown. Therefore, we investigated the effects of aging on NVC in different CO2 states during cognitive paradigms. Seventy-eight participants (18-78 yr), with well-controlled comorbidities, underwent continuous recordings of CBv by bilateral insonation of middle (MCA) and posterior (PCA) cerebral arteries (transcranial Doppler), blood pressure, end-tidal CO2, and heart rate during poikilocapnia, hypercapnia (5% CO2 inhalation), and hypocapnia (paced hyperventilation). Neuroactivation via visuospatial (VS) and attention tasks (AT) was used to stimulate NVC. Peak percentage and absolute change in MCAv/PCAv, were compared between CO2 conditions and age groups (≤30, 31-60, and >60 yr). For the VS task, in poikilocapnia, younger adults had a lower NVC response compared with older adults [mean difference (MD): -7.92% (standard deviation (SD): 2.37), P = 0.004], but comparable between younger and middle-aged groups. In hypercapnia, both younger [MD: -4.75% (SD: 1.56), P = 0.009] and middle [MD: -4.58% (SD: 1.69), P = 0.023] age groups had lower NVC responses compared with older adults. Finally, in hypocapnia, both older [MD: 5.92% (SD: 2.21), P = 0.025] and middle [MD: 5.44% (SD: 2.27), P = 0.049] age groups had greater NVC responses, compared with younger adults. In conclusion, the magnitude of NVC response suppression from baseline during hyper- and hypocapnia, did not differ significantly between age groups. However, the middle age group demonstrated a different NVC response while under hypercapnic conditions, compared with hypocapnia.NEW & NOTEWORTHY This study describes the effects of age on neurovascular coupling under altered CO2 conditions. We demonstrated that both hypercapnia and hypocapnia suppress neurovascular coupling (NVC) responses. Furthermore, that middle age exhibits an NVC response comparable with younger adults under hypercapnia, and older adults under hypocapnia.
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Affiliation(s)
- Aaron Davies
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Dewarkar Gurung
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Kannaphob Ladthavorlaphatt
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Alex Mankoo
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Ronney B Panerai
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Research Centre, British Heart Foundation Cardiovascular Centre, Leicester, United Kingdom
| | - Thompson G Robinson
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Research Centre, British Heart Foundation Cardiovascular Centre, Leicester, United Kingdom
| | - Jatinder S Minhas
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Research Centre, British Heart Foundation Cardiovascular Centre, Leicester, United Kingdom
| | - Lucy C Beishon
- Cerebral Haemodynamics in Ageing and Stroke Medicine (CHiASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Biomedical Research Centre, Glenfield Research Centre, British Heart Foundation Cardiovascular Centre, Leicester, United Kingdom
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Ishikawa J, Toba A, Futami S, Saito Y, Tamura Y, Araki A, Harada K. Association of pulse pressure and mean blood pressure to frailty, sarcopenia, and cognitive dysfunction in elderly outpatients with history of hypertension. Hypertens Res 2024; 47:2029-2040. [PMID: 38671218 DOI: 10.1038/s41440-024-01684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
This study aimed to evaluate the relationship between pulse pressure (PP) and sarcopenia, frailty, and cognitive function in elderly patients with hypertension. We evaluated 435 elderly patients with a history of hypertension who visited the frail outpatient clinic between July 2015 and October 2021. Data at the 1-, 2-, and 3-year follow-ups were available for 222, 177, and 164 patients, respectively. Sarcopenia, frailty, and cognitive function, including Mini-Mental State Examination (MMSE) scores, were evaluated. The patients' mean age was 79.2 ± 6.3 years (male, 34.9%). PP and mean blood pressure (BP) were 60.1 ± 13.6 mmHg and 94.1 ± 13.0 mmHg, respectively. At baseline, lower PP was associated with probable dementia (MMSE score ≤23 points) (OR = 0.960 per 1 mmHg increase; 95% CI, 0.933-0.989; P = 0.006) in the model adjusted for conventional confounding factors and comorbidities, whereas higher PP was associated with low handgrip strength (OR = 1.018 per 1 mmHg increase; 95% CI, 1.001-1.036; P = 0.041). In multivariate-adjusted logistic regression analysis of patients with preserved handgrip strength at baseline, reductions in PP (OR = 0.844; 95% CI, 0.731-0.974; P = 0.020) and mean BP (OR = 0.861; 95% CI, 0.758-0.979; P = 0.022) were significantly associated with the incidence of low handgrip strength at 3 years. In conclusion, a higher PP induced by increased arterial stiffness was associated with lower handgrip strength, whereas a lower PP was associated with probable dementia. Reduced PP was associated with decreased handgrip strength after three years.
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Affiliation(s)
- Joji Ishikawa
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
| | - Ayumi Toba
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shutaro Futami
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshihiro Saito
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazumasa Harada
- Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Allison EY, Al-Khazraji BK. Association of Arterial Stiffness Index and Brain Structure in the UK Biobank: A 10-Year Retrospective Analysis. Aging Dis 2024; 15:1872-1884. [PMID: 37307821 PMCID: PMC11272205 DOI: 10.14336/ad.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/19/2023] [Indexed: 06/14/2023] Open
Abstract
Arterial stiffening and changes in brain structure both occur with normal aging and can be exacerbated via acquired health conditions. While cross-sectional associations exist, the longitudinal relationship between arterial stiffness and brain structure remains unclear. In this study, we investigated 1) associations between baseline arterial stiffness index (ASI) and brain structure (global and regional grey matter volumes (GMV), white matter hyperintensities (WMH)) 10-years post-baseline (10.4±0.8 years) and 2) associations between the 10-year change in ASI from baseline and brain structure 10-years post-baseline in 650 healthy middle- to older-aged adults (53.4±7.5 years) from the UK Biobank. We observed significant associations between baseline ASI and GMV (p<0.001) and WMH (p=0.0036) 10-years post-baseline. No significant associations between 10-year change in ASI and brain structure (global GMV p=0.24; WMH volume p=0.87) were observed. There were significant associations of baseline ASI in 2 of 60 regional brain volumes analyzed (right posterior superior temporal gyrus p=0.001; left superior lateral occipital cortex p<0.001). Strong associations with baseline ASI, but not changes in ASI over 10-years, suggest arterial stiffness at the entry point of older adulthood is more impactful on brain structure 10-years later compared to age-related stiffening. Based on these associations, we suggest clinical monitoring and potential intervention for reducing arterial stiffness should occur in midlife to reduce vascular contributions to structural changes in the brain, supporting a healthy trajectory of brain aging. Our findings also support use of ASI as a surrogate for gold standard measures in showing overall relationships between arterial stiffness and brain structure.
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Affiliation(s)
- Elric Y Allison
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
| | - Baraa K Al-Khazraji
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON, Canada
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11
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Sepúlveda-Lara A, Sepúlveda P, Marzuca-Nassr GN. Resistance Exercise Training as a New Trend in Alzheimer's Disease Research: From Molecular Mechanisms to Prevention. Int J Mol Sci 2024; 25:7084. [PMID: 39000191 PMCID: PMC11241132 DOI: 10.3390/ijms25137084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
Alzheimer's disease is a pathology characterized by the progressive loss of neuronal connections, which leads to gray matter atrophy in the brain. Alzheimer's disease is the most prevalent type of dementia and has been classified into two types, early onset, which has been associated with genetic factors, and late onset, which has been associated with environmental factors. One of the greatest challenges regarding Alzheimer's disease is the high economic cost involved, which is why the number of studies aimed at prevention and treatment have increased. One possible approach is the use of resistance exercise training, given that it has been shown to have neuroprotective effects associated with Alzheimer's disease, such as increasing cortical and hippocampal volume, improving neuroplasticity, and promoting cognitive function throughout the life cycle. However, how resistance exercise training specifically prevents or ameliorates Alzheimer's disease has not been fully characterized. Therefore, the aim of this review was to identify the molecular basis by which resistance exercise training could prevent or treat Alzheimer's disease.
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Affiliation(s)
- Alexis Sepúlveda-Lara
- Doctorado en Ciencias mención Biología Celular y Molecular Aplicada, Facultad de Ciencias Agropecuarias, Universidad de La Frontera, Temuco 4811230, Chile;
| | - Paulina Sepúlveda
- Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco 4811230, Chile;
| | - Gabriel Nasri Marzuca-Nassr
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de la Frontera, Temuco 4811230, Chile
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12
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Bermudez C, Kerley CI, Ramadass K, Farber-Eger EH, Lin YC, Kang H, Taylor WD, Wells QS, Landman BA. Volumetric brain MRI signatures of heart failure with preserved ejection fraction in the setting of dementia. Magn Reson Imaging 2024; 109:49-55. [PMID: 38430976 DOI: 10.1016/j.mri.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is an important, emerging risk factor for dementia, but it is not clear whether HFpEF contributes to a specific pattern of neuroanatomical changes in dementia. A major challenge to studying this is the relative paucity of datasets of patients with dementia, with/without HFpEF, and relevant neuroimaging. We sought to demonstrate the feasibility of using modern data mining tools to create and analyze clinical imaging datasets and identify the neuroanatomical signature of HFpEF-associated dementia. We leveraged the bioinformatics tools at Vanderbilt University Medical Center to identify patients with a diagnosis of dementia with and without comorbid HFpEF using the electronic health record. We identified high resolution, clinically-acquired neuroimaging data on 30 dementia patients with HFpEF (age 76.9 ± 8.12 years, 61% female) as well as 301 age- and sex-matched patients with dementia but without HFpEF to serve as comparators (age 76.2 ± 8.52 years, 60% female). We used automated image processing pipelines to parcellate the brain into 132 structures and quantify their volume. We found six regions with significant atrophy associated with HFpEF: accumbens area, amygdala, posterior insula, anterior orbital gyrus, angular gyrus, and cerebellar white matter. There were no regions with atrophy inversely associated with HFpEF. Patients with dementia and HFpEF have a distinct neuroimaging signature compared to patients with dementia only. Five of the six regions identified in are in the temporo-parietal region of the brain. Future studies should investigate mechanisms of injury associated with cerebrovascular disease leading to subsequent brain atrophy.
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Affiliation(s)
- Camilo Bermudez
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Cailey I Kerley
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Karthik Ramadass
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Eric H Farber-Eger
- Department of Cardiology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Warren D Taylor
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Quinn S Wells
- Department of Cardiology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Bennett A Landman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA; Department of Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA.
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13
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Zuin M, De Vito A, Romagnoli T, Polastri M, Capatti E, Azzini C, Brombo G, Zuliani G. Cerebral Blood Flow in Alzheimer's Disease: A Meta-Analysis on Transcranial Doppler Investigations. Geriatrics (Basel) 2024; 9:58. [PMID: 38804315 PMCID: PMC11130854 DOI: 10.3390/geriatrics9030058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/19/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Cerebrovascular hemodynamic impairment has been reported in Alzheimer's disease (AD). We performed a systematic review and meta-analysis to investigate changes in cerebral blood flow (CBF) in AD patients. METHODS Data were obtained by searching MEDLINE and Scopus for all investigations published between 1 January 2011 and 1 November 2021, comparing the cerebrovascular hemodynamic between AD patients and cognately healthy age-matched controls, using transcranial Doppler (TCD) ultrasound. RESULTS Twelve studies, based on 685 patients [395 with AD and 290 age-matched cognitively healthy controls, with a mean age of 71.5 and 72.1 years, respectively] were included in the analysis. A random effect model revealed that AD patients, in the proximal segments of the middle cerebral artery (MCA), have a significantly lower CBF velocity, compared to controls (MD: -7.80 cm/s, 95%CI: -10.78 to -5.13, p < 0.0001, I2 = 71.0%). Due to a significant Egger's test (t = 3.12, p = 0.008), a trim-and-fill analysis was performed, confirming the difference (MD: -11.05 cm/s, 95%CI: -12.28 to -9.82, p < 0.0001). Meta-regression analysis demonstrated that the mean CBF at the proximal MCA was directly correlated with arterial hypertension (p = 0.03) and MMSE score (p < 0.001), but inversely correlated with age (p = 0.01). In AD patients, the pulsatility index was significantly higher compared to controls (MD: 0.16, 95%CI: 0.07 to 0.25, p < 0.0001, I2: 84.5%), while the breath-holding index test results were significant lower (MD: -1.72, 95%CI: -2.53 to -0.91, p < 0.001, I2: 85.4%). CONCLUSIONS AD patients have a significant impairment in relation to their cerebrovascular perfusion, suggesting that cerebrovascular hemodynamic deterioration, evaluated using TCD, may be a useful diagnostic tool.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Alessandro De Vito
- Department of Neurology, Stroke Division, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy;
| | - Tommaso Romagnoli
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Michele Polastri
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Eleonora Capatti
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Cristiano Azzini
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Gloria Brombo
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
| | - Giovanni Zuliani
- Department of Translational Medicine, University of Ferrara, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy; (M.Z.); (T.R.); (M.P.); (E.C.); (C.A.); (G.B.)
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14
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Lohman T, Shenasa F, Sible I, Kapoor A, Engstrom AC, Dutt S, Head E, Sordo L, M Alitin JP, Gaubert A, Nguyen A, Nation DA. The interactive effect of intra-beat and inter-beat blood pressure variability on neurodegeneration in older adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.01.24306724. [PMID: 38746307 PMCID: PMC11092712 DOI: 10.1101/2024.05.01.24306724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Blood pressure variability (BPV) and arterial stiffness are age-related hemodynamic risk factors for neurodegenerative disease, but it remains unclear whether they exert independent or interactive effects on brain health. When combined with high inter-beat BPV, increased intra-beat BPV indicative of arterial stiffness could convey greater pressure wave fluctuations deeper into the cerebrovasculature, exacerbating neurodegeneration. This interactive effect was studied in older adults using multiple markers of neurodegeneration, including medial temporal lobe (MTL) volume, plasma neurofilament light (NfL) and glial fibrillary acidic protein (GFAP). Older adults (N=105) without major neurological or systemic disease were recruited and underwent brain MRI and continuous BP monitoring to quantify inter-beat BPV through systolic average real variability (ARV) and intra-beat variability through arterial stiffness index (ASI). Plasma NfL and GFAP were assessed. The interactive effect of ARV and ASI on MTL atrophy, plasma NfL, and GFAP was studied using hierarchical linear regression. Voxel-based morphometry (VBM) was used to confirm region-of-interest analysis findings. The interaction between higher ARV and higher ASI was significantly associated with left-sided MTL atrophy in both the region-of-interest and false discovery rate-corrected VBM analysis. The interactive effect was also significantly associated with increased plasma NfL, but not GFAP. The interaction between higher ARV and higher ASI is independently associated with increased neurodegenerative markers, including MTL atrophy and plasma NfL, in independently living older adults. Findings could suggest the increased risk for neurodegeneration associated with higher inter-beat BPV may be compounded by increased intra-beat variability due to arterial stiffness.
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15
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Pacholko A, Iadecola C. Hypertension, Neurodegeneration, and Cognitive Decline. Hypertension 2024; 81:991-1007. [PMID: 38426329 PMCID: PMC11023809 DOI: 10.1161/hypertensionaha.123.21356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Elevated blood pressure is a well-established risk factor for age-related cognitive decline. Long linked to cognitive impairment on vascular bases, increasing evidence suggests a potential association of hypertension with the neurodegenerative pathology underlying Alzheimer disease. Hypertension is well known to disrupt the structural and functional integrity of the cerebral vasculature. However, the mechanisms by which these alterations lead to brain damage, enhance Alzheimer pathology, and promote cognitive impairment remain to be established. Furthermore, critical questions concerning whether lowering blood pressure by antihypertensive medications prevents cognitive impairment have not been answered. Recent developments in neurovascular biology, brain imaging, and epidemiology, as well as new clinical trials, have provided insights into these critical issues. In particular, clinical and basic findings on the link between neurovascular dysfunction and the pathobiology of neurodegeneration have shed new light on the overlap between vascular and Alzheimer pathology. In this review, we will examine the progress made in the relationship between hypertension and cognitive impairment and, after a critical evaluation of the evidence, attempt to identify remaining knowledge gaps and future research directions that may advance our understanding of one of the leading health challenges of our time.
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Affiliation(s)
- Anthony Pacholko
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
| | - Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY
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16
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Wu M, Lu C, Chen F, Fan Y, Li G, Zhou L. Age of hypertension onset and cognitive function in the elderly: an observational study from the NHANES 2011-2014. Eur Geriatr Med 2024; 15:561-570. [PMID: 38231294 DOI: 10.1007/s41999-023-00920-9] [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: 10/25/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE This study aims to evaluate the association between age of hypertension onset and cognitive function in a representative sample of US older adults. METHODS We assessed 2334 elderly adults (including 1655 hypertensive patients) who participated in the National Health and Nutrition Examination Survey 2011-2014. We used the age when the participants were first informed by the doctor that they had hypertension or were first clinically diagnosed with hypertension as the age of onset of hypertension. The Digit Symbol Substitution test (DSST), the Animal Fluency test, the Consortium to Establish a Registry for Alzheimer's disease (CERAD), and a composite-z score calculated by summing z-scores from these three individual tests, were used to assess cognitive function. RESULTS Participants with hypertension onset age < 35 years (early onset hypertension) had the worst performance in almost all cognitive tests, followed by those with onset age ≥ 65 years. Compared with those without hypertension, early onset hypertension was associated with - 4.15 (95% CI - 6.63, - 1.68), - 1.10 (95% CI - 2.08, - 0.12), - 0.75 (95% CI - 1.91, 0.42), and - 0.56 (95% CI - 0.94, - 0.19) scores for DSST, animal fluency test, CERAD, and composite z-score. Participants with early onset hypertension (onset age < 35 years) had higher odds for cognitive decline defined by DSST (OR: 3.28, 95% CI 1.94, 5.54) and composite z-score (OR: 1.77, 95% CI 1.07, 2.92). CONCLUSIONS Early onset hypertension was associated with the worst performance in cognitive function and an increased odds of cognitive decline in the elderly.
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Affiliation(s)
- Min Wu
- Department of Gastroenterology and Hepatology, The Sixth People's Hospital of Chengdu, Chengdu, China
| | - Cong Lu
- Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Fuli Chen
- Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yameng Fan
- School of Public Health, Xi'an Medical University, Xi'an, China
| | - Gang Li
- Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
| | - Long Zhou
- Institute of Cardiovascular Diseases and Department of Cardiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
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17
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Allison EY, Al-Khazraji BK. Cerebrovascular adaptations to habitual resistance exercise with aging. Am J Physiol Heart Circ Physiol 2024; 326:H772-H785. [PMID: 38214906 PMCID: PMC11221804 DOI: 10.1152/ajpheart.00625.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/13/2024]
Abstract
Resistance training (RT) is associated with improved metabolism, bone density, muscular strength, and lower risk of osteoporosis, sarcopenia, and cardiovascular disease. Although RT imparts many physiological benefits, cerebrovascular adaptations to chronic RT are not well defined. Participation in RT is associated with greater resting peripheral arterial diameters, improved endothelial function, and general cardiovascular health, whereas simultaneously linked to reductions in central arterial compliance. Rapid blood pressure fluctuations during resistance exercise, combined with reduced arterial compliance, could lead to cerebral microvasculature damage and subsequent cerebral hypoperfusion. Reductions in cerebral blood flow (CBF) accompany normal aging, where chronic reductions in CBF are associated with changes in brain structure and function, and increased risk of neurodegeneration. It remains unclear whether reductions in arterial compliance with RT relate to subclinical cerebrovascular pathology, or if such adaptations require interpretation in the context of RT specifically. The purpose of this narrative review is to synthesize literature pertaining to cerebrovascular adaptations to RT at different stages of the life span. This review also aims to identify gaps in the current understanding of the long-term impacts of RT on cerebral hemodynamics and provide a mechanistic rationale for these adaptations as they relate to aging, cerebral vasculature, and overall brain health.
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Affiliation(s)
- Elric Y Allison
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Baraa K Al-Khazraji
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
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18
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Reeve EH, Barnes JN, Moir ME, Walker AE. Impact of arterial stiffness on cerebrovascular function: a review of evidence from humans and preclincal models. Am J Physiol Heart Circ Physiol 2024; 326:H689-H704. [PMID: 38214904 PMCID: PMC11221809 DOI: 10.1152/ajpheart.00592.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/08/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
With advancing age, the cerebral vasculature becomes dysfunctional, and this dysfunction is associated with cognitive decline. However, the initiating cause of these age-related cerebrovascular impairments remains incompletely understood. A characteristic feature of the aging vasculature is the increase in stiffness of the large elastic arteries. This increase in arterial stiffness is associated with elevated pulse pressure and blood flow pulsatility in the cerebral vasculature. Evidence from both humans and rodents supports that increases in large elastic artery stiffness are associated with cerebrovascular impairments. These impacts on cerebrovascular function are wide-ranging and include reductions in global and regional cerebral blood flow, cerebral small vessel disease, endothelial cell dysfunction, and impaired perivascular clearance. Furthermore, recent findings suggest that the relationship between arterial stiffness and cerebrovascular function may be influenced by genetics, specifically APOE and NOTCH genotypes. Given the strength of the evidence that age-related increases in arterial stiffness have deleterious impacts on the brain, interventions that target arterial stiffness are needed. The purpose of this review is to summarize the evidence from human and rodent studies, supporting the role of increased arterial stiffness in age-related cerebrovascular impairments.
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Affiliation(s)
- Emily H Reeve
- Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Jill N Barnes
- Department of Kinesiology University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - M Erin Moir
- Department of Kinesiology University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Ashley E Walker
- Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
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19
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Edwards L, Thomas KR, Weigand AJ, Edmonds EC, Clark AL, Brenner EK, Banks SJ, Gilbert PE, Nation DA, Delano-Wood L, Bondi MW, Bangen KJ. Pulse pressure and APOE ε4 dose interact to affect cerebral blood flow in older adults without dementia. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100206. [PMID: 38328026 PMCID: PMC10847851 DOI: 10.1016/j.cccb.2024.100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/20/2023] [Accepted: 01/14/2024] [Indexed: 02/09/2024]
Abstract
This study assessed whether the effect of vascular risk on cerebral blood flow (CBF) varies by gene dose of apolipoprotein (APOE) ε4 alleles. 144 older adults without dementia from the Alzheimer's Disease Neuroimaging Initiative underwent arterial spin labeling and T1-weighted MRI, APOE genotyping, fluorodeoxyglucose positron emission tomography (FDG-PET), lumbar puncture, and blood pressure (BP) assessment. Vascular risk was assessed using pulse pressure (systolic BP - diastolic BP). CBF was examined in six AD-vulnerable regions: entorhinal cortex, hippocampus, inferior temporal cortex, inferior parietal cortex, rostral middle frontal gyrus, and medial orbitofrontal cortex. Linear regressions tested the interaction between APOE ε4 dose and pulse pressure on CBF in each region, adjusting for age, sex, cognitive classification, antihypertensive medication use, FDG-PET, reference CBF region, and AD biomarker positivity. There was a significant interaction between pulse pressure and APOE ɛ4 dose on CBF in the entorhinal cortex, hippocampus, and inferior parietal cortex, such that higher pulse pressure was associated with lower CBF only among ε4 homozygous participants. These findings demonstrate that the association between pulse pressure and regional CBF differs by APOE ε4 dose, suggesting that targeting modifiable vascular risk factors may be particularly important for those genetically at risk for AD.
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Affiliation(s)
- Lauren Edwards
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Kelsey R. Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Alexandra J. Weigand
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Emily C. Edmonds
- Banner Alzheimer's Institute, Tucson, AZ, USA
- Departments of Neurology and Psychology, University of Arizona, Tucson, AZ, USA
| | - Alexandra L. Clark
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Einat K. Brenner
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sarah J. Banks
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Paul E. Gilbert
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Daniel A. Nation
- Department of Psychology, University of California Irvine, Irvine, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark W. Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Katherine J. Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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20
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Abdali K, Chen X, Ross S, Davis S, Zhou Z, Mallet RT, Shi X. Mechanisms maintaining cerebral perfusion during systemic hypotension are impaired in elderly adults. Exp Biol Med (Maywood) 2023; 248:2464-2472. [PMID: 38057956 PMCID: PMC10903242 DOI: 10.1177/15353702231209416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/11/2023] [Indexed: 12/08/2023] Open
Abstract
Postural hypotension abruptly lowers cerebral perfusion, producing unsteadiness which worsens with aging. This study addressed the hypothesis that maintenance of cerebral perfusion weakens in the elderly due to less effective cerebrovascular autoregulation and systemic cardiovascular responses to hypotension. In healthy elderly (n = 13, 68 ± 1 years) and young (n = 13, 26 ± 1 years) adults, systemic hypotension was induced by rapid deflation of bilateral thigh cuffs after 3-min suprasystolic occlusion, while heart rate (HR), mean arterial pressure (MAP), and blood flow velocity of the middle cerebral artery (VMCA) were recorded. VMCA/MAP indexed cerebrovascular conductance (CVC). Durations and rates of recovery of MAP and VMCA from their respective postdeflation nadirs were compared between the groups. Thigh-cuff deflation elicited similar hypotension and cerebral hypoperfusion in the elderly and young adults. However, the time elapsed (TΔ) from cuff deflation to the nadirs of MAP and VMCA, and the time for full recovery (TR) from nadirs to baselines were significantly prolonged in the elderly subjects. The response rates of HR (ΔHR, i.e. cardiac factor), MAP (ΔMAP, i.e. vasomotor factor), and CVC following cuff deflation were significantly slower in the elderly. Collectively, the response rates of the cardiac, vasomotor, and CVC factors largely explained TRVMCA. However, the TRVMCA/ΔMAP slope (-3.0 ± 0.9) was steeper (P = 0.046) than the TRVMCA/ΔHR slope (-1.1 ± 0.4). The TRVMCA/ΔCVC slope (-2.4 ± 0.6) was greater (P = 0.072) than the TRVMCA/ΔHR slope, but did not differ from the TRVMCA/ΔMAP slope (P = 0.52). Both cerebrovascular autoregulatory and systemic mechanisms contributed to cerebral perfusion recovery during systemic hypotension, and the vasomotor factor was predominant over the cardiac factor. Recovery from cerebral hypoperfusion was slower in the elderly adults because of the age-diminished rates of the CVC response and cardiovascular reflex regulation. Systemic vasoconstriction predominated over increased HR for restoring cerebral perfusion after abrupt onset of systemic hypotension.
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Affiliation(s)
- Kulsum Abdali
- Departments of Pharmacology and Neuroscience, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Xiaoan Chen
- Departments of Pharmacology and Neuroscience, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Jishou University, Jishou 416000, China
| | - Sarah Ross
- Departments of Internal Medicine, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Sandra Davis
- Departments of Internal Medicine, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Zhengyang Zhou
- Departments of Biostatistics & Epidemiology, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Robert T Mallet
- Departments of Physiology and Anatomy, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Xiangrong Shi
- Departments of Pharmacology and Neuroscience, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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21
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Saeed A, Lopez O, Cohen A, Reis SE. Cardiovascular Disease and Alzheimer's Disease: The Heart-Brain Axis. J Am Heart Assoc 2023; 12:e030780. [PMID: 37929715 PMCID: PMC10727398 DOI: 10.1161/jaha.123.030780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality in aging adults across the United States. Prior studies indicate that the presence of atherosclerosis, the pathogenic basis of CVD, is linked with dementias. Alzheimer's disease (AD) and AD-related dementias are a major public health challenge in the United States. Recent studies indicate that ≈3.7 million Americans ≥65 years of age had clinical AD in 2017, with projected increases to 9.3 million by 2060. Treatment options for AD remain limited. Development of disease-modifying therapies are challenging due, in part, to the long preclinical window of AD. The preclinical incubation period of AD starts in midlife, providing a critical window for identification and optimization of AD risk factors. Studies link AD with CVD risk factors such as hypertension, inflammation, and dyslipidemia. Both AD and CVD are progressive diseases with decades-long development periods. CVD can clinically manifest several years earlier than AD, making CVD and its risk factors a potential predictor of future AD. The current review focuses on the state of literature on molecular and metabolic pathways modulating the heart-brain axis underlying the potential association of midlife CVD risk factors and their effect on AD and related dementias. Further, we explore potential CVD/dementia preventive strategies during the window of opportunity in midlife and the future of research in the field in the multiomics and novel biomarker use era.
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Affiliation(s)
- Anum Saeed
- University of Pittsburgh School of MedicinePittsburghPAUSA
- Heart and Vascular InstituteUniversity of Pittsburgh Medical CenterPAPittsburghUSA
| | - Oscar Lopez
- University of Pittsburgh School of MedicinePittsburghPAUSA
- Cognitive and Behavioral and Neurology DivisionUniversity of Pittsburgh Medical CenterPAPittsburghUSA
| | - Ann Cohen
- University of Pittsburgh School of MedicinePittsburghPAUSA
- Division of PsychiatryUniversity of Pittsburgh Medical CenterPAPittsburghUSA
| | - Steven E. Reis
- University of Pittsburgh School of MedicinePittsburghPAUSA
- Heart and Vascular InstituteUniversity of Pittsburgh Medical CenterPAPittsburghUSA
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22
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Aghilinejad A, Amlani F, Mazandarani SP, King KS, Pahlevan NM. Mechanistic insights on age-related changes in heart-aorta-brain hemodynamic coupling using a pulse wave model of the entire circulatory system. Am J Physiol Heart Circ Physiol 2023; 325:H1193-H1209. [PMID: 37712923 PMCID: PMC10908406 DOI: 10.1152/ajpheart.00314.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023]
Abstract
Age-related changes in aortic biomechanics can impact the brain by reducing blood flow and increasing pulsatile energy transmission. Clinical studies have shown that impaired cardiac function in patients with heart failure is associated with cognitive impairment. Although previous studies have attempted to elucidate the complex relationship between age-associated aortic stiffening and pulsatility transmission to the cerebral network, they have not adequately addressed the effect of interactions between aortic stiffness and left ventricle (LV) contractility (neither on energy transmission nor on brain perfusion). In this study, we use a well-established and validated one-dimensional blood flow and pulse wave computational model of the circulatory system to address how age-related changes in cardiac function and vasculature affect the underlying mechanisms involved in the LV-aorta-brain hemodynamic coupling. Our results reveal how LV contractility affects pulsatile energy transmission to the brain, even with preserved cardiac output. Our model demonstrates the existence of an optimal heart rate (near the normal human heart rate) that minimizes pulsatile energy transmission to the brain at different contractility levels. Our findings further suggest that the reduction in cerebral blood flow at low levels of LV contractility is more prominent in the setting of age-related aortic stiffening. Maintaining optimal blood flow to the brain requires either an increase in contractility or an increase in heart rate. The former consistently leads to higher pulsatile power transmission, and the latter can either increase or decrease subsequent pulsatile power transmission to the brain.NEW & NOTEWORTHY We investigated the impact of major aging mechanisms of the arterial system and cardiac function on brain hemodynamics. Our findings suggest that aging has a significant impact on heart-aorta-brain coupling through changes in both arterial stiffening and left ventricle (LV) contractility. Understanding the underlying physical mechanisms involved here can potentially be a key step for developing more effective therapeutic strategies that can mitigate the contributions of abnormal LV-arterial coupling toward neurodegenerative diseases and dementia.
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Affiliation(s)
- Arian Aghilinejad
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States
| | - Faisal Amlani
- Laboratoire de Mécanique Paris-Saclay, Université Paris-Saclay, Paris, France
| | - Sohrab P Mazandarani
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Kevin S King
- Barrow Neurological Institute, Phoenix, Arizona, United States
| | - Niema M Pahlevan
- Department of Aerospace and Mechanical Engineering, University of Southern California, Los Angeles, California, United States
- Division of Cardiovascular Medicine, Department of Medicine, University of Southern California, Los Angeles, California, United States
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23
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Lennon MJ, Thalamuthu A, Lam BCP, Crawford JD, Sachdev PS. Genetically Predicted Blood Pressure and Cognition in Midlife: A UK Biobank Study. Hypertension 2023; 80:2112-2121. [PMID: 37589153 DOI: 10.1161/hypertensionaha.123.21612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND This UK Biobank study uses a mendelian randomization approach to mitigate the variability and confounding that has affected previous analyses of the relationship between measured blood pressure (BP) and cognition and thus delineate the true association between the two. METHODS Systolic BP (SBP) and diastolic BP polygenic risk scores (PRSs) were calculated using summary statistics from the International Consortium of Blood Pressure-Genome Wide Association Study (n=299 024). Adjusted nonlinear mixed-effects regression models were used, including a natural splines term for BP-PRS with outcomes of fluid intelligence, reaction time (RT), and composite attention score. Moderating effects of age, sex, and antihypertensive use were assessed in separate models. RESULTS There were 448 575 participants (mean age, 56.3 years; age range, 37-72 years) included in the analysis after genetic and neurological disease exclusions. Genetic propensity for high SBP had an approximately linear association with worsened fluid intelligence (P=0.0018). This relationship was significantly moderated by age (P<0.0001). By contrast, genetic propensity for high and low SBP and diastolic BP predicted worse attention function (P=0.0099 and P=0.0019), with high PRSs predicting worse function than low PRSs. Genetic propensity for low SBP and diastolic BP was associated with considerably worse RTs, while for high SBP-PRSs, the RT plateaued (P<0.0001). The relationships between RT and the PRSs were significantly moderated by sex (P<0.0001) and antihypertensive use (P<0.0001). CONCLUSIONS Genetic propensity for high and low BP impacts on midlife cognition in subtle ways and differentially affects cognitive domains. While a genetic propensity to low BP may preserve nontimed tests in midlife, it may come at a trade-off with worsened attention scores and RT.
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Affiliation(s)
- Matthew J Lennon
- Faculty of Medicine (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry and Mental Health (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
| | - Anbupalam Thalamuthu
- Faculty of Medicine (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry and Mental Health (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
| | - Ben Chun Pan Lam
- Faculty of Medicine (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry and Mental Health (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- School of Psychology and Public Health, La Trobe University, VIC, Australia (B.C.P.L.)
| | - John D Crawford
- Faculty of Medicine (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry and Mental Health (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Faculty of Medicine (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry and Mental Health (M.J.L., A.T., B.C.P.L., J.D.C., P.S.S.), University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia (P.S.S.)
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24
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Lennon MJ, Lam BCP, Lipnicki DM, Crawford JD, Peters R, Schutte AE, Brodaty H, Thalamuthu A, Rydberg-Sterner T, Najar J, Skoog I, Riedel-Heller SG, Röhr S, Pabst A, Lobo A, De-la-Cámara C, Lobo E, Bello T, Gureje O, Ojagbemi A, Lipton RB, Katz MJ, Derby CA, Kim KW, Han JW, Oh DJ, Rolandi E, Davin A, Rossi M, Scarmeas N, Yannakoulia M, Dardiotis T, Hendrie HC, Gao S, Carrière I, Ritchie K, Anstey KJ, Cherbuin N, Xiao S, Yue L, Li W, Guerchet MM, Preux PM, Aboyans V, Haan MN, Aiello AE, Ng TP, Nyunt MSZ, Gao Q, Scazufca M, Sachdev PSS. Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis. JAMA Netw Open 2023; 6:e2333353. [PMID: 37698858 PMCID: PMC10498335 DOI: 10.1001/jamanetworkopen.2023.33353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
Importance The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. Objectives To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. Data Source and Study Selection Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). Data Extraction and Synthesis Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. Main Outcomes and Measures The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. Results The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. Conclusions and Relevance This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.
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Affiliation(s)
- Matthew J. Lennon
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ben Chun Pan Lam
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Darren M. Lipnicki
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - John D. Crawford
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ruth Peters
- The George Institute for Global Health, Sydney, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Aletta E. Schutte
- The George Institute for Global Health, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Eastern Suburbs Older Persons’ Mental Health Service, Sydney, Australia
| | - Anbupalam Thalamuthu
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Therese Rydberg-Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- School of Psychology, Manawatu Campus, Massey University, Palmerston North, New Zealand
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Concepción De-la-Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Elena Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Toyin Bello
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy J. Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Carol A. Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Elena Rolandi
- Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | | | | | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Themis Dardiotis
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
| | - Sujuan Gao
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis
| | - Isabelle Carrière
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Karen Ritchie
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Institut du Cerveau Trocadéro, Paris, France
| | - Kaarin J. Anstey
- University of New South Wales, School of Psychology, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Maëlenn M. Guerchet
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Pierre-Marie Preux
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Victor Aboyans
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
| | - Mary N. Haan
- School of Medicine, University of California, San Francisco
| | - Allison E. Aiello
- Robert N. Butler Columbia Aging Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatric Education and Research Institute, Ministry of Health, Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcia Scazufca
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S. S. Sachdev
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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25
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Tomiyama H. Vascular function: a key player in hypertension. Hypertens Res 2023; 46:2145-2158. [PMID: 37369849 DOI: 10.1038/s41440-023-01354-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
The major functions of the arterial system are to "efficiently deliver blood to the peripheral organs and maintain vascular homeostasis". Both the endothelial and medial layer contribute to the three major functions, namely, conversion of pulsatile to steady blood flow, appropriate distribution of blood flow to the target organs, and vascular protection and homeostasis. Vascular dysfunction contributes to the development of cardiovascular diseases through a combination of several mechanisms, including impaired coronary perfusion, cardiac systolic/diastolic dysfunction, microvascular damage, and abnormal hemodynamics in the arterial tree. The representative marker of endothelial function is flow-mediated vasodilatation and that of the medial layer function is pulse wave velocity, and that of the blood supply function of the arterial tree is the ankle-brachial pressure index. In hypertension, vascular dysfunction could also lead to the development of isolated systolic hypertension, isolated diastolic hypertension, and systolic/diastolic hypertension. Vascular dysfunction is involved in a vicious cycle with abnormal blood pressure variability. Furthermore, a vicious cycle may also exist between vascular dysfunction and hypertension. While the significances of vascular function tests to predict future cardiovascular events has been established in cases of hypertension, their usefulness in assessing the effectiveness of management of the vascular functions in hypertension on the cardiovascular outcomes has not yet been fully clarified. Thus, vascular dysfunction plays crucial roles in the pathophysiology of hypertension, and further research is warranted to establish strategies to improve vascular dysfunction in cases of hypertension. Vascular functions in the pathophysiology of hypertension. Vascular dysfunction and elevation of blood pressure are components of a vicious cycle even from their early stages, which including abnormal blood pressure variabilities. This vicious cycle is associated with hypertensive organ damage and also adverse cardiovascular outcomes. Strategies to break this vicious cycle have not yet been fully established.
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Affiliation(s)
- Hirofumi Tomiyama
- Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
- Division of Preemptive Medicine for Vascular Damage, Tokyo Medical University, Tokyo, Japan.
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26
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An S, Hwang G, Noh SA, Lee HC, Hwang TS. Quantitative Analysis of Brain CT Perfusion in Healthy Beagle Dogs: A Pilot Study. Vet Sci 2023; 10:469. [PMID: 37505873 PMCID: PMC10385523 DOI: 10.3390/vetsci10070469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/29/2023] Open
Abstract
Brain computed tomography (CT) perfusion is a technique that allows for the fast evaluation of cerebral hemodynamics. However, quantitative studies of brain CT perfusion in veterinary medicine are lacking. The purpose of this study was to investigate the normal range of perfusion determined via CT in brains of healthy dogs and to compare values between white matter and gray matter, differences in aging, and each hemisphere. Nine intact male beagle dogs were prospectively examined using dynamic CT scanning and post-processing for brain perfusion. Regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), mean transit time, and time to peak were calculated. Tissue ROIs were drawn in the gray matter and white matter of the frontal, temporal, parietal, and occipital lobes; caudate nucleus; thalamus; piriform lobe; hippocampus; and cerebellum. Significant differences were observed between the white matter regions and gray matter regions for rCBV and rCBF (p < 0.05). However, no significant differences were identified between hemispheres and between young and old groups in brain regions. The findings obtained in this study involving healthy beagle dogs might serve as a reference for regional CT perfusion values in specific brain regions. These results may aid in the characterization of various brain diseases in dogs.
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Affiliation(s)
- Soyon An
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Gunha Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Seul Ah Noh
- AniCom Medical Center, Animal Hospital, Seoul 04599, Republic of Korea
| | - Hee Chun Lee
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Tae Sung Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
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Ivanova MV, Pappas I. Understanding recovery of language after stroke: insights from neurovascular MRI studies. FRONTIERS IN LANGUAGE SCIENCES 2023; 2:1163547. [PMID: 38162928 PMCID: PMC10757818 DOI: 10.3389/flang.2023.1163547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Stroke causes a disruption in blood flow to the brain that can lead to profound language impairments. Understanding the mechanisms of language recovery after stroke is crucial for the prognosis and effective rehabilitation of people with aphasia. While the role of injured brain structures and disruptions in functional connectivity have been extensively explored, the relationship between neurovascular measures and language recovery in both early and later stages has not received sufficient attention in the field. Fully functioning healthy brain tissue requires oxygen and nutrients to be delivered promptly via its blood supply. Persistent decreases in blood flow after a stroke to the remaining non-lesioned tissue have been shown to contribute to poor language recovery. The goal of the current paper is to critically examine stroke studies looking at the relationship between different neurovascular measures and language deficits and mechanisms of language recovery via changes in neurovascular metrics. Measures of perfusion or cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) provide complementary approaches to understanding neurovascular mechanisms post stroke by capturing both cerebral metabolic demands and mechanical vascular properties. While CBF measures indicate the amount of blood delivered to a certain region and serve as a proxy for metabolic demands of that area, CVR indices reflect the ability of the vasculature to recruit blood flow in response to a shortage of oxygen, such as when one is holding their breath. Increases in CBF during recovery beyond the site of the lesion have been shown to promote language gains. Similarly, CVR changes, when collateral vessels are recruited to help reorganize the flow of blood in hypoperfused regions, have been related to functional recovery post stroke. In the current review, we highlight the main findings in the literature investigating neurovascular changes in stroke recovery with a particular emphasis on how language abilities can be affected by changes in CBF and CVR. We conclude by summarizing existing methodological challenges and knowledge gaps that need to be addressed in future work in this area, outlining a promising avenue of research.
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Affiliation(s)
- Maria V. Ivanova
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Ioannis Pappas
- USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
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Chi X, Fan X, Fu G, Liu Y, Zhang Y, Shen W. Research trends and hotspots of post-stroke cognitive impairment: a bibliometric analysis. Front Pharmacol 2023; 14:1184830. [PMID: 37324494 PMCID: PMC10267734 DOI: 10.3389/fphar.2023.1184830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Background: Post-stroke cognitive impairment (PSCI) is a major complication of stroke that affects more than one-third of stroke survivors, threatening their quality of life and increasing the risk of disability and death. Although various studies have described the etiology, epidemiology, and risk factors of PSCI, there are a limited number of comprehensive and accurate reports on research trends and hotspots in this field. Therefore, this review aimed to evaluate research trends, hotspots, and frontiers in PSCI using bibliometric analysis. Methods: We screened the literature spanning 20 years in the Web of Science Core Collection: Science Citation Index Expanded (SCI-Expanded) database from 1 January 2003 to 31 December 2022. We included all eligible literature reports based on our comprehensive search strategy, inclusion criteria, and exclusion criteria. The analysis of annual publications, countries/regions, institutions, journals, co-cited references, and keywords was conducted using CiteSpace and VOSviewer, and the hotspots and major findings of PSCI were summarized. Results: A total of 1,024 publications were included in this review. We found that the number of publications on PSCI increased annually. These publications were published in 75 countries or regions by over 400 institutions. Although Chinese institutions had the highest number of publications, their international influence was limited. The United States showed a strong influence in the field. The journal "Stroke" published the most publications (57) with a high impact factor and was considered the most co-cited journal. The most frequently cited references focused on the prevalence, incidence, neuropsychological assessment scales, criteria, and guidelines of PSCI. The strongest citation burst keywords for PSCI were "neurotrophic factor" and "synaptic plasticity", which were regarded as research focuses and research hotspots, respectively. Conclusion: This review provided a comprehensive summary of the literature of PSCI, identified the authoritative and frequently cited literature and journals, clarified the trends in PSCI research, and highlighted the hotspots in this field. Currently, studies on the mechanisms and treatment of PSCI are limited, and we hope that this review has effectively highlighted the research trajectory of PSCI and will lay the foundation for more innovative research in the future.
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Affiliation(s)
| | | | | | | | | | - Wei Shen
- *Correspondence: Yunling Zhang, ; Wei Shen,
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29
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Yao Q, Jiang K, Lin F, Zhu T, Khan NH, Jiang E. Pathophysiological Association of Alzheimer's Disease and Hypertension: A Clinical Concern for Elderly Population. Clin Interv Aging 2023; 18:713-728. [PMID: 37181536 PMCID: PMC10167960 DOI: 10.2147/cia.s400527] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/22/2023] [Indexed: 05/16/2023] Open
Abstract
Alzheimer's disease (AD), the most common cause of dementia and the fifth leading cause of death in the adult population has a complex pathophysiological link with hypertension (HTN). A growing volume of published literature on a parallel elevation of blood pressure (BP), amyloid plaques, and neurofibrillary tangles formation in post-middle of human brain cells has developed new, widely accepting foundations on this association. In particular, HTN in elderly life mediates cerebral blood flow dysfunction, neuronal dysfunction, and significant decline in cognitive impairment, primarily in the late-life populace, governing the onset of AD. Thus, HTN is an established risk factor for AD. Considering the impact of AD, 1.89 million deaths annually, and the failure of palliative therapies to cure AD, the scientific research community is looking to adopt integrated approaches to target early modified risk factors like HTN to reduce AD burden. The current review highlights the significance and impact of HTN-based prevention in lowering the AD burden in the elderly by providing a comprehensive overview of the physiological relationship between AD and HTN with an in-detail explanation of the role and applications of pathological biomarkers in this clinical association. The review will gain worth in presenting new insights and providing inclusive discussion on the correlation between HTN and cognitive impairment. It will increase across a wider scientific audience to expand understanding of this pathophysiological association.
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Affiliation(s)
- Qianqian Yao
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
| | - Kexin Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
| | - Fei Lin
- School of Medicine, Shangqiu Institute of Technology, Shangqiu, People’s Republic of China
| | - Tao Zhu
- Department of Geriatrics, Kaifeng Traditional Chinese Medicine Hospital, Kaifeng, People’s Republic of China
| | - Nazeer Hussain Khan
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, People’s Republic of China
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, People’s Republic of China
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, People’s Republic of China
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30
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Roberts GS, Peret A, Jonaitis EM, Koscik RL, Hoffman CA, Rivera-Rivera LA, Cody KA, Rowley HA, Johnson SC, Wieben O, Johnson KM, Eisenmenger LB. Normative Cerebral Hemodynamics in Middle-aged and Older Adults Using 4D Flow MRI: Initial Analysis of Vascular Aging. Radiology 2023; 307:e222685. [PMID: 36943077 PMCID: PMC10140641 DOI: 10.1148/radiol.222685] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 03/23/2023]
Abstract
Background Characterizing cerebrovascular hemodynamics in older adults is important for identifying disease and understanding normal neurovascular aging. Four-dimensional (4D) flow MRI allows for a comprehensive assessment of cerebral hemodynamics in a single acquisition. Purpose To establish reference intracranial blood flow and pulsatility index values in a large cross-sectional sample of middle-aged (45-65 years) and older (>65 years) adults and characterize the effect of age and sex on blood flow and pulsatility. Materials and Methods In this retrospective study, patients aged 45-93 years (cognitively unimpaired) underwent cranial 4D flow MRI between March 2010 and March 2020. Blood flow rates and pulsatility indexes from 13 major arteries and four venous sinuses and total cerebral blood flow were collected. Intraobserver and interobserver reproducibility of flow and pulsatility measures was assessed in 30 patients. Descriptive statistics (mean ± SD) of blood flow and pulsatility were tabulated for the entire group and by age and sex. Multiple linear regression and linear mixed-effects models were used to assess the effect of age and sex on total cerebral blood flow and vessel-specific flow and pulsatility, respectively. Results There were 759 patients (mean age, 65 years ± 8 [SD]; 506 female patients) analyzed. For intra- and interobserver reproducibility, median intraclass correlation coefficients were greater than 0.90 for flow and pulsatility measures across all vessels. Regression coefficients β ± standard error from multiple linear regression showed a 4 mL/min decrease in total cerebral blood flow each year (age β = -3.94 mL/min per year ± 0.44; P < .001). Mixed effects showed a 1 mL/min average annual decrease in blood flow (age β = -0.95 mL/min per year ± 0.16; P < .001) and 0.01 arbitrary unit (au) average annual increase in pulsatility over all vessels (age β = 0.011 au per year ± 0.001; P < .001). No evidence of sex differences was observed for flow (β = -1.60 mL/min per male patient ± 1.77; P = .37), but pulsatility was higher in female patients (sex β = -0.018 au per male patient ± 0.008; P = .02). Conclusion Normal reference values for blood flow and pulsatility obtained using four-dimensional flow MRI showed correlations with age. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Steinman in this issue.
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Affiliation(s)
- Grant S. Roberts
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Anthony Peret
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Erin M. Jonaitis
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Rebecca L. Koscik
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Carson A. Hoffman
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Leonardo A. Rivera-Rivera
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Karly A. Cody
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Howard A. Rowley
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Sterling C. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Oliver Wieben
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Kevin M. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Laura B. Eisenmenger
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
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Bown CW, Khan OA, Liu D, Remedios SW, Pechman KR, Terry JG, Nair S, Davis LT, Landman BA, Gifford KA, Hohman TJ, Carr JJ, Jefferson AL. Enlarged perivascular space burden associations with arterial stiffness and cognition. Neurobiol Aging 2023; 124:85-97. [PMID: 36446680 PMCID: PMC9957942 DOI: 10.1016/j.neurobiolaging.2022.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Enlarged perivascular spaces (ePVS) are difficult to quantify, and their etiologies and consequences are poorly understood. Vanderbilt Memory and Aging Project participants (n = 327, 73 ± 7 years) completed 3T brain MRI to quantify ePVS volume and count, longitudinal neuropsychological assessment, and cardiac MRI to quantify aortic stiffness. Linear regressions related (1) PWV to ePVS burden and (2) ePVS burden to cross-sectional and longitudinal neuropsychological performance adjusting for key demographic and medical factors. Higher aortic stiffness related to greater basal ganglia ePVS volume (β = 7.0×10-5, p = 0.04). Higher baseline ePVS volume was associated with worse baseline information processing (β = -974, p = 0.003), executive function (β = -81.9, p < 0.001), and visuospatial performances (β = -192, p = 0.02) and worse longitudinal language (β = -54.9, p = 0.05), information processing (β = -147, p = 0.03), executive function (β = -10.9, p = 0.03), and episodic memory performances (β = -10.6, p = 0.02). Results were similar for ePVS count. Greater arterial stiffness relates to worse basal ganglia ePVS burden, suggesting cardiovascular aging as an etiology. ePVS burden is associated with adverse cognitive trajectory, emphasizing the clinical relevance of ePVS.
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Affiliation(s)
- Corey W Bown
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omair A Khan
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Samuel W Remedios
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Kimberly R Pechman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sangeeta Nair
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bennett A Landman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John Jeffrey Carr
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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32
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Wang C, Reid G, Mackay CE, Hayes G, Bulte DP, Suri S. A Systematic Review of the Association Between Dementia Risk Factors and Cerebrovascular Reactivity. Neurosci Biobehav Rev 2023; 148:105140. [PMID: 36944391 DOI: 10.1016/j.neubiorev.2023.105140] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/15/2023] [Accepted: 03/15/2023] [Indexed: 03/23/2023]
Abstract
Cumulative evidence suggests that impaired cerebrovascular reactivity (CVR), a regulatory response critical for maintaining neuronal health, is amongst the earliest pathological changes in dementia. However, we know little about how CVR is affected by dementia risk, prior to disease onset. Understanding this relationship would improve our knowledge of disease pathways and help inform preventative interventions. This systematic review investigates 59 studies examining how CVR (measured by magnetic resonance imaging) is affected by modifiable, non-modifiable, and clinical risk factors for dementia. We report that non-modifiable risk (older age and apolipoprotein ε4), some modifiable factors (diabetes, traumatic brain injury, hypertension) and some clinical factors (stroke, carotid artery occlusion, stenosis) were consistently associated with reduced CVR. We also note a lack of conclusive evidence on how other behavioural factors such as physical inactivity, obesity, or depression, affect CVR. This review explores the biological mechanisms underpinning these brain- behaviour associations, highlights evident gaps in the literature, and identifies the risk factors that could be managed to preserve CVR in an effort to prevent dementia.
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Affiliation(s)
- Congxiyu Wang
- Department of Psychiatry, University of Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Graham Reid
- Department of Psychiatry, University of Oxford, UK; Department of Experimental Psychology, University of Oxford, UK
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK
| | - Genevieve Hayes
- Institute of Biomedical Engineering, University of Oxford, UK
| | - Daniel P Bulte
- Institute of Biomedical Engineering, University of Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, UK.
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33
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Melgarejo JD, Vernooij MW, Ikram MA, Zhang ZY, Bos D. Intracranial Carotid Arteriosclerosis Mediates the Association Between Blood Pressure and Cerebral Small Vessel Disease. Hypertension 2023; 80:618-628. [PMID: 36458543 PMCID: PMC9944388 DOI: 10.1161/hypertensionaha.122.20434] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
BACKGROUND Intracranial arteriosclerosis could explain the association between blood pressure (BP) and cerebral small vessel disease (CSVD). Therefore, we tested whether intracranial carotid artery calcification (ICAC) mediates the association between BP and CSVD and determined pathophysiological mechanisms based on ICAC subtypes. METHODS One thousand four hundred fifty-eight stroke-free participants from the Rotterdam Study (mean age, 68 years; 52% women) underwent nonenhanced computed tomography scans to quantify ICAC volume (mm3) between 2003 and 2015. ICAC was categorized into intimal and internal elastic lamina calcifications. CSVD included white matter hyperintensities volume, the presence of lacunes, and cerebral microbleeds visualized on magnetic resonance imaging. Office BP included systolic BP, diastolic BP, pulse pressure, and mean arterial pressure. Mediation analysis included a 2-way decomposition to determine the direct association between BP and CSVD and the indirect or mediated effect (negative or positive mediations expressed in %) of log-ICAC volume on such association. RESULTS BP and log-ICAC were correlated and were also associated with CSVD. In all participants, total log-ICAC volume mediated the association of diastolic BP (-14.5%) and pulse pressure (16.5%) with log-white matter hyperintensities. Internal elastic lamina log-ICAC volume mediated -19.5% of the association between diastolic BP and log-white matter hyperintensities; intimal log-ICAC volume did not mediate associations. For lacunes, total and internal elastic lamina log-ICAC volume mediated the association of diastolic BP (-40% and -45.8%) and pulse pressure (26.9% and 18.2%). We did not observe mediations for cerebral microbleeds. CONCLUSIONS Intracranial arteriosclerosis mediates the association between BP and CSVD. Internal elastic lamina calcification, considered a proxy of arterial stiffness, is the leading mechanism explaining the link between BP and CSVD.
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Affiliation(s)
- Jesus D Melgarejo
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.).,Laboratory of Neurosciences, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela (J.D.M.)
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V., D.B.)
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.)
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.)
| | - Daniel Bos
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (J.D.M., M.W.V., M.A.I., D.B.).,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.D.M., Z.-Y.Z., D.B.).,Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V., D.B.)
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Liu D, Szeto WY, Laudanski K. Elevated Serum Fibroblast Growth Factor 23 (FGF-23) Perseveres into a Convalescence Period After Elective Cardiac Surgery, with Receptor Activator of Nuclear Factor κB Ligand (RANKL) and Cartilage Oligomeric Matrix Protein (COMP) Being Part of the Peri-Surgical -Pro-Arteriosclerotic Inflammatory Response. Med Sci Monit 2023; 29:e937934. [PMID: 36635948 PMCID: PMC9847201 DOI: 10.12659/msm.937934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), cartilage oligomeric matrix protein (COMP), bone morphogenetic protein (BMP-2), and fibroblast growth factor 23 (FGF-23) are involved in inflammation, calcium deposition, and fibrosis of blood vessels. Acute changes in these factors may contribute to the progression of arteriosclerosis, especially if their elevated serum levels persist postoperatively. MATERIAL AND METHODS A total of 90 patients (79 White, 4 African American, and 7 Other) undergoing elective heart surgery were enrolled in the study. Blood was collected before surgery and after surgery at 24 hours, 7 days, and 3 months to allow for longitudinal comparisons. After the plasma isolation, several biomarkers levels were studied using an enzymatic-linked assay. Demographic and clinical information were obtained from electronic health records. RESULTS At 24 hours after surgery, RANKL (RANKLbaseline=248.7±215.7 vs RANKLt24h=376.4±329.7; P=0.035), and BMP-2 (BMP-2baseline=283.7±255.4 vs BMP-2t24h=482.4; P=0.015) were significantly elevated compared to baseline, with levels returning to baseline at 7 days. FGF-23 increased significantly from baseline (FGF-23baseline=1020±1210) to 7 days (FGF-237d=2191±5188; P=0.029) and remained significantly higher than baseline at 3 months (FGF-233m=2041±3521; P=0.044). White blood cells (WBC) remained elevated at discharge (WBCbaseline=6.8±2.1 vs WBC24h=15.0±5.3 vs WBCdischarge=8.8±3.4). IL-8 and C-reactive protein normalized at 3 months. Estimated blood loss was significantly correlated with RANKL at 24 hours (r²=0.33; P=0.035). Serum creatinine levels after surgery at 24 hours (r²=0.41; p=0.008) and 7 days (r²=0.59; P=0.000) was strongly correlated with COMP. CONCLUSIONS Persistent elevation of serum FGF-23 indicates a potential for accelerated arteriosclerosis after cardiac surgery.
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Affiliation(s)
- Da Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaonong, PR China
| | - Wilson Y. Szeto
- Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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35
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Sangüesa G, Batlle M, Muñoz-Moreno E, Soria G, Alcarraz A, Rubies C, Sitjà-Roqueta L, Solana E, Martínez-Heras E, Meza-Ramos A, Amaro S, Llufriu S, Mont L, Guasch E. Intense long-term training impairs brain health compared with moderate exercise: Experimental evidence and mechanisms. Ann N Y Acad Sci 2022; 1518:282-298. [PMID: 36256544 PMCID: PMC10092505 DOI: 10.1111/nyas.14912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The consequences of extremely intense long-term exercise for brain health remain unknown. We studied the effects of strenuous exercise on brain structure and function, its dose-response relationship, and mechanisms in a rat model of endurance training. Five-week-old male Wistar rats were assigned to moderate (MOD) or intense (INT) exercise or a sedentary (SED) group for 16 weeks. MOD rats showed the highest motivation and learning capacity in operant conditioning experiments; SED and INT presented similar results. In vivo MRI demonstrated enhanced global and regional connectivity efficiency and clustering as well as a higher cerebral blood flow (CBF) in MOD but not INT rats compared with SED. In the cortex, downregulation of oxidative phosphorylation complex IV and AMPK activation denoted mitochondrial dysfunction in INT rats. An imbalance in cortical antioxidant capacity was found between MOD and INT rats. The MOD group showed the lowest hippocampal brain-derived neurotrophic factor levels. The mRNA and protein levels of inflammatory markers were similar in all groups. In conclusion, strenuous long-term exercise yields a lesser improvement in learning ability than moderate exercise. Blunting of MOD-induced improvements in CBF and connectivity efficiency, accompanied by impaired mitochondrial energetics and, possibly, transient local oxidative stress, may underlie the findings in intensively trained rats.
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Affiliation(s)
- Gemma Sangüesa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
| | - Montserrat Batlle
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
| | - Emma Muñoz-Moreno
- Experimental 7T MRI Unit, Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Guadalupe Soria
- Experimental 7T MRI Unit, Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Laboratory of Surgical Neuroanatomy, Faculty of Medicine and Health Sciences, Institute of Neurosciences, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Anna Alcarraz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Cira Rubies
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Laia Sitjà-Roqueta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Department of Biomedical Sciences, Institute of Neurosciences, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Elisabeth Solana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases (ImaginEM), Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Eloy Martínez-Heras
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases (ImaginEM), Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Aline Meza-Ramos
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Consejo Nacional de Ciencia y Tecnología (CONACYT), Mexico City, Mexico.,Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sergi Amaro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Comprehensive Stroke Center, Institute of Neurosciences, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Sara Llufriu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases (ImaginEM), Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Lluís Mont
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain.,Cardiovascular Institute, Clínic de Barcelona, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Eduard Guasch
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain.,Cardiovascular Institute, Clínic de Barcelona, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Departament de Medicina, Facultat de Medicina seu Casanova, Universitat de Barcelona, Barcelona, Catalonia, Spain
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36
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Zhang X, Yang J, Ruan H, Zheng Y, Zhao L, Li L, Zhang M, Duan L, He S. Association of cumulative blood pressure with cardiovascular mortality in Chinese older people: A longitudinal prospective study. Exp Gerontol 2022; 168:111952. [PMID: 36096321 DOI: 10.1016/j.exger.2022.111952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Long-term cumulative blood pressure (BP) was associated with cardiovascular mortality in middle-aged to older people. Whether cumulative BP was associated with cardiovascular mortality is uncertain in Chinese older people. DESIGN Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationwide, ongoing, prospective cohort study of community-dwelling Chinese older people. SETTING, AND PARTICIPANTS A total of 3361 older participants from the CLHLS study were included (men: 46.68 %, age: ≥65 years, median age: 78.00 years [IQR: 71.0-86.00 years]). METHODS Cumulative BP, including systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP), was determined by the area under the curve based on three measurements of BP (waves 2008, 2011, and 2014). The outcome was cardiovascular mortality, which was followed from wave 2014 to wave 2018. RESULTS During a median follow-up period of 3.98 years, 211 cardiovascular death were recorded. The higher cumulative SBP and PP tended to be positively linearly associated with an elevated risk of cardiovascular mortality. For each SD increment, the adjusted HRs of mortality risk was 1.28 (95 % CI: 1.11-1.47; p = 0.001) and 1.24 (95 % CI, 1.09-1.43; p = 0.002) for cumulative SBP and PP, respectively. While there was no association between cumulative DBP and cardiovascular mortality. In addition, multiple sensitivity analyses suggested robustness of the results. CONCLUSIONS/IMPLICATIONS Our results indicate that cumulative SBP and PP were associated with cardiovascular mortality in Chinese older people; however, there was no such association between cumulative DBP and mortality. Therefore, control of long-term SBP and PP may be required in those people.
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Affiliation(s)
- Xin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Cardiology, Maternal and Child Health Hospital, Longquanyi District, Chengdu, China
| | - Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, Hospital of Traditional Chinese Medicine, Shuangliu District, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Liming Zhao
- Department of Cardiovascular Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology, First People's Hospital, Longquanyi District, Chengdu, China
| | - Linjia Duan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
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Llauradó G, Amigó N, Fuertes-Martín R, Romero A, Cano A, Albert L, Giménez-Palop O, Berlanga E, Fernández-Veledo S, Correig X, Vendrell J, González-Clemente JM. Measurement of Serum N-Glycans in the Assessment of Early Vascular Aging (Arterial Stiffness) in Adults With Type 1 Diabetes. Diabetes Care 2022; 45:2430-2438. [PMID: 35984043 DOI: 10.2337/dc22-0331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/11/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Vascular aging (arterial stiffness [AS]) is an inflammation-linked process that predicts macro- and microvascular complications in adults with type 1 diabetes (T1D). We evaluated the utility of measuring the inflammation-linked N-glycans GlycA and GlycB to assess vascular aging in adults with T1D. RESEARCH DESIGN AND METHODS Eighty-four adults with T1D (>10-year duration without cardiovascular events) and 68 healthy control subjects were evaluated for clinical characteristics (including microvascular complications in patients with T1D), aortic pulse wave velocity (aPWV) (surrogate measure of AS), and serum GlycA and GlycB (peak area [concentration] and height/width [H/W] ratio) using 1H-nuclear magnetic resonance spectroscopy. RESULTS Patients with T1D had higher median (interquartile range) values than healthy control subjects for (P < 0.001 for all comparisons) aPWV 7.9 (6.9-9.1) vs. 6.1 (5.5-6.7) m/s, GlycA 850.4 (781.3-916.1) vs. 652.4 (581.5-727.1) μmoL; GlycB 386.1 (353.2-426.3) vs. 310.0 (280.5-331.9) μmol/L), H/W ratio of GlycA 16.5 (14.9-18.1) vs. 15.0 (13.7-16.7), and H/W ratio of GlycB 5.0 (4.6-5.5) vs. 4.0 (3.4-4.3). Moreover, aPWV correlated (P < 0.001 for all correlations) with GlycA (r = 0.550) and GlycB (r = 0.423) concentrations and with H/W ratios of GlycA (r = 0.453) and GlycB (r = 0.510). Adjusting for potential confounders, GlycA concentration (β = 0.212, P < 0.001) and the H/W ratios of GlycA (β = 0.150, P = 0.009) and GlycB (β = 0.155, P = 0.011) remained independently associated with aPWV. C-statistics for detecting individuals with aPWV >10 m/s were 0.866 (95% CI 0.794-0.937) for GlycA levels and 0.862 (0.780-0.943) for H/W ratio of GlycB. CONCLUSIONS Measurement of serum GlycA and GlycB may have utility in assessing vascular aging in adults with T1D of >10-year duration and no previous cardiovascular events.
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Affiliation(s)
- Gemma Llauradó
- Department of Endocrinology and Nutrition, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.,CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Amigó
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Biosfer Teslab SL, Reus, Spain.,Department of Basic Medical Sciences, Rovira i Virgili University, Tarragona-Reus, Spain
| | - Rocío Fuertes-Martín
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Biosfer Teslab SL, Reus, Spain.,Department of Electronics, Electrical and Automatic Engineering Platform, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - Ana Romero
- Department of Endocrinology and Nutrition, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Albert Cano
- Department of Endocrinology and Nutrition, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Lara Albert
- Department of Endocrinology and Nutrition, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Olga Giménez-Palop
- Department of Endocrinology and Nutrition, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Eugenio Berlanga
- Clinical Laboratory, Biochemistry Department, UDIAT, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Sonia Fernández-Veledo
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Endocrinology and Nutrition Service, Joan XXIII University Hospital, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - Xavier Correig
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Department of Electronics, Electrical and Automatic Engineering Platform, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - Joan Vendrell
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Endocrinology and Nutrition Service, Joan XXIII University Hospital, Pere Virgili Health Research Institute (IISPV), Rovira i Virgili University, Tarragona, Spain
| | - José-Miguel González-Clemente
- CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain.,Department of Endocrinology and Nutrition, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
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38
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Francis CM, Futschik ME, Huang J, Bai W, Sargurupremraj M, Teumer A, Breteler MMB, Petretto E, Ho ASR, Amouyel P, Engelter ST, Bülow R, Völker U, Völzke H, Dörr M, Imtiaz MA, Aziz NA, Lohner V, Ware JS, Debette S, Elliott P, Dehghan A, Matthews PM. Genome-wide associations of aortic distensibility suggest causality for aortic aneurysms and brain white matter hyperintensities. Nat Commun 2022; 13:4505. [PMID: 35922433 PMCID: PMC9349177 DOI: 10.1038/s41467-022-32219-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 07/20/2022] [Indexed: 12/13/2022] Open
Abstract
Aortic dimensions and distensibility are key risk factors for aortic aneurysms and dissections, as well as for other cardiovascular and cerebrovascular diseases. We present genome-wide associations of ascending and descending aortic distensibility and area derived from cardiac magnetic resonance imaging (MRI) data of up to 32,590 Caucasian individuals in UK Biobank. We identify 102 loci (including 27 novel associations) tagging genes related to cardiovascular development, extracellular matrix production, smooth muscle cell contraction and heritable aortic diseases. Functional analyses highlight four signalling pathways associated with aortic distensibility (TGF-β, IGF, VEGF and PDGF). We identify distinct sex-specific associations with aortic traits. We develop co-expression networks associated with aortic traits and apply phenome-wide Mendelian randomization (MR-PheWAS), generating evidence for a causal role for aortic distensibility in development of aortic aneurysms. Multivariable MR suggests a causal relationship between aortic distensibility and cerebral white matter hyperintensities, mechanistically linking aortic traits and brain small vessel disease.
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Affiliation(s)
- Catherine M Francis
- National Heart and Lung Institute, Imperial College London, Programme in Cardiovascular Genetics and Genomics, London, UK
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, SW3 6NP, UK
| | - Matthias E Futschik
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, W12 0NN, UK
| | - Jian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Wenjia Bai
- Department of Brain Sciences, Imperial College London, London, UK
- Department of Computing, Imperial College London, London, UK
| | - Muralidharan Sargurupremraj
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Enrico Petretto
- Programme in Cardiovascular & Metabolic Disorders and Centre for Computational Biology, Duke-NUS Medical School, Singapore, 169857, Republic of Singapore
- Institute of Big Data and Artificial Intelligence, China Pharmaceutical University (CPU), 211198, Nanjing, China
- Computational Biology Programme, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Amanda S R Ho
- Computational Biology Programme, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Philippe Amouyel
- LabEx DISTALZ-U1167, RID-AGE-Risk Factors and Molecular Determinants of Aging-Related Diseases, University of Lille, Lille, France
- Inserm, U1167, Lille, France
- Centre Hospitalier Universitaire Lille, Lille, France
- Institut Pasteur de Lille, Lille, France
| | - Stefan T Engelter
- Department of Neurology and Stroke Center, University Hospital and University of Basel, Petersgraben 4, CH - 4031, Basel, Switzerland
- Department of Clinical Neurology and Neurorehabilitation, University Department of Geriatric Medicine FELIX PLATTER, University of Basel, Basel, Switzerland
| | - Robin Bülow
- Department of Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Mohammed-Aslam Imtiaz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - N Ahmad Aziz
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Valerie Lohner
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - James S Ware
- National Heart and Lung Institute, Imperial College London, Programme in Cardiovascular Genetics and Genomics, London, UK
- Royal Brompton & Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, SW3 6NP, UK
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, W12 0NN, UK
| | - Stephanie Debette
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- Department of Neurology, Institute for Neurodegenerative Diseases, Bordeaux University Hospital - CHU Bordeaux, 33000, Bordeaux, France
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- UK Dementia Research Institute at Imperial College London, London, UK
- Health Data Research (HDR) UK London at Imperial College London, London, UK
- Britsh Heart Foundation Centre of Research Excellence at Imperial College London, London, UK
- National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
- UK Dementia Research Institute at Imperial College London, London, UK.
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London, UK.
- UK Dementia Research Institute at Imperial College London, London, UK.
- National Institute for Health Research Imperial Biomedical Research Centre, Imperial College London, London, UK.
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Mills A, Dakhlallah D, Robinson M, Kirk A, Llavina S, Boyd JW, Chantler PD, Olfert IM. Short-term effects of electronic cigarettes on cerebrovascular function: A time course study. Exp Physiol 2022; 107:994-1006. [PMID: 35661445 PMCID: PMC9357197 DOI: 10.1113/ep090341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/31/2022] [Indexed: 01/12/2023]
Abstract
NEW FINDINGS What is the central question of this study? Acute exposure to electronic cigarettes (Ecigs) triggers abnormal vascular responses in systemic arteries; however, effects on cerebral vessels are poorly understood and time for recovery is not known. We hypothesized that exposure to cigarettes or Ecigs would trigger rapid (<4 h) impairment of the middle cerebral artery (MCA) but that this would resolve by 24 h. What is the main finding and its importance? Cigarettes and Ecigs caused similar degree and duration of MCA impairment. We find it takes ~72 hours after exposure for MCA function to return to normal. This suggests that Ecig use is likely to produce similar adverse vascular health outcomes to those seen with cigarette smoke. ABSTRACT Temporal influences of electronic cigarettes (Ecigs) on blood vessels are poorly understood. In this study, we evaluated a single episode of cigarette versus Ecig exposure on middle cerebral artery (MCA) reactivity and determined how long after the exposure MCA responses took to return to normal. We hypothesized that cigarette and Ecig exposure would induce rapid (<4 h) reduction in MCA endothelial function and would resolve within 24 h. Sprague-Dawley rats (4 months old) were exposed to either air (n = 5), traditional cigarettes (20 puffs, n = 16) or Ecigs (20-puff group, n = 16; or 60-puff group, n = 12). Thereafter, the cigarette and Ecig groups were randomly assigned for postexposure vessel myography testing on day 0 (D0, 1-4 h postexposure), day 1 (D1, 24-28 h postexposure), day 2 (D2, 48-52 h postexposure) and day 3 (72-76 h postexposure). The greatest effect on endothelium-dependent dilatation was observed within 24 h of exposure (∼50% decline between D0 and D1) for both cigarette and Ecig groups, and impairment persisted with all groups for up to 3 days. Changes in endothelium-independent dilatation responses were less severe (∼27%) and shorter lived (recovering by D2) compared with endothelium-dependent dilatation responses. Vasoconstriction in response to serotonin (5-HT) was similar to endothelium-independent dilatation, with greatest impairment (∼45% for all exposure groups) at D0-D1, returning to normal by D2. These data show that exposure to cigarettes and Ecigs triggers a similar level/duration of cerebrovascular dysfunction after a single exposure. The finding that Ecig (without nicotine) and cigarette (with nicotine) exposure produce the same effects suggesting that nicotine is not likely to be triggering MCA dysfunction, and that vaping (with/without nicotine) has potential to produce the same vascular harm and/or disease as smoking.
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Affiliation(s)
- Amber Mills
- Dept. of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, WV 26506
| | - Duaa Dakhlallah
- Dept. of Microbiology, Immunology and Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506,Institute of Global Health and Human Ecology, School of Sciences & Engineering, The American University of Cairo, Egypt
| | - Madison Robinson
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506
| | - Ally Kirk
- Alderson Broaddus University, West Virginia University School of Medicine, Morgantown, WV 26506
| | - Sam Llavina
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV 26506
| | - Jonathan W. Boyd
- Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV 26506,Dept. of Orthopedics, West Virginia University School of Medicine, Morgantown, WV 26506
| | - Paul D. Chantler
- Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506,Dept. of Neuroscience, West Virginia University School of Medicine, Morgantown, WV 26506
| | - I. Mark Olfert
- Dept. of Physiology and Pharmacology, West Virginia University School of Medicine, Morgantown, WV 26506,Division of Exercise Physiology, West Virginia University School of Medicine, Morgantown, WV 26506,Center for Inhalation Toxicology, West Virginia University School of Medicine, Morgantown, WV 26506
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40
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Coffin C, Suerken CK, Bateman JR, Whitlow CT, Williams BJ, Espeland MA, Sachs BC, Cleveland M, Yang M, Rogers S, Hayden KM, Baker LD, Williamson J, Craft S, Hughes TM, Lockhart SN. Vascular and microstructural markers of cognitive pathology. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12332. [PMID: 35814618 PMCID: PMC9257520 DOI: 10.1002/dad2.12332] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/08/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
Introduction Arterial stiffness may play a role in the development of dementia through poorly understood effects on brain microstructural integrity and perfusion. Methods We examined markers of arterial stiffness (carotid-femoral pulse wave velocity [cfPWV]) and elevated systolic blood pressure (SBP) in relation to cognitive function and brain magnetic resonance imaging macrostructure (gray matter [GM] and white matter [WM] volumes), microstructure (diffusion based free water [FW] and fractional anisotropy [FA]), and cerebral blood flow (CBF) in WM and GM in models adjusted for age, race, sex, education, and apolipoprotein E ε4 status. Results Among 460 participants (70 ± 8 years; 44 dementia, 158 mild cognitive impairment, 258 normal cognition), higher cfPWV and SBP were independently associated with higher FW, higher WM hyperintensity volume, and worse cognition (global and executive function). Higher SBP alone was significantly associated with lower WM and GM CBF. Discussion Arterial stiffness is associated with impaired WM microstructure and global and executive cognitive function.
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Affiliation(s)
- Claudia Coffin
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Cynthia K. Suerken
- Department of Biostatistics and Data ScienceDivision of Public Health SciencesWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - James R. Bateman
- Department of NeurologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | | | - Benjamin J. Williams
- Department of NeurologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Mark A. Espeland
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
- Department of Biostatistics and Data ScienceDivision of Public Health SciencesWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Bonnie C. Sachs
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
- Department of NeurologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Maryjo Cleveland
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Mia Yang
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Samantha Rogers
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Kathleen M. Hayden
- Department of Social Sciences and Health PolicyDivision of Public Health SciencesWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Laura D. Baker
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Jeff Williamson
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Suzanne Craft
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Timothy M. Hughes
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Samuel N. Lockhart
- Department of Internal MedicineSection on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
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Stickland RC, Zvolanek KM, Moia S, Caballero-Gaudes C, Bright MG. Lag-Optimized Blood Oxygenation Level Dependent Cerebrovascular Reactivity Estimates Derived From Breathing Task Data Have a Stronger Relationship With Baseline Cerebral Blood Flow. Front Neurosci 2022; 16:910025. [PMID: 35801183 PMCID: PMC9254683 DOI: 10.3389/fnins.2022.910025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebrovascular reactivity (CVR), an important indicator of cerebrovascular health, is commonly studied with the Blood Oxygenation Level Dependent functional MRI (BOLD-fMRI) response to a vasoactive stimulus. Theoretical and empirical evidence suggests that baseline cerebral blood flow (CBF) modulates BOLD signal amplitude and may influence BOLD-CVR estimates. We address how acquisition and modeling choices affect the relationship between baseline cerebral blood flow (bCBF) and BOLD-CVR: whether BOLD-CVR is modeled with the inclusion of a breathing task, and whether BOLD-CVR amplitudes are optimized for hemodynamic lag effects. We assessed between-subject correlations of average GM values and within-subject spatial correlations across cortical regions. Our results suggest that a breathing task addition to a resting-state acquisition, alongside lag-optimization within BOLD-CVR modeling, can improve BOLD-CVR correlations with bCBF, both between- and within-subjects, likely because these CVR estimates are more physiologically accurate. We report positive correlations between bCBF and BOLD-CVR, both between- and within-subjects. The physiological explanation of this positive correlation is unclear; research with larger samples and tightly controlled vasoactive stimuli is needed. Insights into what drives variability in BOLD-CVR measurements and related measurements of cerebrovascular function are particularly relevant when interpreting results in populations with altered vascular and/or metabolic baselines or impaired cerebrovascular reserve.
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Affiliation(s)
- Rachael C. Stickland
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kristina M. Zvolanek
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Stefano Moia
- Basque Center on Cognition, Brain and Language, Donostia, Spain
- University of the Basque Country EHU/UPV, Donostia, Spain
| | | | - Molly G. Bright
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
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42
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Qin S, Basak C. Fitness and arterial stiffness in healthy aging: Modifiable cardiovascular risk factors contribute to altered default mode network patterns during executive function. Neuropsychologia 2022; 172:108269. [PMID: 35595064 DOI: 10.1016/j.neuropsychologia.2022.108269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Abstract
Increases in cardiovascular risks such as high blood pressure and low physical fitness have been independently associated with altered default mode network (DMN) activation patterns in healthy aging. However, cardiovascular risk is a multidimensional health problem. Therefore, we need to investigate multiple cardiovascular risk factors and their contributions to cognition and DMN activations in older adults, which has not yet been done. The current fMRI study examined contributions of two common modifiable cardiovascular risk factors (arterial stiffness and physical fitness) on DMN activations involved during random n-back, a task of executive functioning and working memory, in older adults. The results how that high cardiovascular risk of either increased arterial stiffness or decreased fitness independently contributed to worse task performance and reduced deactivations in two DMN regions: the anterior and posterior cingulate cortices. We then examined not only the potential interaction between the two risk factors, but also their additive (i.e., combined) effect on performance and DMN deactivations. A significant interaction between the two cardiovascular risk factors was observed on performance, with arterial stiffness moderating the relationship between physical fitness and random n-back accuracy. The additive effect of the two factors on task performance was driven by arterial stiffness. Arterial stiffness was also found to be the driving factor when the additive effect of the two risk factors was examined on DMN deactivations. However, in posterior cingulate cortex, a hub region of the DMN, the additive effect on its deactivation was significantly higher than the effect of each risk factor alone. These results suggest that the effects of cardiovascular risks on the aging brain are complicated and multi-dimensional, with arterial stiffness moderating or driving the combined effects on performance and anterior DMN deactivations, but physical fitness contributing additional effect to posterior DMN deactivation during executive functioning.
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Affiliation(s)
- Shuo Qin
- Center for Vital Longevity, University of Texas at Dallas, United States
| | - Chandramallika Basak
- Center for Vital Longevity, University of Texas at Dallas, United States; Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, United States.
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43
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Cerebrovascular function and its association with systemic artery function and stiffness in older adults with and without mild cognitive impairment. Eur J Appl Physiol 2022; 122:1843-1856. [PMID: 35522276 PMCID: PMC9287231 DOI: 10.1007/s00421-022-04956-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/15/2022] [Indexed: 01/23/2023]
Abstract
PURPOSE Our aim was to compare cerebrovascular and systemic vascular function between older adults with and without mild cognitive impairment (MCI), and to determine which measures of vascular function best predict the presence of MCI. METHODS In 41 adults with MCI and 33 adults without MCI (control) we compared middle cerebral artery velocity (MCAv) and cerebrovascular pulsatility index (PI) at rest, cerebrovascular reactivity to CO2, and responsiveness to changes in blood pressure (%∆MCAv/%∆MAP). Systemic vascular function was assessed by flow-mediated dilation (FMD) and stiffness by pulse wave velocity (PWV). RESULTS Cerebrovascular PI was higher in MCI compared with control (mean ± SD: 1.17 ± 0.27 vs. 1.04 ± 0.21), and MCI exhibited a lower %∆MCAv/%∆MAP (1.26 ± 0.44 vs. 1.50 ± 0.55%). Absolute (p = 0.76) and relative cerebrovascular reactivity to CO2 (p = 0.34) was similar between MCI and control. When age was included as a covariate the significant difference in cerebral PI between groups was lost. PWV was higher (13.2 ± 2.2 vs. 11.3 ± 2.5 m s-1) and FMD% (4.41 ± 1.70 vs. 5.43 ± 2.15%) was lower in MCI compared with control. FMD% was positively associated with PI across the cohort. Logistic regression analysis indicated that FMD and PWV significantly discriminated between MCI and controls, independent of age, whereas the inclusion of cerebrovascular measures did not improve the predictive accuracy of the model. CONCLUSION These findings raise the possibility that early changes in systemic vascular stiffness and endothelial function may contribute to altered cerebrovascular haemodynamics and impaired cognitive function, and present potential targets for prevention and treatment strategies in people with MCI.
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Moncion K, Allison EY, Al-Khazraji BK, MacDonald MJ, Roig M, Tang A. What are the effects of acute exercise and exercise training on cerebrovascular hemodynamics following stroke? A systematic review and meta-analysis. J Appl Physiol (1985) 2022; 132:1379-1393. [PMID: 35482325 DOI: 10.1152/japplphysiol.00872.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Limited data exist regarding the effects of acute exercise and exercise training on cerebrovascular hemodynamic variables post-stroke. PURPOSE This systematic review and meta-analysis 1) examined the effects of acute exercise and exercise training on cerebrovascular hemodynamic variables reported in the stroke exercise literature; and 2) synthesized the peak middle cerebral artery blood velocity (MCAv) achieved during an acute bout of moderate-intensity exercise in individuals post-stroke. METHODS Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, AMED) were searched from inception to December 1st 2021, for studies that examined the effect of acute exercise or exercise training on cerebrovascular hemodynamics in adults post-stroke. Two reviewers conducted title and abstract screening, full-text evaluation, data extraction, and quality appraisal. Random effects models were used in meta-analysis. RESULTS Nine studies, including 4 acute exercise (n=61) and 5 exercise training studies (n=193), were included. Meta-analyses were not statistically feasible for several cerebrovascular hemodynamic variables. Descriptive analysis reveals that exercise training may increase cerebral blood flow and cerebrovascular reactivity to carbon dioxide among individuals post-stroke. Meta-analysis of three acute exercise studies revealed no significant changes in MCAv during acute moderate intensity exercise (n=48 participants, mean difference = 5.2 cm/s, 95% CI [-0.6, 11.0], P=0.08) compared to resting MCAv values. CONCLUSION This review suggests that individuals post-stroke may have attenuated cerebrovascular hemodynamics as measured by the MCAv during acute moderate-intensity exercise. Higher quality research utilizing agreed upon hemodynamic variables are needed to synthesize the effects of exercise training on cerebrovascular hemodynamics post-stroke.
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Affiliation(s)
- Kevin Moncion
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Elric Y Allison
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Baraa K Al-Khazraji
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Maureen J MacDonald
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Marc Roig
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Ada Tang
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Olasehinde TA, AKomolafe SF, Oladapo IF, Oyeleye SI. Effect of diet supplemented with African Star Apple Fruit Pulp on purinergic, cholinergic and monoaminergic enzymes, TNF-α expression and redox imbalance in the brain of hypertensive rats. Nutr Neurosci 2022; 26:496-510. [PMID: 35470775 DOI: 10.1080/1028415x.2022.2062925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study examined whether diet supplemented with African star apple fruit pulp (FP) can mitigate the effect of high blood pressure on brain neurochemicals, histopathology and expression of genes linked with neuroinflammation. METHODS Rats were administered with cyclosporine (25 mg/kg.bw) to induce hypertension and were fed with or without FP supplemented diet. Purinergic (Nucleoside triphosphate diphosphohydrolases [NTPdase] and adenosine deaminase [ADA]) cholinergic (acetylcholinesterase [AChE]) and monoaminergic (monoamine oxidase-B) enzymes were assessed in treated and untreated hypertensive rats' brains. Oxidative stress biomarkers (catalase, glutathione-S-transferase, thiols, reactive oxygen species [ROS] and malondialdehyde [MDA]), as well as AChE, tumour necrosis factor and receptor (TNF-α and TNF-α-R) expression, were also determined. RESULTS FP supplemented diet significantly reduced NTPdase and ADA activities and increased Na+/K+-ATPase activities in hypertensive rats' brains compared to the untreated group. Furthermore, FP reduced acetylcholinesterase and monoamine oxidase-B activities compared to the hypertensive group. Redox imbalance was observed in hypertensive rats with inhibition of antioxidant enzymes and high levels of ROS and MDA. However, FP supplemented diet improved antioxidant enzymes, reduced ROS and MDA production in the brain of hypertensive rats. High blood pressure also triggered upregulation of AChE, TNF-α and TNF-α-R while feeding with FP supplemented diet downregulated the genes. CONCLUSION This study demonstrates the neuroprotective role of FP supplemented diet against alterations in neurochemicals associated with Alzheimer's disease, oxidative stress-induced neuronal damage and expression of genes linked with neuroinflammation. Moreover, studies on animal behaviour and human subjects are required to confirm these beneficial effects.
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Affiliation(s)
- Tosin A Olasehinde
- Nutrition and Toxicology Division, Food Technology Department, Federal Institute of Industrial Research, Lagos, Nigeria.,Department of Biochemistry and Microbiology, University of Fort Hare Alice South Africa, Alice, South Africa
| | - Seun F AKomolafe
- Department of Biochemistry, Ekiti State University, Ado-Ekiti, Nigeria
| | - Iyabo F Oladapo
- Department of Basic Medical Science, College of Health Science and Technology, Ijero Ekiti, Nigeria
| | - Sunday I Oyeleye
- Department of Biomedical Technology, Federal University of Technology, Akure, Ondo State.,Functional Food and Nutraceutical Unit, Department of Biochemistry, Federal University of Technology, Akure, Ondo State
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Li C, Zhu Y, Ma Y, Hua R, Zhong B, Xie W. Association of Cumulative Blood Pressure With Cognitive Decline, Dementia, and Mortality. J Am Coll Cardiol 2022; 79:1321-1335. [PMID: 35393012 DOI: 10.1016/j.jacc.2022.01.045] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/23/2021] [Accepted: 01/24/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Elevated blood pressure (BP) has been linked to impaired cognition and dementia in older adults. However, few studies have accounted for long-term cumulative BP exposure. OBJECTIVES The aim of this study was to test whether long-term cumulative BP was independently associated with subsequent cognitive decline, incident dementia, and all-cause mortality among cognitively healthy adults. METHODS This study used data from the HRS (Health and Retirement Study) and ELSA (English Longitudinal Study of Ageing). Cumulative BP was calculated as the area under the curve using measurements from wave 0 (1998-1999) to wave 4 (2008-2009) in ELSA and wave 8 (2006-2007) to wave 10 (2010-2011) in the HRS. Outcomes included cognitive decline, incident dementia, and all-cause mortality. RESULTS A total of 7,566 and 9,294 participants from ELSA and the HRS were included (44.8% and 40.2% men and median age 62.0 years [IQR: 55.0-70.0 years] and 65.0 years [IQR: 58.0-72.0 years], respectively). The median follow-up duration was 8.0 years (IQR: 4.0-8.0 years) and 8.0 years (IQR: 6.0-8.0 years), respectively. Elevated cumulative systolic BP and pulse pressure were independently associated with accelerated cognitive decline (P < 0.001 for both), elevated dementia risk (P < 0.001 for both), and all-cause mortality (P < 0.001 for both), while a significant inverse association was observed for diastolic BP. Strong dose-response relationships were identified, with similar results for the 2 cohorts. CONCLUSIONS Long-term cumulative BP was associated with subsequent cognitive decline, dementia risk, and all-cause mortality in cognitively healthy adults aged ≥50 years. Efforts are required to control long-term systolic BP and pulse pressure and to maintain adequate diastolic BP.
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Affiliation(s)
- Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yidan Zhu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Baoliang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
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Robb WH, Khan OA, Ahmed HA, Li J, Moore EE, Cambronero FE, Pechman KR, Liu D, Gifford KA, Landman BA, Donahue MJ, Hohman TJ, Jefferson AL. Lower cerebral oxygen utilization is associated with Alzheimer's disease-related neurodegeneration and poorer cognitive performance among apolipoprotein E ε4 carriers. J Cereb Blood Flow Metab 2022; 42:642-655. [PMID: 34743630 PMCID: PMC9051148 DOI: 10.1177/0271678x211056393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/05/2021] [Accepted: 09/28/2021] [Indexed: 11/15/2022]
Abstract
Oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) are markers of cerebral oxygen homeostasis and metabolism that may offer insights into abnormal changes in brain aging. The present study cross-sectionally related OEF and CMRO2 to cognitive performance and structural neuroimaging variables among older adults (n = 246, 74 ± 7 years, 37% female) and tested whether apolipoprotein E (APOE)-ε4 status modified these associations. Main effects of OEF and CMRO2 were null (p-values >0.06), and OEF interactions with APOE-ε4 status on cognitive and structural imaging outcomes were null (p-values >0.06). However, CMRO2 interacted with APOE-ε4 status on language (p = 0.002), executive function (p = 0.03), visuospatial (p = 0.005), and episodic memory performances (p = 0.03), and on hippocampal (p = 0.006) and inferior lateral ventricle volumes (p = 0.02). In stratified analyses, lower oxygen metabolism related to worse language (p = 0.02) and episodic memory performance (p = 0.03) among APOE-ε4 carriers only. Associations between CMRO2 and cognitive performance were primarily driven by APOE-ε4 carriers with existing cognitive impairment. Congruence across language and episodic memory results as well as hippocampal and inferior lateral ventricle volume findings suggest that APOE-ε4 may interact with cerebral oxygen metabolism in the pathogenesis of Alzheimer's disease and related neurodegeneration.
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Affiliation(s)
- W Hudson Robb
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Omair A Khan
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
- Department of Biostatistics, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
| | - Humza A Ahmed
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Judy Li
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Elizabeth E Moore
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Francis E Cambronero
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Kimberly R Pechman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
- Department of Biostatistics, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
| | - Bennett A Landman
- Department of Neurology, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
- Department of Biomedical Engineering, Vanderbilt University, Vanderbilt University, Nashville, TN, USA
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt
University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University
Medical Center, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
- Department of Medicine, Vanderbilt University Medical
Center, Vanderbilt University Medical Center, Nashville, TN,
USA
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48
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Moore EE, Khan OA, Shashikumar N, Pechman KR, Liu D, Bell SP, Nair S, Terry JG, Gifford KA, Anderson AW, Landman BA, Blennow K, Zetterberg H, Hohman TJ, Carr JJ, Jefferson AL. Axonal Injury Partially Mediates Associations Between Increased Left Ventricular Mass Index and White Matter Damage. Stroke 2022; 53:808-816. [PMID: 34702069 PMCID: PMC8885768 DOI: 10.1161/strokeaha.121.034349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Left ventricular (LV) mass index is a marker of subclinical LV remodeling that relates to white matter damage in aging, but molecular pathways underlying this association are unknown. This study assessed if LV mass index related to cerebrospinal fluid (CSF) biomarkers of microglial activation (sTREM2 [soluble triggering receptor expressed on myeloid cells 2]), axonal injury (NFL [neurofilament light]), neurodegeneration (total-tau), and amyloid-β, and whether these biomarkers partially accounted for associations between increased LV mass index and white matter damage. We hypothesized higher LV mass index would relate to greater CSF biomarker levels, and these pathologies would partially mediate associations with cerebral white matter microstructure. METHODS Vanderbilt Memory and Aging Project participants who underwent cardiac magnetic resonance, lumbar puncture, and diffusion tensor imaging (n=142, 72±6 years, 37% mild cognitive impairment [MCI], 32% APOE-ε4 positive, LV mass index 51.4±8.1 g/m2, NFL 1070±588 pg/mL) were included. Linear regressions and voxel-wise analyses related LV mass index to each biomarker and diffusion tensor imaging metrics, respectively. Follow-up models assessed interactions with MCI and APOE-ε4. In models where LV mass index significantly related to a biomarker and white matter microstructure, we assessed if the biomarker mediated white matter associations. RESULTS Among all participants, LV mass index was unrelated to CSF biomarkers (P>0.33). LV mass index interacted with MCI (P=0.01), such that higher LV mass index related to increased NFL among MCI participants. Associations were also present among APOE-ε4 carriers (P=0.02). NFL partially mediated up to 13% of the effect of increased LV mass index on white matter damage. CONCLUSIONS Subclinical cardiovascular remodeling, measured as an increase in LV mass index, is associated with neuroaxonal degeneration among individuals with MCI and APOE-ε4. Neuroaxonal degeneration partially reflects associations between higher LV mass index and white matter damage. Findings highlight neuroaxonal degeneration, rather than amyloidosis or microglia, may be more relevant in pathways between structural cardiovascular remodeling and white matter damage.
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Affiliation(s)
- Elizabeth E. Moore
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omair A. Khan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niranjana Shashikumar
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kimberly R. Pechman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan P. Bell
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sangeeta Nair
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G. Terry
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam W. Anderson
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Bennett A. Landman
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA,Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden,Clinical Neurochemistry Lab, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden,Clinical Neurochemistry Lab, Sahlgrenska University Hospital, Mölndal, Sweden,Department of Neurodegenerative Disease, University of College London Institute of Neurology, Queen Square, London, UK,United Kingdom Dementia Research Institute at University College London, London, UK
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John Jeffrey Carr
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA,Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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49
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van Tuijl RJ, Ruigrok YM, Geurts LJ, van der Schaaf IC, Biessels GJ, Rinkel GJE, Velthuis BK, Zwanenburg JJM. Does the Internal Carotid Artery Attenuate Blood-Flow Pulsatility in Small Vessel Disease? A 7 T 4D-Flow MRI Study. J Magn Reson Imaging 2022; 56:527-535. [PMID: 34997655 PMCID: PMC9546379 DOI: 10.1002/jmri.28062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background Increased cerebral blood‐flow pulsatility is associated with cerebral small vessel disease (cSVD). Reduced pulsatility attenuation over the internal carotid artery (ICA) could be a contributing factor to the development of cSVD and could be associated with intracranial ICA calcification (iICAC). Purpose To compare pulsatility, pulsatility attenuation, and distensibility along the ICA between patients with cSVD and controls and to assess the association between iICAC and pulsatility and distensibility. Study Type Retrospective, explorative cross‐sectional study. Subjects A total of 17 patients with cSVD, manifested as lacunar infarcts or deep intracerebral hemorrhage, and 17 age‐ and sex‐matched controls. Field Strength/Sequence Three‐dimensional (3D) T1‐weighted gradient echo imaging and 4D phase‐contrast (PC) MRI with a 3D time‐resolved velocity encoded gradient echo sequence at 7 T. Assessment Blood‐flow velocity pulsatility index (vPI) and arterial distensibility were calculated for seven ICA segments (C1–C7). iICAC presence and volume were determined from available brain CT scans (acquired as part of standard clinical care) in patients with cSVD. Statistical Tests Independent t‐tests and linear mixed models. The threshold for statistically significance was P < 0.05 (two tailed). Results The cSVD group showed significantly higher ICA vPI and significantly lower distensibility compared to controls. Controls showed significant attenuation of vPI over the carotid siphon (−4.9% ± 3.6%). In contrast, patients with cSVD showed no attenuation, but a significant increase of vPI (+6.5% ± 3.1%). iICAC presence and volume correlated positively with vPI (r = 0.578) in patients with cSVD and negatively with distensibility (r = −0.386). Conclusion Decreased distensibility and reduced pulsatility attenuation are associated with increased iICAC and may contribute to cSVD. Confirmation in a larger prospective study is required. Evidence Level 2 Technical Efficacy Stage 2
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Affiliation(s)
- Rick J van Tuijl
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Ynte M Ruigrok
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Lennart J Geurts
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Irene C van der Schaaf
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Gabriël J E Rinkel
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
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50
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Cardim D, Czosnyka M, Chandrapatham K, Badenes R, Bertuccio A, Corradi F, Donnelly J, Pelosi P, Hutchinson PJ, Robba C. Arterial and Venous Cerebral Blood Flow Velocities and Their Correlation in Healthy Volunteers and Traumatic Brain Injury Patients. J Neurosurg Anesthesiol 2022; 34:e24-e33. [PMID: 32555064 DOI: 10.1097/ana.0000000000000704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/13/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Few studies have explored the cerebral venous compartment or the correlation between venous and arterial cerebral blood flows. We aimed to correlate cerebral blood flow velocities in the arterial (middle cerebral artery) and venous (straight sinus) compartments in healthy volunteers and traumatic brain injury (TBI) patients. In addition, we determined the normative range of these parameters. MATERIALS AND METHODS A total of 122 healthy volunteers and 95 severe TBI patients of both sexes were included and stratified into 3 age groups as follows: group 1 (aged, 18 to 44 y); group 2 (aged, 45 to 64 y); group 3 (older than 65 y). Transcranial Doppler systolic cerebral blood flow velocity, diastolic cerebral blood flow velocity, and mean cerebral blood flow velocity (FVs, FVd, FVm, respectively) were measured in the middle cerebral artery and peak cerebral venous blood flow velocity (FVVs) was measured in the straight sinus. The arteriovenous correlation was assessed on the basis of a positive relationship between FVs and FVVs. RESULTS There was an arteriovenous correlation (FVs vs. FVVs) in healthy volunteers (R=0.39, P<0.0001). We found no arteriovenous correlation in the TBI cohort overall, but FVs and FVVs were correlated in age group 1 (R=0.28, P=0.05) and in males (R=0.29, P=0.01). In healthy volunteers, FVs and FVm were significantly higher in males compared with females; and FVs, FVm, FVd, FVVs all increased across the age spectrum. There were no significant differences in any of these parameters in TBI patients. CONCLUSIONS There are age and sex differences in arterial and venous cerebral blood flow velocities in healthy volunteers. Arteriovenous correlation is present in healthy volunteers but absent in TBI patients.
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Affiliation(s)
- Danilo Cardim
- Brain Physics Laboratory
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX
| | - Marek Czosnyka
- Brain Physics Laboratory
- Institute of Electronic Systems, Warsaw University of Technology, Poland
| | | | - Rafael Badenes
- University of Valencia Hospital Clinic, Anesthesiology and Surgical-trauma Intensive Care, Valencia, Spain
| | | | | | - Joseph Donnelly
- Brain Physics Laboratory
- Department of Anesthesiology, University of Auckland, Auckland, New Zealand
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics
- Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology, University of Genoa, Genoa
| | - Peter J Hutchinson
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, UK
| | - Chiara Robba
- Brain Physics Laboratory
- Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology, University of Genoa, Genoa
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