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Jalanko P, Bond B, Laukkanen JA, Brage S, Ekelund U, Laitinen T, Määttä S, Kähönen M, Haapala EA, Lakka TA. Association between arterial health and cognition in adolescents: The PANIC study. Physiol Rep 2024; 12:e16024. [PMID: 38697946 PMCID: PMC11065692 DOI: 10.14814/phy2.16024] [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: 12/13/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.
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Affiliation(s)
- Petri Jalanko
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Helsinki Clinic for Sports and Exercise MedicineFoundation for Sports and Exercise MedicineHelsinkiFinland
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental SciencesUniversity of ExeterExeterUK
| | - Jari A. Laukkanen
- Department of Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Department of MedicineCentral Finland Health Care District Hospital DistrictJyväskyläFinland
| | - Soren Brage
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ulf Ekelund
- Department of Sports MedicineNorwegian School of Sport SciencesOsloNorway
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Sara Määttä
- Department of Clinical NeurophysiologyKuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical PhysiologyTampere University Hospital and Faculty of Medicine and Health Technology, Tampere UniversityTampereFinland
| | - Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Timo A. Lakka
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
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2
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Mi J, Liu C, Chen H, Qian Y, Zhu J, Zhang Y, Liang Y, Wang L, Ta D. Light on Alzheimer's disease: from basic insights to preclinical studies. Front Aging Neurosci 2024; 16:1363458. [PMID: 38566826 PMCID: PMC10986738 DOI: 10.3389/fnagi.2024.1363458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Alzheimer's disease (AD), referring to a gradual deterioration in cognitive function, including memory loss and impaired thinking skills, has emerged as a substantial worldwide challenge with profound social and economic implications. As the prevalence of AD continues to rise and the population ages, there is an imperative demand for innovative imaging techniques to help improve our understanding of these complex conditions. Photoacoustic (PA) imaging forms a hybrid imaging modality by integrating the high-contrast of optical imaging and deep-penetration of ultrasound imaging. PA imaging enables the visualization and characterization of tissue structures and multifunctional information at high resolution and, has demonstrated promising preliminary results in the study and diagnosis of AD. This review endeavors to offer a thorough overview of the current applications and potential of PA imaging on AD diagnosis and treatment. Firstly, the structural, functional, molecular parameter changes associated with AD-related brain imaging captured by PA imaging will be summarized, shaping the diagnostic standpoint of this review. Then, the therapeutic methods aimed at AD is discussed further. Lastly, the potential solutions and clinical applications to expand the extent of PA imaging into deeper AD scenarios is proposed. While certain aspects might not be fully covered, this mini-review provides valuable insights into AD diagnosis and treatment through the utilization of innovative tissue photothermal effects. We hope that it will spark further exploration in this field, fostering improved and earlier theranostics for AD.
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Affiliation(s)
- Jie Mi
- Yiwu Research Institute, Fudan University, Yiwu, China
| | - Chao Liu
- Yiwu Research Institute, Fudan University, Yiwu, China
- Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
| | - Honglei Chen
- Yiwu Research Institute, Fudan University, Yiwu, China
| | - Yan Qian
- Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention, Shanghai, China
| | - Jingyi Zhu
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yachao Zhang
- Medical Ultrasound Department, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Yizhi Liang
- Guangdong Provincial Key Laboratory of Optical Fiber Sensing and Communications, Institute of Photonics Technology, Jinan University, Guangzhou, China
| | - Lidai Wang
- Department of Biomedical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Dean Ta
- Yiwu Research Institute, Fudan University, Yiwu, China
- Department of Electronic Engineering, Fudan University, Shanghai, China
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3
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Defina S, Silva CCV, Cecil CAM, Tiemeier H, Felix JF, Mutzel RL, Jaddoe VWV. Associations of Arterial Thickness, Stiffness, and Blood Pressure With Brain Morphology in Early Adolescence: A Prospective Population-Based Study. Hypertension 2024; 81:162-171. [PMID: 37942629 DOI: 10.1161/hypertensionaha.123.21672] [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: 06/17/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Arterial wall thickness and stiffness, and high blood pressure have been repeatedly associated with poorer brain health. However, previous studies largely focused on mid- or late-life stages. It is unknown whether any arterial health-related brain changes may be observable already in adolescence. METHODS We examined whether (1) carotid intima-media thickness, (2) carotid distensibility, and (3) systolic blood pressure and diastolic blood pressure, measured at the age of 10 years, were associated with brain volumes and white matter microstructure (ie, fractional anisotropy and mean diffusivity) at the age of 14 years. In addition to cross-sectional analyses, we explored associations with longitudinal change in each brain outcome from 10 to 14 years. Analyses were based on 5341 children from the Generation R Study. RESULTS Higher diastolic blood pressure was associated with lower total brain volume (β, -0.04 [95% CI, -0.07 to -0.01]) and gray matter volume (β, -0.04 [95% CI, -0.07 to -0.01]) at the age of 14 years, with stronger associations in higher diastolic blood pressure ranges. Similar associations emerged between systolic blood pressure and brain volumes, but these were no longer significant after adjusting for birth weight. No associations were observed between blood pressure and white matter microstructure or between carotid intima-media thickness or distensibility and brain morphology. CONCLUSIONS Arterial blood pressure, but not intima-media thickness and distensibility, is associated with structural neuroimaging markers in early adolescence. Volumetric measures may be more sensitive to these early arterial health differences compared with microstructural properties of the white matter, but further studies are needed to confirm these results and assess potential causal mechanisms.
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Affiliation(s)
- Serena Defina
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolina C V Silva
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology (C.A.M.C., H.T.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands (C.A.M.C.)
| | - Henning Tiemeier
- Department of Epidemiology (C.A.M.C., H.T.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA (H.T.)
| | - Janine F Felix
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ryan L Mutzel
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Department Nuclear Medicine (R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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4
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De Anda-Duran I, Alonso CF, Libon DJ, Carmichael OT, Kolachalama VB, Suglia SF, Au R, Bazzano LA. Carotid Intima-media Thickness and Midlife Cognitive Function: Impact of Race and Social Disparities in the Bogalusa Heart Study. Neurology 2022; 98:e1828-e1836. [PMID: 35228334 PMCID: PMC9109147 DOI: 10.1212/wnl.0000000000200155] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Carotid intima-media thickness (c-IMT) is a measurement of atherosclerosis, a progressive disease that develops as early as childhood and has been linked with cognitive impairment and dementia in the elderly. However, the relationship between c-IMT and midlife cognitive function as well as race and social disparities on this relationship remains unclear. We examined the association between c-IMT and cognitive function in midlife among Black and White participants from a semi-rural community-based cohort in Bogalusa, Louisiana. METHODS In this cross-sectional analysis of participants from the Bogalusa Heart Study, linear regression models were used to determine the association between c-IMT dichotomized above the 50th percentile (> 0.87mm), an a demographically standardized global cognitive (GCS) and individual cognitive domain-based z-scores. Stratified analyses were performed to evaluate the impact of race and the individual's education status. RESULTS A total of 1,217 participants (age 48 ± 5.28 years) were included, 66% (804) self-identified as White and 34% (413) as Black. Of those, 58% (708) were women, and 42% (509) were men Having a c-IMT > 50th percentile was inversely associated with GCS ([B ± SE]: -0.39 ± 0.18, P=0.03), independent of cardiovascular risk factors (CVRFs) and achieved education. The effect remained significant in Black and White participants after adjustment for CVRFs (Blacks: [B ± SE]: -1.25 ± 0.45, P=0.005; Whites: [B ± SE]: -0.92 ± 0.35, P=0.008), but not for education. The interaction between c-IMT >50th percentile and education was significant (P=0.03), and stratified analysis showed an association with GCS among those with lower achieved education ([B ± SE]: -0.81 ± 0.33, P=0.013) independent of major CVRFs. DISCUSSION Subclinical atherosclerosis, measured as c-IMT, was associated with worse midlife cognitive function, independent of major CVRFs. The association was buffered by education and may be stronger among Black than White participants, likely due to corresponding structural and social determinants. These findings underscore the importance of establishing preventive measures in midlife and suggest subclinical atherosclerosis as a potential target to prevent cognitive decline.
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Affiliation(s)
- Ileana De Anda-Duran
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - David J Libon
- Department of Psychology, Rowan University, Glassboro, NJ, USA.,New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Glassboro, NJ, USA
| | - Owen T Carmichael
- Louisiana State University's Pennington Biomedical Research Centre, Baton Rouge, LA, USA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Computer Science and Faculty of Computing and Data Sciences , Boston University, Boston, MA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA, and Boston University Alzheimer's Disease Center, Boston, MA, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.,Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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5
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Álvarez-Bueno C, Cavero-Redondo I, Bruno RM, Saz-Lara A, Sequí-Dominguez I, Notario-Pacheco B, Martinez-Vizcaino V. Intima Media Thickness and Cognitive Function Among Adults: Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2022; 11:e021760. [PMID: 35179392 PMCID: PMC9075078 DOI: 10.1161/jaha.121.021760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.
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Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Universidad Politécnica y Artística del Paraguay Asunción Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Rehabilitation in Health Research Center (CIRES)Universidad de las Americas Santiago Chile
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa Italy.,INSERM U970 and Université de Paris Paris France
| | - Alicia Saz-Lara
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain
| | | | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
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6
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Liu H, Yang S, He W, Liu X, Sun S, Wang S, Wang Y, Zhou X, Tang T, Xia J, Liu Y, Huang Q. Associations Among Diffusion Tensor Image Along the Perivascular Space (DTI-ALPS), Enlarged Perivascular Space (ePVS), and Cognitive Functions in Asymptomatic Patients With Carotid Plaque. Front Neurol 2022; 12:789918. [PMID: 35082748 PMCID: PMC8785797 DOI: 10.3389/fneur.2021.789918] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/17/2021] [Indexed: 12/15/2022] Open
Abstract
Background and Aim: Carotid atherosclerosis (CAS) is a common pathogenesis of cerebrovascular disease closely related to stroke and silent cerebrovascular disease (SCD), while the insufficient brain perfusion mechanism cannot quite explain the mechanism. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate the glymphatic system activity and correlated DTI-ALPS with enlarged perivascular spaces (ePVS), carotid intima-media thickening (CIMT), mini-mental state examination (MMSE), and serological indicator in individuals with carotid plaque. Methods: Routine MRI and diffusion tensor images scan of the brain, carotid ultrasound, and blood examination were conducted on 74 individuals (52 carotid plaque subjects, 22 non-carotid plaque subjects), whose demographic and clinical characteristics were also recorded. DTI-ALPS index between patients with carotid plaque and normal controls were acquired and the correlations with other variables were analyzed. Results: The values of ALPS-index in the carotid plaque group was significantly lower compared to normal controls (2.12 ± 0.39, 1.95 ± 0.28, respectively, p = 0.034). The ALPS-index was negatively correlated with the basal ganglia (BG)-ePVS score (r = -0.242, p = 0.038) while there was no significant difference in the centrum semiovale (CSO)-ePVS score. Further analysis showed that there are more high-grade ePVS in the BG compared to the carotid plaque group than in the non-carotid plaque group (84.6% vs. 40.9%, p = 0.001). Conclusions: ALPS-index reflects the glymphatic system of the brain, which is associated with early high-risk cerebrovascular diseases. There may be damage in the function of the glymphatic system which induces the expansion of the perivascular space (PVS) in the BG in individuals with carotid plaque.
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Affiliation(s)
- Hui Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Shuai Yang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Wei He
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Emergency, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaojuan Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Shanyi Sun
- Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Song Wang
- Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Yang Wang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoliang Zhou
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Tang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Integrated Traditional and Western, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Xia
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yunhai Liu
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Qing Huang
- Hunan Clinical Research Center for Cerebrovascular Disease, Xiangya Hospital, Central South University, Changsha, China.,Department of Neurology, Stroke Center, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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7
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Fresnais D, Humble MB, Bejerot S, Meehan A, Fure B. The Association between Carotid Intima-Media Thickness and Cognitive Impairment: A Systematic Review and Meta-Analysis. Dement Geriatr Cogn Disord 2021; 50:305-317. [PMID: 34808621 DOI: 10.1159/000518295] [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: 06/13/2021] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that cognitive impairment (CI) and different etiologies of dementia, including Alzheimer's disease (AD), are associated with vascular risk factors and atherosclerosis. In clinical practice, carotid intima-media thickness (CIMT) measured by ultrasonography may be a marker of atherosclerosis. Many studies report increased CIMT in patients with dementia and CI although a firm association has not yet been established. AIM This systematic review and meta-analysis were conducted to study the relationship between CIMT, dementia, and CI. METHODS The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included the following databases: Medline, Embase, Cochrane Library, and Epistemonikos. The search spanned from 2000 to 2020 and was limited to English and Scandinavian languages. RESULTS The main analysis of CIMT in subjects with CI compared to subjects with no cognitive impairment (NCI) included 12 studies; 1,089 subjects with CI and 5,223 with NCI. There was no significant difference in CIMT between the CI and NCI groups. However, subgroup analyses revealed significantly higher CIMT in the mild cognitive impairment (MCI) and dementia groups than the NCI group. In addition, patients with dementia had increased CIMT compared to patients with MCI, and patients with AD demonstrated higher CIMT than those with vascular cognitive impairment (VCI). CONCLUSION CIMT may be higher in subjects with CI than in cognitively healthy subjects although no significant difference was observed in our main analysis. CIMT was higher in the dementia group than the MCI group and in the AD group compared to the VCI group.
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Affiliation(s)
- David Fresnais
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Internal Medicine, Central Hospital Karlstad, Karlstad, Sweden
| | - Mats B Humble
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Susanne Bejerot
- School of Medical Sciences, Örebro University, Örebro, Sweden.,University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Adrian Meehan
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Brynjar Fure
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Internal Medicine, Central Hospital Karlstad, Karlstad, Sweden
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8
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Effect of age stratification on the association between carotid intima-media thickness and cognitive impairment in Chinese hypertensive patients: new insight from the secondary analysis of the China Stroke Primary Prevention Trial (CSPPT). Hypertens Res 2021; 44:1505-1514. [PMID: 34493836 DOI: 10.1038/s41440-021-00743-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
The current study aimed to explore the association between carotid intima-media thickness (CIMT) and cognitive function assessed by the Mini-Mental State Examination (MMSE) and to examine possible effect modifiers in hypertensive patients. A total of 14,322 hypertensive participants (mean age 64.2 ± 7.4 years; 40.9% male) from the China Stroke Primary Prevention Trial (CSPPT) were included in the final analysis. CIMT was measured by ultrasound, and data were collected at the last follow-up visit; MMSE was used to evaluate cognitive function. Nonparametric smoothing plots, multivariate linear regression analysis, subgroup analyses and interaction testing were performed to examine the relationship between the CIMI and cognitive function and effect modification. The mean CIMT was 0.74 ± 0.11 mm, and the mean MMSE score was 23.5 ± 4.8. There was a significant interaction (P interaction < 0.05) in both male and female populations stratified by age (<60 vs. ≥60 years), and higher CIMT was significantly associated with decreased MMSE scores only in participants aged ≥60 years (male: β = -2.29, 95% CI -3.23 to -1.36; female: β = -1.96, 95% CI -2.97 to -0.95). Males with abnormal HDL-C showed a stronger negative association (β = -3.16, 95% CI -4.85 to -1.47) than those with normal HDL-C (normal vs. abnormal, P for interaction = 0.004). We observed that increased CIMT was significantly associated with cognitive impairment in the hypertensive population, especially among individuals with an age greater than 60 years and HDL-C deficiency. Overall, upon diagnosis of hypertension, treatment should start at the earliest opportunity to prevent end-organ damage and cognitive decline.
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9
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Zeki Al Hazzouri A, Vittinghoff E, Hoang T, Golden SH, Fitzpatrick AL, Zhang A, Grasset L, Yaffe K. Body mass index in early adulthood and dementia in late life: Findings from a pooled cohort. Alzheimers Dement 2021; 17:1798-1807. [PMID: 33984188 PMCID: PMC8809510 DOI: 10.1002/alz.12367] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To examine the independent association of body mass index (BMI) in early adulthood with dementia incidence among men and women. METHODS We studied 5104 older adults from the Cardiovascular Health Study (CHS) and the Health, Aging, and Body Composition (Health ABC) study. We imputed early adulthood and midlife BMI using a pooled parent cohort with complete adult lifespan coverage and previously established methods. Dementia was ascertained using criteria such as neuropsychological test battery, medical records, and dementia-related drug use. Pooled logistic regression (PLR) models were used. RESULTS Compared to women with normal BMI in early adulthood, the odds of dementia were higher among both overweight (odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.31 to 2.54) and obese (OR = 2.45; 95% CI = 1.47 to 4.06) women, independent of mid- and late-life BMI. Similar relationship was observed in men. CONCLUSIONS With the growing obesity epidemic among US adults, efforts aimed at reducing dementia may need to begin obesity prevention and treatment early in the life course.
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Affiliation(s)
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California San Francisco, CA
| | - Tina Hoang
- Departments of Psychiatry, University of California San Francisco, CA
| | - Sherita H. Golden
- Department of Medicine Johns Hopkins University School of Medicine and Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Annette L. Fitzpatrick
- Departments of Family Medicine, Epidemiology, and Global Health, School of Public Health, University of Washington, WA
| | - Adina Zhang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY
| | - Leslie Grasset
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, F-33000 Bordeaux, France; Inserm, CIC1401-EC, F-33000 Bordeaux, France
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco, CA
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10
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Ihle-Hansen H, Ihle-Hansen H, Sandset EC, Hagberg G. Subclinical Carotid Artery Atherosclerosis and Cognitive Function: A Mini-Review. Front Neurol 2021; 12:705043. [PMID: 34393982 PMCID: PMC8355501 DOI: 10.3389/fneur.2021.705043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
Carotid artery atherosclerosis, the result of a multitude of vascular risk factors, is a promising marker for use in risk stratification. Recent evidence suggests that carotid artery atherosclerosis affects cognitive function and is an independent risk factor for the development of cognitive impairment. Both atherosclerosis and cognitive impairment develop over a prolonged period (years), and due to the aging population, markers to identify persons at risk are needed. Carotid artery atherosclerosis can easily be visualized using non-invasive ultrasound, potentially enabling early and intensified risk factor management to preserve cognitive function or delay further decline. However, the burden of atherosclerosis and temporal exposure required to pose a risk of cognitive impairment is unclear. This mini-review aims to explore the available evidence on the association between carotid atherosclerosis and cognition, and furthermore identify the remaining gaps in knowledge.
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Affiliation(s)
- Håkon Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Ihle-Hansen
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
| | | | - Guri Hagberg
- Department of Medicine, Bærum Hospital- Vestre Viken Hospital Trust, Drammen, Norway.,Oslo Stroke Unit, Department of Neurology, Oslo University Hospital, Ullevål, Norway
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11
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Andersen SL, Sweigart B, Glynn NW, Wojczynski MK, Thyagarajan B, Mengel-From J, Thielke S, Perls TT, Libon DJ, Au R, Cosentino S, Sebastiani P. Digital Technology Differentiates Graphomotor and Information Processing Speed Patterns of Behavior. J Alzheimers Dis 2021; 82:17-32. [PMID: 34219735 DOI: 10.3233/jad-201119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Coupling digital technology with traditional neuropsychological test performance allows collection of high-precision metrics that can clarify and/or define underlying constructs related to brain and cognition. OBJECTIVE To identify graphomotor and information processing trajectories using a digitally administered version of the Digit Symbol Substitution Test (DSST). METHODS A subset of Long Life Family Study participants (n = 1,594) completed the DSST. Total time to draw each symbol was divided into 'writing' and non-writing or 'thinking' time. Bayesian clustering grouped participants by change in median time over intervals of eight consecutively drawn symbols across the 90 s test. Clusters were characterized based on sociodemographic characteristics, health and physical function data, APOE genotype, and neuropsychological test scores. RESULTS Clustering revealed four 'thinking' time trajectories, with two clusters showing significant changes within the test. Participants in these clusters obtained lower episodic memory scores but were similar in other health and functional characteristics. Clustering of 'writing' time also revealed four performance trajectories where one cluster of participants showed progressively slower writing time. These participants had weaker grip strength, slower gait speed, and greater perceived physical fatigability, but no differences in cognitive test scores. CONCLUSION Digital data identified previously unrecognized patterns of 'writing' and 'thinking' time that cannot be detected without digital technology. These patterns of performance were differentially associated with measures of cognitive and physical function and may constitute specific neurocognitive biomarkers signaling the presence of subtle to mild dysfunction. Such information could inform the selection and timing of in-depth neuropsychological assessments and help target interventions.
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Affiliation(s)
- Stacy L Andersen
- Geriatrics Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Benjamin Sweigart
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary K Wojczynski
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Jonas Mengel-From
- Institute of Public Health, Epidemiology, Biostatistics and Biodemography Unit, University of Southern Denmark, Odense, Denmark
| | - Stephen Thielke
- Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, Seattle, WA, USA
| | - Thomas T Perls
- Geriatrics Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - David J Libon
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology and Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of the Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Paola Sebastiani
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
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12
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Lin HF, Huang LC, Chen CK, Juo SHH, Chen CS. Carotid atherosclerosis among middle-aged individuals predicts cognition: A 10-year follow-up study. Atherosclerosis 2020; 314:27-32. [PMID: 33129083 DOI: 10.1016/j.atherosclerosis.2020.10.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS There is a lack of studies simultaneously evaluating the impact of structural and functional atherosclerosis on cognition. We investigated the long-term predictive and interaction effects of structural and functional carotid atherosclerosis markers on future cognitive decline. METHODS Five hundred and twenty-eight middle-aged participants enrolled in the carotid atherosclerosis examination in Kaohsiung Atherosclerosis Longitudinal Study (KALS) between 2006 and 2009 were tested for cognition between 2016 and 2019. The Montreal Cognitive Assessment (MoCA) was used for the cognitive test. Baseline structural atherosclerosis was assessed by carotid intima-media thickness (cIMT) and plaque, whereas functional atherosclerosis was evaluated by carotid stiffness (β, Ep, and pulse wave velocity). Participants in the top quartile of cIMT and those with plaques were considered to have advanced structural atherosclerosis, whereas participants with all three stiffness parameters in the top quartile were defined to have advanced functional atherosclerosis. RESULTS The mean participant age at baseline was 53.88 ± 8.37 years. Each case of advanced structural atherosclerosis and advanced functional atherosclerosis was associated with low 10-year MoCA scores with p < 0.001 and p = 0.03, respectively. An interaction effect was observed between structural and functional atherosclerosis on the MoCA score 10 years later (p = 0.02). Participants with both advanced structural and functional markers showed a marked impact on future cognitive function, especially executive and language domains. CONCLUSION Carotid atherosclerosis in middle-aged individuals can predict their cognitive function in 10 years. Integrated information regarding both arterial wall and stiffness could help improve the predictive power for cognitive decline.
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Affiliation(s)
- Hsiu-Fen Lin
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Chun-Kai Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Suh-Hang H Juo
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Institute of New Drug Development, China Medical University, Taichung, Taiwan.
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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13
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Zlokovic BV, Gottesman RF, Bernstein KE, Seshadri S, McKee A, Snyder H, Greenberg SM, Yaffe K, Schaffer CB, Yuan C, Hughes TM, Daemen MJ, Williamson JD, González HM, Schneider J, Wellington CL, Katusic ZS, Stoeckel L, Koenig JI, Corriveau RA, Fine L, Galis ZS, Reis J, Wright JD, Chen J. Vascular contributions to cognitive impairment and dementia (VCID): A report from the 2018 National Heart, Lung, and Blood Institute and National Institute of Neurological Disorders and Stroke Workshop. Alzheimers Dement 2020; 16:1714-1733. [PMID: 33030307 DOI: 10.1002/alz.12157] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022]
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) are characterized by the aging neurovascular unit being confronted with and failing to cope with biological insults due to systemic and cerebral vascular disease, proteinopathy including Alzheimer's biology, metabolic disease, or immune response, resulting in cognitive decline. This report summarizes the discussion and recommendations from a working group convened by the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke to evaluate the state of the field in VCID research, identify research priorities, and foster collaborations. As discussed in this report, advances in understanding the biological mechanisms of VCID across the wide spectrum of pathologies, chronic systemic comorbidities, and other risk factors may lead to potential prevention and new treatment strategies to decrease the burden of dementia. Better understanding of the social determinants of health that affect risks for both vascular disease and VCID could provide insight into strategies to reduce racial and ethnic disparities in VCID.
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Affiliation(s)
| | | | | | - Sudha Seshadri
- University of Texas Health Science Center, San Antonio and Boston University, San Antonio, Texas, USA
| | - Ann McKee
- VA Boston Healthcare System and Boston University, Boston, Massachusetts, USA
| | | | - Steven M Greenberg
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kristine Yaffe
- University of California, San Francisco, San Francisco, California, USA
| | | | - Chun Yuan
- University of Washington, Seattle, Washington, USA
| | - Timothy M Hughes
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mat J Daemen
- Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | | | | | | | - Luke Stoeckel
- National Institute on Aging, Bethesda, Maryland, USA
| | - James I Koenig
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Roderick A Corriveau
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Lawrence Fine
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Zorina S Galis
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Jared Reis
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | | | - Jue Chen
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
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14
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Cermakova P, Ding J, Meirelles O, Reis J, Religa D, Schreiner PJ, Jacobs DR, Bryan RN, Launer LJ. Carotid Intima-Media Thickness and Markers of Brain Health in a Biracial Middle-Aged Cohort: CARDIA Brain MRI Sub-study. J Gerontol A Biol Sci Med Sci 2020; 75:380-386. [PMID: 30796828 DOI: 10.1093/gerona/glz039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We investigated whether carotid intima-media thickness is associated with measures of cerebral blood flow (CBF), white matter hyperintensities, and brain volume in a biracial cohort of middle-aged individuals. METHODS We performed a cross-sectional cohort study based on data from a multicenter, population-based study Coronary Artery Risk Development in Young Adults. Using linear and logistic regression, we estimated the association of the composite intima-media thickness measured in three segments of carotid arteries (common carotid artery, carotid artery bulb, and internal carotid artery) with volume (cm3) and CBF (mL/100 g/min) in the total brain and gray matter as well as volume of white matter hyperintensities (cm3). RESULTS In the analysis, 461 participants (54% women, 34% African Americans) were included. Greater intima-media thickness was associated with lower CBF in gray matter (β=-1.36; p = .04) and total brain (β=-1.26; p = .04), adjusting for age, sex, race, education, and total brain volume. The associations became statistically nonsignificant after further controlling for cardiovascular risk factors. Intima-media thickness was not associated with volumes of total brain, gray matter, and white matter hyperintensities. CONCLUSIONS This study suggests that lower CBF in middle age is associated with markers of atherosclerosis in the carotid arteries. This association may reflect early long-term exposure to traditional cardiovascular risk factors. Early intervention on atherosclerotic risk factors may modulate the trajectory of CBF as people age and develop brain pathology.
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Affiliation(s)
- Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic.,Third Faculty of Medicine, Charles University Prague, Czech Republic
| | - Jie Ding
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
| | - Osorio Meirelles
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
| | - Jared Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Dorota Religa
- Theme Aging, Karolinska University Hospital, Huddinge, Sweden.,Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Philadelphia
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Philadelphia
| | - R Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
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15
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Maki PM, Thurston RC. Menopause and Brain Health: Hormonal Changes Are Only Part of the Story. Front Neurol 2020; 11:562275. [PMID: 33071945 PMCID: PMC7538803 DOI: 10.3389/fneur.2020.562275] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/17/2020] [Indexed: 01/12/2023] Open
Abstract
Most studies of menopause and brain aging have focused on the role of the sex steroid hormone, estradiol, as a key mechanisms contributing to cognitive and brain aging in women. An emerging literature demonstrates that beyond endogenous estradiol levels, menopausal symptoms, particularly vasomotor symptoms (VMS), are also key determinants of menopause-related changes in cognition and brain function. Critically, that literature shows the importance of using objective techniques to identify associations of VMS with memory performance, brain structure, and brain function. While self-report measures are important patient-centered outcomes in women's health research, objective measures of VMS typically relate more strongly to indices of cognitive and brain health. Currently, it is premature to make a causal claim about VMS and memory dysfunction, but initial findings raise the possibility that women with VMS might experience an improvement in cognition with VMS treatment. More generally, these findings underscore the utility of investigating female-specific risk factors for cognitive decline.
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Affiliation(s)
- Pauline M Maki
- Women's Mental Health Research Program, Department of Psychiatry, Psychology and Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, United States
| | - Rebecca C Thurston
- Women's Biobehavioral Health Laboratory, Department of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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16
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Zheng K, Qian Y, Lin T, Han F, You H, Tao X, Hou B, Yuan J, Wang H, Zhang D, Lv K, Feng F, Zhu Y, Li X. Carotid intima-media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease. Ther Adv Chronic Dis 2020; 11:2040622320953352. [PMID: 32944208 PMCID: PMC7466901 DOI: 10.1177/2040622320953352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/06/2020] [Indexed: 01/27/2023] Open
Abstract
Background: Carotid intima–media thickness (cIMT) is considered a risk factor for and predictor of cerebrovascular disease. In this study, we explored the contribution of cIMT to cognitive impairment (CI) in dialysis patients and the role of cerebral small vascular disease (CSVD) and brain atrophy in this process. Methods: Cognitive function was assessed using a comprehensive cognitive test battery. CSVD and brain volume were assessed by magnetic resonance imaging, and cIMT was measured by ultrasonography. Multivariable analysis and mediation were used to explore the relevant relationships among cIMT, CI, CSVD and brain volume. Results: Seventy-three dialysis patients were enrolled. Approximately 54.8% were diagnosed with increased cIMT. The increased cIMT group was older and had lower serum albumin and creatinine levels than the normal cIMT group. There was no difference in the CSVD prevalence between the different cIMT groups. Patients in the normal, unilaterally and bilaterally increased cIMT subgroups demonstrated a gradual decrease in brain-matter volume and degenerate cognitive function. cIMT was related to cognitive function and gray-/white-matter volume. Increased cIMT was associated with a significantly increased risk of a reduced Mini Mental State Examination/Montreal Cognitive Assessment score and Trail A/B time delay. Mediation analysis showed that CI was mediated by brain-matter volume but not by CSVD. Conclusion: Increased cIMT was an independent risk factor for impairment of global cognitive function, memory, and executive function. The impact of cIMT on cognition was not induced by CSVD but by brain atrophy. cIMT may be a useful tool for screening patients at high risk of CI in the dialysis population.
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Affiliation(s)
- Ke Zheng
- Department of Nephrology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yujun Qian
- Department of Nephrology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tiaye Lin
- Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Han
- Department of Neurology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui You
- Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xixi Tao
- Department of Diagnostic Ultrasound, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Hou
- Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Yuan
- Department of Neurology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyun Wang
- Department of Nephrology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dingding Zhang
- Central Research Laboratory, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ke Lv
- Department of Diagnostic Ultrasound, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Feng
- Department of Radiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yicheng Zhu
- Department of Neurology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuemei Li
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Dongcheng District, Dongcheng-qu, Beijing 100730, China
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17
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Ford AL, Chin VW, Fellah S, Binkley MM, Bodin AM, Balasetti V, Taiwo Y, Kang P, Lin D, Jen JC, Grand MG, Bogacki M, Liszewski MK, Hourcade D, Chen Y, Hassenstab J, Lee JM, An H, Miner JJ, Atkinson JP. Lesion evolution and neurodegeneration in RVCL-S: A monogenic microvasculopathy. Neurology 2020; 95:e1918-e1931. [PMID: 32887784 PMCID: PMC7682842 DOI: 10.1212/wnl.0000000000010659] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/10/2020] [Indexed: 12/17/2022] Open
Abstract
Objective To characterize lesion evolution and neurodegeneration in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) using multimodal MRI. Methods We prospectively performed MRI and cognitive testing in RVCL-S and healthy control cohorts. Gray and white matter volume and disruption of white matter microstructure were quantified. Asymmetric spin echo acquisition permitted voxel-wise oxygen extraction fraction (OEF) calculation as an in vivo marker of microvascular ischemia. The RVCL-S cohort was included in a longitudinal analysis of lesion subtypes in which hyperintense lesions on fluid-attenuated inversion recovery (FLAIR), T1-postgadolinium, and diffusion-weighted imaging were delineated and quantified volumetrically. Results Twenty individuals with RVCL-S and 26 controls were enrolled. White matter volume and microstructure declined faster in those with RVCL–S compared to controls. White matter atrophy in RVCL-S was highly linear (ρ = −0.908, p < 0.0001). Normalized OEF was elevated in RVCL-S and increased with disease duration. Multiple cognitive domains, specifically those measuring working memory and processing speed, were impaired in RVCL-S. Lesion volumes, regardless of subtype, progressed/regressed with high variability as a function of age, while FLAIR lesion burden increased near time to death (p < 0.001). Conclusion RVCL-S is a monogenic microvasculopathy affecting predominantly the white matter with regard to atrophy and cognitive impairment. White matter volumes in RVCL-S declined linearly, providing a potential metric against which to test the efficacy of future therapies. Progressive elevation of white matter OEF suggests that microvascular ischemia may underlie neurodegeneration in RVCL-S.
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Affiliation(s)
- Andria L Ford
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Victoria W Chin
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Slim Fellah
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael M Binkley
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Allie M Bodin
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vamshi Balasetti
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yewande Taiwo
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter Kang
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Doris Lin
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joanna C Jen
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Gilbert Grand
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Madonna Bogacki
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Kathryn Liszewski
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dennis Hourcade
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yasheng Chen
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jason Hassenstab
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jin-Moo Lee
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hongyu An
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jonathan J Miner
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
| | - John P Atkinson
- From the Department of Neurology (A.L.F., V.W.C., S.F., M.B.M., A.M.B., V.B., Y.T., P.K., Y.C., J.H., J.-M.L.), Mallinckrodt Institute of Radiology (A.L.F., J.-M.L., H.A.), Department of Ophthalmology (M.G.G.), and Department of Medicine (M.B., M.K.L., D.H., J.J.M., J.P.A.), Division of Rheumatology, Washington University School of Medicine, St. Louis, MO; Department of Radiology (D.L.), The Johns Hopkins University School of Medicine, Baltimore, MD; and Department of Neurology (J.C.J.), Icahn School of Medicine at Mount Sinai, New York, NY
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Ahles S, Stevens YR, Joris PJ, Vauzour D, Adam J, de Groot E, Plat J. The Effect of Long-Term Aronia melanocarpa Extract Supplementation on Cognitive Performance, Mood, and Vascular Function: A Randomized Controlled Trial in Healthy, Middle-Aged Individuals. Nutrients 2020; 12:nu12082475. [PMID: 32824483 PMCID: PMC7468716 DOI: 10.3390/nu12082475] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/27/2020] [Accepted: 08/14/2020] [Indexed: 12/13/2022] Open
Abstract
Cognitive decline is associated with lifestyle-related factors such as overweight, blood pressure, and dietary composition. Studies have reported beneficial effects of dietary anthocyanins on cognition in older adults and children. However, the effect of anthocyanin-rich Aronia melanocarpa extract (AME) on cognition is unknown. Therefore, this study aimed to determine the effect of long-term supplementation with AME on cognitive performance, mood, and vascular function in healthy, middle-aged, overweight adults. In a randomized double-blind placebo-controlled parallel study, 101 participants either consumed 90 mg AME, 150 mg AME, or placebo for 24 weeks. The grooved pegboard test, number cross-out test, and Stroop test were performed as measures for psychomotor speed, attention, and cognitive flexibility. Mood was evaluated with a visual analogue scale, serum brain-derived neurotrophic factor (BDNF) was determined, and vascular function was assessed by carotid ultrasounds and blood pressure measurements. AME improved psychomotor speed compared to placebo (90 mg AME: change = -3.37; p = 0.009). Furthermore, 150 mg AME decreased brachial diastolic blood pressure compared to 90 mg AME (change = 2.44; p = 0.011), but not compared to placebo. Attention, cognitive flexibility, BDNF, and other vascular parameters were not affected. In conclusion, AME supplementation showed an indication of beneficial effects on cognitive performance and blood pressure in individuals at risk of cognitive decline.
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Affiliation(s)
- Sanne Ahles
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands; (S.A.); (P.J.J.); (J.A.)
- BioActor BV, Gaetano Martinolaan 85, 6229 GS Maastricht, The Netherlands;
| | - Yala R. Stevens
- BioActor BV, Gaetano Martinolaan 85, 6229 GS Maastricht, The Netherlands;
- Department of Internal Medicine, Division of Gastroenterology-Hepatology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Peter J. Joris
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands; (S.A.); (P.J.J.); (J.A.)
| | - David Vauzour
- Biomedical Research Centre, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK;
| | - Jos Adam
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands; (S.A.); (P.J.J.); (J.A.)
| | - Eric de Groot
- Imagelabonline & Cardiovascular, 4117 GV Erichem, The Netherlands;
- Department of Gastroenterology, Amsterdam UMC—Location Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands; (S.A.); (P.J.J.); (J.A.)
- Correspondence:
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Alvarez-Bueno C, Cunha PG, Martinez-Vizcaino V, Pozuelo-Carrascosa DP, Visier-Alfonso ME, Jimenez-Lopez E, Cavero-Redondo I. Arterial Stiffness and Cognition Among Adults: A Systematic Review and Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2020; 9:e014621. [PMID: 32106748 PMCID: PMC7335587 DOI: 10.1161/jaha.119.014621] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background To estimate the strength of the cross‐sectional and longitudinal association between arterial stiffness, measured by pulse‐wave velocity, and cognitive function, distinguishing between global cognition, executive functions, and memory and to examine the influence of demographic, clinical, and assessment characteristics on this relationship. Methods and Results Systematic review of MEDLINE (via PubMed), Scopus, and WOS databases from their inception to March 2019, to identify cross‐sectional and longitudinal studies on the association between pulse‐wave velocity and cognitive domains (ie, global cognition, executive functions, and memory) among adult population. A total of 29 cross‐sectional and 9 longitudinal studies support the negative relationship between arterial stiffness and cognitive function, including global cognition, executive function, and memory. Demographic, clinical, and assessment characteristics did not substantially modify the strength of this association. Conclusions Evidence reveals a negative association between arterial stiffness, measured using pulse‐wave velocity, and cognition, specifically executive function, memory, and global cognition. This association seems to be independent of demographic, clinical, and assessment characteristics. These results accumulate evidence supporting that pulse‐wave velocity assessment could be a useful tool to identify individuals at high risk of cognitive decline or early stages of cognitive decline, to implement interventions aimed at slowing the progression to dementia.
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Affiliation(s)
- Celia Alvarez-Bueno
- Universidad de Castilla-La Mancha Health and Social Research Center Cuenca Spain
| | - Pedro G Cunha
- Internal Medicine Department Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk Guimarães Portugal
| | - Vicente Martinez-Vizcaino
- Universidad de Castilla-La Mancha Health and Social Research Center Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
| | | | | | - Estela Jimenez-Lopez
- Universidad de Castilla-La Mancha Health and Social Research Center Cuenca Spain.,Department of Psychiatry Hospital Virgen de La Luz Cuenca Spain.,CIBERSAM (Biomedical Research Networking Centre in Mental Health) Barcelona Spain
| | - Ivan Cavero-Redondo
- Universidad de Castilla-La Mancha Health and Social Research Center Cuenca Spain
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Effects of Cerebral Blood Flow and Vessel Conditions on Speech Recognition in Patients With Postlingual Adult Cochlear Implant: Predictable Factors for the Efficacy of Cochlear Implant. Ear Hear 2019; 39:540-547. [PMID: 29095241 DOI: 10.1097/aud.0000000000000507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cochlear implantation (CI) has been the most successful procedure for restoring hearing in a patient with severe and profound hearing loss. However, possibly owing to the variable brain functions of each patient, its performance and the associated patient satisfaction are widely variable. The authors hypothesize that peripheral and cerebral circulation can be assessed by noninvasive and globally available methods, yielding superior presurgical predictive factors of the performance of CI in adult patients with postlingual hearing loss who are scheduled to undergo CI. DESIGN Twenty-two adult patients with cochlear implants for postlingual hearing loss were evaluated using Doppler sonography measurement of the cervical arteries (reflecting cerebral blood flow), flow-mediated dilation (FMD; reflecting the condition of cerebral arteries), and their pre-/post-CI best score on a monosyllabic discrimination test (pre-/post-CI best monosyllabic discrimination [BMD] score). Correlations between post-CI BMD score and the other factors were examined using univariate analysis and stepwise multiple linear regression analysis. The prediction factors were calculated by examining the receiver-operating characteristic curve between post-CI BMD score and the significantly positively correlated factors. RESULTS Age and duration of deafness had a moderately negative correlation. The mean velocity of the internal carotid arteries and FMD had a moderate-to-strong positive correlation with the post-CI BMD score in univariate analysis. Stepwise multiple linear regression analysis revealed that only FMD was significantly positively correlated with post-CI BMD score. Analysis of the receiver-operating characteristic curve showed that a FMD cutoff score of 1.8 significantly predicted post-CI BMD score. CONCLUSIONS These data suggest that FMD is a convenient, noninvasive, and widely available tool for predicting the efficacy of cochlear implants. An FMD cutoff score of 1.8 could be a good index for determining whether patients will hear well with cochlear implants. It could also be used to predict whether cochlear implants will provide good speech recognition benefits to candidates, even if their speech discrimination is poor. This FMD index could become a useful predictive tool for candidates with poor speech discrimination to determine the efficacy of CI before surgery.
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Sekikawa A, Ihara M, Lopez O, Kakuta C, Lopresti B, Higashiyama A, Aizenstein H, Chang YF, Mathis C, Miyamoto Y, Kuller L, Cui C. Effect of S-equol and Soy Isoflavones on Heart and Brain. Curr Cardiol Rev 2019; 15:114-135. [PMID: 30516108 PMCID: PMC6520578 DOI: 10.2174/1573403x15666181205104717] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Observational studies in Asia show that dietary intake of soy isoflavones had a significant inverse association with coronary heart disease (CHD). A recent randomized controlled trial (RCT) of soy isoflavones on atherosclerosis in the US, however, failed to show their benefit. The discrepancy may be due to the much lower prevalence of S-equol producers in Westerners: Only 20-30% of Westerners produce S-equol in contrast to 50-70% in Asians. S-equol is a metabolite of dietary soy isoflavone daidzein by gut microbiome and possesses the most antiatherogenic properties among all isoflavones. Several short-duration RCTs documented that soy isoflavones improves arterial stiffness. Accumulating evidence shows that both atherosclerosis and arterial stiffness are positively associated with cognitive decline/dementia. Therefore, potentially, soy isoflavones, especially S-equol, are protective against cognitive decline/dementia. METHODS/RESULTS This narrative review of clinical and epidemiological studies provides an overview of the health benefits of soy isoflavones and introduces S-equol. Second, we review recent evidence on the association of soy isoflavones and S-equol with CHD, atherosclerosis, and arterial stiffness as well as the association of atherosclerosis and arterial stiffness with cognitive decline/ dementia. Third, we highlight recent studies that report the association of soy isoflavones and S-equol with cognitive decline/dementia. Lastly, we discuss the future directions of clinical and epidemiological research on the relationship of S-equol and CHD and dementia. CONCLUSIONS Evidence from observational studies and short-term RCTs suggests that S-equol is anti-atherogenic and improves arterial stiffness and may prevent CHD and cognitive impairment/ dementia. Well-designed long-term (≥ 2years) RCTs should be pursued.
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Affiliation(s)
- Akira Sekikawa
- Address correspondence to this author at the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 North Bellefield Avenue, Suite 336, Pittsburgh, PA 15213, USA; Tel: 412-383-1063; Fax: 412-648-4401;
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Rouch L, Cestac P, Sallerin B, Andrieu S, Bailly H, Beunardeau M, Cohen A, Dubail D, Hernandorena I, Seux ML, Vidal JS, Hanon O. Pulse Wave Velocity Is Associated With Greater Risk of Dementia in Mild Cognitive Impairment Patients. Hypertension 2018; 72:1109-1116. [DOI: 10.1161/hypertensionaha.118.11443] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Laure Rouch
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Philippe Cestac
- Unité INSERM 1027, Toulouse, France (P.C., S.A.)
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Pôle Pharmacie, Centre Hospitalier Universitaire de Toulouse, France (P.C., B.S.)
| | - Brigitte Sallerin
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Pôle Pharmacie, Centre Hospitalier Universitaire de Toulouse, France (P.C., B.S.)
- Unité INSERM 1048, Toulouse, France (B.S.)
| | - Sandrine Andrieu
- Unité INSERM 1027, Toulouse, France (P.C., S.A.)
- University Paul Sabatier Toulouse III, France (P.C., B.S., S.A.)
- Unité INSERM 1048, Toulouse, France (B.S.)
- Pôle Epidémiologie et Santé Publique, Centre Hospitalier Universitaire de Toulouse, France (S.A.)
| | - Henri Bailly
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Maëlle Beunardeau
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Adrien Cohen
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Delphine Dubail
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Intza Hernandorena
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Marie-Laure Seux
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Jean-Sébastien Vidal
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
| | - Olivier Hanon
- From the EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France (L.R., H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
- Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France (H.B., M.B., A.C., D.D., I.H., M.-L.S., J.-S.V., O.H.)
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Alhusaini S, Karama S, Nguyen T, Thiel A, Bernhardt BC, Cox SR, Corley J, Taylor A, Evans AC, Star JM, Bastin ME, Wardlaw JM, Deary IJ, Ducharme S. Association between carotid atheroma and cerebral cortex structure at age 73 years. Ann Neurol 2018; 84:576-587. [PMID: 30179274 PMCID: PMC6328248 DOI: 10.1002/ana.25324] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To examine the relationship between carotid atherosclerosis and cerebral cortical thickness and investigate whether cortical thickness mediates the association between carotid atheroma and relative cognitive decline. METHODS We assessed 554 community-dwelling subjects (male/female: 296/258) from the Lothian Birth Cohort 1936 who underwent brain magnetic resonance imaging and carotid Doppler ultrasound studies at age 73 years. The relationship between carotid atherosclerosis markers (internal carotid artery stenosis, intima-media thickness, velocity, pulsatility, and resistivity indexes) and vertex-wide cerebral cortical thickness was examined cross-sectionally, controlling for gender, extensive vascular risk factors (VRFs), and intelligence quotient at age 11 (IQ-11). We also determined the association between carotid stenosis and a composite measure of fluid intelligence at age 73 years. A mediation model was applied to examine whether cortical thickness mediated the relationship between carotid stenosis and cognitive function. RESULTS A widespread negative association was identified between carotid stenosis (median = 15%) and cerebral cortical thickness at age 73 years, independent of the side of carotid stenosis, other carotid measures, VRFs, and IQ-11. This association increased in an almost dose-response relationship from mild to severe degrees of carotid stenosis, across the anterior and posterior circulation territories. A negative association was also noted between carotid stenosis and fluid intelligence (standardized beta coefficient = -0.151, p = 0.001), which appeared partly (approximately 22%) mediated by carotid stenosis-related thinning of the cerebral cortex. INTERPRETATION The findings suggest that carotid stenosis represents a marker of processes that accelerate aging of the cerebral cortex and cognition that is in part independent of measurable VRFs. Cortical thinning within the anterior and posterior circulation territories partially mediated the relationship between carotid atheroma and fluid intelligence. Ann Neurol 2018;84:576-587.
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Affiliation(s)
- Saud Alhusaini
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
| | - Sherif Karama
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
- Department of Psychiatry, Douglas Mental Health University InstituteMcGill UniversityMontrealQuebecCanada
| | - Tuong‐Vi Nguyen
- Department of Psychiatry, McGill University Health CentreMcGill UniversityMontrealQuebecCanada
- Department of Obstetrics–Gynecology, McGill University Health CentreMcGill UniversityMontrealQuebecCanada
| | - Alexander Thiel
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
- Department of NeurologyJewish General Hospital, Lady Davis Institute for Medical ResearchMontrealQuebecCanada
| | - Boris C. Bernhardt
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
| | - Simon R. Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Adele Taylor
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Alan C. Evans
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
| | - John M. Star
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
- Alzheimer Scotland Dementia Research Centre, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Mark E. Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
- Brain Research Imaging Centre, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | - Joanna M. Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
- Brain Research Imaging Centre, Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUnited Kingdom
- UK Dementia Research Institute at the University of EdinburghEdinburghUnited Kingdom
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
- Alzheimer Scotland Dementia Research Centre, Department of PsychologyUniversity of EdinburghEdinburghUnited Kingdom
| | - Simon Ducharme
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuebecCanada
- McConnell Brain Imaging Centre, Montreal Neurological InstituteMcGill UniversityMontrealQuebecCanada
- Department of Psychiatry, McGill University Health CentreMcGill UniversityMontrealQuebecCanada
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Carotid circumferential wall stress is not associated with cognitive performance among individuals in late middle age: The Maastricht Study. Atherosclerosis 2018; 276:15-22. [PMID: 30006323 DOI: 10.1016/j.atherosclerosis.2018.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/06/2018] [Accepted: 07/03/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Arterial remodelling aims at normalising circumferential wall stress (CWS). Greater CWS in the carotid artery has previously been associated with the prevalence and severity of cerebral small vessel disease, a major cause of ageing-related cognitive decline. Here we test the hypothesis that greater carotid CWS is associated with poorer cognitive performance. METHODS We studied 722 individuals (60 ± 8 years, 55% men, 42.5% highly educated, blood pressure 137 ± 19/77 ± 11 mmHg, n = 197 with type 2 diabetes) who completed a neuropsychological assessment and underwent vascular ultrasound to measure the intima-media thickness (IMT) and interadventitial diameter (IAD) of the left common carotid artery at a plaque-free site. From IMT and IAD, lumen diameter (LD) was calculated. These structural measures were then combined with local carotid pulse pressure and brachial mean arterial pressure to obtain a measure of pulsatile (CWSpulsatile) and average (CWSmean) mechanical load on the vessel wall. Cognitive domains assessed were memory, executive function and attention, and processing speed. RESULTS After adjustment for age, sex, and education, regression analyses showed that neither CWSpulsatile nor CWSmean were associated with measures of cognitive performance (p-values ≥0.31). This null association did not differ by age or educational level, and was observed in both individuals with and without carotid plaque, diabetes and/or hypertension. In addition, none of the individual measures of carotid structure (i.e. IMT, IAD, and LD) was related to cognitive performance. CONCLUSIONS The present cross-sectional study shows that carotid CWS is not associated with cognitive performance, at least not among relatively highly educated individuals in late middle age with adequately controlled cardiovascular risk factors.
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Oviedo DC, Lezcano H, Perez AR, Villarreal AE, Carreira MB, Isaza B, Wesley L, Grajales SA, Fernandez S, Frank A, Britton GB. Vascular biomarkers and ApoE4 expression in mild cognitive impairment and Alzheimer's disease. AIMS Neurosci 2018; 5:148-161. [PMID: 32341958 PMCID: PMC7181887 DOI: 10.3934/neuroscience.2018.2.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
Vascular pathology and genetic markers such as apolipoprotein E allele ε4 (ApoE ε4) are risk factors for the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). In Panama, a high prevalence of vascular risk factors and an increase in the aging population, generate the need to investigate biomarkers using specific, sensitive, non-invasive and cost-efficient methods that could be used in primary care. The main objective of this study was to explore the association between vascular biomarkers such as intima-media thickness (IMT) and stenosis, ApoΕ ε4 and cognitive function in a sample of older adults, including healthy controls (n = 41), MCI (n = 33), and AD (n = 12). A descriptive and cross-sectional study was conducted. Participants were part of the Panama Aging Research Initiative (PARI), the first prospective study in aging in Panama. Assessments included a neuropsychological battery, ApoΕ ε4 genotyping and a Doppler ultrasound of the left carotid artery to examine the presence of vascular risk factors. Neuropsychological tests were combined to form six cognitive domains: Global cognition, language, visuospatial abilities, learning and memory, attention and executive functions. Multivariable analyses (using age, education, and ApoE ε4 expression as covariates) were conducted. Participants with increased IMT showed poorer performance in memory and those with carotid stenosis showed poorer performance in language, visuospatial abilities and attention, independent of age, education or ApoΕ ε4 expression. The results support the use of vascular markers in cognitive assessments of aged individuals.
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Affiliation(s)
- Diana C Oviedo
- Universidad Católica Santa María La Antigua (USMA), Panamá
| | | | - Ambar R Perez
- Universidad Católica Santa María La Antigua (USMA), Panamá.,Centro de Neurociencias y Unidad de Investigación Clínica, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panamá
| | - Alcibiades E Villarreal
- Centro de Neurociencias y Unidad de Investigación Clínica, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panamá
| | - Maria B Carreira
- Centro de Neurociencias y Unidad de Investigación Clínica, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panamá
| | - Baltasar Isaza
- Servicio de Radiología, Complejo Hospitalario Arnulfo Arias Madrid, Caja del Seguro Social, Panamá
| | - Lavinia Wesley
- Servicio de Radiología, Complejo Hospitalario Arnulfo Arias Madrid, Caja del Seguro Social, Panamá
| | - Shantal A Grajales
- Centro de Neurociencias y Unidad de Investigación Clínica, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panamá
| | - Sara Fernandez
- Departmento de Psicología Básica II (Procesos Cognitivos), Facultad de Psicología, Universidad Complutense de Madrid, Madrid, España
| | - Ana Frank
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, España
| | - Gabrielle B Britton
- Centro de Neurociencias y Unidad de Investigación Clínica, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panamá
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Wardlaw JM, Allerhand M, Eadie E, Thomas A, Corley J, Pattie A, Taylor A, Shenkin SD, Cox S, Gow A, Starr JM, Deary IJ. Carotid disease at age 73 and cognitive change from age 70 to 76 years: A longitudinal cohort study. J Cereb Blood Flow Metab 2017; 37:3042-3052. [PMID: 28155579 PMCID: PMC5536260 DOI: 10.1177/0271678x16683693] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cognitive decline and carotid artery atheroma are common at older ages. In community-dwelling subjects, we assessed cognition at ages 70, 73 and 76 and carotid Doppler ultrasound at age 73, to determine whether carotid stenosis was related to cognitive decline. We used latent growth curve models to examine associations between four carotid measures (internal carotid artery stenosis, velocity, pulsatility and resistivity indices) and four cognitive ability domains (memory, visuospatial function, crystallised intelligence, processing speed) adjusted for cognitive ability at age 11, current age, gender and vascular risk factors. Amongst 866 participants, carotid stenosis (median 12.96%) was not associated with cognitive abilities at age 70 or cognitive decline from age 70 to 76. Increased ICA pulsatility and resistivity indices were associated with slower processing speed (both P < 0.001) and worse visuospatial function ( P = 0.036, 0.031, respectively) at age 70, and declining crystallised intelligence from ages 70 to 76 ( P = 0.008, 0.006, respectively). The findings suggest that vascular stiffening, rather than carotid luminal narrowing, adversely influences cognitive ageing and provides a potential target for ameliorating age-related cognitive decline.
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Affiliation(s)
- Joanna M Wardlaw
- 1 Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,2 Department of Neuroradiology, NHS Lothian, Western General Hospital, Edinburgh, UK.,3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Michael Allerhand
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Elizabeth Eadie
- 2 Department of Neuroradiology, NHS Lothian, Western General Hospital, Edinburgh, UK
| | - Avril Thomas
- 2 Department of Neuroradiology, NHS Lothian, Western General Hospital, Edinburgh, UK
| | - Janey Corley
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Adele Taylor
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Susan D Shenkin
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,4 Geriatric Medicine, University of Edinburgh, Royal Infirmary, Edinburgh, UK
| | - Simon Cox
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Alan Gow
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.,5 Department of Psychology, Heriot-Watt University, Edinburgh, UK
| | - John M Starr
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- 3 Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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27
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Gardener H, Caunca MR, Dong C, Cheung YK, Elkind MSV, Sacco RL, Rundek T, Wright CB. Ultrasound Markers of Carotid Atherosclerosis and Cognition: The Northern Manhattan Study. Stroke 2017; 48:1855-1861. [PMID: 28630235 PMCID: PMC5482565 DOI: 10.1161/strokeaha.117.016921] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/04/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Ultrasound markers of carotid atherosclerosis may be related to cognitive status. We hypothesized that individuals with greater carotid intima-media thickness (cIMT) and carotid plaque burden would exhibit worse cognition. METHODS One thousand one hundred sixty-six stroke-free participants from the NOMAS (Northern Manhattan Study) underwent carotid ultrasound and neuropsychological examination. Among them, 826 underwent a second neuropsychological examination an average of 5 years later. cIMT and plaque were assessed by a standardized B-mode ultrasound imaging and reading protocol. We used multivariable linear regression to examine cIMT, carotid plaque presence, and carotid plaque area as correlates of domain-specific neuropsychological Z scores cross-sectionally and over time. We also investigated possible effect modification by APOE ε4 allele, age, and race/ethnicity. RESULTS Participants had a mean (SD) age of 70 (9) years and were 60% women, 66% Hispanic, 15% white, and 18% black. Those with greater cIMT exhibited worse episodic memory after adjustment for demographics and vascular risk factors (β=-0.60; P=0.04). APOE ε4 carriers with greater cIMT exhibited worse episodic memory (β=-1.31; P=0.04), semantic memory (β=-1.45; P=0.01), and processing speed (β=-1.21; P=0.03). Participants with greater cIMT at baseline did not exhibit significantly greater cognitive decline after adjustment. APOE ε4noncarriers with greater cIMT exhibited greater declines in executive function (β=-0.98; P=0.06). Carotid plaque burden was not significantly associated with cognition at baseline or over time. CONCLUSIONS Subclinical carotid atherosclerosis was associated with worse cognition among those at higher risk for Alzheimer disease. Interventions targeting early stages of atherosclerosis may modify cognitive aging.
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Affiliation(s)
- Hannah Gardener
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.).
| | - Michelle R Caunca
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Chuanhui Dong
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Ying Kuen Cheung
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Mitchell S V Elkind
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Ralph L Sacco
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Tatjana Rundek
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
| | - Clinton B Wright
- From the Evelyn F. McKnight Brain Institute, Neuroscience Program (H.G., M.R.C., C.D., R.L.S., T.R.), Department of Neurology (H.G., M.R.C., C.D., R.L.S., T.R.), and Department of Public Health Sciences (M.R.C., R.L.S., T.R.), Miller School of Medicine, University of Miami, FL; Department of Neurology, College of Physicians and Surgeons (M.S.V.E.), Department of Biostatistics, Mailman School of Public Health (Y.K.C.), and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; and National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD (C.B.W.)
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28
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Malojcic B, Giannakopoulos P, Sorond FA, Azevedo E, Diomedi M, Oblak JP, Carraro N, Boban M, Olah L, Schreiber SJ, Pavlovic A, Garami Z, Bornstein NM, Rosengarten B. Ultrasound and dynamic functional imaging in vascular cognitive impairment and Alzheimer's disease. BMC Med 2017; 15:27. [PMID: 28178960 PMCID: PMC5299782 DOI: 10.1186/s12916-017-0799-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/21/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The vascular contributions to neurodegeneration and neuroinflammation may be assessed by magnetic resonance imaging (MRI) and ultrasonography (US). This review summarises the methodology for these widely available, safe and relatively low cost tools and analyses recent work highlighting their potential utility as biomarkers for differentiating subtypes of cognitive impairment and dementia, tracking disease progression and evaluating response to treatment in various neurocognitive disorders. METHODS At the 9th International Congress on Vascular Dementia (Ljubljana, Slovenia, October 2015) a writing group of experts was formed to review the evidence on the utility of US and arterial spin labelling (ASL) as neurophysiological markers of normal ageing, vascular cognitive impairment (VCI) and Alzheimer's disease (AD). Original articles, systematic literature reviews, guidelines and expert opinions published until September 2016 were critically analysed to summarise existing evidence, indicate gaps in current knowledge and, when appropriate, suggest standards of use for the most widely used US and ASL applications. RESULTS Cerebral hypoperfusion has been linked to cognitive decline either as a risk or an aggravating factor. Hypoperfusion as a consequence of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation. US can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Microvascular pathology and hypoperfusion at the level of capillaries and small arterioles can also be assessed by ASL, an MRI signal. Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and, most importantly, disease progression, incomplete standardisation and missing validated cut-off values limit their use in daily routine. CONCLUSIONS US and ASL are promising tools with excellent temporal resolution, which will have a significant impact on our understanding of the vascular contributions to VCI and AD and may also be relevant for assessing future prevention and therapeutic strategies for these conditions. Our work provides recommendations regarding the use of non-invasive imaging techniques to investigate the functional consequences of vascular burden in dementia.
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Affiliation(s)
- Branko Malojcic
- Department of Neurology, University Hospital Center Zagreb, Zagreb School of Medicine, Kispaticeva 12, 10000, Zagreb, Croatia.
| | | | - Farzaneh A Sorond
- Department of Neurology, Northwestern University Feinberg School of Medicine Chicago, Chicago, IL, USA
| | - Elsa Azevedo
- Department of Neurology, São João Hospital Center and Faculty of Medicine of University of Porto, Porto, Portugal
| | - Marina Diomedi
- Cerebrovascular Disease Center, Stroke Unit, University of Rome Tor Vergata, Rome, Italy
| | - Janja Pretnar Oblak
- Department of Vascular Neurology and Intensive Therapy, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Nicola Carraro
- Department of Medical Sciences, Clinical Neurology-Stroke Unit, University Hospital, University of Trieste, Trieste, Italy
| | - Marina Boban
- Department of Neurology, University Hospital Center Zagreb, Zagreb School of Medicine, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Laszlo Olah
- Department of Neurology, University of Debrecen, Debrecen, Hungary
| | - Stephan J Schreiber
- Department of Neurology, Charite - Universitätsmedizin Berlin, Berlin, Germany
| | - Aleksandra Pavlovic
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zsolt Garami
- Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Nantan M Bornstein
- Neurology Department, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel
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Vogrin B, Slak Rupnik M, Mičetić-Turk D. Increased augmentation index and central systolic arterial pressure are associated with lower school and motor performance in young adolescents. J Int Med Res 2017; 45:1892-1900. [PMID: 28703627 PMCID: PMC5805191 DOI: 10.1177/0300060516678717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective In adults, improper arterial function has been linked to cognitive
impairment. The pulse wave velocity (PWV), augmentation index (AIx) and
other vascular parameters are useful indicators of arterial health. In our
study, we monitored arterial properties, body constitution, school success,
and motor skills in young adolescents. We hypothesize that reduced cognitive
and motor abilities have a vascular origin in children. Methods We analysed 81 healthy school children aged 11–16 years. Anthropometry
central systolic arterial pressure, body mass index (BMI), standard
deviation scores (SDS) BMI, general school performance grade, and eight
motor tests were assessed. PWV, AIx, and central systolic arterial pressure
(SBPao) were measured. Results AIx and SBPao correlated negatively with school performance grades. Extremely
high AIx, PWV and SBPao values were observed in 5% of children and these
children had average to low school performance. PWV correlated significantly
with weight, height, and waist and hip circumference. AIx, PWV, school
success, and BMI correlated strongly with certain motor functions. Conclusions Increased AIx and SBPao are associated with lower school and motor
performance in children. PWV is influenced by the body’s constitution.
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Affiliation(s)
| | - Marjan Slak Rupnik
- 2 Institute of Physiology, Medical faculty, University of Maribor, Slovenia.,4 Center of physiology and pharmacology, Medical University Vienna, Austria
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30
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Cohen-Manheim I, Pinchas-Mizrachi R, Doniger GM, Simon ES, Sinnreich R, Kark JD. Measures of carotid atherosclerosis and cognitive function in midlife: The Jerusalem LRC longitudinal study. INTELLIGENCE 2016. [DOI: 10.1016/j.intell.2016.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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