Arterial stiffness and progression of structural brain changes

Jochemsen, H.M.; Muller, Majon; Bots, Michiel L.; Scheltens, Philip; Vincken, Koen L.; Mali, Wptm; Graaf, Y. van der; Geerlings, Mirjam I.

doi:10.1212/wnl.0000000000001201

Cited by 37 publications

(35 citation statements)

References 41 publications

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“…1, 26 In particular, the association between central artery stiffness and WMH burden has been frequently and consistently reported among older individuals 3, 4, 27 . In the FHS Offspring cohort of older individuals, recent findings suggest that only CFPWV and MAP are associated with WMH burden.…”

Section: Discussionmentioning

confidence: 99%

Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study

Maillard¹,

Mitchell

Himali

et al. 2016

Stroke

101

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Background and Purpose Previous work from the Framingham Heart Study suggests that brain changes due to arterial aging may begin in young adulthood and that such changes precede cognitive deficits. The objective of this study was to determine the association of arterial stiffness with measures of white matter and gray matter integrity in young adults. Methods 1903 participants from the Framingham Heart Study Third Generation (mean age, 46±8.7 years) had complete tonometry measurements and brain MRI (T1-weighted and DTI). Tonometry measures included carotid-femoral pulse wave velocity (CFPWV), augmentation index, carotid-brachial pressure amplification and central pulse pressure. Fractional anisotropy (FA) and gray matter (GM) density images were computed from DTI and T1 images. Registration to a common anatomical template enabled voxel-based linear regressions relating measures of FA and GM to tonometry measures, adjusting for relevant covariables. Results Higher CFPWV was associated with lower regional FA, including the corpus callosum and the corona radiata (8.7 and 8.6cc respectively, p<0.001), as well as lower GM density in the thalamus region (0.9cc, p<0.001). Analyses did not reveal significant associations between other tonometry measures and FA or GM. Conclusions Among young healthy adults, higher aortic stiffness was associated with measures of reduced WM and GM integrity in areas implicated in cognitive decline and Alzheimer's disease. Greater aortic stiffness may result in subclinical vascular brain injury at ages much younger than previously described.

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Section: Discussionmentioning

confidence: 99%

Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study

Maillard¹,

Mitchell

Himali

et al. 2016

Stroke

101

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“…The relationship between vascular health and brain anatomy has been previously investigated using systemic (largely peripheral) measures of arterial status (Beauchet et al, 2013; Jochemsen et al, 2015; Rabkin, 2012; Raz et al, 2008; Singer et al, 2014; Tsao et al, 2016). However, there is now considerable evidence that the cerebrovascular system may present specific alterations and pathologies with aging, which are somewhat independent of those observed in the rest of the body.…”

Section: Discussionmentioning

confidence: 99%

“…The exact reason for this pattern is unknown, but a number of potential explanations are possible. For example, younger adults experience little atrophy, and therefore less variance exists across regions, leading to a floor effect (see top of figure 6a; see also Beauchet et al, 2013; Fjell et al, 2013; Jochemsen et al, 2015; Rabkin, 2012; Raz et al, 2008; Tsao et al, 2016). Additionally, younger adults also experience less vascular damage from reactive oxidative species, and have more robust compensatory and/or repair mechanisms to mitigate cerebrovascular stiffness effects (El-Assar et al, 2012; Hoenig et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, studies of the association between arterial stiffness (measured outside the brain) and volumetric brain changes have provided less clear findings. For instance, a recent study examined the association between overall cortical volume and arterial stiffness (measured as the distension – or lack thereof – of the carotid arteries) using an ultrasound-based wall-tracker system in 526 older participants (Jochemsen et al, 2015; Segers et al, 2004). Although cross-sectional analyses revealed a negative correlation between carotid distension and total gray matter volume (and also a positive correlation with increased white matter lesion volume), these findings did not reach significance in a prospective analysis after a 4-year follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Individual differences in regional cortical volumes across the life span are associated with regional optical measures of arterial elasticity

et al. 2017

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Aging is often accompanied by changes in brain anatomy and cerebrovascular health. However, the specific relationship between declines in regional cortical volumes and loss of cerebral arterial elasticity is less clear, as only global or very localized estimates of cerebrovascular health have been available. Here we employed a novel tomographic optical method (pulse-DOT) to derive local estimates of cerebral arterial elasticity and compared regional volumetric estimates (obtained with FreeSurfer) with optical arterial elasticity estimates from the same regions in 47 healthy adults (aged 18–75). Between-subject analyses revealed a global correlation between cortical volume and cortical arterial elasticity, which was a significant mediator of the association between age and cortical volume. Crucially, a novel within-subject analysis highlighted the spatial association between regional variability in cortical volumes and arterial elasticity in the same regions. This association strengthened with age. Gains in the predictability of cortical volumes from arterial elasticity data were obtained by sharpening the resolution up to individual cortical regions. These results indicate that some of the variance of sub-clinical age-related brain atrophy is associated with differences in the status of cerebral arteries, and can help to explain the unique patterns of brain atrophy found within each individual.

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“…Although not without fundamental criticism, other modifications of PWV (eg, ba-PWV) have been advocated. In the Second Manifestation of Arterial Disease-Magnetic Resonance (SMART-MR) Study, 10 more complex stiffness parameters of the common carotid arteries (distensibility, compliance, Young and Peterson modulus, and β stiffness index) were tested in relation with progression of total brain, cortical gray matter, ventricular and total white matter lesion volumes, and both lacunar and nonlacunar infarcts, but the yield of sound associations was meager.…”

Section: De Buyzere Stiff Arteries and Brain Aging In The Young 491mentioning

confidence: 99%

Young Adults With Stiff Arteries

Buyzere

2016

Hypertension

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T he arterial system gradually stiffens because of the time integrated and shared effects of several traditional risk indicators. In clinical practice, this detrimental process can be monitored noninvasively by the carotid-femoral pulse wave velocity (cf-PWV), which is considered the "gold standard" methodology for the stiffness of the thoracic and abdominal aorta. PWV improved cardiovascular risk prediction when added to standard risk factors including systolic blood pressure in several community-based samples including the Framingham Heart Study.Stiffening of the arterial wall is increasingly considered as a hallmark of unsuccessful aging and shifted our interest to interactions between the fields of arterial stiffening and hypertension and the fields of subtle brain damage and mild cognitive impairment/dementia on the other side. A decade of intensive research linked increased cf-PWV with a higher prevalence and extent of brain lesions on nuclear magnetic resonance imaging (MRI) and lower cognitive scores on a whole array of neuropsychological tests, however, with varying degrees of uncertainty.In the meta-analysis by van Sloten et al, 1 41 arterial stiffness studies with cognition-related outcomes showed considerable heterogeneity. Some of the studies showed significant associations with cognitive impairment but many associations were relatively weak. The weakest evidence is expected for less specific and less precise measurements of cognitive function (eg, scrutinizing Mini-Mental Status Examination). Relative strength of the associations might have been weakened by competing conditions, such as atherothrombosis and neurodegenerative diseases.Hajjar et al 2 demonstrated that PWV is superior to elevated blood pressure in predicting hypertension-related cognitive decline. Higher PWV was associated with a steeper decline in executive, memory, and working memory scores after appropriate adjustments. PWV increased the explained variance of the association between hypertension and executive function from 1% to 10%.In the same meta-analysis by van Sloten et al 1 on 23 studies, greater stiffness was associated more convincingly with markers of cerebral small vessel disease (CSVD) with odds ratios all around 1.30 per 1 SD increase in the cross-sectional analyses: 1.30 for white matter hyperintensities (WMH), 1.32 for cerebral microbleeds, and 1.29 for cerebral infarcts. Of interest, the Framingham Heart Study 3 confirmed significant associations between cf-PWV and lower total cerebral brain volume, greater WMH volume, and greater prevalence of silent cerebral infarcts. Nonetheless, a word of caution might be in place as in a more recent study 4 of elderly without cognitive impairment the significance for a crude analysis between cf-PWV and WMH was lost after adjustment for common cardiovascular covariates.The large majority of these studies targeted elderly individuals because arterial stiffness, cognitive decline, and brain damage are traditionally viewed as inherent to irreversible processes of aging. Foci of ongo...

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Arterial stiffness and progression of structural brain changes

Cited by 37 publications

References 41 publications

Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study

Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study

Individual differences in regional cortical volumes across the life span are associated with regional optical measures of arterial elasticity

Young Adults With Stiff Arteries

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