Cerebro- and cardiovascular reactivity and neuropsychological performance in hypertensive patients

Kovács, Katalin Réka; Szekeres, Csilla; Bajkó, Zoltán; Csapó, Krisztina; Molnár, Szabolcs; Oláh, László; Magyar, Mária Tünde; Bereczki, Dániel; Kardos, Lászĺo; Soltész, Pál; Bojtor, Andrea Burainé; Csiba, László

doi:10.1016/j.jns.2010.07.022

Cited by 12 publications

(13 citation statements)

References 18 publications

(15 reference statements)

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“…The auditory attention/working memory factor score is comprised of digit span forward, digit span backward and the letter number sequencing task. Prior research has shown that the individual components of the attention/working memory factor score, particularly digit span, have been linked to BP dysregulation during midlife (45, 46). …”

Section: Discussionmentioning

confidence: 99%

The KEEPS-Cognitive and Affective Study: Baseline Associations between Vascular Risk Factors and Cognition

Wharton

Gleason

Dowling

et al. 2014

JAD

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Background Midlife vascular risk factors influence later cognitive decline and Alzheimer’s disease (AD). The decrease in serum estradiol levels during menopause has been associated with cognitive impairment and increased vascular risk, such as high blood pressure (BP), which independently contribute to cognitive dysfunction and AD. Methods We describe the extent to which vascular risk factors relate to cognition in healthy, middle–aged, recently postmenopausal women enrolled in the Kronos Early Estrogen Prevention Cognitive and Affective Study (KEEPS-Cog) at baseline. KEEPS-Cog is a double-blind, randomized, placebo-controlled, parallel group design, clinical trial, investigating the efficacy of low-dose, transdermal 17β-estradiol and oral conjugated equine estrogen on cognition. Results The KEEPS-Cog cohort (N=662) is healthy and free of cognitive dysfunction. Higher systolic BP was related to poorer performance in auditory working memory and attention (unadjusted p=0.004; adjusted p=0.10). This relationship was not associated with endogenous hormone levels. Conclusions Lower BP early in menopause may positively affect cognitive domains known to be associated with AD.

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Section: Discussionmentioning

confidence: 99%

The KEEPS-Cognitive and Affective Study: Baseline Associations between Vascular Risk Factors and Cognition

Wharton

Gleason

Dowling

et al. 2014

JAD

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“…Given similar diagnoses, individuals with CVR impairment have a much higher risk of disabling stroke than those without (Blaser et al, 2002;Bokkers et al, 2011;Kuroda et al, 2004;Mandell et al, 2011;Mandell et al, 2008;Markus and Cullinane, 2001;Schoof et al, 2007;Silvestrini et al, 2000 ;Tsivgoulis and Alexandrov, 2008). In addition, reduced CVR has also been cited as a marker for lacunar infarction (Birns et al, 2009;Mandell et al, 2011), microbleeding (Birns et al, 2009;Conijn et al, 2012), as well as cortical atrophy (Fierstra et al, 2010) and cognitive decline in individuals at risk of stroke (Hurford et al, 2014;Kovács et al, 2010). Furthermore, CVR is of direct diagnostic value in patient management Mandell et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Quantitative mapping of cerebrovascular reactivity using resting-state BOLD fMRI: Validation in healthy adults

2016

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In conventional neuroimaging, cerebrovascular reactivity (CVR) is quantified primarily using the blood-oxygenation level-dependent (BOLD) functional MRI (fMRI) signal, specifically, as the BOLD response to intravascular carbon dioxide (CO 2 ) modulations, in units of [%ΔBOLD/ mmHg]. While this method has achieved wide appeal and clinical translation, the tolerability of CO 2 -related tasks amongst patients and the elderly remains a challenge in more routine and largescale applications. In this work, we propose an improved method to quantify CVR by exploiting intrinsic fluctuations in CO 2 and corresponding changes in the resting-state BOLD signal (rsqCVR). Our rs-qCVR approach requires simultaneous monitoring of PETCO 2 , cardiac pulsation and respiratory volume. In 16 healthy adults, we compare our quantitative CVR estimation technique to the prospective CO 2 -targeting based CVR quantification approach (qCVR, the "standard"). We also compare our rs-CVR to non-quantitative alternatives including the restingstate fluctuation amplitude (RSFA), amplitude of low-frequency fluctuation (ALFF) and globalsignal regression. When all subjects were pooled, only RSFA and ALFF were significantly associated with qCVR. However, for characterizing regional CVR variations within each subject, only the PETCO 2 -based rs-qCVR measure is strongly associated with standard qCVR in 100% of the subjects (p<=0.1). In contrast, for the more qualitative CVR measures, significant withinsubject association with qCVR was only achieved in 50-70% of the subjects. Our work establishes the feasibility of extracting quantitative CVR maps using rs-fMRI, opening the possibility of mapping functional connectivity and qCVR simultaneously.

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“…Experimentally, CVR is defined as the degree of vasodilatation or constriction in response to a vasoactive agent or task. CVR is an indication of vascular reserve (Ito et al, 2003) and autoregulatory efficiency (Nur et al, 2009), and CVR impairment has been observed in cerebral steno-occlusive vascular diseases Mandell et al, 2008), lacunar infarction (Birns et al, 2009;Mandell et al, 2011), microbleeding (Birns et al, 2009;Conijn et al, 2012) and cognitive decline in aging as well as dementia (Hurford et al, 2014;Kastrup et al, 1998;Kovács et al, 2010;Suri et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Comparing cerebrovascular reactivity measured using BOLD and cerebral blood flow MRI: The effect of basal vascular tension on vasodilatory and vasoconstrictive reactivity

et al. 2015

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Cerebrovascular reactivity (CVR) is an important metric of cerebrovascular health. While the BOLD fMRI method in conjunction with carbon-dioxide (CO 2 ) based vascular manipulation has been the most commonly used, the BOLD signal is not a direct measure of vascular changes, and the use of arterial-spin labeling (ASL) cerebral blood flow (CBF) imaging is increasingly advocated. Nonetheless, given the differing dependencies of BOLD and CBF on vascular baseline conditions and the diverse CO 2 manipulation types currently used in the literature, knowledge of potential biases introduced by each technique is critical for the interpretation of CVR measurements. In this work, we use simultaneous BOLD-CBF acquisitions during both vasodilatory (hypercapnic) and vasoconstrictive (hypocapnic) stimuli to measure CVR. We further imposed different levels of baseline vascular tension by inducing hypercapnic and hypocapnic baselines, separately from normocapnia by 4 mm Hg. We saw significant and diverse dependencies on vascular stimulus and baseline condition in both BOLD and CBF CVR measurements: (i) BOLD-based CVR is more sensitive to basal vascular tension than CBF-based CVR; (ii) the use of a combination of vasodilatory and vasoconstrictive stimuli maximizes the sensitivity of CBF-based CVR to vascular tension changes; (iii) the BOLD and CBF vascular response delays are both significantly lengthened at predilated baseline. As vascular tension can often be altered by potential pathology, our findings are important considerations when interpreting CVR measurements in health and disease.

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Cerebro- and cardiovascular reactivity and neuropsychological performance in hypertensive patients

Cited by 12 publications

References 18 publications

The KEEPS-Cognitive and Affective Study: Baseline Associations between Vascular Risk Factors and Cognition

The KEEPS-Cognitive and Affective Study: Baseline Associations between Vascular Risk Factors and Cognition

Quantitative mapping of cerebrovascular reactivity using resting-state BOLD fMRI: Validation in healthy adults

Comparing cerebrovascular reactivity measured using BOLD and cerebral blood flow MRI: The effect of basal vascular tension on vasodilatory and vasoconstrictive reactivity

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