Disrupted Frontoparietal Network Mediates White Matter Structure Dysfunction Associated with Cognitive Decline in Hypertension Patients

Abstract

Some previous reports have suggested that hypertension is a risk factor for dementia and cognitive impairments. Using behavioral data from 1007 elderly human subjects (405 hypertensive patients) of Han ethnicity from Beijing, China, the present study aimed to assess the effects of hypertension on cognitive performance and explore related neuronal changes via advanced resting-state functional magnetic resonance imaging and diffusion tensor imaging data from 84 of these subjects (44 hypertensive patients). Cognitively, we found that patients with hypertension showed decreased executive functions and attention compared with those with normotension in the large sample. In magnetic resonance imaging scan sample, using independent component analysis to examine the functional connectivity difference between the two groups, we found that the frontoparietal networks in the hypertensive group exhibited altered patterns compared with the control group, mainly in the inferior parietal lobe, left inferior frontal lobe, and precuneus. Using tract-based spatial statistics to investigate the between-group structural difference, we found that the hypertensive group showed significantly reduced integrity of white matter in the bilateral superior longitudinal fasciculus. Importantly, using the mediation analysis, we found that the functional connectivity of the frontoparietal networks mediates the impact of white matter on executive function in the hypertensive group. The results demonstrate that hypertension targets a specific pattern of cognitive decline, possibly due to deficits in the white matter and functional connectivity in frontal and parietal lobes. Our findings highlight the importance of brain protection in hypertension.

Effects of stage I hypertension on the recovery of early postoperative attention networks in elderly patients undergoing elective hip or knee arthroplasty surgery

“…Although hypertension may eventually affect all of these domains, executive function is commonly affected earlier [26]. In a previous study, HPs showed declines in mainly executive function and attention compared with NPs, possibly due to the impact of white matter on executive function mediated by the frontoparietal network in the former [22]. In this study, HPs manifested mainly executive function impairment supporting this evidence indirectly, without orienting network decline.…”

“…Because HPs had reduced alerting network effect scores and greater difficulty resolving conflict than NPs did on POD 7 in this study, we suspect that they sustained more substantial damage to the frontal and parietal areas of the brain. Magnetic resonance imaging (MRI) studies have revealed altered patterns involving the parietal and frontal lobes in HPs relative to NPs [22]. The frontoparietal network is important for executive function, attention control, and working-memory processing [23].…”

Retained executive abilities in mild cognitive impairment are associated with increased white matter network connectivity

“…The tractography differences noted between the MCI-highEF group and the MCI-lowEF group in the superior longitudinal fasciculus have been described not only in AD dementia [20], but also accompanying cognitive impairment in Parkinson’s disease and chronic hypertension. While the pathophysiology of these diseases may be different, it is important to note that differences in these regions accompany similar diminished executive changes [25, 26]. As such, it may be that a disruption in the efficiency of this tract in MCI is most indicative of whom will go on to develop dementia.…”

Vascular burden is associated with a decline in default-mode and global resting-state functional connectivity in individuals at risk for Alzheimer’s disease

“…[24][25][26][27] Hypertension has been suggested to impair RSFC in older adults. 28 Higher total-cholesterol levels have been associated with both lower and higher RSFC within the DMN and lower RSFC within the SAL network, 29,30 but associations have not been found in all studies. 26 VRFs might therefore reduce brain functional health, which could increase vulnerability to AD pathology and/or cognitive impairments.…”