Effect of Cerebrovascular Risk Factors on Regional Cerebral Blood Flow

Laar, Peter Jan van; Graaf, Yolanda van der; Mali, Willem P.Th.M.; Hendrikse, Jeroen

doi:10.1148/radiol.2453061932

Cited by 24 publications

(19 citation statements)

References 53 publications

(58 reference statements)

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“…These values are comparable to those from our prior study(9) and appear appropriate for age in comparison to epidemiological data (33). Similarly, values observed were somewhat higher but comparable to ours and others for mean rCBF in the thalamic area (63.8 (2.1) ml/min/ml) and response in this area to the 2-back memory task (3.9 (.9) ml/min/ml)(9, 39, 40). …”

Section: Resultssupporting

confidence: 91%

Brain Imaging Findings Predict Blood Pressure Response to Pharmacological Treatment

et al. 2008

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Abstract-Hypertension appears to alter brain morphology, as well as the cerebrovascular support for information processing. Because these effects might reflect progressive effects of essential hypertension on the brain, we asked whether structural and functional brain indices would predict the success of pharmacological treatment of hypertension among 45 previously unmedicated individuals. After initial structural MRI and functional positron emission tomography imaging, subjects were randomly assigned in a double-blind fashion for treatment for 1 year with either lisinopril or atenolol. Systolic and diastolic blood pressure decreases after treatment stabilization were correlated to a pretreatment index of brain aging (combined ratings of ventricle and sulcal size and white matter hyperintensities) and the pretreatment change in regional cerebral blood flow during working memory in the thalamus and posterior parietal regions of interest. In multiple regression analyses, the structural brain index and the blood flow response in the thalamus predicted 20% of the variance in the systolic blood pressure response to treatment controlling for pretreatment blood pressure, age, gender, and type and dose of medication. Alcohol use influenced the thalamic response measure, but covariates did not alter the relation between greater indices of brain aging and less successful blood pressure response to treatment. The state of the brain may be an important factor in the remediation of blood pressure. A lthough characteristics placing a person at risk for essential hypertension are well known, predictors of blood pressure (BP) response to pharmacological treatment, other than current BP, have received less attention. 1,2 Once hypertension management has begun, appropriate clinical management and compliance with the medical regimen are clearly factors in treatment outcome. 3 In addition, different treatment approaches may be more effective with, eg, diastolic hypertension versus isolated systolic hypertension; but clear clinical evidence for this has yet to be established. 4 Cerebrovascular factors are rarely considered as central to disease diagnosis or treatment but are considered only if frank cerebrovascular disease co-occurs with hypertension. 5 Increasing evidence of central nervous system involvement as either a cause or consequence of essential hypertension, 6 -12 however, led us to ask whether brain morphological indices of brain aging or regional cerebral blood flow responsivity would predict BP decline during pharmacological treatment of essential hypertension.A number of factors suggest that cerebral structure and function might relate to success of BP treatment. First, hypertension has been characterized as accelerated aging, and aging changes in the brain are well established. [13][14][15][16] Second, hypertension has been related to changes in both brain structure and cerebrovascular responsivity during information processing. 6,9,[17][18][19] Third, hypertension in mid-to-late life is associated with mild cognit...

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Section: Resultssupporting

confidence: 91%

Brain Imaging Findings Predict Blood Pressure Response to Pharmacological Treatment

et al. 2008

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“…Available evidence and findings from this study, however, counter the interpretation that atherosclerotic changes confounded our BOLD reactivity and connectivity indices. First, cerebral perfusion is not associated with carotid stenosis in CVD patients (70) or carotid IMT in community samples (71), consistent with brain blood flow autoregulatory mechanisms in healthy adults. Second, we detected minimal atherosclerotic plaques in this sample ( n = 4), and results were unchanged when those with plaques were omitted from analyses.…”

Section: Discussionmentioning

confidence: 64%

Preclinical Atherosclerosis Covaries with Individual Differences in Reactivity and Functional Connectivity of the Amygdala

Gianaros

Hariri

Sheu

et al. 2009

Biological Psychiatry

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Background-Cardiovascular disease (CVD) is a major source of medical comorbidity for patients with mood and anxiety disorders, and it remains the leading public health burden for the general population in industrialized nations. Indirect neurobiological evidence suggests that preclinical risk for atherosclerosis, the main contributor to CVD, may be conferred by interindividual variation in the functionality of the amygdala, a brain system jointly involved in processing behaviorally salient stimuli and regulating the cardiovascular system.

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“…Hypertension modifies the intricate mechanisms of cerebral blood flow (CBF) regulation, including functional hyperemia, cerebrovascular autoregulation, and endothelial regulation (Iadecola and Davisson, 2008). In patients with symptomatic atherosclerotic disease, hypertension has been shown to be associated with elevated CBF (van Laar et al, 2008). For all of the above, continued research on the effects of hypertension on cerebrovascular function is a crucial step in the design of preventive therapies aimed at minimizing the risk of development of cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging quantification of regional cerebral blood flow and cerebrovascular reactivity to carbon dioxide in normotensive and hypertensive rats

et al. 2011

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Hypertension afflicts 25% of the general population and over 50% of the elderly. In the present work, arterial spin labeling MRI was used to non-invasively quantify regional cerebral blood flow (CBF), cerebrovascular resistance and CO2 reactivity in spontaneously hypertensive rats (SHR) and in normotensive Wistar Kyoto rats (WKY), at two different ages (3 months and 10 months) and under the effects of two anesthetics, α-chloralose and 2% isoflurane (1.5 MAC). Repeated CBF measurements were highly consistent, differing by less than 10% and 18% within and across animals, respectively. Under α-chloralose, whole brain CBF at normocapnia did not differ between groups (young WKY: 61±3ml/100g/min; adult WKY: 62±4ml/100g/min; young SHR: 70±9ml/100g/min; adult SHR: 69±8ml/100g/min), indicating normal cerebral autoregulation in SHR. At hypercapnia, CBF values increased significantly, and a linear relationship between CBF and PaCO2 levels was observed. In contrast, 2% isoflurane impaired cerebral autoregulation. Whole brain CBF in SHR was significantly higher than in WKY rats at normocapnia (young SHR: 139±25ml/100g/min; adult SHR: 104±23ml/100g/min; young WKY: 55±9ml/100g/min; adult WKY: 71±19ml/100g/min). CBF values increased significantly with increasing CO2; however, there was a clear saturation of CBF at PaCO2 levels greater than 70 mmHg in both young and adult rats, regardless of absolute CBF values, suggesting that isoflurane interferes with the vasodilatory mechanisms of CO2. This behavior was observed for both cortical and subcortical structures. Under either anesthetic, CO2 reactivity values in adult SHR were decreased, confirming that hypertension, when combined with age, increases cerebrovascular resistance and reduces cerebrovascular compliance.

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Effect of Cerebrovascular Risk Factors on Regional Cerebral Blood Flow

Abstract: In patients with symptomatic atherosclerotic disease, hypertension is related to higher rCBF and hyperhomocysteinemia is related to lower rCBF.

Cited by 24 publications

References 53 publications

Brain Imaging Findings Predict Blood Pressure Response to Pharmacological Treatment

Brain Imaging Findings Predict Blood Pressure Response to Pharmacological Treatment

Preclinical Atherosclerosis Covaries with Individual Differences in Reactivity and Functional Connectivity of the Amygdala

Magnetic resonance imaging quantification of regional cerebral blood flow and cerebrovascular reactivity to carbon dioxide in normotensive and hypertensive rats

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