Longitudinal changes in cerebral blood flow and their relation with cognitive decline in patients with dementia: Current knowledge and future directions

Weijs, Ralf W.J.; Shkredova, Daria A.; Brekelmans, A.C.M.; Thijssen, Dick H. J.; Claassen, Jurgen A.H.R.

doi:10.1002/alz.12666

Cited by 17 publications

(22 citation statements)

References 66 publications

(173 reference statements)

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Section: Methodsmentioning

confidence: 97%

“…We used a regional-specific brain structure approach in our present analysis, which is in line with recent meta-analyses demonstrating age-related decline in global CBF is driven by region-specific brain structures (Weijs et al, 2022). Additionally, region-specific cerebral blood flow has been linked to domain-specific cognitive function in aging individuals (Weijs et al, 2022). Whole-cortical gray matter and 3 regional-specific brain segments (primary motor cortex, superior parietal cortex) were identified a priori based on their distinguishable functional involvement in cognitive performance domains shown to acutely benefit from exercise, notably episodic memory, selective attention, and cognitive processing speed (Davranche et al, 2009; Kamijo et al, 2007, 2009; Kao et al, 2017; Peiffer et al, 2007).…”

Section: Methodsmentioning

confidence: 97%

“…To date, a clinically-meaningful CBF threshold indicative of poor cerebrovascular health has not been established, as CBF has been assessed using different methods (e.g. single-photon emission computed tomography (SPECT), transcranial Doppler ultrasound (TCD), ASL-MRI)) (Alwatban et al, 2020(Alwatban et al, , 2021Kaufman et al, 2021;Vidoni et al, 2022;Ward et al, 2018;Weijs et al, 2022;Wolters et al, 2017). As a first step, the present study used the cohort median value for regional perfusion level to classify older individuals with "low" and "high" baseline perfusion; however, future studies are needed to empirically test the clinical significance of this baseline perfusion threshold as a metric of cerebrovascular health in larger cohorts of older adults and utilizing a standardized CBF assessment approach.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Clinically, low resting cerebral perfusion levels in older individuals is an indicator of poor cerebrovascular health (Nagai et al, 2010;Weijs et al, 2022) and a prognostic biomarker for the development of cognitive impairment and dementia in the preclinical stages of disease (Weijs et al, 2022;Wolters et al, 2017). Lower cerebral perfusion and dysfunctional CBF regulation has been linked to age-related neural dysfunction (Stefanidis et al, 2020), cognitive impairment (Weijs et al, 2022;Wolters et al, 2017), and neurodegenerative diseases such as . CC-BY-NC 4.0 International license available under a was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.…”

Section: Introductionmentioning

confidence: 99%

“…Over the course of aging, there is a decline in CBF that occurs as early as middle age (Xing et al, 2017) and may be attenuated by engagement in regular physical activity (Sugawara et al, 2020; Thomas et al, 2013). Clinically, low resting cerebral perfusion levels in older individuals is an indicator of poor cerebrovascular health (Nagai et al, 2010; Weijs et al, 2022) and a prognostic biomarker for the development of cognitive impairment and dementia in the preclinical stages of disease (Weijs et al, 2022; Wolters et al, 2017). Lower cerebral perfusion and dysfunctional CBF regulation has been linked to age-related neural dysfunction (Stefanidis et al, 2020), cognitive impairment (Weijs et al, 2022; Wolters et al, 2017), and neurodegenerative diseases such as Alzheimer’s disease (Iadecola, 2004; Ouellette & Lacoste, 2021; Xie et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Hippocampal blood flow rapidly and preferentially increases after a bout of moderate-intensity exercise in older adults with poor cerebrovascular health

Palmer

Morris

Billinger

et al. 2022

Preprint

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Over the course of aging, there is an early degradation of cerebrovascular health that may be attenuated with aerobic exercise training. Yet, the acute cerebrovascular response to a single bout of exercise remains elusive, particularly within key brain regions most affected by age-related disease processes. We investigated the acute global and region-specific cerebral blood flow (CBF) response to 15 minutes of moderate-intensity aerobic exercise in older adults (≥65years) (n=60) using arterial spin labeling magnetic resonance imaging. Within 0-6 minutes post-exercise, CBF decreased across all regions, an effect that was attenuated in the hippocampus. The exercise-induced CBF drop was followed by a rebound effect over the 24-minute post-exercise assessment period, an effect that was most robust in the hippocampus. Individuals with low baseline perfusion demonstrated the greatest hippocampal-specific CBF effect post-exercise, showing no immediate drop and a rapid increase in CBF that exceeded baseline levels within 6-12 minutes post-exercise. Gains in domain-specific cognitive performance post-exercise were not associated with changes in regional CBF, suggesting dissociable effects of exercise on acute neural and vascular plasticity. Together, the present findings support a precision-medicine framework for the use of exercise to target brain health that carefully considers age-related changes in the cerebrovascular system.

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Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 97%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hippocampal blood flow rapidly and preferentially increases after a bout of moderate-intensity exercise in older adults with poor cerebrovascular health

Palmer

Morris

Billinger

et al. 2022

Preprint

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Long-Term Brain Structure and Cognition Following Bariatric Surgery

Custers,

Vreeken,

Kleemann

et al. 2024

JAMA Netw Open

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ImportanceWeight loss induced by bariatric surgery (BS) is associated with improved cognition and changed brain structure; however, previous studies on the association have used small cohorts and short follow-up periods, making it difficult to determine long-term neurological outcomes associated with BS.ObjectiveTo investigate long-term associations of weight loss after BS with cognition and brain structure and perfusion.Design, Setting, and ParticipantsThis cohort study included participants from the Bariatric Surgery Rijnstate and Radboudumc Neuroimaging and Cognition in Obesity study. Data from participants with severe obesity (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared] &gt;40, or BMI &gt;35 with comorbidities) eligible for Roux-en-Y gastric bypass and aged 35 to 55 years were enrolled from a hospital specialized in BS (Rijnstate Hospital, Arnhem, the Netherlands). Participants were recruited between September 2018 and December 2020 with follow-up till March 2023. Data were collected before BS and at 6 and 24 months after BS. Data were analyzed from March to November 2023.ExposureRoux-en-Y gastric bypass.Main Outcomes and MeasuresPrimary outcomes included body weight, BMI, waist circumference, blood pressure, medication use, cognitive performance (20% change index of compound z-score), brain volumes, cortical thickness, cerebral blood flow (CBF), and spatial coefficient of variation (sCOV). Secondary outcomes include cytokines, adipokines, depressive symptoms (assessed using the Beck Depression Inventory), and physical activity (assessed using the Baecke Questionnaire).ResultsA total of 133 participants (mean [SD] age, 46.8 [5.7] years; 112 [84.2%] female) were included. Global cognition was at least 20% higher in 52 participants (42.9%) at 24 months after BS. Compared with baseline, at 24 months, inflammatory markers were lower (mean [SD] high-sensitivity C-reactive protein: 4.77 [5.80] μg/mL vs 0.80 [1.09] μg/mL; P &lt; .001), fewer patients used antihypertensives (48 patients [36.1%] vs 22 patients [16.7%]), and patients had lower depressive symptoms (median [IQR] BDI score: 9.0 [5.0-13.0] vs 3.0 [1.0-6.0]; P &lt; .001) and greater physical activity (mean [SD] Baecke score: 7.64 [1.29] vs 8.19 [1.35]; P &lt; .001). After BS, brain structure and perfusion were lower in most brain regions, while hippocampal and white matter volume remained stable. CBF and sCOV did not change in nucleus accumbens and parietal cortex. The temporal cortex showed a greater thickness (mean [SD] thickness: 2.724 [0.101] mm vs 2.761 [0.007] mm; P = .007) and lower sCOV (median [IQR] sCOV: 4.41% [3.83%-5.18%] vs 3.97% [3.71%-4.59%]; P = .02) after BS.Conclusions and RelevanceThese findings suggest that BS was associated with health benefits 2 years after surgery. BS was associated with improved cognition and general health and changed blood vessel efficiency and cortical thickness of the temporal cortex. These results may improve treatment options for patients with obesity and dementia.

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A decade of aging in healthy older adults: longitudinal findings on cerebrovascular and cognitive health

Weijs¹,

Oudegeest-Sander

Vloet³

et al. 2023

GeroScience

Self Cite

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Research suggests an association between cerebrovascular health and cognitive decline, but previous work is limited by its cross-sectional nature or short (< 1–2 years) follow-up. Our aim was to examine, across 10 years of follow-up in healthy older adults, changes in cerebrovascular health and their relationship with subjective memory complaints as an early marker of cognitive decline. Between 2008 and 2010, twenty-eight healthy older adults (69 ± 4 years) underwent baseline blood pressure and transcranial Doppler measurements to assess middle cerebral artery blood velocity (MCAv), cerebrovascular resistance index (CVRi), and measures of cerebral autoregulation (CA). After 9–12 years of follow-up, these measurements were repeated, and presence of memory complaints was evaluated. Linear mixed-model analyses explored effects of aging on cerebrovascular parameters and whether memory complaints were associated with cerebrovascular changes. Across a median follow-up of 10.9 years, no changes in MCAv, CVRi, or CA were found. At baseline, these parameters were not different between subjects with (n = 15) versus without (n = 13) memory complaints. During follow-up, subjects with memory complaints showed larger decreases in MCAv (− 10% versus + 9%, P = 0.041) and increases in CVRi (+ 26% versus − 9%, P = 0.029) compared to other peers without memory complaints, but no distinct changes in CA parameters (P > 0.05). Although a decade of aging does not lead to deterioration in cerebral blood flow or autoregulation, our findings suggest that reductions in cerebral blood flow and increases in cerebrovascular resistance are associated with early subjective cognitive decline.

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Longitudinal changes in cerebral blood flow and their relation with cognitive decline in patients with dementia: Current knowledge and future directions

Abstract: Longitudinal changes in cerebral blood flow and their relation with cognitive decline in patients with dementia: Current knowledge and future directions.

Cited by 17 publications

References 66 publications

Hippocampal blood flow rapidly and preferentially increases after a bout of moderate-intensity exercise in older adults with poor cerebrovascular health

Hippocampal blood flow rapidly and preferentially increases after a bout of moderate-intensity exercise in older adults with poor cerebrovascular health

Long-Term Brain Structure and Cognition Following Bariatric Surgery

A decade of aging in healthy older adults: longitudinal findings on cerebrovascular and cognitive health

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