Cortical thinning is associated with brain pulsatility in older adults: An MRI and NIRS study

Sex-specific effects of intensity and dose of physical activity on BOLD-fMRI cerebrovascular reactivity and cerebral pulsatility

Cerebrovascular reactivity (CVR) and cerebral pulsatility (CP) are important indicators of cerebrovascular health, which are associated with physical activity (PA). While sex differences influence the impact of PA on cerebrovascular health, sex-specific effects of PA intensity and dose on CP and CVR remains unknown. This study aimed to evaluate the sex-specific effects of self-reported PA dose and intensity on CVR and CP. The Human Connectome Project - Aging dataset was used, including 626 participants (350 females, 276 males) aged 36-85. The effect of menopausal status was also assessed. Resting state fMRI data was used to estimate both CVR and CP. Weekly self-reported PA was quantified as metabolic equivalent of task. Females presented a unique non-linear relationship between relative CVR and total PA in the cerebral cortex. Females and menopausal subgroups revealed negative linear relationships with total and walking PA in occipital and cingulate regions. Males exhibited negative linear relationships between total and vigorous PA and CVR in parietal and cingulate regions. Postmenopausal females showed greater reductions across more regions in CP than other groups. Overall, males and females appear to benefit from different amounts and intensities of PA, with menopause status influencing the effect of PA on cerebrovascular health.

The pulsatile brain, pulse pressure, cognition, and antihypertensive treatments in older adults: a functional NIRS study

Age-related arterial stiffness increases pulsatility that reaches the cerebral microcirculation, compromises cerebrovascular health and lead to cognitive decline. The presence of cardiovascular risk factors (CVRFs) such as high blood pressure can exacerbate this effect. Despite extensive research on the impact of antihypertensive treatments on reducing arterial stiffness, little is known about the impact of antihypertensive treatments on pulsatility in cerebral microcirculation. This study investigated the impact of antihypertensive treatments on cerebral pulsatility and cognition in older adults with CVRFs. Participants were 42 older adults with diverse CVRFs in two groups of untreated (n = 21, mean 67.2 ± 5.9 years old, 57.1% female) and treated with antihypertensive medications (n = 21, mean 67.2 ± 5.5 years old, 61.1% female). Cognitive scores of processing speed and executive functions were evaluated behaviorally using the four subsets of the Stroop test. A near-infrared spectroscopy (NIRS) device recorded hemodynamics data from the frontal and motor cortex subregions. The data were then used to extract an optical index of cerebral pulsatility. Results indicated that after controlling for CVRFs, the antihypertensive treatment was associated with lower cerebral pulsatility (untreated 33.99 ± 6.68 vs. treated 28.88 ± 5.39 beats/min, p = 0.009). In both groups cerebral pulsatility was associated with pulse pressure (p < 0.05). Also, treated group had significantly higher cognitive scores in executive functions compared with the untreated group (p < 0.05). These results suggest that beyond its known effect on blood pressure, antihypertensive treatments might also favor cerebrovascular health by reducing pulsatility in the cerebral microcirculation.

Age group classification based on optical measurement of brain pulsation using machine learning

Optical techniques, such as functional near-infrared spectroscopy (fNIRS), contain high potential for the development of non-invasive wearable systems for evaluating cerebral vascular condition in aging, due to their portability and ability to monitor real-time changes in cerebral hemodynamics. In this study, thirty-six healthy adults were measured by single channel fNIRS to explore differences between two age groups using machine learning (ML). The subjects, measured during functional magnetic resonance imaging (fMRI) at Oulu University Hospital, were divided into young (age ≤ 32) and elderly (age ≥ 57) groups. Brain pulses were extracted from fNIRS using a single 830 nm wavelength. Four feature sets were derived from log-normal parameters estimated by pulse decomposition algorithm. ML experiments utilized support vector machines and random forest learners, along with maximum relevance minimum redundancy and principal component analysis for feature selection. Performance with increasing sample size was estimated using learning curve method. The best mean balanced accuracies for each feature set were over 75% (75.9%, 76.4%, 79.3%, 76.9%), indicating the pulse features containing age related information. Learning curves indicated stable classification performance with increasing sample size. The results demonstrate the potential of using single channel fNIRS in the analysis of aging.

Sex-specific effects of intensity and dose of physical activity on BOLD-fMRI cerebrovascular reactivity and cerebral pulsatility

Cerebrovascular reactivity (CVR) and cerebral pulsatility (CP) are important indicators of cerebrovascular health and have been shown to be associated with physical activity (PA). Sex differences have been shown to influence the impact of PA on cerebrovascular health. However, the sex-specific effects of PA on CP and CVR, particularly in relation to intensity and dosage of PA, remains unknown. Thus, this cross-sectional study aimed to evaluate the sex-specific effects of different intensities and doses of PA on CVR and CP. The Human Connectome - Aging dataset was used, including 626 participants (350 females, 276 males) aged 36-85 (mean age: 58.8 ± 14.1 years). Females were stratified into premenopausal and postmenopausal groups to assess the potential influence of menopausal status. Novel tools based solely on resting state fMRI data were used to estimate both CVR and CP. The International Physical Activity Questionnaire was used to quantify weekly self-reported PA as metabolic equivalent of task. Results indicated that both sexes and menopausal subgroups revealed negative linear relationships between relative CVR and PA. Furthermore, females presented a unique non-linear relationship between relative CVR and total PA in the cerebral cortex. In females, there were also relationships with total and walking PA in occipital and cingulate regions. In males, we observed relationships between total or vigorous PA and CVR in parietal and cingulate regions. Sex-specific effects were also observed with CP, whereby females benefited across a greater number of regions and intensities than males, especially in the postmenopause group. Overall, males and females appear to benefit from different amounts and intensities of PA, with menopause status significantly influencing the effect of PA on cerebrovascular outcomes, underscoring the need for sex-specific recommendations in promoting cerebrovascular health.

Clinical magnetic resonance imaging evaluation of glymphatic function

The glymphatic system is a system of specialized perivascular spaces in the brain that facilitates removal of toxic waste solutes from the brain. Evaluation of glymphatic system function by means of magnetic resonance imaging (MRI) has thus far been largely focused on rodents because of the limitations of intrathecal delivery of gadolinium-based contrast agents to humans. This review discusses MRI methods that can be employed clinically for glymphatic-related measurements intended for early diagnosis, prevention, and the treatment of various neurological conditions. Although glymphatic system-based MRI research is in its early stages, recent studies have identified promising noninvasive MRI markers associated with glymphatic system alterations in neurological diseases. However, further optimization in data acquisition, validation, and modeling are needed to investigate the glymphatic system within the clinical setting.

Non-Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries With MRI

Background

Damping of heartbeat‐induced pressure pulsations occurs in large arteries such as the aorta and extends to the small arteries and microcirculation. Since recently, 7 T MRI enables investigation of damping in the small cerebral arteries.

Purpose

To investigate flow pulsatility damping between the first segment of the middle cerebral artery (M1) and the small perforating arteries using magnetic resonance imaging.

Study Type

Retrospective.

Subjects

Thirty‐eight participants (45% female) aged above 50 without history of heart failure, carotid occlusive disease, or cognitive impairment.

Field Strength/Sequence

3 T gradient echo (GE) T1‐weighted images, spin‐echo fluid‐attenuated inversion recovery images, GE two‐dimensional (2D) phase‐contrast, and GE cine steady‐state free precession images were acquired. At 7 T, T1‐weighted images, GE quantitative‐flow, and GE 2D phase‐contrast images were acquired.

Assessment

Velocity pulsatilities of the M1 and perforating arteries in the basal ganglia (BG) and semi‐oval center (CSO) were measured. We used the damping index between the M1 and perforating arteries as a damping indicator (velocity pulsatility_M1/velocity pulsatility_CSO/BG). Left ventricular stroke volume (LVSV), mean arterial pressure (MAP), pulse pressure (PP), and aortic pulse wave velocity (PWV) were correlated with velocity pulsatility in the M1 and in perforating arteries, and with the damping index of the CSO and BG.

Statistical Tests

Correlations of LVSV, MAP, PP, and PWV with velocity pulsatility in the M1 and small perforating arteries, and correlations with the damping indices were evaluated with linear regression analyses.

Results

PP and PWV were significantly positively correlated to M1 velocity pulsatility. PWV was significantly negatively correlated to CSO velocity pulsatility, and PP was unrelated to CSO velocity pulsatility (P = 0.28). PP and PWV were uncorrelated to BG velocity pulsatility (P = 0.25; P = 0.68). PWV and PP were significantly positively correlated with the CSO damping index.

Data Conclusion

Our study demonstrated a dynamic damping of velocity pulsatility between the M1 and small cerebral perforating arteries in relation to proximal stress.

Level of Evidence

4

Technical Efficacy

Stage 1

Longitudinal Impact of Physical Activity on Brain Pulsatility Index and Cognition in Older Adults with Cardiovascular Risk Factors: A NIRS Study

Recent studies have shown that optical indices of cerebral pulsatility, including cerebral pulse amplitude, are linked to cerebrovascular health. A chronically higher cerebral pulsatility is associated with cognitive decline. Although it is widely known that regular physical activity improves cognitive functions, little is known about the association between physical activity and the optical index of cerebral pulsatility. This study assessed the impact of 12 months of regular physical activity on the changes in the optical index of cerebral pulsatility and explored its association with cognition. A total of 19 older adults (aged 59-79 years) with cardiovascular risk factors (CVRF) completed the study. Low-intensity, short-duration walking as a brief cardiovascular challenge was used to study the impact of regular physical activity on post-walking changes in cerebral pulsatility index. The participants walked on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data from the frontal and motor cortex subregions. Our data indicated that 12 months of physical activity was associated with lower global cerebral pulse amplitude, which was associated with higher cognitive scores in executive functions. Further, the global cerebral pulsatility index was reduced after short-duration walking, and this reduction was greater after 12 months of regular physical activity compared with the baseline. This may be an indication of improvement in cerebrovascular response to the cardiovascular challenge after regular physical activity. This study suggests that 12 months of physical activity may support cognitive functions through improving cerebral pulsatility in older adults with CVRF.