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Kapoor A, Dutt S, Alitin JPM, Sible IJ, Marshall A, Shenasa F, Engstrom AC, Gaubert A, Shao X, Bradford DR, Rodgers K, Mather M, Wang DJJ, Nation DA. Older adults with reduced cerebrovascular reactivity exhibit high white matter hyperintensity burden. Neurobiol Aging 2024; 139:5-10. [PMID: 38579393 DOI: 10.1016/j.neurobiolaging.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
Cerebrovascular reactivity (CVR) deficits may contribute to small vessel disease, such as white matter hyperintensities (WMH). Moreover, apolipoprotein-e4 (APOE4) carriers at genetic risk for Alzheimer's disease exhibit cerebrovascular dysfunction relative to non-carriers. We examined whether older adults, and APOE4 carriers specifically, with diminished CVR would exhibit higher WMH burden. Independently living older adults (N = 125, mean age = 69.2 years; SD = 7.6; 31.2% male) free of dementia or clinical stroke underwent brain MRI to quantify cerebral perfusion during CVR to hypercapnia and hypocapnia and determine WMH volume. Adjusting for age, sex and intracranial volume, hierarchical regression analysis revealed a significant association between whole brain CVR to hypercapnia and WMH overall [B = -.02, 95% CI (-.04, -.008), p =.003] and in APOE4 carriers [B = -.03, 95% CI (-.06, -.009), p =.009]. Findings suggest deficits in cerebral vasodilatory capacity are associated with WMH burden in older adults and future studies are warranted to further delineate the effect of APOE4 on precipitating WMH.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Allison C Engstrom
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - David Robert Bradford
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Kathleen Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Mara Mather
- University of Southern California Leonard Davis School of Gerontology, USA
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- University of Southern California Leonard Davis School of Gerontology, USA; Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, University of Southern California Keck School of Medicine, USA.
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Sible IJ, Jang JY, Blanken AE, Alitin JPM, Engstrom A, Dutt S, Marshall AJ, Kapoor A, Shenasa F, Gaubert A, Nguyen A, Ferrer F, Bradford DR, Rodgers KE, Mather M, Duke Han S, Nation DA. Short-term blood pressure variability and brain functional network connectivity in older adults. NEUROIMAGE. REPORTS 2024; 4:100198. [PMID: 38699510 PMCID: PMC11064972 DOI: 10.1016/j.ynirp.2024.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Blood pressure variability is increasingly linked with cerebrovascular disease and Alzheimer's disease, independent of mean blood pressure levels. Elevated blood pressure variability is also associated with attenuated cerebrovascular reactivity, which may have implications for functional hyperemia underpinning brain network connectivity. It remains unclear whether blood pressure variability is related to functional network connectivity. We examined relationships between beat-to-beat blood pressure variability and functional connectivity in brain networks vulnerable to aging and Alzheimer's disease. Methods 53 community-dwelling older adults (mean [SD] age = 69.9 [7.5] years, 62.3% female) without history of dementia or clinical stroke underwent continuous blood pressure monitoring and resting state fMRI scan. Blood pressure variability was calculated as variability independent of mean. Functional connectivity was determined by resting state fMRI for several brain networks: default, salience, dorsal attention, fronto-parietal, and language. Multiple linear regression examined relationships between short-term blood pressure variability and functional network connectivity. Results Elevated short-term blood pressure variability was associated with lower functional connectivity in the default network (systolic: standardized ß = -0.30 [95% CI -0.59, -0.01], p = .04). There were no significant associations between blood pressure variability and connectivity in other functional networks or between mean blood pressure and functional connectivity in any network. Discussion Older adults with elevated short-term blood pressure variability exhibit lower resting state functional connectivity in the default network. Findings support the role of blood pressure variability in neurovascular dysfunction and Alzheimer's disease. Blood pressure variability may represent an understudied early vascular risk factor for neurovascular dysfunction relevant to Alzheimer's disease, with potential therapeutic implications.
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Affiliation(s)
- Isabel J. Sible
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA 92697, USA
| | - Anna E. Blanken
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, 94158, USA
| | - John Paul M. Alitin
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Allie Engstrom
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Shubir Dutt
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, 94158, USA
| | - Anisa J. Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Aimée Gaubert
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Amy Nguyen
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Farrah Ferrer
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - David R. Bradford
- Center for Innovation in Brain Science, Department of Pharmacology, The University of Arizona, Tucson, AZ, 85721, USA
| | - Kathleen E. Rodgers
- Center for Innovation in Brain Science, Department of Pharmacology, The University of Arizona, Tucson, AZ, 85721, USA
| | - Mara Mather
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - S. Duke Han
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Department of Family Medicine, Keck School of Medicine of University of Southern California, Alhambra, CA 91803, USA
| | - Daniel A. Nation
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
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Fico BG, Miller KB, Rivera-Rivera LA, Corkery AT, Pearson AG, Loggie NA, Howery AJ, Rowley HA, Johnson KM, Johnson SC, Wieben O, Barnes JN. Cerebral hemodynamics comparison using transcranial doppler ultrasound and 4D flow MRI. Front Physiol 2023; 14:1198615. [PMID: 37304825 PMCID: PMC10250020 DOI: 10.3389/fphys.2023.1198615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction: Age-related changes in cerebral hemodynamics are controversial and discrepancies may be due to experimental techniques. As such, the purpose of this study was to compare cerebral hemodynamics measurements of the middle cerebral artery (MCA) between transcranial Doppler ultrasound (TCD) and four-dimensional flow MRI (4D flow MRI). Methods: Twenty young (25 ± 3 years) and 19 older (62 ± 6 years) participants underwent two randomized study visits to evaluate hemodynamics at baseline (normocapnia) and in response to stepped hypercapnia (4% CO2, and 6% CO2) using TCD and 4D flow MRI. Cerebral hemodynamic measures included MCA velocity, MCA flow, cerebral pulsatility index (PI) and cerebrovascular reactivity to hypercapnia. MCA flow was only assessed using 4D flow MRI. Results: MCA velocity between the TCD and 4D flow MRI methods was positively correlated across the normocapnia and hypercapnia conditions (r = 0.262; p = 0.004). Additionally, cerebral PI was significantly correlated between TCD and 4D flow MRI across the conditions (r = 0.236; p = 0.010). However, there was no significant association between MCA velocity using TCD and MCA flow using 4D flow MRI across the conditions (r = 0.079; p = 0.397). When age-associated differences in cerebrovascular reactivity using conductance were compared using both methodologies, cerebrovascular reactivity was greater in young adults compared to older adults when using 4D flow MRI (2.11 ± 1.68 mL/min/mmHg/mmHg vs. 0.78 ± 1.68 mL/min/mmHg/mmHg; p = 0.019), but not with TCD (0.88 ± 1.01 cm/s/mmHg/mmHg vs. 0.68 ± 0.94 cm/s/mmHg/mmHg; p = 0.513). Conclusion: Our results demonstrated good agreement between the methods at measuring MCA velocity during normocapnia and in response to hypercapnia, but MCA velocity and MCA flow were not related. In addition, measurements using 4D flow MRI revealed effects of aging on cerebral hemodynamics that were not apparent using TCD.
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Affiliation(s)
- Brandon G. Fico
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Kathleen B. Miller
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Leonardo A. Rivera-Rivera
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Adam T. Corkery
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Andrew G. Pearson
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Nicole A. Loggie
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Anna J. Howery
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
| | - Howard A. Rowley
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Kevin M. Johnson
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veteran’s Hospital, Madison, WI, United States
| | - Oliver Wieben
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jill N. Barnes
- Department of Kinesiology, Bruno Balke Biodynamics Laboratory, University of Wisconsin-Madison, Madison, WI, United States
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Ding X, Zha T, Abudurousuli G, Zhao C, Chen Z, Zhang Y, Gui B. Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis. BMC Geriatr 2023; 23:123. [PMID: 36879186 PMCID: PMC9987102 DOI: 10.1186/s12877-023-03804-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Postoperative cognitive dysfunction (POCD) is common after surgery and anesthesia, particularly in older patients. It has been reported that regional cerebral oxygen saturation (rSO2) monitoring potentially influences the occurrence of POCD. However, its role in the prevention of POCD remains controversial in older patients. Additionally, the quality of evidence on this topic is still relatively poor. METHODS The electronic databases PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched using the indicated keywords from their inception to June 10, 2022. We limited our meta-analysis to randomized controlled trials (RCTs) that assessed the effects of rSO2 monitoring on POCD in older patients. Methodological quality and risk of bias were assessed. The primary outcome was the incidence of POCD during hospitalization. The secondary outcomes were postoperative complications and the length of hospital stay (LOS). Odds ratios (OR) and 95% confidence intervals (CI) were calculated to determine the incidence of POCD and postoperative complications. The standardized mean difference (SMD) instead of the raw mean difference and 95% CI were calculated for LOS. RESULTS Six RCTs, involving 377 older patients, were included in this meta-analysis. The incidence of POCD ranges from 17 to 89%, with an overall prevalence of 47% in our pooled analysis. Our results demonstrated that rSO2-guided intervention could reduce the incidence of POCD in older patients undergoing non-cardiac surgery (OR, 0.44; 95% CI, 0.25 to 0.79; P = 0.006) rather than cardiac surgery (OR, 0.69; 95% CI, 0.32 to 1.52; P = 0.36). Intraoperative rSO2 monitoring was also associated with a significantly shorter LOS in older patients undergoing non-cardiac surgery (SMD, -0.93; 95% CI, -1.75 to -0.11; P = 0.03). Neither the incidence of postoperative cardiovascular (OR, 1.12; 95% CI, 0.40 to 3.17; P = 0.83) nor surgical (OR, 0.78; 95% CI, 0.35 to 1.75; P = 0.54) complications were affected by the use of rSO2 monitoring. CONCLUSION The use of rSO2 monitoring is associated with a lower risk of POCD and a shorter LOS in older patients undergoing non-cardiac surgery. This may have the potential to prevent POCD in high-risk populations. Further large RCTs are still warranted to support these preliminary findings.
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Affiliation(s)
- Xiahao Ding
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Tianming Zha
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Gulibositan Abudurousuli
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Cuimei Zhao
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China.,Department of Anesthesiology, Nanjing Qixia District Hospital, 210046, Nanjing, China
| | - Zixuan Chen
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Yang Zhang
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Bo Gui
- Department of Anesthesiology and Perioperative Medicine, 1st Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, 210029, Nanjing, Jiangsu, China.
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Kecskés S, Menyhárt Á, Bari F, Farkas E. Nimodipine augments cerebrovascular reactivity in aging but runs the risk of local perfusion reduction in acute cerebral ischemia. Front Aging Neurosci 2023; 15:1175281. [PMID: 37181624 PMCID: PMC10174256 DOI: 10.3389/fnagi.2023.1175281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction The efficacy of cerebrovascular reactivity (CVR) is taken as an indicator of cerebrovascular health. Methods and Results We found that CVR tested with the inhalation of 10 % CO2 declined in the parietal cortex of 18-20-month-old rats. The CVR deficit in old rats was coincident with cerebrovascular smooth muscle cell and astrocyte senescence, revealed by the immuno-labeling of the cellular senescence marker p16 in these cells. In a next series of experiments, CVR was severely impaired in the acute phase of incomplete global forebrain ischemia produced by the bilateral occlusion of the common carotid arteries in young adult rats. In acute ischemia, CVR impairment often manifested as a perfusion drop rather than blood flow elevation in response to hypercapnia. Next, nimodipine, an L-type voltage-gated calcium channel antagonist was administered topically to rescue CVR in both aging, and cerebra ischemia. Nimodipine augmented CVR in the aged brain, but worsened CVR impairment in acute cerebral ischemia. Discussion A careful evaluation of benefits and side effects of nimodipine is recommended, especially in acute ischemic stroke.
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Affiliation(s)
- Szilvia Kecskés
- Cerebral Blood Flow and Metabolism Research Group, Hungarian Centre of Excellence for Molecular Medicine – University of Szeged, Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Ákos Menyhárt
- Cerebral Blood Flow and Metabolism Research Group, Hungarian Centre of Excellence for Molecular Medicine – University of Szeged, Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Ferenc Bari
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Eszter Farkas
- Cerebral Blood Flow and Metabolism Research Group, Hungarian Centre of Excellence for Molecular Medicine – University of Szeged, Szeged, Hungary
- Department of Cell Biology and Molecular Medicine, Albert Szent-Györgyi Medical School and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- *Correspondence: Eszter Farkas,
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Sible IJ, Jang JY, Dutt S, Yew B, Alitin JPM, Li Y, Blanken AE, Ho JK, Marshall AJ, Kapoor A, Shenasa F, Gaubert A, Nguyen A, Sturm VE, Mather M, Rodgers KE, Shao X, Wang DJ, Nation DA. Older Adults With Higher Blood Pressure Variability Exhibit Cerebrovascular Reactivity Deficits. Am J Hypertens 2023; 36:63-68. [PMID: 36149821 PMCID: PMC9793985 DOI: 10.1093/ajh/hpac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Elevated blood pressure (BP) variability is predictive of increased risk for stroke, cerebrovascular disease, and other vascular brain injuries, independent of traditionally studied average BP levels. However, no studies to date have evaluated whether BP variability is related to diminished cerebrovascular reactivity, which may represent an early marker of cerebrovascular dysfunction presaging vascular brain injury. METHODS The present study investigated BP variability and cerebrovascular reactivity in a sample of 41 community-dwelling older adults (mean age 69.6 [SD 8.7] years) without a history of dementia or stroke. Short-term BP variability was determined from BP measurements collected continuously during a 5-minute resting period followed by cerebrovascular reactivity during 5-minute hypocapnia and hypercapnia challenge induced by visually guided breathing conditions. Cerebrovascular reactivity was quantified as percent change in cerebral perfusion by pseudo-continuous arterial spin labeling (pCASL)-MRI per unit change in end-tidal CO2. RESULTS Elevated systolic BP variability was related to lower whole brain cerebrovascular reactivity during hypocapnia (ß = -0.43 [95% CI -0.73, -0.12]; P = 0.008; adjusted R2 =.11) and hypercapnia (ß = -0.42 [95% CI -0.77, -0.06]; P = 0.02; adjusted R2 = 0.19). CONCLUSIONS Findings add to prior work linking BP variability and cerebrovascular disease burden and suggest BP variability may also be related to prodromal markers of cerebrovascular dysfunction and disease, with potential therapeutic implications.
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Affiliation(s)
- Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Anisa J Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Amy Nguyen
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
| | - Virginia E Sturm
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94158, USA
- Department of Neurology, University of California, San Francisco, San Francisco, CA, 94158, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Mara Mather
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Kathleen E Rodgers
- Center for Innovation in Brain Science, Department of Pharmacology, The University of Arizona, Tucson, AZ, 85721, USA
| | - Xingfeng Shao
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Danny J Wang
- Laboratory of Functional MRI Technology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, 90033, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA 92697, USA
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
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7
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Kapoor A, Yew B, Jang JY, Dutt S, Li Y, Alitin JPM, Gaubert A, Ho JK, Blanken AE, Sible IJ, Marshall A, Shao X, Mather M, Wang DJJ, Nation DA. Older adults with perivascular spaces exhibit cerebrovascular reactivity deficits. Neuroimage 2022; 264:119746. [PMID: 36370956 PMCID: PMC10033456 DOI: 10.1016/j.neuroimage.2022.119746] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perivascular spaces on brain magnetic resonance imaging (MRI) may indicate poor fluid drainage in the brain and have been associated with numerous neurological conditions. Cerebrovascular reactivity (CVR) is a marker of cerebrovascular function and represents the ability of cerebral blood vessels to regulate cerebral blood flow in response to vasodilatory or vasoconstrictive stimuli. We aimed to examine whether pathological widening of the perivascular space in older adults may be associated with deficits in CVR. METHODS Independently living older adults free of dementia or clinical stroke were recruited from the community and underwent brain MRI. Pseudo-continuous arterial spin labeling MRI quantified whole brain cerebral perfusion at rest and during CVR to hypercapnia and hypocapnia induced by visually guided breathing exercises. Perivascular spaces were visually scored using existing scales. RESULTS Thirty-seven independently living older adults (mean age = 66.3 years; SD = 6.8; age range 55-84 years; 29.7% male) were included in the current analysis. Multiple linear regression analysis revealed a significant negative association between burden of perivascular spaces and global CVR to hypercapnia (B = -2.0, 95% CI (-3.6, -0.4), p = .015), adjusting for age and sex. Perivascular spaces were not related to CVR to hypocapnia. DISCUSSION Perivascular spaces are associated with deficits in cerebrovascular vasodilatory response, but not vasoconstrictive response. Enlargement of perivascular spaces could contribute to, or be influenced by, deficits in CVR. Additional longitudinal studies are warranted to improve our understanding of the relationship between cerebrovascular function and perivascular space enlargement.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Aimee Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System & Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Mara Mather
- Davis School of Gerontology and Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Department of Psychological Science, University of California, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA.
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8
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Mutch WAC. Anesthesia and Postoperative Cognitive Impairment: Types of Knowing. Anesth Analg 2022; 135:1315-1320. [PMID: 36384015 DOI: 10.1213/ane.0000000000006194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- W Alan C Mutch
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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