Takashi Tarumi1, Thomas S Harris1, Candace Hill1, Zohre German1, Jonathan Riley1, Marcel Turner1, Kyle B Womack1, Diana R Kerwin1, Nancy L Monson1, Ann M Stowe1, Dana Mathews1, C Munro Cullum1, Rong Zhang2. 1. From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas. 2. From the Institute for Exercise and Environmental Medicine (T.T., C.H., J.R., M.T., R.Z.) and Texas Alzheimer's and Memory Disorders (D.R.K.), Texas Health Presbyterian Hospital Dallas; and the Departments of Internal Medicine (T.T., R.Z.), Neurology and Neurotherapeutics (T.S.H., Z.G., K.B.W., N.L.M., A.M.S., D.M., C.M.C., R.Z.), Psychiatry (K.B.W., C.M.C.), and Radiology (D.M.), University of Texas Southwestern Medical Center, Dallas. rongzhang@texashealth.org.
Abstract
OBJECTIVE: To determine whether cortical β-amyloid (Aβ) deposition is associated with circadian blood pressure (BP) profiles and dynamic cerebral blood flow (CBF) regulation in patients with amnestic mild cognitive impairment (aMCI). METHODS: Forty participants with aMCI were included in this study. Cortical Aβ depositions were measured by (18)F-florbetapir PET and expressed as the standardized uptake value ratio (SUVR) relative to the cerebellum. Circadian BP profiles were measured by 24-hour ambulatory monitoring during awake and sleep periods. The dipping status of sleep BP (i.e., the percent changes from the awake BP) was calculated and dichotomized into the dipper (≥10%) and nondipper (<10%) groups. Dynamic CBF regulation was assessed by a transfer function analysis between beat-to-beat changes in BP and CBF velocity measured from the middle cerebral artery during a repeated sit-stand maneuver. RESULTS: Age was positively correlated with a greater Aβ deposition in the posterior cingulate, precuneus, and mean cortex. Accounting for the age effect, attenuated reductions in sleep systolic BP were associated with higher levels of posterior cingulate SUVR. Consistently, the nondippers exhibited a higher SUVR in the posterior cingulate than the dippers. Transfer function gain between changes in BP and CBF velocity was diminished in the nondippers, and moreover those individuals with a lower gain exhibited a higher SUVR in the posterior cingulate. CONCLUSIONS: Attenuated reductions in sleep BP are associated with a greater Aβ burden in the posterior cingulate and altered dynamic CBF regulation in patients with aMCI.
OBJECTIVE: To determine whether cortical β-amyloid (Aβ) deposition is associated with circadian blood pressure (BP) profiles and dynamic cerebral blood flow (CBF) regulation in patients with amnestic mild cognitive impairment (aMCI). METHODS: Forty participants with aMCI were included in this study. Cortical Aβ depositions were measured by (18)F-florbetapir PET and expressed as the standardized uptake value ratio (SUVR) relative to the cerebellum. Circadian BP profiles were measured by 24-hour ambulatory monitoring during awake and sleep periods. The dipping status of sleep BP (i.e., the percent changes from the awake BP) was calculated and dichotomized into the dipper (≥10%) and nondipper (<10%) groups. Dynamic CBF regulation was assessed by a transfer function analysis between beat-to-beat changes in BP and CBF velocity measured from the middle cerebral artery during a repeated sit-stand maneuver. RESULTS: Age was positively correlated with a greater Aβ deposition in the posterior cingulate, precuneus, and mean cortex. Accounting for the age effect, attenuated reductions in sleep systolic BP were associated with higher levels of posterior cingulate SUVR. Consistently, the nondippers exhibited a higher SUVR in the posterior cingulate than the dippers. Transfer function gain between changes in BP and CBF velocity was diminished in the nondippers, and moreover those individuals with a lower gain exhibited a higher SUVR in the posterior cingulate. CONCLUSIONS: Attenuated reductions in sleep BP are associated with a greater Aβ burden in the posterior cingulate and altered dynamic CBF regulation in patients with aMCI.
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