Brigid Waldron-Perrine1, Jason E Kisser2, Aaron Brody3, E Mark Haacke4, Rachelle Dawood5, Scott Millis1, Phillip Levy6. 1. Department of Physical Medicine and Rehabilitation, Wayne State University and Detroit Medical Center, Detroit, Michigan, USA. 2. Department of Psychology and Neuropsychology, Detroit Medical Center, Detroit, Michigan, USA. 3. Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA. 4. Department of Radiology,Wayne State University and Detroit Medical Center, Detroit, Michigan, USA. 5. Department of Emergency Medicine, Wayne State University, Detroit, Michigan, USA. 6. Department of Emergency Medicine and Integrative Biosciences Center, Wayne State University, Detroit, Michigan, USA.
Abstract
BACKGROUND: African Americans (AAs) are at high risk for hypertension (HTN) and poor blood pressure (BP) control. Persistently elevated BP contributes to cardiovascular morbidity. White matter hyperintensities (WMHs) are a definable magnetic resonance imaging (MRI) marker of cerebrovascular injury linked to impairments in higher level thinking (i.e., executive functions), memory formation, and speed of perceptual-motor processing. METHODS: This subinvestigation evaluated neuropsychological functioning in association with WMH on brain MRIs in 23 otherwise-healthy hypertensive AAs participating in an NIH-funded study of the effects of vitamin D on BP and cardiac remodeling in AA patients 30-74 years of age with HTN and left ventricular hypertrophy. Neuropsychological assessment included psychomotor processing speed [(Symbol Digit Modality Test (SDMT) and Trail Making Test], executive functioning (Controlled Oral Word Association Test and Trail Making Test Part B), memory (Rey Auditory Verbal Learning Test), and fine motor functioning (Finger Tapping). RESULTS: Significant correlations (P < 0.05) were found between volume of periventricular lesions and trails A (r = 0.51) and dominant hand finger tapping speed (r = -0.69) and between subcortical lesion volume and trails A (r = 0.60), both dominant (r = -0.62) and nondominant hand finger tapping speed (r = -0.76) and oral SDMT (r = -0.60); higher lesion volumes correlated to worse neuropsychological performance. CONCLUSIONS: Psychomotor tests including the Trail Making Test and finger tapping speed are sensitive indicators of subclinical deficits in mental processing speed and could serve as early markers of deep subcortical cerebrovascular injury in otherwise-healthy individuals with uncontrolled chronic HTN.
BACKGROUND: African Americans (AAs) are at high risk for hypertension (HTN) and poor blood pressure (BP) control. Persistently elevated BP contributes to cardiovascular morbidity. White matter hyperintensities (WMHs) are a definable magnetic resonance imaging (MRI) marker of cerebrovascular injury linked to impairments in higher level thinking (i.e., executive functions), memory formation, and speed of perceptual-motor processing. METHODS: This subinvestigation evaluated neuropsychological functioning in association with WMH on brain MRIs in 23 otherwise-healthy hypertensive AAs participating in an NIH-funded study of the effects of vitamin D on BP and cardiac remodeling in AA patients 30-74 years of age with HTN and left ventricular hypertrophy. Neuropsychological assessment included psychomotor processing speed [(Symbol Digit Modality Test (SDMT) and Trail Making Test], executive functioning (Controlled Oral Word Association Test and Trail Making Test Part B), memory (Rey Auditory Verbal Learning Test), and fine motor functioning (Finger Tapping). RESULTS: Significant correlations (P < 0.05) were found between volume of periventricular lesions and trails A (r = 0.51) and dominant hand finger tapping speed (r = -0.69) and between subcortical lesion volume and trails A (r = 0.60), both dominant (r = -0.62) and nondominant hand finger tapping speed (r = -0.76) and oral SDMT (r = -0.60); higher lesion volumes correlated to worse neuropsychological performance. CONCLUSIONS: Psychomotor tests including the Trail Making Test and finger tapping speed are sensitive indicators of subclinical deficits in mental processing speed and could serve as early markers of deep subcortical cerebrovascular injury in otherwise-healthy individuals with uncontrolled chronic HTN.
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