Corey W Bown1, Omair A Khan1,2, Elizabeth E Moore1, Dandan Liu1,2, Kimberly R Pechman1,3, Francis E Cambronero1, James G Terry4, Sangeeta Nair4, L Taylor Davis1,3,4, Katherine A Gifford1,3, Bennett A Landman1,4,5,6, Timothy J Hohman1,3,7, John Jeffrey Carr8, Angela L Jefferson1,3,5. 1. Vanderbilt Memory & Alzheimer's Center (C.W.B., O.A.K., E.E.M., D.L., K.R.P., F.E.C., L.T.D., K.A.G., B.A.L., T.J.H., A.L.J.), Vanderbilt University Medical Center, Nashville, TN. 2. Department of Biostatistics (O.A.K., D.L.), Vanderbilt University Medical Center, Nashville, TN. 3. Department of Neurology (K.R.P., L.T.D., K.A.G., T.J.H., A.L.J.), Vanderbilt University Medical Center, Nashville, TN. 4. Department of Radiology and Radiological Sciences (J.G.T., S.N., L.T.D., B.A.L.), Vanderbilt University Medical Center, Nashville, TN. 5. Department of Biomedical Engineering (B.A.L., A.L.J.), Vanderbilt University, Nashville, TN. 6. Department of Electrical Engineering and Computer Science (B.A.L.), Vanderbilt University, Nashville, TN. 7. Vanderbilt Genetics Institute (T.J.H.), Vanderbilt University Medical Center, Nashville, TN. 8. Division of Cardiovascular Medicine, Department of Medicine (J.J.C.), Vanderbilt University Medical Center, Nashville, TN.
Abstract
OBJECTIVE: To determine whether baseline aortic stiffness, measured by aortic pulse wave velocity (PWV), relates to longitudinal cerebral gray or white matter changes among older adults. Baseline cardiac magnetic resonance imaging will be used to assess aortic PWV while brain magnetic resonance imaging will be used to assess gray matter and white matter hyperintensity (WMH) volumes at baseline, 18 months, 3 years, 5 years, and 7 years. Approach and Results: Aortic PWV (m/s) was quantified from cardiac magnetic resonance. Multimodal 3T brain magnetic resonance imaging included T1-weighted imaging for quantifying gray matter volumes and T2-weighted fluid-attenuated inversion recovery imaging for quantifying WMHs. Mixed-effects regression models related baseline aortic PWV to longitudinal gray matter volumes (total, frontal, parietal, temporal, occipital, hippocampal, and inferior lateral ventricle) and WMH volumes (total, frontal, parietal, temporal, and occipital) adjusting for age, sex, race/ethnicity, education, cognitive diagnosis, Framingham stroke risk profile, APOE (apolipoprotein E)-ε4 carrier status, and intracranial volume. Two hundred seventy-eight participants (73±7 years, 58% male, 87% self-identified as non-Hispanic White, 159 with normal cognition, and 119 with mild cognitive impairment) from the Vanderbilt Memory & Aging Project (n=335) were followed on average for 4.9±1.6 years with PWV measurements occurring from September 2012 to November 2014 and longitudinal brain magnetic resonance imaging measurements occurring from September 2012 to June 2021. Higher baseline aortic PWV was related to greater decrease in hippocampal (β=-3.6 [mm3/y]/[m/s]; [95% CI, -7.2 to -0.02] P=0.049) and occipital lobe (β=-34.2 [mm3/y]/[m/s]; [95% CI, -67.8 to -0.55] P=0.046) gray matter volume over time. Higher baseline aortic PWV was related to greater increase in WMH volume over time in the temporal lobe (β=17.0 [mm3/y]/[m/s]; [95% CI, 7.2-26.9] P<0.001). All associations may be driven by outliers. CONCLUSIONS: In older adults, higher baseline aortic PWV related to greater decrease in gray matter volume and greater increase in WMHs over time. Because of unmet cerebral metabolic demands and microvascular remodeling, arterial stiffening may preferentially affect certain highly active brain regions like the temporal lobes. These same regions are affected early in the course of Alzheimer disease.
OBJECTIVE: To determine whether baseline aortic stiffness, measured by aortic pulse wave velocity (PWV), relates to longitudinal cerebral gray or white matter changes among older adults. Baseline cardiac magnetic resonance imaging will be used to assess aortic PWV while brain magnetic resonance imaging will be used to assess gray matter and white matter hyperintensity (WMH) volumes at baseline, 18 months, 3 years, 5 years, and 7 years. Approach and Results: Aortic PWV (m/s) was quantified from cardiac magnetic resonance. Multimodal 3T brain magnetic resonance imaging included T1-weighted imaging for quantifying gray matter volumes and T2-weighted fluid-attenuated inversion recovery imaging for quantifying WMHs. Mixed-effects regression models related baseline aortic PWV to longitudinal gray matter volumes (total, frontal, parietal, temporal, occipital, hippocampal, and inferior lateral ventricle) and WMH volumes (total, frontal, parietal, temporal, and occipital) adjusting for age, sex, race/ethnicity, education, cognitive diagnosis, Framingham stroke risk profile, APOE (apolipoprotein E)-ε4 carrier status, and intracranial volume. Two hundred seventy-eight participants (73±7 years, 58% male, 87% self-identified as non-Hispanic White, 159 with normal cognition, and 119 with mild cognitive impairment) from the Vanderbilt Memory & Aging Project (n=335) were followed on average for 4.9±1.6 years with PWV measurements occurring from September 2012 to November 2014 and longitudinal brain magnetic resonance imaging measurements occurring from September 2012 to June 2021. Higher baseline aortic PWV was related to greater decrease in hippocampal (β=-3.6 [mm3/y]/[m/s]; [95% CI, -7.2 to -0.02] P=0.049) and occipital lobe (β=-34.2 [mm3/y]/[m/s]; [95% CI, -67.8 to -0.55] P=0.046) gray matter volume over time. Higher baseline aortic PWV was related to greater increase in WMH volume over time in the temporal lobe (β=17.0 [mm3/y]/[m/s]; [95% CI, 7.2-26.9] P<0.001). All associations may be driven by outliers. CONCLUSIONS: In older adults, higher baseline aortic PWV related to greater decrease in gray matter volume and greater increase in WMHs over time. Because of unmet cerebral metabolic demands and microvascular remodeling, arterial stiffening may preferentially affect certain highly active brain regions like the temporal lobes. These same regions are affected early in the course of Alzheimer disease.
Authors: Janice M Diaz-Otero; Hannah Garver; Gregory D Fink; William F Jackson; Anne M Dorrance Journal: Am J Physiol Heart Circ Physiol Date: 2015-12-04 Impact factor: 4.733
Authors: Ana C Anderson; David E Anderson; Lisa Bregoli; William D Hastings; Nasim Kassam; Charles Lei; Rucha Chandwaskar; Jozsef Karman; Ee W Su; Mitsuomi Hirashima; Jeffrey N Bruce; Lawrence P Kane; Vijay K Kuchroo; David A Hafler Journal: Science Date: 2007-11-16 Impact factor: 47.728