Maillard Pauline, Mitchell Gary F, Himali Jayandra J, Beiser Alexa, Tsao Connie W, Pase Matthew P, Satizabal Claudia L, Vasan Ramachandran S, Seshadri Sudha, DeCarli Charles
From the Imaging of Dementia and Aging (IDeA) Laboratory, Davis, CA (P.M.); Department of Neurology and Center for Neurosciences, University of California, Davis, CA (P.M., C.D.); Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.); The Framingham Heart Study, MA (J.J.H., A.B., M.P.P., C.L.S., S.S.); Boston University School of Medicine, MA (J.J.H., A.B., M.P.P., C.L.S., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (C.W.T.); and Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia (M.P.P.).
Stroke. 2016 Apr;47(4):1030-6. doi: 10.1161/STROKEAHA.116.012949. Epub 2016 Mar 10.
Previous work from the Framingham Heart Study suggests that brain changes because of arterial aging may begin in young adulthood and that such changes precede cognitive deficits. The objective of this study was to determine the association of arterial stiffness with measures of white matter and gray matter (GM) integrity in young adults.
One thousand nine hundred three participants from the Framingham Heart Study Third Generation (mean age, 46±8.7 years) had complete tonometry measurements and brain magnetic resonance imaging (T1-weighted and diffusion tensor imaging). Tonometry measures included carotid-femoral pulse wave velocity, augmentation index, carotid-brachial pressure amplification, and central pulse pressure. Fractional anisotropy and GM density images were computed from diffusion tensor imaging and T1 images. Registration to a common anatomic template enabled voxel-based linear regressions relating measures of fractional anisotropy and GM to tonometry measures, adjusting for relevant covariables.
Higher carotid-femoral pulse wave velocity was associated with lower regional fractional anisotropy, including the corpus callosum and the corona radiata (8.7 and 8.6 cc, respectively, P<0.001), as well as lower GM density in the thalamus region (0.9 cc, P<0.001). Analyses did not reveal significant associations between other tonometry measures and fractional anisotropy or GM.
Among young healthy adults, higher aortic stiffness was associated with measures of reduced white matter and GM integrity in areas implicated in cognitive decline and Alzheimer's disease. Greater aortic stiffness may result in subclinical vascular brain injury at ages much younger than previously described.
弗明汉心脏研究先前的工作表明，动脉老化导致的脑部变化可能始于青年期，且这些变化先于认知缺陷出现。本研究的目的是确定青年成人中动脉僵硬度与白质和灰质（GM）完整性测量指标之间的关联。
弗明汉心脏研究第三代的1903名参与者（平均年龄46±8.7岁）进行了完整的眼压测量和脑磁共振成像（T1加权和扩散张量成像）。眼压测量指标包括颈股脉搏波速度、增强指数、颈臂压力放大率和中心脉压。从扩散张量成像和T1图像计算出分数各向异性和GM密度图像。通过配准到一个共同的解剖模板，进行基于体素的线性回归，将分数各向异性和GM的测量指标与眼压测量指标相关联，并对相关协变量进行调整。
较高的颈股脉搏波速度与较低的区域分数各向异性相关，包括胼胝体和放射冠（分别为8.7和8.6立方厘米，P<0.001），以及丘脑区域较低的GM密度（0.9立方厘米，P<0.001）。分析未发现其他眼压测量指标与分数各向异性或GM之间存在显著关联。
在年轻健康成人中，较高的主动脉僵硬度与认知功能下降和阿尔茨海默病相关区域白质和GM完整性降低的测量指标有关。更高的主动脉僵硬度可能在比先前描述的年龄小得多的时候就导致亚临床血管性脑损伤。
