1 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA.
2 Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
J Cereb Blood Flow Metab. 2019 Jul;39(7):1247-1257. doi: 10.1177/0271678X18754973. Epub 2018 Jan 22.
Cigarette smoking is often associated with dementia. This association is thought to be mediated by hypoperfusion; however, how smoking behavior relates to cerebral blood flow (CBF) remains unclear. Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort (mean age = 50; = 522), we examined the association between smoking behavior (status, cumulative pack-years, age at smoking initiation, and years since cessation) and CBF (arterial spin labeling) in brain lobes and regions linked to dementia. We used adjusted linear regression models and tested whether associations differed between current and former-smokers. Compared to never-smokers, former-smokers had lower CBF in the parietal and occipital lobes, cuneus, precuneus, putamen, and insula; in contrast, current-smokers did not have lower CBF. The relationship between pack-years and CBF was different between current and former-smokers ( for interaction < 0.05): Among current-smokers, higher pack-years were associated with higher occipital, temporal, cuneus, putamen, insula, hippocampus, and caudate CBF; former-smokers had lower caudate CBF with increasing pack-years. Results show links between smoking and CBF at middle-age in regions implicated in cognitive and compulsive/addictive processes. Differences between current and former smoking suggest that distinct pathological and/or compensatory mechanisms may be involved depending on the timing and history of smoking exposure.
吸烟通常与痴呆有关。这种关联被认为是由灌注不足介导的；然而，吸烟行为与脑血流（CBF）的关系尚不清楚。本研究使用来自冠状动脉风险发展在年轻人（CARDIA）队列（平均年龄= 50；n=522）的数据，研究了吸烟行为（状态、累计包年数、开始吸烟的年龄和戒烟年限）与脑叶和与痴呆相关的区域的 CBF（动脉自旋标记）之间的关系。我们使用了调整后的线性回归模型，并检验了当前吸烟者和前吸烟者之间的关联是否存在差异。与从不吸烟者相比，前吸烟者的顶叶和枕叶、楔前叶、壳核、丘脑和岛叶的 CBF 较低；而当前吸烟者的 CBF 没有降低。包年数与 CBF 的关系在当前吸烟者和前吸烟者之间存在差异（for interaction < 0.05）：在当前吸烟者中，较高的包年数与较高的枕叶、颞叶、楔前叶、壳核、岛叶、海马体和尾状核 CBF 相关；而随着包年数的增加，前吸烟者的尾状核 CBF 降低。研究结果表明，在与认知和强迫/成瘾过程相关的区域，吸烟与 CBF 之间存在联系。当前吸烟和前吸烟之间的差异表明，根据吸烟暴露的时间和历史，可能涉及不同的病理和/或代偿机制。
