From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany.
Neurology. 2019 Feb 19;92(8):e758-e773. doi: 10.1212/WNL.0000000000006947. Epub 2019 Jan 23.
To test whether elevated blood pressure (BP) relates to gray matter (GM) volume (GMV) changes in young adults who had not previously been diagnosed with hypertension (systolic BP [SBP]/diastolic BP [DBP] ≥140/90 mm Hg).
We associated BP with GMV from structural 3T T1-weighted MRI of 423 healthy adults between 19 and 40 years of age (mean age 27.7 ± 5.3 years, 177 women, SBP/DBP 123.2/73.4 ± 12.2/8.5 mm Hg). Data originated from 4 previously unpublished cross-sectional studies conducted in Leipzig, Germany. We performed voxel-based morphometry on each study separately and combined results in image-based meta-analyses (IBMA) to assess cumulative effects across studies. Resting BP was assigned to 1 of 4 categories: (1) SBP <120 and DBP <80 mm Hg, (2) SBP 120-129 or DBP 80-84 mm Hg, (3) SBP 130-139 or DBP 85-89 mm Hg, (4) SBP ≥140 or DBP ≥90 mm Hg.
IBMA yielded the following results: (1) lower regional GMV was correlated with higher peripheral BP; (2) lower GMV was found with higher BP when comparing individuals in subhypertensive categories 3 and 2, respectively, to those in category 1; (3) lower BP-related GMV was found in regions including hippocampus, amygdala, thalamus, frontal, and parietal structures (e.g., precuneus).
BP ≥120/80 mm Hg was associated with lower GMV in regions that have previously been related to GM decline in older individuals with manifest hypertension. Our study shows that BP-associated GM alterations emerge continuously across the range of BP and earlier in adulthood than previously assumed. This suggests that treating hypertension or maintaining lower BP in early adulthood might be essential for preventing the pathophysiologic cascade of asymptomatic cerebrovascular disease to symptomatic end-organ damage, such as stroke or dementia.
检测未曾被诊断为高血压（收缩压 [SBP]/舒张压 [DBP]≥140/90mmHg）的年轻成年人中，血压升高是否与灰质体积（GMV）变化有关。
我们将血压与 423 名年龄在 19 至 40 岁（平均年龄 27.7±5.3 岁，177 名女性，SBP/DBP 123.2/73.4±12.2/8.5mmHg）健康成年人的结构 3T T1 加权 MRI 的 GMV 相关联。这些数据来自德国莱比锡的 4 项先前未发表的横断面研究。我们分别对每项研究进行基于体素的形态计量学分析，然后通过图像基础荟萃分析（IBMA）对研究结果进行综合评估，以评估各研究之间的累积效应。静息血压被分为以下 4 个类别之一：（1）SBP＜120mmHg 且 DBP＜80mmHg；（2）SBP 120-129mmHg 或 DBP 80-84mmHg；（3）SBP 130-139mmHg 或 DBP 85-89mmHg；（4）SBP≥140mmHg 或 DBP≥90mmHg。
IBMA 得出以下结果：（1）外周血压越高，局部 GMV 越低；（2）与 SBP ＜120mmHg 和 DBP＜80mmHg 的个体相比，分别处于亚高血压类别 3 和 2 的个体的 GMV 越低；（3）在海马体、杏仁核、丘脑、额叶和顶叶结构（如楔前叶）等区域发现了与血压相关的 GMV 降低。
BP≥120/80mmHg 与先前与高血压个体 GM 下降相关的区域的 GMV 降低有关。本研究表明，BP 相关的 GM 改变在整个 BP 范围内连续出现，并且比以前认为的更早出现在成年早期。这表明，在成年早期治疗高血压或维持较低的血压对于预防无症状脑血管疾病向症状性终末器官损害（如中风或痴呆）的病理生理级联反应可能至关重要。
