Mason Sarah Ann, Al Saikhan Lamia, Jones Siana, Bale Gemma, James Sarah-Naomi, Murray-Smith Heidi, Rapala Alicja, Williams Suzanne, Wong Brian, Richards Marcus, Fox Nick C, Hardy Rebecca, Schott Jonathan M, Chaturvedi Nish, Hughes Alun D
MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK.
Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, 2835 King Faisal Street, Dammam, Kingdom of Saudi Arabia.
Artery Res. 2020 Sep;26(3):170-179. doi: 10.2991/artres.k.200417.001. Epub 2020 Apr 24.
The commonest causes of dementia are Alzheimer's disease and vascular cognitive impairment. Although these conditions have been viewed as distinct entities, there is increasing evidence that neurodegenerative and vascular pathologies interact or overlap to cause cognitive decline, and that at least in some cases individuals at risk of cognitive decline exhibit abnormal cardiovascular physiology long before emergence of disease. However, the mechanisms linking haemodynamic disturbances with cognitive impairment and the various pathologies that cause dementia are poorly understood. A sub-sample of 502 participants from the Medical Research Council National Survey of Health and Development (NSHD) have participated in the first visit of a neuroscience sub-study referred to as Insight 46, where clinical, cognitive, imaging, and lifestyle data have been collected for the purpose of elucidating the pathological changes preceding dementia. This paper outlines the cardiovascular phenotyping performed in the follow-up visit of Insight 46, with the study participants now aged 74. In addition to standard cardiovascular assessments such as blood pressure measurements, echocardiography, and electrocardiography (ECG), functional Near Infrared Spectroscopy (fNIRS) has been included to provide an assessment of cerebrovascular function. A detailed description of the fNIRS protocol along with preliminary results from pilot data is presented. The combination of lifestyle data, brain structure/function, cognitive performance, and cardiovascular health obtained not only from Insight 46, but also from the whole NSHD provides an exciting opportunity to advance our understanding of the cardiovascular mechanisms underlying dementia and cognitive decline, and identify novel targets for intervention.
痴呆最常见的病因是阿尔茨海默病和血管性认知障碍。尽管这些病症一直被视为不同的实体，但越来越多的证据表明，神经退行性病变和血管病变相互作用或重叠，导致认知能力下降，而且至少在某些情况下，有认知能力下降风险的个体在疾病出现之前很久就表现出异常的心血管生理状况。然而，将血液动力学紊乱与认知障碍以及导致痴呆的各种病变联系起来的机制却知之甚少。医学研究理事会全国健康与发展调查（NSHD）的502名参与者的子样本参加了一项名为Insight 46的神经科学子研究的首次访视，该研究收集了临床、认知、影像和生活方式数据，以阐明痴呆之前的病理变化。本文概述了在Insight 46随访中进行的心血管表型分析，研究参与者目前年龄为74岁。除了标准的心血管评估，如血压测量、超声心动图和心电图（ECG）外，还纳入了功能性近红外光谱（fNIRS）以评估脑血管功能。本文还介绍了fNIRS方案的详细描述以及试点数据的初步结果。不仅从Insight 46，而且从整个NSHD获得的生活方式数据、脑结构/功能、认知表现和心血管健康的综合信息，为增进我们对痴呆和认知能力下降潜在心血管机制的理解以及确定新的干预靶点提供了一个令人兴奋的机会。
