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动态脑自动调节与神经血管耦合在认知障碍中的相互作用。

The Interaction of Dynamic Cerebral Autoregulation and Neurovascular Coupling in Cognitive Impairment.

机构信息

Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.

出版信息

Curr Alzheimer Res. 2021;18(14):1067-1076. doi: 10.2174/1567205019666211227102936.

Abstract

BACKGROUND

Dynamic cerebral autoregulation (dCA) remains intact in both ageing and dementia, but studies of neurovascular coupling (NVC) have produced mixed findings.

OBJECTIVE

We investigated the effects of task-activation on dCA in healthy older adults (HOA), and patients with mild cognitive impairment (MCI) and Alzheimer's Disease (AD).

METHODS

Resting and task-activated data from thirty HOA, twenty-two MCI, and thirty-four AD were extracted from a database. The autoregulation index (ARI) was determined at rest and during five cognitive tasks from transfer function analysis. NVC responses were present where group-specific thresholds of cross-correlation peak function and variance ratio were exceeded. Cumulative response rate (CRR) was the total number of positive responses across five tasks and two hemispheres.

RESULTS

ARI differed between groups in dominant (p=0.012) and non-dominant (p=0.042) hemispheres at rest but not during task-activation (p=0.33). ARI decreased during language and memory tasks in HOA (p=0.002) but not in MCI or AD (p=0.40). There was a significant positive correlation between baseline ARI and CRR in all groups (r=0.26, p=0.018), but not within sub-groups.

CONCLUSION

dCA efficiency was reduced in task-activation in healthy but not cognitively impaired participants. These results indicate differences in neurovascular processing in healthy older adults relative to cognitively impaired individuals.

摘要

背景

在衰老和痴呆症中,动态脑自动调节(dCA)仍然完好无损,但神经血管耦合(NVC)的研究结果却喜忧参半。

目的

我们研究了任务激活对健康老年人(HOA)、轻度认知障碍(MCI)和阿尔茨海默病(AD)患者的 dCA 的影响。

方法

从数据库中提取了三十名 HOA、二十二名 MCI 和三十四名 AD 的静息和任务激活数据。使用传递函数分析确定了自动调节指数(ARI)在静息和五项认知任务期间的变化。当交叉相关峰函数和方差比的组特异性阈值超过时,会出现 NVC 响应。累积响应率(CRR)是五项任务和两个半球中所有阳性响应的总数。

结果

在静息状态下,主导(p=0.012)和非主导(p=0.042)半球的 ARI 在组间存在差异,但在任务激活时则没有(p=0.33)。在 HOA 中,语言和记忆任务期间 ARI 下降(p=0.002),而在 MCI 或 AD 中则没有(p=0.40)。在所有组中,基线 ARI 与 CRR 之间存在显著的正相关(r=0.26,p=0.018),但在亚组中则没有。

结论

在健康参与者中,dCA 在任务激活时的效率降低,但在认知受损的参与者中则没有。这些结果表明,与认知受损的个体相比,健康老年人的神经血管处理存在差异。

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