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胼胝体的区域性易损性与心血管风险有关。

Regional Vulnerability of the Corpus Callosum in the Context of Cardiovascular Risk.

机构信息

Department of Neurology, University of California, San Francisco, Memory and Aging Center, San Francisco, CA, USA.

Palo Alto University, CA, USA.

出版信息

J Geriatr Psychiatry Neurol. 2023 Sep;36(5):397-406. doi: 10.1177/08919887231154931. Epub 2023 Jan 29.

Abstract

Many factors outside of cardiovascular health can impact the structure of white matter. Identification of reliable and clinically meaningful biomarkers of the neural effects of systemic and cardiovascular health are needed to refine etiologic predictions. We examined whether the corpus callosum demonstrates regional vulnerability to systemic cardiovascular risk factors. Three hundred and ninety-four older adults without dementia completed brain MRI, neurobehavioral evaluations, and blood draws. A subset ( = 126, = 128) of individuals had blood plasma analyzed for inflammatory markers of interest (IL-6 and TNF-alpha). Considering diffusion tensor imaging (DTI) is a particularly reliable measure of white matter integrity, we utilized DTI to examine fractional anisotropy (FA) of anterior and posterior regions of the corpus callosum. Using multiple linear regression models, we simultaneously examined FA of the genu and the splenium to compare their associations with systemic and cardiovascular risk factors. Lower FA of the genu but not splenium was associated with greater systemic and cardiovascular risk, including higher systolic blood pressure (β = -0.17, = .020), hemoglobin A1C (β = -0.21, = .016) and IL-6 (β = -0.34, = .005). FA of the genu was uniquely associated with cognitive processing speed (β = 0.20, = .0015) and executive functioning (β = 0.15, = .012), but not memory performances (β = 0.05, = .357). Our results demonstrated differential vulnerability of the corpus callosum, such that frontal regions showed stronger, independent associations with biomarkers of systemic and cardiovascular health in comparison to posterior regions. Posterior white matter integrity may not reflect cardiovascular health. Clinically, these findings support the utility of examining the anterior corpus callosum as an indicator of cerebrovascular health.

摘要

许多心血管健康以外的因素都会影响白质的结构。为了完善病因预测,需要确定可靠且具有临床意义的系统性和心血管健康对神经影响的生物标志物。我们研究了胼胝体的哪些区域容易受到系统性心血管危险因素的影响。394 名没有痴呆症的老年人完成了脑部 MRI、神经行为评估和血液采集。其中一部分(n=126)的个体的血浆被分析了感兴趣的炎症标志物(IL-6 和 TNF-alpha)。鉴于扩散张量成像(DTI)是一种特别可靠的白质完整性测量方法,我们利用 DTI 检查了胼胝体的前区和后区的各向异性分数(FA)。使用多元线性回归模型,我们同时检查了胼胝体的膝部和压部的 FA,以比较它们与系统性和心血管危险因素的关联。膝部的 FA 降低与更高的系统性和心血管风险有关,包括更高的收缩压(β=-0.17,p=0.020)、血红蛋白 A1C(β=-0.21,p=0.016)和 IL-6(β=-0.34,p=0.005)。膝部的 FA 与认知加工速度(β=0.20,p=0.0015)和执行功能(β=0.15,p=0.012)呈独特关联,而与记忆表现无关(β=0.05,p=0.357)。我们的结果表明,胼胝体的不同区域存在脆弱性,与后部区域相比,前部区域与系统性和心血管健康的生物标志物有更强的独立关联。后部白质的完整性可能不能反映心血管健康。临床上,这些发现支持将前胼胝体作为脑血管健康指标进行检查的实用性。

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Regional Vulnerability of the Corpus Callosum in the Context of Cardiovascular Risk.胼胝体的区域性易损性与心血管风险有关。
J Geriatr Psychiatry Neurol. 2023 Sep;36(5):397-406. doi: 10.1177/08919887231154931. Epub 2023 Jan 29.

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