Yang Sheng, Webb Alastair John Stewart
Wolfson Centre for Prevention of Stroke and Dementia, Nuffield, Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, UK.
J Cereb Blood Flow Metab. 2025 May;45(5):897-907. doi: 10.1177/0271678X241302172. Epub 2024 Nov 22.
Mid-life vascular risk factors predict late-life cerebrovascular diseases and poor global brain health. Although endothelial dysfunction is hypothesized to contribute to this process, evidence of impaired neurovascular function in early stages remains limited. In this cross-sectional study of 31,934 middle-aged individuals from UK Biobank without established cerebrovascular disease, the overall 10-year risk of cardiovascular events was associated with reduced neurovascular coupling (p < 2 × 10) during a visual task with functional MRI, including in participants with no clinically apparent brain injury on MRI. Diabetes, smoking, waist-hip ratio, and hypertension were each strongly associated with decreased neurovascular coupling with the strongest relationships for diabetes and smoking, whilst in older adults there was an inverted U-shaped relationship with DBP, peaking at 70-80 mmHg DBP. These findings indicate that mid-life vascular risk factors are associated with impaired cerebral endothelial-dependent neurovascular function in the absence of overt brain injury. Neurovascular dysfunction, measured by neurovascular coupling, may play a role in the development of late-life cerebrovascular disease, underscoring the need for further longitudinal studies to explore its potential as a mediator of long-term cerebrovascular risk.
中年血管危险因素可预测晚年脑血管疾病和整体脑健康状况不佳。尽管有假说认为内皮功能障碍促成了这一过程，但早期神经血管功能受损的证据仍然有限。在这项对英国生物银行中31934名无已确诊脑血管疾病的中年个体进行的横断面研究中，心血管事件的总体10年风险与功能性磁共振成像视觉任务期间神经血管耦合减少相关（p < 2×10），包括在磁共振成像上无明显脑损伤的参与者中。糖尿病、吸烟、腰臀比和高血压均与神经血管耦合减少密切相关，其中糖尿病和吸烟的相关性最强，而在老年人中，舒张压与神经血管耦合呈倒U形关系，在舒张压70 - 80 mmHg时达到峰值。这些发现表明，在无明显脑损伤的情况下，中年血管危险因素与脑内皮依赖性神经血管功能受损有关。通过神经血管耦合测量的神经血管功能障碍可能在晚年脑血管疾病的发生中起作用，这突出表明需要进一步开展纵向研究，以探索其作为长期脑血管风险中介因素的潜力。
