Brainstem network connectivity with mid-anterior insula predicts lower systolic blood pressure at rest in older adults with hypertension.
Brainstem network connectivity with mid-anterior insula predicts lower systolic blood pressure at rest in older adults with hypertension.
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DOI：
10.1038/s41371-020-00476-2
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发表时间：
2021-12
影响因子：
2.7
通讯作者：
Schneiderman N
中科院分区：
文献类型：
--
作者：
McIntosh RC;Lobo JD;Yang A;Schneiderman N
心率和血压的中枢调节为高血压(HTN)的神经源性机制提供了基础。绝经后(PM)年龄与静息状态功能脑连接(RsFC)的变化以及HTN风险的增加相一致。支持心脏自主控制的神经网络在患有HTN和不患有HTN的PM妇女之间是否存在差异尚不清楚。来自Nathan Kline研究所的表型和功能神经成像数据首先评估了22名绝经后HTN女性和22名正常血压对照组在内在网络连接性方面的组差异。HTN患者中脑-脑干-小脑网络与双侧中前脑岛的固有rsFC较低(经校正，p<；0.05)。从44名PM女性和111名没有表现出代谢性或神经退行性疾病的成年人队列中提取了指示这些区域rsFC的Z分数，并与办公室内的收缩压和舒张压进行了比较。合并样本中有脑干核团的左侧(r=−0.17，p=0.019)和右侧(r=−0.14，p=0.048)较低的rsFC与较高的收缩压相关。这种效应在绝经后年龄的男性和女性中的大小支持了HTN老年患者血压调节的神经源性机制。
Central regulation of heart rate and blood pressure provides the bases for a neurogenic mechanism of hypertension (HTN). Post menopause (PM) age coincides with changes in resting state functional brain connectivity (rsFC) as well as increased risk for HTN. Whether the neural networks underpinning cardioautonomic control differ between PM women with and without HTN is unclear. Phenotypic and functional neuroimaging data from the Nathan Kline Institute was first evaluated for group differences in intrinsic network connectivity between 22 HTN post menopausal women and 22 normotensive controls. Intrinsic rsFC of the midbrain-brainstem-cerebellar network with bilateral mid-anterior insula was lower in women with HTN (FWE-corrected, p < 0.05). Z-scores indicating rsFC of these regions were extracted from the 44 PM women and a cohort of 111 adults, not presenting with metabolic or neurodegenerative disease, and compared to in-office systolic and diastolic blood pressure. Lower rsFC of the left (r = −0.17, p = 0.019) and right (r = −0.14, p = 0.048) mid-anterior insula with brainstem nuclei was associated with higher systolic blood pressure in the combined sample. The magnitude of this effect in men and women of post menopausal age supports a neurogenic mechanism for blood pressure regulation in older adults with HTN.