Cumulative Blood Pressure Exposure, Basal Ganglia, and Thalamic Morphology in Midlife.
Cumulative Blood Pressure Exposure, Basal Ganglia, and Thalamic Morphology in Midlife.
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DOI：
10.1161/hypertensionaha.120.14678
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发表时间：
2020-05
期刊：
影响因子：
--
通讯作者：
Sorond FA
中科院分区：
文献类型：
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作者：
Jenkins LM;Garner CR;Kurian S;Higgins JP;Parrish TB;Sedaghat S;Nemeth AJ;Lloyd-Jones DM;Launer LJ;Hausdorff JM;Wang L;Sorond FA
高血压（BP）会对大脑结构和功能产生负面影响。高血压与白色高信号（WMH）、老年认知和活动障碍有关。然而，从青年期开始暴露于BP对中年期大脑结构和功能的影响尚不清楚。在认知功能障碍和活动障碍临床发作之前，识别与BP暴露相关的早期脑结构变化，对于理解机制和制定干预措施至关重要。我们在一项来自年轻成人冠状动脉风险发展（CARDIA）研究的144名（61名女性）个体的子研究中检查了年轻成人累积BP暴露对大脑结构的影响。在第30年（Y30，第9次访视），参与者（56±4岁）完成脑部MRI和步态测量（步速、节律和姿势控制）。计算9次访视期间的累积收缩压和舒张压（cSBP、cDBP），将连续两次访视之间的平均值乘以访视之间的年数。基底神经节和丘脑的基于表面的分析是使用FreeSurfer启动的大变形形态度量映射实现的。形态测量的变化回归到累积BP定位区域的形状变化。Y30 WMH体积较小，与累积BP呈正相关，但与步态无关。在尾状核、壳核、伏核、苍白球和丘脑中观察到与cSBP呈负相关的形态测量学关系。凹的右内侧壳核形状介导cSBP和步幅宽度之间的关系。基底神经节和丘脑形态学变化，而不是体积，可能是影响中年步态的BP暴露的灰质结构特征的早期表现。
High blood pressure (BP) negatively affects brain structure and function. Hypertension is associated with white matter hyperintensities (WMH), cognitive and mobility impairment in late-life. However, the impact of BP exposure from young adulthood on brain structure and function in mid-life is unclear. Identifying early brain structural changes associated with BP exposure, before clinical onset of cognitive dysfunction and mobility impairment, is essential for understanding mechanisms and developing interventions. We examined the effect of cumulative BP exposure from young adulthood on brain structure in a substudy of 144 (61 female) individuals from the Coronary Artery Risk Development in Young Adults (CARDIA) study. At year 30 (Y30, 9th visit), participants (56±4 years old) completed brain MRI and gait measures (pace, rhythm, and postural control). Cumulative systolic and diastolic BP (cSBP, cDBP) over 9 visits were calculated, multiplying mean values between two consecutive visits by years between visits. Surface-based analysis of basal ganglia and thalamus was achieved using FreeSurfer-initiated Large Deformation Diffeomorphic Metric Mapping. Morphometric changes were regressed onto cumulative BP to localize regions of shape variation. Y30 WMH volumes were small, and positively correlated with cumulative BP, but not gait. Negative morphometric associations with cSBP were seen in the caudate, putamen, nucleus accumbens, pallidum and thalamus. A concave right medial putamen shape mediated the relationship between cSBP and stride width. Basal ganglia and thalamic morphometric changes, rather than volumes, may be earlier manifestation of grey matter structural signatures of BP exposure that impact midlife gait.