权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Non-Atherosclerotic Brain Arterial Remodeling and Associated Vascular Dementia Risk

非动脉粥样硬化性脑动脉重塑和相关血管性痴呆风险

基本信息

批准号：
10194703
负责人：
MELISSA C CAUGHEY
金额：
$ 45.83万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10194703
关键词：
3-Dimensional Age Aging Arterial Fatty Streak Arteries Atherosclerosis Atherosclerosis Risk in Communities Attention Autopsy Blood Pressure Blood Vessels Blood flow Brain Brain imaging Caliber Central Artery Cerebrovascular system Clinical Clinical Data Cognition Cognitive Collagen Communities Cross-Sectional Studies Data Dementia Deposition Elastin Elderly Evaluation Funding General Population Head Image Impairment Incidence Individual Internal carotid artery structure Intracranial Atherosclerotic Disease Investigation Magnetic Resonance Imaging Measures Mechanics Medial Microvascular Dysfunction Modification Monitor Neurocognitive Neurologic Examination Observational Study Outcome Participant Patients Physiologic pulse Positioning Attribute Prevalence Prospective Studies Public Health Reporting Resolution Risk Factors Risk Marker Role Sampling Series Stenosis Testing Thick Time Vascular Dementia Vascular Diseases Visit White Matter Hyperintensity arterial remodeling arterial stiffness basilar artery biracial brain parenchyma brain remodeling capillary bed cardiovascular risk factor cognitive function cognitive testing cohort cost efficient dementia risk electric impedance epidemiology study high risk hypoperfusion imaging biomarker intracranial artery macrovascular disease member middle age middle cerebral artery mild cognitive impairment population based pressure prospective rate of change research study shear stress transmission process vascular factor vascular risk factor

项目摘要

Non-Atherosclerotic Brain Arterial Remodeling and Associated Vascular Dementia Risk Non-atherosclerotic brain arterial remodeling (NABAR) of the large intracranial arteries has recently emerged as a determinant of poor cognitive outcomes. Vascular aging is associated with elastin fragmentation and collagen deposition, and may present as either outward or tortuous remodeling, both of which may occur in the absence of atherosclerosis. In cross-sectional studies, non-atherosclerotic outward remodeling of the cerebral vasculature has been reported in association with diminished cognitive function. However, the extent to which brain arterial remodeling is permanent vs. reversible, or whether it progresses with age in older individuals is unknown. Mechanistic studies suggest that arterial wall thickness is regulated by intraluminal pressure and wall tension, and that arterial lumen diameter is regulated by blood flow and shear stress. Tortuous elongation has also been associated with mechanical factors, including blood flow, blood pressure, axial tension and wall changes. It is thus plausible that brain arterial remodeling may be dynamic rather than static, even in individuals of advanced age. We propose to examine prevalence and rate of change in NABAR, quantified by luminal diameters and degree of tortuosity, in older individuals from the general population who were imaged by brain MRI at 2 time points. We aim to determine whether vascular risk factors at midlife and their trajectories since midlife associate with NABAR in late life. We will also identify putative factors which may be associated with an accelerated 5-year progression of remodeling in late life. As secondary aims, we will examine the prospective relationship between NABAR and 5-year neurocognitive outcomes (change in cognition and incidence of vascular mild cognitive impairment or vascular dementia), as well as the correlation between 5- year change in NABAR and 5-year change in cognition. We will be uniquely positioned to carry out this project in the Atherosclerosis Risk in Communities study, which has collected clinical data from cohort members over the past 30 years, including multiple assessments by brain MRI and cognitive testing. We will quantify NABAR (dilation and tortuosity) in the basilar artery, middle cerebral arteries, and internal carotid arteries, using existing MRI data (TOF MRA and 3D vessel wall imaging) from ARIC study visit 5 (2011-2013, completed) and visit 6/7 (2016-2019).

非动脉粥样硬化性脑动脉重塑与相关血管性痴呆风险颅内大动脉的非动脉粥样硬化性脑动脉重塑（NABAR）最近出现作为认知结果差的决定因素。血管老化与弹性蛋白断裂有关，胶原沉积，并可能表现为向外或曲折的重塑，这两种情况都可能发生在没有动脉粥样硬化。在横断面研究中，非动脉粥样硬化性的脑外重塑，据报道，脉管系统的损害与认知功能减退有关。然而，在多大程度上脑动脉重塑是永久性的还是可逆的，或者它是否随着年龄的增长而进展，未知机制研究表明，动脉壁厚度受管腔内压力和壁厚的调节。张力，动脉管腔直径由血流和剪切应力调节。曲折的伸长还与机械因素有关，包括血流、血压、轴向张力和壁变化因此，似乎脑动脉重塑可能是动态的，而不是静态的，即使是在脑血管病中，老年人。我们建议检查NABAR的患病率和变化率，量化为普通人群中接受成像的老年人的管腔直径和迂曲度在2个时间点进行脑MRI检查。我们的目标是确定中年时的血管危险因素及其轨迹因为中年与NABAR在晚年有联系。我们还将确定可能与之相关的假定因素，并在晚年加速了5年的重塑进程作为次要目标，我们将研究 NABAR和5年神经认知结果之间的前瞻性关系（认知和血管性轻度认知障碍或血管性痴呆的发病率），以及5- NABAR年变化和认知5年变化。我们将处于独特的位置来执行这个项目在社区动脉粥样硬化风险研究中，该研究收集了来自队列成员的临床数据，过去30年来，包括通过大脑MRI和认知测试进行的多次评估。我们将量化NABAR （扩张和迂曲）在基底动脉，大脑中动脉和颈内动脉，使用 ARIC研究访视5（2011-2013，已完成）的现有MRI数据（TOF MRA和3D血管壁成像），以及访问6/7（2016-2019）。