Neuroimaging and Neuropsychological Biomarkers of Vascular Risk Factors

描述（由申请人提供）：脑血管疾病的风险因素，如高血压、肥胖和糖尿病，很少单独发生。三个或更多个血管风险因素的聚类包括心脏代谢综合征（CMS）的临床诊断。近年来，CMS的患病率急剧上升，最近估计有近34%的美国成年人符合标准。在中年诊断CMS，甚至在出现临床显著神经系统症状之前，与血管相关神经退行性疾病的风险大幅增加相关，包括血管性认知障碍、痴呆以及主要神经系统事件，如中风。虽然有大量的研究探讨了个体因素（如血压）对脑组织的负面影响，但对CMS相关神经健康变化的神经机制仍然知之甚少。目前的项目旨在更好地了解多种共同发生的风险因素如何影响血管和神经的完整性，以及认知和功能状态如何受到影响。我们将确定CMS的非侵入性神经影像学、认知和功能生物标志物，这些生物标志物可用于检测谁可能有更大的认知能力下降和痴呆风险。这将通过三个目标来实现，包括1）了解CMS如何影响特定的结构和功能脑网络，2）了解血管完整性指数、脑血管储备（CVR）如何影响CMS中的结构和功能脑网络，3）了解CVR如何与结构和功能脑完整性相互作用，以影响认知、精神和功能状态。最终，该项目旨在提供重要的翻译数据，可用于临床治疗， 管理多种血管风险因素。

DESCRIPTION (provided by applicant): Risk factors for cerebrovascular disease, such as hypertension, obesity, and diabetes, rarely occur in isolation. The clustering of three or more vascular risk factors comprises a clinical diagnosis of cardio-metabolic syndrome (CMS). In recent years, the prevalence of CMS has risen dramatically, with recent estimates of nearly 34% of US adults meeting criteria. A diagnosis of CMS in midlife, even prior to the development of clinically significant neurologic symptoms, is associated with a substantially increased risk for vascular-related neurodegenerative conditions, including vascular cognitive impairment, dementia, as well as major neurologic events such as stroke. While there is a great deal of research examining the negative impact of individual factors, such as blood pressure, on brain tissue, there is still little knowledge of the neural mechanisms underlying CMS-related changes to neural health. The current project seeks to better understand how multiple co-occurring risk factors affect vascular and neural integrity, and how cognitive and functional status is subsequently impacted. We will identify noninvasive neuroimaging, cognitive and functional biomarkers of CMS that can be used in detecting who may be at greater risk for cognitive decline and dementia. This will be accomplished with three Aims that include 1) understanding how CMS impacts specific structural and functional brain networks, 2) understanding how an index of vascular integrity, cerebrovascular reserve (CVR), impacts structural and functional brain networks in CMS, and 3) understanding how CVR interacts with structural and functional brain integrity to affect cognitive, psychiatric, and functional status. Ultimately, this project ams to provide important translational data that can be used in clinical settings for the treatment and management of multiple vascular risk factors.