Cardiac Autonomic Function, Cognitive Performance, and Neurocognitive Outcomes

心脏自主功能、认知表现和神经认知结果

基本信息

批准号：
10615166
负责人：
Christopher Schaich
金额：
$ 9.71万
依托单位：
WAKE FOREST UNIVERSITY HEALTH SCIENCES
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：
2021-08-15 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10615166
关键词：
Adult Affect Alzheimer&apos s disease pathology Alzheimer&apos s disease related dementia Area Arrhythmia Atherosclerosis Risk in Communities Autonomic Dysfunction Biological Markers Blood Vessels Brain region Cardiac Cardiovascular Diseases Cardiovascular system Cerebrovascular Disorders Cerebrum Cessation of life Clinical Cognition Cognitive Cohort Studies Data Dementia Development Devices Disease Outcome Diurnal Rhythm Education Elderly Electrocardiogram Etiology Event Future Goals Heart Heart failure Hour Impaired cognition Impairment Incidence Infarction Intervention K-Series Research Career Programs Knowledge Lacunar Infarctions Language Link Literature Longitudinal Studies Measures Memory Mentored Research Scientist Development Award Mentors Methods Morbidity - disease rate Neurocognitive Neurologic Neurosciences Outcome Parents Participant Performance Perfusion Periodicity Persons Prefrontal Cortex Prevalence Prevention strategy Public Health Research Research Project Grants Resources Risk Risk Factors Role Signal Transduction Technology Training Vascular Diseases Ventricular White Matter Hyperintensity Work age related aging brain analytical tool brain health brain volume burden of illness cardiovascular disorder risk cardiovascular health career cerebral microbleeds circadian cognitive function cognitive performance cognitive testing cohort dementia risk executive function experience heart rate variability indexing innovation insight mild cognitive impairment mortality neuroimaging neuroimaging marker novel phenotypic data population based signal processing skills tool translational study treatment strategy vascular contributions vascular risk factor wearable device

项目摘要

Project Summary Prevalence of Alzheimer’s disease and related dementias (ADRD), currently affecting an estimated 47 million people worldwide, is expected to triple by 2050. A poor understanding of its etiology has hindered progress toward treatments and preventive strategies. Several lines of evidence suggest that cardiovascular diseases (CVD) and various CVD risk factors are strongly associated with incidence of dementia. Vascular risk factors are easily identifiable and often modifiable. Therefore, discovery of vascular risk factors that precede CVD and cognitive impairment or decline would significantly enhance our understanding of the vascular etiology of ADRD. Heart rate variability (HRV) and QT interval variability (QTV), derived from electrocardiogram (ECG) analysis, are well-known indices of autonomic control over the heart. Lower HRV and higher QTV, indicating worse cardiac autonomic function, are strongly predictive of future cardiovascular morbidity and mortality. Notably, lower HRV and QT abnormalities have been noted in ADRD and mild cognitive impairment (MCI). Thus, the study of HRV and QTV may provide valuable insight into the role of cardiac autonomic function in the development of dementia. However, in most studies HRV and QTV are derived from standard short-term ECG (ranging from 10 seconds to several minutes duration), which does not reflect real-world conditions due to the requirement of stationarity. Although wearable devices such as Zio XT Patch allow ECG recording of up to 14 days duration, methods used to analyze HRV and QTV are based on the stationarity assumption, resulting in measures that may be uninterpretable or misleading when applied to such extra long-term recordings. Thus, innovative signal analysis tools are required to utilize the full potential of these ECGs. Recently, a new signal processing method was developed specifically to derive novel measures of HRV and QTV from extra long-term ECG that better represent cardiac autonomic function in real-world settings. The primary goal of this K01 mentored career development award is to implement this innovative analysis tool in a large, ongoing cohort study of older adults to derive novel measures of HRV and QTV from recently collected 14-day Zio Patch recordings. In Aim 1, we will evaluate the association of these novel measures with cognitive performance and risk of prevalent or incident MCI or dementia. In Aim 2, we will determine if their diurnal variation is related to worse cognitive performance or risk of MCI or dementia. Finally, we will leverage recent neuroimaging data in a subset of participants to determine if extra long-term HRV or QTV is associated with neuroimaging biomarkers of ADRD or cerebrovascular disease. If successful, the proposed study may provide insight into the mechanisms linking vascular risk factors and CVD to ADRD, and potentially identify cardiac autonomic function as a modifiable intervention target. In addition, this K01 award will provide the resources necessary to support the Candidate’s transition to an independent research career in an area of growing public health importance.

项目摘要阿尔茨海默氏病和相关痴呆症（ADRD）的患病率目前影响约4700万全世界的人，预计到2050年将三倍。对其病因的了解不足，阻碍了进步采取治疗和预防策略。几条证据表明心血管疾病（CVD）和各种CVD风险因素与痴呆症的发生密切相关。血管危险因素很容易识别，通常可以修改。因此，发现CVD之前的血管危险因素认知障碍或下降将显着增强我们对 adrd。心率变异性（HRV）和QT间隔变异性（QTV），来自心电图（ECG）分析是对心脏自主控制的知名指数。较低的HRV和较高的QTV，表明更糟糕的心脏自主神经功能可以很好地预测未来的心血管发病率和死亡率。值得注意的是，在ADRD和轻度认知障碍（MCI）中已经注意到HRV和QT异常较低。这是对HRV和QTV的研究，可以为心脏自主功能在痴呆症的发展。但是，在大多数研究中，HRV和QTV来自标准的短期ECG （持续时间从10秒到几分钟），这并不能反映出实际情况尽管可穿戴设备（例如Zio XT补丁）可允许ECG记录高达14 持续时间，用于分析HRV和QTV的方法基于平稳性假设，从而导致应用于此类额外的长期记录时可能无法解释或误导的措施。那，需要创新的信号分析工具来利用这些心电图的全部潜力。最近，一个新信号加工方法是专门为从额外的长期来得出HRV和QTV的新型HRV和QTV的新方法的在现实世界中更好地代表心脏自主功能的心电图。此K01的主要目标 Menored Career Development Award旨在在一个持续的群体中实施此创新分析工具研究老年人从最近收集的14天Zio贴片中得出HRV和QTV的新型HRV和QTV的研究录音。在AIM 1中，我们将评估这些新型措施与认知表现的关联和流行或事件MCI或痴呆症的风险。在AIM 2中，我们将确定它们的昼夜变化是否与 MCI或痴呆症的认知表现较差或风险。最后，我们将利用最新的神经影像学数据参与者的一部分，以确定额外的长期HRV或QTV是否与神经成像有关 ADRD或脑血管疾病的生物标志物。如果成功，拟议的研究可能会洞悉将血管危险因素和CVD连接到ADRD的机制，并有可能识别心脏自主功能作为可修改的干预目标。此外，该K01奖将为支持提供必要的资源候选人在公共健康重要性越来越重要的领域过渡到独立研究职业。