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Cerebrovascular Disease and Cognitive Performance in African Americans

非裔美国人的脑血管疾病和认知表现

基本信息

批准号：
8829928
负责人：
Jasmin Divers
金额：
$ 50.05万
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：
2011
资助国家：
美国
起止时间：
2011-06-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8829928
关键词：
Accounting Admixture African African American Age Albuminuria American Anisotropy Attention Bioinformatics Biological Factors Biological Markers Blood Glucose Blood Pressure Blood Vessels Brain Cardiovascular Diseases Cerebrovascular Disorders Cerebrum Clinical Clinical Management Cognitive Communities DNA Data Dementia Development Diabetes Mellitus Disease Disease Management Education Environmental Exposure Environmental Risk Factor Epidemiologic Studies Epidemiology European Framingham Heart Study Gene Frequency Genetic Genetic screening method Genomic Segment Genomics Health Health Policy Health Services Accessibility Health behavior Healthcare Heart Heart Diseases Image Impaired cognition Impairment Incidence Individual Inherited Lesion Magnetic Resonance Imaging Maps Measures Microvascular Dysfunction Non-Insulin-Dependent Diabetes Mellitus Patients Perfusion Population Population Study Predisposition Race Recruitment Activity Relative (related person)Reporting Resource Allocation Resources Risk Risk Factors Sampling Sampling Studies Severities Societal Factors Socioeconomic Status Stroke Structure Testing Ursidae Family Variant Vascular Dementia Vascular Diseases Vulnerable Populations White Matter Disease White Matter Hyperintensity Work base burden of illness cognitive function cognitive performance cognitive testing cohort disorder risk ethnic difference ethnic minority population experience genetic risk factor genetic variant genome wide association study gray matter high risk imaging biomarker modifiable risk prevent racial difference sex trait white matter

项目摘要

DESCRIPTION (provided by applicant): The incidence rates of cerebral vascular disease (CBVD) and its associated cognitive impairment are rapidly increasing around the world. African Americans (AA) and patients with diabetes have higher rates of CBVD and associated cognitive dysfunction. However, the impact of race on the development of CBVD assessed by Magnetic Resonance Imaging (MRI) of the brain and cognitive testing remains poorly studied. Controversy exists regarding the severity of cerebral small blood vessel disease in AA, relative to European Americans (EA). Small blood vessel disease appears as "white mater hyperintensities" (WMH) on brain MRI. Several studies have reported more WMH, and some less WMH, in AA relative to EA. Existing studies failed to account for the effects of potentially modifiable environmental risk factors that impact development of WMH, such as access to healthcare, socioeconomic status, blood pressure and blood sugar control. This application proposes to determine the environmental and genetic factors that underlie cerebral structural and functional changes in 600 AA with type 2 diabetes. We plan to re-evaluate 600 AA in the ongoing AA-Diabetes Heart Study (AA-DHS) with cerebral MRI and a battery of cognitive tests; these individuals have previously been tested for the presence of silent (sub-clinical) heart disease and all have DNA available for genetic testing. We plan to test for relationships between alterations in brain structure (including WMH) and brain function with cognitive performance in these AA subjects. To determine whether racial differences in the relationships between CBVD and cognitive performance are present, results in AA would be contrasted with similar data in EA who have T2D from the related Diabetes Heart Study (DHS-MIND). This proposal will attempt to detect the inherited and environmental factors that produce susceptibility to CBVD in AA. We expect that modifiable environmental risk factors may explain the higher rates of CBVD reported in existing studies of AA. Furthermore, attention to these modifiable risk factors may reduce the rates of CBVD and cognitive dysfunction in the high risk AA population.

描述（由申请人提供）：脑血管疾病（CBVD）及其相关认知障碍的发病率在世界范围内迅速增加。非裔美国人 (AA) 和糖尿病患者的 CBVD 和相关认知功能障碍的发生率较高。然而，通过大脑磁共振成像 (MRI) 和认知测试评估种族对 CBVD 发展的影响仍然很少研究。相对于欧洲美国人 (EA)，AA 脑小血管疾病的严重程度存在争议。小血管疾病在脑 MRI 上表现为“白质高信号”(WMH)。一些研究报告称，与 EA 相比，AA 中的 WMH 较高，有些研究则较少。现有研究未能解释影响 WMH 发展的潜在可改变环境风险因素的影响，例如获得医疗保健、社会经济地位、血压和血糖控制。本申请旨在确定 2 型糖尿病患者的 600 AA 大脑结构和功能变化背后的环境和遗传因素。我们计划在正在进行的 AA 糖尿病心脏研究 (AA-DHS) 中通过脑 MRI 和一系列认知测试重新评估 600 AA；这些人之前已经接受过无症状（亚临床）心脏病的检测，并且都具有可用于基因检测的 DNA。我们计划测试这些 AA 受试者的大脑结构（包括 WMH）和大脑功能的变化与认知表现之间的关系。为了确定 CBVD 和认知表现之间的关系是否存在种族差异，将 AA 的结果与相关糖尿病心脏研究 (DHS-MIND) 中患有 T2D 的 EA 中的类似数据进行对比。该提案将尝试检测 AA 中产生 CBVD 易感性的遗传和环境因素。我们预计，可改变的环境风险因素可以解释现有 AA 研究中报告的 CBVD 发生率较高的原因。此外，关注这些可改变的危险因素可能会降低高危 AA 人群的 CBVD 和认知功能障碍的发生率。