Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions.
AuthorKern, Kyle C
Wright, Clinton B
Bergfield, Kaitlin L
Fitzhugh, Megan C
Moeller, James R
Elkind, Mitchell S V
Sacco, Ralph L
DeCarli, Charles S
Alexander, Gene E
AffiliationUniv Arizona, Neurosci Grad Interdisciplinary Program
Univ Arizona, Physiol Sci Grad Interdisciplinary Programs
Univ Arizona, Dept Psychol
Univ Arizona, Evelyn F McKnight Brain Inst
Univ Arizona, Dept Psychiat
Univ Arizona, Inst BIO5
Keywordswhite matter hyperintensities
scaled subprofile model
MetadataShow full item record
PublisherFRONTIERS MEDIA SA
CitationBlood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions. 2017, 9:132 Front Aging Neurosci
JournalFrontiers in aging neuroscience
Rights© 2017 Kern, Wright, Bergfield, Fitzhugh, Chen, Moeller, Nabizadeh, Elkind, Sacco, Stern, DeCarli and Alexander. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractCerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship. Using a case-control design matching for age, gender, and educational attainment we selected 64 participants with normal blood pressure, controlled hypertension or uncontrolled hypertension from the Northern Manhattan Study cohort. We applied gray matter voxel-based morphometry with the scaled subprofile model to (1) identify regional covariance patterns of gray matter volume differences associated with white matter lesion load, (2) compare this relationship across blood pressure groups, and (3) relate it to cognitive performance. In this group of participants aged 60-86 years, we identified a pattern of reduced gray matter volume associated with white matter lesion load in bilateral temporal-parietal regions with relative preservation of volume in the basal forebrain, thalami and cingulate cortex. This pattern was expressed most in the uncontrolled hypertension group and least in the normotensives, but was also more evident in older and more educated individuals. Expression of this pattern was associated with worse performance in executive function and memory. In summary, white matter lesions from small-vessel disease are associated with a regional pattern of gray matter atrophy that is mitigated by blood pressure control, exacerbated by aging, and associated with cognitive performance.
NoteOpen Access Journal
VersionFinal published version
SponsorsAmerican Heart Association Bugher Center [14BFSC17690003]; diaDexus Inc.; Bristol- Myers Squibb/Sanoti Pharmaceuticals Partnership; NIH/NINDS; National Institute on Aging [R01 AG049464, P30 AGO19610]; State of Arizona; ADHS; Advanced Research Institute for Biomedical Imaging; McKnight Brain Research Foundation; [K02 NS 059729]; [R01 IIL 108623]; [SPRINT MRI WFUHS 330214]; [R01 NS 29993]