Association between white matter microstructure, executive functions, and processing speed in older adults: The impact of vascular health
Heidi I.L. Jacobs, Elizabeth C. Leritz, Victoria J. Williams, Martin P.J. Van Boxtel, Wim van der Elst, Jelle Jolles, Frans R.J. Verhey, Regina E. McGlinchey, William P. Milberg, David H. Salat
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引用次数: 126
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Abstract
Cerebral white matter damage is not only a commonly reported consequence of healthy aging, but is also associated with cognitive decline and dementia. The aetiology of this damage is unclear; however, individuals with hypertension have a greater burden of white matter signal abnormalities (WMSA) on MR imaging than those without hypertension. It is therefore possible that elevated blood pressure (BP) impacts white matter tissue structure which in turn has a negative impact on cognition. However, little information exists about whether vascular health indexed by BP mediates the relationship between cognition and white matter tissue structure. We used diffusion tensor imaging to examine the impact of vascular health on regional associations between white matter integrity and cognition in healthy older adults spanning the normotensive to moderate–severe hypertensive BP range (43–87 years; N = 128). We examined how white matter structure was associated with performance on tests of two cognitive domains, executive functioning (EF) and processing speed (PS), and how patterns of regional associations were modified by BP and WMSA. Multiple linear regression and structural equation models demonstrated associations between tissue structure, EF and PS in frontal, temporal, parietal, and occipital white matter regions. Radial diffusivity was more prominently associated with performance than axial diffusivity. BP only minimally influenced the relationship between white matter integrity, EF and PS. However, WMSA volume had a major impact on neurocognitive associations. This suggests that, although BP and WMSA are causally related, these differential metrics of vascular health may act via independent pathways to influence brain structure, EF and PS. Hum Brain Mapp, 2013. © 2011 Wiley Periodicals, Inc.
老年人白质微结构、执行功能和处理速度之间的关系:血管健康的影响
脑白质损伤不仅是健康衰老的常见结果,而且还与认知能力下降和痴呆有关。这种损伤的病因尚不清楚;然而,与没有高血压的人相比,高血压患者在MR成像上有更大的白质信号异常(WMSA)负担。因此,血压升高可能会影响白质组织结构,从而对认知产生负面影响。然而,关于血压指标血管健康是否介导认知与白质组织结构之间的关系,目前知之甚少。我们使用弥散张量成像(diffusion tensor imaging,弥散张量成像)研究了血管健康对白质完整性和认知之间的区域关联的影响,这些健康老年人跨越了正常至中重度高血压血压范围(43-87岁;N = 128)。我们研究了脑白质结构如何与两个认知领域——执行功能(EF)和处理速度(PS)的测试表现相关联,以及脑白质结构和脑白质结构如何改变区域关联模式。多元线性回归和结构方程模型表明,组织结构、EF和PS在额叶、颞叶、顶叶和枕叶白质区域之间存在关联。与轴向扩散率相比,径向扩散率与性能的关系更为显著。BP对白质完整性、EF和PS之间的关系影响很小,而WMSA体积对神经认知关联有主要影响。这表明,尽管血压和WMSA存在因果关系,但这些血管健康的差异指标可能通过独立的途径影响大脑结构、EF和PS。©2011 Wiley期刊公司
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