Alterations in cerebral artery flow velocity acceleration pattern correlate with cognitive impairment in diabetes mellitus.

IF 1.4 4区 心理学 Q4 CLINICAL NEUROLOGY
Ahmet Tas, Muhammed Ikbal Bayhan, Mehlika Yildiz, Yaren Alan, Zeynep Atay, Fatih Sezer, Cagla Kitapli, Ilke Kara Tas, Sabahattin Umman, Murat Sezer
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引用次数: 0

Abstract

Introduction: Flow velocity acceleration pattern is related to shear stress, pressure changes, cardiovascular risk factors, diabetes mellitus, hypertension, endothelial dysfunction and arterial stiffness. Considering the hemodynamic alterations in cognitive impairment, perturbations in cerebral artery flow acceleration pattern may correlate with cognitive impairment, which could enhance our understanding of how cardiovascular risk factors drive cognitive decline from a mechanistic point of view.

Method: The first derivative of middle cerebral artery flow velocity waveforms obtained via transcranial Doppler were computed to visualize acceleration/deceleration waves (a,b,c,d,e) in ensemble-averaged signals. Vascular Aging Index was calculated per its definition (VAI:(b-c-d-e)/a). Relationship between multiple cognitive domains and VAI was evaluated with standard statistical tests.

Results: VAI was significantly correlated with HVLT total recall (Hopkins Verbal Learning Test-revised) (r: -0.310 p: 0.046, n: 42), delayed recall (r: -0.396 p: 0.009), % Retention (r: -0.305 p: 0.050) and components of RCFT(Rey-Osterrieth Complex Figure Test), namely raw copy score (r: -0.524 p < 0.001), immediate recall (r: -0.323 p: 0.037). Controlling for age, body mass index, gray matter volume and diabetes duration yielded stronger correlations but lower group numbers due to missing data. Correlation coefficients for VAI with HVLT delayed recall and % Retention were -0.439 (p: 0.012) and -0.444(p: 0.011 n: 36) respectively. Likewise the adjusted correlations of VAI with RCFT components were improved (Raw Copy r: -0.557 p < 0.001, Immediate Recall r: -0.440 p: 0.012, Delayed Recall (r: -0.358 p: 0.044).

Conclusion: In patients with diabetes, cerebral artery flow velocity acceleration pattern correlates with cognitive performance in visuo-constructional and verbal cognitive domains. Computational fluid dynamics may aid developing a better mechanistic understanding of arterial hemodynamics-cortical function coupling.

糖尿病患者脑动脉血流加速模式改变与认知功能障碍相关。
血流速度加速模式与剪应力、压力变化、心血管危险因素、糖尿病、高血压、内皮功能障碍和动脉僵硬有关。考虑到认知障碍的血流动力学改变,脑动脉血流加速模式的扰动可能与认知障碍有关,这可以从机制的角度增强我们对心血管危险因素如何驱动认知能力下降的理解。方法:计算经颅多普勒获得的大脑中动脉血流速度波形的一阶导数,以显示集合平均信号中的加速/减速波(a,b,c,d,e)。按其定义计算血管老化指数(VAI:(b-c-d-e)/a)。采用标准统计检验评价多认知域与VAI的关系。结果:VAI与HVLT总回忆率(Hopkins Verbal Learning Test-revised) (r: -0.310 p: 0.046, n: 42)、延迟回忆率(r: -0.396 p: 0.009)、保留率(r: -0.305 p: 0.050)和RCFT(Rey-Osterrieth Complex Figure Test)成分即原始副本分数(r: -0.524 p: -0.323 p: 0.037)显著相关。控制年龄、身体质量指数、灰质体积和糖尿病持续时间产生了更强的相关性,但由于缺少数据,组数较低。VAI与HVLT延迟回忆率和%保留率的相关系数分别为-0.439 (p: 0.012)和-0.444(p: 0.011 n: 36)。同样,VAI与RCFT成分的调整相关性也得到了改善(原始拷贝r: -0.557 p: -0.440 p: 0.012,延迟召回(r: -0.358 p: 0.044)。结论:糖尿病患者脑动脉血流速度加速模式与视觉-结构和语言认知领域的认知表现相关。计算流体动力学可能有助于更好地理解动脉血流动力学-皮质功能耦合的机制。
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来源期刊
Applied Neuropsychology-Adult
Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY
CiteScore
4.50
自引率
11.80%
发文量
134
期刊介绍: pplied Neuropsychology-Adult publishes clinical neuropsychological articles concerning assessment, brain functioning and neuroimaging, neuropsychological treatment, and rehabilitation in adults. Full-length articles and brief communications are included. Case studies of adult patients carefully assessing the nature, course, or treatment of clinical neuropsychological dysfunctions in the context of scientific literature, are suitable. Review manuscripts addressing critical issues are encouraged. Preference is given to papers of clinical relevance to others in the field. All submitted manuscripts are subject to initial appraisal by the Editor-in-Chief, and, if found suitable for further considerations are peer reviewed by independent, anonymous expert referees. All peer review is single-blind and submission is online via ScholarOne Manuscripts.
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