Association between cerebral microstructural change and cognitive impairment in hypertension
Poster No:
2284
Submission Type:
Abstract Submission
Authors:
Jun-Cheng Weng1,2, Tai-Hsin Hung2,3, Hsin Chen1, Yen-Hsuan Hsu4, Yuan-Hsiung Tsai3,5, Vincent Chin-Hung Chen2,3
Institutions:
1Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, 2Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan, 3School of Medicine, Chang Gung University, Taoyuan, Taiwan, 4Department of Psychology, National Chung Cheng University, Chiayi, Taiwan, 5Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
First Author:
Jun-Cheng Weng
Department of Medical Imaging and Radiological Sciences, Chang Gung University|Department of Psychiatry, Chang Gung Memorial Hospital
Taoyuan, Taiwan|Chiayi, Taiwan
Department of Medical Imaging and Radiological Sciences, Chang Gung University|Department of Psychiatry, Chang Gung Memorial Hospital
Taoyuan, Taiwan|Chiayi, Taiwan
Co-Author(s):
Tai-Hsin Hung
Department of Psychiatry, Chang Gung Memorial Hospital|School of Medicine, Chang Gung University
Chiayi, Taiwan|Taoyuan, Taiwan
Department of Psychiatry, Chang Gung Memorial Hospital|School of Medicine, Chang Gung University
Chiayi, Taiwan|Taoyuan, Taiwan
Hsin Chen
Department of Medical Imaging and Radiological Sciences, Chang Gung University
Taoyuan, Taiwan
Department of Medical Imaging and Radiological Sciences, Chang Gung University
Taoyuan, Taiwan
Yuan-Hsiung Tsai
School of Medicine, Chang Gung University|Department of Diagnostic Radiology, Chang Gung Memorial Hospital
Taoyuan, Taiwan|Chiayi, Taiwan
School of Medicine, Chang Gung University|Department of Diagnostic Radiology, Chang Gung Memorial Hospital
Taoyuan, Taiwan|Chiayi, Taiwan
Vincent Chin-Hung Chen
Department of Psychiatry, Chang Gung Memorial Hospital|School of Medicine, Chang Gung University
Chiayi, Taiwan|Taoyuan, Taiwan
Department of Psychiatry, Chang Gung Memorial Hospital|School of Medicine, Chang Gung University
Chiayi, Taiwan|Taoyuan, Taiwan
Introduction:
Hypertension (HTN) is a growing public health problem worldwide that is a leading cause of cognitive impairment. It is a risk factor for cognitive decline, mild cognitive impairment and dementia. However, the results of previous studies are inconsistent and the relationship between various cognitive functions and changes in the brain volume is unclear. This study uses a brain MRI to determine the changes in the brain that are a result of the association between hypertension and cognitive impairment.
Methods:
All 58 participants were divided into two groups: the hypertension group (HTN group, n=30) and the normal control group (NC group, n=28). 30 HTN patients have all been diagnosed with hypertension by specialist physicians, and their blood pressure is > 140/90 mmHg [1] during a visit. All participants were subject to a 3T MRI (Siemens Tim Trio scanner) and Magnetization Preparation Rapid Acquisition Gradient Echo (MP-RAGE) to access the MR imaging. All participants were also subject to cognitive questionnaires; Chinese Version Verbal Learning Test (CVVLT) [2], Digit Symbol Substitution (DSS) [3], Trail Making Test parts A and B (TMT-A and TMT-B) [4], Chang Gung University Orthographical Fluency Test (CGUOFT) [5], Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA) [6] were used to measure the cognitive state. Voxel-based morphometry (VBM) was used to determine differences in the volume of the brain for the HTN group and the NC group. Multiple regression was used to determine the association between brain volume and the results of the cognitive assessments, in terms of memory, executive function, and global cognitive function.
Results:
The relationship between memory function and brain volume: For the 30 HTN patients, in terms of the multiple regression analysis of the association between the score for CVVLT immediate recall, CVVLT 30 seconds recall, CVVLT 10 minutes recall and brain volume (Fig. 1) there is a positive correlation in the left hippocampus, the left immediate gyrus, the left inferior parietal lobule, the left precuneus, the brainstem and the right anterior cingulate, with a corrected p-value< 0.05. There is no instance of a negative correlation.
The relationship between executive function and brain volume: For the 30 HTN patients, in terms of the multiple regression analysis of the association between the scores for DSS, TMT-A, TMT-B, CGUOFT, and brain volume (Fig. 2), there is a positive correlation in the right middle frontal gyrus, the right inferior frontal gyrus and the left insula with a corrected p-value< 0.05 for the analysis between DSS, CGUOFT and brain volume. There is a negative correlation in the right medial frontal gyrus, the left cingulate gyrus and the bilateral hippocampus, with a corrected p-value< 0.05 for the analysis between TMT-A, TMT-B and brain volume.
The relationship between global cognitive function and brain volume: For the 30 HTN patients, in terms of the multiple regression analysis of the association between the score of MoCA, MMSE, and brain volume, there is a positive correlation in the left thalamus, the left caudate, the left lentiform nucleus, the left precuneus, the left insula and the left superior frontal gyrus, with a corrected p-value< 0.05. There is no instance of a negative correlation.
The relationship between executive function and brain volume: For the 30 HTN patients, in terms of the multiple regression analysis of the association between the scores for DSS, TMT-A, TMT-B, CGUOFT, and brain volume (Fig. 2), there is a positive correlation in the right middle frontal gyrus, the right inferior frontal gyrus and the left insula with a corrected p-value< 0.05 for the analysis between DSS, CGUOFT and brain volume. There is a negative correlation in the right medial frontal gyrus, the left cingulate gyrus and the bilateral hippocampus, with a corrected p-value< 0.05 for the analysis between TMT-A, TMT-B and brain volume.
The relationship between global cognitive function and brain volume: For the 30 HTN patients, in terms of the multiple regression analysis of the association between the score of MoCA, MMSE, and brain volume, there is a positive correlation in the left thalamus, the left caudate, the left lentiform nucleus, the left precuneus, the left insula and the left superior frontal gyrus, with a corrected p-value< 0.05. There is no instance of a negative correlation.
Conclusions:
The results of this study apply mainly to the frontal cortex, the basal ganglia, the limbic system, the cingulate and the brainstem and are consistent with those for previous hypertension studies. The frontal cortex, the basal ganglia, the cingulate and the limbic system are correlated to memory, executive function and cognition and hypertension can impair executive function, memory and cognition speed and preserve attention. The results verify the neuropsychopathology of hypertension-related structural impairment and inform the development of cognitive rehabilitation for individuals with hypertension.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 2
Higher Cognitive Functions:
Executive Function, Cognitive Control and Decision Making
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Neuroanatomy Other
Novel Imaging Acquisition Methods:
Anatomical MRI 1
Perception, Attention and Motor Behavior:
Perception and Attention Other
Keywords:
Cerebrovascular Disease
Cortex
Limbic Systems
Memory
Morphometrics
MRI
STRUCTURAL MRI
Structures
White Matter
1|2Indicates the priority used for review
·Fig. 1 The association between the CVVLT score and brain volume.
·Fig. 2 The association between the DSS, TMT-A, TMT-B, CGUOFT score and brain volume.
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