Associations Between Cerebral Vasoreactivity and Cognitive Function in the Middle-Aged Non-Demented Population

Article type: Research Article

Authors: Chen, Wan-Ting^a | Chi, Nai-Fang^{b; c} | Cheng, Hao-Min^{c; d; e; f} | Ko, Yu-Ting^e | Chuang, Shao-Yuan^g | Pan, Wen-Harn^g | Chen, Chen-Huan^{c; d; e; f} | Chung, Chih-Ping^{b; c; *} | Wang, Pei-Ning^{b; h; *}

Affiliations: [a] Division of Neurology, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan | [b] Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan | [c] School of Medicine, National Yang-Ming University, Taiwan | [d] Institute of Public Health, National Yang-Ming University, Taipei, Taiwan | [e] Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan | [f] Center for Evidence-based Medicine and Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan | [g] Division of Health Services and Preventive Medicine, Institute of Population Health Sciences, National Health Research Institutes, Taiwan | [h] Brain Research Center, National Yang Ming University, Taipei, Taiwan

Correspondence: [*] Correspondence to: Chih-Ping Chung, MD, PhD, and Pei-Ning Wang, MD, Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan. Tel.: +886 2 28757578; E-mails: pin324pin324@gmail.com (Chung) and pnwang@vghtpe.gov.tw (Wang).

Abstract: Background:Increasing evidence shows early vascular dysregulation in the pathophysiology of Alzheimer’s disease (AD) in elderly population. Objective:We wondered about the relationship between vascular health and cognitive performance in middle-aged adults. The present study aims to evaluate whether and which brain vascular hemodynamic parameters are associated with cognitive functions in a middle-aged, non-demented population. Methods:We recruited 490 middle-aged community-based participants (30–60 years). Transcranial color-coded sonography was used to measure cerebral vascular hemodynamics, including mean flow velocity, pulsatility index, and breath-holding index (BHI) in the middle cerebral arteries (MCAs). Cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA). A multivariate linear regression model was used to determine the association between the MoCA scores and each intracranial hemodynamic parameter. Results:In 369 participants (median age 52 years [IQR 47–56], 48.8% men) with robust acoustic windows, the factors related to poorer MoCA scores were older age, less education extent, and the habitats of cigarette smoking or alcohol consumption. Multivariate analyses did not show a significant association between any intracranial hemodynamic parameters in both MCAs and MoCA scores in the total study population. Left MCA BHI was found to be significantly and independently correlated with the MoCA scores only in people aged 55–60 years (n = 111, B = 0.70, 95% confidence interval, 0.13–1.26, p = 0.017), however, not in people younger than 55 years. Conclusion:Our results emphasize the role of neurovascular abnormalities in the early pathophysiology of cognitive impairment and suggest cerebral vasoreactivity as the earliest detectable cognition-associated hemodynamic parameter.

Keywords: Alzheimer’s disease, cerebrovascular reactivity, cognitive impairment, vasomotor system, vasoreactivity

DOI: 10.3233/JAD-215317

Journal: Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 679-690, 2022