Asymmetric Insular Function Predicts Positional Blood Pressure in Nondemented Elderly

Abstract

40% of non-demented octogenarians have Braak stages consistent with insular involvement, and may be at risk for “age–related” autonomic dysfunction. We examined the association between insular resting Cerebral Blood Flow (rCBF) and cardiovascular functions in 29 non-demented elderly subjects who were highly screened to exclude comorbid cardiovascular disease. Mean insular rCBF was significantly higher on the right (R) than left (L). However, 35.4% of subjects had L dominant rCBF = a "HIGH” risk group. R insular rCBF was significantly lower in the HIGH risk group. This subset had significantly increased positional drops in systolic blood pressure. While these data cannot address AD as the specific cause, this possibility is being investigated in other cohorts.

Multimodal MRI Neuroimaging Biomarkers for Cognitive Normal Adults, Amnestic Mild Cognitive Impairment, and Alzheimer's Disease

“…The observations have been consistent with those observed using SPECT. Using dynamic contrast method, CBF has been found significantly reduced in insular cortex [ 83 , 84 ]. Because the insula is an important brain structure for the autonomic control of blood pressure and heart rate, the observations suggested that AD pathology has effect on ventral autonomic cardioregulatory dysfunction.…”