Cerebrovascular reactivity is blunted in young adults with major depressive disorder: The influence of current depressive symptomology

Darling, Ashley; Richey, Rauchelle E.; Akins, John D.; Saunders, Erika F.H.; Greaney, Jody L.

doi:10.1016/j.jad.2021.08.061

Cited by 12 publications

(4 citation statements)

References 56 publications

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“…In patients with depression, a decrease in CBF (22,23) has been observed, and in these patients, CVR is reported to be affected or diminished (24,26). The mechanisms affecting cerebral vasomotor function and impacting CBF are diverse, ranging from endothelial response (27), microglia (28), cytokines (29), among others.…”

Section: Discussionmentioning

confidence: 99%

Decreased cerebral blood flow in a supine position in patients with a history of syncope and presyncope during the Tilt Table Test

Cano,

González-Hermosillo,

Murata

et al. 2024

Preprint

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Objective: To analyze the hemodynamic response, cerebral blood flow, and the sympathovagal balance between patients with structurally healthy hearts who have a history of syncope and presyncope that exhibited signs or symptoms of presyncope without progressing to syncope during the tilt-table test, and a healthy group. Methodology: A retrospective study was conducted on patients attending the dysautonomia clinic of a tertiary care center. Individuals of both sexes aged 15 to 50 years were included. Patients with positive tests for VVS, OH, or POTS, and those with negative results were excluded. As a healthy group, healthy volunteers without a personal history of syncope or presyncope and with a negative tilt-table test were included. Statistical Analysis: Categorical variables were expressed as percentages and quantitative variables as mean ± standard deviation. Repeated measures ANOVA, the χ2 test, and effect size using Glass's Δ were used for group comparisons. A P-value < 0.05 was considered statistically significant. The R software, RStudio, and the effsize package were used for analysis. Results: The main finding was a significant decrease in cerebral blood flow secondary to an increase in cerebral vascular resistance in patients from a supine position at the start and throughout the test, compared to the control group. Conclusion: The analysis of cerebral hemodynamics allows for the identification of a subpopulation of patients who exhibit decreased cerebral blood flow from a supine position during the tilt-table test while maintaining cardiovascular stability without progressing to syncope.

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Section: Discussionmentioning

confidence: 99%

Decreased cerebral blood flow in a supine position in patients with a history of syncope and presyncope during the Tilt Table Test

Cano,

González-Hermosillo,

Murata

et al. 2024

Preprint

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“…Mental illness is associated with chronic stimulation of the autonomic nervous system and catecholamine production; over time, this leads to increased blood pressure, arterial stiffness, and thrombogenesis. These physiological disruptions can lead to microvascular endothelial dysfunction from oxidative stress [37], changes in peripheral vascular and cerebrovascular reactivity [38], dysregulated serotoninergic signaling [39], arrhythmogenesis, reduced heart rate variability, and impaired ventricular function [40]. Such physiologic alterations may also explain the significant association between CVDs and anxiety disorders [41].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Disease Burden in Persons with Mental Illness: Comparison between a U.S. Psychiatry Outpatient Sample and a U.S. General Population Sample

Dhingra,

He,

Saunders

et al. 2024

Mental Illness

Self Cite

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Background. Cardiovascular disease (CVD) and depression are the leading causes of disability in the U.S. Using electronic health record data, we describe the CVD burden among persons with mental illness enrolled in the Penn State Psychiatry Clinical Assessment and Rating Evaluation System (PCARES) Registry between 2015 and 2020. Methods. CVD burden assessment included prevalence of CVD conditions (any major CVD or individual CVD risk factors), indicated medication prescriptions for CVD risk factors, and mean levels of body mass index (BMI, kg/m2), glycosylated hemoglobin (HbA1C, %), glucose (mg/dl), and lipids (mg/dl). We compared the CVD burden between the PCARES sample to a representative sample of adults from the U.S. general population (NHANES 2013-2016) using one-sample chi-square/t-tests for proportions/means. The CVD burden in NHANES participants was adjusted to PCARES age, race, and sex statistics. Results. The PCARES sample (N=3556) had a mean (SE) age of 42.4 (0.3) years and comprised 63.0% women, 85.0% non-Hispanic Caucasians, and 41.0% with major depressive disorder. CVD burden was higher in the PCARES sample compared to NHANES participants for any major CVD (8.6% vs. 4.6%), diabetes (18.4% vs. 10.4%), BMI (30.3 vs. 28.3), HbA1C (6.1 vs. 5.6), cholesterol (185.6 vs. 181.7), triglycerides (153.3 vs. 136.1), and indicated antihypertensive (94.3% vs. 76.9%) and cholesterol-lowering (49.5% vs. 36.7%) medications (Bonferroni-corrected p=0.03 for each outcome). The CVD burden was lower in the PCARES sample compared to NHANES participants for hypertension (45.9% vs. 50.4%), dyslipidemia (43.2% vs. 61.9%), HDL-C (48.4 vs. 41.4), and LDL-C (107.9 vs. 112.0) (Bonferroni-corrected p=0.03 for each outcome). Glucose levels (110.9 vs. 111.9) and indicated antidiabetic medications (87.4% vs. 86.6%) were similar in the two samples (p>0.05). Conclusions. The CVD burden was higher in persons with mental illness compared to the U.S. general population. Integrated mental and physical healthcare services could reduce long-term disability among persons with mental illness.

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“…This was assessed using transcranial Doppler, as previously described [19][20][21][22][23] . Middle cerebral artery (MCA) mean blood velocity was measured using transcranial Doppler ultrasound (TCD) following standard procedures 24 .…”

Section: Cerebral Vascular Functionmentioning

confidence: 99%

“…Following rebreathing, the Y-valve was switched back to ambient air for a 3-min recovery period. Throughout the rebreathe protocol, 100% oxygen was continuously administered into the 5 L bag to maintain arterial normoxia (S p O 2 about 97%) [19][20][21][22][23] .…”

Section: Protocol -Peripheral and Cerebral Vascular Functionmentioning

confidence: 99%

Pod-based e-cigarettes versus combustible cigarettes: The impact on peripheral and cerebral vascular function and subjective experiences

Taleb¹,

Dabroy²,

Akins³

et al. 2023

Tob. Induc. Dis.

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INTRODUCTION The vaping epidemic in the US has been largely attributed to the emergence of pod-based e-cigarette devices. While these devices continue to be promoted as alternatives to cigarettes, their impact on cardiovascular and behavioral outcomes remains incompletely understood. This study assessed the impact of pod-based e-cigarettes on peripheral and cerebral vascular function, along with subjective experiences among adult cigarette smokers. METHODS In a crossover laboratory design study, a total of 19 (e-cigarette naïve) cigarette smokers (aged 21–43 years) attended two lab sessions. In one session, participants smoked a cigarette and in the other, vaped a pod-based e-cigarette. Participants completed questions assessing subjective experiences. Peripheral macrovascular and microvascular function was assessed via brachial artery FMD and reactive hyperemia, while cerebral vascular function was assessed as the blood velocity response of the middle cerebral artery during hypercapnia. Measurements were taken before and after exposure. RESULTS Compared with baseline, there was a reduction in peripheral macrovascular function (indexed by FMD), following e-cigarette (pre=9.3±4.3%; post=6.4±4.1%) and cigarette use (pre=10.2±3.7%; post=6.8±3.8%; main effect of time p<0.0001). Cerebral vascular function (indexed by cerebral vasodilatory response during hypercapnia) was also reduced following e-cigarette (pre=53±19%; post=44±15%) and cigarette use (pre=54±21%; post=44±17%; main effect of time p<0.01). The magnitude of reduction in peripheral and cerebral vascular function was similar between conditions (condition × time, p>0.05). Compared with vaping an e-cigarette, participants scored higher for measures of satisfaction, taste, puff liking, and suppression of craving following smoking (p>0.05). CONCLUSIONS Similar to smoking, vaping a pod-based e-cigarette leads to an impairment in peripheral and cerebral vascular function while providing a reduced subjective experience compared with a cigarette among adult smokers. While these data challenge the notion that e-cigarette use is a safe and satisfactory alternative to cigarette use, large longitudinal studies are needed to assess the long-term impact of pod-based e-cigarette devices on cardiovascular and behavioral outcomes.

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Cerebrovascular reactivity is blunted in young adults with major depressive disorder: The influence of current depressive symptomology

Cited by 12 publications

References 56 publications

Decreased cerebral blood flow in a supine position in patients with a history of syncope and presyncope during the Tilt Table Test

Decreased cerebral blood flow in a supine position in patients with a history of syncope and presyncope during the Tilt Table Test

Cardiovascular Disease Burden in Persons with Mental Illness: Comparison between a U.S. Psychiatry Outpatient Sample and a U.S. General Population Sample

Pod-based e-cigarettes versus combustible cigarettes: The impact on peripheral and cerebral vascular function and subjective experiences

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