Cognitive impairment and white matter damage in hypertension: a pilot study

Hannesdóttir, Kristín; Nitkunan, Arani; Charlton, Rebecca A.; Barrick, Thomas R.; MacGregor, Graham A.; Markus, Hugh S.

doi:10.1111/j.1600-0404.2008.01098.x

Cited by 60 publications

(65 citation statements)

References 34 publications

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“…However, as periventricular and subcortical white matter lesions are more severe in hypertensive than in normal elderly persons, 26 it is still reasonable to suggest that frontal and PPL metabolic changes could be induced directly or indirectly by white matter disease. Although IB was not different between our normotensive and hypertensive patients, the pattern of change of white matter disease from normotensive to resistant hypertensive patients was quite analogous to the lesion load reported by Hannesdotir et al 23 In that study, the lesion load proved to be significantly higher in treated relative to untreated hypertensive patients. In our case, differences in IB perhaps failed to be significant because our whole-hypertensive sample composed of patients under treatment.…”

Section: Discussionsupporting

confidence: 65%

“…However, in our series the NAA/Cr ratio changed with treatment outcome but not with IB. In addition, the increase of NAA/Cr in controlled hypertension points to a favorable outcome of antihypertensive treatment 22,23 and not to the expected deleterious effect of white matter disease. Therefore, we hypothesize that, beyond white matter disease, frontal NAA/Cr changes could be caused by something else.…”

Section: Discussionmentioning

confidence: 99%

“…22 Contrary to these results, NAA/Cr was not found to differ between treated and untreated hypertensive patients in a recent related study. 23 The different outcomes might be due to the different methods used. In the Hannesdottir et al 23 study, NAA/Cr ratio was averaged from the ratio values across all voxels measured within a field of view of 22 cm centered in the centrum ovale, including the white and gray matters.…”

Section: Discussionmentioning

confidence: 99%

“…23 The different outcomes might be due to the different methods used. In the Hannesdottir et al 23 study, NAA/Cr ratio was averaged from the ratio values across all voxels measured within a field of view of 22 cm centered in the centrum ovale, including the white and gray matters. In the other studies, the authors carried out either an absolute quantification of white matter metabolites in a similar field of view 21 or metabolite ratio measurements in very specific brain areas (insular cortex, thalami and parieto-occipital peritrigonal white matter), 22 as we did with our single-voxel analysis of the frontal lobe and the PPL.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the originality of these results also dwells in the sample characteristics. Although, in the other quoted papers, comparisons were carried out between groups of normal vs asymptomatic hypertensive patients, 5,22 symptomatic vs asymptomatic hypertensive patients, 21 or treated vs untreated patients, 23 we focused on the effect of medical treatment by comparing two groups of treated asymptomatic hypertensive patients with opposing outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

et al. 2009

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Hypertension is associated with cognitive decline in elderly persons. We studied asymptomatic hypertensive subjects using brain magnetic resonance (MR) spectroscopy to evaluate metabolite impairments before the appearance of symptoms in patients with different treatment outcomes. In all, 14 healthy controls and 37 asymptomatic hypertensive patients (17 controlled and 20 resistant) underwent brain structural MR and MR spectroscopy of the posterior paralimbic (PPL) area and left frontal white matter. Ischemic burden (IB), global cortical atrophy and microbleeds were analyzed with visual scales. Metabolite ratios involving N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho) and myoinositol (mI) were computed. Ultrasound measurements, including intima-media thickness, plaques and hemodynamic ratios, were obtained. Intergroup differences in IB, atrophy and metabolite ratios, and the atrophy and IB relationship were assessed with parametric and nonparametric statistical tests. In addition, the impacts of demographic, analytic and clinical factors, ischemia and atrophy, and ultrasound measurements on metabolite ratios were assessed. The significance level was set at Pp0.05. Higher atrophy scores presented with higher total or frontal IB (Po0.05). However, there was no intergroup difference in atrophy and IB. PPL mI/Cr was increased in resistant hypertension (Po0.021), whereas frontal NAA/Cr (Po0.007) showed opposite trends between controlled (increased ratios) and resistant (decreased ratios) hypertension. Unlike PPL mI/Cr, frontal NAA/Cr showed significant correlations with the lipid profile and ultrasound measurements. PPL mI/Cr increases in resistant hypertension, and frontal NAA/Cr diverges between controlled and resistant hypertension before physical and neuropsychological symptoms appear.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

et al. 2009

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Current awareness in geriatric psychiatry

2009

Int J Geriat Psychiatry

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of geriatric psychiatry. Each bibliography is divided into 9 sections: 1 Reviews; 2 General; 3 Assessment; 4 Epidemiology; 5 Therapy; 6 Care; 7 Dementia; 8 Depression; 9 Psychology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

Xue

Hou

et al. 2019

Int J Geriat Psychiatry

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Objective Subjects with mild cognitive impairment (MCI) may revert to normal cognition (NC), but predictive factors are under study. We therefore sought to identify factors which could help in predicting reversion from MCI to NC. Methods Relevant studies were retrieved from PubMed, EMBASE, Cochrane Library, MEDLINE, Web of Science, EBSCO, and OVID. According to the inclusion and exclusion criteria, high‐quality assessments of relevant literatures were conducted, followed by data extraction and meta‐analysis with Stata 12.0 software. Results A total of 17 studies with 6829 participants were included in the meta‐analysis. The overall reversion rate is 27.57%. Positive predictive factors were found in younger age (SMD = −0.345, 95% CI, −0.501 to −0.189), higher education level (SMD = 0.337, 95% CI, 0.117‐0.558), no APOE ε4 allele (OR = 0.728, 95% CI, 0.575‐0.922), no hypertension (OR = 0.826, 95% CI, 0.692‐0.987), no stroke (OR = 0.696, 95% CI, 0.507‐0.953), and higher Mini‐Mental State Examination (MMSE) score (SMD = 0.707, 95% CI, 0.461‐0.953). Conclusion Individuals who are at young age, have higher education level and MMSE score, and have no APOEe4 allele, no hypertension, and no stroke had a high probability to revert from MCI to NC.

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Cognitive impairment and white matter damage in hypertension: a pilot study

Abstract: These results suggest there is cognitive impairment in hypertension. Treated hypertension was associated with deficits in memory while untreated hypertension revealed a more 'subcortical' pattern of cognitive impairment.

Cited by 60 publications

References 34 publications

Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes

Current awareness in geriatric psychiatry

Factors for predicting reversion from mild cognitive impairment to normal cognition: A meta‐analysis

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