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Spontaneous slow hemodynamic oscillations are impaired in cerebral microangiopathy
Matthias L Schroeter1, Markus M Bücheler, Christoph Preul
1Max-Planck-Institute for Human Cognitive and Brain Sciences, University of Leipzig, Leipzig, Germany. schroet@cbs.mpg.de
Abstract:
Small-vessel disease or cerebral microangiopathy (CMA) is a common finding in elderly people. It is related to a variety of vascular risk factors and may finally lead to subcortical ischemic vascular dementia. Because vessel stiffness is increased, we hypothesized that slow spontaneous oscillations are reduced in cerebral hemodynamics. Accordingly, we examined spontaneous oscillations in the visual cortex of 13 patients suffering from CMA, and compared them with 14 age-matched controls. As an imaging method we applied functional near-infrared spectroscopy, because it is particularly sensitive to the microvasculature. Spontaneous low-frequency oscillations (LFOs) (0.07 to 0.12 Hz) were specifically impaired in CMA in contrast to spontaneous very-low-frequency oscillations (0.01 to 0.05 Hz), which remained unaltered. Vascular reagibility was reduced during visual stimulation. Interestingly, changes were tightly related to neuropsychological deficits, namely executive dysfunction. Vascular alterations had to be attributed mainly to the vascular risk factor arterial hypertension. Further, results suggest that the impairments might be, at least partly, reversed by medical treatment such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Results indicate that functional near-infrared spectroscopy may detect changes in the microvasculature due to CMA, namely an impairment of spontaneous LFOs, and of vascular reagibility. Hence, CMA accelerates microvascular changes due to aging, leading to impairments of autoregulation.
Insights
Cerebral microangiopathy (CMA) impairs spontaneous low-frequency oscillations in brain hemodynamics, particularly affecting elderly individuals. This finding, detected by functional near-infrared spectroscopy, correlates with cognitive deficits.
Area of Science:
- Neuroscience
- Cerebrovascular Diseases
- Medical Imaging
Background:
- Cerebral microangiopathy (CMA) is prevalent in the elderly, linked to vascular risk factors and potentially causing vascular dementia.
- Increased arterial stiffness in CMA suggests potential alterations in cerebral hemodynamic oscillations.
- Understanding CMA's impact on microvasculature is crucial for managing cognitive decline in aging populations.
Purpose of the Study:
- To investigate spontaneous hemodynamic oscillations in the visual cortex of patients with CMA.
- To compare oscillatory patterns between CMA patients and age-matched controls using functional near-infrared spectroscopy (fNIRS).
- To explore the relationship between hemodynamic changes, vascular risk factors, and cognitive function in CMA.
Main Methods:
- Functional near-infrared spectroscopy (fNIRS) was employed to assess spontaneous oscillations in the visual cortex.
- 13 patients with CMA and 14 age-matched healthy controls participated in the study.
- Analysis focused on spontaneous low-frequency oscillations (LFOs, 0.07–0.12 Hz) and very-low-frequency oscillations (VLFOs, 0.01–0.05 Hz).
Main Results:
- Spontaneous LFOs were significantly impaired in CMA patients compared to controls; VLFOs remained unaltered.
- Reduced vascular reactivity was observed during visual stimulation in CMA patients.
- Hemodynamic alterations correlated with executive dysfunction and were primarily linked to arterial hypertension.
Conclusions:
- fNIRS can detect microvascular changes in CMA, specifically impaired LFOs and vascular reactivity.
- CMA accelerates age-related microvascular changes, leading to impaired cerebral autoregulation and cognitive deficits.
- Potential for therapeutic intervention, possibly with ACE inhibitors/ARBs, to reverse some vascular impairments.
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