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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Systemic and cerebral hemodynamics during cognitive testing.

Jill M Wecht1, Dwindally Rosado-Rivera, Adejoke Jegede

  • 1Center of Excellence: Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY 10468, USA. jm.wecht@va.gov

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 28, 2011
PubMed
Summary
This summary is machine-generated.

Hypotension impacts cognitive function in individuals with spinal cord injury (SCI). Blood pressure normalization may improve cognition in tetraplegia, while paraplegia requires further investigation into cerebral vascular responses.

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Area of Science:

  • Neuroscience
  • Neurology
  • Physiology

Background:

  • Cognitive deficits affect 10-60% of individuals with spinal cord injury (SCI), often linked to traumatic brain injury (TBI).
  • Previous research indicated memory deficits and attention/processing speed issues in SCI individuals, irrespective of hypotension but matched for TBI.

Purpose of the Study:

  • To investigate the relationship between cerebral blood flow (CBF), mean arterial pressure (MAP), cerebral vascular resistance index (CVRi), and cognitive performance in individuals with SCI.
  • To compare cognitive function and cerebrovascular parameters between non-SCI controls, paraplegic, and tetraplegic individuals.

Main Methods:

  • Twenty-nine participants (16 non-SCI, 6 paraplegic, 7 tetraplegic) underwent cognitive testing using the Stroop test.
  • Cerebral blood flow (CBF) was measured using transcranial Doppler ultrasound during rest and cognitive tasks.
  • Mean arterial pressure (MAP) and cerebral vascular resistance index (CVRi) were calculated.

Main Results:

  • The paraplegic group showed significantly lower Stroop Color (SC) task performance compared to controls.
  • Tetraplegic individuals exhibited lower MAP, which correlated with SC task performance.
  • Paraplegic individuals displayed reduced CBF and increased CVRi compared to controls, with higher CVRi than the tetraplegic group.

Conclusions:

  • Asymptomatic hypotension is linked to cognitive performance in tetraplegia, suggesting BP normalization as a potential intervention.
  • Further research is needed to understand the inappropriate cerebral vascular response and cognitive deficits in paraplegia.