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Updated: Apr 25, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Regional cerebral arterial transit time hemodynamics correlate with vascular risk factors and cognitive function in
B J MacIntosh1, W Swardfager2, A D Robertson3
1From the Canadian Partnership for Stroke Recovery (B.J.M., W.S., A.D.R., E.T., N.H., B.S., K.L.L.) Physical Sciences (B.J.M., B.S.) Departments of Medical Biophysics (B.J.M., E.T., B.S.,) bmac@sri.utoronto.ca.
Insights
Vascular risk factors like obesity are linked to altered cerebral arterial transit time in coronary artery disease patients, potentially impacting cognitive function. Specifically, obesity correlated with slower transit times in certain brain regions associated with poorer cognition.
Area of Science:
- Neuroimaging
- Cardiovascular Health
- Cognitive Science
Background:
- Coronary artery disease (CAD) patients are at risk for cognitive decline.
- Cerebral arterial transit time (CATT) reflects blood flow dynamics from arteries to capillaries.
- Arterial spin-labeling (ASL) MR imaging can estimate CATT.
Purpose of the Study:
- To investigate the relationship between vascular risk factors and regional CATT differences.
- To explore the association between cognitive performance and CATT in CAD patients.
- To identify specific brain regions where CATT is altered in relation to vascular health and cognition.
Main Methods:
- ASL MRI was used to estimate CATT in 29 men with CAD.
- Cognitive tests assessed memory, attention, processing speed, and executive function.
- Principal component analysis modeled vascular risk and cognition, with voxelwise CATT map analyses.
Main Results:
- Two vascular risk components identified: 'pressor' (age, BP) and 'obesity' (body fat, BMI).
- Obesity inversely correlated with CATT in posterior cingulate, precuneus, lateral occipital, middle temporal, and frontal pole regions (P < .05).
- Poorer cognitive performance inversely correlated with precuneus CATT (P < .05); obesity-related regions showed association with poorer cognition (r² = 0.21).
Conclusions:
- Altered cerebral hemodynamics, particularly in default mode network regions, may mediate the impact of vascular risk on cognition in CAD patients.
- Regional CATT differences are associated with both vascular risk factors and cognitive performance in this population.
- Findings suggest CATT as a potential biomarker for cognitive impairment in cardiovascular disease.
Background And Purpose:
Arterial transit time is the time needed for blood to travel from large arteries to capillaries, as estimated from arterial spin-labeling MR imaging. The purpose of this study was to determine whether vascular risk factors and cognitive performance are related to regional differences in cerebral arterial transit time in patients with coronary artery disease who are at risk for cognitive decline.
Materials And Methods:
Arterial transit time was estimated from multiple postlabel delay pseudocontinuous arterial spin-labeling images obtained from 29 men with coronary artery disease. Tests of memory, attention, processing speed, and executive function were administered. Principal component analysis was used to create separate models of cognition and vascular risk, which were related to brain regions through voxelwise analyses of arterial transit time maps.
Results:
Principal component analysis identified 2 components of vascular risk: 1) "pressor" (age, systolic blood pressure, and pulse pressure) and 2) "obesity" (body fat percentage and body mass index). Obesity was inversely related to arterial transit time in the posterior cingulate, precuneus, lateral occipital cortices, middle temporal gyrus, and frontal pole (P corrected < .05), whereas pressor was not significant. Cognitive scores were factored into a single component. Poor performance was inversely related to precuneus arterial transit time (P corrected < .05). The average arterial transit time in regions identified by obesity was associated with poorer cognitive function (r(2) = 0.21, t = -2.65, P = .01).
Conclusions:
Altered cerebral hemodynamics, notably in nodal structures of the default mode network, may be one way that vascular risk factors impact cognition in patients with coronary artery disease.
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