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Hippocampal Blood Flow Abnormality Associated With Depressive Symptoms and Cognitive Impairment in Patients With
Hideaki Suzuki1, Yasuharu Matsumoto, Hideki Ota
1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.
Insights
Chronic heart failure (CHF) patients show reduced hippocampal blood flow, linked to higher depressive symptoms and memory loss. These findings suggest hippocampal abnormalities contribute to cognitive and emotional issues in CHF.
Area of Science:
- Cardiology
- Neurology
- Psychiatry
Background:
- Depressive symptoms and memory impairment are common in chronic heart failure (CHF).
- The hippocampus, crucial for emotion and memory, is a potential neural substrate for these symptoms.
- Mechanisms underlying these symptoms in CHF patients require further elucidation.
Purpose of the Study:
- To investigate the association between hippocampal cerebral blood flow (CBF) and cognitive/emotional symptoms in CHF patients.
- To compare hippocampal CBF between CHF patients and controls with structural heart disease but no CHF symptoms.
Main Methods:
- Prospective enrollment of 40 Stage C CHF patients and 40 Stage B patients (controls).
- Measurement of hippocampal CBF in four segments using brain MRI.
- Assessment of depressive symptoms (Geriatric Depression Scale) and memory (immediate and delayed recall).
Main Results:
- Significantly lower hippocampal CBF in the posterior segment was observed in Stage C CHF patients compared to Stage B controls.
- Hippocampal CBF showed a significant association with depressive symptoms and delayed memory scores in Stage C patients.
- Patients with lower hippocampal CBF exhibited higher depressive symptoms and poorer memory performance.
Conclusions:
- Hippocampal abnormalities, indicated by reduced CBF, are linked to depressive symptoms and cognitive impairment in CHF patients.
- These findings highlight the hippocampus as a key area affected in CHF, contributing to associated neuropsychiatric symptoms.
Background:
Depressive symptoms and memory impairment are prevalent in patients with chronic heart failure (CHF). Although the mechanisms remain to be elucidated, the hippocampus (an important brain area for emotion and memory) may be a possible neural substrate for these symptoms.
Methods And Results:
We prospectively enrolled 40 Stage C patients, who had past or current CHF symptoms, and as controls 40 Stage B patients, who had structural heart disease but had never had CHF symptoms, in Brain Assessment and Investigation in Heart Failure Trial (B-HeFT) (UMIN000008584). As the primary index, we measured cerebral blood flow (CBF) in the 4 anterior-posterior segments of the hippocampus, using brain MRI analysis. Depressive symptoms, immediate memory (IM) and delayed memory (DM) were assessed using Geriatric Depression Scale (GDS), and Wechsler Memory Scale-revised (WMS-R), respectively. Hippocampus CBF in the most posterior segment was significantly lower in Stage C than in Stage B group (P=0.029 adjusted for Holm's method). Multiple regression analysis identified significant association between hippocampus CBF and GDS or DM score in Stage C group (all P<0.05). GDS score was significantly higher, and IM and DM scores were lower in Stage C patients with hippocampus CBF below the median than those with hippocampus CBF above the median (all P<0.05).
Conclusions:
Hippocampus abnormalities are associated with depressive symptoms and cognitive impairment in CHF patients. (Circ J 2016; 80: 1773-1780).
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