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Cerebral blood flow and cognitive functioning in patients with disorders along the heart-brain axis: Cerebral blood
Anna E Leeuwis1, Astrid M Hooghiemstra1,2, Esther E Bron3
1Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC VU University Medical Center Amsterdam the Netherlands.
Insights
Reduced cerebral blood flow (CBF) is not the primary cause of cognitive impairment in heart failure (HF) and carotid occlusive disease (COD) patients. This study investigated hemodynamic dysfunction and cognitive function in these groups.
Area of Science:
- Neuroscience
- Cardiology
- Radiology
Background:
- Hemodynamic dysfunction impacts cognitive function.
- Investigated patients with heart failure (HF), carotid occlusive disease (COD), and possible vascular cognitive impairment (VCI).
Purpose of the Study:
- To examine the role of hemodynamic dysfunction in cognition.
- To relate cerebral blood flow (CBF) to cognitive functioning in patient groups.
Main Methods:
- Utilized pseudo-continuous arterial spin labeling (ASL) to measure CBF.
- Assessed cognitive function using neuropsychological tests across global cognition and four domains.
- Included 439 participants from the Dutch multi-center Heart-Brain Study.
Main Results:
- CBF was lowest in COD, followed by VCI and HF patients compared to controls.
- No significant association was found between CBF and cognitive functioning.
- Reduced CBF did not explain cognitive impairment in the studied patient groups.
Conclusions:
- Reduced CBF is not the primary factor explaining cognitive impairment in patients with hemodynamic dysfunction.
- Findings suggest other mechanisms contribute to cognitive deficits in HF, COD, and VCI.
Introduction:
We examined the role of hemodynamic dysfunction in cognition by relating cerebral blood flow (CBF), measured with arterial spin labeling (ASL), to cognitive functioning, in patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (MRI; ie, possible vascular cognitive impairment [VCI]).
Methods:
We included 439 participants (124 HF; 75 COD; 127 possible VCI; 113 reference participants) from the Dutch multi-center Heart-Brain Study. We used pseudo-continuous ASL to estimate whole-brain and regional partial volume-corrected CBF. Neuropsychological tests covered global cognition and four cognitive domains.
Results:
CBF values were lowest in COD, followed by VCI and HF, compared to reference participants. This did not explain cognitive impairment, as we did not find an association between CBF and cognitive functioning.
Discussion:
We found that reduced CBF is not the major explanatory factor underlying cognitive impairment in patients with hemodynamic dysfunction along the heart-brain axis.
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