Clinical neurovascular coupling through cerebrovascular reserve and cognitive function

Area of Science:

• Neurology
• Cerebrovascular Medicine
• Neuroimaging

Background:

• Neurovascular coupling is vital for matching cerebral blood flow (CBF) to neural activity.
• Chronic cerebral hypoperfusion impacts this coupling, affecting cognitive function.
• Assessing cognitive function and cerebrovascular reserve (CVR) is clinically relevant in these patients.

Purpose of the Study:

• To investigate the relationship between cognitive function and CVR in patients with steno-occlusive disease.
• To determine how factors like HbA1c and periventricular hyperintensity (PVH) affect this relationship.
• To evaluate the impact of anastomosis surgery on cognitive function and CVR.

Main Methods:

• Neuropsychological testing (COGNISTAT) assessed cognitive function.
• ¹²³I-iodoamphetamine SPECT with acetazolamide challenge evaluated CVR.
• Multiple regression analysis examined relationships between COGNISTAT scores, CVR, and risk factors (HbA1c, PVH grade, lipids).

Main Results:

• A significant regression relationship (adjusted R² > 0.45) was found between COGNISTAT scores and CVR in 41 patients and subgroups.
• Higher HbA1c and PVH grade were associated with lower CVR's influence on cognition.
• Anastomosis surgery improved both COGNISTAT scores and CVR, maintaining their relationship.

Conclusions:

• A significant relationship exists between cognitive function and CVR, suggesting a clinical neurovascular coupling mechanism.
• This relationship is modulated by HbA1c levels and PVH grade.
• Anastomosis surgery can restore cognitive function and CVR, preserving neurovascular coupling.