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Ciencia Básica y Patogénesis
Trevor Lohman1, Fatemah Shenasa2, Isabel Sible3
1Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 24, 2025
Resumen
La alta variabilidad de la presión arterial, específicamente el aumento de la variabilidad real promedio (ARV) y el índice de rigidez arterial ambulatoria (AASI), se asocia con marcadores de neurodegeneración en adultos mayores. Esta inestabilidad hemodinámica combinada exacerba la atrofia del lóbulo temporal medial y aumenta los niveles de neurofilamento ligero.
Área de la Ciencia:
- Neurología
- Ciencia Cardiovascular
- Investigación sobre el envejecimiento
Sus antecedentes:
- La variabilidad de la presión arterial (VPA) es un factor de riesgo establecido para enfermedades neurodegenerativas relacionadas con la edad.
- Los efectos distintos e interactivos de diferentes medidas de VPA sobre la salud cerebral siguen sin entenderse por completo.
- La presión del pulso elevada junto con una alta variabilidad latido a latido pueden indicar inestabilidad hemodinámica, lo que podría empeorar la neurodegeneración.
Objetivo del estudio:
- Investigar los efectos interactivos de dos medidas distintas de variabilidad de la presión arterial sobre marcadores de neurodegeneración en adultos mayores.
- Examinar la asociación entre la variabilidad real promedio (ARV) y el índice de rigidez arterial ambulatoria (AASI) con la atrofia del lóbulo temporal medial y biomarcadores específicos.
Principales métodos:
- 105 adultos mayores se sometieron a monitorización continua de la presión arterial y RM cerebral.
- La variabilidad de la presión arterial latido a latido se cuantificó utilizando la variabilidad real promedio (ARV) sistólica y el índice de rigidez arterial ambulatoria (AASI).
- Se analizó el impacto interactivo de ARV y AASI sobre la atrofia del lóbulo temporal medial, el neurofilamento ligero (NfL) en plasma y la proteína ácida fibrilar glial (GFAP).
Principales resultados:
- Una interacción significativa entre ARV y AASI más altos se asoció con volúmenes reducidos del hipocampo y la corteza entorrinal.
- Este término de interacción se correlacionó con atrofia del lóbulo temporal medial del lado izquierdo, confirmada por análisis de la región de interés y morfometría basada en vóxeles.
- El efecto combinado de ARV y AASI altos se relacionó significativamente con niveles elevados de NfL en plasma, pero no de GFAP.
Conclusiones:
- La interacción entre ARV y AASI elevados predice de forma independiente un aumento de los marcadores de neurodegeneración en adultos mayores de la comunidad.
- Las personas que presentaron tanto ARV como AASI altos demostraron los marcadores más pronunciados de neurodegeneración del lóbulo temporal medial.
- Estos hallazgos resaltan el impacto perjudicial de la inestabilidad hemodinámica combinada en la salud cerebral en las poblaciones de edad avanzada.
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