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Steady-State Cerebral Autoregulation in Older Adults with Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis.
J Appl Physiol (1985). 2020 Jul 02 [Online ahead of print]JA

Abstract

We examined whether steady-state cerebral autoregulation (CA) is impaired in older adults with amnestic mild cognitive impairment (aMCI), a prodromal stage of clinical Alzheimer disease (AD). Forty-two patients with aMCI and 27 cognitively normal older adults (NC) of similar age, sex, and education underwent stepwise decreases and increases in mean arterial pressure (MAP) induced by intravenous infusion of sodium nitroprusside and phenylephrine, respectively. Changes in cerebral blood flow (CBF) were measured in the internal carotid and vertebral artery. Linear mixed modelling, including random effects of both individual intercept and regression slope, was used to quantify the MAP-CBF relationship accounting for the non-independent CBF measures. Changes in end-tidal CO2 (ETCO2) associated with changes in MAP were also included in the model to account for their effects on CBF. Marginal mean values of MAP were reduced by 13-14 mmHg during sodium nitroprusside and increased by 20-24 mmHg during phenylephrine infusion in both groups with similar doses of drug infusion. A steeper slope of changes in CBF in response to changes in MAP was observed in aMCI relative to NC, indicating impaired CA (MAP*Group, P < 0.05). These findings indicate CA was impaired in older adults with aMCI, suggesting that cerebrovascular dysfunction may occur early in the development of AD.

Authors+Show Affiliations

Institute of Exercise and Environmental Medicine, Texas Health Prebyterian Hospital Dallas, United States.Institute of Exercise and Environmental Medicine, Texas Health Prebyterian Hospital Dallas, United States.Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, China.Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, China.Institute of Exercise and Environmental Medicine, Texas Health Prebyterian Hospital Dallas, United States.Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, United States.Department of Neurology and Neutherapeutics, UT Southwestern, United States.Department of Psychiatry, University of Texas Southwestern Medical School, United States.Department of Psychiatry & Neurology, Univeristy of Texas Southwestern Medical Center, United States.Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32614686

Citation

Zhang, Li, et al. "Steady-State Cerebral Autoregulation in Older Adults With Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis." Journal of Applied Physiology (Bethesda, Md. : 1985), 2020.
Zhang L, Pasha EP, Liu J, et al. Steady-State Cerebral Autoregulation in Older Adults with Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis. J Appl Physiol. 2020.
Zhang, L., Pasha, E. P., Liu, J., Xing, C. Y., Cardim, D., Tarumi, T., Womack, K., Hynan, L. S., Cullum, C. M., & Zhang, R. (2020). Steady-State Cerebral Autoregulation in Older Adults with Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis. Journal of Applied Physiology (Bethesda, Md. : 1985). https://doi.org/10.1152/japplphysiol.00193.2020
Zhang L, et al. Steady-State Cerebral Autoregulation in Older Adults With Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis. J Appl Physiol. 2020 Jul 2; PubMed PMID: 32614686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Steady-State Cerebral Autoregulation in Older Adults with Amnestic Mild Cognitive Impairment: Linear Mixed Model Analysis. AU - Zhang,Li, AU - Pasha,Evan P, AU - Liu,Jie, AU - Xing,Chang-Yang, AU - Cardim,Danilo, AU - Tarumi,Takashi, AU - Womack,Kyle, AU - Hynan,Linda S, AU - Cullum,C Munro, AU - Zhang,Rong, Y1 - 2020/07/02/ PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - Alzheimer's disease KW - cerebral autoregulation KW - cerebral blood flow KW - linear mixed model KW - mild cognitive impairment JF - Journal of applied physiology (Bethesda, Md. : 1985) JO - J. Appl. Physiol. N2 - We examined whether steady-state cerebral autoregulation (CA) is impaired in older adults with amnestic mild cognitive impairment (aMCI), a prodromal stage of clinical Alzheimer disease (AD). Forty-two patients with aMCI and 27 cognitively normal older adults (NC) of similar age, sex, and education underwent stepwise decreases and increases in mean arterial pressure (MAP) induced by intravenous infusion of sodium nitroprusside and phenylephrine, respectively. Changes in cerebral blood flow (CBF) were measured in the internal carotid and vertebral artery. Linear mixed modelling, including random effects of both individual intercept and regression slope, was used to quantify the MAP-CBF relationship accounting for the non-independent CBF measures. Changes in end-tidal CO2 (ETCO2) associated with changes in MAP were also included in the model to account for their effects on CBF. Marginal mean values of MAP were reduced by 13-14 mmHg during sodium nitroprusside and increased by 20-24 mmHg during phenylephrine infusion in both groups with similar doses of drug infusion. A steeper slope of changes in CBF in response to changes in MAP was observed in aMCI relative to NC, indicating impaired CA (MAP*Group, P < 0.05). These findings indicate CA was impaired in older adults with aMCI, suggesting that cerebrovascular dysfunction may occur early in the development of AD. SN - 1522-1601 UR - https://www.unboundmedicine.com/medline/citation/32614686/Steady-State_Cerebral_Autoregulation_in_Older_Adults_with_Amnestic_Mild_Cognitive_Impairment:_Linear_Mixed_Model_Analysis L2 - https://journals.physiology.org/doi/10.1152/japplphysiol.00193.2020?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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