Abstract
Mechanisms underlying cognitive impairment (CI) in hypertensive patients remain relatively unclear. The present study aimed to explore the relationship among serum exosomal microRNAs (miRNAs), cerebrovascular reactivity (CVR), and cognitive function in hypertensive patients. Seventy-three hypertensive patients with CI (HT-CI), 67 hypertensive patients with normal cognition (HT-NC), and 37 healthy controls underwent identification of exosomal miRNA, multimodal magnetic resonance imaging (MRI) scans, and neuropsychological tests. CVR mapping was investigated based on resting-state functional MRI data. Compared with healthy subjects and HT-NC subjects, HT-CI subjects displayed decreased serum exosomal miRNA-330-3p. The group difference of CVR was mainly found in the left frontal lobe and demonstrated that HT-CI group had a lower CVR than both HT-NC group and control group. Furthermore, both the CVR in the left medial superior frontal gyrus and the miRNA-330-3p level were significantly correlated with executive function (r = −0.275, P = 0.021, and r = −0.246, P = 0.04, respectively) in HT-CI subjects, and the CVR was significantly correlated with the miRNA-330-3p level (r = 0.246, P = 0.040). Notably, path analysis showed that the CVR mediated the association between miRNA-330-3p and executive function. In conclusion, decreased miRNA-330-3p might contribute to CI in hypertensive patients by decreasing frontal CVR and could be a biomarker of early diagnosis.
Highlights
As a worldwide public health problem, hypertension is detected in 31.1% of adults worldwide (Mills et al, 2016)
We previously demonstrated that both miRNA-330-3p and cerebrovascular reactivity (CVR) in the left medial superior frontal lobe were significantly correlated with executive function, and miRNA-330-3p was associated with CVR
While many studies found that functional magnetic resonance imaging (fMRI) activity in the frontal cortex was associated with multiple cognitive performances (Wierenga et al, 2008; Obler et al, 2010; Gu et al, 2019; Liu R. et al, 2019), the present study extended these associations to regional vasodilatory activity and cognitive performance, i.e., the CVR in the frontal regions was significantly associated with executive function, visuospatial function, and language
Summary
As a worldwide public health problem, hypertension is detected in 31.1% of adults worldwide (Mills et al, 2016). It has been reported that hypertension is one of the major risk factors for dementia. There is a strong correlation between hypertension and the progression of dementia (Li et al, 2016). High blood pressure has been correlated with multiple cognitive dysfunctions such as executive. A 40-year follow-up study of a population-based cohort investigated the association of vascular risk factors with all types of dementia and found that high systolic blood pressure was consistently associated with all types of dementia (Ronnemaa et al, 2011). In a 17-year observational study of 668 non-demented elderly Japanese, subjects with hypertension had at least three-fold greater risk of vascular dementia compared to subjects with normal blood pressure (Ninomiya et al, 2011)
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