Prefrontal-Parietal White Matter Volumes in Healthy Elderlies Are Decreased in Proportion to the Degree of Cardiovascular Risk and Related to Inhibitory Control Deficits.

Pedro P Santos,Geraldo F Busatto,Paulo A Lotufo,Claudia Da Costa Leite,Márcia Scazufca,Paula S Da Silveira,Jaqueline H Tamashiro-Duran,Tânia C De Toledo Ferraz Alves,Maurício Wajngarten,Patricia Rzezak,Paulo R Menezes,Homero Vallada,Fabio L Souza-Duran

doi:10.3389/fpsyg.2017.00057

Pedro P Santos, Geraldo F Busatto + Show 11 more

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https://doi.org/10.3389/fpsyg.2017.00057

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Journal: Frontier in Psychology	Publication Date: Jan 26, 2017
Citations: 3	License type: cc-by

Affiliation: Universidade de São Paulo

Abstract

Cardiovascular risk (CVR) factors may be associated with poor cognitive functioning in elderlies and impairments in brain structure. Using MRI and voxel-based morphometry (VBM), we assessed regional white matter (WM) volumes in a population-based sample of individuals aged 65–75 years (n = 156), subdivided in three CVR subgroups using the Framingham Risk Score. Cognition was assessed using the Short Cognitive Performance Test. In high-risk subjects, we detected significantly reduced WM volume in the right juxtacortical dorsolateral prefrontal region compared to both low and intermediate CVR subgroups. Findings remained significant after accounting for the presence of the APOEε4 allele. Inhibitory control performance was negatively related to right prefrontal WM volume, proportionally to the degree of CVR. Significantly reduced deep parietal WM was also detected bilaterally in the high CVR subgroup. This is the first large study documenting the topography of CVR-related WM brain volume deficits. The significant association regarding poor response inhibition indicates that prefrontal WM deficits related to CVR are clinically meaningful, since inhibitory control is known to rely on prefrontal integrity.

Highlights

Cardiovascular risk factors (CVRF), including dyslipidemia, diabetes, smoking, hypertension and obesity, are highly prevalent in elderly populations and are associated with deficits in cognitive performance (Mortamais et al, 2014; Pierdomenico et al, 2015).In recent years, several magnetic resonance imaging (MRI) studies have demonstrated the presence of macro-structural brain changes related to the severity of CVRF in groups of elderlyWhite Matter and Cognitive Deficits in Elderlies subjects
To the best of our knowledge, this is the first populationbased voxelwise morphometric MRI study of elderly individuals investigating the presence of white matter (WM) volume variations using the Framingham Risk Score (FRS) score as a composite measure of CVR, in a sample free from dementia, MCI and silent gross cerebrovascular lesions
Voxelwise analyses of regional WM volumes allow assessment of the topographical distribution of WM changes associated with CVRF across the whole brain, providing complementary information to the more commonly reported macro-structural MRI investigations of WM hyperintensities (Smith et al, 2010; Gebeily et al, 2014; Nunley et al, 2015), gross cerebrovascular lesions (Launer et al, 2015; Petrou et al, 2016) and gray matter volume abnormalities (Freedman et al, 2015; Kharabian Masouleh et al, 2016) related to CVRF

Summary

Introduction

Cardiovascular risk factors (CVRF), including dyslipidemia, diabetes, smoking, hypertension and obesity, are highly prevalent in elderly populations and are associated with deficits in cognitive performance (Mortamais et al, 2014; Pierdomenico et al, 2015).In recent years, several magnetic resonance imaging (MRI) studies have demonstrated the presence of macro-structural brain changes related to the severity of CVRF in groups of elderlyWhite Matter and Cognitive Deficits in Elderlies subjects. Elderly individuals may present an excess of white matter (WM) hyperintensities, thought to reflect microvascular injuries (Söderlund et al, 2003; Gouw et al, 2011; Barker et al, 2014) Such lesions, most often located in frontal WM regions (Maillard et al, 2012) are significantly related to the degree of CVRF (Markus et al, 2005; Kearney-Schwartz et al, 2009; Williams et al, 2010; Rostrup et al, 2012; Homayoon et al, 2013) and are usually associated with impaired cognitive functioning (Knopman et al, 2001; Au et al, 2006; Debette et al, 2011). Regional WM volume changes in these MRI studies have been most often reported in the frontal lobe (Raz et al, 2003; Last et al, 2007; Walther et al, 2010; Chen et al, 2012; Moran et al, 2013), as well as in temporal (Walther et al, 2010; Chen et al, 2012; Moran et al, 2013) and parietal regions (Walther et al, 2010; van Bloemendaal et al, 2016)

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