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The related main theme: A. Stroke and Cerebral vascular disorders

腦血管反應性與認知功能的關聯性在中年健康族群的社區研究

Associations between cerebral arterial vasoreactivity and cognitive function in middle-aged healthy community-based population

Authers:

陳琬婷, MD 1, 2 , 鍾芷萍, PhD, MD 2, 6 , 鄭浩民, PhD, MD 3, 4, 5 , 柯昱廷,  3 , 莊紹源, PhD 7 , 潘文涵, PhD 7 , 陳震寰, PhD, MD 3, 4, 5 , 王培寧, MD 2, 6 , 
Chen  Wan-Ting, MD 1, 2 , Chung  Chih-Ping, PhD, MD 2, 6 , Cheng  Hao-Min, PhD, MD 3, 4, 5 , Ko  Yu-Ting,  3 , Chuang  Shao-Yuan, PhD 7 , Pan  Wen-Harn, PhD 7 , Chen  Chen-Huan, PhD, MD 3, 4, 5 , Wang  Pei-Ning, MD 2, 6 , 
1 台北市立聯合醫院忠孝院區神經內科
2 台北榮民總醫院神經醫學中心神經內科
3 台北榮民總醫院心臟內科
4 台北榮民總醫院實證醫學與醫學教育中心
5 國立陽明大學公共衛生研究所
6 國立陽明大學腦科學研究中心
7 國家衛生研究院群體健康科學研究所預防醫學部門
1 Division of Neurology, Taipei City Hospital, Zhongxiao Branch
2 Neurological Institute, Taipei Veterans General Hospital
3 Division of Cardiology, Taipei Veterans General Hospital
4 Center for Evidence-based Medicine and Department of Medical Education, Taipei Veterans General Hospital
5 Medicine and Institute of Public Health, National Yang-Ming University
6 Brain Research Center, National Yang Ming University
7 Division of Health Services and Preventive Medicine, Institute of Population Health Sciences; National Health Research Institutes
Corresponding Author:

鍾芷萍
Chung  Chih-Ping , PhD, MD
台北榮民總醫院神經醫學中心神經內科
Neurological Institute, Taipei Veterans General Hospital

keywords: cerebral vasoreactivity, cognitive function
Abstract for original article

OBJECTIVES /BACKGROUND:
Transcranial doppler studies have found increased pulsatility and impaired CO2 vasoreactivity in cerebral arteries, mainly the middle cerebral arteries (MCAs), in elderly people with either dementia or mild cognitive impairment (MCI). The present study aimed to investigate the relationship between cerebral vasoreactivity and cognitive functions in middle-aged healthy community-based population.

MATERIAL and METHOD:
The research continued the existing community-based cohort (cohort on cardiovascular disease risk evolution; CVDFACTS) and recruited 30 to 60 year-old participants without cognitive impairment or stroke history. Montreal Cognitive Assessment (MoCA) was performed to assess cognitive functions. Intracranial hemodynamics was assessed with transcranial color-coded sonography (TCCS) by means of cerebral vasomotor reactivity to hypercapnia, measuring mean flow velocity, arterial pulsatility index (PI), and breath-holding index (BHI) in MCAs.

RESULT:
490 participants underwent MoCA and TCCS, of which with poor temporal acoustic windows over left MCA in 136 (29.25%) and right MCA in 137 (29.46%) were excluded. A total of 369 subjects (50.77±6.31 years; 48.8% men) were included. Multivariate linear analyses adjusting for age, sex, education years and vascular risk factors were used to evaluate the association between intracranial hemodynamics and cognitive functions. BHI over the left MCA positively correlated with MoCA score was observed, which was more significant in the elder subgroup (age 56-60, n=111).

DISCUSSION:
Cerebral arterial vasoreactivity over the left side contributed to cognitive function in the elder middle aged (age 56-60) healthy adults, but the association was not significant in the younger (age 33-55) subgroup.


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