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Imaging technique identifies early brain damage in adults with hypertension

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Diffusion tensor imaging identified damage to brain fibers of adults with high BP that may affect certain cognitive skills, decision-making and the ability to control emotions, according to study data presented at the American Heart Association’s Council on Hypertension Scientific Sessions.

“We wanted to find a way to assess brain damage that could predict the development of dementia associated with vascular diseases,” Daniela Carnevale, PhD, assistant professor, Neuromed Institute, Sapienza University of Rome, said in a press release. 

Daniela Carnevale

Carnevale and colleagues used diffusion tensor imaging and cognitive assessment to evaluate and compare the structural and functional properties of the main connections between different brain regions. The researchers examined specific cognitive functions and cognitive assessments in 30 participants aged 35 to 70 years who underwent diffusion tensor imaging: 15 were receiving medication for moderate to severe high BP and 15 had normal BP.

Although none of the participants showed abnormalities on standard MRI, diffusion tensor imaging showed that participants with high BP vs. those with normal BP had elevated systolic BP (138 ± 4 mm Hg vs. 118 ± 3 mm Hg) and diastolic BP (87 ± 2 mm Hg vs. 75 ± 2 mm Hg; P < .001); elevated left ventricular hypertrophic remodeling (LV mass/body square area, 112 ± 5 g/m² vs. 83 ± 3 g/m² for normotensive; P < .0001); and a moderate increase in albuminuria (15.7 ± 2.6 mg/24 hours vs. 8.8 ± 1.6 mg/24 hours; P < .03).

Participants with high BP also performed worse on function and memory cognitive assessments. In particular, participants with high BP had lower factional anisotropy in projection fibers related to impairment for nonverbal functions (anterior thalamic radiation, 0.358 ± 0.012 vs. 0.33 ± 0.006; P < .05); association fibers involved in executive functioning and emotional regulation (superior longitudinal fasciculus, 0.388 ± 0.013 vs. 0.356 ± 0.007; P < .05); and limbic system fibers involved in attention tasks (cingulate gyrus, 0.364 ± 0.009 vs. 0.328 ± 0.01; P < .01). Additionally, there was evidence of damage to the heart and kidneys from high BP.

Based on these findings, “we suggest to clinicians to start considering the potential brain damage in the clinical approach to hypertensive patients. It could be important to have early [access to results] of brain imaging and cognitive assessment in order to monitor the eventual development of dementia,” Carnevale told Cardiology Today. – by Trish Shea, MA

Reference:

Carnevale D, et al. Abstract P157. Presented at: American Heart Association’s Council on Hypertension Scientific Sessions; Sept. 16-19, 2015; Washington, D.C.

Disclosure: The study was supported by Italian Ministry of Health funding to the Neuromed Institute. Carnevale reports no relevant financial disclosures.