Cargando…

Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients

BACKGROUND: Significant reduction of dynamic vasomotor reactivity (DVR) was recently reported in patients with amnestic mild cognitive impairment (MCI) relative to age-matched controls. These results were obtained via a novel approach that utilizes data-based predictive dynamic models to quantify DV...

Descripción completa

Detalles Bibliográficos
Autores principales: Marmarelis, Vasilis Z., Shin, Dae C., Zhang, Rong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369119/
https://www.ncbi.nlm.nih.gov/pubmed/32333588
http://dx.doi.org/10.3233/JAD-191238
_version_ 1783560730630422528
author Marmarelis, Vasilis Z.
Shin, Dae C.
Zhang, Rong
author_facet Marmarelis, Vasilis Z.
Shin, Dae C.
Zhang, Rong
author_sort Marmarelis, Vasilis Z.
collection PubMed
description BACKGROUND: Significant reduction of dynamic vasomotor reactivity (DVR) was recently reported in patients with amnestic mild cognitive impairment (MCI) relative to age-matched controls. These results were obtained via a novel approach that utilizes data-based predictive dynamic models to quantify DVR. OBJECTIVE: Using the same methodological approach, we seek to quantify the dynamic effects of the CO2-driven chemoreflex and baroreflex upon heart-rate in order to examine their possible correlation with the observed DVR impairment in each MCI patient. METHODS: The employed approach utilizes time-series data to obtain subject-specific predictive input-output models of the dynamic effects of changes in arterial blood pressure and end-tidal CO2 (putative “inputs”) upon cerebral blood flow velocity in large cerebral arteries, cortical tissue oxygenation, and heart-rate (putative “outputs”). RESULTS: There was significant dysregulation of CO2-driven heart-rate chemoreflex (p = 0.0031), but not of baroreflex (p = 0.5061), in MCI patients relative to age-matched controls. The model-based index of CO2-driven heart-rate chemoreflex gain (CRG) correlated significantly with the DVR index in large cerebral arteries (p = 0.0146), but not with the DVR index in small/micro-cortical vessels (p = 0.1066). This suggests that DVR impairment in small/micro-cortical vessels is not mainly due to CO2-driven heart-rate chemoreflex dysregulation, but to other factors (possibly dysfunction of neurovascular coupling). CONCLUSION: Improved delineation between MCI patients and controls is achieved by combining the DVR index for small/micro-cortical vessels with the CRG index (p = 2×10(–5)). There is significant correlation (p < 0.01) between neuropsychological test scores and model-based DVR indices. Combining neuropsychological scores with DVR indices reduces the composite diagnostic index p-value (p∼10(–10)).
format Online
Article
Text
id pubmed-7369119
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher IOS Press
record_format MEDLINE/PubMed
spelling pubmed-73691192020-07-22 Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients Marmarelis, Vasilis Z. Shin, Dae C. Zhang, Rong J Alzheimers Dis Research Article BACKGROUND: Significant reduction of dynamic vasomotor reactivity (DVR) was recently reported in patients with amnestic mild cognitive impairment (MCI) relative to age-matched controls. These results were obtained via a novel approach that utilizes data-based predictive dynamic models to quantify DVR. OBJECTIVE: Using the same methodological approach, we seek to quantify the dynamic effects of the CO2-driven chemoreflex and baroreflex upon heart-rate in order to examine their possible correlation with the observed DVR impairment in each MCI patient. METHODS: The employed approach utilizes time-series data to obtain subject-specific predictive input-output models of the dynamic effects of changes in arterial blood pressure and end-tidal CO2 (putative “inputs”) upon cerebral blood flow velocity in large cerebral arteries, cortical tissue oxygenation, and heart-rate (putative “outputs”). RESULTS: There was significant dysregulation of CO2-driven heart-rate chemoreflex (p = 0.0031), but not of baroreflex (p = 0.5061), in MCI patients relative to age-matched controls. The model-based index of CO2-driven heart-rate chemoreflex gain (CRG) correlated significantly with the DVR index in large cerebral arteries (p = 0.0146), but not with the DVR index in small/micro-cortical vessels (p = 0.1066). This suggests that DVR impairment in small/micro-cortical vessels is not mainly due to CO2-driven heart-rate chemoreflex dysregulation, but to other factors (possibly dysfunction of neurovascular coupling). CONCLUSION: Improved delineation between MCI patients and controls is achieved by combining the DVR index for small/micro-cortical vessels with the CRG index (p = 2×10(–5)). There is significant correlation (p < 0.01) between neuropsychological test scores and model-based DVR indices. Combining neuropsychological scores with DVR indices reduces the composite diagnostic index p-value (p∼10(–10)). IOS Press 2020-06-02 /pmc/articles/PMC7369119/ /pubmed/32333588 http://dx.doi.org/10.3233/JAD-191238 Text en © 2020 – IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Marmarelis, Vasilis Z.
Shin, Dae C.
Zhang, Rong
Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title_full Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title_fullStr Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title_full_unstemmed Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title_short Dysregulation of CO2-Driven Heart-Rate Chemoreflex Is Related Closely to Impaired CO2 Dynamic Vasomotor Reactivity in Mild Cognitive Impairment Patients
title_sort dysregulation of co2-driven heart-rate chemoreflex is related closely to impaired co2 dynamic vasomotor reactivity in mild cognitive impairment patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369119/
https://www.ncbi.nlm.nih.gov/pubmed/32333588
http://dx.doi.org/10.3233/JAD-191238
work_keys_str_mv AT marmarelisvasilisz dysregulationofco2drivenheartratechemoreflexisrelatedcloselytoimpairedco2dynamicvasomotorreactivityinmildcognitiveimpairmentpatients
AT shindaec dysregulationofco2drivenheartratechemoreflexisrelatedcloselytoimpairedco2dynamicvasomotorreactivityinmildcognitiveimpairmentpatients
AT zhangrong dysregulationofco2drivenheartratechemoreflexisrelatedcloselytoimpairedco2dynamicvasomotorreactivityinmildcognitiveimpairmentpatients