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The Hyperintense study: Assessing the effects of induced blood pressure increase and decrease on MRI markers of cerebral small vessel disease: Study rationale and protocol
BACKGROUND: Neuroimaging markers of cerebral small vessel disease (SVD) are common in older individuals, but the pathophysiological mechanisms causing these lesions remain poorly understood. Although hypertension is a major risk factor for SVD, the direct causal effects of increased blood pressure a...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9446329/ https://www.ncbi.nlm.nih.gov/pubmed/36082259 http://dx.doi.org/10.1177/23969873221100331 |
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author | Janssen, Esther ter Telgte, Annemieke Verburgt, Esmée de Jong, Joost JA Marques, José P Kessels, Roy PC Backes, Walter H Maas, Marnix C Meijer, Frederick JA Deinum, Jaap Riksen, Niels P Tuladhar, Anil M de Leeuw, Frank-Erik |
author_facet | Janssen, Esther ter Telgte, Annemieke Verburgt, Esmée de Jong, Joost JA Marques, José P Kessels, Roy PC Backes, Walter H Maas, Marnix C Meijer, Frederick JA Deinum, Jaap Riksen, Niels P Tuladhar, Anil M de Leeuw, Frank-Erik |
author_sort | Janssen, Esther |
collection | PubMed |
description | BACKGROUND: Neuroimaging markers of cerebral small vessel disease (SVD) are common in older individuals, but the pathophysiological mechanisms causing these lesions remain poorly understood. Although hypertension is a major risk factor for SVD, the direct causal effects of increased blood pressure are unknown. The Hyperintense study is designed to examine cerebrovascular and structural abnormalities, possibly preceding SVD, in young adults with hypertension. These patients undergo a diagnostic work-up that requires patients to temporarily discontinue their antihypertensive agents, often leading to an increase in blood pressure followed by a decrease once effective medication is restarted. This allows examination of the effects of blood pressure increase and decrease on the cerebral small vessels. METHODS: Hyperintense is a prospective observational cohort study in 50 hypertensive adults (18–55 years) who will temporarily discontinue antihypertensive medication for diagnostic purposes. MRI and clinical data is collected at four timepoints: before medication withdrawal (baseline), once antihypertensives are largely or completely withdrawn (T = 1), when patients have restarted medication (T = 2) and reached target blood pressure and 1 year later (T = 3). The 3T MRI protocol includes conventional structural sequences and advanced techniques to assess various aspects of microvascular integrity, including blood-brain barrier function using Dynamic Contrast Enhanced MRI, white matter integrity, and microperfusion. Clinical assessments include motor and cognitive examinations and blood sampling. DISCUSSION: The Hyperintense study will improve the understanding of the pathophysiological mechanisms following hypertension that may cause SVD. This knowledge can ultimately help to identify new targets for treatment of SVD, aimed at prevention or limiting disease progression. |
format | Online Article Text |
id | pubmed-9446329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-94463292022-09-07 The Hyperintense study: Assessing the effects of induced blood pressure increase and decrease on MRI markers of cerebral small vessel disease: Study rationale and protocol Janssen, Esther ter Telgte, Annemieke Verburgt, Esmée de Jong, Joost JA Marques, José P Kessels, Roy PC Backes, Walter H Maas, Marnix C Meijer, Frederick JA Deinum, Jaap Riksen, Niels P Tuladhar, Anil M de Leeuw, Frank-Erik Eur Stroke J Study Protocols BACKGROUND: Neuroimaging markers of cerebral small vessel disease (SVD) are common in older individuals, but the pathophysiological mechanisms causing these lesions remain poorly understood. Although hypertension is a major risk factor for SVD, the direct causal effects of increased blood pressure are unknown. The Hyperintense study is designed to examine cerebrovascular and structural abnormalities, possibly preceding SVD, in young adults with hypertension. These patients undergo a diagnostic work-up that requires patients to temporarily discontinue their antihypertensive agents, often leading to an increase in blood pressure followed by a decrease once effective medication is restarted. This allows examination of the effects of blood pressure increase and decrease on the cerebral small vessels. METHODS: Hyperintense is a prospective observational cohort study in 50 hypertensive adults (18–55 years) who will temporarily discontinue antihypertensive medication for diagnostic purposes. MRI and clinical data is collected at four timepoints: before medication withdrawal (baseline), once antihypertensives are largely or completely withdrawn (T = 1), when patients have restarted medication (T = 2) and reached target blood pressure and 1 year later (T = 3). The 3T MRI protocol includes conventional structural sequences and advanced techniques to assess various aspects of microvascular integrity, including blood-brain barrier function using Dynamic Contrast Enhanced MRI, white matter integrity, and microperfusion. Clinical assessments include motor and cognitive examinations and blood sampling. DISCUSSION: The Hyperintense study will improve the understanding of the pathophysiological mechanisms following hypertension that may cause SVD. This knowledge can ultimately help to identify new targets for treatment of SVD, aimed at prevention or limiting disease progression. SAGE Publications 2022-05-12 2022-09 /pmc/articles/PMC9446329/ /pubmed/36082259 http://dx.doi.org/10.1177/23969873221100331 Text en © European Stroke Organisation 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Study Protocols Janssen, Esther ter Telgte, Annemieke Verburgt, Esmée de Jong, Joost JA Marques, José P Kessels, Roy PC Backes, Walter H Maas, Marnix C Meijer, Frederick JA Deinum, Jaap Riksen, Niels P Tuladhar, Anil M de Leeuw, Frank-Erik The Hyperintense study: Assessing the effects of induced blood pressure increase and decrease on MRI markers of cerebral small vessel disease: Study rationale and protocol |
title | The Hyperintense study: Assessing the effects of induced blood
pressure increase and decrease on MRI markers of cerebral small vessel disease:
Study rationale and protocol |
title_full | The Hyperintense study: Assessing the effects of induced blood
pressure increase and decrease on MRI markers of cerebral small vessel disease:
Study rationale and protocol |
title_fullStr | The Hyperintense study: Assessing the effects of induced blood
pressure increase and decrease on MRI markers of cerebral small vessel disease:
Study rationale and protocol |
title_full_unstemmed | The Hyperintense study: Assessing the effects of induced blood
pressure increase and decrease on MRI markers of cerebral small vessel disease:
Study rationale and protocol |
title_short | The Hyperintense study: Assessing the effects of induced blood
pressure increase and decrease on MRI markers of cerebral small vessel disease:
Study rationale and protocol |
title_sort | hyperintense study: assessing the effects of induced blood
pressure increase and decrease on mri markers of cerebral small vessel disease:
study rationale and protocol |
topic | Study Protocols |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9446329/ https://www.ncbi.nlm.nih.gov/pubmed/36082259 http://dx.doi.org/10.1177/23969873221100331 |
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