Verbal working memory and atherosclerosis in patients with cardiovascular disease: an fMRI study.
OBJECTIVE
Intimal-medial thickening (IMT) of the carotid wall is an accepted peripheral marker of atherosclerosis. It is associated with increased risk for myocardial infarction and stroke, and lower attention-executive-psychomotor functioning. The purpose of this study was to examine the relationship between IMT and brain activity during a verbal working memory (VWM) task in patients with cardiovascular disease (CVD).


METHODS
Thirteen CVD patients underwent functional magnetic resonance imaging (fMRI) during a 2-Back VWM task, and B-mode ultrasound of the carotid arteries. IMT was calculated using an automated algorithm based on a validated edge-detection technique. The relationship between IMT and 2-Back-related brain activity was modeled using partial correlations controlling for age and small vessel disease as measured by white matter signal hyperintensities on MRI (WMH).


RESULTS
Higher IMT was associated with lower 2-Back-related signal intensity and in the right middle frontal gyrus, independent of age and WMH.


CONCLUSIONS
IMT may be one mechanism contributing to brain dysfunction in CVD. The blood oxygenation level-dependent (BOLD) contrast appears to be highly sensitive to peripheral vascular health as measured by IMT. Future studies should examine the sensitivity and specificity of the BOLD response for predicting cognitive decline in CVD.
Haley
Andreana P
AP
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island, USA. aphaley@brown.edu
Sweet
Lawrence H
LH
Gunstad
John
J
Forman
Daniel E
DE
Poppas
Athena
A
Paul
Robert H
RH
Tate
David F
DF
Cohen
Ronald A
RA
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D050197:Atherosclerosis / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010364:Pattern Recognition, Visual / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology*; D012680:Sensitivity and Specificity; D014706:Verbal Learning / Q000502:physiology*