title: Cardiovascular risk in cognitively preserved elderlies is associated with glucose hypometabolism in the posterior cingulate cortex and precuneus regardless of brain atrophy and apolipoprotein gene variations.
abstract: Cardiovascular risk factors (CVRF) possibly contribute to the emergence of Alzheimer's disease (AD). Fluorodeoxyglucose-positron emission tomography (FDG-PET) has been widely used to demonstrate specific patterns of reduced cerebral metabolic rates of glucose (CMRgl) in subjects with AD and in non-demented carriers of the apolipoprotein ε4 (APOE ε4) allele, the major genetic risk factor for AD. However, functional neuroimaging studies investigating the impact of CVRF on cerebral metabolism have been scarce to date. The present FDG-PET study investigated 59 cognitively preserved elderlies divided into three groups according to their cardiovascular risk based on the Framingham 10-year risk Coronary Heart Disease Risk Profile (low-, medium-, and high-risk) to examine whether different levels of CVRF would be associated with reduced CMRgl, involving the same brain regions affected in early stages of AD. Functional imaging data were corrected for partial volume effects to avoid confounding effects due to regional brain atrophy, and all analyses included the presence of the APOE ε4 allele as a confounding covariate. Significant cerebral metabolism reductions were detected in the high-risk group when compared to the low-risk group in the left precuneus and posterior cingulate gyrus. This suggests that findings of brain hypometabolism similar to those seen in subjects with AD can be detected in association with the severity of cardiovascular risk in cognitively preserved individuals. Thus, a greater knowledge about how such factors influence brain functioning in healthy subjects over time may provide important insigths for the future development of strategies aimed at delaying or preventing the vascular-related triggering of pathologic brain changes in the AD.
authors.affiliation: Laboratory of Neuroimaging in Psychiatry (LIM-21), Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. jhatsu@gmail.com
authors.forename: Jaqueline Hatsuko
authors.initials: JH
authors.lastname: Tamashiro-Duran
authors.forename: Paula
authors.initials: P
authors.lastname: Squarzoni
authors.forename: Fábio Luís
authors.initials: FL
authors.lastname: de Souza Duran
authors.forename: Pedro Kallas
authors.initials: PK
authors.lastname: Curiati
authors.forename: Homero Pinto
authors.initials: HP
authors.lastname: Vallada
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Buchpiguel
authors.forename: Paulo Andrade
authors.initials: PA
authors.lastname: Lotufo
authors.forename: Mauricio
authors.initials: M
authors.lastname: Wajngarten
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
authors.forename: Márcia
authors.initials: M
authors.lastname: Scazufca
authors.forename: Tânia Corrêa
authors.initials: TC
authors.lastname: de Toledo Ferraz Alves
authors.forename: Geraldo Filho
authors.initials: GF
authors.lastname: Busatto
mesh_terms: D000368:Aged; D000483:Alleles; D053327:Apolipoprotein E4 / Q000235:genetics* / Q000378:metabolism; D001053:Apolipoproteins / Q000235:genetics / Q000378:metabolism; D001284:Atrophy / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000235:genetics* / Q000503:physiopathology; D003071:Cognition; D004247:DNA / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000235:genetics / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography; D012307:Risk Factors
chemical_list: D053327:Apolipoprotein E4; D001053:Apolipoproteins; D004247:DNA; D005947:Glucose