title: Reduced regional brain cortical thickness in patients with heart failure.
abstract: OBJECTIVE
  Autonomic, cognitive, and neuropsychologic deficits appear in heart failure (HF) subjects, and these compromised functions depend on cerebral cortex integrity in addition to that of subcortical and brainstem sites. Impaired autoregulation, low cardiac output, sleep-disordered-breathing, hypertension, and diabetic conditions in HF offer considerable potential to affect cortical areas by loss of neurons and glia, which would be expressed as reduced cortical thicknesses. However, except for gross descriptions of cortical volume loss/injury, regional cortical thickness integrity in HF is unknown. Our goal was to assess regional cortical thicknesses across the brain in HF, compared to control subjects.
  
  
  RESULTS
  We examined localized cortical thicknesses in 35 HF and 61 control subjects with high-resolution T1-weighted images (3.0-Tesla MRI) using FreeSurfer software, and assessed group differences with analysis-of-covariance (covariates; age, gender; p<0.05; FDR). Significantly-reduced cortical thicknesses appeared in HF over controls in multiple areas, including the frontal, parietal, temporal, and occipital lobes, more markedly on the left side, within areas that control autonomic, cognitive, affective, language, and visual functions.
  
  
  CONCLUSIONS
  Heart failure subjects show reduced regional cortical thicknesses in sites that control autonomic, cognitive, affective, language, and visual functions that are deficient in the condition. The findings suggest chronic tissue alterations, with regional changes reflecting loss of neurons and glia, and presumably are related to earlier-described axonal changes. The pathological mechanisms contributing to reduced cortical thicknesses likely include hypoxia/ischemia, accompanying impaired cerebral perfusion from reduced cardiac output and sleep-disordered-breathing and other comorbidities in HF.
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, United States of America; Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States of America; Department of Bioengineering, University of California Los Angeles, Los Angeles, California, United States of America; The Brain Research Institute, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Yadav
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Palomares
authors.affiliation: Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Bumhee
authors.initials: B
authors.lastname: Park
authors.affiliation: Department of Neurology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Shantanu H
authors.initials: SH
authors.lastname: Joshi
authors.affiliation: School of Nursing, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ogren
authors.affiliation: School of Nursing, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Macey
authors.affiliation: Division of Cardiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: The Brain Research Institute, University of California Los Angeles, Los Angeles, California, United States of America; Department of Neurobiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Harper
authors.affiliation: School of Nursing, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Woo
mesh_terms: D015992:Body Mass Index; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology*; D003071:Cognition; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012890:Sleep