title: Disrupted Frontoparietal Network Mediates White Matter Structure Dysfunction Associated with Cognitive Decline in Hypertension Patients.
abstract: Some previous reports have suggested that hypertension is a risk factor for dementia and cognitive impairments. Using behavioral data from 1007 elderly human subjects (405 hypertensive patients) of Han ethnicity from Beijing, China, the present study aimed to assess the effects of hypertension on cognitive performance and explore related neuronal changes via advanced resting-state functional magnetic resonance imaging and diffusion tensor imaging data from 84 of these subjects (44 hypertensive patients). Cognitively, we found that patients with hypertension showed decreased executive functions and attention compared with those with normotension in the large sample. In magnetic resonance imaging scan sample, using independent component analysis to examine the functional connectivity difference between the two groups, we found that the frontoparietal networks in the hypertensive group exhibited altered patterns compared with the control group, mainly in the inferior parietal lobe, left inferior frontal lobe, and precuneus. Using tract-based spatial statistics to investigate the between-group structural difference, we found that the hypertensive group showed significantly reduced integrity of white matter in the bilateral superior longitudinal fasciculus. Importantly, using the mediation analysis, we found that the functional connectivity of the frontoparietal networks mediates the impact of white matter on executive function in the hypertensive group. The results demonstrate that hypertension targets a specific pattern of cognitive decline, possibly due to deficits in the white matter and functional connectivity in frontal and parietal lobes. Our findings highlight the importance of brain protection in hypertension.
  
  
  CONCLUSIONS
  Hypertension is a risk factor for cognitive decline and dementia. However, the neural mechanism underlying cognitive decline in hypertension is largely unknown. We studied the relationship among cognitive decline, brain functional, and structural changes in hypertensive patients via advanced resting-state functional magnetic resonance imaging and diffusion tensor imaging data in a Chinese cohort. Hypertensive patients showed executive dysfunction, along with disrupted functional connectivity in frontoparietal (FP) networks and reduced integrity of white matter in the bilateral superior longitudinal fasciculus. Importantly, the functional connectivity changes mediate the impact of white matter alterations on cognitive decline in the hypertensive group. Our findings provide a better understanding of the mechanism of cognitive decline in hypertension and highlight the importance of brain protection in hypertension.
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liang
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
authors.forename: Yaojing
authors.initials: Y
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
authors.forename: Junying
authors.initials: J
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China, Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing 100700, China, and.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Wei
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Banner Alzheimer's Institute, Phoenix, Arizona 85006.
authors.forename: Kewei
authors.initials: K
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
authors.forename: Ni
authors.initials: N
authors.lastname: Shu
authors.affiliation: Banner Alzheimer's Institute, Phoenix, Arizona 85006.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Reiman
authors.affiliation: State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China, Institute of Basic Research in Clinical Medicine, China Academy of Traditional Chinese Medicine, Beijing 100700, China, and zhang_rzs@bnu.edu.cn.
authors.forename: Zhanjun
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001931:Brain Mapping; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology* / Q000534:rehabilitation; D056324:Diffusion Tensor Imaging; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000473:pathology*; D025341:Principal Component Analysis; D012146:Rest; D013223:Statistics as Topic; D066127:White Matter / Q000473:pathology*
keywords: frontoparietal networks; functional connectivity; hypertension; superior longitudinal fasciculus