Blood vessel dysfunction in temporal lobes linked to mild cognitive impairment

Researchers suggest adding blood vessel health to dementia diagnostics.

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Cerebrovascular reactivity (CVR) is how well blood vessels in the brain adjust blood flow when needed and is connected to brain function in conditions like stroke and Alzheimer’s. However, few studies have looked at CVR in the medial temporal lobe, a brain area that’s affected early in Alzheimer’s and is important for memory.

A new study by the University of Southern California examined whether medial temporal CVR is associated with memory function in older adults with and without mild cognitive impairment (MCI).

The study suggests that mild cognitive impairment is linked to blood vessel dysfunction in the brain’s temporal lobes. The study found that issues with tiny blood vessels in the brain could be an early sign of dementia and a possible target for treatment. This was observed in people regardless of amyloid buildup in their brains.

Senior author Daniel Nation, a professor of gerontology and medicine at the USC Leonard Davis School of Gerontology, said, “We’re studying the ability of these very small vessels to respond to stimuli and to dilate, and they’re showing dysfunction in people who have memory problems.”

“It could implicate blood vessel dysfunction in a very early stage of memory loss. It happened whether or not people had Alzheimer ‘s-related brain changes. They still had this blood vessel problem if they had memory issues.”

Researchers studied 144 older adults living alone. These volunteers took a mental assessment, gave blood samples, and had a brain MRI.

During the MRI, they held their breath for 15 seconds to widen brain blood vessels, a process called “cerebrovascular reactivity,” which helps regulate brain oxygen levels.

Researchers focused on blood vessels in the temporal lobes (near the ears). Those whose blood vessels didn’t widen properly showed signs of cognitive problems.

Nation said, “With this approach, we can pinpoint the problem to the blood vessels and their ability to dilate. That’s not how people usually think about memory impairment in older adults. There’s an increasing realization that the main cause of dementia is not Alzheimer’s disease; it’s mixed pathology. If you focus on amyloid, you’re certainly not going to get the full picture. Maybe this technique should be incorporated into our diagnostic approaches.”

First author Arunima Kapoor, a graduate student at the University of California, Irvine, said, “Our findings underscore the need to focus on vascular health as a critical factor in memory decline.”

Nation said that some blood pressure drugs may protect vascular function in a way that preserves memory, but more research is needed.

Journal Reference:

  1. Arunima Kapoor, Shubir Dutt et al. Association of Medial Temporal Lobe Cerebrovascular Reactivity and Memory Function in Older Adults With and Without Cognitive Impairment. Neurology. DOI: 10.1212/WNL.0000000000210210
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