Risk factors for cerebrovascular disease, such as hypertension, obesity, and diabetes, rarely occur in isolation. The clustering of three or more vascular risk factors comprises a clinical diagnosis of cardio-metabolic syndrome (CMS). In recent years, the prevalence of CMS has risen dramatically, with recent estimates of nearly 34% of US adults meeting criteria. A diagnosis of CMS in midlife, even prior to the development of clinically significant neurologic symptoms, is associated with a substantially increased risk for vascular-related neurodegenerative conditions, including vascular cognitive impairment, dementia, as well as major neurologic events such as stroke. While there is a great deal of research examining the negative impact of individual factors, such as blood pressure, on brain tissue, there is still little knowledge of the neural mechanisms underlying CMS-related changes to neural health. The current project seeks to better understand how multiple co-occurring risk factors affect vascular and neural integrity, and how cognitive and functional status is subsequently impacted. We will identify noninvasive neuroimaging, cognitive and functional biomarkers of CMS that can be used in detecting who may be at greater risk for cognitive decline and dementia. This will be accomplished with three Aims that include 1) understanding how CMS impacts specific structural and functional brain networks, 2) understanding how an index of vascular integrity, cerebrovascular reserve (CVR), impacts structural and functional brain networks in CMS, and 3) understanding how CVR interacts with structural and functional brain integrity to affect cognitive, psychiatric, and functional status. Ultimately, this project ams to provide important translational data that can be used in clinical settings for the treatment and management of multiple vascular risk factors.

Public Health Relevance

A diagnosis of cardio-metabolic syndrome is a significant risk factor for the development of cerebrovascular disease. Understanding the complex effect that multiple vascular risk factors have on structural and functional brain integrity, and on cognitive and functional status, will provide important information that can be used in targeting medical interventions that may help prevent the development of worsening disease, vascular cognitive impairment, and dementia.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project (R01)
Project #
1R01NS086882-01A1
Application #
8817058
Study Section
Clinical Neuroscience and Neurodegeneration Study Section (CNN)
Program Officer
Corriveau, Roderick A
Project Start
2014-09-30
Project End
2019-06-30
Budget Start
2014-09-30
Budget End
2015-06-30
Support Year
1
Fiscal Year
2014
Total Cost
$395,219
Indirect Cost
$89,785
Name
Harvard Medical School
Department
None
Type
Schools of Medicine
DUNS #
047006379
City
Boston
State
MA
Country
United States
Zip Code
02115