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A new study in Cardiovascular Research indicates that patients with high blood pressure are at a higher risk of developing dementia. This research also shows that an MRI can be used to detect early signatures of neurological damage in people with high blood pressure, before symptoms of dementia.
High blood pressure is a chronic condition that causes progressive organ damage. The clinical approach to treatment of dementia patients usually starts after symptoms are clearly evident. However, it has becoming increasingly clear that when signs of brain damage are manifest, it may be too late to reverse the neurodegenerative process.
Physicians lack procedures for assessing progression markers that could reveal pre-symptomatic alterations and identify patients at risk of developing dementia. Researchers screened subjects admitted at the Regional Excellence Hypertension Center of the Italian Society of Hypertension in the Department of Angiocardioneurology and Translational Medicine of the I.R.C.C.S, Neuromed, in Italy.
Researchers recruited people aged 40 to 65, compliant to give written informed consent and with the possibility to perform a dedicated 3 Tesla MRI scan. This work was conducted on patients with no sign of structural damage and no diagnosis of dementia. All patients underwent clinical examination to determine their hypertensive status and the related target organ damage.
Patients were subjected to an MRI scan to identify microstructural damage.To gain insights in the neurocognitive profile of patients a specific group of tests was administered. As primary outcome of the study the researchers aimed at finding any specific signature of brain changes in white matter microstructure of hypertensive patients, associated with an impairment of the related cognitive functions.
The result indicated that hypertensive patients showed significant alterations in three specific white matter fiber-tracts. Hypertensive patients also scored significantly worse in the cognitive domains ascribable to brain regions connected through those fiber-tracts, showing decreased performances in executive functions, processing speed, memory and related learning tasks.
Overall, white matter fiber-tracking on MRIs showed an early signature of damage in hypertensive patients when otherwise undetectable by conventional neuroimaging. As these changes can be detected before patients show symptoms, these patients could be targeted with medication earlier to prevent further deterioration in brain function.
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