Association between cerebral microstructure and cognitive decline in patients with hypertension

Hypertension (HTN) represents an escalating global public health concern and is recognized as a major contributor to cognitive impairment. It has been identified as a significant risk factor for cognitive decline, mild cognitive impairment (MCI), and dementia. Nevertheless, previous research has yielded inconsistent findings, and the specific relationships among various cognitive domains and alterations in gray matter volume remain insufficiently understood.

The present study employs brain magnetic resonance imaging (MRI) to investigate structural brain changes associated with the relationship between hypertension and cognitive impairment. A total of fifty-eight participants were recruited and categorized into two groups: patients with hypertension and a normotensive control (NC) group. All participants were subject to a brain MRI and cognitive questionnaires; CVVLT, DSS, TMT-A, TMT-B, CGUOFT, MMSE and MoCA were used to measure the cognitive state.

Voxel-based morphometry and vertex-wise shape analyses were used to determine differences in the volume and shape of the brain for the HTN group and the NC group. Multiple regression was used to determine the association between gray matter volume and the results of the cognitive assessments, in terms of memory, executive function, and global cognitive function. The HTN group has a larger gray matter volume in the middle frontal gyrus, the precentral gyrus, the insula, the amygdala and the cingulate gyrus and the HTN group has a smaller gray matter volume in the fusiform gyrus.

In terms of memory function, there is a positive correlation with the hippocampus, the parahippocampal gyrus, the inferior parietal lobule, the brainstem and the anterior cingulate. In terms of executive function, there is a positive correlation with the middle frontal gyrus, the inferior frontal gyrus and the insula and a negative correlation with the medial frontal gyrus, the cingulate gyrus and the hippocampus. In terms of global cognitive function, there is a positive correlation with the thalamus, the caudate, the lentiform nucleus, the precuneus, the insula and the superior frontal gyrus.

These findings contribute to our understanding of the structural and cognitive alterations associated with hypertension and may inform future studies of cognitive interventions in patients with hypertension. A Research grants NSTC115-2221-E-182-013-MY3 and NSTC112-2221-E-182-013-MY3 from the National Science and Technology Council, Taipei, Taiwan, supported this study. This study was also supported by grants NMRPD1R0511~3 from Chang Gung University, Taoyuan, Taiwan, and CMRPG6K0191 from Chang Gung Memorial Hospital, Chiayi, Taiwan.

The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Tai-Hsin Hung and Vincent Chin-Hung Chen contributed equally to this work. School of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan Department of Psychiatry, Tai-An Hospital, Taichung, Taiwan Department of Medical Imaging and Radiological Sciences, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist, 33302, Taoyuan, Taiwan Department of Psychology, National Chung Cheng University, Chiayi, Taiwan Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan Department of Counseling and Clinical Psychology, Columbia University, New York, NY, USA Clinical Metabolomics Core Lab, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan The authors declare no competing interests.