ArticleStroke and vascular neurology2023
Blood pressure-related white matter microstructural disintegrity and associated cognitive function impairment in asymptomatic adults.
Article in Stroke and vascular neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Association of Weight-Adjusted-Waist Index With Brain Health: A 16-Year Population-Based Longitudinal Cohort Study.CNS neuroscience & therapeutics · 2026Article
- Tissue-specific diffusion abnormalities and localized free-water reductions in hypertension despite no detectable group difference in the DTI-ALPS index.Frontiers in medicine · 2026Article
- Polygenic risk for schizophrenia is associated with white matter microstructure, cognitive and mental health.Schizophrenia (Heidelberg, Germany) · 2025Article
- Progression of cognitive and functional decline before and after stroke: evidence from four prospective cohort studies across 23 countries.Journal of neurology · 2025Article
- Does Ideal Blood Pressure Vary by Cognitive Domain? A UK Biobank Study.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Blood pressure and the brain: the conundrum of hypertension and dementia.Cardiovascular research · 2025Review
- Effects of Aging, Estimated Fitness, and Cerebrovascular Status on White Matter Microstructural Health.Human brain mapping · 2025Article
- Blood Pressure and Cognitive Function in Older Adults.Clinics in geriatric medicine · 2024Review
- Association of Blood Pressure With Brain White Matter Microstructural Integrity Assessed With MRI Diffusion Tensor Imaging in Healthy Young Adults.Hypertension (Dallas, Tex. : 1979) · 2024Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivesWe aimed to investigate the white matter (WM) microstructural/cytostructural disintegrity patterns related to higher systolic blood pressure (SBP), and whether they mediate SBP effects on cognitive performance in middle-aged adults.
methodsUsing the UK Biobank study of community-dwelling volunteers aged 40-69 years, we included participants without a history of stroke, dementia, demyelinating disease or traumatic brain injury. We investigated the association of SBP with MRI diffusion metrics: fractional anisotropy (FA), mean diffusivity (MD), intracellular volume fraction (a measure of neurite density), isotropic (free) water volume fraction (ISOVF) and orientation dispersion across WM tracts. Then, we determined whether WM diffusion metrics mediated the effects of SBP on cognitive function.
resultsWe analysed 31 363 participants-mean age of 63.8 years (SD: 7.7), and 16 523 (53%) females. Higher SBP was associated with lower FA and neurite density, but higher MD and ISOVF. Among different WM tracts, diffusion metrics of the internal capsule anterior limb, external capsule, superior and posterior corona radiata were most affected by higher SBP. Among seven cognitive metrics, SBP levels were only associated with 'fluid intelligence' (adjusted p<0.001). In mediation analysis, the averaged FA of external capsule, internal capsule anterior limb and superior cerebellar peduncle mediated 13%, 9% and 13% of SBP effects on fluid intelligence, while the averaged MD of external capsule, internal capsule anterior and posterior limbs, and superior corona radiata mediated 5%, 7%, 7% and 6% of SBP effects on fluid intelligence, respectively. DISCUSSION: Among asymptomatic adults, higher SBP is associated with pervasive WM microstructure disintegrity, partially due to reduced neuronal count, which appears to mediate SBP adverse effects on fluid intelligence. Diffusion metrics of select WM tracts, which are most reflective of SBP-related parenchymal damage and cognitive impairment, may serve as imaging biomarkers to assess treatment response in antihypertensive trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.