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A fMRI Study of Verbal Working Memory, Cardiac Output, and Ejection Fraction in Elderly Patients with Cardiovascular Disease

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Abstract

Cardiovascular disease (CVD) is associated with cognitive deficits even in the absence of stroke. We examined the relationship between cardiac performance, as measured by cardiac output (CO) and ejection fraction (EF), and brain activity during a verbal working memory (VWM) task in elderly CVD patients who tend to be at increased risk for vascular cognitive impairments. Seventeen patients were recruited from a cohort participating in an ongoing prospective study examining the effects of CVD on cognitive function in the elderly. Participants were diagnosed with CVD (age 68 ± 8) and completed a 2-back VWM task in a 1.5T fMRI paradigm. CO and EF were calculated from echocardiogram measures. Task-related activation was averaged in a priori regions of interest. The relationship between CO, EF, and 2-back-related activity was modeled using partial correlations (two-tailed p < .05) controlling for age and 2-back accuracy. All participants were globally cognitively intact as indicated by Mini-Mental Status Exam and Dementia Rating Scale scores. Mean accuracy on the 2-back was 78 ± 9% while reaction time averaged 1,027 ± 192 ms. Mean CO and EF values showed a large range (CO: 3.55 to 6.31; EF: 0.36 to 0.76) but average values were within the normal range. After controlling for age and 2-back accuracy, lower EF was related to decrease in left insula activity (r = 0.61, p = 0.03). There were trends for EF to be related to accuracy (r = 0.47, p = 0.09) and reaction time (r = −0.48, p = 0.09). CO was also related to insula activity (r = 0.60, p = 0.04) and activity in the supplementary motor area activity (r = 0.66, p = 0.01). Cardiac performance was related to decreased efficiency in task related brain areas and tended to be related to performance on a VWM task in elderly patients with CVD. Results have implications for a line of investigation indicating that cardiac and systemic vascular indices could be used as proxy measures to examine mechanisms of cerebrovascular dysfunction in the elderly.

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Acknowledgments

This work was supported by the following grants F32AG022773 (ALJ), F32HL074568 (JJG), F32NS042404 (LHS), T32AG020498 (BAJ, APH).

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Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA

    Farzin Irani, Lawrence H. Sweet, Beth A. Jerskey, Richard C. Mulligan, Athena Poppas & Ronald A. Cohen

  2. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA

    Farzin Irani

  3. Department of Psychology, University of Texas, Austin, TX, USA

    Andreana P. Haley

  4. Department of Psychology, Kent State University, Kent, OH, USA

    John J. Gunstad

  5. Department of Neurology, Alzheimer’s Disease Center, Boston University School of Medicine, Boston, MA, USA

    Angela L. Jefferson

  6. Butler Hospital TRG, Brown University Medical School, 345 Blackstone Bvld., Providence, RI, 02906, USA

    Lawrence H. Sweet

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  1. Farzin Irani
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Correspondence to Lawrence H. Sweet.

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Funding Source: R01-AG017975 (RAC)

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Irani, F., Sweet, L.H., Haley, A.P. et al. A fMRI Study of Verbal Working Memory, Cardiac Output, and Ejection Fraction in Elderly Patients with Cardiovascular Disease. Brain Imaging and Behavior 3, 350–357 (2009). https://doi.org/10.1007/s11682-009-9077-0

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  • DOI: https://doi.org/10.1007/s11682-009-9077-0

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