Table_1_Exploration of cerebral hemodynamic pathways through which large artery function affects neurovascular coupling in young women.DOCX

BackgroundThe interactions between large artery function and neurovascular coupling (NVC) are emerging as important contributors to cognitive health. Women are disproportionally affected by Alzheimer's disease and related dementia later in life. Understanding large artery correlates of NVC in young women may help with preservation of cognitive health with advancing age.
PurposeTo explore the association between large artery function, NVC and cognitive performance in young women.
MethodsVascular measurements were made in 61 women (21 ± 4 yrs) at rest and during a cognitive challenge (Stroop task). Transcranial Doppler was used to measure left middle cerebral artery (MCA) maximum velocity (Vmax), mean velocity (Vmean), and pulsatility index (PI). NVC was determined as MCA blood velocity reactivity to the Stroop task. Large artery function was determined using carotid-femoral pulse wave velocity (cfPWV) as a proxy measure of aortic stiffness and carotid ultrasound-derived measures of compliance and reactivity (diameter change to the Stroop task). Cognitive function was assessed separately using a computerized neurocognitive battery that included appraisal of response speed, executive function, information processing efficiency, memory, attention/concentration, and impulsivity.
ResultsMCA Vmax reactivity was positively associated with executive function (β = 0.26, 95% CI 0.01–0.10); MCA Vmean reactivity was negatively associated with response speed (β = −0.33, 95% CI −0.19 to −0.02) and positively with memory score (β = 0.28, 95% CI 0.01–0.19). MCA PI reactivity was negatively associated with attention performance (β = −0.29, 95% CI −14.9 to −1.0). Path analyses identified significant paths (p < 0.05) between carotid compliance and carotid diameter reactivity to select domains of cognitive function through MCA reactivity.
ConclusionsNVC was associated with cognitive function in young women. Carotid artery function assessed as carotid compliance and carotid reactivity may contribute to optimal NVC in young women through increased blood flow delivery and reduced blood flow pulsatility.

研究背景：大动脉功能与神经血管耦合（Neurovascular Coupling, NVC）之间的相互作用，正逐渐成为影响认知健康的关键因素。女性在晚年罹患阿尔茨海默病及相关痴呆的比例显著偏高。阐明青年女性群体中神经血管耦合与大动脉功能的关联，或有助于延缓衰老进程中的认知健康衰退。
研究目的：探讨青年女性的大动脉功能、神经血管耦合与认知表现三者间的关联。
研究方法：本研究纳入61名年龄为21±4岁的女性受试者，分别在静息状态及认知任务（斯特鲁普任务，Stroop task）执行过程中采集血管相关数据。采用经颅多普勒超声（Transcranial Doppler）检测受试者左侧大脑中动脉（Middle Cerebral Artery, MCA）的最大流速（Maximum Velocity, Vmax）、平均流速（Mean Velocity, Vmean）及搏动指数（Pulsatility Index, PI），以大脑中动脉血流流速对斯特鲁普任务的反应性作为神经血管耦合的评估指标。大动脉功能通过颈股脉搏波速度（carotid-femoral pulse wave velocity, cfPWV）评估主动脉僵硬度，并结合颈动脉超声测得的血管顺应性及对斯特鲁普任务的直径反应性进行综合判定。认知功能评估采用计算机化神经认知成套测验，涵盖反应速度、执行功能、信息处理效率、记忆、注意力/专注力以及冲动性等多个维度。
研究结果：大脑中动脉最大流速反应性与执行功能呈正相关（β=0.26，95%置信区间[CI]：0.01~0.10）；大脑中动脉平均流速反应性与反应速度呈负相关（β=-0.33，95%CI：-0.19~-0.02），而与记忆得分呈正相关（β=0.28，95%CI：0.01~0.19）；大脑中动脉搏动指数反应性与注意力表现呈负相关（β=-0.29，95%CI：-14.9~-1.0）。路径分析结果显示，颈动脉顺应性、颈动脉直径反应性可通过大脑中动脉反应性，对特定认知功能领域产生显著影响（p<0.05）。
研究结论：青年女性的神经血管耦合与认知功能存在关联。以颈动脉顺应性及颈动脉反应性评估的颈动脉功能，或可通过提升血流灌注量、降低血流搏动性，助力青年女性维持最优的神经血管耦合状态。