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Study protocol: the Heart and Brain study

Abstract:

Background: It is well-established that what’s good for the heart is good for the brain; vascular factors such as hypertension, diabetes, and high cholesterol, and genetic factors such as the apolipoprotein E4 allele increase the risk of developing both cardiovascular disease and dementia. However, the mechanisms underlying the heart-brain association remain unclear. Recent evidence suggests that impairments in vascular phenotypes and cerebrovascular reactivity (CVR) may play an important role in cognitive decline. The Heart and Brain Study combines state-of-the-art vascular ultrasound, cerebrovascular magnetic resonance imaging (MRI) and cognitive testing in participants of the long-running Whitehall II Imaging cohort to examine these physiological processes together. This paper describes the study protocol, data pre-processing and overarching objectives.

Methods and Design: The 775 participants of the Whitehall II Imaging cohort, aged 65 years or older in 2019, have received cardiovascular and clinical assessments at 5-year-intervals since 1985, as well as a 3T brain MRI scan and neuropsychological tests between 2012-2016 (Whitehall II Wave MRI-1). Approximately 20% of this cohort are selected for the Heart and Brain Study, which involves a single testing session at the University of Oxford (Wave MRI-2). Between 2019-2023, participants will undergo ultrasound scans of the ascending aorta and common carotid arteries, measures of central and peripheral blood pressure, and 3T MRI scans to measure CVR in response to 5% carbon dioxide in air, vessel-selective cerebral blood flow, and cerebrovascular lesions. The structural and diffusion MRI scans and neuropsychological battery conducted at Wave MRI-1 will also be repeated. Using this extensive life-course data, the Heart and Brain Study will examine how 30-year trajectories of vascular risk throughout midlife (40-70 years) affect vascular phenotypes, cerebrovascular health, longitudinal brain atrophy and cognitive decline at older ages.

Discussion: The study will generate one of the most comprehensive datasets to examine the longitudinal determinants of the heart-brain association. We will evaluate novel physiological processes in order to describe the optimal window for managing vascular risk in order to delay cognitive decline. Ultimately, the Heart and Brain Study will inform strategies to identify at-risk individuals for targeted interventions to prevent or delay dementia.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3389/fphys.2021.643725

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MPLS
Department:
Engineering Science
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Sub department:
Psychiatry
Role:
Author
ORCID:
0000-0002-5190-7038
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Clinical Neurosciences
Role:
Author


Publisher:
Frontiers Media
Journal:
Frontiers in Physiology More from this journal
Volume:
12
Issue:
2021
Article number:
643725
Publication date:
2021-03-31
Acceptance date:
2021-03-03
DOI:
EISSN:
1664-042X


Language:
English
Keywords:
Pubs id:
1165821
Local pid:
pubs:1165821
Deposit date:
2021-03-03

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