Microvascular Dysfunction and Whole‐Brain White Matter Connectivity: The Maastricht Study

Author:

Beran Magdalena123ORCID,van Gennip April C.E.12ORCID,Stehouwer Coen D.A.12ORCID,Jansen Jacobus F.A.456ORCID,Gupta Monideepa D.12,Houben Alfons J.H.M.12ORCID,Berendschot Tos T.J.M.47ORCID,Webers Carroll A.B.47ORCID,Wesselius Anke8ORCID,Schalkwijk Casper G.12ORCID,Backes Walter H.124ORCID,de Jong Joost J.A.45ORCID,van der Kallen Carla J.H.12ORCID,van Greevenbroek Marleen M.J.12ORCID,Köhler Sebastian4910ORCID,Vonk Jet M.J.311ORCID,Geerlings Mirjam I.3121314ORCID,Schram Miranda T.12415ORCID,van Sloten Thomas T.1216ORCID

Affiliation:

1. Department of Internal Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands

2. School for Cardiovascular Diseases CARIM Maastricht University Maastricht The Netherlands

3. Department of Epidemiology and Global Health, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands

4. School for Mental Health and Neuroscience (MHeNS) Maastricht University Maastricht The Netherlands

5. Department of Radiology and Nuclear Medicine Maastricht University Medical Centre+ (MUMC+) Maastricht The Netherlands

6. Department of Electrical Engineering Eindhoven University of Technology Eindhoven The Netherlands

7. Department of Ophthalmology Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands

8. Department of Epidemiology Maastricht University Maastricht The Netherlands

9. Alzheimer Centrum Limburg Maastricht University Medical Center+ (MUMC+) Maastricht The Netherlands

10. Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine & Life Sciences Maastricht University Maastricht The Netherlands

11. Memory and Aging Center, Department of Neurology University of California San Francisco San Francisco CA USA

12. Department of General Practice Amsterdam UMC, University of Amsterdam Amsterdam The Netherlands

13. Amsterdam Public Health, Aging & Later Life, and Personalized Medicine Amsterdam The Netherlands

14. Amsterdam Neuroscience, Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep Amsterdam The Netherlands

15. Heart and Vascular Centre, Maastricht University Medical Centre Maastricht The Netherlands

16. Department of Vascular Medicine University Medical Center Utrecht Utrecht The Netherlands

Abstract

Background Microvascular dysfunction is involved in the development of various cerebral disorders. It may contribute to these disorders by disrupting white matter tracts and altering brain connectivity, but evidence is scarce. We investigated the association between multiple biomarkers of microvascular function and whole‐brain white matter connectivity. Methods and Results Cross‐sectional data from The Maastricht Study, a Dutch population‐based cohort (n=4326; age, 59.4±8.6 years; 49.7% women). Measures of microvascular function included urinary albumin excretion, central retinal arteriolar and venular calibers, composite scores of flicker light–induced retinal arteriolar and venular dilation, and plasma biomarkers of endothelial dysfunction (intercellular adhesion molecule‐1, vascular cell adhesion molecule‐1, E‐selectin, and von Willebrand factor). White matter connectivity was calculated from 3T diffusion magnetic resonance imaging to quantify the number (average node degree) and organization (characteristic path length, global efficiency, clustering coefficient, and local efficiency) of white matter connections. A higher plasma biomarkers of endothelial dysfunction composite score was associated with a longer characteristic path length (β per SD, 0.066 [95% CI, 0.017–0.114]) after adjustment for sociodemographic, lifestyle, and cardiovascular factors but not with any of the other white matter connectivity measures. After multiple comparison correction, this association was nonsignificant. None of the other microvascular function measures were associated with any of the connectivity measures. Conclusions These findings suggest that microvascular dysfunction as measured by indirect markers is not associated with whole‐brain white matter connectivity.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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