Abstract Body: Immunity and inflammation play a pivotal role in hypertension onset and cardiovascular organ damage. This role has been thoroughly characterized for classical hypertension targets as the kidneys, the heart and the vasculature. Many studies have characterized this in the experimental context, however immunoinflammatory challenges links with brain injury in the clinical context of hypertension are still lacking. In this study we will characterize how immunoinflammatory mediators can be predictors of cerebral injury characterized by advanced neuroimaging in hypertensive patients.
Hypertensive patients underwent cerebral MRI and by advanced neuroimaging we characterized the microstructural injury by DTI fiber tracking. We administered the Montreal Cognitive Assessment to evaluate cognitive function, measured circulating C-reactive protein (hs-CRP) and counted circulating white blood cells (WBC).
We found a large cluster of white matter tracts whose integrity parameters were associated with immunoinflammatory biomarkers (Figure A). In particular, a cluster of tracts of the limbic system and encompassing the corpus callosum show a correlation between their loss of integrity and hs-CRP levels. Another cluster of associative tracts spanning the temporal lobe show association between their loss of integrity and the WBC. Finally, the Frontal Aslant and the Uncinate Fasciculus show association with both immunoinflammatory markers (Figure B).
In this study we performed advanced neuroimaging analyses to characterize the interplay between immunoinflammatory risk and cerebral alterations in hypertensives. Furthermore, our previous work identified that white matter damage in the Forceps Minor and Superior Longitudinal Fasciculus was a typical trait of hypertensive patients and associated to loss of cognitive functions. Our data further show the inflammatory risk association with worse cognitive functions, suggesting a clinical relevance in terms of damage evidenced by advanced MRI in hypertensive patients.