Resting State Network

Background: Intravenous Tissue Plasminogen Activator (TPA) is the only FDA approved medical therapy for acute ischemic stroke (AIS). Prior study suggests that early recanalization is associated with better stroke outcome. Our aim was to correlate task-negative and task-positive (TN/TP) resting state network activity with tissue perfusion and functional outcome, in stroke patients who received TPA. Method: AIS patients were consented and underwent NIH stroke scale (NIHSS) assessment and magnetic resonance imaging (MRI) scans during TPA infusion (baseline) and six hours post stroke. The MRI sequences include contrast-enhanced perfusion weighted image (PWI) and resting state Blood Oxygen Level-Dependent or BOLD (RSB) images acquired using a Siemens Treo 3T MRI scanner. Additionally, the RSB scan and the NIHSS were obtained at a 30-day follow up visit. Results: Fourteen patients (mean age ± SD=63 ±14, 50% male, 50% white, 43% black and 7% others) who qualified for TPA completed the study at baseline and 6 hours post stroke. Of these, 6 patients had valid follow up data at 30 days. Three patients without cerebral ischemia were excluded. A paired samples t-test comparing baseline and 6h post stroke showed a significantly improved TP network t(10)= -4.24 p< 0.05. The resting network connectivity improved from 6 hours post stroke to 30-days follow up, t(5)= -5.35 p< 0.01. Similarly, NIHSS, at 6h post stroke t(10)= 3.62 p< 0.01 and at 30-days follow up t(5)= -3.4 p< 0.01 were significantly better than the NIHSS at baseline. The 6-hours post-stroke perfusion correlated with the resting network connectivity in both the damaged (r=-0.56 p= 0.07) and intact hemispheres (r= -0.57 p= 0.06). Differences in functional connectivity and NIHSS scores from baseline to 6 h were positively correlated (r= 0.56 p=0.07). Conclusion: In this pilot study we found that TPA led to changes in MRI based resting state networks and associated functional outcome. Correlations were found between perfusion, functional connectivity and NIHSS. This suggests that the improvement of resting state network means improved efficiency of brain activity indicated by functional outcome and may be a potential predictive MRI biomarker for TPA response. A larger study is needed to verify this finding.

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RESTING STATE NETWORK AND MINDFULNESS IN MOTION PLUS DASH DIET IN AFRICAN AMERICANS WITH MILD COGNITIVE IMPAIRMENT

Innovation in Aging ◽

10.1093/geroni/igz038.417 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S112-S113

Author(s):

Kathy D Wright ◽

Klatt Maryanna ◽

Ingrid Adams ◽

Cady Block ◽

Todd Monroe ◽

...

Keyword(s):

Blood Pressure ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Pilot Study ◽

African Americans ◽

Resting State ◽

Mindfulness Practice ◽

Control Group ◽

Breathing Exercises ◽

Resting State Network

Abstract The resting state network (RSN) is a target of interest in neurodegenerative research, with evidence linking functional connectivity of its constituent nodes with mild cognitive impairment and dementia. Given the emerging linkage between Alzheimer’s disease and related dementia disorders (ADRD) and hypertension (HTN), non-pharmacological interventions that promote RSN connectivity and blood pressure are needed. The purpose of this pilot study protocol is to deliver a novel intervention, combining mindfulness and the Dietary Approaches to Stop Hypertension (DASH), to improve RSN connectivity and blood pressure in African American (AA) older adults with MCI and HTN. Thirty-six AAs aged 65 and older will be randomized to mindfulness plus DASH, attention control (non-health related education), or a control group. The Mindfulness in Motion (MIM) plus DASH intervention is delivered in 8-weekly group sessions of 6-10 participants. MIM includes mindful movements from chair/standing, breathing exercises and guided meditation. The DASH intervention uses a critical thinking approach that involves problem solving, goal setting, reflection, and developing self-efficacy. Both components are culturally tailored for older African Americans. Cognitive examination, diet and mindfulness practice surveys, blood pressure, and functional magnetic resonance imaging (RSN) data are collected at baseline and 3 months. Forty-eight AAs were screened and 17 were enrolled (women= 13; men= 4) to date. Of the 17 enrolled, 7 were eligible for neuroimaging. Findings from this pilot study may provide the preliminary evidence that MIM plus DASH may improve RSN connectivity and blood pressure in this population at risk for ADRD.

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