Evaluation of the Link Between Carotid Arterial Wall Viscosity and Major Neurocognitive Disorders

Preliminary work in the laboratories has highlighted the role of vaso-relaxing endothelial factors and smooth muscle tone in the regulation of the Arterial Pulse Rate (APR) of the radial artery in the basal and stimulated state and the alteration of this stimulated regulation during Arterial Hypertension (AH). Furthermore, a decrease in relative carotid APR in middle-aged subjects compared to young subjects, and an increase in carotid APR in diabetic patients has been found in unpublished results. The link between aortic arterial stiffness and the existence of vascular dementia but also Alzheimer's is strongly suggested. Indeed, the increase in arterial stiffness could be responsible for an increase in pulsatility transmitted to the brain, participating in the accumulation of beta amyloid proteins. A probable inflammatory and oxidative stress component could also have an added deleterious role through the production of free radicals. Thus, previous studies have shown the existence of a link between arterial stiffness and the presence of leukoaraiosis, lacunae, microbleeds but also with brain volume and the progression of cerebral atrophy. These repercussions on the cerebral parenchyma are visible on MRI. A link has also been suggested between increased arterial stiffness and impaired cognitive function (as demonstrated by neurocognitive tests) or the presence of markers of small vessel damage in neuroimaging (microbleeds, lacunae, leukoaraiosis). One hypothesis to explain this link is that arterial stiffness promotes impaired hippocampal microcirculation. Other studies have shown that carotid-femoral pressure wave velocity (CFV), a marker of large arterial stiffness, was higher in populations with Alzheimer's disease and vascular dementia than in older populations without cognitive impairment or with minor neurocognitive impairment. However, no studies have evaluated the link between baseline VPA and vascular dementia or Alzheimer's disease. Our study suggests that carotid VPA is associated with increased cerebrovascular injury, impaired cognitive testing, and the diagnosis of vascular dementia.