Association Between Central Elastic Artery Stiffness and Cerebral Perfusion in Deep Subcortical Gray and White Matter

BACKGROUND: Central elastic artery stiffness can increase vascular resistance and induce hypertrophic remodeling of cerebral arterioles and, in turn, may increase the risk of cerebral hypoperfusion. In this study, we examined whether central artery stiffness was directly associated with cerebral perfusion. METHODS: Thirty-five adults (15 men and 20 women; 49 ± 7 years) were studied. Central artery stiffness was determined by carotid-femoral pulse wave velocity (cfPWV). Regional cerebral perfusion in deep subcortical white and gray matter was measured using arterial spin labeling (ASL). RESULTS: Participants were divided into two groups created by a median split of pooled subjects (median cfPWV = 1,090 cm/s). The group with high cfPWV showed significantly lower cerebral perfusion in frontal (29.9 ± 3.6 vs. 50.7 ± 3.7 ml/100 g/min, P = 0.001) and parietal (33.4 ± 6.0 vs. 57.5 ± 5.7 ml/100 g/min, P < 0.01) white matter and hippocampus (44.4 ± 4.4 vs. 60.1 ± 6.1 ml/100 g/min, P = 0.04) than the low cfPWV group. Simple correlation analysis revealed that cfPWV is significantly associated with cerebral perfusion in frontal (r = -0.64, P < 0.001) and parietal (r = -0.36, P = 0.03) white matter. Multiple linear regression analysis further indicated that 11% of the variability in frontal white matter perfusion (ΔR(2) = 0.11, P = 0.03) is explained by cfPWV (β = -0.54, P = 0.03), independent of age, sex, race, heart rate, blood pressure, and cardiovascular medication. CONCLUSIONS: Central elastic artery stiffness is inversely and significantly associated with cerebral perfusion in deep subcortical frontal white matter, independent of potential confounding factors.