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Autoregulation of Blood Pressure and Thought: Preliminary Results of an Application of Brain Imaging to Psychosomatic Medicine

From the Departments of Psychiatry and Psychology, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, Pennsylvania

Address reprint requests to: J. Richard Jennings, PhD, E1329 WPIC, 3811 O’Hara St., Pittsburgh, PA 15213. Email: JenningsJR{at}msx.upmc.edu

ABSTRACT

OBJECTIVE: This presentation seeks to demonstrate the use of brain imaging techniques for understanding the interaction between hypertension and psychosocial function.

METHODS: The historical background for the study of brain function among hypertensive patients is reviewed. An initial and a current project examining rCBF with ¹⁵O water radiotracer and PET in unmedicated hypertensives and normotensives are described. The rCBF response is assessed during the performance of spatial and verbal working memory tasks of increasing memory load. The assessment also addresses the influence on rCBF and performance of white matter hyperintensities and the presence of carotid artery thickening.

RESULTS: Initial results suggest that hypertensives relative to normotensives show less CBF and less posterior parietal rCBF in response to increases in memory load. Hypertensives, however, increase lateral prefrontal (Broca’s area)/insula and amygdala/hippocampal rCBF more than normotensives.

CONCLUSION: Initial results are sufficient to show that hypertension induces changes in rCBF. A tentative hypothesis is that a relatively general decrease in rCBF responsivity induces specific compensatory cognitive strategies as well as subcortical activation. The rCBF changes appear to have implications for information processing and, as such, hold promise for understanding prior reports relating hypertension to affective regulation and cardiovascular reactivity. Imaging techniques provide a powerful tool for psychosomatic research.

Key Words: hypertension, • information processing, • brain imaging, • positron emission tomography, • magnetic resonance imaging, • white matter hyperintensities, • carotid atherosclerosis.

Abbreviations: PET = positron emission tomography;; MRI = magnetic resonance imaging;; CBF = cerebral blood flow;; rCBF = regional cerebral blood flow;; ROI = region of interest;; SPM = statistical parametric mapping

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