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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

View larger version (40K): [in a new window]   Fig. 1. Performance on the alphabet arithmetic task of hypertensives and controls, left bars, and relatively younger and older subjects, right bars.

View larger version (19K): [in a new window]   Fig. 2. Hypothetical diagram of autoregulation of the cerebral vasculature based on Chillon and Baumbach (21). Cerebral arterial diameter (- - -) and cerebral blood flow (—) are plotted against arterial pressure. Cerebral resistance arteries are shown as dilating during reduction and constricting during increases in mean arterial pressure. This serves to maintain relatively constant cerebral blood in the range of pressures diagrammed as the autoregulatory plateau. Beyond the range of the autoregulatory plateau, vessel diameter is shown as responding passively to changes in arterial blood pressure.

View larger version (18K): [in a new window]   Fig. 3. Performance on the Wechsler memory scale for the hypertensives (----) and control (----) groups.

View larger version (21K): [in a new window]   Fig. 4. Regional CBF in the posterior parietal region of interest for the control/no-load memory task and the three-item dynamic load, spatial 2-back task. Results are plotted separately for hypertensives () and controls ().

View larger version (22K): [in a new window]   Fig. 5. Regional CBF in the amygdala/hippocampal region of interest for the hypertensives () and controls () as separated by whether they performed above or below the median on the spatial 2-back task.

View larger version (56K): [in a new window]   Fig. 6. Relative rCBF activation corresponding to increasing spatial working memory load among the normtensives (top) and hypertensives (bottom). Each figure shows a standardized MRI brain view from six perspectives—the top row is front and rear view, middle row right and left side view, bottom row top and bottom view. Statistically significant functional activation is projected on the surface of this brain. The red indicates areas which are statistically significant, p < .05 (using the correction for the number of comparisons employed in the computer routines of Statistical Parametric Maping 99).

View larger version (26K): [in a new window]   Fig. 7. Mean voxel activation in a 5-mm sphere surrounding the most significant voxel in the direct comparison of spatial memory activation to spatial working memory. controls; , hypertensives.