Impact of Age on Cardiovascular, Cerebrovascular and Cognitive Health in Spinal Cord Injury
| Status: | Completed |
|---|---|
| Conditions: | Hospital, Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 25 - 65 |
| Updated: | 10/19/2017 |
| Start Date: | July 2013 |
| End Date: | July 2017 |
As the spinal cord injured population ages, these individuals are being exposed to an
increased prevalence of age-associated diseases, which coupled with the secondary
complications of the injury may contribute to the reduced life expectancies. Decentralized
autonomic regulation in persons with SCI results in a multitude of cardiovascular changes,
which may contribute to accelerated aging. Adverse cardiovascular changes may have
deleterious effects on cerebral blood flow dynamics and an increase in cerebral vascular
resistance index in individuals with SCI during cognitive testing. Deficits in memory and
processing speed in individuals with SCI may relate to cardiovascular and cerebrovascular
dysfunction. Identifying the associations between healthy aging versus premature or
accelerated aging in organ system function in the SCI population is an important first step
towards prevention and amelioration of these changes. Therefore the study objectives are to
compare, among individuals with SCI, age-matched non-SCI and older non-SCI individuals
arterial stiffness and cerebral vascular resistance index; memory, processing speed, and
executive function; and volume of white matter hyperintensities. 60 individuals with SCI, 30
age-matched non-SCI controls, and 20 older non-SCI controls will be recruited for this study.
All potential subjects will undergo a two-part screening process which consists of an initial
screening via telephone and a detailed, in-person screening. Eligible subjects will be
invited to participate in a 4 hour laboratory visit during which their arterial stiffness,
blood pressure, heart rate, respiration rate and, blood flow to the brain will be monitored
at rest and during a comprehensive series of cognitive tests. A subset of the participants
will be asked to take part in an MRI brain imaging session: 40 persons with SCI, 10
age-matched non-SCI and 10 older non-SCI. Eligible subjects will be asked to participate in a
1 hour MRI/functional magnetic resonance imaging(fMRI) session.
We hypothesize that arterial stiffness and cerebral vascular resistance index will be
increased in the SCI group compared to the age-matched non-SCI but will be comparable to the
older non-SCI groups. In addition, we hypothesize that the prevalence of mild to moderate
cognitive impairments in memory, processing speed, and executive function will be increased
in the SCI individuals compared to the age-matched non-SCI but will be comparable to the
older non-SCI individuals.
increased prevalence of age-associated diseases, which coupled with the secondary
complications of the injury may contribute to the reduced life expectancies. Decentralized
autonomic regulation in persons with SCI results in a multitude of cardiovascular changes,
which may contribute to accelerated aging. Adverse cardiovascular changes may have
deleterious effects on cerebral blood flow dynamics and an increase in cerebral vascular
resistance index in individuals with SCI during cognitive testing. Deficits in memory and
processing speed in individuals with SCI may relate to cardiovascular and cerebrovascular
dysfunction. Identifying the associations between healthy aging versus premature or
accelerated aging in organ system function in the SCI population is an important first step
towards prevention and amelioration of these changes. Therefore the study objectives are to
compare, among individuals with SCI, age-matched non-SCI and older non-SCI individuals
arterial stiffness and cerebral vascular resistance index; memory, processing speed, and
executive function; and volume of white matter hyperintensities. 60 individuals with SCI, 30
age-matched non-SCI controls, and 20 older non-SCI controls will be recruited for this study.
All potential subjects will undergo a two-part screening process which consists of an initial
screening via telephone and a detailed, in-person screening. Eligible subjects will be
invited to participate in a 4 hour laboratory visit during which their arterial stiffness,
blood pressure, heart rate, respiration rate and, blood flow to the brain will be monitored
at rest and during a comprehensive series of cognitive tests. A subset of the participants
will be asked to take part in an MRI brain imaging session: 40 persons with SCI, 10
age-matched non-SCI and 10 older non-SCI. Eligible subjects will be asked to participate in a
1 hour MRI/functional magnetic resonance imaging(fMRI) session.
We hypothesize that arterial stiffness and cerebral vascular resistance index will be
increased in the SCI group compared to the age-matched non-SCI but will be comparable to the
older non-SCI groups. In addition, we hypothesize that the prevalence of mild to moderate
cognitive impairments in memory, processing speed, and executive function will be increased
in the SCI individuals compared to the age-matched non-SCI but will be comparable to the
older non-SCI individuals.
The cognitive test battery will consists of the tests listed below, administered in the order
given.
1. Digit Span
2. California Verbal Learning Test
3. Symbol Digit Modalities Test
4. Letter Number Sequencing
5. California Verbal Learning Test Delay
6. Paced Auditory Serial Addition Test
7. D-KEFS Verbal Fluency
8. D-KEFS Color-Word
9. WASI Vocabulary
10. WASI Matrix Reasoning
given.
1. Digit Span
2. California Verbal Learning Test
3. Symbol Digit Modalities Test
4. Letter Number Sequencing
5. California Verbal Learning Test Delay
6. Paced Auditory Serial Addition Test
7. D-KEFS Verbal Fluency
8. D-KEFS Color-Word
9. WASI Vocabulary
10. WASI Matrix Reasoning
Inclusion Criteria:
SCI
- Between the ages of 25 and 49 years old
- Duration of injury must be between 5 and 10 years
- AIS grade of A or B
- Non-ambulatory (wheelchair dependent)
- At least 20/60 minimum acuity in worst eye on the Snell Eye Exam
- A score ≥24 on the Montreal Cognitive Assessment
- English literate
- Able to provide informed consent
Age-matched non-SCI
- Between the ages of 25 and 49 years old
- At least 20/60 minimum acuity in worst eye on the Snell Eye Exam
- A score ≥24 on the Montreal Cognitive Assessment
- English literate
- Able to provide informed consent
Older non-SCI
- Between the ages of 55 and 65 years old
- At least 20/60 minimum acuity in worst eye on the Snell Eye Exam
- A score ≥24 on the Montreal Cognitive Assessment
- English literate
- Able to provide informed consent
Exclusion Criteria:
- Acute illness or infection
- Documented history of:
- Controlled or uncontrolled hypertension or Diabetes mellitus
- Recent illicit drug abuse (from medical chart, within the past 6-months)
- Epilepsy or seizures
- Neurodegenerative disease including Alzheimer's disease, Parkinson's disease,
Dementia, Stroke, Multiple sclerosis
- Severe TBI (identified by TBI screening tool)
- Any significant history of psychiatric disease/disorders:
- Post-traumatic stress disorder
- schizophrenia
- Bipolar disease
- Substance abuse or dependence within the past 6 months
MRI has additional exclusion:
- Subject has been informed that it is medically unsafe to receive a regular MRI as part
of my medical care
- Pregnant
- Right handed
- Prone to claustrophobia
- Metal in body including:
- metal fragments or pieces in subject's eye or any other part of body
- brain stimulators
- pacemakers, or other implanted electrical devices or pumps
- aneurysm clips
- metallic prostheses (including metal pins and rods, heart valves)
- internal hearing aids
- permanent eyeliner
- shrapnel fragments
- piercing that cannot be taken out
We found this trial at
1
site
West Orange, New Jersey 07052
Principal Investigator: Nancy Chiaravalloti, Ph.D
Phone: 973-324-3581
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