Cerebrovascular reactivity (CVR) deficits may contribute to small vessel disease, such as white matter hyperintensities (WMH). Moreover, apolipoprotein-e4 () carriers at genetic risk for Alzheimer’s disease exhibit cerebrovascular dysfunction relative to non-carriers. We examined whether older adults, and carriers specifically, with diminished CVR would exhibit higher WMH burden. Independently living older adults (N = 125, mean age = 69.2 years; SD = 7.6; 31.2% male) free of dementia or clinical stroke underwent brain MRI to quantify cerebral perfusion during CVR to hypercapnia and hypocapnia and determine WMH volume. Adjusting for age, sex and intracranial volume, hierarchical regression analysis revealed a significant association between whole brain CVR to hypercapnia and WMH overall [B = −.02, 95% CI (-.04, −.008), p =.003] and in carriers [B = −.03, 95% CI (-.06, −.009), p =.009]. Findings suggest deficits in cerebral vasodilatory capacity are associated with WMH burden in older adults and future studies are warranted to further delineate the effect of on precipitating WMH.

中文翻译：

---

脑血管反应性降低的老年人表现出较高的白质高信号负担

脑血管反应性 (CVR) 缺陷可能导致小血管疾病，例如白质高信号 (WMH)。此外，与非携带者相比，具有阿尔茨海默病遗传风险的载脂蛋白-e4 ()携带者表现出脑血管功能障碍。我们研究了 CVR 降低的老年人（特别是携带者）是否会表现出更高的 WMH 负担。没有痴呆或临床中风的独立生活老年人（N = 125，平均年龄 = 69.2 岁；SD = 7.6；31.2% 男性）接受脑 MRI，以量化 CVR 至高碳酸血症和低碳酸血症期间的脑灌注并确定 WMH 体积。调整年龄、性别和颅内容积后，层次回归分析显示全脑 CVR 与高碳酸血症和 WMH 总体之间存在显着相关性 [B = −.02, 95% CI (-.04, −.008), p =.003]在载体中 [B = −.03, 95% CI (-.06, −.009), p =.009]。研究结果表明，老年人的脑血管舒张能力缺陷与 WMH 负担相关，未来的研究有必要进一步阐明脑血管舒张能力对 WMH 诱发的影响。