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Behrens, Maria Isabel

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Behrens

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Maria Isabel

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  • Publication
    Cardiovascular risk factors and the allostatic interoceptive network in dementia
    (2025) Hazelton, Jessica; Migeot, Joaquín; Gonzalez, Raul; Altschuler, Florencia; Duran, Claudia; Wen, Olivia; Galván, Dante; Barttfeld, Pablo; Medel , Vicente; González, Cecilia; Castro, Ana; Hernández, Hernán; Gonzalez, Carolina; Castaner, Olga; Hu, Kun; Li, Peng; Maria Isabel Behrens; Behrens, Maria Isabel; Bruno, Martin; Cardona, Juan; Custodio, Nilton; Santamaria, Hernando; Garcia, Adolfo; Godoy, Maria; Avila, José; Maito, Marce; Matallana, Diana; Miller, Bruce; Lopera, Francisco; Okada , Maira; Pina, Stefanie; Possin, Katherine; France, Elisa de Paula; Reyes, Pablo; Slachevsky Chonchol, Andrea; Sosa, Ana; Takada, Leonel; Yokoyama, Jennifer; Ibanez, Agustin
    Aims: Cardiovascular risk factors, such diabetes, hypertension, blood pressure, obesity, and smoking, are linked with allostatic-interoception-the continuous monitoring of internal bodily states in anticipation of environmental demands. These risk factors are associated with dementia risk. How these factors affect brain networks vulnerable to neurodegeneration and involved in allostatic-interoception, such as the Allostatic-Interoceptive Network (AIN), is unknown. We investigated the relationship between cardiovascular risk and AIN structure and function in frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). Methods and results: We recruited 1501 participants (304 with FTLD, 512 with AD, and 685 healthy controls) from the Multi-Partner Consortium to Expand Dementia Research in Latin America (ReDLat). A cardiovascular risk score was calculated based on: age, sex, diabetes, hypertension, systolic blood pressure, body mass index, and smoking status. Cardiovascular risk was associated with grey matter integrity and functional connectivity in age- and sex-matched patient-control groups focusing on predefined regions of interest within the AIN. Higher cardiovascular risk was associated with reduced structural integrity and functional connectivity within the AIN in both FTLD and AD. FTLD patients showed more extensive structural and functional connectivity disruptions throughout the AIN. In AD patients, structural reductions in the AIN were prominent, with functional connectivity restricted to the hippocampus, parahippocampal gyrus, and orbitofrontal regions. Conclusion: Cardiovascular risk factors appear to adversely impact the AIN structure and function, with disease-specific patterns of vulnerability. Results underscore the importance of integrating cardiovascular health into models of neurodegenerative disease and managing cardiovascular health to support brain integrity in dementia.
  • Publication
    Critical Review of the Methodological Shortcoming of Ambulatory Blood Pressure Monitoring and Cognitive Function Studies
    (2025) Haghayegh, Shahab; Hermida, Ramon; Smolensky, Michael; Jimenez, Mili; Duran, Claudia; Slachevsky Chonchol, Andrea; Behrens, Maria Isabel; Aguillon, David; Santamaria, Hernando; García, Adolfo; Matallana, Diana; Ibáñez, Agustín; Hu, Kun
    Growing evidence suggests that abnormal diurnal blood pressure rhythms may be associated with many adverse health outcomes, including increased risk of cognitive impairment and dementia. This study evaluates methodological aspects of research on bidirectional associations between ambulatory blood pressure monitoring (ABPM) patterns and cognitive function. By examining the 28 recent studies included in a recent systematic review on the association between ABPM patterns with cognitive function and risk of dementia, our review revealed several significant limitations in study design, sample characteristics, ABPM protocol, cognitive assessment, and data analysis. The major concerns include a lack of diversity in study populations with underrepresentation of Blacks and Latinos, a predominant focus on Alzheimer's disease or all-cause dementia without distinguishing other dementia subtypes, different and not standardized measures of cognition or dementia, prevalent use of 24 h monitoring without considering the adaption effect, inconsistent definitions of dipping status, and ignorance of individual differences in timings of daily activities such as bed and awakening times. In addition, confounding variables such as class, dose, and timing of antihypertensive medication are inadequately controlled or considered. Further, longitudinal studies were scarce examining the bidirectional relationship between ABPM patterns and cognitive decline over time. Collectively, these deficiencies undermine the reliability and generalizability of current findings. Addressing these methodological challenges is crucial for a more comprehensive understanding of diurnal blood pressure rhythms in diverse populations and for developing an evidence-based guideline for ambulatory monitoring and control of blood pressure across the sleep-wake cycle to prevent cognitive decline and dementia.