Impact of the Central Blood Pressure Level in Cerebral Metabolic Aging: a 18F-FDG PET Study.

Study Overview
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Brief Summary
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Cerebral glycolytic metabolism can be quantified by quantitative analysis of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET). This allows to identify neurological diseases at an early stage of functional abnormalities, before any anatomical lesions, and to differentiate them from the normal brain aging. Aging mainly leads to atrophy with a decrease in cerebral metabolism in the prefrontal cortex, with consequent deterioration of cognitive processes, in particular executive functions (5). In a population of 92 control subjects, investigators have already quantified the importance of the aging in frontal cortex hypometabolism. These patients were referred for a 18F-FDG PET in the follow-up of lymphoma considered to be in complete remission (PET without cerebral step), without any chemoradiotherapy within 2 months and with normal neuropsychological tests (Mini Mental State Examination, MMSE, Mini International Neuropsychiatric Interview MINI and Frontal Assessment Battery FAB). However, cerebral aging can be accelerated by vascular risk factors, including increased central blood pressure, as investigators have recently reported in a pilot study involving elderly patients. This central pressure, which is directly linked to the cerebral micro-vascularization, can be easily measured by applanation tonometry. In this pilot study, investigators showed that a central pulse pressure equal or greater than 50 mmHg was associated with a significant frontal hypometabolism in elderly patients. This confirmed, at a stage of pre-clinical remodeling, the worse prognostic significance for this criterion, as reported in large epidemiological studies (increased risk of stroke and cardiac vascular events). However, it is not yet known whether the level of central blood pressure interfere with the brain metabolism of younger subjects, especially with regard to aging observed throughout life. If this hypothesis is confirmed, preventive therapeutic strategies for accelerated aging, could thus integrate the monitoring of central pressure and cerebral metabolism. The objective of this study is to determine, in a population of control subjects and on a larger scale, the impact of central blood pressure on brain metabolic aging , by using 18F-FDG PET.

Official Title
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Impact of the Central Blood Pressure Level in Cerebral Metabolic Aging: a 18F-FDG PET Study.

Conditions
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Aging Disorder

Intervention / Treatment
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* Device: PET with a cerebral step
* Device: Central blood pressure measurement
* Other: Neurocognitive tests


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: > 18 years old, with written informed consent, Subjects referred for 18F-FDG PET in a non-oncological setting, Absence of pregnancy or breastfeeding, Lack of chemotherapy in the previous year and no cerebral radiotherapy. No history of psychiatric or neurological pathology. Absence of treatment with psychotropic action, and absence of corticosteroids. Exclusion Criteria: abnormal neuropsychological tests: Mini Mental State Examination (MMSE) <27, Current major depressive episode on the Mini International Neuropsychologic Interview (MINI), Frontal Assessment Battery (FAB) <15. 18F-FDG PET examination showing ischemic, neurodegenerative, neoplastic or other brain lesions (independent of a normal or accelerated aging process).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Subjects<br>Subjects referred to a FDG PET scan (standard PET without cerebral step) without any oncologic setting. Patients will be included as following critera: 25% of subjects will have under 40 years old, 25% between 40 and 60 yeard old et 50% higher than 60 years old. | Device: PET with a cerebral step<br>* Positron Emission Tomography with a cerebral step before to carry out the standard Position Emission Tomography<br>Device: Central blood pressure measurement<br>* Central blood pressure measurement<br>Other: Neurocognitive tests<br>* Mini Mental State Examination, MMSE, Mini International Neuropsychiatric Interview MINI and Frontal Assessment Batery FAB<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| volume of brain areas detected by quantitative analysis |  | At inclusion | 
| topography of brain areas detected by quantitative analysis |  | At inclusion | 
| central blood pressure |  | At inclusion | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Aging, Central pressure, FDG PET