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J Appl Physiol (April 25, 2003). doi:10.1152/japplphysiol.00101.2003
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Submitted on January 31, 2003
Accepted on April 19, 2003

Regional Brain Gray Matter Loss in Heart Failure

Mary A Woo1, Paul M Macey2, Gregg C Fonarow3, Michele A Hamilton3, and Ronald M Harper4*

1 School of Nursing, University of California at Los Angeles, Los Angeles, CA, USA
2 Department of Neurobiology, University of California at Los Angeles, Los Angeles, CA, USA
3 Division of Cardiology, University of California at Los Angeles, Los Angeles, CA, USA
4 Department of Neurobiology, University of California at Los Angeles, Los Angeles, CA, USA; Brain Research Institute, University of California at Los Angeles, Los Angeles, CA, USA

* To whom correspondence should be addressed. E-mail: rharper{at}ucla.edu.

Heart failure (HF) patients exhibit enhanced sympathetic tone, aberrant responses to blood pressure challenges, and sleep-related breathing disorders, suggesting that the syndrome is accompanied by central neural deficits. We assessed regional gray matter volumes over the entire brain in nine HF patients (51 ± 10 years; left ventricular ejection fraction 0.27 ± 0.06; six males), and 27 healthy controls (46 ± 12 years; 22 males) using T1-weighted magnetic resonance imaging to evaluate potential neural damage. Regional volumes were evaluated using voxel based morphometry while controlling for age, gender and handedness. HF patients showed significant and largely-lateralized gray matter loss in autonomic and respiratory-related areas as well as regions not classically associated with such control, including the insula and basal ganglia, right cingulate gyrus, parahippocampal/fusiform gyrus, dorsal midbrain extending to the posterior and medial thalamus, ventral and superior-lateral frontal cortex, bilateral cerebellar quadrangular lobules and right fastigial and neighboring nuclei, and bilateral deep parietal and lateral parietal-occipital cortex. Areas of gray matter loss may contribute to inappropriate cognitive, autonomic, and breathing regulation in HF.




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