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Asymmetric Insular Function Predicts Positional Blood Pressure in Nondemented Elderly

Received July 24, 2007; revised December 21, 2007, and January 25, 2008; accepted January 31, 2008. Drs. Royall and Polk are affiliated with the Department of Psychiatry at The University of Texas Health Sciences Center at San Antonio and the South Texas Veterans Health Administration Geriatric Research Education and Clinical Center (GRECC); Drs. Royall and Kellogg are affiliated with the Department of Medicine at The University of Texas Health Sciences Center at San Antonio, and the South Texas Veterans Health Administration GRECC; Dr. Royall is also affiliated with the Departments of Medicine and Pharmacology at The University of Texas Health Sciences Center at San Antonio; Drs. Gao and Zhao are affiliated with the Department of Radiology and Research Imaging Center at The University of Texas Health Sciences Center at San Antonio. Address correspondence to Dr. Donald Royall, Department of Psychiatry, The University of Texas Health Science Center, 7703 Floyd Curl Dr., Mail code: 7792, San Antonio, TX 78229-3900; royall{at}uthscsa.edu (e-mail).

Forty percent of nondemented octogenarians have Braak stages consistent with insular involvement, and may be at risk for "age-related" autonomic dysfunction. The authors examined the association between insular resting cerebral blood flow (rCBF) and cardiovascular functions in 29 nondemented elderly subjects who were highly screened to exclude comorbid cardiovascular disease. Mean insular rCBF was significantly higher on the right than left. However, 35.4% of participants had left dominant rCBF (a high-risk group). Right insular rCBF was significantly lower in the high-risk group. This subset had significantly increased positional drops in systolic blood pressure. While these data cannot address Alzheimer’s disease as the specific cause, this possibility is being investigated in other cohorts.

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