Study Background and Rationale:
Pulmonary hypertension (PH), particularly in older adults, is associated with high rates of depression, anxiety, and neurocognitive deficits, suggesting disrupted central nervous system (CNS) signaling. While previous studies using brain MRI have hinted at anatomical changes, the role of neuroinflammation and functional brain connectivity in PH remains poorly understood. Preliminary data from existing studies have shown distinct brain changes in PH patients, highlighting the need for further research into CNS involvement in PH to improve diagnosis and treatment strategies.
Study Objectives and Hypothesis:
Objective: To assess cortical-hypothalamic volume and thickness in patients with pulmonary hypertension (PH) using MRI and survey data analysis.
Hypothesis: Patients with PH will exhibit altered hypothalamic-cortical thickness as detected by brain MRI, and altered cognitive and depression/anxiety survey data will correlate with disease severity.
Study Design: This is a retrospective study focusing on patients in the UK Biobank database that carry a diagnosis of PH. Specific analysis will relate to:
1.Structural MRI of Brain with diffusion weighted imaging (DWI; if available): To measure regional brain volumes and thickness, with an emphasis on the hypothalamic region (paraventricular nucleus, PVN).
2.Neurocognitive Tests: Standard cognitive assessments such as the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to evaluate cognitive function, in addition to available depression/anxiety scales.
2.Genetic Data (if available): To assess for common allelic variants associated with neuroinflammation in neurodegenerative disease.
Inclusion Criteria:
· Adults aged 18-75
· Diagnosed with PH
· Healthy controls matched for age and sex
Exclusion Criteria:
· Severe cognitive impairments
· Structural neurologic disease