Cutaneous and Muscle Reactive Hyperemia in Young Adults with Major Depressive Disorder

The reactive hyperemic vasodilatory response to a brief period of tissue ischemia provides an index of microvascular function and is an independent predictor of cardiovascular morbidity and mortality. As such, reactive hyperemia is a non-invasive technique that is commonly utilized to provide an index of vascular health in various patient groups. Major depressive disorder (MDD), a non-traditional risk factor for cardiovascular disease (CVD), has been associated with blunted reactive hyperemia, though this is not a universal finding. Further, to date, the quantification of the reactive hyperemic response in adults with MDD has been limited to the forearm muscle, assessed as Doppler ultrasound derived blood velocity in the brachial artery following a period of suprasystolic cuff occlusion. PURPOSE: Here, we sought to more comprehensively assess microvascular reactive hyperemia in otherwise healthy young adults with MDD. We tested the hypothesis that both muscle and cutaneous vasodilation would be blunted in adults with MDD compared to non-depressed young adults. METHODS: Nine healthy adults (HA; age: 22±2 yrs: body mass index: 26.5 ± 1.8 kg/m2) and ten adults with MDD (non-medicated; age: 22±2 yrs: body mass index: 22.6 ± 4.4 kg/m2) participated. Forearm reactive hyperemia was assessed as the increase in blood velocity in the brachial artery following 5-min of suprasystolic cuff occlusion (distal to the olecranon process). In a subset of adults (n=5 HA; n=4 MDD), cutaneous reactive hyperemia was concurrently assessed via laser Doppler flowmetry-derived flux (perfusion units; PU). Peak and total (area-under-the-curve; AUC) reactive hyperemia were quantified for each methodological approach. RESULTS: Neither the brachial artery Doppler ultrasound-derived peak (HA: 1020±383 vs. MDD: 950±239 s-1; p=0.65) nor the total blood flow (HA: 284±77 vs. MDD: 233±153 a.u.; p=0.41) reactive hyperemic response was different between groups. Further, there were no group differences in cutaneous reactive hyperemia (peak: 83±37 HA vs. 79±15 PU MDD, p=0.85; AUC: 8764±2273 HA vs. 8935±1439 a.u. MDD; p=0.90). CONCLUSION: These preliminary data indicate that neither the muscle nor cutaneous vasodilatory response to a brief period of tissue ischemia is blunted in young adults with MDD, suggesting preserved microvascular function

The Relation Between Cognitive Function and Cerebral Vasodilatory Reactivity in Young Adults with Major Depressive Disorder

Major depressive disorder (MDD) has been associated with an elevated risk of developing neurocognitive diseases (e.g., dementia). Although the precise neurobiological mechanisms remain incompletely understood, cerebrovascular dysfunction is thought to directly contribute, at least in part, to impairments in cognitive function. Cerebral vasodilatory reactivity to a hypercapnic stimulus is blunted in older adults with MDD compared to age-matched non-depressed adults. Further, impaired cerebral vasodilation has been linked to reduced cognitive activity in older adults with depression. However, to date, limited studies have examined the relation between cognitive function and cerebrovascular function in otherwise healthy young adults with MDD. PURPOSE: We tested the hypothesis that greater hypercapnia-induced cerebral vasodilation would be related to greater fluid cognitive ability (i.e., the capacity to process and integrate new information) in young adults with MDD. METHODS: Ten adults with MDD (non-medicated; age: 22±2 yrs: body mass index: 22.8±4.5 kg/m2; education level: all enrolled in a four-year university) participated. Cognitive function was assessed via the NIH Toolbox Cognitive Function Battery (iPad). A composite fluid cognitive ability score was derived from the specific tests within the battery that measure fluid ability [e.g., Flanker, Dimensional Change Cart Sort (DCCS)]; an age-correct standard T-score of 100 indicates ability that is average compared with national data. Beat-to-beat mean arterial pressure (MAP; finger photoplethysmography), middle cerebral artery blood velocity (MCAv; transcranial Doppler ultrasound), and end-tidal carbon dioxide concentration (PETCO2; capnograph) were continuously measured during normocapnic baseline and during rebreathing-induced hypercapnia. The hypercapnia-induced (∆PETCO2=9 mmHg) increase in cerebral vascular conductance index (∆CVCi=MCAv/MAP) was used as an index of cerebral vasodilatory reactivity. RESULTS: Hypercapnia elicited an increase in CVCi in all subjects (mean: 30±12%; range: 18-60%). The age-corrected composite fluid cognitive ability standard score was 100±15 (range: 79-119). The increase in CVCi was not related to fluid cognitive ability (slope=-0.12±0.3; r2=0.02, p=0.67). In addition, the increase in CVCi was not related to either the age-corrected standard score for the Flanker task (slope=-0.38±0.4; r2=0.12, p=0.32) or for the DCCS task (slope=0.09±0.3; r2=0.02, p=0.72), both of which specifically measure executive function. CONCLUSION: These preliminary data suggest that cerebral vasodilatory reactivity to a hypercapnic stimulus is not related to fluid cognitive function in otherwise healthy college-aged adults with MDD

Semaphorin-Plexin Signaling Guides Patterning of the Developing Vasculature

AbstractMajor vessels of the vertebrate circulatory system display evolutionarily conserved and reproducible anatomy, but the cues guiding this stereotypic patterning remain obscure. In the nervous system, axonal pathways are shaped by repulsive cues provided by ligands of the semaphorin family that are sensed by migrating neuronal growth cones through plexin receptors. We show that proper blood vessel pathfinding requires the endothelial receptor PlexinD1 and semaphorin signals, and we identify mutations in plexinD1 in the zebrafish vascular patterning mutant out of bounds. These results reveal the fundamental conservation of repulsive patterning mechanisms between axonal migration in the central nervous system and vascular endothelium during angiogenesis

Uncoordinated maturation of developing and regenerating postnatal mammalian vestibular hair cells

Sensory hair cells are mechanoreceptors required for hearing and balance functions. From embryonic development, hair cells acquire apical stereociliary bundles for mechanosensation, basolateral ion channels that shape receptor potential, and synaptic contacts for conveying information centrally. These key maturation steps are sequential and presumed coupled; however, whether hair cells emerging postnatally mature similarly is unknown. Here, we show that in vivo postnatally generated and regenerated hair cells in the utricle, a vestibular organ detecting linear acceleration, acquired some mature somatic features but hair bundles appeared nonfunctional and short. The utricle consists of two hair cell subtypes with distinct morphological, electrophysiological and synaptic features. In both the undamaged and damaged utricle, fate-mapping and electrophysiology experiments showed that Plp1+ supporting cells took on type II hair cell properties based on molecular markers, basolateral conductances and synaptic properties yet stereociliary bundles were absent, or small and nonfunctional. By contrast, Lgr5+ supporting cells regenerated hair cells with type I and II properties, representing a distinct hair cell precursor subtype. Lastly, direct physiological measurements showed that utricular function abolished by damage was partially regained during regeneration. Together, our data reveal a previously unrecognized aberrant maturation program for hair cells generated and regenerated postnatally and may have broad implications for inner ear regenerative therapies

Uncoordinated maturation of developing and regenerating postnatal mammalian vestibular hair cells.

Sensory hair cells are mechanoreceptors required for hearing and balance functions. From embryonic development, hair cells acquire apical stereociliary bundles for mechanosensation, basolateral ion channels that shape receptor potential, and synaptic contacts for conveying information centrally. These key maturation steps are sequential and presumed coupled; however, whether hair cells emerging postnatally mature similarly is unknown. Here, we show that in vivo postnatally generated and regenerated hair cells in the utricle, a vestibular organ detecting linear acceleration, acquired some mature somatic features but hair bundles appeared nonfunctional and short. The utricle consists of two hair cell subtypes with distinct morphological, electrophysiological and synaptic features. In both the undamaged and damaged utricle, fate-mapping and electrophysiology experiments showed that Plp1+ supporting cells took on type II hair cell properties based on molecular markers, basolateral conductances and synaptic properties yet stereociliary bundles were absent, or small and nonfunctional. By contrast, Lgr5+ supporting cells regenerated hair cells with type I and II properties, representing a distinct hair cell precursor subtype. Lastly, direct physiological measurements showed that utricular function abolished by damage was partially regained during regeneration. Together, our data reveal a previously unrecognized aberrant maturation program for hair cells generated and regenerated postnatally and may have broad implications for inner ear regenerative therapies