Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Author response: White matter hyperintensities mediate the association of nocturnal blood pressure with cognition

  • Anthony G. Chesebro, scientist, Columbia University
  • Jesus D. Melgarejo, scientist, University of Zulia
  • Reinier Leendertz, scientist, University of Zulia
  • Kay C. Igwe, scientist, Columbia University
  • Patrick J. Lao, scientist, Columbia University
  • Krystal K. Laing, scientist, Columbia University
  • Batool Rizvi, scientist, Columbia University
  • Mariana Budge, scientist, Columbia University
  • Irene B. Meier, scientist, Columbia University
  • Gustavo Calmon, scientist, Columbia University
  • Joseph H. Lee, scientist, Columbia University
  • Gladys Maestre, scientist, University of Texas Rio Grande Valley
  • Adam M. Brickman, scientist, Columbia University
Submitted June 05, 2020

We would like to thank Fisher et al. for their comment on our study1 and apologize for failing to cite their important paper2 in our work. We agree that white matter hyperintensity volumes in periventricular and deep regions are typically highly correlated, and we speculate that the reason we observed regional effects whereas Paganini-Hill and colleagues did not was due to age differences between our samples. White matter hyperintensities are typically more prominent in periventricular regions at early ages and become more diffuse with age.3 Our participants were, on average, 30 years younger than those included in the Paganini-Hill et al. report; we may have captured the earliest white matter changes, which may have greater regional specificity in terms of their clinical correlates. We also agree that tract-specific analysis of white matter hyperintensities will provide greater insight into the effects of this damage on cognition, and recent work4,5 further supports this as a promising line of inquiry. In addition to the comment regarding timing of hypertension medications, we would also emphasize that the frequency of ambulatory blood pressure measurements—particularly multiple times per hour6—plays an important role in the diagnostic value of these measurements, and further work is needed to determine the optimal number and overall timescale of ambulatory blood pressure assessment. Given the similar findings between our two groups, we concur that the use of nighttime blood pressure variability is an important marker of vascular health.

Disclosure

The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.

References

  1. Chesebro AG, Melgarejo JD, Leendertz R, et al. White matter hyperintensities mediate the association of nocturnal blood pressure with cognition. Neurology 2020;94:1803–1810.
  2. Paganini-Hill A, Bryant N, Corrada MM, et al. Blood Pressure Circadian Variation, Cognition and Brain Imaging in 90+ Year-Olds. Front Aging Neurosci. 2019;11:54.
  3. Sachdev P, Wen W, Chen X, Brodaty H. Progression of white matter hyperintensities in elderly individuals over 3 years. Neurology. 2007;68:214–222.
  4. Seiler S, Fletcher E, Hassan-Ali K, et al. Cerebral tract integrity relates to white matter hyperintensities, cortex volume, and cognition. Neurobiology of Aging. 2018;72:14–22.
  5. Rizvi B, Lao PJ, Colón J, et al. Tract-defined regional white matter hyperintensities and memory. NeuroImage: Clinical. 2020;25:102143.
  6. O’Brien E, Parati G, Stergiou G. Ambulatory Blood Pressure Measurement: What Is the International Consensus? Hypertension. 2013;62:988–994.

Navigate back to article

Neurology: 99 (7)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise