Molecular Layer Atrophy Mediates the Association of Cumulative Blood Pressure Exposure With Cognitive Decline
Bibliographic record
Abstract
BACKGROUND: High blood pressure (BP) is a known risk factor for cognitive decline and dementia, but the underlying mechanisms are largely unknown. We investigated the associations of cumulative BP exposure with hippocampal subfield volume and cognitive function and determined whether hippocampal subfield atrophy mediates the association between cumulative BP exposure and cognitive decline. METHODS: Between December 2020 and March 2023, participants were prospectively included from the Kailuan study. The cumulative BP was calculated as the area under the curve (mm Hg×years) using measurements from 2006 to 2023. A brain magnetic resonance imaging and the Montreal Cognitive Assessment was conducted beginning in 2020. The hippocampus was automatically segmented into 12 subfields via FreeSurfer 7.4.1 software (http://surfer.nmr.mgh.harvard.edu/). RESULTS: A total of 1035 participants were included in this study. Increased cumulative systolic BP was associated with decreased volumes in the parasubiculum, presubiculum, subiculum, CA4, dentate gyrus, and molecular layer, and higher cumulative diastolic BP was associated with a lower volume in the presubiculum. Higher cumulative systolic BP and diastolic BP were associated with lower Montreal Cognitive Assessment scores. Decreased volumes in the subiculum; cornu ammonis (CA) 1, 2-3, and 4; dentate gyrus; molecular layer; fimbria; and hippocampal tail were associated with lower Montreal Cognitive Assessment scores. The molecular layer volume mediated negative associations of cumulative systolic BP and diastolic BP exposure with Montreal Cognitive Assessment scores, with mediating effect proportions of 5.61% and 8.68%, respectively. CONCLUSIONS: Increased cumulative BP was associated with hippocampal subfield atrophy and cognitive decline, and the molecular layer volume mediated the negative association between cumulative BP and cognitive decline.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".