Date of Award

2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Neurology

College

College of Graduate Studies

First Advisor

Leonardo Bonilha

Second Advisor

Roberts Adams

Third Advisor

DeAnna Adkins

Fourth Advisor

Mark A. Eckert

Fifth Advisor

Julius Fridriksson

Sixth Advisor

Chris Rorden

Abstract

Cardiovascular disease (CVD) remains the leading cause of mortality in the United States. Stroke and dementia are the leading causes of adult disability worldwide, and the 5th and 6th leading causes of mortality respectively in the United States. Furthermore, CVD annually accounts for approximately $330 billion in direct and indirect costs in the United States: approximately one in seven health care dollars is spent on CVD. While these diseases have different etiologies, and present with different clinical manifestations and prognosis, converging evidence increasingly supports the idea of CVD as a common pathophysiological origin of cerebrovascular disease, potentially indicating a complex interplay between brain health and cardiovascular health. In this thesis, we leverage methodological advancements in systems and computational neurosciences related to the human brain connectome to assess individual topological network organization and integrity in acute and chronic stroke cohorts, and in a non-stroke cohort with varying CV risk factor burden, using graph theory and network analysis. We propose measures that underly neuroanatomical mechanisms that constitute efficient transfer of information and brain health. We demonstrate the impact of cardiovascular risk factors on brain health, even before overt clinical manifestation, and the resulting impact on cognitive performance, and further determine the underlying pathophysiology relating white matter disease and post-stroke outcomes.

Rights

All rights reserved. Copyright is held by the author.

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