Compensatory functional reorganization may precede hypertension-related brain damage and cognitive decline

Our study aimed at exploring structural and functional differences in the brain during higher cognitive processing between middle-aged hypertensive patients and controls matched for sex, age and years of education.Two groups of 20 patients took part in MRI examinations. This article reports the results of functional MRI during a Stroop color interference task and structural evaluations based on a modified Fazekas scale.No intergroup differences were found in regards to the severity of white matter lesions (Mann-Whitney U test = 150.5, P > 0.1), nor from the task performance in the scanner (t(35) = 0.2, P > 0.1). However, brain activation patterns between patients and controls varied. Hypertensive patients involved significantly more cerebral areas during the processing, regardless of the task difficulty. Differences were found in 26 diverse regions of both primary and associative cortices (with a peak voxel located in the cuneus, Z = 6.94, P < 0.05 family-wise error corrected at voxel level).Our findings provide an insight into the brain mechanisms related to essential hypertension and suggest a functional reorganization (neuroplasticity) early in the course of the disease.