Neurovascular coupling, the relationship between cerebral blood flow and neuronal activity, is attenuated in patients with impaired executive function. We tested the hypothesis that peripheral vascular function may associate with executive function in older subjects with cardiovascular risk factors and that treatment with the antioxidant L-arginine would improve both vascular and executive function. Nineteen subjects with type 2 diabetes mellitus and/or controlled hypertension were enrolled. Subjects were treated with L-arginine or placebo for 4 days in a randomized, double-blinded, cross-over study. Brachial artery vascular function, peripheral artery tonometry, and Trail Making Test Part B testing were performed on day 1 and day 4 during each condition. L-arginine significantly reduced the digital reactive hyperemia index, and the comparison of changes against placebo was significant (P = .01). With executive function testing, we observed a significant interaction between treatment and order. Restricting the analysis to the first treatment period, subjects treated with placebo decreased their Trail Making Test Part B times by 57.3 ± 52.5 seconds from day 1 to day 4 (P = .01) while those treated with arginine had no significant change (6.4 ± 18.4 seconds worse, P = .37). In addition, L-arginine was associated with increased mean arterial pressure from 88 ± 9 mm Hg to 92 ± 11 mm Hg, which trended toward significance. L-arginine treatment worsened digital microvascular and executive function in older subjects with cardiovascular risk factors. These data further support a link between vascular and executive function.

执行功能受损的患者神经血管耦合（脑血流与神经元活动之间的关系）减弱。我们检验了以下假设：在具有心血管危险因素的老年受试者中，外周血管功能可能与执行功能相关，并且抗氧化剂L-精氨酸的治疗将改善血管和执行功能。招募了19名2型糖尿病和/或控制性高血压的受试者。在一项随机，双盲，交叉研究中，受试者接受L-精氨酸或安慰剂治疗4天。在每种情况下的第1天和第4天进行了肱动脉血管功能，外周动脉眼压测量和Trail制作测试B部分测试。L-精氨酸可显着降低数字反应性充血指数，P  = 0.01）。通过执行功能测试，我们观察到治疗和订单之间存在显着的相互作用。将分析限制在第一个治疗阶段，从安慰剂治疗的受试者从第1天到第4天，他们的Trail制作测试B部分时间减少了57.3±52.5秒（P = .01），而精氨酸治疗的受试者则没有显着变化（6.4±更糟的是18.4秒，P  = 0.37）。此外，L-精氨酸与平均动脉压从88±9 mm Hg升高到92±11 mm Hg相关，具有显着趋势。在患有心血管危险因素的老年受试者中，L-精氨酸治疗会使数字微血管和执行功能恶化。这些数据进一步支持了血管功能与执行功能之间的联系。