Neurovascular coupling, cerebral white matter integrity, and response to cocoa in older people

I bet your doctor can't put two and two together to have hot cocoa added to your daily diet protocol in the hospital.  Failure to do that is worth a call to the president asking what the hell the performance goals are for stroke doctors.
http://www.neurology.org/content/81/10/904

1. Farzaneh A. Sorond, MD, PhD,
2. Shelley Hurwitz, PhD,
3. David H. Salat, PhD,
4. Douglas N. Greve, PhD and
5. Naomi D.L. Fisher, MD

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1. Correspondence to Dr. Sorond: fsorond@partners.org

1. Published online before print August 7, 2013, doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0b013e3182a351aa Neurology September 3, 2013 vol. 81 no. 10 904-909

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Abstract

Objective: To investigate the relationship between neurovascular coupling and cognitive function in elderly individuals with vascular risk factors and to determine whether neurovascular coupling could be modified by cocoa consumption.

Methods: Sixty older people (aged 72.9 ± 5.4 years) were studied in a parallel-arm, double-blind clinical trial of neurovascular coupling and cognition in response to 24 hours and 30 days of cocoa consumption. Cognitive measures included Mini-Mental State Examination and Trail Making Test A and B. Neurovascular coupling was measured from the beat-to-beat blood flow velocity responses in the middle cerebral arteries to the N-Back Task. In a subset of MRI-eligible participants, cerebral white matter structural integrity was also measured.

Results: Neurovascular coupling was associated with Trails B scores (p = 0.002) and performance on the 2-Back Task. Higher neurovascular coupling was also associated with significantly higher fractional anisotropy in cerebral white matter hyperintensities (p = 0.02). Finally, 30 days of cocoa consumption was associated with increased neurovascular coupling (5.6% ± 7.2% vs −2.4% ± 4.8%; p = 0.001) and improved Trails B times (116 ± 78 seconds vs 167 ± 110 seconds; p = 0.007) in those with impaired neurovascular coupling at baseline.

Conclusion: There is a strong correlation between neurovascular coupling and cognitive function, and both can be improved by regular cocoa consumption in individuals with baseline impairments. Better neurovascular coupling is also associated with greater white matter structural integrity.