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Reiländer A, Engel M, Nöth U, Deichmann R, Shrestha M, Wagner M, Gracien RM, Seiler A. Cortical microstructural involvement in cerebral small vessel disease. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100218. [PMID: 38510580 PMCID: PMC10951897 DOI: 10.1016/j.cccb.2024.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background In cerebral small vessel disease (CSVD), cortical atrophy occurs at a later stage compared to microstructural abnormalities and therefore cannot be used for monitoring short-term disease progression. We aimed to investigate whether cortical diffusion tensor imaging (DTI) and quantitative (q) magnetic resonance imaging (MRI) are able to detect early microstructural involvement of the cerebral cortex in CSVD. Materials and Methods 33 CSVD patients without significant cortical or whole-brain atrophy and 16 healthy control subjects were included and underwent structural MRI, DTI and high-resolution qMRI with T2, T2* and T2' mapping at 3 T as well as comprehensive cognitive assessment. After tissue segmentation and reconstruction of the cortical boundaries with the Freesurfer software, DTI and qMRI parameters were saved as surface datasets and averaged across all vertices. Results Cortical diffusivity and quantitative T2 values were significantly increased in patients compared to controls (p < 0.05). T2 values correlated significantly positively with white matter hyperintensity (WMH) volume (p < 0.01). Both cortical diffusivity and T2 showed significant negative associations with axonal damage to the white matter fiber tracts (p < 0.05). Conclusions Cortical diffusivity and quantitative T2 mapping are suitable to detect microstructural involvement of the cerebral cortex in CSVD and represent promising imaging biomarkers for monitoring disease progression and effects of therapeutical interventions in clinical studies.
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Affiliation(s)
- Annemarie Reiländer
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Marlene Engel
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Manoj Shrestha
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University, Frankfurt, Germany
- Institute of Neuroradiology, Goethe University Hospital, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Alexander Seiler
- Brain Imaging Center, Goethe University, Frankfurt, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
- Neurovascular Center, University Hospital Schleswig-Holstein, Kiel, Germany
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2
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Luo H, Li J, Chen Y, Wu B, Liu J, Han M, Wu Y, Jia W, Yu P, Cheng R, Wang X, Ke J, Xian H, Tu J, Yi Y. Feasibility of a clinical-radiomics combined model to predict the occurrence of stroke-associated pneumonia. BMC Neurol 2024; 24:45. [PMID: 38273251 PMCID: PMC10809767 DOI: 10.1186/s12883-024-03532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/08/2024] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To explore the predictive value of radiomics in predicting stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients and construct a prediction model based on clinical features and DWI-MRI radiomics features. METHODS Univariate and multivariate logistic regression analyses were used to identify the independent clinical predictors for SAP. Pearson correlation analysis and the least absolute shrinkage and selection operator with ten-fold cross-validation were used to calculate the radiomics score for each feature and identify the predictive radiomics features for SAP. Multivariate logistic regression was used to combine the predictive radiomics features with the independent clinical predictors. The prediction performance of the SAP models was evaluated using receiver operating characteristics (ROC), calibration curves, decision curve analysis, and subgroup analyses. RESULTS Triglycerides, the neutrophil-to-lymphocyte ratio, dysphagia, the National Institutes of Health Stroke Scale (NIHSS) score, and internal carotid artery stenosis were identified as clinically independent risk factors for SAP. The radiomics scores in patients with SAP were generally higher than in patients without SAP (P < 0. 05). There was a linear positive correlation between radiomics scores and NIHSS scores, as well as between radiomics scores and infarct volume. Infarct volume showed moderate performance in predicting the occurrence of SAP, with an AUC of 0.635. When compared with the other models, the combined prediction model achieved the best area under the ROC (AUC) in both training (AUC = 0.859, 95% CI 0.759-0.936) and validation (AUC = 0.830, 95% CI 0.758-0.896) cohorts (P < 0.05). The calibration curves and decision curve analysis further confirmed the clinical value of the nomogram. Subgroup analysis showed that this nomogram had potential generalization ability. CONCLUSION The addition of the radiomics features to the clinical model improved the prediction of SAP in AIS patients, which verified its feasibility.
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Affiliation(s)
- Haowen Luo
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
| | - Jingyi Li
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Yongsen Chen
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Bin Wu
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Jianmo Liu
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
| | - Mengqi Han
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Yifan Wu
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Weijie Jia
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Pengfei Yu
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
| | - Rui Cheng
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Xiaoman Wang
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Jingyao Ke
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Hongfei Xian
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, China
| | - Jianglong Tu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China.
| | - Yingping Yi
- Department of Medical Big Data Research Centre, The Second Affiliated Hospital of Nanchang University, 1MinDe Road, Nanchang, 330006, P.R. China.
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3
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Tract-specific statistics based on diffusion-weighted probabilistic tractography. Commun Biol 2022; 5:138. [PMID: 35177755 PMCID: PMC8854429 DOI: 10.1038/s42003-022-03073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
Diffusion-weighted neuroimaging approaches provide rich evidence for estimating the structural integrity of white matter in vivo, but typically do not assess white matter integrity for connections between two specific regions of the brain. Here, we present a method for deriving tract-specific diffusion statistics, based upon predefined regions of interest. Our approach derives a population distribution using probabilistic tractography, based on the Nathan Kline Institute (NKI) Enhanced Rockland sample. We determine the most likely geometry of a path between two regions and express this as a spatial distribution. We then estimate the average orientation of streamlines traversing this path, at discrete distances along its trajectory, and the fraction of diffusion directed along this orientation for each participant. The resulting participant-wise metrics (tract-specific anisotropy; TSA) can then be used for statistical analysis on any comparable population. Based on this method, we report both negative and positive associations between age and TSA for two networks derived from published meta-analytic studies (the “default mode” and “what-where” networks), along with more moderate sex differences and age-by-sex interactions. The proposed method can be applied to any arbitrary set of brain regions, to estimate both the spatial trajectory and DWI-based anisotropy specific to those regions. Andrew Reid et al. use publicly available data to present a method for deriving tract-specific statistics based on diffusion-weighted MRI, based upon arbitrarily-defined regions of interest. Their approach enables them to report both negative and positive associations between age and tract-specific anisotropy along with more moderate sex differences and age-by-sex interactions.
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4
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Vipin A, Wong BYX, Kumar D, Low A, Ng KP, Kandiah N. Association between white matter hyperintensity load and grey matter atrophy in mild cognitive impairment is not unidirectional. Aging (Albany NY) 2021; 13:10973-10988. [PMID: 33861727 PMCID: PMC8109133 DOI: 10.18632/aging.202977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 12/23/2022]
Abstract
Neuroimaging measures of Alzheimer's disease (AD) include grey matter volume (GMV) alterations in the Default Mode Network (DMN) and Executive Control Network (ECN). Small-vessel cerebrovascular disease, often visualised as white matter hyperintensities (WMH) on MRI, is often seen in AD. However, the relationship between WMH load and GMV needs further examination. We examined the load-dependent influence of WMH on GMV and cognition in 183 subjects. T1-MRI data from 93 Mild Cognitive Impairment (MCI) and 90 cognitively normal subjects were studied and WMH load was categorized into low, medium and high terciles. We examined how differing loads of WMH related to whole-brain voxel-wise and regional DMN and ECN GMV. We further investigated how regional GMV moderated the relationship between WMH and cognition. We found differential load-dependent effects of WMH burden on voxel-wise and regional atrophy in only MCI. At high load, as expected WMH negatively related to both ECN and DMN GMV, however at low load, WMH positively related to ECN GMV. Additionally, negative associations between WMH and memory and executive function were moderated by regional GMV. Our results demonstrate non-unidirectional relationships between WMH load, GMV and cognition in MCI.
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Affiliation(s)
- Ashwati Vipin
- National Neuroscience Institute, Singapore, Singapore
| | | | - Dilip Kumar
- National Neuroscience Institute, Singapore, Singapore
| | - Audrey Low
- National Neuroscience Institute, Singapore, Singapore
| | - Kok Pin Ng
- National Neuroscience Institute, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian-Nanyang Technological University, Singapore, Singapore
| | - Nagaendran Kandiah
- National Neuroscience Institute, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian-Nanyang Technological University, Singapore, Singapore
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5
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Heinen R, Groeneveld ON, Barkhof F, de Bresser J, Exalto LG, Kuijf HJ, Prins ND, Scheltens P, van der Flier WM, Biessels GJ. Small vessel disease lesion type and brain atrophy: The role of co-occurring amyloid. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12060. [PMID: 32695872 PMCID: PMC7364862 DOI: 10.1002/dad2.12060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 12/05/2022]
Abstract
INTRODUCTION It is unknown whether different types of small vessel disease (SVD), differentially relate to brain atrophy and if co-occurring Alzheimer's disease pathology affects this relation. METHODS In 725 memory clinic patients with SVD (mean age 67 ± 8 years, 48% female) we compared brain volumes of those with moderate/severe white matter hyperintensities (WMHs; n = 326), lacunes (n = 132) and cerebral microbleeds (n = 321) to a reference group with mild WMHs (n = 197), also considering cerebrospinal fluid (CSF) amyloid status in a subset of patients (n = 488). RESULTS WMHs and lacunes, but not cerebral microbleeds, were associated with smaller gray matter (GM) volumes. In analyses stratified by CSF amyloid status, WMHs and lacunes were associated with smaller total brain and GM volumes only in amyloid-negative patients. SVD-related atrophy was most evident in frontal (cortical) GM, again predominantly in amyloid-negative patients. DISCUSSION Amyloid status modifies the differential relation between SVD lesion type and brain atrophy in memory clinic patients.
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Affiliation(s)
- Rutger Heinen
- Department of Neurology and NeurosurgeryUMC Utrecht Brain CenterUtrecht UniversityUtrechtthe Netherlands
| | - Onno N. Groeneveld
- Department of Neurology and NeurosurgeryUMC Utrecht Brain CenterUtrecht UniversityUtrechtthe Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear MedicineAmsterdam NeuroscienceVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Institutes of Neurology & Healthcare EngineeringUniversity College London (UCL)LondonUK
| | - Jeroen de Bresser
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Lieza G. Exalto
- Department of Neurology and NeurosurgeryUMC Utrecht Brain CenterUtrecht UniversityUtrechtthe Netherlands
| | - Hugo J. Kuijf
- Image Sciences InstituteUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Niels D. Prins
- Alzheimer Center & Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Brain Research CenterAmsterdamthe Netherlands
| | - Philip Scheltens
- Alzheimer Center & Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
- Brain Research CenterAmsterdamthe Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center & Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Geert Jan Biessels
- Department of Neurology and NeurosurgeryUMC Utrecht Brain CenterUtrecht UniversityUtrechtthe Netherlands
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6
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Ritchie SJ, Cox SR, Shen X, Lombardo MV, Reus LM, Alloza C, Harris MA, Alderson HL, Hunter S, Neilson E, Liewald DCM, Auyeung B, Whalley HC, Lawrie SM, Gale CR, Bastin ME, McIntosh AM, Deary IJ. Sex Differences in the Adult Human Brain: Evidence from 5216 UK Biobank Participants. Cereb Cortex 2019; 28:2959-2975. [PMID: 29771288 PMCID: PMC6041980 DOI: 10.1093/cercor/bhy109] [Citation(s) in RCA: 441] [Impact Index Per Article: 88.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/20/2018] [Indexed: 02/07/2023] Open
Abstract
Sex differences in the human brain are of interest for many reasons: for example, there are sex differences in the observed prevalence of psychiatric disorders and in some psychological traits that brain differences might help to explain. We report the largest single-sample study of structural and functional sex differences in the human brain (2750 female, 2466 male participants; mean age 61.7 years, range 44-77 years). Males had higher raw volumes, raw surface areas, and white matter fractional anisotropy; females had higher raw cortical thickness and higher white matter tract complexity. There was considerable distributional overlap between the sexes. Subregional differences were not fully attributable to differences in total volume, total surface area, mean cortical thickness, or height. There was generally greater male variance across the raw structural measures. Functional connectome organization showed stronger connectivity for males in unimodal sensorimotor cortices, and stronger connectivity for females in the default mode network. This large-scale study provides a foundation for attempts to understand the causes and consequences of sex differences in adult brain structure and function.
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Affiliation(s)
- Stuart J Ritchie
- Department of Psychology, The University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Department of Psychology, The University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
| | - Xueyi Shen
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Michael V Lombardo
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Lianne M Reus
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Clara Alloza
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Mathew A Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Helen L Alderson
- Department of Psychiatry, Queen Margaret Hospital, Dunfermline, UK
| | | | - Emma Neilson
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - David C M Liewald
- Department of Psychology, The University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
| | - Bonnie Auyeung
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | | | - Stephen M Lawrie
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Catharine R Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK.,Brain Research Imaging Centre, The University of Edinburgh, Edinburgh, UK.,Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Andrew M McIntosh
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK.,Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Department of Psychology, The University of Edinburgh, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, UK
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7
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Krongold M, Cooper C, Bray S. Modular Development of Cortical Gray Matter Across Childhood and Adolescence. Cereb Cortex 2018; 27:1125-1136. [PMID: 26656727 DOI: 10.1093/cercor/bhv307] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Brain maturation across childhood and adolescence is characterized by cortical thickness (CT) and volume contraction, and early expansion of surface area (SA). These processes occur asynchronously across the cortical surface, with functional, topographic, and network-based organizing principles proposed to account for developmental patterns. Characterizing regions undergoing synchronized development can help determine whether "maturational networks" overlap with well-described functional networks, and whether they are targeted by neurodevelopmental and psychiatric disorders. In the present study, we modeled changes with age in CT, SA, and volume from 335 typically developing subjects in the NIH MRI study of normal brain development, with 262 followed longitudinally for a total of 724 scans. Vertices showing similar maturation between 5 and 22 years were grouped together using data-driven clustering. Patterns of CT development distinguished sensory and motor regions from association regions, and were vastly different from SA patterns, which separated anterior from posterior regions. Developmental modules showed little similarity to networks derived from resting-state functional connectivity. Our findings present a novel perspective on maturational changes across the cortex, showing that several proposed organizing principles of cortical development co-exist, albeit in different structural parameters, and enable visualization of developmental trends occurring in parallel at remote cortical sites.
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Affiliation(s)
- Mark Krongold
- Child and Adolescent Imaging Research Program, Alberta Children's Hospital, Calgary, AB, Canada T3B 6A8.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada T3B 6A8.,Biomedical Engineering Graduate Program
| | - Cassandra Cooper
- Child and Adolescent Imaging Research Program, Alberta Children's Hospital, Calgary, AB, Canada T3B 6A8.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada T3B 6A8
| | - Signe Bray
- Child and Adolescent Imaging Research Program, Alberta Children's Hospital, Calgary, AB, Canada T3B 6A8.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada T3B 6A8.,Department of Radiology, Cumming School of Medicine.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada T2N 1N4
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8
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Schwarz NF, Nordstrom LK, Pagen LHG, Palombo DJ, Salat DH, Milberg WP, McGlinchey RE, Leritz EC. Differential associations of metabolic risk factors on cortical thickness in metabolic syndrome. NEUROIMAGE-CLINICAL 2017; 17:98-108. [PMID: 29062686 PMCID: PMC5641920 DOI: 10.1016/j.nicl.2017.09.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/31/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
Objective Metabolic syndrome (MetS) refers to a cluster of risk factors for cardiovascular disease, including obesity, hypertension, dyslipidemia, and hyperglycemia. While sizable prior literature has examined associations between individual risk factors and quantitative measures of cortical thickness (CT), only very limited research has investigated such measures in MetS. Furthermore, the relative contributions of these risk factors to MetS-related effects on brain morphology have not yet been studied. The primary goal of this investigation was to examine how MetS may affect CT. A secondary goal was to explore the relative contributions of individual risk factors to regional alterations in CT, with the potential to identify risk factor combinations that may underlie structural changes. Methods Eighteen participants with MetS (mean age = 59.78 years) were age-matched with 18 healthy control participants (mean age = 60.50 years). CT measures were generated from T1-weighted images and groups were contrasted using whole-brain general linear modeling. A follow-up multivariate partial least squares correlation (PLS) analysis, including the full study sample with complete risk factor measurements (N = 53), was employed to examine which risk factors account for variance in group structural differences. Results Participants with MetS demonstrated significantly reduced CT in left hemisphere inferior parietal, rostral middle frontal, and lateral occipital clusters and in a right hemisphere precentral cluster. The PLS analysis revealed that waist circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, and glucose were significant contributors to reduced CT in these clusters. In contrast, diastolic blood pressure showed a significantly positive association with CT while systolic blood pressure did not emerge as a significant contributor. Age was not associated with CT. Conclusion These results indicate that MetS can be associated with regionally specific reductions in CT. Importantly, a novel link between a risk factor profile comprising indices of obesity, hyperglycemia, dyslipidemia and diastolic BP and localized alterations in CT emerged. While the pathophysiological mechanisms underlying these associations remain incompletely understood, these findings may be relevant for future investigations of MetS and might have implications for treatment approaches that focus on specific risk factor profiles with the aim to reduce negative consequences on the structural integrity of the brain. Cortical thickness is reduced bilaterally in metabolic syndrome. Five out of six risk factor components contribute to altered cortical thickness. Particular risk factor combination may be an important target for intervention.
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Affiliation(s)
- Nicolette F Schwarz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Leslie K Nordstrom
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Linda H G Pagen
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Daniela J Palombo
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | - David H Salat
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; The Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - William P Milberg
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Regina E McGlinchey
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth C Leritz
- Neuroimaging Research for Veterans Center (NeRVe), Geriatric Research Education and Clinical Center (GRECC), Veterans Administration Boston Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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9
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Dani M, Brooks D, Edison P. Suspected non-Alzheimer's pathology - Is it non-Alzheimer's or non-amyloid? Ageing Res Rev 2017; 36:20-31. [PMID: 28235659 DOI: 10.1016/j.arr.2017.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/04/2017] [Accepted: 02/16/2017] [Indexed: 01/10/2023]
Abstract
Neurodegeneration, the progressive loss of neurons, is a major process involved in dementia and age-related cognitive impairment. It can be detected clinically using currently available biomarker tests. Suspected Non-Alzheimer Pathology (SNAP) is a biomarker-based concept that encompasses a group of individuals with neurodegeneration, but no evidence of amyloid deposition (thereby distinguishing it from Alzheimer's disease (AD)). These individuals may often have a clinical diagnosis of AD, but their clinical features, genetic susceptibility and progression can differ significantly, carrying crucial implications for precise diagnostics, clinical management, and efficacy of clinical drug trials. SNAP has caused wide interest in the dementia research community, because it is still unclear whether it represents distinct pathology separate from AD, or whether in some individuals, it could represent the earliest stage of AD. This debate has raised pertinent questions about the pathways to AD, the need for biomarkers, and the sensitivity of current biomarker tests. In this review, we discuss the biomarker and imaging trials that first recognized SNAP. We describe the pathological correlates of SNAP and comment on the different causes of neurodegeneration. Finally, we discuss the debate around the concept of SNAP, and further unanswered questions that are emerging.
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10
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Reijmer YD, Fotiadis P, Charidimou A, van Veluw SJ, Xiong L, Riley GA, Martinez-Ramirez S, Schwab K, Viswanathan A, Gurol ME, Greenberg SM. Relationship between white matter connectivity loss and cortical thinning in cerebral amyloid angiopathy. Hum Brain Mapp 2017; 38:3723-3731. [PMID: 28462514 DOI: 10.1002/hbm.23629] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/08/2017] [Accepted: 04/17/2017] [Indexed: 02/07/2023] Open
Abstract
Patients with cerebral amyloid angiopathy (CAA) show loss of white matter connectivity and cortical thinning on MRI, primarily in posterior brain regions. Here we examined whether a potential causal relationship exists between these markers of subcortical and cortical brain injury by examining whether changes in cortical thickness progress in tandem with changes in their underlying connections. Thirty-one patients with probable CAA with brain MRI at two time points were included (follow-up time: 1.3 ± 0.4 years). Brain networks were reconstructed using diffusion MRI-based fiber tractography. Of each network node, we calculated the change in fractional anisotropy-weighted connectivity strength over time and the change in cortical thickness. The association between change in connectivity strength and cortical thickness was assessed with (hierarchical) linear regression models. Our results showed that decline in posterior network connectivity over time was strongly related to thinning of the occipital cortex (β = 0.65 (0.35-0.94), P < 0.001), but not to thinning of the other posterior or frontal cortices. However, at the level of individual network nodes, we found no association between connectivity strength and cortical thinning of the corresponding node (β = 0.009 ± 0.04, P = 0.80). Associations were independent of age, sex, and other brain MRI markers of CAA. To conclude, CAA patients with greater progressive loss of posterior white matter connectivity also have greater progression of occipital cortical thinning, but our results do not support a direct causal relationship between them. The association can be better explained by a shared underlying mechanism, which may form a potential target for future treatments. Hum Brain Mapp 38:3723-3731, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Yael D Reijmer
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Neurology, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Panagiotis Fotiadis
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andreas Charidimou
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susanne J van Veluw
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Li Xiong
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Grace A Riley
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sergi Martinez-Ramirez
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kristin Schwab
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anand Viswanathan
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - M Edip Gurol
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven M Greenberg
- Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Diciotti S, Orsolini S, Salvadori E, Giorgio A, Toschi N, Ciulli S, Ginestroni A, Poggesi A, De Stefano N, Pantoni L, Inzitari D, Mascalchi M. Resting state fMRI regional homogeneity correlates with cognition measures in subcortical vascular cognitive impairment. J Neurol Sci 2017; 373:1-6. [DOI: 10.1016/j.jns.2016.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/19/2016] [Accepted: 12/02/2016] [Indexed: 02/03/2023]
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12
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Reid AT, Hoffstaedter F, Gong G, Laird AR, Fox P, Evans AC, Amunts K, Eickhoff SB. A seed-based cross-modal comparison of brain connectivity measures. Brain Struct Funct 2016; 222:1131-1151. [PMID: 27372336 DOI: 10.1007/s00429-016-1264-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022]
Abstract
Human neuroimaging methods have provided a number of means by which the connectivity structure of the human brain can be inferred. For instance, correlations in blood-oxygen-level-dependent (BOLD) signal time series are commonly used to make inferences about "functional connectivity." Correlations across samples in structural morphometric measures, such as voxel-based morphometry (VBM) or cortical thickness (CT), have also been used to estimate connectivity, putatively through mutually trophic effects on connected brain areas. In this study, we have compared seed-based connectivity estimates obtained from four common correlational approaches: resting-state functional connectivity (RS-fMRI), meta-analytic connectivity modeling (MACM), VBM correlations, and CT correlations. We found that the two functional approaches (RS-fMRI and MACM) had the best agreement. While the two structural approaches (CT and VBM) had better-than-random convergence, they were no more similar to each other than to the functional approaches. The degree of correspondence between modalities varied considerably across seed regions, and also depended on the threshold applied to the connectivity distribution. These results demonstrate some degrees of similarity between connectivity inferred from structural and functional covariances, particularly for the most robust functionally connected regions (e.g., the default mode network). However, they also caution that these measures likely capture very different aspects of brain structure and function.
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Affiliation(s)
- Andrew T Reid
- Institute for Neuroscience and Medicine (INM-1), Jülich Research Center, Wilhelm-Johnen-Straße, 52428, Jülich, Germany. .,Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands.
| | - Felix Hoffstaedter
- Institute for Neuroscience and Medicine (INM-1), Jülich Research Center, Wilhelm-Johnen-Straße, 52428, Jülich, Germany.,Department of Clinical Neuroscience and Medicine, Heinrich Heine University, Düsseldorf, Germany
| | - Gaolang Gong
- School of Brain and Cognitive Sciences, National Key Laboratory of Cognitive Neuroscience and Learning, Beijing, China
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Peter Fox
- University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA.,South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Alan C Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Katrin Amunts
- Institute for Neuroscience and Medicine (INM-1), Jülich Research Center, Wilhelm-Johnen-Straße, 52428, Jülich, Germany.,C. & O. Vogt Institute for Brain Research, Heinrich Heine University, Düsseldorf, Germany
| | - Simon B Eickhoff
- Institute for Neuroscience and Medicine (INM-1), Jülich Research Center, Wilhelm-Johnen-Straße, 52428, Jülich, Germany.,Department of Clinical Neuroscience and Medicine, Heinrich Heine University, Düsseldorf, Germany
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13
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Peres R, De Guio F, Chabriat H, Jouvent E. Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data. J Cereb Blood Flow Metab 2016; 36:681-95. [PMID: 26787108 PMCID: PMC4821027 DOI: 10.1177/0271678x15625352] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/10/2015] [Indexed: 11/16/2022]
Abstract
Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases.
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Affiliation(s)
- Roxane Peres
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France
| | - François De Guio
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France
| | - Hugues Chabriat
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hosp, F-75475 Paris, France
| | - Eric Jouvent
- Univ Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, Paris, France DHU NeuroVasc Sorbonne Paris Cité, Paris, France Department of Neurology, AP-HP, Lariboisière Hosp, F-75475 Paris, France
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14
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Cho EB, Shin HY, Park SE, Chun P, Jang HR, Yang JJ, Kim HJ, Kim YJ, Jung NY, Lee JS, Lee J, Jang YK, Jang EY, Kang M, Lee JM, Kim C, Min JH, Ryu S, Na DL, Seo SW. Albuminuria, Cerebrovascular Disease and Cortical Atrophy: among Cognitively Normal Elderly Individuals. Sci Rep 2016; 6:20692. [PMID: 26878913 PMCID: PMC4754729 DOI: 10.1038/srep20692] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 01/11/2016] [Indexed: 01/19/2023] Open
Abstract
We tested the hypothesis that decreased glomerular filtration rate and albuminuria have different roles in brain structure alterations. We enrolled 1,215 cognitively normal individuals, all of whom underwent high-resolution T1-weighted volumetric magnetic resonance imaging scans. The cerebral small vessel disease burdens were assessed with white matter hyperintensities (WMH), lacunes, and microbleeds. Subjects were considered to have an abnormally elevated urine albumin creatinine ratio if the value was ≥17 mg/g for men and ≥25 mg/g for women. Albuminuria, but not estimated glomerular filtration rate (eGFR), was associated with increased WMH burdens (p = 0.002). The data was analyzed after adjusting for age, sex, education, history of hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, stroke, total cholesterol level, body mass index, status of smoking and alcohol drinking, and intracranial volume. Albuminuria was also associated with cortical thinning, predominantly in the frontal and occipital regions (both p < 0.01) in multiple linear regression analysis. However, eGFR was not associated with cortical thickness. Furthermore, path analysis for cortical thickness showed that albuminuria was associated with frontal thinning partially mediated by WMH burdens. The assessment of albuminuria is needed to improve our ability to identify individuals with high risk for cognitive impairments, and further institute appropriate preventive measures.
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Affiliation(s)
- Eun Bin Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Neurology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Hee-Young Shin
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Eon Park
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Phillip Chun
- Department of Emergency Medicine Behavioral Emergencies Research Lab, San Diego, CA, USA
- Department of Biology, University of California San Diego, CA, USA
| | - Hye Ryoun Jang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin-ju Yang
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Na-Yeon Jung
- Department of Neurology, Pusan National University Hospital, Pusan National University College of Medicine and Biomedical Research Institute, Busan, Korea
| | - Jin San Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Juyoun Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Young Kyoung Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Eun Young Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Mira Kang
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine and the Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Korea
- Divison of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Ju-Hong Min
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
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15
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Lambert C, Sam Narean J, Benjamin P, Zeestraten E, Barrick TR, Markus HS. Characterising the grey matter correlates of leukoaraiosis in cerebral small vessel disease. Neuroimage Clin 2015; 9:194-205. [PMID: 26448913 PMCID: PMC4564392 DOI: 10.1016/j.nicl.2015.07.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 01/05/2023]
Abstract
Cerebral small vessel disease (SVD) is a heterogeneous group of pathological disorders that affect the small vessels of the brain and are an important cause of cognitive impairment. The ischaemic consequences of this disease can be detected using MRI, and include white matter hyperintensities (WMH), lacunar infarcts and microhaemorrhages. The relationship between SVD disease severity, as defined by WMH volume, in sporadic age-related SVD and cortical thickness has not been well defined. However, regional cortical thickness change would be expected due to associated phenomena such as underlying ischaemic white matter damage, and the observation that widespread cortical thinning is observed in the related genetic condition CADASIL (Righart et al., 2013). Using MRI data, we have developed a semi-automated processing pipeline for the anatomical analysis of individuals with cerebral small vessel disease and applied it cross-sectionally to 121 subjects diagnosed with this condition. Using a novel combined automated white matter lesion segmentation algorithm and lesion repair step, highly accurate warping to a group average template was achieved. The volume of white matter affected by WMH was calculated, and used as a covariate of interest in a voxel-based morphometry and voxel-based cortical thickness analysis. Additionally, Gaussian Process Regression (GPR) was used to assess if the severity of SVD, measured by WMH volume, could be predicted from the morphometry and cortical thickness measures. We found significant (Family Wise Error corrected p < 0.05) volumetric decline with increasing lesion load predominately in the parietal lobes, anterior insula and caudate nuclei bilaterally. Widespread significant cortical thinning was found bilaterally in the dorsolateral prefrontal, parietal and posterio-superior temporal cortices. These represent distinctive patterns of cortical thinning and volumetric reduction compared to ageing effects in the same cohort, which exhibited greater changes in the occipital and sensorimotor cortices. Using GPR, the absolute WMH volume could be significantly estimated from the grey matter density and cortical thickness maps (Pearson's coefficients 0.80 and 0.75 respectively). We demonstrate that SVD severity is associated with regional cortical thinning. Furthermore a quantitative measure of SVD severity (WMH volume) can be predicted from grey matter measures, supporting an association between white and grey matter damage. The pattern of cortical thinning and volumetric decline is distinctive for SVD severity compared to ageing. These results, taken together, suggest that there is a phenotypic pattern of atrophy associated with SVD severity.
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Affiliation(s)
- Christian Lambert
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Janakan Sam Narean
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Philip Benjamin
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Eva Zeestraten
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Thomas R. Barrick
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
| | - Hugh S. Markus
- Neurosciences Research Centre, Cardiovascular and Cell Sciences Research Institute, St George's University of London, United Kingdom
- Stroke Research Group, Division of Clinical Neurosciences, University of Cambridge, United Kingdom
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16
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Synergistic Effects of Age on Patterns of White and Gray Matter Volume across Childhood and Adolescence. eNeuro 2015; 2:eN-NWR-0003-15. [PMID: 26464999 PMCID: PMC4596017 DOI: 10.1523/eneuro.0003-15.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 03/25/2015] [Accepted: 04/30/2015] [Indexed: 12/21/2022] Open
Abstract
The human brain develops with a nonlinear contraction of gray matter across late childhood and adolescence with a concomitant increase in white matter volume. Across the adult population, properties of cortical gray matter covary within networks that may represent organizational units for development and degeneration. Although gray matter covariance may be strongest within structurally connected networks, the relationship to volume changes in white matter remains poorly characterized. In the present study we examined age-related trends in white and gray matter volume using T1-weighted MR images from 360 human participants from the NIH MRI study of Normal Brain Development. Images were processed through a voxel-based morphometry pipeline. Linear effects of age on white and gray matter volume were modeled within four age bins, spanning 4-18 years, each including 90 participants (45 male). White and gray matter age-slope maps were separately entered into k-means clustering to identify regions with similar age-related variability across the four age bins. Four white matter clusters were identified, each with a dominant direction of underlying fibers: anterior-posterior, left-right, and two clusters with superior-inferior directions. Corresponding, spatially proximal, gray matter clusters encompassed largely cerebellar, fronto-insular, posterior, and sensorimotor regions, respectively. Pairs of gray and white matter clusters followed parallel slope trajectories, with white matter changes generally positive from 8 years onward (indicating volume increases) and gray matter negative (decreases). As developmental disorders likely target networks rather than individual regions, characterizing typical coordination of white and gray matter development can provide a normative benchmark for understanding atypical development.
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17
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Tuladhar AM, Reid AT, Shumskaya E, de Laat KF, van Norden AGW, van Dijk EJ, Norris DG, de Leeuw FE. Relationship between white matter hyperintensities, cortical thickness, and cognition. Stroke 2015; 46:425-32. [PMID: 25572411 DOI: 10.1161/strokeaha.114.007146] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE White matter hyperintensities (WMH) are associated with clinically heterogeneous symptoms that cannot be explained by these lesions alone. It is hypothesized that these lesions are associated with distant cortical atrophy and cortical thickness network measures, which can result in an additional cognitive impairment. Here, we investigated the relationships between WMH, cortical thickness, and cognition in subjects with cerebral small vessel disease. METHODS A total of 426 subjects with cerebral small vessel disease were included, aged between 50 and 85 years, without dementia, and underwent MRI scanning. Cortical thickness analysis was performed, and WMH were manually segmented. Graph theory was applied to examine the relationship between network measures and WMH, and structural covariance matrices were constructed using inter-regional cortical thickness correlations. RESULTS Higher WMH load was related to lower cortical thickness in frontotemporal regions, whereas in paracentral regions, this was related to higher cortical thickness. Network analyses revealed that measures of network disruption were associated with WMH and cognitive performance. Furthermore, WMH in specific white matter tracts were related to regional-specific cortical thickness and network measures. Cognitive performances were related to cortical thickness in frontotemporal regions and network measures, and not to WMH, while controlling for cortical thickness. CONCLUSIONS These cross-sectional results suggest that cortical changes (regional-specific damage and network breakdown), mediated (in)directly by WMH (tract-specific damage) and other factors (eg, vascular risk factors), might lead to cognitive decline. These findings have implications in understanding the relationship between WMH, cortical morphology, and the possible attendant cognitive decline and eventually dementia.
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Affiliation(s)
- Anil M Tuladhar
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Andrew T Reid
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Elena Shumskaya
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Karlijn F de Laat
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Anouk G W van Norden
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Ewoud J van Dijk
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - David G Norris
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.)
| | - Frank-Erik de Leeuw
- From the Department of Neurology, Center for Neuroscience (A.M.T., A.G.W.v.N., E.J.v.D., F.-E.d.L.), Centre for Cognitive Neuroimaging (E.S., D.G.N.), Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Institute of Neuroscience and Medicine (INM-1), Research Center Julich, Julich, Germany (A.T.R.); Department of Neurology, HagaZiekenhuis Den Haag, Den Haag, The Netherlands (K.F.d.L.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Essen, Germany (D.G.N.); and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands (D.G.N.).
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Mattle HP, Brainin M, Chamorro A, Dichgans M, Lees KR, Leys D, Michel P. Second European Stroke Science Workshop. Stroke 2014; 45:e113-22. [DOI: 10.1161/strokeaha.114.005583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Heinrich P. Mattle
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Michael Brainin
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Angel Chamorro
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Martin Dichgans
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Kennedy R. Lees
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Didier Leys
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
| | - Patrik Michel
- From the Department of Neurology, Inselspital, University of Bern, Bern, Switzerland (H.P.M.); Department for Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria (M.B.); Institute of Neurosciences, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (A.C.); Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Munich,
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van Velsen EFS, Vernooij MW, Vrooman HA, van der Lugt A, Breteler MMB, Hofman A, Niessen WJ, Ikram MA. Brain cortical thickness in the general elderly population: the Rotterdam Scan Study. Neurosci Lett 2013; 550:189-94. [PMID: 23831346 DOI: 10.1016/j.neulet.2013.06.063] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 06/18/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
Abstract
Cortical thickness is considered a potentially relevant marker for neurodegenerative diseases. However, the relationship of demographic and vascular risk factors with cortical thickness remains unclear. In a population-based sample of 1022 non-demented elderly persons (mean age 68.4±7.3 years), we examined aging effects on global and lobar cortical thickness and the relationship with demographic variables and cardiovascular risk factors. We used a validated model-based approach to calculate mean cortical thickness (μm) in brain MR-images. We found that women had a significant thicker cortex than men (p<0.01). Further, with increasing age, cortical thickness decreased (approximately 0.2% per year), with the largest age effects for the occipital and temporal lobes, and the decrease in the frontal lobe being more apparent in men than in women (p-interaction<0.001). Additionally, higher education, higher diastolic blood pressure and larger intra-cranial volume were related to a larger cortical thickness, whilst diabetes mellitus and higher HDL cholesterol levels were related to a thinner cortex.
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Affiliation(s)
- Evert F S van Velsen
- Department of Epidemiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Righart R, Duering M, Gonik M, Jouvent E, Reyes S, Hervé D, Chabriat H, Dichgans M. Impact of regional cortical and subcortical changes on processing speed in cerebral small vessel disease. NEUROIMAGE-CLINICAL 2013; 2:854-61. [PMID: 24179837 PMCID: PMC3777834 DOI: 10.1016/j.nicl.2013.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/20/2013] [Accepted: 06/12/2013] [Indexed: 11/06/2022]
Abstract
Slowed processing speed is common in elderly subjects and frequently related to cerebral small vessel disease. Previous studies have demonstrated associations between processing speed and subcortical ischemic lesions as well as cortical alterations but the precise functional–anatomical relationships remain poorly understood. Here we assessed the impact of both cortical and subcortical changes on processing speed by measuring regional cortical thickness and regional lesion volumes within distinct white-matter tracts. To limit confounding effects from age-related pathologies we studied patients with CADASIL, a genetic small vessel disease. General linear model analysis revealed significant associations between cortical thickness in the medial frontal and occipito-temporal cortex and processing speed. Bayesian network analysis showed a robust conditional dependency between the volume of lacunar lesions in the left anterior thalamic radiation and cortical thickness of the left medial frontal cortex, and between thickness of the left medial frontal cortex and processing speed, whereas there was no direct dependency between lesion volumes in the left anterior thalamic radiation and processing speed. Our results suggest that the medial frontal cortex has an intermediate position between lacunar lesions in the anterior thalamic radiation and deficits in processing speed. In contrast, we did not observe such a relationship for the occipito-temporal region. These findings reinforce the key role of frontal–subcortical circuits in cognitive impairment resulting from cerebral small vessel disease. Slowed processing speed is a key feature of cerebral small vessel disease. Processing speed correlates with cortical thickness in frontal and occipital areas. Effects of ischemic lesions on processing speed are mediated by cortical changes.
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Affiliation(s)
- Ruthger Righart
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-University, 81377 Munich, Germany ; German Center for Neurodegenerative Diseases (DZNE, Munich), 80336 Munich, Germany
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Networks of anatomical covariance. Neuroimage 2013; 80:489-504. [PMID: 23711536 DOI: 10.1016/j.neuroimage.2013.05.054] [Citation(s) in RCA: 306] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 05/08/2013] [Accepted: 05/09/2013] [Indexed: 01/18/2023] Open
Abstract
Functional imaging or diffusion-weighted imaging techniques are widely used to understand brain connectivity at the systems level and its relation to normal neurodevelopment, cognition or brain disorders. It is also possible to extract information about brain connectivity from the covariance of morphological metrics derived from anatomical MRI. These covariance patterns may arise from genetic influences on normal development and aging, from mutual trophic reinforcement as well as from experience-related plasticity. This review describes the basic methodological strategies, the biological basis of the observed covariance as well as applications in normal brain and brain disease before a final review of future prospects for the technique.
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Okada R, Okada T, Okada A, Muramoto H, Katsuno M, Sobue G, Hamajima N. Severe brain atrophy in the elderly as a risk factor for lower respiratory tract infection. Clin Interv Aging 2012. [PMID: 23204841 PMCID: PMC3508559 DOI: 10.2147/cia.s36289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study is to determine whether elderly subjects with severe brain atrophy, which is associated with neurodegeneration and difficulty swallowing (dysphagia), are more susceptible to lower respiratory tract infections (LRTI), including pneumonia. METHODS The severity of brain atrophy was assessed by computed tomography in 51 nursing home residents aged 60-96 years. The incidence of LRTI, defined by body temperature ≥ 38.0°C, presence of two or more respiratory symptoms, and use of antibiotics, was determined over 4 years. The incidence of LRTI was compared according to the severity and type of brain atrophy. RESULTS The incidence rate ratio of LRTI was significantly higher (odds ratio 4.60, 95% confidence interval 1.18-17.93, fully adjusted P = 0.028) and the time to the first episode of LRTI was significantly shorter (log-rank test, P = 0.019) in subjects with severe brain atrophy in any lobe. Frontal and parietal lobe atrophy was associated with a significantly increased risk of LRTI, while temporal lobe atrophy, ventricular dilatation, and diffuse white matter lesions did not influence the risk of LRTI. CONCLUSION Elderly subjects with severe brain atrophy are more susceptible to LRTI, possibly as a result of neurodegeneration causing dysphagia and silent aspiration. Assessing the severity of brain atrophy might be useful to identify subjects at increased risk of respiratory infections in a prospective manner.
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Affiliation(s)
- Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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de Laat KF, Reid AT, Grim DC, Evans AC, Kötter R, van Norden AGW, de Leeuw FE. Cortical thickness is associated with gait disturbances in cerebral small vessel disease. Neuroimage 2011; 59:1478-84. [PMID: 21854857 DOI: 10.1016/j.neuroimage.2011.08.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 07/27/2011] [Accepted: 08/04/2011] [Indexed: 10/17/2022] Open
Abstract
Although gait disturbances are present in a substantial portion of patients with cerebral small vessel disease (SVD), their pathogenesis has not been clarified as they are not entirely explained by the white matter lesions (WMLs) and lacunar infarcts. The role of cortical thickness in these patients remains largely unknown. We aimed to assess the regions of cortical thickness associated with distinct gait parameters in patients with SVD, and whether these associations were dependent on WMLs and lacunar infarcts. MRI data were obtained from 415 subjects with SVD, aged between 50 and 85 years. We assessed cortical thickness using surface-based cortical thickness analysis, and gait performance using the GAITRite system. Cortical thickness of predominantly the orbitofrontal and ventrolateral prefrontal cortex, the inferior parietal lobe, cingulate areas and visual association cortices was positively related to stride length. Thickness of the primary and supplementary motor cortices and the cingulate cortex was positively related to cadence, while thickness of the orbitofrontal and ventrolateral prefrontal cortex, anterior cingulate cortex and especially the inferior parietal lobe and superior temporal gyrus was negatively related to stride width. The associations with stride length and width were partially explained by the subcortical WMLs and lacunar infarcts. Cortical thickness may therefore be important in gait disturbances in individuals with SVD, with different cortical patterns for specific gait parameters. We suggest that cortical atrophy is part of the disease processes in patients with SVD.
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Affiliation(s)
- Karlijn F de Laat
- Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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