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Meng Y, Wang S, Zhu W, Wang T, Liu D, Wang M, Pi J, Liu Y, Zhuo Z, Pan Y, Wang Y. Association of Mean Upper Cervical Spinal Cord Cross-Sectional Area With Cerebral Small Vessel Disease: A Community-Based Cohort Study. Stroke 2024; 55:687-695. [PMID: 38269540 DOI: 10.1161/strokeaha.123.044666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND The purpose of this study was to investigate the association between the mean upper cervical spinal cord cross-sectional area (MUCCA) and the risk and severity of cerebral small vessel disease (CSVD). METHODS Community-dwelling residents in Lishui City, China, from the cross-sectional survey in the PRECISE cohort study (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) conducted from 2017 to 2019. We included 1644 of 3067 community-dwelling adults in the PRECISE study after excluding those with incorrect, incomplete, insufficient, or missing clinical or imaging data. Total and modified total CSVD scores, as well as magnetic resonance imaging features, including white matter hyperintensity, lacunes, cerebral microbleeds, enlarged perivascular spaces, and brain atrophy, were assessed at the baseline. The Spinal Cord Toolbox was used to measure the upper cervical spinal cord cross-sectional area of the C1 to C3 segments of the spinal cord and its average value was taken as MUCCA. Participants were divided into 4 groups according to quartiles of MUCCA. Associations were analyzed using linear regression models adjusted for age, sex, current smoking and drinking, medical history, intracranial volume, and total cortical volume. RESULTS The means±SD age of the participants was 61.4±6.5 years, and 635 of 1644 participants (38.6%) were men. The MUCCA was smaller in patients with CSVD than those without CSVD. Using the total CSVD score as a criterion, the MUCCA was 61.78±6.12 cm2 in 504 of 1644 participants with CSVD and 62.74±5.94 cm2 in 1140 of 1644 participants without CSVD. Using the modified total CSVD score, the MUCCA was 61.81±6.04 cm2 in 699 of 1644 participants with CSVD and 62.91±5.94 cm2 in 945 of 1644 without CSVD. There were statistical differences between the 2 groups after adjusting for covariates in 3 models. The MUCCA was negatively associated with the total and modified total CSVD scores (adjusted β value, -0.009 [95% CI, -0.01 to -0.003] and -0.007 [95% CI, -0.01 to -0.0006]) after adjustment for covariates. Furthermore, the MUCCA was negatively associated with the white matter hyperintensity burden (adjusted β value, -0.01 [95% CI, -0.02 to -0.003]), enlarged perivascular spaces in the basal ganglia (adjusted β value, -0.005 [95% CI, -0.009 to -0.001]), lacunes (adjusted β value, -0.004 [95% CI, -0.007 to -0.0007]), and brain atrophy (adjusted β value, -0.009 [95% CI, -0.01 to -0.004]). CONCLUSIONS The MUCCA and CSVD were correlated. Spinal cord atrophy may serve as an imaging marker for CSVD; thus, small vessel disease may involve the spinal cord in addition to being intracranial.
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Affiliation(s)
- Yufei Meng
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, China (Y.M.)
| | - Suying Wang
- Department of Neurology and Cerebrovascular Research Laboratory, Lishui Central Hospital and Fifth Affiliated Hospital of Wenzhou Medical University, Zhejiang, China (S.W.)
| | - Wanlin Zhu
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
| | - Tingting Wang
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- China National Clinical Research Center for Neurological Diseases, Beijing (T.W., D.L., M.W., Y.P., Y.W.)
| | - Dandan Liu
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- China National Clinical Research Center for Neurological Diseases, Beijing (T.W., D.L., M.W., Y.P., Y.W.)
| | - Mengxing Wang
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- China National Clinical Research Center for Neurological Diseases, Beijing (T.W., D.L., M.W., Y.P., Y.W.)
| | - Jingtao Pi
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
| | - Yaou Liu
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
| | - Zhizheng Zhuo
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- China National Clinical Research Center for Neurological Diseases, Beijing (T.W., D.L., M.W., Y.P., Y.W.)
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital (Y.M., W.Z., T.W., D.L., M.W., J.P., Y.L., Z.Z., Y.P., Y.W.), Capital Medical University, China
- Advanced Innovation Center for Human Brain Protection (Y.W.), Capital Medical University, China
- Beijing Laboratory of Oral Health (Y.W.), Capital Medical University, China
- Chinese Institute for Brain Research, Beijing, China (Y.W.)
- National Center for Neurological Diseases, Beijing, China (Y.W.)
- China National Clinical Research Center for Neurological Diseases, Beijing (T.W., D.L., M.W., Y.P., Y.W.)
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Mu S, Lu W, Yu G, Zheng L, Qiu J. Deep learning-based grading of white matter hyperintensities enables identification of potential markers in multi-sequence MRI data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107904. [PMID: 37924768 DOI: 10.1016/j.cmpb.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND White matter hyperintensities (WMHs) are widely-seen in the aging population, which are associated with cerebrovascular risk factors and age-related cognitive decline. At present, structural atrophy and functional alterations coexisted with WMHs lacks comprehensive investigation. This study developed a WMHs risk prediction model to evaluate WHMs according to Fazekas scales, and to locate potential regions with high risks across the entire brain. METHODS We developed a WMHs risk prediction model, which consisted of the following steps: T2 fluid attenuated inversion recovery (T2-FLAIR) image of each participant was firstly segmented into 1000 tiles with the size of 32 × 32 × 1, features from the tiles were extracted using the ResNet18-based feature extractor, and then a 1D convolutional neural network (CNN) was used to score all tiles based on the extracted features. Finally, a multi-layer perceptron (MLP) was constructed to predict the Fazekas scales based on the tile scores. The proposed model was trained using T2-FLAIR images, we selected tiles with abnormal scores in the test set after prediction, and evaluated their corresponding gray matter (GM) volume, white matter (WM) volume, fractional anisotropy (FA), mean diffusivity (MD), and cerebral blood flow (CBF) via longitudinal and multi-sequence Magnetic Resonance Imaging (MRI) data analysis. RESULTS The proposed WMHs risk prediction model could accurately predict the Fazekas ratings based on the tile scores from T2-FLAIR MRI images with accuracy of 0.656, 0.621 in training data set and test set, respectively. The longitudinal MRI validation revealed that most of the high-risk tiles predicted by the WMHs risk prediction model in the baseline images had WMHs in the corresponding positions in the longitudinal images. The validation on multi-sequence MRI demonstrated that WMHs were associated with GM and WM atrophies, WM micro-structural and perfusion alterations in high-risk tiles, and multi-modal MRI measures of most high-risk tiles showed significant associations with Mini Mental State Examination (MMSE) score. CONCLUSION Our proposed WMHs risk prediction model can not only accurately evaluate WMH severities according to Fazekas scales, but can also uncover potential markers of WMHs across modalities. The WMHs risk prediction model has the potential to be used for the early detection of WMH-related alterations in the entire brain and WMH-induced cognitive decline.
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Affiliation(s)
- Si Mu
- College of Mechanical and Electronic Engineering, Shandong Agricultural University, Tai'an, Shandong, 271000, China
| | - Weizhao Lu
- Department of Radiology, the Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Guanghui Yu
- Department of Radiology, the Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, 271000, China
| | - Lei Zheng
- Department of Radiology, Rushan Hospital of Chinese Medicine, Rushan, Shandong, 264500, China.
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medicine Sciences, Tai'an, Shandong, 271000, China; Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250000, China.
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Mu R, Qin X, Zheng W, Yang P, Huang B, Li X, Liu F, Deng K, Zhu X. Amide proton transfer could be a surrogate imaging marker for predicting vascular cognitive impairment. Brain Res Bull 2023; 204:110793. [PMID: 37863439 DOI: 10.1016/j.brainresbull.2023.110793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/27/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUD Emerging evidence suggests an overlap in the underlying pathways contributing to both cerebral small vessel disease (CSVD) and the neurodegenerative disease. Studies investigating the progression of CSVD should incorporate markers that reflect neurodegenerative lesions. OBJECTIVE We aim to investigate whether Amide proton transfer (APT) can serve as a potential marker for reflecting vascular cognitive impairment (VCI). METHOD Participants were categorized into one of three groups based on their Montreal Cognitive Assessment (MoCA) scores: normal control group (age,54.9 ± 7.9; male, 52.9%), mild cognitive impairment (MCI) group (age,55.7 ± 6.9; male, 42.6%), or vascular dementia (VaD) group (age,57.6 ± 5.5, male, 58.5%). One way analysis of variance was performed to compare the demographic and APT variables between groups. Multiple logistic regression analysis wwas constructed to examine the relationship between APT values and VCI grouping. A hierarchical linear regression model was employed to examine the associations between patients' demographic factors, imaging markers, APT values, and MoCA. RESULTS The APT values of frontal white matter, hippocampus, amygdala, and thalamus were significantly different among different groups (p < 0.05). The APT values of frontal white matter, amygdala, and thalamus indicate a significant positive effect on MCI grouping. the APT values of frontal white matter, amygdala, and thalamus indicate a significant positive effect on VaD grouping. The demographic data, CSVD imaging markers and APT values can account for 5.1%, 20.1% and 27.7% of the variation in MoCA, respectively. CONCLUSION APT imaging can partially identifying and predicting the occurrence of VCI.
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Affiliation(s)
- Ronghua Mu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Xiaoyan Qin
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Wei Zheng
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Peng Yang
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Bingqin Huang
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China; Graduate School, Guilin Medical University, 541002 Guilin, China
| | - Xin Li
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Fuzhen Liu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China
| | - Kan Deng
- Philips (China) Investment Co., Ltd., Guangzhou Branch, 510000 Guangzhou, China
| | - Xiqi Zhu
- Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 541004 Guilin, China.
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Hua M, Ma AJ, Liu ZQ, Ji LL, Zhang J, Xu YF, Chen WY, Mao LL. Arteriolosclerosis CSVD: a common cause of dementia and stroke and its association with cognitive function and total MRI burden. Front Aging Neurosci 2023; 15:1163349. [PMID: 37520130 PMCID: PMC10375409 DOI: 10.3389/fnagi.2023.1163349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/26/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Arteriolosclerosis cerebral small vessel disease (CSVD) is a common type of CSVD. This study aimed to explore the factors associated with cognitive function and total MRI burden related to the disease. Methods The demographic characteristics, clinical manifestations, cognitive function score, Barthel Index (BI), blood test index, and follow-up results of arteriolosclerosis CSVD patients treated for the first time in our hospital from January 2014 to August 2022 were collected. White matter hyperintensity (WMH) Fazekas score, total MRI burden, and cerebral atrophy grade were evaluated according to brain MRI findings. Factors associated with CSVD cognitive function were analyzed by binary logistic regression. The correlative factors related to the total MRI burden of CSVD were analyzed by ordered multiple logistic regression. Results A total of 146 patients were included in this study, of which 132 cases (90.4%) had hypertension. There were 108 patients (74.0%) with cognitive dysfunction, 97 patients (66.4%) with balance and gait disorders, and 83 patients (56.8%) with moderate-to-severe dependence in daily life (BI ≤ 60 points). Of 146 patients, 79 (54.1%) completed clinical and imaging follow-ups for a median of 3 years. The number of patients with cognitive impairment and BI ≤ 60 points after follow-up significantly increased compared with the first admission (P < 0.001). There were also significant differences in total MRI burden (P = 0.001), WMH Fazekas score, and cerebral atrophy grade (P < 0.001). Mean age (P = 0.012), median deep WMH Fazekas score (P = 0.028), and median deep (P < 0.001) and superficial (P =0.002) cerebral atrophy grade of patients with cognitive impairment at first admission were all higher than those with non-cognitive impairment. Multivariate analysis showed that deep cerebral atrophy was independently and significantly associated with cognitive impairment of CSVD (P = 0.024), and hypertension was significantly and independently associated with total MRI burden (P = 0.001). Conclusion The disease course of arteriolosclerosis CSVD may be related to cognitive function and total MRI burden. Deep cerebral atrophy was an independent risk factor for cognitive dysfunction in arteriolosclerosis CSVD, and hypertension was an independent risk factor for total MRI burden.
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Affiliation(s)
| | | | | | | | | | | | - Wen-Ya Chen
- Department of Neurology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Lun-Lin Mao
- Department of Neurology, Wujin Hospital Affiliated to Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
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Cheng H, Teng J, Jia L, Xu L, Yang F, Li H, Ling C, Liu W, Li J, Li Y, Guo Z, Geng X, Guo J, Zhang D. Association between morphologic features of intracranial distal arteries and brain atrophy indexes in cerebral small vessel disease: a voxel-based morphometry study. Front Neurol 2023; 14:1198402. [PMID: 37396753 PMCID: PMC10313400 DOI: 10.3389/fneur.2023.1198402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/24/2023] [Indexed: 07/04/2023] Open
Abstract
Background Brain atrophy represents a final common pathway for pathological processes in patients with cerebral small vessel disease (CSVD) and is now recognized as a strong independent predictor of clinical status and progression. The mechanism underlying brain atrophy in patients with CSVD is not yet fully comprehended. This study aims to investigate the association of morphologic features of intracranial distal arteries (A2, M2, P2 and more distal) with different brain structures [gray matter volume (GMV), white matter volume (WMV), and cerebrospinal fluid volume (CSFV)]. Furthermore, we also examined whether a correlation existed between these cerebrovascular characteristics and GMV in different brain regions. Method A total of 39 participants were eventually enrolled. The morphologic features of intracranial distal arteries based on TOF-MRA were extracted and quantified using the intracranial artery feature extraction technique (iCafe). The brain 3D-T1 images were segmented into gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) using the "Segment" tool in CAT12 for the voxel-based morphometry (VBM) analysis. Univariable and multivariable linear regression models were used to investigate the relationship between these cerebrovascular features and different brain structures. Partial correlation analysis with a one-tailed method was used to evaluate the relationship between these cerebrovascular features and GMV in different brain regions. Results Our findings indicate that both distal artery length and density were positively correlated with GM fraction in CSVD patients, regardless of whether univariable or multivariable linear regression analyses were performed. In addition, distal artery length (β = -0.428, p = 0.007) and density (β = -0.337, p = 0.036) were also found to be negative associated with CSF fraction, although this relationship disappeared after adjusting for potential confounders. Additional adjustment for the effect of WMHs volume did not change these results. In subgroup anasysis, we found that participants in the highest distal artery length tertile had significantly higher GM fraction and lower CSF fraction level than participants in the lowest distal artery length tertile. In partial correlation analysis, we also found that these cerebrovascular characteristics associated with regional GMV, especially subcortical nuclear. Conclusion The morphologic features of intracranial distal arteries, including artery length, density and average tortuosity, measured from 3D-TOF MRA, are associated with generalized or focal atrophy indexes of CSVD.
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Affiliation(s)
- Hongjiang Cheng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Junfang Teng
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Longbin Jia
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Lina Xu
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Fengbing Yang
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Huimin Li
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Chen Ling
- Graduate School, Changzhi Medical College, Changzhi, Shanxi, China
| | - Wei Liu
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Jinna Li
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Yujuan Li
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Zixuan Guo
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Xia Geng
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Jiaying Guo
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
| | - Dandan Zhang
- Department of Neurology, Jincheng People’s Hospital, Jincheng, Shanxi, China
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Vipin A, Kumar D, Soo SA, Zailan FZ, Leow YJ, Koh CL, Ng ASL, Ng KP, Kandiah N. APOE4 carrier status determines association between white matter disease and grey matter atrophy in early-stage dementia. Alzheimers Res Ther 2023; 15:103. [PMID: 37270543 DOI: 10.1186/s13195-023-01251-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND White matter hyperintensities, a neuroimaging marker of small-vessel cerebrovascular disease and apolipoprotein ε4 (APOE4) allele, are important dementia risk factors. However, APOE4 as a key effect modifier in the relationship between white matter hyperintensities and grey matter volume needs further exploration. METHODS One hundred ninety-two early-stage dementia (including mild cognitive impairment and mild dementia) and 259 cognitively unimpaired participants from a neurocognitive research cohort with neuroimaging data, APOE genotyping, and neuropsychological assessments were studied. We investigated independent and interactive effects of white matter hyperintensities and APOE4 on whole-brain voxel-wise grey matter volume using voxel-based morphometry (uncorrected p < 0.001; minimum cluster size = 100 voxels). We further assessed interactive effects between APOE4 and white matter hyperintensities on global cognition, memory, and executive function in early-stage dementia and cognitively unimpaired participants. RESULTS Independent of APOE4 status, higher white matter hyperintensity load was associated with greater grey matter atrophy across frontal, parietal, temporal, and occipital lobes in cognitively unimpaired and early-stage dementia subjects. However, interaction analyses and independent sample analyses revealed that APOE4 non-carriers demonstrated greater white matter hyperintensity-associated grey matter atrophy compared to APOE4 carriers in both cognitively unimpaired and early-stage dementia groups. Additional confirmatory analyses among APOE4 non-carriers demonstrated that white matter hyperintensities resulted in widespread grey matter loss. Analyses of cognitive function demonstrated that higher white matter hyperintensity load was associated with worse global (Mini-Mental State Examination, Montreal Cognitive Assessment) and executive function (Color Trails 2) in APOE4 non-carriers compared to APOE4 carriers in early-stage dementia but not cognitively unimpaired participants. CONCLUSIONS The association between white matter hyperintensities and grey matter loss is more pronounced in APOE4 non-carriers than APOE4 carriers in the cognitively unimpaired and early-stage dementia stages. Furthermore, white matter hyperintensity presence results in poorer executive function in APOE4 non-carriers compared to APOE4 carriers. This finding may have significant impact on the design of clinical trials with disease modifying therapies.
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Grants
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
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Affiliation(s)
- Ashwati Vipin
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Dilip Kumar
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - See Ann Soo
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Fatin Zahra Zailan
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Yi Jin Leow
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Chen Ling Koh
- National Neuroscience Institute, Singapore, Singapore
| | - Adeline Su Lyn Ng
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Kok Pin Ng
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Nagaendran Kandiah
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore.
- National Neuroscience Institute, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Aribisala BS, Valdés Hernández MDC, Okely JA, Cox SR, Ballerini L, Dickie DA, Wiseman SJ, Riha RL, Muñoz Maniega S, Radakovic R, Taylor A, Pattie A, Corley J, Redmond P, Bastin ME, Deary I, Wardlaw JM. Sleep quality, perivascular spaces and brain health markers in ageing - A longitudinal study in the Lothian Birth Cohort 1936. Sleep Med 2023; 106:123-131. [PMID: 37005116 DOI: 10.1016/j.sleep.2023.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/07/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Sleep is thought to play a major role in brain health and general wellbeing. However, few longitudinal studies have explored the relationship between sleep habits and imaging markers of brain health, particularly markers of brain waste clearance such as perivascular spaces (PVS), of neurodegeneration such as brain atrophy, and of vascular disease, such as white matter hyperintensities (WMH). We explore these associations using data collected over 6 years from a birth cohort of older community-dwelling adults in their 70s. METHOD We analysed brain MRI data from ages 73, 76 and 79 years, and self-reported sleep duration, sleep quality and vascular risk factors from community-dwelling participants in the Lothian Birth Cohort 1936 (LBC1936) study. We calculated sleep efficiency (at age 76), quantified PVS burden (at age 73), and WMH and brain volumes (age 73 to 79), calculated the white matter damage metric, and used structural equation modelling (SEM) to explore associations and potential causative pathways between indicators related to brain waste cleaning (i.e., sleep and PVS burden), brain and WMH volume changes during the 8th decade of life. RESULTS Lower sleep efficiency was associated with a reduction in normal-appearing white matter (NAWM) volume (β = 0.204, P = 0.009) from ages 73 to 79, but not concurrent volume (i.e. age 76). Increased daytime sleep correlated with less night-time sleep (r = -0.20, P < 0.001), and with increasing white matter damage metric (β = -0.122, P = 0.018) and faster WMH growth (β = 0.116, P = 0.026). Shorter night-time sleep duration was associated with steeper 6-year reduction of NAWM volumes (β = 0.160, P = 0.011). High burden of PVS at age 73 (volume, count, and visual scores), was associated with faster deterioration in white matter: reduction of NAWM volume (β = -0.16, P = 0.012) and increasing white matter damage metric (β = 0.37, P < 0.001) between ages 73 and 79. On SEM, centrum semiovale PVS burden mediated 5% of the associations between sleep parameters and brain changes. CONCLUSION Sleep impairments, and higher PVS burden, a marker of impaired waste clearance, were associated with faster loss of healthy white matter and increasing WMH in the 8th decade of life. A small percentage of the effect of sleep in white matter health was mediated by the burden of PVS consistent with the proposed role for sleep in brain waste clearance.
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Affiliation(s)
- Benjamin S Aribisala
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Computer Science, Lagos State University, Lagos, Nigeria
| | - Maria Del C Valdés Hernández
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Judith A Okely
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Lucia Ballerini
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Stewart J Wiseman
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Renata L Riha
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Sleep Medicine, Royal Infirmary of Edinburgh, NHS Lothian, UK
| | - Susana Muñoz Maniega
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK
| | - Ratko Radakovic
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; Faculty of Health and Medical Sciences, University of East Anglia, Norwich, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Euan MacDonald Centre for MND Research, University of Edinburgh, Edinburgh, UK
| | - Adele Taylor
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Mark E Bastin
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian Deary
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute Centre at the University of Edinburgh, UK.
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Ellström K, Abul-Kasim K, Siennicki-Lantz A, Elmståhl S. Associations of carotid artery flow parameters with MRI markers of cerebral small vessel disease and patterns of brain atrophy. J Stroke Cerebrovasc Dis 2023; 32:106981. [PMID: 36657270 DOI: 10.1016/j.jstrokecerebrovasdis.2023.106981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES A growing body of evidence links age related brain pathologies to systemic vascular processes. We aimed to study the prevalence and interrelations between magnetic resonance imaging (MRI) markers of cerebral small vessel disease and patterns of brain atrophy, and their association to carotid duplex ultrasound flow parameters. MATERIALS AND METHODS We investigated a population based randomised cohort of older adults (n=391) aged 70-87, part of the Swedish Good Aging in Skåne Study. Peak systolic and end diastolic velocities of the carotid arteries were measured by ultrasound, and resistivity- and pulsatility indexes were calculated. Subjects with increased peak systolic velocity indicating carotid stenosis were excluded from analysis. Nine MRI findings were rated by visual scales: white matter changes, pontine white matter changes, microbleeds, lacunar infarctions, medial temporal lobe atrophy, global cortical atrophy, parietal atrophy, precuneus atrophy and central atrophy. RESULTS MRI pathologies were found in 80% of subjects. Mean end diastolic velocity in common carotid arteries was inversely associated with white matter hyperintensities (OR=0.92; p=0.004), parietal lobe atrophy (OR=0.94; p=0.039), global cortical atrophy (OR=0.90; p=0.013), precuneus atrophy (OR=0.94; p=0.022), "number of CSV pathologies" (β=-0.07; p<0.001) and "MRI-burden score" (β=-0.11; p<0.001), after adjustment for age and sex. The latter three were also associated with pulsatility and resistivity indexes. CONCLUSIONS Low carotid end diastolic velocity, as well as increased carotid resistivity and pulsatility, were associated with signs of cerebral small vessel disease and patterns of brain atrophy, indicating a vascular component in the process of brain aging.
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Affiliation(s)
- Katarina Ellström
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden.
| | - Kasim Abul-Kasim
- Department of Clinical Sciences Lund, Division of Diagnostic Radiology, Lund University, Sweden
| | - Arkadiusz Siennicki-Lantz
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Skåne University Hospital, Lund University, Jan Waldenströms gata 35, pl13, Malmö SE 205 02, Sweden
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Hazany S, Nguyen KL, Lee M, Zhang A, Mokhtar P, Crossley A, Luthra S, Butani P, Dergalust S, Ellingson B, Hinman JD. Regional Cerebral Small Vessel Disease (rCSVD) Score: A clinical MRI grading system validated in a stroke cohort. J Clin Neurosci 2022; 105:131-136. [PMID: 36183571 PMCID: PMC10163829 DOI: 10.1016/j.jocn.2022.09.014] [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: 07/27/2022] [Revised: 09/06/2022] [Accepted: 09/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Current methods for quantitative assessment of cerebral small vessel disease (CSVD) ignore critical aspects of the disease, namely lesion type and regionality. We developed and tested a new scoring system for CSVD, "regional Cerebral Small Vessel Disease" (rCSVD) based on regional assessment of magnetic resonance imaging (MRI) features. METHODS 141 patients were retrospectively included with a derivation cohort of 46 consecutive brain MRI exams and a validation cohort of 95 patients with known cerebrovascular disease. We compared the predictive value of rCSVD against existing scoring methods. We determined the predictive value of rCSVD score for all-cause mortality and recurrent strokes. RESULTS 46 (44 male) veteran patients (age: 66-93 years), were included for derivation of the rCSVD score. A non-overlapping validation cohort consisted of 95 patients (89 male; age: 34-91 years) with known cerebrovascular disease were enrolled. Based on ROC analysis with comparison of AUC (Area Under the Curve), "rCSVD" score performed better compared to "total SVD score" and Fazekas score for predicting all-cause mortality (0.75 vs 0.68 vs 0.69; p = 0.046). "rCSVD" and total SVD scores were predictive of recurrent strokes in our validation cohort (p-values 0.004 and 0.001). At a median of 5.1 years (range 2-17 years) follow-up, Kaplan-Meier survival analysis demonstrated an rCSVD score of 2 to be a significant predictor of all-cause-mortality. CONCLUSION "rCSVD" score can be derived from routine brain MRI, has value in risk stratification of patients at risk of CSVD, and has potential in clinical trials once fully validated in a larger patient cohort.
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Affiliation(s)
- Saman Hazany
- Department of Radiology, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, USA.
| | - Kim-Lien Nguyen
- Division of Cardiology and Radiology, VA Greater Los Angeles Healthcare System and David, Geffen School of Medicine at UCLA, USA
| | - Martin Lee
- Department of Biostatistics, Fielding School of Public Health at UCLA, USA
| | - Andrew Zhang
- Department of Radiology, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, USA
| | - Parsa Mokhtar
- Department of Psychobiology, University of California Los Angeles, USA
| | - Alexander Crossley
- Department of Neurology, VA Greater Los Angeles Healthcare System and David Geffen, School of Medicine at UCLA, USA
| | - Sakshi Luthra
- College of Letters and Sciences, University of California Los Angeles, USA
| | - Pooja Butani
- Department of Neurology, VA Greater Los Angeles Healthcare System and David Geffen, School of Medicine at UCLA, USA
| | - Sunita Dergalust
- Department of Pharmacy, VA Greater Los Angeles Healthcare System, USA
| | - Benjamin Ellingson
- Department of Radiology and Psychiatry, David Geffen School of Medicine at UCLA, USA
| | - Jason D Hinman
- Department of Neurology, VA Greater Los Angeles Healthcare System and David Geffen, School of Medicine at UCLA, USA
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Liu M, Li Q, Chen G, Su N, Zhou M, Liu X, Sun K. The value of mobile magnetic resonance imaging in early warning for stroke: A prospective case-control study. Front Neurosci 2022; 16:975217. [PMID: 36033625 PMCID: PMC9411978 DOI: 10.3389/fnins.2022.975217] [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: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Aims To evaluate the predictive value of mobile magnetic resonance imaging (MRI) in screening stroke. Methods This was a prospective case-control study performed on healthy residents over 40 years old in remote rural areas of northern China between May 2019 and May 2020. Multivariate logistic regression and receiver operator characteristic curve (ROC) analysis were used to evaluate the screening model. Results A total of 1,224 patients (500 [40.8%] men) enrolled, including 56 patients who suffered from stroke (aged 64.05 ± 7.27). The individuals who developed stroke were significantly older (P < 0.001), had a significantly higher occurrence of heart disease (P = 0.015), diabetes (P = 0.005), dyslipidemia (P = 0.009), and significantly increased waist circumference (P = 0.02), systolic blood pressure (SBP) (P = 0.003), glycosylated hemoglobin (HbA1c) level (P = 0.007), triglyceride (TG) level (P = 0.025), low density lipoprotein cholesterol (LDL-c) level (P = 0.04), and homocysteine (HCY) level (P < 0.001). Multivariate logistic regression analysis showed that age (OR = 1.055, 95% CI: 1.017–1.094, P = 0.004), HCY (OR = 1.029, 95% CI: 1.012–1.047, P = 0.001) and mobile MRI (OR = 4.539, 95% CI: 1.726–11.939, P = 0.002) were independently associated with stroke. The area under the curve (AUC) of the combined model including national screening criteria, mobile MRI results, and stroke risk factors was 0.786 (95% CI: 0.721–0.851), with a sensitivity of 69.6% and specificity of 80.4%. Conclusion Mobile MRI can be used as a simple and easy means to screen stroke.
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Affiliation(s)
- Miaomiao Liu
- The Third People’s Hospital of Longgang District, Shenzhen, China
- Graduate School of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Qingyang Li
- Department of Radiology, The First Clinical Medical College of Inner Mongolia Medical University, Huhhot, China
| | - Guoqiang Chen
- Department of Radiology, Baotou Central Hospital, Baotou, China
| | - Ning Su
- Department of Radiology, Baotou Central Hospital, Baotou, China
| | - Maorong Zhou
- Department of Radiology, Baotou Central Hospital, Baotou, China
| | - Xiaolin Liu
- Department of Radiology, Baotou Central Hospital, Baotou, China
| | - Kai Sun
- The Third People’s Hospital of Longgang District, Shenzhen, China
- *Correspondence: Kai Sun,
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11
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Su C, Yang X, Wei S, Zhao R. Association of Cerebral Small Vessel Disease With Gait and Balance Disorders. Front Aging Neurosci 2022; 14:834496. [PMID: 35875801 PMCID: PMC9305071 DOI: 10.3389/fnagi.2022.834496] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 06/14/2022] [Indexed: 12/27/2022] Open
Abstract
Cerebral small vessel disease (CSVD) is a common cerebrovascular disease and an important cause of gait and balance disorders. Gait and balance disorders can further lead to an increased risk of falls and a decreased quality of life. CSVD can damage gait and balance function by affecting cognitive function or directly disrupting motor pathways, and different CSVD imaging features have different characteristics of gait and balance impairment. In this article, the correlation between different imaging features of sporadic CSVD and gait and balance disorders has been reviewed as follows, which can provide beneficial help for standardized management of CSVD.
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12
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Abdominal Obesity: An Independent Influencing Factor of Visuospatial and Executive/Language Ability and the Serum Levels of Aβ40/Aβ42/Tau Protein. DISEASE MARKERS 2022; 2022:3622149. [PMID: 35401883 PMCID: PMC8993554 DOI: 10.1155/2022/3622149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/17/2022] [Indexed: 12/25/2022]
Abstract
Background Although obesity affects human health and cognitive function, the influence of abdominal obesity on cognitive function is still unclear. Methods The MoCA scale was used to evaluate the overall cognitive function and the function of each subitem of 196 subjects, as well as the SDMT and TMT-A scales for evaluating the attention and information processing speed. In addition, radioimmunoassay was used to detect the serum levels of Aβ40, Aβ42, and tau protein in 45 subjects. Subjects were divided into abdominal and nonabdominal obesity groups. Before and after correcting confounding factors, the differences in cognitive scale evaluation indexes and three protein levels between the two groups were compared. We also explore further the correlation between various cognitive abilities and the waist circumference/levels of the three proteins. Linear regression was used to identify the independent influencing factors of various cognitive functions and three protein levels. Results After correcting for multiple factors, we observed the lower scores of visuospatial function, execution, and language in the MoCA scale, as well as higher levels of Aβ40 and tau protein in the abdominal obesity group, supported by the results of correlation analysis. Abdominal obesity was identified as an independent negative influencing factor of MoCA visual space, executive power, and language scores and an independent positive influencing factor of Aβ40, Aβ42, and tau protein levels. Conclusion Abdominal obesity may play a negative role in visuospatial, executive ability, and language function and a positive role in the Aβ40, Aβ42, and tau protein serum levels.
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13
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Statsenko Y, Habuza T, Smetanina D, Simiyu GL, Uzianbaeva L, Neidl-Van Gorkom K, Zaki N, Charykova I, Al Koteesh J, Almansoori TM, Belghali M, Ljubisavljevic M. Brain Morphometry and Cognitive Performance in Normal Brain Aging: Age- and Sex-Related Structural and Functional Changes. Front Aging Neurosci 2022; 13:713680. [PMID: 35153713 PMCID: PMC8826453 DOI: 10.3389/fnagi.2021.713680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The human brain structure undergoes considerable changes throughout life. Cognitive function can be affected either negatively or positively. It is challenging to segregate normal brain aging from the accelerated one. OBJECTIVE To work out a descriptive model of brain structural and functional changes in normal aging. MATERIALS AND METHODS By using voxel-based morphometry and lesion segmentation along with linear statistics and machine learning (ML), we analyzed the structural changes in the major brain compartments and modeled the dynamics of neurofunctional performance throughout life. We studied sex differences in lifelong dynamics of brain volumetric data with Mann-Whitney U-test. We tested the hypothesis that performance in some cognitive domains might decline as a linear function of age while other domains might have a non-linear dependence on it. We compared the volumetric changes in the major brain compartments with the dynamics of psychophysiological performance in 4 age groups. Then, we tested linear models of structural and functional decline for significant differences between the slopes in age groups with the T-test. RESULTS White matter hyperintensities (WMH) are not the major structural determinant of the brain normal aging. They should be viewed as signs of a disease. There is a sex difference in the speed and/or in the onset of the gray matter atrophy. It either starts earlier or goes faster in males. Marked sex difference in the proportion of total cerebrospinal fluid (CSF) and intraventricular CSF (iCSF) justifies that elderly men are more prone to age-related brain atrophy than women of the same age. CONCLUSION The article gives an overview and description of the conceptual structural changes in the brain compartments. The obtained data justify distinct patterns of age-related changes in the cognitive functions. Cross-life slowing of decision-making may follow the linear tendency of enlargement of the interhemispheric fissure because the center of task switching and inhibitory control is allocated within the medial wall of the frontal cortex, and its atrophy accounts for the expansion of the fissure. Free online tool at https://med-predict.com illustrates the tests and study results.
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Affiliation(s)
- Yauhen Statsenko
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tetiana Habuza
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Darya Smetanina
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gillian Lylian Simiyu
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Liaisan Uzianbaeva
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Bronxcare Hospital System, Bronx, NY, United States
| | - Klaus Neidl-Van Gorkom
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nazar Zaki
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Inna Charykova
- Laboratory of Psychology, Republican Scientific-Practical Center of Sports, Minsk, Belarus
| | - Jamal Al Koteesh
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Radiology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Taleb M. Almansoori
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maroua Belghali
- Department of Health and Physical Education, College of Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Milos Ljubisavljevic
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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14
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Jochems ACC, Muñoz Maniega S, Del C Valdés Hernández M, Barclay G, Anblagan D, Ballerini L, Meijboom R, Wiseman S, Taylor AM, Corley J, Chappell FM, Backhouse EV, Stringer MS, Dickie DA, Bastin ME, Deary IJ, Cox SR, Wardlaw JM. Contribution of white matter hyperintensities to ventricular enlargement in older adults. Neuroimage Clin 2022; 34:103019. [PMID: 35490587 PMCID: PMC9062739 DOI: 10.1016/j.nicl.2022.103019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/24/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Lateral ventricles might increase due to generalized tissue loss related to brain atrophy. Alternatively, they may expand into areas of tissue loss related to white matter hyperintensities (WMH). We assessed longitudinal associations between lateral ventricle and WMH volumes, accounting for total brain volume, blood pressure, history of stroke, cardiovascular disease, diabetes and smoking at ages 73, 76 and 79, in participants from the Lothian Birth Cohort 1936, including MRI data from all available time points. Lateral ventricle volume increased steadily with age, WMH volume change was more variable. WMH volume decreased in 20% and increased in remaining subjects. Over 6 years, lateral ventricle volume increased by 3% per year of age, 0.1% per mm Hg increase in blood pressure, 3.2% per 1% decrease of total brain volume, and 4.5% per 1% increase of WMH volume. Over time, lateral ventricle volumes were 19% smaller in women than men. Ventricular and WMH volume changes are modestly associated and independent of general brain atrophy, suggesting that their underlying processes do not fully overlap.
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Affiliation(s)
- Angela C C Jochems
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - Susana Muñoz Maniega
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Maria Del C Valdés Hernández
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Gayle Barclay
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Devasuda Anblagan
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Lucia Ballerini
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Rozanna Meijboom
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Stewart Wiseman
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Francesca M Chappell
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ellen V Backhouse
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Michael S Stringer
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK
| | - David Alexander Dickie
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, UK
| | - Mark E Bastin
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts Group, The University of Edinburgh, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at the University of Edinburgh, Edinburgh, UK; Lothian Birth Cohorts Group, The University of Edinburgh, UK.
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15
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Backhouse EV, Shenkin SD, McIntosh AM, Bastin ME, Whalley HC, Valdez Hernandez M, Muñoz Maniega S, Harris MA, Stolicyn A, Campbell A, Steele D, Waiter GD, Sandu AL, Waymont JMJ, Murray AD, Cox SR, de Rooij SR, Roseboom TJ, Wardlaw JM. Early life predictors of late life cerebral small vessel disease in four prospective cohort studies. Brain 2021; 144:3769-3778. [PMID: 34581779 PMCID: PMC8719837 DOI: 10.1093/brain/awab331] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/12/2021] [Accepted: 07/07/2021] [Indexed: 11/12/2022] Open
Abstract
Development of cerebral small vessel disease, a major cause of stroke and dementia, may be influenced by early life factors. It is unclear whether these relationships are independent of each other, of adult socio-economic status or of vascular risk factor exposures. We examined associations between factors from birth (ponderal index, birth weight), childhood (IQ, education, socio-economic status), adult small vessel disease, and brain volumes, using data from four prospective cohort studies: STratifying Resilience And Depression Longitudinally (STRADL) (n = 1080; mean age = 59 years); the Dutch Famine Birth Cohort (n = 118; mean age = 68 years); the Lothian Birth Cohort 1936 (LBC1936; n = 617; mean age = 73 years), and the Simpson's cohort (n = 110; mean age = 78 years). We analysed each small vessel disease feature individually and summed to give a total small vessel disease score (range 1-4) in each cohort separately, then in meta-analysis, adjusted for vascular risk factors and adult socio-economic status. Higher birth weight was associated with fewer lacunes [odds ratio (OR) per 100 g = 0.93, 95% confidence interval (CI) = 0.88 to 0.99], fewer infarcts (OR = 0.94, 95% CI = 0.89 to 0.99), and fewer perivascular spaces (OR = 0.95, 95% CI = 0.91 to 0.99). Higher childhood IQ was associated with lower white matter hyperintensity burden (OR per IQ point = 0.99, 95% CI 0.98 to 0.998), fewer infarcts (OR = 0.98, 95% CI = 0.97 to 0.998), fewer lacunes (OR = 0.98, 95% CI = 0.97 to 0.999), and lower total small vessel disease burden (OR = 0.98, 95% CI = 0.96 to 0.999). Low education was associated with more microbleeds (OR = 1.90, 95% CI = 1.33 to 2.72) and lower total brain volume (mean difference = -178.86 cm3, 95% CI = -325.07 to -32.66). Low childhood socio-economic status was associated with fewer lacunes (OR = 0.62, 95% CI = 0.40 to 0.95). Early life factors are associated with worse small vessel disease in later life, independent of each other, vascular risk factors and adult socio-economic status. Risk for small vessel disease may originate in early life and provide a mechanistic link between early life factors and risk of stroke and dementia. Policies investing in early child development may improve lifelong brain health and contribute to the prevention of dementia and stroke in older age.
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Affiliation(s)
- Ellen V Backhouse
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- MRC UK Dementia Research Institute at the University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Susan D Shenkin
- Geriatric Medicine, Usher Institute, The University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Mark E Bastin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Institute of Neuroscience and Psychology, Glasgow G12 8QB, UK
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Heather C Whalley
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Maria Valdez Hernandez
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Institute of Neuroscience and Psychology, Glasgow G12 8QB, UK
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Susana Muñoz Maniega
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Institute of Neuroscience and Psychology, Glasgow G12 8QB, UK
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - Mathew A Harris
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Aleks Stolicyn
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Archie Campbell
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - Douglas Steele
- Division of Imaging Sciences and Technology, Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Anca-Larisa Sandu
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Jennifer M J Waymont
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Institute of Neuroscience and Psychology, Glasgow G12 8QB, UK
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Simon R Cox
- Lothian Birth Cohorts Group, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Susanne R de Rooij
- Department of Epidemiology and Data Science, Amsterdam University, Medical Centres, University of Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Epidemiology and Data Science, Amsterdam University, Medical Centres, University of Amsterdam, The Netherlands
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- MRC UK Dementia Research Institute at the University of Edinburgh, Edinburgh, EH16 4SB, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE), Institute of Neuroscience and Psychology, Glasgow G12 8QB, UK
- Brain Research Imaging Centre, Division of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4TJ, UK
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Narasimhan M, Schwartz R, Halliday G. Parkinsonism and cerebrovascular disease. J Neurol Sci 2021; 433:120011. [PMID: 34686356 DOI: 10.1016/j.jns.2021.120011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 11/27/2022]
Abstract
The relationship between cerebrovascular disease and parkinsonism is commonly seen in everyday clinical practice but remains ill-defined and under-recognised with little guidance for the practising neurologist. We attempt to define this association and to illustrate key clinical, radiological and pathological features of the syndrome of Vascular Parkinsonism (VaP). VaP is a major cause of morbidity in the elderly associated with falls, hip fractures and cognitive impairment. Although acute parkinsonism is reported in the context of an acute cerebrovascular event, the vast majority of VaP presents as an insidious syndrome usually in the context of vascular risk factors and radiological evidence of small vessel disease. There may be an anatomic impact on basal ganglia neuronal networks, however the effect of small vessel disease (SVD) on these pathways is not clear. There are now established reporting standards for radiological features of SVD on MRI. White matter hyperintensities and lacunes have been thought to be the representative radiological features of SVD but other features such as the perivascular space are gaining more importance, especially in context of the glymphatic system. It is important to consider VaP in the differential diagnosis of Parkinson disease (PD) and in these situations, neuroimaging may offer diagnostic benefit especially in those patients with atypical presentations or refractoriness to levodopa. Proactive management of vascular risk factors, monitoring of bone density and an exercise program may offer easily attainable therapeutic targets in PD and VaP. Levodopa therapy should be considered in patients with VaP, however the dose and effect may be different from use in PD. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Manisha Narasimhan
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Raymond Schwartz
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Glenda Halliday
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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17
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Lecordier S, Manrique-Castano D, El Moghrabi Y, ElAli A. Neurovascular Alterations in Vascular Dementia: Emphasis on Risk Factors. Front Aging Neurosci 2021; 13:727590. [PMID: 34566627 PMCID: PMC8461067 DOI: 10.3389/fnagi.2021.727590] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/05/2021] [Indexed: 12/25/2022] Open
Abstract
Vascular dementia (VaD) constitutes the second most prevalent cause of dementia in the world after Alzheimer’s disease (AD). VaD regroups heterogeneous neurological conditions in which the decline of cognitive functions, including executive functions, is associated with structural and functional alterations in the cerebral vasculature. Among these cerebrovascular disorders, major stroke, and cerebral small vessel disease (cSVD) constitute the major risk factors for VaD. These conditions alter neurovascular functions leading to blood-brain barrier (BBB) deregulation, neurovascular coupling dysfunction, and inflammation. Accumulation of neurovascular impairments over time underlies the cognitive function decline associated with VaD. Furthermore, several vascular risk factors, such as hypertension, obesity, and diabetes have been shown to exacerbate neurovascular impairments and thus increase VaD prevalence. Importantly, air pollution constitutes an underestimated risk factor that triggers vascular dysfunction via inflammation and oxidative stress. The review summarizes the current knowledge related to the pathological mechanisms linking neurovascular impairments associated with stroke, cSVD, and vascular risk factors with a particular emphasis on air pollution, to VaD etiology and progression. Furthermore, the review discusses the major challenges to fully elucidate the pathobiology of VaD, as well as research directions to outline new therapeutic interventions.
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Affiliation(s)
- Sarah Lecordier
- Neuroscience Axis, Research Center of CHU de Québec-Université Laval, Québec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec City, QC, Canada
| | - Daniel Manrique-Castano
- Neuroscience Axis, Research Center of CHU de Québec-Université Laval, Québec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec City, QC, Canada
| | - Yara El Moghrabi
- Neuroscience Axis, Research Center of CHU de Québec-Université Laval, Québec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec City, QC, Canada
| | - Ayman ElAli
- Neuroscience Axis, Research Center of CHU de Québec-Université Laval, Québec City, QC, Canada.,Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec City, QC, Canada
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18
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Morys F, Dadar M, Dagher A. Association Between Midlife Obesity and Its Metabolic Consequences, Cerebrovascular Disease, and Cognitive Decline. J Clin Endocrinol Metab 2021; 106:e4260-e4274. [PMID: 33677592 PMCID: PMC8475210 DOI: 10.1210/clinem/dgab135] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Indexed: 01/08/2023]
Abstract
CONTEXT Chronic obesity is associated with several complications, including cognitive impairment and dementia. However, we have only piecemeal knowledge of the mechanisms linking obesity to central nervous system damage. Among candidate mechanisms are other elements of obesity-associated metabolic syndrome, such as hypertension, dyslipidemia, and diabetes, but also systemic inflammation. While there have been several neuroimaging studies linking adiposity to changes in brain morphometry, a comprehensive investigation of the relationship has so far not been done. OBJECTIVE To identify links between adiposity and cognitive dysfunction. METHODS This observational cohort study (UK Biobank), with an 8-year follow-up, included more than 20 000 participants from the general community, with a mean age of 63 years. Only participants with data available on both baseline and follow-up timepoints were included. The main outcome measures were cognitive performance and mediator variables: hypertension, diabetes, systemic inflammation, dyslipidemia, gray matter measures, and cerebrovascular disease (volume of white matter hyperintensities on magnetic resonance imaging). RESULTS Using structural equation modeling, we found that body mass index, waist-to-hip ratio, and body fat percentage were positively related to higher plasma C-reactive protein, dyslipidemia, hypertension, and diabetes. In turn, hypertension and diabetes were related to cerebrovascular disease. Finally, cerebrovascular disease was associated with lower cortical thickness and volume and higher subcortical volumes, but also cognitive deficits (largest significant pcorrected = 0.02). CONCLUSIONS We show that adiposity is related to poor cognition, with metabolic consequences of obesity and cerebrovascular disease as potential mediators. The outcomes have clinical implications, supporting a role for the management of adiposity in the prevention of late-life dementia and cognitive decline.
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Affiliation(s)
- Filip Morys
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
- Correspondence: Filip Morys, Ph.D., Université McGill, 3801 University Street, H3A 2B4 Montreal, Canada.
| | - Mahsa Dadar
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Québec, Canada
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada
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19
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Evans LE, Taylor JL, Smith CJ, Pritchard HAT, Greenstein AS, Allan SM. Cardiovascular co-morbidities, inflammation and cerebral small vessel disease. Cardiovasc Res 2021; 117:2575-2588. [PMID: 34499123 DOI: 10.1093/cvr/cvab284] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
Cerebral small vessel disease (cSVD) is the most common cause of vascular cognitive impairment and affects all levels of the brain's vasculature. Features include diverse structural and functional changes affecting small arteries and capillaries that lead to a decline in cerebral perfusion. Due to an aging population, incidence of cerebral small vessel disease (cSVD) is continually rising. Despite its prevalence and its ability to cause multiple debilitating illnesses, such as stroke and dementia, there are currently no therapeutic strategies for the treatment of cSVD. In the healthy brain, interactions between neuronal, vascular and inflammatory cells are required for normal functioning. When these interactions are disturbed, chronic pathological inflammation can ensue. The interplay between cSVD and inflammation has attracted much recent interest and this review discusses chronic cardiovascular diseases, particularly hypertension, and explores how the associated inflammation may impact on the structure and function of the small arteries of the brain in cSVD. Molecular approaches in animal studies are linked to clinical outcomes in patients and novel hypotheses regarding inflammation and cSVD are proposed that will hopefully stimulate further discussion and study in this important area.
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Affiliation(s)
- Lowri E Evans
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Jade L Taylor
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Craig J Smith
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.,Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal Hospital, Manchester Academic Health Sciences Centre (MAHSC)
| | - Harry A T Pritchard
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Adam S Greenstein
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Stuart M Allan
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK.,Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
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20
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Bretzner M, Bonkhoff AK, Schirmer MD, Hong S, Dalca AV, Donahue KL, Giese AK, Etherton MR, Rist PM, Nardin M, Marinescu R, Wang C, Regenhardt RW, Leclerc X, Lopes R, Benavente OR, Cole JW, Donatti A, Griessenauer CJ, Heitsch L, Holmegaard L, Jood K, Jimenez-Conde J, Kittner SJ, Lemmens R, Levi CR, McArdle PF, McDonough CW, Meschia JF, Phuah CL, Rolfs A, Ropele S, Rosand J, Roquer J, Rundek T, Sacco RL, Schmidt R, Sharma P, Slowik A, Sousa A, Stanne TM, Strbian D, Tatlisumak T, Thijs V, Vagal A, Wasselius J, Woo D, Wu O, Zand R, Worrall BB, Maguire JM, Lindgren A, Jern C, Golland P, Kuchcinski G, Rost NS. MRI Radiomic Signature of White Matter Hyperintensities Is Associated With Clinical Phenotypes. Front Neurosci 2021; 15:691244. [PMID: 34321995 PMCID: PMC8312571 DOI: 10.3389/fnins.2021.691244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Neuroimaging measurements of brain structural integrity are thought to be surrogates for brain health, but precise assessments require dedicated advanced image acquisitions. By means of quantitatively describing conventional images, radiomic analyses hold potential for evaluating brain health. We sought to: (1) evaluate radiomics to assess brain structural integrity by predicting white matter hyperintensities burdens (WMH) and (2) uncover associations between predictive radiomic features and clinical phenotypes. METHODS We analyzed a multi-site cohort of 4,163 acute ischemic strokes (AIS) patients with T2-FLAIR MR images with total brain and WMH segmentations. Radiomic features were extracted from normal-appearing brain tissue (brain mask-WMH mask). Radiomics-based prediction of personalized WMH burden was done using ElasticNet linear regression. We built a radiomic signature of WMH with stable selected features predictive of WMH burden and then related this signature to clinical variables using canonical correlation analysis (CCA). RESULTS Radiomic features were predictive of WMH burden (R 2 = 0.855 ± 0.011). Seven pairs of canonical variates (CV) significantly correlated the radiomics signature of WMH and clinical traits with respective canonical correlations of 0.81, 0.65, 0.42, 0.24, 0.20, 0.15, and 0.15 (FDR-corrected p-values CV 1 - 6 < 0.001, p-value CV 7 = 0.012). The clinical CV1 was mainly influenced by age, CV2 by sex, CV3 by history of smoking and diabetes, CV4 by hypertension, CV5 by atrial fibrillation (AF) and diabetes, CV6 by coronary artery disease (CAD), and CV7 by CAD and diabetes. CONCLUSION Radiomics extracted from T2-FLAIR images of AIS patients capture microstructural damage of the cerebral parenchyma and correlate with clinical phenotypes, suggesting different radiographical textural abnormalities per cardiovascular risk profile. Further research could evaluate radiomics to predict the progression of WMH and for the follow-up of stroke patients' brain health.
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Affiliation(s)
- Martin Bretzner
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
- Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Anna K. Bonkhoff
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Markus D. Schirmer
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Sungmin Hong
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Adrian V. Dalca
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Kathleen L. Donahue
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Anne-Katrin Giese
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Mark R. Etherton
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Pamela M. Rist
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Marco Nardin
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Razvan Marinescu
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Clinton Wang
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Robert W. Regenhardt
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
| | - Xavier Leclerc
- Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Renaud Lopes
- Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences and Cognition, University of Lille, Lille, France
- CNRS, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, Lille, France
| | - Oscar R. Benavente
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - John W. Cole
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States
| | - Amanda Donatti
- School of Medical Sciences, University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, Brazil
| | - Christoph J. Griessenauer
- Department of Neurosurgery, Geisinger, Danville, PA, United States
- Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Laura Heitsch
- Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States
- Department of Neurology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, MO, United States
| | - Lukas Holmegaard
- Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jordi Jimenez-Conde
- Department of Neurology, Neurovascular Research Group (NEUVAS), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Steven J. Kittner
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven – University of Leuven, Leuven, Belgium
- VIB, Vesalius Research Center, Laboratory of Neurobiology, Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Christopher R. Levi
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Department of Neurology, John Hunter Hospital, Newcastle, NSW, Australia
| | - Patrick F. McArdle
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Caitrin W. McDonough
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL, United States
| | - James F. Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
| | - Chia-Ling Phuah
- Department of Neurology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, MO, United States
| | | | - Stefan Ropele
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University of Graz, Graz, Austria
| | - Jonathan Rosand
- Henry and Allison McCance Center for Brain Health, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Jaume Roquer
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Tatjana Rundek
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Ralph L. Sacco
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Reinhold Schmidt
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University of Graz, Graz, Austria
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL), Egham, United Kingdom
- Ashford and St. Peter’s Hospitals, Chertsey and Ashford, United Kingdom
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Alessandro Sousa
- Department of Neurology, University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD, United States
| | - Tara M. Stanne
- Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Strbian
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Turgut Tatlisumak
- Department of Clinica Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Department of Neurology Austin Health, Heidelberg, VIC, Australia
| | - Achala Vagal
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Johan Wasselius
- Department of Clinical Sciences Lund, Radiology, Lund University, Lund, Sweden
- Department of Radiology, Neuroradiology, Skåne University Hospital, Malmö, Sweden
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Ona Wu
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ramin Zand
- Department of Neurology, Geisinger, Danville, PA, United States
| | - Bradford B. Worrall
- Department of Neurology and Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Jane M. Maguire
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Arne Lindgren
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden
| | - Christina Jern
- Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Polina Golland
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Grégory Kuchcinski
- Inserm, CHU Lille, U1172 - LilNCog (JPARC) - Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Natalia S. Rost
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States
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Hsu YH, Liang CK, Chou MY, Wang YC, Liao MC, Chang WC, Hsiao CC, Lai PH, Lin YT. Sarcopenia is independently associated with parietal atrophy in older adults. Exp Gerontol 2021; 151:111402. [PMID: 33984449 DOI: 10.1016/j.exger.2021.111402] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/05/2021] [Accepted: 05/05/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION As populations age, sarcopenia becomes a major health problem among adults aged 65 years and older. However, little information is available about the relationship between sarcopenia and brain structure abnormalities. The objective of this study was to investigate associations between sarcopenia and brain atrophy in older adults and relationships with regional brain areas. METHODS This prospective cohort study recruited 102 retirement community residents aged 65 years and older. All participants underwent gait speed measurement, handgrip strength measurement and muscle mass measurement by dual X-ray absorptiometry. Diagnosis of sarcopenia was made according to criteria of the Asian Working Group for Sarcopenia (AWGSOP). All patients underwent magnetic resonance imaging (MRI), and images were analysed for global cortical atrophy (GCA) (range 0-3), parietal atrophy (PA) (range 0-3) and medial temporal atrophy (MTA) (range 0-4). RESULTS Among 102 older adult participants (81.4 ± 8.2 years), 47 (46.1%) were diagnosed with sarcopenia according to AWGSOP criteria. The sarcopenia group had more moderate to severe PA (Grade 2: 19.1% vs. 5.5%; grade 3:6.4% vs. 0%, P = 0.016) and GCA (Grade 2: 40.4% vs. 18.2%, P = 0.003) and a trend of more moderate to severe MTA (Grade 2: 46.8% vs. 30.9%; grade 3: 8.5% vs. 1.8%, P = 0.098) than the non-sarcopenia group. In univariate logistic regression, sarcopenia was significantly associated with PA (OR 5.94, 95% CI 1.56-22.60, P = 0.009), GCA (OR 3.05, 95% CI 1.24-7.51, P = 0.015), and MTA (OR 2.55, 95% CI 1.14-5.69, P = 0.023). In multivariable logistic regression analysis, sarcopenia was an independent risk factor for PA (adjusted OR 6.90, 95% CI 1.30-36.47, P = 0.023). After adjusting for all covariates, only age had a significant relationship with GCA (Adjusted OR 1.09, 95% CI 1.00-1.19, P = 0.044) and MTA (Adjusted OR 1.09, 95% CI 1.01-1.17, P = 0.022). CONCLUSIONS This is the first study to explore associations between sarcopenia and global as well as regional brain atrophy in older adults. The sarcopenia group had higher rates of moderate to severe PA, GCA and MTA than the non-sarcopenia group. PA was significantly associated with sarcopenia in older adults. Further longitudinal studies are needed to address the mechanism and pathogenesis of brain atrophy and sarcopenia.
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Affiliation(s)
- Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Taiwan
| | - Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Cheng Chang
- Division of Metabolism and Endocrinology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chia-Chi Hsiao
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan
| | - Ping-Hong Lai
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan; Faculty of National Yang-Ming University School of Medicine, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Pharmacy, Tajen University, Pingtung, Taiwan.
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22
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DiGregorio J, Arezza G, Gibicar A, Moody AR, Tyrrell PN, Khademi A. Intracranial volume segmentation for neurodegenerative populations using multicentre FLAIR MRI. NEUROIMAGE: REPORTS 2021. [DOI: 10.1016/j.ynirp.2021.100006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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23
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Ntiri EE, Holmes MF, Forooshani PM, Ramirez J, Gao F, Ozzoude M, Adamo S, Scott CJM, Dowlatshahi D, Lawrence-Dewar JM, Kwan D, Lang AE, Symons S, Bartha R, Strother S, Tardif JC, Masellis M, Swartz RH, Moody A, Black SE, Goubran M. Improved Segmentation of the Intracranial and Ventricular Volumes in Populations with Cerebrovascular Lesions and Atrophy Using 3D CNNs. Neuroinformatics 2021; 19:597-618. [PMID: 33527307 DOI: 10.1007/s12021-021-09510-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2021] [Indexed: 11/30/2022]
Abstract
Successful segmentation of the total intracranial vault (ICV) and ventricles is of critical importance when studying neurodegeneration through neuroimaging. We present iCVMapper and VentMapper, robust algorithms that use a convolutional neural network (CNN) to segment the ICV and ventricles from both single and multi-contrast MRI data. Our models were trained on a large dataset from two multi-site studies (N = 528 subjects for ICV, N = 501 for ventricular segmentation) consisting of older adults with varying degrees of cerebrovascular lesions and atrophy, which pose significant challenges for most segmentation approaches. The models were tested on 238 participants, including subjects with vascular cognitive impairment and high white matter hyperintensity burden. Two of the three test sets came from studies not used in the training dataset. We assessed our algorithms relative to four state-of-the-art ICV extraction methods (MONSTR, BET, Deep Extraction, FreeSurfer, DeepMedic), as well as two ventricular segmentation tools (FreeSurfer, DeepMedic). Our multi-contrast models outperformed other methods across many of the evaluation metrics, with average Dice coefficients of 0.98 and 0.96 for ICV and ventricular segmentation respectively. Both models were also the most time efficient, segmenting the structures in orders of magnitude faster than some of the other available methods. Our networks showed an increased accuracy with the use of a conditional random field (CRF) as a post-processing step. We further validated both segmentation models, highlighting their robustness to images with lower resolution and signal-to-noise ratio, compared to tested techniques. The pipeline and models are available at: https://icvmapp3r.readthedocs.io and https://ventmapp3r.readthedocs.io to enable further investigation of the roles of ICV and ventricles in relation to normal aging and neurodegeneration in large multi-site studies.
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Affiliation(s)
- Emmanuel E Ntiri
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Melissa F Holmes
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Parisa M Forooshani
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Fuqiang Gao
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Miracle Ozzoude
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Sabrina Adamo
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Dar Dowlatshahi
- Department of Medicine, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Donna Kwan
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Anthony E Lang
- The Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Canada.,Department of Medicine (Neurology division), University of Toronto, Toronto, Canada
| | - Sean Symons
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, University of Western Ontario, London, Canada
| | - Stephen Strother
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | | | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medicine (Neurology division), University of Toronto, Toronto, Canada.,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Toronto, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medicine (Neurology division), University of Toronto, Toronto, Canada.,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Toronto, Canada
| | - Alan Moody
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,Department of Medicine (Neurology division), University of Toronto, Toronto, Canada.,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Toronto, Canada
| | - Maged Goubran
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada. .,Department of Medical Biophysics, University of Toronto, Toronto, Canada. .,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Toronto, Canada.
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24
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Litak J, Mazurek M, Kulesza B, Szmygin P, Litak J, Kamieniak P, Grochowski C. Cerebral Small Vessel Disease. Int J Mol Sci 2020; 21:ijms21249729. [PMID: 33419271 PMCID: PMC7766314 DOI: 10.3390/ijms21249729] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 01/18/2023] Open
Abstract
Cerebral small vessel disease (CSVD) represents a cluster of various vascular disorders with different pathological backgrounds. The advanced vasculature net of cerebral vessels, including small arteries, capillaries, arterioles and venules, is usually affected. Processes of oxidation underlie the pathology of CSVD, promoting the degenerative status of the epithelial layer. There are several classifications of cerebral small vessel diseases; some of them include diseases such as Binswanger’s disease, leukoaraiosis, cerebral microbleeds (CMBs) and lacunar strokes. This paper presents the characteristics of CSVD and the impact of the current knowledge of this topic on the diagnosis and treatment of patients.
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Affiliation(s)
- Jakub Litak
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
- Department of Immunology, Medical University of Lublin, 20-093 Lublin, Poland
- Correspondence:
| | - Marek Mazurek
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Bartłomiej Kulesza
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Paweł Szmygin
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Joanna Litak
- St. John’s Cancer Center in Lublin, 20-090 Lublin, Poland;
| | - Piotr Kamieniak
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Cezary Grochowski
- Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
- Laboratory of Virtual Man, Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
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25
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Rensma SP, Stehouwer CD, Van Boxtel MP, Houben AJ, Berendschot TT, Jansen JF, Schalkwijk CG, Verhey FR, Kroon AA, Henry RM, Backes WH, Dagnelie PC, van Dongen MC, Eussen SJ, Bosma H, Köhler S, Reesink KD, Schram MT, van Sloten TT. Associations of Arterial Stiffness With Cognitive Performance, and the Role of Microvascular Dysfunction. Hypertension 2020; 75:1607-1614. [DOI: 10.1161/hypertensionaha.119.14307] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mechanisms underlying cognitive impairment are incompletely understood but may include arterial stiffness and microvascular dysfunction. In the population-based Maastricht Study, we investigated the association between arterial stiffness and cognitive performance, and whether any such association was mediated by microvascular dysfunction. We included cross-sectional data of 2544 participants (age, 59.7 years; 51.0% men; 26.0% type 2 diabetes mellitus). We used carotid-femoral pulse wave velocity and carotid distensibility coefficient as measures of aortic and carotid stiffness, respectively. We calculated a composite score of microvascular dysfunction based on magnetic resonance imaging features of cerebral small vessel disease, flicker light-induced retinal arteriolar and venular dilation response, albuminuria, and plasma biomarkers of microvascular dysfunction (sICAM-1 [soluble intercellular adhesion molecule-1], sVCAM-1 [soluble vascular adhesion molecule-1], sE-selectin [soluble E-selectin], and vWF [von Willebrand factor]). Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the average of these domains. Higher aortic stiffness (per m/s) was associated with lower cognitive function (β, −0.018 SD [95% CI, −0.036 to −0.000]) independent of age, sex, education, and cardiovascular risk factors, but higher carotid stiffness was not. Higher aortic stiffness (per m/s) was associated with a higher microvascular dysfunction score (β, 0.034 SD [95% CI, 0.014 to 0.053]), and a higher microvascular dysfunction score (per SD) was associated with lower cognitive function (β, −0.089 SD [95% CI, −0.124 to −0.053]). Microvascular dysfunction significantly explained 16.2% of the total effect of aortic stiffness on cognitive function. The present study showed that aortic stiffness, but not carotid stiffness, is independently associated with worse cognitive performance, and that this association is in part explained by microvascular dysfunction.
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Affiliation(s)
- Sytze P. Rensma
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | - Coen D.A. Stehouwer
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | - Martin P.J. Van Boxtel
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
- Department of Psychiatry and Neuropsychology (M.P.J.V.B., F.R.J.V.)
| | - Alfons J.H.M. Houben
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | | | - Jaap F.A. Jansen
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
- Department of Radiology and Nuclear Medicine (J.F.A.J., W.H.B.)
- Department of Electrical Engineering, Eindhoven University of Technology, the Netherlands (J.F.A.J.)
| | - Casper G. Schalkwijk
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | - Frans R.J. Verhey
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
- Department of Psychiatry and Neuropsychology (M.P.J.V.B., F.R.J.V.)
| | - Abraham A. Kroon
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | - Ronald M.A. Henry
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
| | - Walter H. Backes
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
- Department of Radiology and Nuclear Medicine (J.F.A.J., W.H.B.)
| | - Pieter C. Dagnelie
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
- Department of Epidemiology (P.C.D., M.C.J.M.v.D., S.J.P.M.E.)
| | - Martin C.J.M. van Dongen
- Department of Epidemiology (P.C.D., M.C.J.M.v.D., S.J.P.M.E.)
- CAPHRI Care and Public Health Research Institute (M.C.J.M.v.D., H.B.)
| | - Simone J.P.M. Eussen
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Epidemiology (P.C.D., M.C.J.M.v.D., S.J.P.M.E.)
| | - Hans Bosma
- CAPHRI Care and Public Health Research Institute (M.C.J.M.v.D., H.B.)
- Department of Social Medicine (H.B.)
| | - Sebastian Köhler
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
| | - Koen D. Reesink
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Biomedical Engineering, Maastricht University Medical Centre, Maastricht, the Netherlands (K.D.R.)
| | - Miranda T. Schram
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
- MheNs School for Mental Health and Neuroscience (M.P.J.V.B., J.F.A.J., F.R.J.V., W.H.B., S.K., M.T.S.)
| | - Thomas T. van Sloten
- From the CARIM School for Cardiovascular Diseases (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., S.J.P.M.E., K.D.R., M.T.S., T.T.v.S.)
- Department of Internal Medicine (S.P.R., C.D.A.S., A.J.H.M.H., C.G.S., A.A.K., R.M.A.H., P.C.D., M.T.S., T.T.v.S.)
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26
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Patwa J, Flora SJS. Heavy Metal-Induced Cerebral Small Vessel Disease: Insights into Molecular Mechanisms and Possible Reversal Strategies. Int J Mol Sci 2020; 21:ijms21113862. [PMID: 32485831 PMCID: PMC7313017 DOI: 10.3390/ijms21113862] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022] Open
Abstract
Heavy metals are considered a continuous threat to humanity, as they cannot be eradicated. Prolonged exposure to heavy metals/metalloids in humans has been associated with several health risks, including neurodegeneration, vascular dysfunction, metabolic disorders, cancer, etc. Small blood vessels are highly vulnerable to heavy metals as they are directly exposed to the blood circulatory system, which has comparatively higher concentration of heavy metals than other organs. Cerebral small vessel disease (CSVD) is an umbrella term used to describe various pathological processes that affect the cerebral small blood vessels and is accepted as a primary contributor in associated disorders, such as dementia, cognitive disabilities, mood disorder, and ischemic, as well as a hemorrhagic stroke. In this review, we discuss the possible implication of heavy metals/metalloid exposure in CSVD and its associated disorders based on in-vitro, preclinical, and clinical evidences. We briefly discuss the CSVD, prevalence, epidemiology, and risk factors for development such as genetic, traditional, and environmental factors. Toxic effects of specific heavy metal/metalloid intoxication (As, Cd, Pb, Hg, and Cu) in the small vessel associated endothelium and vascular dysfunction too have been reviewed. An attempt has been made to highlight the possible molecular mechanism involved in the pathophysiology, such as oxidative stress, inflammatory pathway, matrix metalloproteinases (MMPs) expression, and amyloid angiopathy in the CSVD and related disorders. Finally, we discussed the role of cellular antioxidant defense enzymes to neutralize the toxic effect, and also highlighted the potential reversal strategies to combat heavy metal-induced vascular changes. In conclusion, heavy metals in small vessels are strongly associated with the development as well as the progression of CSVD. Chelation therapy may be an effective strategy to reduce the toxic metal load and the associated complications.
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De Guio F, Duering M, Fazekas F, De Leeuw FE, Greenberg SM, Pantoni L, Aghetti A, Smith EE, Wardlaw J, Jouvent E. Brain atrophy in cerebral small vessel diseases: Extent, consequences, technical limitations and perspectives: The HARNESS initiative. J Cereb Blood Flow Metab 2020; 40:231-245. [PMID: 31744377 PMCID: PMC7370623 DOI: 10.1177/0271678x19888967] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Brain atrophy is increasingly evaluated in cerebral small vessel diseases. We aim at systematically reviewing the available data regarding its extent, correlates and cognitive consequences. Given that in this context, brain atrophy measures might be biased, the first part of the review focuses on technical aspects. Thereafter, data from the literature are analyzed in light of these potential limitations, to better understand the relationships between brain atrophy and other MRI markers of cerebral small vessel diseases. In the last part, we review the links between brain atrophy and cognitive alterations in patients with cerebral small vessel diseases.
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Affiliation(s)
- François De Guio
- Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), APHP, Lariboisière Hospital, Paris, DHU NeuroVasc, Univ Paris Diderot, and U1141 INSERM, France
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Frank-Erik De Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University, Nijmegen, The Netherlands
| | - Steven M Greenberg
- Department of Neurology, Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Leonardo Pantoni
- "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Agnès Aghetti
- Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), APHP, Lariboisière Hospital, Paris, DHU NeuroVasc, Univ Paris Diderot, and U1141 INSERM, France
| | - Eric E Smith
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Joanna Wardlaw
- Centre for Clinical Brain Sciences, Edinburgh Imaging, UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Eric Jouvent
- Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), APHP, Lariboisière Hospital, Paris, DHU NeuroVasc, Univ Paris Diderot, and U1141 INSERM, France
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Niu Z, Zhang P, Li D, Zhu C, Feng L, Xiong G, Song N, Tang P, Liu F. Association of Apolipoprotein E Polymorphisms with White Matter Lesions and Brain Atrophy. Psychiatry Investig 2020; 17:96-105. [PMID: 32000479 PMCID: PMC7047002 DOI: 10.30773/pi.2019.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/28/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Apolipoprotein E (ApoE) is mainly synthesized in the liver. So far, it is unknown the relationship among APOE gene polymorphisms and WML, brain atrophy. Therefore, the aim of the study was to assess the associations of APOE gene polymorphisms in patients with WML and brain atrophy. METHODS A total of 58 patients with WML, 128 patients with brain atrophy, 112 patients with co-occurrence of WML and brain atrophy and 95 healthy elderly volunteers were recruited from Renmin Hospital of WuHan University. RESULTS Allele E3 was the most common allele. The alleles E2 had significantly higher levels of ApoB and lower age in WML group. The alleles E2 was associated with the lower level of ApoB, LDL-Ch, TCh, and sdLDL in co-occurrence group. The E3/E3 genotype has higher level of sdLDL, but lower age and female frequency in WML. The E3/E4 genotype had higher level of TG, but lower age in WML. Gender, Age, E2, Hyperhomocysteinemia and UA were also significantly associated with disease progression. CONCLUSION This study found that clinical data, lipids and metabolic complications were closely related to ApoE genotypes and alleles, and also disease progression and type.
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Affiliation(s)
- ZhiLi Niu
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - PingAn Zhang
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - Dong Li
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - ChengLiang Zhu
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - LiNa Feng
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - Ge Xiong
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - NaNa Song
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - Pei Tang
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
| | - Feng Liu
- Department of Laboratory Science, Renmin Hospital of WuHan University, Wuhan, China
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Kim Y, Lee H, Son TO, Jang H, Cho SH, Kim SE, Kim SJ, Lee JS, Kim JP, Jung YH, Lockhart SN, Kim HJ, Na DL, Park HY, Seo SW. Reduced forced vital capacity is associated with cerebral small vessel disease burden in cognitively normal individuals. NEUROIMAGE-CLINICAL 2019; 25:102140. [PMID: 31896465 PMCID: PMC6940695 DOI: 10.1016/j.nicl.2019.102140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 01/18/2023]
Abstract
Decreased FVC (% pred) was associated with increased cerebral small vessel disease burden even in cognitively normal subjects. This reduced lung function was related to low Mini-Mental Status Examination (MMSE) scores in cognitively normal subjects. Path analyses showed that white matter hyperintensities partially mediated the positive relationship between FVC (% pred) and MMSE score. There was no significant association between low FVC (% pred) and cortical thickness in cognitively normal subjects.
Background Pulmonary dysfunction is associated with elevated risk of cognitive decline. However, the mechanism underlying this relationship has not been fully investigated. In this study, we investigate the relationships between pulmonary function, cerebral small vessel disease (CSVD) markers, cortical thickness, and the Mini-Mental Status Examination (MMSE) scores in cognitively normal individuals. Methods We used a cross-sectional study design. We identified 1924 patients who underwent pulmonary function testing, three-dimensional brain magnetic resonance imaging (MRI), and the MMSE. Pulmonary function was analyzed according to the quintiles of percentage predicted values (% pred) for forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV1). Regarding CSVD markers, we visually rated white matter hyperintensities (WMH) and manually counted lacunes and microbleeds. Cortical thickness was measured by surface-based methods. Results Compared with the highest quintile of FVC, the lowest quintile of FVC (% pred) showed a higher risk of WMH (OR 1.98, 95% CI: 1.21–3.24) and lacunes (OR 1.86, 95% CI: 1.12–3.08). There were no associations between FVC or FEV1 and cortical thickness. Low FVC, but not FEV1, was associated with low MMSE scores. Path analyses showed that WMH partially mediated the positive relationship between FVC (% pred) and MMSE score. Conclusions Our findings suggested that decreased pulmonary function was associated with increased CSVD burdens, which in turn wass associated with decreased cognition, even in cognitively normal subjects.
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Affiliation(s)
- Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, South Korea
| | - Tea Ok Son
- Cheongju Samsung Rehabilitation Hospital, Cheongju, South Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Si Eun Kim
- Departments of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, South Korea
| | - Seung Joo Kim
- Department of Neurology, Gyeongsang National University School of Medicine and Gyeonsang National University Changwon Hospital, Changwon, South Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, South Korea
| | - Jun Pyo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Young Hee Jung
- Department of Neurology, Myongji Hospital, Hanyang University Medical Center, Republic of Korea
| | - Samuel N Lockhart
- Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Gangnam-gu, Republic of Korea
| | - Hye Yun Park
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Kangnam-ku, Seoul 06351, South Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Neuroscience Center, Samsung Medical Center, Seoul, South Korea; Samsung Alzheimer Research Center, Samsung Medical Center, Seoul, South Korea; Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea; Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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30
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Chen YC, Wei XE, Lu J, Qiao RH, Shen XF, Li YH. Correlation Between the Number of Lenticulostriate Arteries and Imaging of Cerebral Small Vessel Disease. Front Neurol 2019; 10:882. [PMID: 31456742 PMCID: PMC6699475 DOI: 10.3389/fneur.2019.00882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/30/2019] [Indexed: 01/22/2023] Open
Abstract
Background and purpose: Hypoperfusion plays an important role in the pathophysiology of cerebral small vessel disease (SVD). Lenticulostriate arteries (LSAs) are some of the most important cerebral arterial small vessels. This study aimed to investigate whether the number of LSAs was associated with the cerebral perfusion in SVD patients and determine the correlation between the number of LSAs and SVD severity. Methods: Five hundred and ninety-four consecutive patients who underwent digital subtraction angiography were enrolled in this study. The number of LSAs was determined. Computed tomography perfusion (CTP) was used to calculate the cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP). Magnetic resonance imaging (MRI) was performed to assess cerebral infarct, cerebral microbleeds (CMBs), white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVSs), and lacunes. An SVD compound score was calculated to express the level of cerebral SVD load. Results: The SVD scores were negatively correlated with the number of the LSAs (P < 0.001, rs = −0.44). The number of LSAs was inversely associated with the presence of any type of SVD (P < 0.001). The adjusted ORs of the SVD severity were 0.31 for LSA group 1 (LSA > 20) vs. group 2 (LSA = 10–20) and 0.47 for LSA group 2 (LSA = 10–20) vs. group 3 (LSA < 10). MTT and TTP were significantly higher and CBF was significantly lower when the number of LSAs was between 5 and 10 on each side of the basal ganglia (P < 0.001, <0.001, and <0.001, respectively). The CBV was slightly lower when the number of LSAs was between 5 and 10, while it was significantly lower when the number was <5 on each side of the basal ganglia (P < 0.05, <0.0001, respectively). Conclusion: LSA count was lower in SVD patients than the non-SVD participants and there was a positive correlation between the cerebral perfusion and the number of LSAs. The LSA number was negatively associated with SVD severity, hypoperfusion might play an important role. This finding may have potentially important clinical implications for monitoring LSA in SVD patients.
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Affiliation(s)
- Yuan-Chang Chen
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiao-Er Wei
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jing Lu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Rui-Hua Qiao
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xue-Feng Shen
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yue-Hua Li
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Forsberg KME, Zhang Y, Reiners J, Ander M, Niedermayer A, Fang L, Neugebauer H, Kassubek J, Katona I, Weis J, Ludolph AC, Del Tredici K, Braak H, Yilmazer-Hanke D. Endothelial damage, vascular bagging and remodeling of the microvascular bed in human microangiopathy with deep white matter lesions. Acta Neuropathol Commun 2018; 6:128. [PMID: 30470258 PMCID: PMC6260986 DOI: 10.1186/s40478-018-0632-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022] Open
Abstract
White matter lesions (WMLs) are a common manifestation of small vessel disease (SVD) in the elderly population. They are associated with an enhanced risk of developing gait abnormalities, poor executive function, dementia, and stroke with high mortality. Hypoperfusion and the resulting endothelial damage are thought to contribute to the development of WMLs. The focus of the present study was the analysis of the microvascular bed in SVD patients with deep WMLs (DWMLs) by using double- and triple-label immunohistochemistry and immunofluorescence. Simultaneous visualization of collagen IV (COLL4)-positive membranes and the endothelial glycocalyx in thick sections allowed us to identify endothelial recession in different types of string vessels, and two new forms of small vessel/capillary pathology, which we called vascular bagging and ghost string vessels. Vascular bags were pouches and tubes that were attached to vessel walls and were formed by multiple layers of COLL4-positive membranes. Vascular bagging was most severe in the DWMLs of cases with pure SVD (no additional vascular brain injury, VBI). Quantification of vascular bagging, string vessels, and the density/size of CD68-positive cells further showed widespread pathological changes in the frontoparietal and/or temporal white matter in SVD, including pure SVD and SVD with VBI, as well as a significant effect of the covariate age. Plasma protein leakage into vascular bags and the white matter parenchyma pointed to endothelial damage and basement membrane permeability. Hypertrophic IBA1-positive microglial cells and CD68-positive macrophages were found in white matter areas covered with networks of ghost vessels in SVD, suggesting phagocytosis of remnants of string vessels. However, the overall vessel density was not altered in our SVD cohort, which might result from continuous replacement of vessels. Our findings support the view that SVD is a progressive and generalized disease process, in which endothelial damage and vascular bagging drive remodeling of the microvasculature.
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Cuadrado-Godia E, Dwivedi P, Sharma S, Ois Santiago A, Roquer Gonzalez J, Balcells M, Laird J, Turk M, Suri HS, Nicolaides A, Saba L, Khanna NN, Suri JS. Cerebral Small Vessel Disease: A Review Focusing on Pathophysiology, Biomarkers, and Machine Learning Strategies. J Stroke 2018; 20:302-320. [PMID: 30309226 PMCID: PMC6186915 DOI: 10.5853/jos.2017.02922] [Citation(s) in RCA: 160] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/02/2018] [Indexed: 12/15/2022] Open
Abstract
Cerebral small vessel disease (cSVD) has a crucial role in lacunar stroke and brain hemorrhages and is a leading cause of cognitive decline and functional loss in elderly patients. Based on underlying pathophysiology, cSVD can be subdivided into amyloidal and non-amyloidal subtypes. Genetic factors of cSVD play a pivotal role in terms of unraveling molecular mechanism. An important pathophysiological mechanism of cSVD is blood-brain barrier leakage and endothelium dysfunction which gives a clue in identification of the disease through circulating biological markers. Detection of cSVD is routinely carried out by key neuroimaging markers including white matter hyperintensities, lacunes, small subcortical infarcts, perivascular spaces, cerebral microbleeds, and brain atrophy. Application of neural networking, machine learning and deep learning in image processing have increased significantly for correct severity of cSVD. A linkage between cSVD and other neurological disorder, such as Alzheimer's and Parkinson's disease and non-cerebral disease, has also been investigated recently. This review draws a broad picture of cSVD, aiming to inculcate new insights into its pathogenesis and biomarkers. It also focuses on the role of deep machine strategies and other dimensions of cSVD by linking it with several cerebral and non-cerebral diseases as well as recent advances in the field to achieve sensitive detection, effective prevention and disease management.
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Affiliation(s)
- Elisa Cuadrado-Godia
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Sanjiv Sharma
- Department of Computer Science & Engineering and Information Technology, Madhav Institute of Technology and Science, Gwalior, India
| | - Angel Ois Santiago
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Jaume Roquer Gonzalez
- Department of Neurology, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Mercedes Balcells
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Biological Engineering, IQS School of Engineering, Barcelona, Spain
| | - John Laird
- Department of Cardiology, St. Helena Hospital, St. Helena, CA, USA
| | - Monika Turk
- Deparment of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | | | | | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, Cagliari, Italy
| | | | - Jasjit S Suri
- Stroke Monitoring Division, AtheroPoint, Roseville, CA, USA
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Abstract
Cerebral small vessel disease (CSVD) is composed of several diseases affecting the small arteries, arterioles, venules, and capillaries of the brain, and refers to several pathological processes and etiologies. Neuroimaging features of CSVD include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. The main clinical manifestations of CSVD include stroke, cognitive decline, dementia, psychiatric disorders, abnormal gait, and urinary incontinence. Currently, there are no specific preventive or therapeutic measures to improve this condition. In this review, we will discuss the pathophysiology, clinical aspects, neuroimaging, progress of research to treat and prevent CSVD and current treatment of this disease.
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Affiliation(s)
- Qian Li
- 1 Department of Pediatrics, The Third Affiliated Hospital & Field Surgery Institution, Army Medical University, Chongqing, China.,Both the authors contributed equally as co-authors
| | - Yang Yang
- 2 Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.,Both the authors contributed equally as co-authors
| | - Cesar Reis
- 3 Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Tao Tao
- 2 Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Wanwei Li
- 1 Department of Pediatrics, The Third Affiliated Hospital & Field Surgery Institution, Army Medical University, Chongqing, China
| | - Xiaogang Li
- 2 Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - John H Zhang
- 3 Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, USA.,4 Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda, CA, USA
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Valdés Hernández MDC, Reid S, Mikhael S, Pernet C. Do 2-year changes in superior frontal gyrus and global brain atrophy affect cognition? ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:706-716. [PMID: 30511008 PMCID: PMC6258225 DOI: 10.1016/j.dadm.2018.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction Metabolic alterations to the superior frontal gyrus (SFG) have been linked to cognitive decline. Whether these indicate structural atrophy, which could be screened for at a larger scale using noninvasive structural imaging, is unknown. Methods We assessed annual structural magnetic resonance imaging scans and cognitive data from 3 consecutive years from 204 participants from the AD Neuroimaging Initiative database (mean age 72.24 [8.175] years). We evaluated associations between brain structural changes and performance in the Montreal Cognitive Assessment, Everyday Cognition Visuospatial subtest (ECog Visuospatial), and Functional Assessment Questionnaire. Results Changes in the surface area of the SFG were associated with changes in the outcome of the ECog Visuospatial test (P < .05), but an inconsistent pattern of association was found between the 2-year global brain atrophy progression and changes in the outcome from the three cognitive tests selected. Discussion The extent into which (and if) changes in the SFG influence cognition warrant further evaluation in a larger period in more heterogeneous population.
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Affiliation(s)
- Maria Del C Valdés Hernández
- Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Row Fogo Centre into Ageing and the Brain at the Edinburgh Dementia Research Centre in the UK, Dementia Research Initiative, Edinburgh, UK.,Edinburgh Imaging (www.ed.ac.uk/edinburgh-imaging), University of Edinburgh, Edinburgh, UK
| | - Stuart Reid
- College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Shadia Mikhael
- Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Cyril Pernet
- Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Edinburgh Imaging (www.ed.ac.uk/edinburgh-imaging), University of Edinburgh, Edinburgh, UK
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Yang S, Yuan J, Qin W, Yang L, Fan H, Li Y, Hu W. Twenty-four-hour ambulatory blood pressure variability is associated with total magnetic resonance imaging burden of cerebral small-vessel disease. Clin Interv Aging 2018; 13:1419-1427. [PMID: 30127599 PMCID: PMC6089119 DOI: 10.2147/cia.s171261] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background Lacunae, brain atrophy, white matter hyperintensity, enlarged perivascular space and microbleed are magnetic resonance imaging (MRI) markers of cerebral small-vessel disease (cSVD). Studies have reported that higher blood pressure variability (BPV) predicted cardiovascular risk in hypertensive patients; however, the association between BPV and the total MRI burden of cSVD has not been investigated. In this study, we aimed to explore this relationship between BPV and cSVD MRI burden. Methods We prospectively recruited patients who attended our hospital for annual physical examination. Twenty-four-hour ambulatory BP monitoring was performed using an automated system. BPV was quantified by SD, weighted SD, and coefficient of variation. One point was awarded for the presence of each marker, producing a score between 0 and 5. Spearman correlation and ordinal logistic regression analyses were used to test the relationship between BPV and total cSVD MRI burden. Results A total of 251 subjects with an average age of 68 years were enrolled in this study, and 52.6% were male; 163 (64.94%) had one or more markers of cSVD. Correlation analysis indicated that higher systolic BP (SBP) levels and BPV metrics of SBP were positively related to higher cSVD burden. Ordinal logistic regression analyses demonstrated that higher SBP levels and SBP variability were independent risk factors for cSVD. There were no significant differences in 24-hour, day and night diastolic BP levels or BPV metrics of diastolic BP among the five subgroups. Conclusion Twenty-four-hour, day and night SBP levels and SBP variability were positively related to cSVD burden. Higher SBP levels and SBP variability were independent risk factors for cSVD.
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Affiliation(s)
- Shuna Yang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Junliang Yuan
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Wei Qin
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Lei Yang
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Huimin Fan
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Yue Li
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
| | - Wenli Hu
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,
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Su N, Liang X, Zhai FF, Zhou LX, Ni J, Yao M, Tian F, Zhang SY, Jin ZY, Cui LY, Gong G, Zhu YC. The consequence of cerebral small vessel disease: Linking brain atrophy to motor impairment in the elderly. Hum Brain Mapp 2018; 39:4452-4461. [PMID: 29956412 DOI: 10.1002/hbm.24284] [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] [Received: 04/06/2018] [Revised: 05/31/2018] [Accepted: 06/12/2018] [Indexed: 11/08/2022] Open
Abstract
In the elderly, brain structural deficits and gait disturbances due to cerebral small vessel disease (CSVD) have been well demonstrated. The relationships among CSVD, brain atrophy, and motor impairment, however, are far from conclusive. Particularly, the effect of CSVD on subcortical nuclear atrophy, motor performance of upper extremities, and associating patterns between brain atrophy and motor impairment remains largely unknown. To address these gaps, this study recruited 770 community-dwelling subjects (35-82 years of age), including both CSVD and non-CSVD individuals. For each subject, four motor tests involving upper and lower extremities were completed. High-resolution structural MRI was applied to extract gray matter (GM) volume, white matter volume, cortical thickness, surface area, and subcortical nuclear (caudate, putamen, pallidum, and thalamus) volumes. The results showed worse motor performance of lower extremities but relatively preserved performance of upper extremities in the CSVD group. Intriguingly, there was a significant association between the worse performance of upper extremities and atrophy of whole-brain GM and pallidum in the CSVD group but not in the non-CSVD group. In addition, mediation analysis confirmed a functional CSVD-to-"brain atrophy"-to-"motor impairment" pathway, that is, a mediating role of thalamic atrophy in the CSVD effect on walking speed in the elderly, indicating that CSVD impairs walking performance through damaging the integrity of the thalamus in aging populations. These findings provide important insight into the functional consequences of CSVD and highlight the importance of evaluating upper extremities functions and exploring their brain mechanisms in CSVD populations during aging.
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Affiliation(s)
- Ning Su
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinyu Liang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Fei-Fei Zhai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Xin Zhou
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Ni
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Yao
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Tian
- State Key Laboratory of Computer Science, Institute of Software, Chinese Academy of Sciences, Beijing, China
| | - Shu-Yang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng-Yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Ying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Yi-Cheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Mimenza-Alvarado A, Aguilar-Navarro SG, Yeverino-Castro S, Mendoza-Franco C, Ávila-Funes JA, Román GC. Neuroimaging Characteristics of Small-Vessel Disease in Older Adults with Normal Cognition, Mild Cognitive Impairment, and Alzheimer Disease. Dement Geriatr Cogn Dis Extra 2018; 8:199-206. [PMID: 29928288 PMCID: PMC6006607 DOI: 10.1159/000488705] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/23/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Cerebral small-vessel disease (SVD) represents the most frequent type of vascular brain lesions, often coexisting with Alzheimer disease (AD). By quantifying white matter hyperintensities (WMH) and hippocampal and parietal atrophy, we aimed to describe the prevalence and severity of SVD among older adults with normal cognition (NC), mild cognitive impairment (MCI), and probable AD and to describe associated risk factors. Methods This study included 105 older adults evaluated with magnetic resonance imaging and clinical and neuropsychological tests. We used the Fazekas scale (FS) for quantification of WMH, the Scheltens scale (SS) for hippocampal atrophy, and the Koedam scale (KS) for parietal atrophy. Logistic regression models were performed to determine the association between FS, SS, and KS scores and the presence of NC, MCI, or probable AD. Results Compared to NC subjects, SVD was more prevalent in MCI and probable AD subjects. After adjusting for confounding factors, logistic regression showed a positive association between higher scores on the FS and probable AD (OR = 7.6, 95% CI 2.7–20, p < 0.001). With the use of the SS and KS (OR = 4.5, 95% CI 3.5–58, p = 0.003 and OR = 8.9, 95% CI 1–72, p = 0.04, respectively), the risk also remained significant for probable AD. Conclusions These results suggest an association between severity of vascular brain lesions and neurodegeneration.
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Affiliation(s)
- Alberto Mimenza-Alvarado
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara G Aguilar-Navarro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara Yeverino-Castro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - César Mendoza-Franco
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Alberto Ávila-Funes
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
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Al-Janabi OM, Panuganti P, Abner EL, Bahrani AA, Murphy R, Bardach SH, Caban-Holt A, Nelson PT, Gold BT, Smith CD, Wilcock DM, Jicha GA. Global Cerebral Atrophy Detected by Routine Imaging: Relationship with Age, Hippocampal Atrophy, and White Matter Hyperintensities. J Neuroimaging 2018; 28:301-306. [PMID: 29314393 DOI: 10.1111/jon.12494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/29/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Interpreting the clinical significance of moderate-to-severe global cerebral atrophy (GCA) is a conundrum for many clinicians, who visually interpret brain imaging studies in routine clinical practice. GCA may be attributed to normal aging, Alzheimer's disease (AD), or cerebrovascular disease (CVD). Understanding the relationships of GCA with aging, AD, and CVD is important for accurate diagnosis and treatment decisions for cognitive complaints. METHODS To elucidate the relative associations of age, moderate-to-severe white matter hyperintensities (WMHs), and moderate-to-severe medial temporal lobe atrophy (MTA), with moderate-to-severe GCA, we visually rated clinical brain imaging studies of 325 participants from a community based sample. Logistic regression analysis was conducted to assess the relations of GCA with age, WMH, and MTA. RESULTS The mean age was 76.2 (±9.6) years, 40.6% were male, and the mean educational attainment was 15.1 (±3.7) years. Logistic regression results demonstrated that while a 1-year increase in age was associated with GCA (OR = 1.04; P = .04), MTA (OR = 3.7; P < .001), and WMH (OR = 8.80; P < .001) were strongly associated with GCA in our study population. Partial correlation analysis showed that the variance of GCA explained by age is less than the variance attributed to MTA and WMH (r = .13, .21, and .43, respectively). CONCLUSIONS Moderate-to-severe GCA is most likely to occur in the presence of AD or CVD and should not be solely attributed to age when evaluating clinical imaging findings in the workup of cognitive complaints. Developing optimal diagnostic and treatment strategies for cognitive decline in the setting of GCA requires an understanding of its risk factors in the aging population.
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Affiliation(s)
- Omar M Al-Janabi
- Sanders-Brown Center on Aging, Lexington, KY.,Departments of Behavioral Science, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Pradeep Panuganti
- Neurology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Erin L Abner
- Sanders-Brown Center on Aging, Lexington, KY.,Epidemiology and Biostatistics, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Ahmed A Bahrani
- Sanders-Brown Center on Aging, Lexington, KY.,Biomedical Engineering, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Ronan Murphy
- Sanders-Brown Center on Aging, Lexington, KY.,Neurology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Shoshana H Bardach
- Sanders-Brown Center on Aging, Lexington, KY.,Gerontology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Allison Caban-Holt
- Sanders-Brown Center on Aging, Lexington, KY.,Departments of Behavioral Science, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Peter T Nelson
- Sanders-Brown Center on Aging, Lexington, KY.,Pathology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Brian T Gold
- Sanders-Brown Center on Aging, Lexington, KY.,Neuroscience, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Charles D Smith
- Sanders-Brown Center on Aging, Lexington, KY.,Neurology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Donna M Wilcock
- Sanders-Brown Center on Aging, Lexington, KY.,Physiology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
| | - Gregory A Jicha
- Sanders-Brown Center on Aging, Lexington, KY.,Departments of Behavioral Science, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY.,Neurology, University of Kentucky Colleges of Medicine, Public Health and Engineering, Lexington, KY
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Deep microbleeds and periventricular white matter disintegrity are independent predictors of attention/executive dysfunction in non-dementia patients with small vessel disease. Int Psychogeriatr 2017; 29:793-803. [PMID: 27938433 DOI: 10.1017/s1041610216002118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cerebral small vessel disease (SVD) is the common cause of cognitive decline in the old population. MRI can be used to clarify its mechanisms. However, the surrogate markers of MRI for early cognitive impairment in SVD remain uncertain to date. We investigated the cognitive impacts of cerebral microbleeds (CMBs), diffusion tensor imaging (DTI), and brain volumetric measurements in a cohort of post-stroke non-dementia SVD patients. METHODS Fifty five non-dementia SVD patients were consecutively recruited and categorized into two groups as no cognitive impairment (NCI) (n = 23) or vascular mild cognitive impairment (VaMCI) (n = 32). Detailed neuropsychological assessment and multimodal MRI were completed. RESULTS The two groups differed significantly on Z scores of all cognitive domains (all p < 0.01) except for the language. There were more patients with hypertension (p = 0.038) or depression (p = 0.019) in the VaMCI than those in the NCI group. Multiple regression analysis of cognition showed periventricular mean diffusivity (MD) (β = -0.457, p < 0.01) and deep CMBs numbers (β = -0.352, p < 0.01) as the predictors of attention/executive function, which explained 45.2% of the total variance. Periventricular MD was the independent predictor for either memory (β = -0.314, p < 0.05) or visuo-spatial function (β = -0.375, p < 0.01); however, only small proportion of variance could be accounted for (9.8% and 12.4%, respectively). Language was not found to be correlated with any of the MRI parameters. No correlation was found between brain atrophic indices and any of the cognitive measures. CONCLUSION Arteriosclerotic CMBs and periventricular white matter disintegrity seem to be independent MRI surrogated markers in the early stage of cognitive impairment in SVD.
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Pinter D, Ritchie SJ, Doubal F, Gattringer T, Morris Z, Bastin ME, del C. Valdés Hernández M, Royle NA, Corley J, Muñoz Maniega S, Pattie A, Dickie DA, Staals J, Gow AJ, Starr JM, Deary IJ, Enzinger C, Fazekas F, Wardlaw J. Impact of small vessel disease in the brain on gait and balance. Sci Rep 2017; 7:41637. [PMID: 28134332 PMCID: PMC5278543 DOI: 10.1038/srep41637] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/22/2016] [Indexed: 11/09/2022] Open
Abstract
Gait and balance impairment is highly prevalent in older people. We aimed to assess whether and how single markers of small vessel disease (SVD) or a combination thereof explain gait and balance function in the elderly. We analysed 678 community-dwelling healthy subjects from the Lothian Birth Cohort 1936 at the age of 71-74 years who had undergone comprehensive risk factor assessment, gait and balance assessment as well as brain MRI. We investigated the impact of individual SVD markers (white matter hyperintensity - WMH, microbleeds, lacunes, enlarged perivascular spaces, brain atrophy) as seen on structural brain MRI and of a global SVD score on the patients' performance. A regression model revealed that age, sex, and hypertension significantly explained gait speed. Among SVD markers white matter hyperintensity (WMH) score or volume were additional significant and independent predictors of gait speed in the regression model. A similar association was seen with the global SVD score. Our study confirms a negative impact of SVD-related morphologic brain changes on gait speed in addition to age, sex and hypertension independent from brain atrophy. The presence of WMH seems to be the major driving force for SVD on gait impairment in healthy elderly subjects.
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Affiliation(s)
- Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Stuart J. Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Fergus Doubal
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Zoe Morris
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Mark E. Bastin
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Maria del C. Valdés Hernández
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Natalie A. Royle
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Janie Corley
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Susana Muñoz Maniega
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Alison Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - David A. Dickie
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Centre, Maastricht, 6211, Netherlands
| | - Alan J. Gow
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, UK
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Alzheimer Scotland Dementia Research Centre, Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
- Division of Neuroradiology, Vascular and Interventional Neuroradiology, Department of Radiology, Medical University of Graz, Graz, 8036, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, 8036, Austria
| | - Joanna Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9YL, UK
- Brain Research Imaging Centre, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
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Del C Valdés Hernández M, Kyle J, Allan J, Allerhand M, Clark H, Muñoz Manieg S, Royle NA, Gow AJ, Pattie A, Corley J, Bastin ME, Starr JM, Wardlaw JM, Deary IJ, Combet E. Dietary Iodine Exposure and Brain Structures and Cognition in Older People. Exploratory Analysis in the Lothian Birth Cohort 1936. J Nutr Health Aging 2017; 21:971-979. [PMID: 29083437 DOI: 10.1007/s12603-017-0954-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Iodine deficiency is one of the three key micronutrient deficiencies highlighted as major public health issues by the World Health Organisation. Iodine deficiency is known to cause brain structural alterations likely to affect cognition. However, it is not known whether or how different (lifelong) levels of exposure to dietary iodine influences brain health and cognitive functions. METHODS From 1091 participants initially enrolled in The Lothian Birth Cohort Study 1936, we obtained whole diet data from 882. Three years later, from 866 participants (mean age 72 yrs, SD±0.8), we obtained cognitive information and ventricular, hippocampal and normal and abnormal tissue volumes from brain structural magnetic resonance imaging scans (n=700). We studied the brain structure and cognitive abilities of iodine-rich food avoiders/low consumers versus those with a high intake in iodine-rich foods (namely dairy and fish). RESULTS We identified individuals (n=189) with contrasting diets, i) belonging to the lowest quintiles for dairy and fish consumption, ii) milk avoiders, iii) belonging to the middle quintiles for dairy and fish consumption, and iv) belonging to the middle quintiles for dairy and fish consumption. Iodine intake was secured mostly though the diet (n=10 supplement users) and was sufficient for most (75.1%, median 193 µg/day). In individuals from these groups, brain lateral ventricular volume was positively associated with fat, energy and protein intake. The associations between iodine intake and brain ventricular volume and between consumption of fish products (including fish cakes and fish-containing pasties) and white matter hyperintensities (p=0.03) the latest being compounded by sodium, proteins and saturated fats, disappeared after type 1 error correction. CONCLUSION In this large Scottish older cohort, the proportion of individuals reporting extreme (low vs. high)/medium iodine consumption is small. In these individuals, low iodine-rich food intake was associated with increased brain volume shrinkage, raising an important hypothesis worth being explored for designing appropriate guidelines.
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Affiliation(s)
- M Del C Valdés Hernández
- Dr. Maria C. Valdés Hernández, Department of Neuroimaging Sciences, Centre for Clinical Brain Sciences, University of Edinburgh, 49 Little France Crescent, Chancellor's Building, Edinburgh, EH16 4SB, UK. Telephone:+44-131-4659527, Fax: +44-131-3325150, E-mail:
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Duan D, Li C, Shen L, Cui C, Shu T, Zheng J. Regional Gray Matter Atrophy Coexistent with Occipital Periventricular White Matter Hyper Intensities. Front Aging Neurosci 2016; 8:214. [PMID: 27656141 PMCID: PMC5013128 DOI: 10.3389/fnagi.2016.00214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 08/24/2016] [Indexed: 01/03/2023] Open
Abstract
White matter hyperintensities (WMHs) and brain atrophy often coexist in the elderly. Additionally, WMH is often observed as occipital periventricular hyperintensities (OPVHs) with low-grade periventricular (PV) white matter (WM) lesions and is usually confined within an anatomical structure. However, the effects of OPVHs on gray matter (GM) atrophy remain largely unknown. In this study, we investigated GM atrophy in OPVHs patients and explored the relationship between such atrophy and clinical risk factors. T1-weighted and T2-weighted Magnetic resonance imaging (MRI) were acquired, and voxel-based morphometry (VBM) analysis was applied. The clinical (demographic and cardiovascular) risk factors of the OPVHs patients and healthy controls were then compared. Lastly, scatter plots and correlation analysis were applied to explore the relationship between the MRI results and clinical risk factors in the OPVHs patients. OPVHs patients had significantly reduced GM in the right supramarginal gyrus, right angular gyrus, right middle temporal gyrus, right anterior cingulum and left insula compared to healthy controls. Additionally, OPVHs patients had GM atrophy in the left precentral gyrus and left insula cortex, and such atrophy is associated with a reduction in low-density lipoprotein cholesterol (LDL-C) and apolipoprotein-B (Apo-B).
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Affiliation(s)
- Dazhi Duan
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Congyang Li
- Department of Neurology, Chengdu Military General Hospital Chengdu, China
| | - Lin Shen
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Chun Cui
- Department of Radiology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Tongsheng Shu
- Department of Radiology, Xinqiao Hospital, Third Military Medical University Chongqing, China
| | - Jian Zheng
- Department of Neurology, Xinqiao Hospital, Third Military Medical University Chongqing, China
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Lees H, Walters H, Cox LS. Animal and human models to understand ageing. Maturitas 2016; 93:18-27. [PMID: 27372369 DOI: 10.1016/j.maturitas.2016.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 12/12/2022]
Abstract
Human ageing is the gradual decline in organ and tissue function with increasing chronological time, leading eventually to loss of function and death. To study the processes involved over research-relevant timescales requires the use of accessible model systems that share significant similarities with humans. In this review, we assess the usefulness of various models, including unicellular yeasts, invertebrate worms and flies, mice and primates including humans, and highlight the benefits and possible drawbacks of each model system in its ability to illuminate human ageing mechanisms. We describe the strong evolutionary conservation of molecular pathways that govern cell responses to extracellular and intracellular signals and which are strongly implicated in ageing. Such pathways centre around insulin-like growth factor signalling and integration of stress and nutritional signals through mTOR kinase. The process of cellular senescence is evaluated as a possible underlying cause for many of the frailties and diseases of human ageing. Also considered is ageing arising from systemic changes that cannot be modelled in lower organisms and instead require studies either in small mammals or in primates. We also touch briefly on novel therapeutic options arising from a better understanding of the biology of ageing.
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Affiliation(s)
- Hayley Lees
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK
| | - Hannah Walters
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK
| | - Lynne S Cox
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford, OX1 3QU, UK.
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44
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Kim J, Valdés Hernández MDC, Royle NA, Maniega SM, Aribisala BS, Gow AJ, Bastin ME, Deary IJ, Wardlaw JM, Park J. 3D shape analysis of the brain's third ventricle using a midplane encoded symmetric template model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 129:51-62. [PMID: 27084320 PMCID: PMC4841787 DOI: 10.1016/j.cmpb.2016.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/12/2016] [Accepted: 02/22/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Structural changes of the brain's third ventricle have been acknowledged as an indicative measure of the brain atrophy progression in neurodegenerative and endocrinal diseases. To investigate the ventricular enlargement in relation to the atrophy of the surrounding structures, shape analysis is a promising approach. However, there are hurdles in modeling the third ventricle shape. First, it has topological variations across individuals due to the inter-thalamic adhesion. In addition, as an interhemispheric structure, it needs to be aligned to the midsagittal plane to assess its asymmetric and regional deformation. METHOD To address these issues, we propose a model-based shape assessment. Our template model of the third ventricle consists of a midplane and a symmetric mesh of generic shape. By mapping the template's midplane to the individuals' brain midsagittal plane, we align the symmetric mesh on the midline of the brain before quantifying the third ventricle shape. To build the vertex-wise correspondence between the individual third ventricle and the template mesh, we employ a minimal-distortion surface deformation framework. In addition, to account for topological variations, we implement geometric constraints guiding the template mesh to have zero width where the inter-thalamic adhesion passes through, preventing vertices crossing between left and right walls of the third ventricle. The individual shapes are compared using a vertex-wise deformity from the symmetric template. RESULTS Experiments on imaging and demographic data from a study of aging showed that our model was sensitive in assessing morphological differences between individuals in relation to brain volume (i.e. proxy for general brain atrophy), gender and the fluid intelligence at age 72. It also revealed that the proposed method can detect the regional and asymmetrical deformation unlike the conventional measures: volume (median 1.95ml, IQR 0.96ml) and width of the third ventricle. Similarity measures between binary masks and the shape model showed that the latter reconstructed shape details with high accuracy (Dice coefficient ≥0.9, mean distance 0.5mm and Hausdorff distance 2.7mm). CONCLUSIONS We have demonstrated that our approach is suitable to morphometrical analyses of the third ventricle, providing high accuracy and inter-subject consistency in the shape quantification. This shape modeling method with geometric constraints based on anatomical landmarks could be extended to other brain structures which require a consistent measurement basis in the morphometry.
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Affiliation(s)
- Jaeil Kim
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Maria del C Valdés Hernández
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK
| | - Natalie A Royle
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK
| | - Susana Muñoz Maniega
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK
| | - Benjamin S Aribisala
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK; Computer Science Department, Lagos State University, Nigeria
| | - Alan J Gow
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Psychology, School of Life Sciences, Heriot-Watt University, Edinburgh, UK
| | - Mark E Bastin
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Brain Research Imaging Centre, Department of Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; SINAPSE (Scottish Imaging Network, A Platform for Scientific Excellence) Collaboration, Scotland, UK
| | - Jinah Park
- School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
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De Silva TM, Miller AA. Cerebral Small Vessel Disease: Targeting Oxidative Stress as a Novel Therapeutic Strategy? Front Pharmacol 2016; 7:61. [PMID: 27014073 PMCID: PMC4794483 DOI: 10.3389/fphar.2016.00061] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/04/2016] [Indexed: 12/25/2022] Open
Abstract
Cerebral small vessel disease (SVD) is a major contributor to stroke, and a leading cause of cognitive impairment and dementia. Despite the devastating effects of cerebral SVD, the pathogenesis of cerebral SVD is still not completely understood. Moreover, there are no specific pharmacological strategies for its prevention or treatment. Cerebral SVD is characterized by marked functional and structural abnormalities of the cerebral microcirculation. The clinical manifestations of these pathological changes include lacunar infarcts, white matter hyperintensities, and cerebral microbleeds. The main purpose of this review is to discuss evidence implicating oxidative stress in the arteriopathy of both non-amyloid and amyloid (cerebral amyloid angiopathy) forms of cerebral SVD and its most important risk factors (hypertension and aging), as well as its contribution to cerebral SVD-related brain injury and cognitive impairment. We also highlight current evidence of the involvement of the NADPH oxidases in the development of oxidative stress, enzymes that are a major source of reactive oxygen species in the cerebral vasculature. Lastly, we discuss potential pharmacological strategies for oxidative stress in cerebral SVD, including some of the historical and emerging NADPH oxidase inhibitors.
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Affiliation(s)
- T. Michael De Silva
- Department of Pharmacology, Biomedicine Discovery Institute, Monash UniversityMelbourne, VIC, Australia
| | - Alyson A. Miller
- Cerebrovascular and Stroke Laboratory, School of Health and Biomedical Sciences, RMIT UniversityMelbourne, VIC, Australia
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Habes M, Erus G, Toledo JB, Zhang T, Bryan N, Launer LJ, Rosseel Y, Janowitz D, Doshi J, Van der Auwera S, von Sarnowski B, Hegenscheid K, Hosten N, Homuth G, Völzke H, Schminke U, Hoffmann W, Grabe HJ, Davatzikos C. White matter hyperintensities and imaging patterns of brain ageing in the general population. Brain 2016; 139:1164-79. [PMID: 26912649 DOI: 10.1093/brain/aww008] [Citation(s) in RCA: 275] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 12/17/2015] [Indexed: 01/18/2023] Open
Abstract
White matter hyperintensities are associated with increased risk of dementia and cognitive decline. The current study investigates the relationship between white matter hyperintensities burden and patterns of brain atrophy associated with brain ageing and Alzheimer's disease in a large populatison-based sample (n = 2367) encompassing a wide age range (20-90 years), from the Study of Health in Pomerania. We quantified white matter hyperintensities using automated segmentation and summarized atrophy patterns using machine learning methods resulting in two indices: the SPARE-BA index (capturing age-related brain atrophy), and the SPARE-AD index (previously developed to capture patterns of atrophy found in patients with Alzheimer's disease). A characteristic pattern of age-related accumulation of white matter hyperintensities in both periventricular and deep white matter areas was found. Individuals with high white matter hyperintensities burden showed significantly (P < 0.0001) lower SPARE-BA and higher SPARE-AD values compared to those with low white matter hyperintensities burden, indicating that the former had more patterns of atrophy in brain regions typically affected by ageing and Alzheimer's disease dementia. To investigate a possibly causal role of white matter hyperintensities, structural equation modelling was used to quantify the effect of Framingham cardiovascular disease risk score and white matter hyperintensities burden on SPARE-BA, revealing a statistically significant (P < 0.0001) causal relationship between them. Structural equation modelling showed that the age effect on SPARE-BA was mediated by white matter hyperintensities and cardiovascular risk score each explaining 10.4% and 21.6% of the variance, respectively. The direct age effect explained 70.2% of the SPARE-BA variance. Only white matter hyperintensities significantly mediated the age effect on SPARE-AD explaining 32.8% of the variance. The direct age effect explained 66.0% of the SPARE-AD variance. Multivariable regression showed significant relationship between white matter hyperintensities volume and hypertension (P = 0.001), diabetes mellitus (P = 0.023), smoking (P = 0.002) and education level (P = 0.003). The only significant association with cognitive tests was with the immediate recall of the California verbal and learning memory test. No significant association was present with the APOE genotype. These results support the hypothesis that white matter hyperintensities contribute to patterns of brain atrophy found in beyond-normal brain ageing in the general population. White matter hyperintensities also contribute to brain atrophy patterns in regions related to Alzheimer's disease dementia, in agreement with their known additive role to the likelihood of dementia. Preventive strategies reducing the odds to develop cardiovascular disease and white matter hyperintensities could decrease the incidence or delay the onset of dementia.
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Affiliation(s)
- Mohamad Habes
- Institute for Community Medicine, University of Greifswald, Germany Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA Department of Psychiatry, University of Greifswald, Germany
| | - Guray Erus
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA
| | - Jon B Toledo
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania, USA
| | - Tianhao Zhang
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA
| | - Nick Bryan
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA
| | - Lenore J Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, USA
| | - Yves Rosseel
- Department of Data Analysis, Ghent University, Belgium
| | | | - Jimit Doshi
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA
| | - Sandra Van der Auwera
- Department of Psychiatry, University of Greifswald, Germany German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | | | | | - Norbert Hosten
- Department of Radiology, University of Greifswald, Germany
| | - Georg Homuth
- Institute for Genetics and Functional Genomics, University of Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University of Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University of Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University of Greifswald, Germany German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry, University of Greifswald, Germany German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Christos Davatzikos
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, USA
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47
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Banerjee G, Wilson D, Jäger HR, Werring DJ. Novel imaging techniques in cerebral small vessel diseases and vascular cognitive impairment. Biochim Biophys Acta Mol Basis Dis 2015; 1862:926-38. [PMID: 26687324 DOI: 10.1016/j.bbadis.2015.12.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/07/2015] [Accepted: 12/08/2015] [Indexed: 11/27/2022]
Abstract
Dementia is a global growing concern, affecting over 35 million people with a global economic impact of over $604 billion US. With an ageing population the number of people affected is expected double over the next two decades. Vascular cognitive impairment can be caused by various types of cerebrovascular disease, including cortical and subcortical infarcts, and the more diffuse white matter injury due to cerebral small vessel disease. Although this type of cognitive impairment is usually considered the second most common form of dementia after Alzheimer's disease, there is increasing recognition of the vascular contribution to neurodegeneration, with both pathologies frequently coexisting. The aim of this review is to highlight the recent advances in the understanding of vascular cognitive impairment, with a focus on small vessel diseases of the brain. We discuss recently identified small vessel imaging markers that have been associated with cognitive impairment, namely cerebral microbleeds, enlarged perivascular spaces, cortical superficial siderosis, and microinfarcts. We will also consider quantitative techniques including diffusion tensor imaging, magnetic resonance perfusion imaging with arterial spin labelling, functional magnetic resonance imaging and positron emission tomography. As well as potentially shedding light on the mechanism by which cerebral small vessel diseases cause dementia, these novel imaging biomarkers are also of increasing relevance given their ability to guide diagnosis and reflect disease progression, which may in the future be useful for therapeutic interventions. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.
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Affiliation(s)
- Gargi Banerjee
- UCL Stroke Research Centre, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, 10-12 Russell Square, London WC1B 3EE, UK
| | - Duncan Wilson
- UCL Stroke Research Centre, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, 10-12 Russell Square, London WC1B 3EE, UK
| | - Hans R Jäger
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
| | - David J Werring
- UCL Stroke Research Centre, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, 10-12 Russell Square, London WC1B 3EE, UK
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48
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Cai Z, Wang C, He W, Tu H, Tang Z, Xiao M, Yan LJ. Cerebral small vessel disease and Alzheimer's disease. Clin Interv Aging 2015; 10:1695-704. [PMID: 26604717 PMCID: PMC4629951 DOI: 10.2147/cia.s90871] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is a group of pathological processes with multifarious etiology and pathogenesis that are involved into the small arteries, arterioles, venules, and capillaries of the brain. CSVD mainly contains lacunar infarct or lacunar stroke, leukoaraiosis, Binswanger's disease, and cerebral microbleeds. CSVD is an important cerebral microvascular pathogenesis as it is the cause of 20% of strokes worldwide and the most common cause of cognitive impairment and dementia, including vascular dementia and Alzheimer's disease (AD). It has been well identified that CSVD contributes to the occurrence of AD. It seems that the treatment and prevention for cerebrovascular diseases with statins have such a role in the same function for AD. So far, there is no strong evidence-based medicine to support the idea, although increasing basic studies supported the fact that the treatment and prevention for cerebrovascular diseases will benefit AD. Furthermore, there is still lack of evidence in clinical application involved in specific drugs to benefit both AD and CSVD.
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Affiliation(s)
- Zhiyou Cai
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China
| | - Chuanling Wang
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China
| | - Wenbo He
- Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China
| | - Hanjun Tu
- Department of Basic Research Center, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China
| | - Zhengang Tang
- Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, People’s Republic of China
| | - Ming Xiao
- Department of Anatomy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Liang-Jun Yan
- Department of Pharmaceutical Sciences, UNT System College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX, USA
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49
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Ritchie SJ, Dickie DA, Cox SR, Valdes Hernandez MDC, Corley J, Royle NA, Pattie A, Aribisala BS, Redmond P, Muñoz Maniega S, Taylor AM, Sibbett R, Gow AJ, Starr JM, Bastin ME, Wardlaw JM, Deary IJ. Brain volumetric changes and cognitive ageing during the eighth decade of life. Hum Brain Mapp 2015; 36:4910-25. [PMID: 26769551 PMCID: PMC4832269 DOI: 10.1002/hbm.22959] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 07/24/2015] [Accepted: 08/20/2015] [Indexed: 12/19/2022] Open
Abstract
Later‐life changes in brain tissue volumes—decreases in the volume of healthy grey and white matter and increases in the volume of white matter hyperintensities (WMH)—are strong candidates to explain some of the variation in ageing‐related cognitive decline. We assessed fluid intelligence, memory, processing speed, and brain volumes (from structural MRI) at mean age 73 years, and at mean age 76 in a narrow‐age sample of older individuals (n = 657 with brain volumetric data at the initial wave, n = 465 at follow‐up). We used latent variable modeling to extract error‐free cognitive levels and slopes. Initial levels of cognitive ability were predictive of subsequent brain tissue volume changes. Initial brain volumes were not predictive of subsequent cognitive changes. Brain volume changes, especially increases in WMH, were associated with declines in each of the cognitive abilities. All statistically significant results were modest in size (absolute r‐values ranged from 0.114 to 0.334). These results build a comprehensive picture of macrostructural brain volume changes and declines in important cognitive faculties during the eighth decade of life. Hum Brain Mapp 36:4910–4925, 2015. © 2015 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc
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Affiliation(s)
- Stuart J Ritchie
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - David Alexander Dickie
- Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Simon R Cox
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Maria Del C Valdes Hernandez
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Janie Corley
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Natalie A Royle
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Alison Pattie
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Benjamin S Aribisala
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom.,Computer Science Department, Faculty of Science, Lagos State University, Lagos, PMB 001, Nigeria
| | - Paul Redmond
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Susana Muñoz Maniega
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Adele M Taylor
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Ruth Sibbett
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Alzheimer Scotland Dementia Research Centre, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Alan J Gow
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Alzheimer Scotland Dementia Research Centre, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Neuroimaging Sciences, Brain Research Imaging Centre, the University of Edinburgh, Edinburgh, EH4 2XU, United Kingdom.,Scottish Imaging Network, a Platform for Scientific Excellence (SINAPSE) Collaboration.,Centre for Clinical Brain Sciences, the University of Edinburgh, Edinburgh, EH16 4TJ, United Kingdom
| | - Ian J Deary
- Department of Psychology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology, the University of Edinburgh, Edinburgh, EH8 9JZ, United Kingdom
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50
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De Vis JB, Zwanenburg JJ, van der Kleij LA, Spijkerman JM, Biessels GJ, Hendrikse J, Petersen ET. Cerebrospinal fluid volumetric MRI mapping as a simple measurement for evaluating brain atrophy. Eur Radiol 2015; 26:1254-62. [PMID: 26318506 PMCID: PMC4820466 DOI: 10.1007/s00330-015-3932-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 07/11/2015] [Accepted: 07/16/2015] [Indexed: 12/28/2022]
Abstract
Objectives To assess whether volumetric cerebrospinal fluid (CSF) MRI can be used as a surrogate for brain atrophy assessment and to evaluate how the T2 of the CSF relates to brain atrophy. Methods Twenty-eight subjects [mean age 64 (sd 2) years] were included; T1-weighted and CSF MRI were performed. The first echo data of the CSF MRI sequence was used to obtain intracranial volume, CSF partial volume was measured voxel-wise to obtain CSF volume (VCSF) and the T2 of CSF (T2,CSF) was calculated. The correlation between VCSF / T2,CSF and brain atrophy scores [global cortical atrophy (GCA) and medial temporal lobe atrophy (MTA)] was evaluated. Results Relative total, peripheral subarachnoidal, and ventricular VCSF increased significantly with increased scores on the GCA and MTA (R = 0.83, 0.78 and 0.78 and R = 0.72, 0.62 and 0.86). Total, peripheral subarachnoidal, and ventricular T2 of the CSF increased significantly with higher scores on the GCA and MTA (R = 0.72, 0.70 and 0.49 and R = 0.60, 0.57 and 0.41). Conclusion A fast, fully automated CSF MRI volumetric sequence is an alternative for qualitative atrophy scales. The T2 of the CSF is related to brain atrophy and could thus be a marker of neurodegenerative disease. Key points • A 1:11 min CSF MRI volumetric sequence can evaluate brain atrophy. • CSF MRI provides accurate atrophy assessment without partial volume effects. • CSF MRI data can be processed quickly without user interaction. • The measured T2of the CSF is related to brain atrophy. Electronic supplementary material The online version of this article (doi:10.1007/s00330-015-3932-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J B De Vis
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands.
| | - J J Zwanenburg
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands
| | - L A van der Kleij
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands
| | - J M Spijkerman
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands
| | - G J Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Hendrikse
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands
| | - E T Petersen
- Department of Radiology, University Medical Center Utrecht, HP E 01.132, P.O.Box 85500, 3508, GA, Utrecht, The Netherlands.,Danish Research Centre for Magnetic Resonance, Hvidovre Hospital, Hvidovre, Denmark
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