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Pan J, Qiu Z, Fu G, Liang J, Li Y, Feng Y, Zhang X, Lv X. Non-complete recovery of temporal lobe white matter diffusion metrics at one year Post-Radiotherapy: Implications for Radiation-Induced necrosis risk. Radiother Oncol 2024; 199:110420. [PMID: 39029591 DOI: 10.1016/j.radonc.2024.110420] [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: 12/15/2023] [Revised: 06/20/2024] [Accepted: 07/01/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Temporal lobe (TL) white matter (WM) injuries are often seen early after radiotherapy (RT) in nasopharyngeal carcinoma patients (NPCs), which fail to fully recover in later stages, exhibiting a "non-complete recovery pattern". Herein, we explored the correlation between non-complete recovery WM injuries and TL necrosis (TLN), identifying dosimetric predictors for TLN-related high-risk WM injuries. METHODS We longitudinally examined 161 NPCs and 19 healthy controls employing multi-shell diffusion MRI. Automated fiber-tract quantification quantified diffusion metrics within TL WM tract segments. ANOVA identified non-complete recovery WM tract segments one-year post-RT. Cox regression models discerned TLN risk factors utilizing non-complete recovery diffusion metrics. Normal tissue complication probability (NTCP) models and dose-response analysis further scrutinized RT-related toxicity to high-risk WM tract segments. RESULTS Seven TL WM tract segments exhibited a "non-complete recovery pattern". Cox regression analysis identified mean diffusivity of the left uncinate fasciculus segment 1, neurite density index (NDI) of the left cingulum hippocampus segment 1, and NDI of the right inferior longitudinal fasciculus segment 1 as TLN risk predictors (hazard ratios [HRs] with confidence interval [CIs]: 1.45 [1.17-1.81], 1.07 [1.00-1.15], and 1.15 [1.03-1.30], respectively; all P-values < 0.05). In NTCP models, D10cc.L, D20cc.L and D10cc.R demonstrated superior performance, with TD50 of 37.22 Gy, 24.96 Gy and 37.28 Gy, respectively. CONCLUSIONS Our findings underscore the significance of the "non-complete recovery pattern" in TL WM tract segment injuries during TLN development. Understanding TLN-related high-risk WM tract segments and their tolerance doses could facilitate early intervention in TLN and improve RT protocols.
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Affiliation(s)
- Jie Pan
- Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, China
| | - Ziru Qiu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Gui Fu
- Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, China
| | - Jiahui Liang
- Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, China
| | - Yunpeng Li
- Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence & Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou, China; Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xinyuan Zhang
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Medical Image Processing and Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China.
| | - Xiaofei Lv
- Department of Medical Imaging, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou 510060, China.
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Fruhwirth V, Berger L, Gattringer T, Fandler-Höfler S, Kneihsl M, Eppinger S, Ropele S, Fink A, Deutschmann H, Reishofer G, Enzinger C, Pinter D. White matter integrity and functional connectivity of the default mode network in acute stroke are associated with cognitive outcome three months post-stroke. J Neurol Sci 2024; 462:123071. [PMID: 38850772 DOI: 10.1016/j.jns.2024.123071] [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: 03/21/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Knowledge about factors that are associated with post-stroke cognitive outcome is important to identify patients with high risk for impairment. We therefore investigated the associations of white matter integrity and functional connectivity (FC) within the brain's default-mode network (DMN) in acute stroke patients with cognitive outcome three months post-stroke. METHODS Patients aged between 18 and 85 years with an acute symptomatic MRI-proven unilateral ischemic middle cerebral artery infarction, who had received reperfusion therapy, were invited to participate in this longitudinal study. All patients underwent brain MRI within 24-72 h after symptom onset, and participated in a neuropsychological assessment three months post-stroke. We performed hierarchical regression analyses to explore the incremental value of baseline white matter integrity and FC beyond demographic, clinical, and macrostructural information for cognitive outcome. RESULTS The study cohort comprised 34 patients (mean age: 64 ± 12 years, 35% female). The initial median National Institutes of Health Stroke Scale (NIHSS) score was 10, and significantly improved three months post-stroke to a median NIHSS = 1 (p < .001). Nonetheless, 50% of patients showed cognitive impairment three months post-stroke. FC of the non-lesioned anterior cingulate cortex of the affected hemisphere explained 15% of incremental variance for processing speed (p = .007), and fractional anisotropy of the non-lesioned cingulum of the affected hemisphere explained 13% of incremental variance for cognitive flexibility (p = .033). CONCLUSIONS White matter integrity and functional MRI markers of the DMN in acute stroke explain incremental variance for post-stroke cognitive outcome beyond demographic, clinical, and macrostructural information.
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Affiliation(s)
- Viktoria Fruhwirth
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Lisa Berger
- Institute of Psychology, Department of Neuropsychology - Neuroimaging, University of Graz, Graz, Austria
| | - Thomas Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | | | - Markus Kneihsl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Andreas Fink
- Institute of Psychology, Department of Biological Psychology, University of Graz, Graz, Austria
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Gernot Reishofer
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria; Department of Neurology, Research Unit for Neuronal Plasticity and Repair, Medical University of Graz, Graz, Austria.
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Li P, Lu H, Shi X, Yan J, Zhou L, Yang J, Wang B, Zhao Y, Liu L, Zhu Y, Xu L, Yang X, Su X, Yang Y, Zhang T, Guo L, Liu X. Protective effects of human urinary kallidinogenase against corticospinal tract damage in acute ischemic stroke patients. Neuroreport 2024; 35:431-438. [PMID: 38526971 DOI: 10.1097/wnr.0000000000002028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
This study aimed to assess the effects of human urinary kallidinogenase (HUK) on motor function outcome and corticospinal tract recovery in patients with acute ischemic stroke (AIS). This study was a randomized, controlled, single-blinded trial. Eighty AIS patients were split into two groups: the HUK and control groups. The HUK group was administered HUK and standard treatment, while the control group received standard treatment only. At admission and discharge, the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI) and muscle strength were scored. The primary endpoint was the short-term outcomes of AIS patients under different treatments. The secondary endpoint was the degree of corticospinal tract fiber damage under different treatments. There was a significant improvement in the NIHSS Scale, BI and muscle strength scores in the HUK group compared with controls (Mann-Whitney U test; P < 0.05). Diffusion tensor tractography classification and intracranial arterial stenosis were independent predictors of short-term recovery by linear regression analysis. The changes in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) decline rate were significantly smaller in the HUK group than in the control group ( P < 0.05). Vascular endothelial growth factor (VEGF) increased significantly after HUK treatment ( P < 0.05), and the VEGF change was negatively correlated with changes in ADC. HUK is beneficial for the outcome in AIS patients especially in motor function recovery. It may have protective effects on the corticospinal tract which is reflected by the reduction in the FA and ADC decline rates and increased VEGF expression. The study was registered on ClinicalTrials.gov (unique identifier: NCT04102956).
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Affiliation(s)
- Peifang Li
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
- Department of Neurology, Handan Central Hospital, Handan
| | - Honglin Lu
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Xiaoman Shi
- Department of Pediatrics, Affiliated Hospital of Hebei University, Baoding
| | - Jiajia Yan
- Department of Neurology, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou
| | - Lixia Zhou
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Jipeng Yang
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Binbin Wang
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Yanying Zhao
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Luji Liu
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Yipu Zhu
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Lei Xu
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Xiaoli Yang
- Department of Neurology, Hebei University of Engineering School of Medicine, Handan
| | - Xudong Su
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Yi Yang
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Tong Zhang
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Li Guo
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
| | - Xiaoyun Liu
- Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, China
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Yamazaki R, Akamatsu Y, Yoshida J, Yamashita F, Sasaki M, Fujiwara S, Kobayashi M, Koji T, Ogasawara K. Association between preoperative white matter hyperintensities and postoperative new ischemic lesions on magnetic resonance imaging in patients with cognitive decline after carotid endarterectomy. Neurosurg Rev 2024; 47:91. [PMID: 38379090 DOI: 10.1007/s10143-024-02324-0] [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: 08/01/2023] [Revised: 12/27/2023] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
Although cognitive decline after carotid endarterectomy (CEA) is mainly related to postoperative cerebral hyperperfusion, approximately 30% of patients with cognitive decline do not have postoperative cerebral hyperperfusion. In patients with acute ischemic events, the development of cognitive decline after such events is associated with the presence of chronic cerebral white matter hyperintensities (WMHs). The present prospective observational study aimed to determine whether preoperative WMHs and postoperative new ischemic lesions (PNILs) are associated with cognitive decline after CEA in patients without cerebral hyperperfusion after CEA. Brain magnetic resonance imaging (MRI) was performed preoperatively, and WMHs were graded according to the Fazekas scale in patients undergoing CEA for severe stenosis of the ipsilateral internal carotid. Diffusion-weighted MRI was performed before and after CEA to determine the development of PNILs. Neuropsychological testing was performed preoperatively and at 2 months postoperatively to determine the development of postoperative cognitive decline (PCD). In 142 patients without postoperative cerebral hyperperfusion, logistic regression analysis revealed that preoperative Fazekas scale of periventricular WMHs (PVWMHs) (95% confidence interval [CI]: 1.78-28.10; P = 0.0055) and PNILs in the eloquent areas (95% CI: 7.42-571.89; P = 0.0002) were significantly associated with PCD. The specificity and positive-predictive value for the prediction of PCD were significantly greater for the combination of preoperative Fazekas scale 2 or 3 of PVWMHs and PNILs in the eloquent areas than for each individually. Preoperative PVWMHs, PNILs in the eloquent areas, and the combination of both were associated with PCD in patients without cerebral hyperperfusion after CEA.
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Affiliation(s)
- Ryouga Yamazaki
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Yosuke Akamatsu
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Jun Yoshida
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Shunrou Fujiwara
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Masakazu Kobayashi
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Takahiro Koji
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, 2-1-1 Idai-Dori, Yahaba, Iwate, 028-3695, Japan.
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Namgung E, Lee EJ, Kim YH, Kang DW. White Matter Structural Connectivity Associated With Visual Field Recovery After Stroke. J Stroke 2024; 26:116-120. [PMID: 38246721 PMCID: PMC10850453 DOI: 10.5853/jos.2023.02222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 01/23/2024] Open
Affiliation(s)
- Eun Namgung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Eun-Jae Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Nunaps Inc., Seoul, Korea
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Wang J, Ding X, Li C, Huang C, Ke C, Xu C, Wan C. Early exercise intervention promotes myelin repair in the brains of ischemic rats by inhibiting the MEK/ERK pathway. Transl Neurosci 2024; 15:20220335. [PMID: 38511170 PMCID: PMC10951688 DOI: 10.1515/tnsci-2022-0335] [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: 11/11/2023] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Our previous studies have shown that early exercise intervention after stroke increases neural activity and synaptic plasticity and promotes the recovery of nerve fiber bundle integrity in the brain. However, the effect of exercise on the repair of myelin in the brain and the related mechanism are still unclear. In this study, we randomly divided the rats into three groups. Before and after 28 days of intervention, body weight, nerve function, the infarct size, white matter fiber bundle integrity, and nerve myelin structure and function were observed by measuring body weight, analysis of modified neurological severity score, CatWalk gait analysis, MRI, luxol fast blue staining, immunofluorescence, and transmission electron microscopy. Changes in the expression of proteins in the MEK/ERK pathway were assessed. The results showed that early exercise intervention resulted in neurological recovery, decreased the infarct volume and increased nerve fiber integrity, the myelin coverage area, myelin basic protein (MBP) fluorescence intensity expression, and myelin thickness. Furthermore, the expression level of MBP was significantly increased after early exercise intervention, while the expression levels of p-MEK1/2 and p-ERK1/2 were significantly reduced. In the cell study, MBP expression levels were significantly higher in the oxygen and glucose deprivation and administration group.In summary, early exercise intervention after stroke can promote myelin repair by inhibiting the MEK/ERK signaling pathway.
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Affiliation(s)
- Junyi Wang
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Xinyu Ding
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Chen Li
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Chuan Huang
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Changkai Ke
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Chunlei Xu
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Chunxiao Wan
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
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Varghese R, Chang B, Kim B, Liew SL, Schweighofer N, Winstein CJ. Corpus Callosal Microstructure Predicts Bimanual Motor Performance in Chronic Stroke Survivors: a Preliminary Cross-Sectional Study. Top Stroke Rehabil 2023; 30:626-634. [PMID: 35856402 PMCID: PMC9852360 DOI: 10.1080/10749357.2022.2095085] [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: 12/05/2021] [Accepted: 06/19/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Microstructural changes in the corpus callosum (CC) are associated with more severe motor impairment in the paretic hand, poor recovery, and general disability. The purpose of this study was to determine if CC microstructure predicts bimanual motor performance in chronic stroke survivors. METHODS We examined the relationship between the fractional anisotropy (FA) across the CC, in both the sensorimotor and non-sensorimotor regions, and movement times for two self-initiated and self-paced bimanual tasks in 41 chronic stroke survivors. Using publicly available control datasets (n = 52), matched closely for imaging acquisition parameters, we also explored the effect of stroke and age on callosal microstructure. RESULTS In mild-to-moderate chronic stroke survivors with relatively localized lesions to the motor areas, lower callosal FA values, suggestive of a more disorganized microstructure, were associated with slower bimanual performance. Associations were strongest for the primary motor fibers (b = -2.19 ± 1.03, p = .035), followed closely by premotor/supplementary motor (b = -2.07 ± 1.07, p = .041) and prefrontal (b = -1.92 ± 0.97, p = .05) fibers of the callosum. Secondary analysis revealed that compared to neurologically age-similar adults, chronic stroke survivors exhibited significantly lower mean FA in all regions of the CC, except the splenium. CONCLUSION Remote widespread changes in the callosal genu and body are associated with slower performance on cooperative bimanual tasks that require precise and interdependent coordination of the hands. Measures of callosal microstructure may prove to be a useful predictor of real-world bimanual performance in chronic stroke survivors.
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Affiliation(s)
- Rini Varghese
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089
| | - Brianna Chang
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089
| | - Bokkyu Kim
- SUNY Upstate Medical University, Department of Physical Therapy, Syracuse, NY 13210
| | - Sook-Lei Liew
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089
| | - Nicolas Schweighofer
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089
| | - Carolee J. Winstein
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033
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Jia J, Zheng L, Ye L, Chen J, Shu S, Xu S, Bao X, Xia S, Liu R, Xu Y, Zhang M. CD11c + microglia promote white matter repair after ischemic stroke. Cell Death Dis 2023; 14:156. [PMID: 36828819 PMCID: PMC9958101 DOI: 10.1038/s41419-023-05689-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/26/2023]
Abstract
Ischemic stroke leads to white matter damage and neurological deficits. However, the characteristics of white matter injury and repair after stroke are unclear. Additionally, the precise molecular communications between microglia and white matter repair during the stroke rehabilitation phase remain elusive. In this current study, MRI DTI scan and immunofluorescence staining were performed to trace white matter and microglia in the mouse transient middle cerebral artery occlusion (tMCAO) stroke model. We found that the most serious white matter damage was on Day 7 after the ischemic stroke, then it recovered gradually from Day 7 to Day 30. Parallel to white matter recovery, we observed that microglia centered around the damaged myelin sheath and swallowed myelin debris in the ischemic areas. Then, microglia of the ischemic hemisphere were sorted by flow cytometry for RNA sequencing and subpopulation analysis. We found that CD11c+ microglia increased from Day 7 to Day 30, demonstrating high phagocytotic capabilities, myelin-supportive genes, and lipid metabolism associated genes. CD11c+ microglia population was partly depleted by the stereotactic injecting of rAAV2/6M-taCasp3 (rAAV2/6M-CMV-DIO-taCasp3-TEVp) into CD11c-cre mice. Selective depletion of CD11c+ microglia disrupted white matter repair, oligodendrocyte maturation, and functional recovery after stroke by Rotarod test, Adhesive Removal test, and Morris Water Maze test. These findings suggest that spontaneous white matter repair occurs after ischemic stroke, while CD11c+ microglia play critical roles in this white matter restorative progress.
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Affiliation(s)
- Junqiu Jia
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Lili Zheng
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Lei Ye
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Jian Chen
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Shu Shu
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Siyi Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Zhenjiang, China
| | - Xinyu Bao
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Shengnan Xia
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China
| | - Renyuan Liu
- Department of Radiology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China.
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.
| | - Meijuan Zhang
- Department of Neurology, Drum Tower Hospital, The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Medical School, Nanjing University, Nanjing, China.
- Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.
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Haddad SMH, Scott CJM, Ozzoude M, Berezuk C, Holmes M, Adamo S, Ramirez J, Arnott SR, Nanayakkara ND, Binns M, Beaton D, Lou W, Sunderland K, Sujanthan S, Lawrence J, Kwan D, Tan B, Casaubon L, Mandzia J, Sahlas D, Saposnik G, Hassan A, Levine B, McLaughlin P, Orange JB, Roberts A, Troyer A, Black SE, Dowlatshahi D, Strother SC, Swartz RH, Symons S, Montero-Odasso M, ONDRI Investigators, Bartha R. Comparison of Diffusion Tensor Imaging Metrics in Normal-Appearing White Matter to Cerebrovascular Lesions and Correlation with Cerebrovascular Disease Risk Factors and Severity. Int J Biomed Imaging 2022; 2022:5860364. [PMID: 36313789 PMCID: PMC9616672 DOI: 10.1155/2022/5860364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 04/21/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2023] Open
Abstract
Alterations in tissue microstructure in normal-appearing white matter (NAWM), specifically measured by diffusion tensor imaging (DTI) fractional anisotropy (FA), have been associated with cognitive outcomes following stroke. The purpose of this study was to comprehensively compare conventional DTI measures of tissue microstructure in NAWM to diverse vascular brain lesions in people with cerebrovascular disease (CVD) and to examine associations between FA in NAWM and cerebrovascular risk factors. DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured in cerebral tissues and cerebrovascular anomalies from 152 people with CVD participating in the Ontario Neurodegenerative Disease Research Initiative (ONDRI). Ten cerebral tissue types were segmented including NAWM, and vascular lesions including stroke, periventricular and deep white matter hyperintensities, periventricular and deep lacunar infarcts, and perivascular spaces (PVS) using T1-weighted, proton density-weighted, T2-weighted, and fluid attenuated inversion recovery MRI scans. Mean DTI metrics were measured in each tissue region using a previously developed DTI processing pipeline and compared between tissues using multivariate analysis of covariance. Associations between FA in NAWM and several CVD risk factors were also examined. DTI metrics in vascular lesions differed significantly from healthy tissue. Specifically, all tissue types had significantly different MD values, while FA was also found to be different in most tissue types. FA in NAWM was inversely related to hypertension and modified Rankin scale (mRS). This study demonstrated the differences between conventional DTI metrics, FA, MD, AD, and RD, in cerebral vascular lesions and healthy tissue types. Therefore, incorporating DTI to characterize the integrity of the tissue microstructure could help to define the extent and severity of various brain vascular anomalies. The association between FA within NAWM and clinical evaluation of hypertension and disability provides further evidence that white matter microstructural integrity is impacted by cerebrovascular function.
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Affiliation(s)
- Seyyed M. H. Haddad
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, Canada
| | - Christopher J. M. Scott
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada
| | - Miracle Ozzoude
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada
| | | | - Melissa Holmes
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada
| | - Sabrina Adamo
- Clinical Neurosciences, University of Toronto, Toronto, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada
| | - Stephen R. Arnott
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Nuwan D. Nanayakkara
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, Canada
| | - Malcolm Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kelly Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | | | - Jane Lawrence
- Thunder Bay Regional Health Research Institute, Thunder Bay, Canada
| | | | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Leanne Casaubon
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Jennifer Mandzia
- Department of Medicine, Division of Neurology, University of Western Ontario, London, Canada
| | - Demetrios Sahlas
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | - Ayman Hassan
- Thunder Bay Regional Research Institute, Thunder Bay, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | | | - J. B. Orange
- School of Communication Sciences and Disorders, Western University, London, Canada
| | - Angela Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorder, Northwestern University, Evanston, USA
| | - Angela Troyer
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
| | - Sandra E. Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Sunnybrook Health Sciences Centre, University of Toronto, Stroke Research Program, Toronto, Canada
| | | | - Stephen C. Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Richard H. Swartz
- Sunnybrook Health Sciences Centre, University of Toronto, Stroke Research Program, Toronto, Canada
| | - Sean Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Parkwood Hospital, St. Joseph's Health Care London, London, Canada
| | - ONDRI Investigators
- Ontario Neurodegenerative Disease Initiative, Ontario Brain Institute, Toronto, Canada
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, Canada
- Department of Medical Biophysics, University of Western Ontario, London, Canada
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10
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Sagnier S, Catheline G, Dilharreguy B, Linck PA, Coupé P, Munsch F, Bigourdan A, Poli M, Debruxelles S, Renou P, Olindo S, Rouanet F, Dousset V, Tourdias T, Sibon I. Normal-Appearing White Matter Deteriorates over the Year After an Ischemic Stroke and Is Associated with Global Cognition. Transl Stroke Res 2022; 13:716-724. [PMID: 35106712 DOI: 10.1007/s12975-022-00988-8] [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: 10/02/2021] [Revised: 11/19/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Normal-appearing white matter (NAWM) is a hub of plasticity, but data relating to its influence on post-ischemic stroke (IS) outcome remain scarce. The aim of this study was to evaluate the relationship between NAWM integrity and cognitive outcome after an IS. A longitudinal study was conducted including supra-tentorial IS patients. A 3-Tesla brain MRI was performed at baseline and 1 year, allowing the analyses of mean fractional anisotropy (FA) and mean diffusivity (MD) in NAWM masks, along with the volume of white matter hyperintensities (WMH) and IS. A Montreal Cognitive Assessment (MoCA), an Isaacs set test, and a Zazzo's cancellation task were performed at baseline, 3 months and 1 year. Mixed models were built, followed by Tract-based Spatial Statistics (TBSS) analyses. Ninety-five patients were included in the analyses (38% women, median age 69 ± 20). FA significantly decreased, and MD significantly increased between baseline and 1 year, while cognitive scores improved. Patients who decreased their NAWM FA more over the year had a slower cognitive improvement on MoCA (β = - 0.11, p = 0.05). The TBSS analyses showed that patients who presented the highest decrease of FA in various tracts of white matter less improved their MoCA performances, regardless of WMH and IS volumes, demographic confounders, and clinical severity. NAWM integrity deteriorates over the year after an IS, and is associated with a cognitive recovery slowdown. The diffusion changes recorded here in patients starting with an early preserved white matter structure could have long term impact on cognition.
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Affiliation(s)
- Sharmila Sagnier
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France.
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France.
- INCIA Université Bordeaux 2, 146 rue Léo Saignat Zone Nord, Bâtiment 2A, 2e étage, 33076, Bordeaux, France.
| | - Gwenaëlle Catheline
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | - Bixente Dilharreguy
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
| | | | - Pierrick Coupé
- UMR-5800, CNRS, Université de Bordeaux, LaBRI, Talence, France
| | - Fanny Munsch
- Beth Israel Deaconess Medical Center, Harvard University, Boston, USA
| | | | - Mathilde Poli
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | - Pauline Renou
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
| | | | | | - Vincent Dousset
- CHU de Bordeaux, Neuroradiologie, Bordeaux, France
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France
| | - Thomas Tourdias
- CHU de Bordeaux, Neuroradiologie, Bordeaux, France
- INSERM-U1215, Neurocentre Magendie, Bordeaux, France
| | - Igor Sibon
- UMR-5287, CNRS, Université de Bordeaux, EPHE PSL Research University, Bordeaux, France
- CHU de Bordeaux, Unité Neuro-Vasculaire, Bordeaux, France
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11
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García AO, Brambati SM, Desautels A, Marcotte K. Timing stroke: A review on stroke pathophysiology and its influence over time on diffusion measures. J Neurol Sci 2022; 441:120377. [DOI: 10.1016/j.jns.2022.120377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/30/2022] [Accepted: 07/31/2022] [Indexed: 11/26/2022]
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12
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Syeda W, Ermine CM, Khilf MS, Wright D, Brait VH, Nithianantharajah J, Kolbe S, Johnston LA, Thompson LH, Brodtmann A. Long-term structural brain changes in adult rats after mild ischaemic stroke. Brain Commun 2022; 4:fcac185. [PMID: 35898722 PMCID: PMC9309495 DOI: 10.1093/braincomms/fcac185] [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: 08/08/2021] [Revised: 03/09/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Preclinical studies of remote degeneration have largely focused on brain changes over the first few days or weeks after stroke. Accumulating evidence suggests that neurodegeneration occurs in other brain regions remote to the site of infarction for months and even years following ischaemic stroke. Brain atrophy appears to be driven by both axonal degeneration and widespread brain inflammation. The evolution and duration of these changes are increasingly being described in human studies, using advanced brain imaging techniques. Here, we sought to investigate long-term structural brain changes in a model of mild focal ischaemic stroke following injection of endothlin-1 in adult Long–Evans rats (n = 14) compared with sham animals (n = 10), over a clinically relevant time-frame of 48 weeks. Serial structural and diffusion-weighted MRI data were used to assess dynamic volume and white matter trajectories. We observed dynamic regional brain volume changes over the 48 weeks, reflecting both normal changes with age in sham animals and neurodegeneration in regions connected to the infarct following ischaemia. Ipsilesional cortical volume loss peaked at 24 weeks but was less prominent at 36 and 48 weeks. We found significantly reduced fractional anisotropy in both ipsi- and contralesional motor cortex and cingulum bundle regions of infarcted rats (P < 0.05) from 4 to 36 weeks, suggesting ongoing white matter degeneration in tracts connected to but distant from the stroke. We conclude that there is evidence of significant cortical atrophy and white matter degeneration up to 48 weeks following infarct, consistent with enduring, pervasive stroke-related degeneration.
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Affiliation(s)
- Warda Syeda
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
- Melbourne Neuropsychiatry Centre, The University of Melbourne , Parkville, Victoria , Australia
| | - Charlotte M Ermine
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
| | - Mohamed Salah Khilf
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
| | - David Wright
- Department of Neuroscience, Monash University , Clayton , Australia
| | - Vanessa H Brait
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
| | - Jess Nithianantharajah
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
| | - Scott Kolbe
- Department of Neuroscience, Monash University , Clayton , Australia
| | - Leigh A Johnston
- The Melbourne Brain Centre Imaging Unit, The University of Melbourne , Parkville, Victoria , Australia
- Department of Biomedical Engineering, The University of Melbourne , Parkville, Victoria , Australia
| | - Lachlan H Thompson
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health , Parkville, Victoria , Australia
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13
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Ferreira Furtado LM, Bernardes HM, de Souza Félix Nunes FA, Gonçalves CA, Da Costa Val Filho JA, de Miranda AS. The Role of Neuroplasticity in Improving the Decision-Making Quality of Individuals With Agenesis of the Corpus Callosum: A Systematic Review. Cureus 2022; 14:e26082. [PMID: 35747104 PMCID: PMC9206817 DOI: 10.7759/cureus.26082] [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] [Accepted: 06/18/2022] [Indexed: 11/29/2022] Open
Abstract
Although individuals with agenesis of corpus callosum (ACC) possess intelligence coefficients within regular parameters, current studies have demonstrated decision-making compromise and potential negative social consequences. Furthermore, alternative pathways regarding brain connectivity in acallosal patients combined with cognitive therapy that would potentially mitigate such difficulties. Therefore, this study aimed to examine the current state of the art regarding brain foundations in the role of neuroplasticity by improving the decision-making quality in ACC. A systematic revision of literature was performed including studies conducted on non-syndromic ACC individuals and analyzing the impact of the potential role of neuroplasticity on the decision-making published to date. Studies with patients who underwent callosotomy were excluded. Experimental studies performed on animal models were included. During this period, 849 studies were identified; among them, 11 were eligible for qualitative analysis. Despite the paucity of evidence on this matter, patients with ACC present considerable decision-making difficulties mainly due to the functional connectivity impairment in the frontal lobes. Moreover, neuroplasticity was characterized by increased anterior commissure width as compared with controls. Notwithstanding, no studies were conducted on cognitive therapists managing this type of disease. Although the reorganization of inter-hemispheric bundles on anterior commissure has demonstrated the main natural neuroanatomic strategy in ACC, further evidence will be needed to clarify whether cognitive stimulus could improve the decision-making quality.
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14
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Pierre WC, Zhang E, Londono I, De Leener B, Lesage F, Lodygensky GA. Non-invasive in vivo MRI detects long-term microstructural brain alterations related to learning and memory impairments in a model of inflammation-induced white matter injury. Behav Brain Res 2022; 428:113884. [DOI: 10.1016/j.bbr.2022.113884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/18/2022] [Accepted: 04/03/2022] [Indexed: 11/28/2022]
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15
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White matter microstructural damage in chronic ischemic stroke affecting the left inferior frontal gyrus: association with cognitive functions. Clin Neurol Neurosurg 2022; 217:107238. [DOI: 10.1016/j.clineuro.2022.107238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 01/01/2023]
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16
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Chiou-Tan F, Ughwanogho U, Taber K. Special anatomy series: Updates in structural, functional, and clinical relevance of the corpus callosum: What new imaging techniques have revealed. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2022. [DOI: 10.4103/jisprm.jisprm-000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Li C, Ke C, Su Y, Wan C. Exercise Intervention Promotes the Growth of Synapses and Regulates Neuroplasticity in Rats With Ischemic Stroke Through Exosomes. Front Neurol 2021; 12:752595. [PMID: 34777222 PMCID: PMC8581302 DOI: 10.3389/fneur.2021.752595] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Stroke is the leading cause of death and disability. Exercise produces neuroprotection by improving neuroplasticity. Exercise can induce exosome production. According to several studies, exosomes are involved in repairing brain function, but the relationship and mechanism of exercise, exosomes, and neuroprotection have not been elucidated. This study intends to explore the relationship and potential mechanism by observing the changes in the exosome level, infarct volume, neurological function and behavioral scores, synapses, and corticospinal tract (CST). Methods: Rats were randomly divided into four groups: a sham operation (SHAM) group, middle cerebral artery occlusion (MCAO) with sedentary intervention (SED-MCAO) group, MCAO with exercise intervention (EX-MCAO) group, and MCAO with exercise intervention and exosome injection (EX-MCAO-EXO) group. The exercise intervention was started 1 day after MCAO and lasted for 4 weeks. All rats were assessed using the modified neurological severity score (mNSS). The levels of exosomes in serum and brain, gait analysis, and magnetic resonance scan were performed 1 and 4 weeks after the intervention. After 4 weeks of intervention, the number of synapses, synaptophysin (Syn), and postsynaptic density protein 95(PSD-95) expression was detected. Results: After 4 weeks of intervention, (1) the EX-MCAO and EX-MCAO-EXO groups showed higher serum exosome (pEX−MCAO = 0.000, pEX−MCAO−EXO = 0.000) and brain exosome (pEX−MCAO = 0.001, pEX−MCAO−EXO = 0.000) levels than the SED-MCAO group, of which the EX-MCAO group had the highest serum exosome (p = 0.000) and the EX-MCAO-EXO group had the highest brain exosome (p = 0.03) levels. (2) The number of synapses in the EX-MCAO (p = 0.032) and EX-MCAO-EXO groups (p = 0.000) was significantly higher than that in the SED-MCAO group. The EX-MCAO-EXO group exhibited a greater number of synapses than the EX-MCAO (p = 0.000) group. (3) The synaptic plasticity-associated proteins were expressed significantly higher in the EX-MCAO (pSyn = 0.010, pPSD−95 = 0.044) and EX-MCAO-EXO (pSyn = 0.000, pPSD−95 = 0.000) groups than in the SED-MCAO group, and the EX-MCAO-EXO group (pSyn = 0.000, pPSD−95 = 0.046) had the highest expression. (4) Compared with the SED-MCAO group, the EX-MCAO group had significantly improved infarct volume ratio (p = 0.000), rFA value (p = 0.000), and rADC (p = 0.000). Compared with the EX-MCAO group, the EX-MCAO-EXO group had a significantly improved infarct volume ratio (p = 0.000), rFA value (p = 0.000), and rADC value (p = 0.001). (5) Compared with the SED-MCAO group, the EX-MCAO group (p = 0.001) and EX-MCAO-EXO group (p = 0.000) had significantly lower mNSS scores and improved gait. (6) The brain exosome levels were negatively correlated with the mNSS score, infarct volume ratio, and rADC value and positively correlated with the rFA value, Syn, and PSD-95 expression. The serum and brain exosome levels showed a positive correlation. Conclusions: Exercise intervention increases the serum exosome level in MCAO rats, which are recruited into the brain, leading to improved synaptic growth and CST integrity, a reduced infarct volume, and improved neurological function and gait.
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Affiliation(s)
- Chen Li
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, Tianjin, China
| | - Changkai Ke
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, Tianjin, China
| | - Yue Su
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunxiao Wan
- Department of Physical Medicine and Rehabilitation, Tianjin Medical University General Hospital, Tianjin, China
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18
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Li Y, Yu Z, Wu P, Chen J. The disrupted topological properties of structural networks showed recovery in ischemic stroke patients: a longitudinal design study. BMC Neurosci 2021; 22:47. [PMID: 34340655 PMCID: PMC8330082 DOI: 10.1186/s12868-021-00652-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/22/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Stroke is one of the leading causes of substantial disability worldwide. Previous studies have shown brain functional and structural alterations in adults with stroke. However, few studies have examined the longitudinal reorganization in whole-brain structural networks in stroke. METHODS Here, we applied graph theoretical analysis to investigate the longitudinal topological organization of white matter networks in 20 ischemic stroke patients with a one-month interval between two timepoints. Two sets of clinical scores, Fugl-Meyer motor assessment (FMA) and neurological deficit scores (NDS), were assessed for all patients on the day the image data were collected. RESULTS The stroke patients exhibited significant increases in FMA scores and significant reductions in DNS between the two timepoints. All groups exhibited small-world organization (σ > 1) in the brain structural network, including a high clustering coefficient (γ > 1) and a low normalized characteristic path length (λ ≈ 1). However, compared to healthy controls, stroke patients showed significant decrease in nodal characteristics at the first timepoint, primarily in the right supplementary motor area, right middle temporal gyrus, right inferior parietal lobe, right postcentral gyrus and left posterior cingulate gyrus. Longitudinal results demonstrated that altered nodal characteristics were partially restored one month later. Additionally, significant correlations between the nodal characteristics of the right supplementary motor area and the clinical scale scores (FMA and NDS) were observed in stroke patients. Similar behavioral-neuroimaging correlations were found in the right inferior parietal lobe. CONCLUSION Altered topological properties may be an effect of stroke, which can be modulated during recovery. The longitudinal results and the neuroimaging-behavioral relationship may provide information for understanding brain recovery from stroke. Future studies should detect whether observed changes in structural topological properties can predict the recovery of daily cognitive function in stroke.
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Affiliation(s)
- Yongxin Li
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, 510632, China.
| | - Zeyun Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Ping Wu
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
| | - Jiaxu Chen
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, 510632, China.
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Lohkamp KJ, Kiliaan AJ, Shenk J, Verweij V, Wiesmann M. The Impact of Voluntary Exercise on Stroke Recovery. Front Neurosci 2021; 15:695138. [PMID: 34321996 PMCID: PMC8311567 DOI: 10.3389/fnins.2021.695138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/15/2021] [Indexed: 12/29/2022] Open
Abstract
Stroke treatment is limited to time-critical thrombectomy and rehabilitation by physiotherapy. Studies report beneficial effects of exercise; however, a knowledge gap exists regarding underlying mechanisms that benefit recovery of brain networks and cognition. This study aims to unravel therapeutic effects of voluntary exercise in stroke-induced mice to develop better personalized treatments. Male C57Bl6/JOlaHsd mice were subjected to transient middle cerebral artery occlusion. After surgery, the animals were divided in a voluntary exercise group with access to running wheels (RW), and a control group without running wheels (NRW). During 6 days post-stroke, activity/walking patterns were measured 24/7 in digital ventilated cages. Day 7 post-surgery, animals underwent MRI scanning (11.7T) to investigate functional connectivity (rsfMRI) and white matter (WM) integrity (DTI). Additionally, postmortem polarized light imaging (PLI) was performed to quantify WM fiber density and orientation. After MRI the animals were sacrificed and neuroinflammation and cerebral vascularisation studied. Voluntary exercise promoted myelin density recovery corresponding to higher fractional anisotropy. The deteriorating impact of stroke on WM dispersion was detected only in NRW mice. Moreover, rsfMRI revealed increased functional connectivity, cerebral blood flow and vascular quality leading to improved motor skills in the RW group. Furthermore, voluntary exercise showed immunomodulatory properties post-stroke. This study not only helped determining the therapeutic value of voluntary exercise, but also provided understanding of pathological mechanisms involved in stroke.
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Affiliation(s)
- Klara J Lohkamp
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Preclinical Imaging Center - PRIME, Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Amanda J Kiliaan
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Preclinical Imaging Center - PRIME, Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Justin Shenk
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Preclinical Imaging Center - PRIME, Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Vivienne Verweij
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Preclinical Imaging Center - PRIME, Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Maximilian Wiesmann
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Preclinical Imaging Center - PRIME, Radboud Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
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20
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Xue T, Sun Q, Zhang Y, Wu X, Shen H, Li X, Wu J, Li H, Wang Z, Chen G. Phosphorylation at S548 as a Functional Switch of Sterile Alpha and TIR Motif-Containing 1 in Cerebral Ischemia/Reperfusion Injury in Rats. Mol Neurobiol 2021; 58:453-469. [PMID: 32968873 DOI: 10.1007/s12035-020-02132-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022]
Abstract
Sterile alpha and Toll/interleukin-1 receptor motif-containing 1 (SARM1) is a pro-degenerative molecule in Wallerian degeneration, which is mainly expressed in brain/neurons and colocalized with mitochondria and microtubules. The aim of this study was to determine the role of SARM1 in cerebral ischemia/reperfusion (I/R) injury and the underlying mechanisms. In vivo, a middle cerebral artery occlusion/reperfusion (MCAO/R) model in adult male Sprague Dawley rats (250-300 g) was established, and in vitro, cultured primary neurons were subjected to oxygen-glucose deprivation/reoxygenation (OGD/R) to imitate I/R injury. Overexpression lentiviruses encoding wild-type SARM1 and SARM1 with serine 548 alanine mutation (S548A) were constructed and administered to rats by intra-penumbral injection. First, the potential role of SARM1 in cerebral I/R injury was confirmed by the increased protein levels of SARM1 within penumbra tissue, especially in neurons. Second, there was an increase in the phosphorylation ratio of p-SARM1(S548)/SARM1 at 2 h after MCAO/R. Third, on the basis of site-specific mutagenesis, we identified S548 as a key site for SARM1 phosphorylation in I/R conditions. Fourth, SARM1 (S548A) overexpression reduced infarct size, neuronal death, and neurobehavioral dysfunction, while wild-type SARM1 overexpression had the opposite effects. Finally, we found that SARM1 phosphorylation at the S548 site switched SARM1 function from promoting mitochondrial transport to inhibiting mitochondrial transport along axons after I/R injury. Restriction of SARM1 phosphorylation at S548 may be a promising intervention target for I/R injury; thus, exogenous administration of SARM1 (S548A) may be a novel strategy for improving neurological outcomes.
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Affiliation(s)
- Tao Xue
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Qing Sun
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yijie Zhang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xin Wu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Haitao Shen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xiang Li
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Jiang Wu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Haiying Li
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
| | - Gang Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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21
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Verhelst H, Dhollander T, Gerrits R, Vingerhoets G. Fibre-specific laterality of white matter in left and right language dominant people. Neuroimage 2021; 230:117812. [PMID: 33524578 DOI: 10.1016/j.neuroimage.2021.117812] [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: 10/27/2020] [Revised: 12/23/2020] [Accepted: 01/20/2021] [Indexed: 12/13/2022] Open
Abstract
Language is the most commonly described lateralised cognitive function, relying more on the left hemisphere compared to the right hemisphere in over 90% of the population. Most research examining the structure-function relationship of language lateralisation only included people showing a left language hemisphere dominance. In this work, we applied a state-of-the-art "fixel-based" analysis approach, allowing statistical analysis of white matter micro- and macrostructure on a fibre-specific level in a sample of participants with left and right language dominance (LLD and RLD). Both groups showed a similar extensive pattern of white matter lateralisation including a comparable leftwards lateralisation of the arcuate fasciculus, regardless of their functional language lateralisation. These results suggest that lateralisation of language functioning and the arcuate fasciculus are driven by independent biases. Finally, a significant group difference of lateralisation was detected in the forceps minor, with a leftwards lateralisation in LLD and rightwards lateralisation for the RLD group.
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Affiliation(s)
- Helena Verhelst
- Department of Experimental Psychology, Ghent University, Belgium.
| | - Thijs Dhollander
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Robin Gerrits
- Department of Experimental Psychology, Ghent University, Belgium
| | - Guy Vingerhoets
- Department of Experimental Psychology, Ghent University, Belgium
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