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Bentin JM, Heegaard S, Jørgensen NR, Grahnemo L, Hamann S. Optic disc drusen: Dystrophic calcification, a potential target for treatment. Eye (Lond) 2024; 38:2359-2364. [PMID: 38778137 PMCID: PMC11306397 DOI: 10.1038/s41433-024-03138-6] [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: 01/11/2024] [Revised: 04/05/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Optic disc drusen (ODD) are calcified, acellular bodies, seen in the optic nerve head of up to 2% of the population. Although seldomly affecting visual acuity, visual field defects are common, and severe, ischemic complications causing irreversible vision loss are known to occur. Different treatment strategies for ODD have been explored, but so far without success. This review focuses on the unique, calcified property of ODD, describing what we know about ODD pathogenesis and previously tried treatment strategies. In this context, we discuss current knowledge about calcium and pathological calcifications, including intracranial and ocular calcifications. We also explore some of the obstacles that must be addressed to develop a therapy centred on the concept of calcification, should calcification be identified as a pathogenic factor contributing to vision loss.
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Affiliation(s)
- Josephine Mejdahl Bentin
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Translational Research Centre, Rigshospitalet, Copenhagen, Denmark
| | - Louise Grahnemo
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Steffen Hamann
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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2
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Castillo PR, Patel V, Mera RM, Rumbea DA, Del Brutto OH. Choroid plexus calcifications are not associated with putative markers of glymphatic dysfunction: A population study in middle-aged and older adults. Neuroradiol J 2024; 37:342-350. [PMID: 38490679 PMCID: PMC11138340 DOI: 10.1177/19714009241240315] [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] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND AND PURPOSE Recent studies have suggested an association between dysfunction of the choroid plexus and the glymphatic system. However, information is inconclusive. Following a population-based study design, we aimed to assess the association between choroid plexus calcifications (CPCs)-as a surrogate of choroid plexus dysfunction-and severity and progression of putative markers of glymphatic dysfunction, including white matter hyperintensities (WMH) of presumed vascular origin and abnormally enlarged basal ganglia perivascular spaces (BG-PVS). METHODS This study recruited community-dwellers aged ≥40 years living in neighboring Ecuadorian villages. Participants who had baseline head CTs and brain MRIs were included in cross-sectional analyses and those who additional had follow-up MRIs (after a mean of 6.4 ± 1.5 years) were included in longitudinal analyses. Logistic and Poisson regression models, adjusted for demographics and cardiovascular risk factors, were fitted to assess associations between CPCs and WMH and enlarged BG-PVS severity and progression. RESULTS A total of 590 individuals were included in the cross-sectional component of the study, and 215 in the longitudinal component. At baseline, 25% of participants had moderate-to-severe WMH and 27% had abnormally enlarged BG-PVS. At follow-up, 36% and 20% of participants had WMH and enlarged BG-PVS progression, respectively. Logistic regression models showed no significant differences between CPCs volumes stratified in quartiles and severity of WMH and enlarged BG-PVS. Poisson regression models showed no association between the exposure and WMH and enlarged BG-PVS progression. Baseline age remained significant in these models. CONCLUSIONS Choroid plexus calcifications are not associated with putative markers of glymphatic system dysfunction.
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Affiliation(s)
| | - Vishal Patel
- Department of Radiology, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
| | - Denisse A Rumbea
- School of Medicine and Research Center, Universidad Espíritu Santo – Ecuador, Samborondón, Ecuador
| | - Oscar H Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo – Ecuador, Samborondón, Ecuador
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Matsuoka T, Oya N, Imai A, Sun W, Kitabayashi Y, Akazawa K, Yamada K, Ikeda K, Matoba S, Narumoto J. Intracranial calcifications associated with factors related and unrelated to atherosclerosis in older people: A community dwelling cohort study. Heliyon 2024; 10:e30011. [PMID: 38707275 PMCID: PMC11066399 DOI: 10.1016/j.heliyon.2024.e30011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
The cause of intracranial calcification is not fully understood. The aim of the current study was to identify factors associated with intracranial calcification and to determine whether these factors differ in calcification of different sites. A total of 404 community-dwelling people aged 65 or older were included in the study. All subjects underwent brain computed tomography (CT), blood tests, and a Mini-Mental State Examination (MMSE). Intracranial calcifications were scored using CT. Stepwise regression analysis was performed to examine factors associated with intracranial calcification, with each calcification score used as a dependent variable. Independent variables included age, gender, hemoglobin A1c (HbA1c), dyslipidemia, estimated glomerular filtration rate (eGFR), blood pressure, body mass index (BMI), smoking, serum iron, ferritin, and intact parathyroid hormone (PTH). Stepwise regression analysis detected male gender as a predictor of pineal gland calcification and intact PTH as a predictor of basal ganglia calcification. Age and lifestyle diseases were identified as predictors of calcification of the falx cerebri, internal carotid arteries, and vertebral arteries. These results indicate that the mechanisms of calcifications of the pineal gland and basal ganglia might differ from that of artery calcification, and that causes of intracranial calcification might be classified using factors that are and are not related to atherosclerosis.
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Affiliation(s)
- Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Psychiatry, NHO Maizuru Medical Center, Kyoto, Japan
| | - Nozomu Oya
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Weiyi Sun
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Kentaro Akazawa
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koji Ikeda
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Longevity and Regional Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Longevity and Regional Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Snijders BMG, Peters MJL, van den Brink S, van Trijp MJCA, de Jong PA, Vissers LATM, Verduyn Lunel FM, Emmelot-Vonk MH, Koek HL. Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr's Disease and Systematic Review. J Clin Med 2024; 13:2365. [PMID: 38673641 PMCID: PMC11050861 DOI: 10.3390/jcm13082365] [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: 03/05/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Background: It is unclear whether patients with basal ganglia calcifications (BGC) should undergo infectious disease testing as part of their diagnostic work-up. We investigated the occurrence of possibly associated infections in patients with BGC diagnosed with Fahr's disease or syndrome and consecutively performed a systematic review of published infectious diseases associated with BGC. Methods: In a cross-sectional study, we evaluated infections in non-immunocompromised patients aged ≥ 18 years with BGC in the Netherlands, who were diagnosed with Fahr's disease or syndrome after an extensive multidisciplinary diagnostic work-up. Pathogens that were assessed included the following: Brucella sp., cytomegalovirus, human herpesvirus type 6/8, human immunodeficiency virus (HIV), Mycobacterium tuberculosis, rubella virus, and Toxoplasma gondii. Next, a systematic review was performed using MEDLINE and Embase (2002-2023). Results: The cross-sectional study included 54 patients (median age 65 years). We did not observe any possible related infections to the BGC in this population. Prior infection with Toxoplasma gondii occurred in 28%, and in 94%, IgG rubella antibodies were present. The positive tests were considered to be incidental findings by the multidisciplinary team since these infections are only associated with BGC when congenitally contracted and all patients presented with adult-onset symptoms. The systematic search yielded 47 articles, including 24 narrative reviews/textbooks and 23 original studies (11 case series, 6 cross-sectional and 4 cohort studies, and 2 systematic reviews). Most studies reported congenital infections associated with BGC (cytomegalovirus, HIV, rubella virus, Zika virus). Only two studies reported acquired pathogens (chronic active Epstein-Barr virus and Mycobacterium tuberculosis). The quality of evidence was low. Conclusions: In our cross-sectional study and systematic review, we found no convincing evidence that acquired infections are causing BGC in adults. Therefore, we argue against routine testing for infections in non-immunocompromised adults with BGC in Western countries.
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Affiliation(s)
- Birgitta M. G. Snijders
- Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Mike J. L. Peters
- Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Internal Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | | | | | - Pim A. de Jong
- Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Laurens A. T. M. Vissers
- Department of Internal Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Frans M. Verduyn Lunel
- Department of Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | | | - Huiberdina L. Koek
- Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
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Sun Z, Li C, Muccio M, Jiang L, Masurkar A, Buch S, Chen Y, Zhang J, Haacke EM, Wisniewski T, Ge Y. Vascular Aging in the Choroid Plexus: A 7T Ultrasmall Superparamagnetic Iron Oxide (USPIO)-MRI Study. J Magn Reson Imaging 2024. [PMID: 38587279 DOI: 10.1002/jmri.29381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The choroid plexus (ChP), a densely vascularized structure, has drawn increasing attention for its involvement in brain homeostasis and waste clearance. While the volumetric changes have been explored in many imaging studies, few studies have investigated the vascular degeneration associated with aging in the ChP. PURPOSE To investigate the sub-structural characteristics of the ChP, particularly the vascular compartment using high-resolution 7T imaging enhanced with Ferumoxytol, an ultrasmall super-paramagnetic iron oxide, which greatly increase the susceptibility contrast for vessels. STUDY TYPE Prospective. SUBJECTS Forty-nine subjects without neurological disorders (age: 21-80 years; 42 ± 17 years; 20 females). FIELD STRENGTH/SEQUENCE 7-T with 2D and 3D T2* GRE, 3D MPRAGE T1, 2D TSE T2, and 2D FLAIR. ASSESSMENT The vascular and stromal compartments of the ChP were segmented using K-means clustering on post-contrast 2D GRE images. Visual and qualitative assessment of ChP vascular characteristics were conducted independently by three observers. Vascular density (Volvessel/VolChP ratio) and susceptibility change (Δχ) induced by Ferumoxytol were analyzed on 3D GRE-derived susceptibility-weighted imaging and quantitative susceptibility mapping, respectively. STATISTICAL TESTS Independent t-test, Mann-Whitney U test, and Chi-square test were utilized for group comparisons. The relationship between age and ChP's vascular alterations was examined using Pearson's correlation. Intra-class coefficient was calculated for inter-observer agreement. A P value <0.05 was considered statistically significant. RESULTS 2D GRE images demonstrated superior contrast and accurate delineation of ChP substructures (ICC = 0.86). Older subjects exhibited a significantly smaller vascular density (16.5 ± 4.34%) and lower Δχ (22.10 ± 12.82 ppb) compared to younger subjects (24.85 ± 6.84% and 34.64 ± 12.69 ppb). Vascular density and mean Δχ within the ChP negatively correlated with age (r = -0.48, and r = -0.45). DATA CONCLUSION Ferumoxytol-enhanced 7T images can demonstrate ChP alterations in elderly with decreased vascular density and expansion of nonvascular compartment. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhe Sun
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Chenyang Li
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Marco Muccio
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Li Jiang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arjun Masurkar
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Jiangyang Zhang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Thomas Wisniewski
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Departments of Pathology and Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Yulin Ge
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
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Andravizou A, Stavropoulou De Lorenzo S, Kesidou E, Michailidou I, Parissis D, Boziki MK, Stamati P, Bakirtzis C, Grigoriadis N. The Time Trajectory of Choroid Plexus Enlargement in Multiple Sclerosis. Healthcare (Basel) 2024; 12:768. [PMID: 38610190 PMCID: PMC11011748 DOI: 10.3390/healthcare12070768] [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: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Choroid plexus (CP) can be seen as a watchtower of the central nervous system (CNS) that actively regulates CNS homeostasis. A growing body of literature suggests that CP alterations are involved in the pathogenesis of multiple sclerosis (MS) but the underlying mechanisms remain elusive. CPs are enlarged and inflamed in relapsing-remitting (RRMS) but also in clinically isolated syndrome (CIS) and radiologically isolated syndrome (RIS) stages, far beyond MS diagnosis. Increases in the choroid plexus/total intracranial volume (CP/TIV) ratio have been robustly associated with increased lesion load, higher translocator protein (TSPO) uptake in normal-appearing white matter (NAWM) and thalami, as well as with higher annual relapse rate and disability progression in highly active RRMS individuals, but not in progressive MS. The CP/TIV ratio has only slightly been correlated with magnetic resonance imaging (MRI) findings (cortical or whole brain atrophy) and clinical outcomes (EDSS score) in progressive MS. Therefore, we suggest that plexus volumetric assessments should be mainly applied to the early disease stages of MS, whereas it should be taken into consideration with caution in progressive MS. In this review, we attempt to clarify the pathological significance of the temporal CP volume (CPV) changes in MS and highlight the pitfalls and limitations of CP volumetric analysis.
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Affiliation(s)
- Athina Andravizou
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Sotiria Stavropoulou De Lorenzo
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Evangelia Kesidou
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Iliana Michailidou
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Dimitrios Parissis
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Marina-Kleopatra Boziki
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, 41334 Larissa, Greece;
| | - Christos Bakirtzis
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
| | - Nikolaos Grigoriadis
- Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece; (A.A.); (S.S.D.L.); (E.K.); (I.M.); (D.P.); (M.-K.B.); (N.G.)
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Wang J, Fang CL, Noller K, Wei Z, Liu G, Shen K, Song K, Cao X, Wan M. Bone-derived PDGF-BB drives brain vascular calcification in male mice. J Clin Invest 2023; 133:e168447. [PMID: 37815871 PMCID: PMC10688993 DOI: 10.1172/jci168447] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
Brain vascular calcification is a prevalent age-related condition often accompanying neurodegenerative and neuroinflammatory diseases. The pathogenesis of large-vessel calcifications in peripheral tissue is well studied, but microvascular calcification in the brain remains poorly understood. Here, we report that elevated platelet-derived growth factor BB (PDGF-BB) from bone preosteoclasts contributed to cerebrovascular calcification in male mice. Aged male mice had higher serum PDGF-BB levels and a higher incidence of brain calcification compared with young mice, mainly in the thalamus. Transgenic mice with preosteoclast-specific Pdgfb overexpression exhibited elevated serum PDGF-BB levels and recapitulated age-associated thalamic calcification. Conversely, mice with preosteoclast-specific Pdgfb deletion displayed diminished age-associated thalamic calcification. In an ex vivo cerebral microvascular culture system, PDGF-BB dose-dependently promoted vascular calcification. Analysis of osteogenic gene array and single-cell RNA-Seq (scRNA-Seq) revealed that PDGF-BB upregulated multiple osteogenic differentiation genes and the phosphate transporter Slc20a1 in cerebral microvessels. Mechanistically, PDGF-BB stimulated the phosphorylation of its receptor PDGFRβ (p-PDGFRβ) and ERK (p-ERK), leading to the activation of RUNX2. This activation, in turn, induced the transcription of osteoblast differentiation genes in PCs and upregulated Slc20a1 in astrocytes. Thus, bone-derived PDGF-BB induced brain vascular calcification by activating the p-PDGFRβ/p-ERK/RUNX2 signaling cascade in cerebrovascular cells.
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Affiliation(s)
- Jiekang Wang
- Department of Orthopaedic Surgery
- Department of Biomedical Engineering, and
| | | | | | - Zhiliang Wei
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Ke Shen
- Department of Orthopaedic Surgery
| | - Kangping Song
- Department of Orthopaedic Surgery
- Department of Biomedical Engineering, and
| | - Xu Cao
- Department of Orthopaedic Surgery
- Department of Biomedical Engineering, and
| | - Mei Wan
- Department of Orthopaedic Surgery
- Department of Biomedical Engineering, and
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Xiao C, Cassini T, Benavides D, Ebrahim A, Adams D, Toro C. Genomic Diagnoses for Ectopic Intracerebral Calcifications. Neurol Genet 2023; 9:e200083. [PMID: 37547187 PMCID: PMC10399077 DOI: 10.1212/nxg.0000000000200083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/24/2023] [Indexed: 08/08/2023]
Abstract
Background and Objectives Ectopic intracerebral calcifications (EICs) in the basal ganglia, thalamus, cerebellum, or white matter are seen in a variety of disease states or may be found incidentally on brain imaging. The clinical significance and proportion of cases attributable to an underlying genetic cause is unknown. Methods This retrospective cohort study details the clinical, imaging, and genomic findings of 44 patients with EICs who had no established diagnosis despite extensive medical workup. Results In total, 15 of 44 patients received a diagnosis through genomic testing explaining their calcifications, and 2 more received a diagnosis that has not been previously associated with EICs. Six of the 15 were found to have one of the 4 genes (PDGFB, PDGFRB, SLC20A2, and XPR1) conventionally associated with the phenotypic term "idiopathic basal ganglia calcifications." Discussion These findings support the use of genomic testing for symptomatic patients with EICs.
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Affiliation(s)
- Changrui Xiao
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
| | - Thomas Cassini
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
| | - Daniel Benavides
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
| | - Anusha Ebrahim
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
| | - David Adams
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
| | - Camilo Toro
- From the National Human Genome Research Institute (C.X., T.C., D.B., A.E., D.A., C.T.), Bethesda, MD; and Department of Neurology (C.X.), University of California - Irvine
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9
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Ota M, Sato N, Nakaya M, Shigemoto Y, Kimura Y, Chiba E, Yokoi Y, Tsukamoto T, Matsuda H. Relationship between the tau protein and choroid plexus volume in Alzheimer's disease. Neuroreport 2023; 34:546-550. [PMID: 37384934 DOI: 10.1097/wnr.0000000000001923] [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: 07/01/2023]
Abstract
Tau protein accumulation in the brain is thought to be one of the causes of Alzheimer's disease (AD). Recent studies found that the choroid plexus (CP) has a role in β-amyloid and tau protein clearance in the brain. We evaluated the relationships between CP volume and the ß-amyloid and tau protein depositions. Participants were 20 patients with AD and 35 healthy subjects who underwent MRI and PET scanning using the ß-amyloid tracer 11C-PiB and the tau/inflammatory tracer 18F-THK5351. We computed the volume of the CP and estimated the relationships between the CP volume and ß-amyloid and tau protein/inflammatory deposition by Spearman's correlation test. The CP volume was significantly positively correlated with both the standardized uptake value ratio (SUVR) of 11C-PiB and the SUVR of 18F-THK5351 in all participants. The CP volume was also significantly positively correlated with the SUVR of 18F-THK5351in patients with AD. Our data suggested that the volume of the CP was a good biomarker for the evaluation of tau deposition and neuroinflammation.
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Affiliation(s)
- Miho Ota
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
- Department of Neuropsychiatry, University of Tsukuba, Tsukuba, Ibaraki
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
| | - Moto Nakaya
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku
| | - Yoko Shigemoto
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
| | - Emiko Chiba
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
| | - Yuma Yokoi
- Department of Psychiatry, National Center of Neurology and Psychiatry
- Department of Educational Promotion, Clinical Research & Education Promotion Division, National Center of Neurology and Psychiatry
| | - Tadashi Tsukamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Kodaira, Tokyo and
| | - Hiroshi Matsuda
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo
- Department of Biofunctional Imaging, Fukushima Medical University, Fukushima City, Fukushima, Japan
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Butler T, Wang XH, Chiang GC, Li Y, Zhou L, Xi K, Wickramasuriya N, Tanzi E, Spector E, Ozsahin I, Mao X, Razlighi QR, Fung EK, Dyke JP, Maloney T, Gupta A, Raj A, Shungu DC, Mozley PD, Rusinek H, Glodzik L. Choroid Plexus Calcification Correlates with Cortical Microglial Activation in Humans: A Multimodal PET, CT, MRI Study. AJNR Am J Neuroradiol 2023; 44:776-782. [PMID: 37321857 PMCID: PMC10337614 DOI: 10.3174/ajnr.a7903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND PURPOSE The choroid plexus (CP) within the brain ventricles is well-known to produce cerebrospinal fluid (CSF). Recently, the CP has been recognized as critical in modulating inflammation. MRI-measured CP enlargement has been reported in neuroinflammatory disorders like MS as well as with aging and neurodegeneration. The basis of MRI-measured CP enlargement is unknown. On the basis of tissue studies demonstrating CP calcification as a common pathology associated with aging and disease, we hypothesized that previously unmeasured CP calcification contributes to MRI-measured CP volume and may be more specifically associated with neuroinflammation. MATERIALS AND METHODS We analyzed 60 subjects (43 healthy controls and 17 subjects with Parkinson's disease) who underwent PET/CT using 11C-PK11195, a radiotracer sensitive to the translocator protein expressed by activated microglia. Cortical inflammation was quantified as nondisplaceable binding potential. Choroid plexus calcium was measured via manual tracing on low-dose CT acquired with PET and automatically using a new CT/MRI method. Linear regression assessed the contribution of choroid plexus calcium, age, diagnosis, sex, overall volume of the choroid plexus, and ventricle volume to cortical inflammation. RESULTS Fully automated choroid plexus calcium quantification was accurate (intraclass correlation coefficient with manual tracing = .98). Subject age and choroid plexus calcium were the only significant predictors of neuroinflammation. CONCLUSIONS Choroid plexus calcification can be accurately and automatically quantified using low-dose CT and MRI. Choroid plexus calcification-but not choroid plexus volume-predicted cortical inflammation. Previously unmeasured choroid plexus calcium may explain recent reports of choroid plexus enlargement in human inflammatory and other diseases. Choroid plexus calcification may be a specific and relatively easily acquired biomarker for neuroinflammation and choroid plexus pathology in humans.
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Affiliation(s)
- T Butler
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - X H Wang
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - G C Chiang
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - Y Li
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - L Zhou
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - K Xi
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - N Wickramasuriya
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - E Tanzi
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - E Spector
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - I Ozsahin
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - X Mao
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
- Department of Radiology (X.M., E.K.F., J.P.D., D.C.S., P.D.M.), Weill Cornell Medicine, New York, New York
| | - Q R Razlighi
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - E K Fung
- Department of Radiology (X.M., E.K.F., J.P.D., D.C.S., P.D.M.), Weill Cornell Medicine, New York, New York
| | - J P Dyke
- Department of Radiology (X.M., E.K.F., J.P.D., D.C.S., P.D.M.), Weill Cornell Medicine, New York, New York
| | - T Maloney
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - A Gupta
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
| | - A Raj
- Department of Radiology (A.R.), University of California, San Francisco, San Francisco, California
| | - D C Shungu
- Department of Radiology (X.M., E.K.F., J.P.D., D.C.S., P.D.M.), Weill Cornell Medicine, New York, New York
| | - P D Mozley
- Department of Radiology (X.M., E.K.F., J.P.D., D.C.S., P.D.M.), Weill Cornell Medicine, New York, New York
| | - H Rusinek
- Department of Radiology (H.R.), New York University, New York, New York
| | - L Glodzik
- From the Brain Health Imaging Institute (T.B., X.H.W., G.C.C., Y.L., L.Z., K.X., N.W., E.T., E.S., I.O., X.M., Q.R.R., T.M., A.G., L.G.)
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Novakova Martinkova J, Ferretti MT, Ferrari A, Lerch O, Matuskova V, Secnik J, Hort J. Longitudinal progression of choroid plexus enlargement is associated with female sex, cognitive decline and ApoE E4 homozygote status. Front Psychiatry 2023; 14:1039239. [PMID: 36970283 PMCID: PMC10031049 DOI: 10.3389/fpsyt.2023.1039239] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/27/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction Choroid plexus (CP)-related mechanisms have been implicated in the pathogenesis of neurodegenerative diseases, including Alzheimer's disease. In this pilot study, we aimed to elucidate the association between longitudinal changes in CP volume, sex and cognitive impairment. Methods We assessed longitudinal changes in CP volume in a cohort of n = 613 subjects across n = 2,334 datapoints from ADNI 2 and ADNI-GO, belonging to cognitively unimpaired (CN), stable mild cognitive impairment (MCI), clinically diagnosed Alzheimer's disease dementia (AD) or convertor (to either AD or MCI) subgroups. CP volume was automatically segmented and used as a response variable in linear mixed effect models with random intercept clustered by patient identity. Temporal effects of select variables were assessed by interactions and subgroup analyses. Results We found an overall significant increase of CP volume in time (14.92 mm3 per year, 95% confidence interval, CI (11.05, 18.77), p < 0.001). Sex-disaggregated results showed an annual rate of increase 9.48 mm3 in males [95% CI (4.08, 14.87), p < 0.001], and 20.43 mm3 in females [95% CI (14.91, 25.93), p < 0.001], indicating more than double the rate of increase in females, which appeared independent of other temporal variables. The only diagnostic group with a significant CP increase as compared to CN was the convertors group, with an increase of 24.88 mm3/year [95% CI (14, 35.82), p < 0.001]. ApoE exhibited a significant temporal effect, with the E4 homozygote group's CP increasing at more than triple the rate of non-carrier or heterozygote groups [40.72, 95% CI (25.97, 55.46), p < 0.001 vs. 12.52, 95% CI (8.02, 17.02), p < 0.001 for ApoE E4 homozygotes and E4 non-carriers, respectively], and may have modified the diagnostic group relationship. Conclusion Our results contribute to potential mechanisms for sex differences in cognitive impairment with a novel finding of twice the annual choroid plexus enlargement in females and provide putative support for CP-related mechanisms of cognitive deterioration and its relationship to ApoE E4.
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Affiliation(s)
- Julie Novakova Martinkova
- Cognitive Center, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | | | - Ondrej Lerch
- Cognitive Center, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Veronika Matuskova
- Cognitive Center, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Juraj Secnik
- Cognitive Center, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Jakub Hort
- Cognitive Center, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
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Carecchio M, Mainardi M, Bonato G. The clinical and genetic spectrum of primary familial brain calcification. J Neurol 2023; 270:3270-3277. [PMID: 36862146 DOI: 10.1007/s00415-023-11650-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
Primary familial brain calcification (PFBC), formerly known as Fahr's disease, is a rare neurodegenerative disease characterized by bilateral progressive calcification of the microvessels of the basal ganglia and other cerebral and cerebellar structures. PFBC is thought to be due to an altered function of the Neurovascular Unit (NVU), where abnormal calcium-phosphorus metabolism, functional and microanatomical alterations of pericytes and mitochondrial alterations cause a dysfunction of the blood-brain barrier (BBB) and the generation of an osteogenic environment with surrounding astrocyte activation and progressive neurodegeneration. Seven causative genes have been discovered so far, of which four with dominant (SLC20A2, PDGFB, PDGFRB, XPR1) and three with recessive inheritance (MYORG, JAM2, CMPK2). Clinical presentation ranges from asymptomatic subjects to movement disorders, cognitive decline and psychiatric disturbances alone or in various combinations. Radiological patterns of calcium deposition are similar in all known genetic forms, but central pontine calcification and cerebellar atrophy are highly suggestive of MYORG mutations and extensive cortical calcification has been associated with JAM2 mutations. Currently, no disease-modifying drugs or calcium-chelating agents are available and only symptomatic treatments can be offered.
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Affiliation(s)
- Miryam Carecchio
- Department of Neuroscience, University of Padua, Via Niccolò Giustiniani, 5, 35128, Padua, Italy.
| | - Michele Mainardi
- Department of Neuroscience, University of Padua, Via Niccolò Giustiniani, 5, 35128, Padua, Italy
| | - Giulia Bonato
- Department of Neuroscience, University of Padua, Via Niccolò Giustiniani, 5, 35128, Padua, Italy
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Basal ganglia calcifications: No association with cognitive function. J Neuroradiol 2023; 50:266-270. [PMID: 35134441 DOI: 10.1016/j.neurad.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE Basal ganglia calcifications (BGC), a form of vascular calcification, are a common brain computed tomography (CT) finding. We investigated whether BGC are associated with cognitive function and examined the association between vascular risk factors and BGC. MATERIAL AND METHODS Patients who visited a memory clinic of a Dutch general hospital between April 2009 and April 2015 were included. The patients underwent a standard diagnostic work up including cognitive tests (Cambridge Cognitive Examination, including the Mini Mental State Examination) and brain CT. Vascular risk factors such as hypertension, diabetes mellitus, hyperlipidemia and smoking were assessed. CTs were analyzed for presence and severity (absent, mild, moderate or severe) of BGC. Multivariable logistic regression was used to identify risk factors for BGC and linear regression for the association between BGC and cognitive function. RESULTS Of the 1992 patients, 40.3% was male. The median age was 80 years and 866 patients (43.5%) had BGC. BGC was associated with female gender (odds ratio (OR) 1.27, 95% confidence interval (CI) 1.06-1.53, p 0.011), and inversely associated with hypertension (OR 0.74, 95% CI 0.60-0.89, p 0.002) and use of antihypertensive drugs (OR 0.79, 95% CI 0.64-0.98, p 0.031). No association was found between presence and severity of BGC and cognitive function or other vascular risk factors. CONCLUSIONS No association with cognitive function was found. Risk factors for BGC were female gender, while hypertension and antihypertensive drug use were associated with a lower risk of BGC.
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Bjornsdottir S, Ing S, Mitchell DM, Sikjaer T, Underbjerg L, Hassan-Smith Z, Sfeir J, Gittoes NJ, Clarke L BL. Epidemiology and Financial Burden of Adult Chronic Hypoparathyroidism. J Bone Miner Res 2022; 37:2602-2614. [PMID: 36054571 PMCID: PMC10087725 DOI: 10.1002/jbmr.4675] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/10/2022]
Abstract
Chronic hypoparathyroidism is characterized by low serum calcium, increased serum phosphorus, and inappropriately low or decreased serum parathyroid hormone. This rare disorder is associated with a variety of complications. The prevalence, incidence, mortality, financial burden, and epidemiology of complications of this disorder are not well understood. This narrative review summarizes current information on the epidemiology and complications of chronic hypoparathyroidism. The reported prevalence of chronic hypoparathyroidism ranges from 6.4-37/100,000, and the incidence is reported to be 0.8-2.3/100,000/year. Mortality is not increased in studies from Denmark or South Korea but was increased in studies from Scotland and Sweden. The financial burden of this disorder is substantial because of increased health care resource utilization in two studies but not well quantitated. Recognized complications include hypercalciuria, nephrocalcinosis, kidney stones, and chronic kidney disease; low bone turnover and possibly upper extremity fractures; cardiac and vascular calcifications; basal ganglia calcifications, cataracts, infections, neuropsychiatric complications, and difficulties with pregnancy. This review concludes that chronic hypoparathyroidism is a rare disorder associated with significant morbidity that may not increase overall mortality but is associated with a substantial financial burden. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Steven Ing
- Division of Endocrinology, Diabetes and Metabolism, Ohio State University, Columbus, OH, USA
| | - Deborah M Mitchell
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Line Underbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Zaki Hassan-Smith
- Centre for Endocrinology, Diabetes, and Metabolism, Queen Elizabeth Hospital, Birmingham, UK
| | - Jad Sfeir
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Neil J Gittoes
- Centre for Endocrinology, Diabetes, and Metabolism, Queen Elizabeth Hospital, Birmingham, UK
| | - Bart L Clarke L
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
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SUZEN M, DİLAVER E, UÇKAN S. Evaluation of prevalence and dimension of Pineal Gland Calcification by cone-beam computed tomography (CBCT). CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1111722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract
Objective: This study aimed to investigate the prevalence and dimensions of pineal gland calcification using cone-beam computed tomography (CBCT) in patients undergoing dental treatment.
Materials and Methods: CBCTs that localized pineal gland in the fov range was selected in this retrospective study. The presence of pineal gland calcification (PGC) was noted. Vertical, horizontal and areal measurements were made by a single observer (M.S). Variables such as age, gender for each patient were recorded using previous clinical examination data.
Results: The prevalence of pineal gland calcification was 33.64% (female to male ratio 3:2). The difference between males and females was not significant (p>0.05). PGC was highly seen in older patients when compared with younger patients (p:000). The average vertical and horizontal dimension of PGC was 2,56±0,98mm and 3,39±1,29 mm respectively. The average total calcified area was 5,45±3,75 mm2.
Conclusion: This study did not find any correlation between age, gender, and linear measurements. However, the average calcified are in men was found to be significantly higher than in women.
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Affiliation(s)
- Muazzez SUZEN
- Istanbul Medipol University, Faculty of Dentistry, Department of Oral And Maxillofacial surgery
| | - Emrah DİLAVER
- İstanbul Medipol University,School of dentistry,Deparment of Oral and Maxillofacial Surgery
| | - Sina UÇKAN
- Istanbul Medipol University,School of dentistry,Deparment of Oral and Maxillofacial Surgery
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Alqarni AM, Alsaadi MJ, Fatani M, Alahmari DM, Azeem FKA, Almalki MJ, Alqarni A, Abounassif MM, Alfuraih AM. The association between posterior brain cerebral circulation calcification and coronary arteries calcification and its stroke risk in a Saudi population: a retrospective study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [PMCID: PMC9358375 DOI: 10.1186/s43055-022-00858-1] [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] [Indexed: 11/10/2022] Open
Abstract
Background Anterior cerebral circulation calcification and stroke occurrence association is well established in the literature. Posterior cerebral circulation calcification associated with coronary calcification and stroke incidence has not been properly investigated in Saudi Arabia. Therefore, the present study aimed to investigate the clinical relationship between posterior cerebral circulation calcification and coronary artery calcifications and to describe the association between risk factors and stroke occurrence based on computed tomography imaging. Results A total of 101 patients were enrolled in the study. The mean age was 64.9 ± 12.4. Of the patients, 69.3 were male. Most of the patients were Saudi (72.3%), 28.6% were smokers, 36.4% were overweight, and 22.1% were obese. Exactly 61.4% had mild coronary artery calcification, 26.7% had moderate calcification, and 11.9% had severe calcification. 34.7% had an anterior stroke, and 23.8% had a posterior stroke. Posterior cerebral circulation calcification was more evident in patients with coronary artery calcification, and it increased with the severity level (p = 0.001). Posterior cerebral circulation calcification was significantly associated with stroke (67.4%, p = < 0.001). Conclusion Coronary artery calcification is significantly associated with posterior cerebral circulation calcification. Furthermore, stroke incidence increased with the presence of posterior cerebral circulation calcification.
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Tsai YL, Yen CT, Wang YF. Astrocyte Dysregulation and Calcium Ion Imbalance May Link the Development of Osteoporosis and Alzheimer’s Disease. J Alzheimers Dis 2022; 88:439-445. [DOI: 10.3233/jad-220218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The typical symptoms of patients with Alzheimer’s disease (AD) are amyloid-β (Aβ) plaques and tau hyperphosphorylation. However, recent studies show that these symptoms are not the cause of the disease but are generated after the pathogenesis. Compared with other types of dementia, AD has the obvious features of pineal gland calcification and decreased melatonin production. The pineal gland is mainly composed of pinealocytes that release melatonin and astrocytes. Astrocytes function to maintain a balanced concentration of calcium ions, provide nerve cell nutrients, and migrate nutrients in vivo. Calcium ions are among the most important neurotransmitters. Once triggered, a calcium wave can be formed between astrocytes to activate other astrocytes to transmit information. Most calcium is stored in the skeleton. Bone tissue is composed mainly of osteocytes, osteoblasts, and osteoclasts. Of these, osteocyte is a kind of astrocyte which regulates the activity of osteoclasts and osteoblasts. The pineal gland is composed mainly of astrocytes; osteocytes are also a kind of astrocyte. Therefore, we conclude that when astrocytes are gradually disabled, calcium may be lost from the bones, prompting osteoporosis. The calcium ions then released into the blood may accumulate and cause ectopic calcification in the pineal gland, which promotes the occurrence of AD. Finally, this study used aspects of drugs and hormones (bone and calcium metabolism hormones and melatonin) to infer the hypothesis, which proposes that astrocyte dysregulation promotes the long-term imbalance of calcium ions in vivo and leads to osteoporosis and AD.
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Affiliation(s)
- Yi-Liang Tsai
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Chieh-Tsung Yen
- Department of Neurology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Department of Radiology, School of Medicine, Tzu Chi University, Hualien, Taiwan
- Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Choi JD, Moon Y, Kim HJ, Yim Y, Lee S, Moon WJ. Choroid Plexus Volume and Permeability at Brain MRI within the Alzheimer Disease Clinical Spectrum. Radiology 2022; 304:635-645. [PMID: 35579521 DOI: 10.1148/radiol.212400] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background Mounting evidence suggests that the choroid plexus (CP) plays an important role in the pathophysiology of Alzheimer disease (AD), but its imaging profile in cognitive impairment remains unclear. Purpose To evaluate CP volume, permeability, and susceptibility by using MRI in patients at various stages of cognitive impairment. Materials and Methods This retrospective study evaluated patients with cognitive symptoms who underwent 3.0-T MRI of the brain, including dynamic contrast-enhanced (DCE) imaging and quantitative susceptibility mapping (QSM), between January 2013 and May 2020. CP volume was automatically segmented using three-dimensional T1-weighted sequences; the volume transfer constant (ie, Ktrans) and fractional plasma volume (ie, Vp) were determined using DCE MRI, and susceptibility was assessed using QSM. The effects of CP volume, expressed as the ratio to intracranial volume, on cognition were evaluated using multivariable linear regression adjusted for age, sex, education, apolipoprotein E ε4 allele status, and volumetric measures. Results A total of 532 patients with cognitive symptoms (mean age, 72 years ± 9 [SD]; 388 women) were included: 78 with subjective cognitive impairment (SCI), 158 with early mild cognitive impairment (MCI), 149 with late MCI, and 147 with AD. Among these, 132 patients underwent DCE MRI and QSM. CP volume was greater in patients at more severe stages (ratio of intracranial volume × 103: 0.9 ± 0.3 for SCI, 1.0 ± 0.3 for early MCI, 1.1 ± 0.3 for late MCI, and 1.3 ± 0.4 for AD; P < .001). Lower Ktrans (r = -0.19; P = .03) and Vp (r = -0.20; P = .02) were negatively associated with CP volume; susceptibility was not (r = 0.15; P = .10). CP volume was negatively associated with memory (B = -0.67; standard error of the mean [SEM], 0.21; P = .01), executive function (B = -0.90; SEM, 0.31; P = .01), and global cognition (B = -0.82; SEM, 0.32; P = .01). Conclusion Among patients with cognitive symptoms, larger choroid plexus volume was associated with severity of cognitive impairment in the Alzheimer disease spectrum. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Chiang in this issue.
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Affiliation(s)
- Jong Duck Choi
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
| | - Yeonsil Moon
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
| | - Hee-Jin Kim
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
| | - Younghee Yim
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
| | - Subin Lee
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
| | - Won-Jin Moon
- From the Departments of Radiology (J.D.C., W.J.M.) and Neurology (Y.M.), Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 05030, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea (Y.M., W.J.M.); Department of Neurology, Hanyang University Hospital, Hanyang University School of Medicine, Seoul, Korea (H.J.K.); Department of Radiology, Chung-Ang University Hospital, Chung-Ang University School of Medicine, Seoul, Korea (Y.Y.); and Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea (S.L.)
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19
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Physiologic intracranial calcifications incidentally detected on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e281-e286. [PMID: 35701294 DOI: 10.1016/j.oooo.2022.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study aims to determine the incidence of physiologic intracranial calcifications on cone beam computed tomography (CBCT) and to contribute to the differentiation between physiologic and pathologic intracranial calcifications by sharing their characteristic appearances, with the largest number of patients in the literature and many different types of physiologic calcifications. STUDY DESIGN CBCT images of 996 patients admitted to the clinic between 2018 and 2019 were scanned retrospectively. Petroclinoid (PCL) and interclinoid ligaments (ICL), pineal gland, coronoid plexus, falx cerebri, tentorium cerebelli, and other dural calcifications were evaluated in each radiograph. RESULTS Physiologic calcification was present in 49.4% of the cases, and pineal gland calcification was the most common (47.6%) type. PCL calcification was detected in 22.1%, and it was mostly bilateral partial. There were complete ICL in 1.2%, coronoid plexus in 11.3%, falx cerebri in 6.3%, tentorium cerebelli in 1.1%, and other dural calcifications in 3.6%. Only PCL calcifications differed between sexes and were more common in males. PCL, pineal gland, and coronoid plexus calcifications were most detected in the third decade of the cases. CONCLUSIONS Intracranial calcifications are detected incidentally in CBCT examinations. Some calcifications may indicate pathologic conditions, and patients may need to be referred for further evaluation.
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20
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Wakamatsu K, Chiba Y, Murakami R, Matsumoto K, Miyai Y, Kawauchi M, Yanase K, Uemura N, Ueno M. Immunohistochemical expression of osteopontin and collagens in choroid plexus of human brains. Neuropathology 2021; 42:117-125. [PMID: 34964160 PMCID: PMC9546339 DOI: 10.1111/neup.12791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 01/22/2023]
Abstract
Evidence showing the functional significance of the choroid plexus is accumulating. Although it is clinically well‐known that calcification is frequently seen in the choroid plexus of aged human brains, it is unclear why calcification occurs in the aged choroid plexus and what exert effects on the calcification has. In this study, immunohistochemical localizations of collagens and other molecules related to fibrosis or calcification were investigated on the choroid plexus of autopsied human brains. Densely fibrous or calcified materials were located in the stroma just below the epithelial cells of the choroid plexus of all human brains examined. Immunoreactivity for collagen type I was identified in the stroma just below the epithelial cells, consistent with the densely fibrous or calcified area, whereas that for collagen type III was observed in almost all stroma other than the densely fibrous or calcified areas. Linear or membranous immunoreactivity for collagen type IV was intermittently localized on the epithelium‐facing side of the materials, suggesting an injured basement membrane. In addition, clear immunoreactivity for osteopontin was localized on the epithelium‐facing side of the fibrous or calcified materials as well as in the cytoplasm of epithelial cells. These findings indicate that collagen type I exists in contact with osteopontin in and around the densely fibrous or calcified materials in the choroid plexus. They suggest that the densely fibrous or calcified materials are deposited in the subepithelial stroma just below an injured basement membrane of epithelial cells via the collagen type I and osteopontin.
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Affiliation(s)
- Keiji Wakamatsu
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Yoichi Chiba
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Ryuta Murakami
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Koichi Matsumoto
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Yumi Miyai
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Machi Kawauchi
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Ken Yanase
- Department of Anesthesiology, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Naoya Uemura
- Department of Anesthesiology, Faculty of Medicine Kagawa University Takamatsu Japan
| | - Masaki Ueno
- Department of Pathology and Host Defense, Faculty of Medicine Kagawa University Takamatsu Japan
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21
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Leon-Llamas JL, Villafaina S, Murillo-Garcia A, Rohlfs Domínguez P, Gusi N. Relationship between pineal gland, sleep and melatonin in fibromyalgia women: a magnetic resonance imaging study. Acta Neuropsychiatr 2021; 34:1-9. [PMID: 34903309 DOI: 10.1017/neu.2021.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A total of 80% of fibromyalgia (FM) population have reported poor sleep. In this regard, the pineal gland, involved in circadian rhythm processes as a key neuroendocrine organ which mainly synthesises and secretes melatonin, has never been studied before in this population. Therefore, this study aimed to evaluate the parenchyma pineal volume and its relation to sleep hours, sleep quality index and melatonin level at night. A total of 50 participants, 30 women with FM and 20 healthy control women underwent cranial magnetic resonance imaging. The total pineal volume, cyst pineal volume and parenchyma pineal volume were manually calculated in cubic millimetres. Also, the total pineal volume was estimated using Hasehawa method. Parenchyma pineal volume was significantly correlated with sleep hours (p-value = 0.041) and nocturnal melatonin level (p-value = 0.027). Moreover, there was also a non-significant correlation between parenchyma pineal volume and sleep quality index (p-value = 0.055). Furthermore, a mean parenchyma pineal volume of 102.00 (41.46) mm³ was observed, with a prevalence of 29.60% cyst in FM group. This is the first study that has reported pineal gland volumes, cyst prevalence and correlative relationships between parenchyma pineal volume and sleep hours and melatonin levels in women with FM.
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Affiliation(s)
- Juan Luis Leon-Llamas
- AFYCAV Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Santos Villafaina
- AFYCAV Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
- Teacher Training Collegue, University of Extremadura, Cáceres, Spain
| | - Alvaro Murillo-Garcia
- AFYCAV Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Paloma Rohlfs Domínguez
- AFYCAV Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
- Department of Psychology and Anthropology, School of Nursing and Occupational Therapy, University of Extremadura, Badajoz, Spain
- Department of Evolutionary Psychology and Education, Faculty of Education, University of Basque Country, Leioa, Spain
| | - Narcis Gusi
- AFYCAV Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
- Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Health Institute Carlos III, Madrid, Spain
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22
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Ghorbanlou M, Moradi F, Mehdizadeh M. Frequency, shape, and estimated volume of intracranial physiologic calcification in different age groups investigated by brain computed tomography scan: a retrospective study. Anat Cell Biol 2021; 55:63-71. [PMID: 34866062 PMCID: PMC8968236 DOI: 10.5115/acb.21.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 11/27/2022] Open
Abstract
Intracranial calcification is referred to calcification of parenchyma and vascular structures in brain which can be physiologic or pathologic. This study was conducted with the purpose of investigating the frequency, location, pattern, dimensions and estimated volume of intracranial physiologic calcification (IPC) by computer tomography in different age groups. In this cross-sectional retrospective study, brain computed tomography scans of 216 patients were analyzed in 9 age groups each containing 24 patients from 2 to 89 years old. Data were analyzed by SPSS software using one way analysis of variance (ANOVA, post hoc Tukey), chi square, and linear regression tests (P≤0.05 was considered significant). Rate of calcification in different areas were as follows: pineal gland (75.0%), habenula (36.4%), pineohabenula (15.0%), right lateral ventricle choroid plexus (RCP) (67.7%), left lateral ventricle choroid plexus (LCP) (62.7%), falx cerebri (26.8%), petroclinoid ligament (13.2%), tentorium cerebelli (6.8%), third ventricle choroid plexus (0.9%), fourth ventricle choroid plexus (2.7%), basal ganglia (0.9%). A significant correlation exists between the presence of calcification in pineal, habenula, RCP, and LCP (P≤0.001). Nodular shape of calcification was dominant (47.9%). Estimated volume of pineal calcification showed increased levels in group 8 (70–79 years old) compared to group 2 (10–19 years old) (P≤0.05). Since the accurate description of radiologic appearance of IPCs (location, shape, and size) accompanied with age and clinical manifestation is of great importance in diagnosis and distinguishing from pathologic calcification—for example in patients with melatonin dysregulation or schizophrenic patients—this study was required.
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Affiliation(s)
- Mehrdad Ghorbanlou
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.,Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moradi
- Department of Anatomy, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mehdi Mehdizadeh
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Reproductive Sciences and Technology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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23
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Alisch JSR, Kiely M, Triebswetter C, Alsameen MH, Gong Z, Khattar N, Egan JM, Bouhrara M. Characterization of Age-Related Differences in the Human Choroid Plexus Volume, Microstructural Integrity, and Blood Perfusion Using Multiparameter Magnetic Resonance Imaging. Front Aging Neurosci 2021; 13:734992. [PMID: 34603011 PMCID: PMC8485051 DOI: 10.3389/fnagi.2021.734992] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
The choroid plexus (CP) is an important cerebral structure involved in cerebrospinal fluid production and transport of solutes into the brain. Recent studies have uncovered the involvement of the CP in neurological disorders such as Alzheimer's disease and multiple sclerosis. However, our understanding of human age-related microstructural and functional changes in the CP with aging and neuropathology is limited. In this cross-sectional study, we investigated age and sex differences in the CP structure and function using advanced quantitative magnetic resonance imaging methodology in a large cohort (n = 155) of cognitively unimpaired individuals over a wide age range between 21 and 94 years. Our analysis included volumetric measurements, relaxometry measures (T 1 and T 2), diffusion tensor imaging (DTI) measures of fractional anisotropy (FA) and mean diffusivity (MD), as well as measures of cerebral blood flow (CBF). Our results revealed that CP volume was increasing with advancing age. We conjecture that this novel observation is likely attributed to alterations in the CP microstructure or function as well as to ventriculomegaly. Indeed, we also found that CBF was lower with advanced age, while, consistent with previous studies, T 1, T 2 and MD were higher, and FA was lower with advanced age. We attribute these functional and microstructural differences to a deteriorated CP structural integrity with aging. Furthermore, our relaxometry and DTI measures were found to be associated with differences in blood perfusion revealing lower microstructural integrity with lower CBF. Finally, in agreement with literature, sex-related differences in MD and CBF were statistically significant. This work lays the foundation for ongoing investigation of the involvement of CP in neurodegeneration.
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Affiliation(s)
| | | | | | | | | | | | | | - Mustapha Bouhrara
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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24
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Evaluation of Physiological Intracranial Calcifications in Children Using Computed Tomography. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2020-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction. Physiological intracranial calcifications have an increasing prevalence with the age and can be found in both children and in adults. These calcifications are basically asymptomatic and their presence can only be noticed through neuro-imaging.
The aim of the paper was to evaluate physiological intracranial calcifications in children using computed tomography, in our conditions.
Materials and methods. The study was designed as a retrospective, observational, non-randomized clinical study. It was conducted at the Department of Radiology, Clinical Center Kragujevac, Serbia. The study included all the patients scanned by CT from 1st October, 2008. to 30th September, 2018.. The criteria for the inclusion were: the patients aged up to 18 years who underwent a non-contrast computed tomography in the observed period, with diagnosed intracranial calcifications that do not have pathological etiology.
Results. Our study included 420 patients. Out of them, 213 (50.7%) were boys and 207 (49.3%) were girls. The mean age was 12.47. We divided the patients into two age categories: the first one included the patients aged 1 to 10 years and the other one included the patients aged 11 to 18 years. Our study has demonstrated that physiological intracranial calcifications are the most frequent in habenula (28.1%), followed by the pineal gland (22.6%) and choroid plexus (18.8%).
Conclusion. There is a small number of studies with the subject of physiological intracranial calcification distribution, especially in children. It is important to know in which locations we can expect physiological intracranial calcifications, as well as the age in which they become detectable by imaging, in order not to mix them with hemorrhages, pathological tumor or metabolic mineralization.
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25
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Parker WE, Weidman EK, Chazen JL, Niogi SN, Uribe-Cardenas R, Kaplitt MG, Hoffman CE. Magnetic resonance-guided focused ultrasound for ablation of mesial temporal epilepsy circuits: modeling and theoretical feasibility of a novel noninvasive approach. J Neurosurg 2020; 133:63-70. [PMID: 31200385 DOI: 10.3171/2019.4.jns182694] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 04/05/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The authors tested the feasibility of magnetic resonance-guided focused ultrasound (MRgFUS) ablation of mesial temporal lobe epilepsy (MTLE) seizure circuits. Up to one-third of patients with mesial temporal sclerosis (MTS) suffer from medically refractory epilepsy requiring surgery. Because current options such as open resection, laser ablation, and Gamma Knife radiosurgery pose potential risks, such as infection, hemorrhage, and ionizing radiation, and because they often produce visual or neuropsychological deficits, the authors developed a noninvasive MRgFUS ablation strategy for mesial temporal disconnection to mitigate these risks. METHODS The authors retrospectively reviewed 3-T MRI scans obtained with diffusion tensor imaging (DTI). The study group included 10 patients with essential tremor (ET) who underwent pretreatment CT and MRI prior to MRgFUS, and 2 patients with MTS who underwent MRI. Fiber tracking of the fornix-fimbria pathway and inferior optic radiations was performed, ablation sites mimicking targets of open posterior hippocampal disconnection were modeled, and theoretical MRgFUS surgical plans were devised. Distances between the targets and optic radiations were measured, helmet angulations were prescribed, and the numbers of available MRgFUS array elements were calculated. RESULTS Tractograms of fornix-fimbria and optic radiations were generated in all ET and MTS patients successfully. Of the 10 patients with both the CT and MRI data necessary for the analysis, 8 patients had adequate elements available to target the ablation site. A margin (mean 8.5 mm, range 6.5-9.8 mm) of separation was maintained between the target lesion and optic radiations. CONCLUSIONS MRgFUS offers a noninvasive option for seizure tract disruption. DTI identifies fornix-fimbria and optic radiations to localize optimal ablation targets and critical surrounding structures, minimizing risk of postoperative visual field deficits. This theoretical modeling study provides the necessary groundwork for future clinical trials to apply this novel neurosurgical technique to patients with refractory MTLE and surgical contraindications, multiple prior surgeries, or other factors favoring noninvasive treatment.
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Affiliation(s)
| | - Elizabeth K Weidman
- 2Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - J Levi Chazen
- 2Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | - Sumit N Niogi
- 2Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
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26
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SWI and phase imaging reveal intracranial calcifications in the P301L mouse model of human tauopathy. MAGMA (NEW YORK, N.Y.) 2020; 33:769-781. [PMID: 32468149 PMCID: PMC7669813 DOI: 10.1007/s10334-020-00855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
Objective Brain calcifications are associated with several neurodegenerative diseases. Here, we describe the occurrence of intracranial calcifications as a new phenotype in transgenic P301L mice overexpressing four repeat tau, a model of human tauopathy. Materials and methods Thirty-six P301L mice (Thy1.2) and ten age-matched non-transgenic littermates of different ages were assessed. Gradient echo data were acquired in vivo and ex vivo at 7 T and 9.4 T for susceptibility-weighted imaging (SWI) and phase imaging. In addition, ex vivo micro-computed tomography (μCT) was performed. Histochemistry and immunohistochemistry were used to investigate the nature of the imaging lesions. Results SW images revealed regional hypointensities in the hippocampus, cortex, caudate nucleus, and thalamus of P301L mice, which in corresponding phase images indicated diamagnetic lesions. Concomitantly, µCT detected hyperdense lesions, though fewer lesions were observed compared to MRI. Diamagnetic susceptibility lesions in the hippocampus increased with age. The immunochemical staining of brain sections revealed osteocalcin-positive deposits. Furthermore, intra-neuronal and vessel-associated osteocalcin-containing nodules co-localized with phosphorylated-tau (AT8 and AT100) in the hippocampus, while vascular osteocalcin-containing nodules were detected in the thalamus in the absence of phosphorylated-tau deposition. Discussion SWI and phase imaging sensitively detected intracranial calcifications in the P301L mouse model of human tauopathy. Electronic supplementary material The online version of this article (10.1007/s10334-020-00855-3) contains supplementary material, which is available to authorized users.
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27
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Cuccione E, Chhour P, Si-Mohamed S, Dumot C, Kim J, Hubert V, Da Silva CC, Vandamme M, Chereul E, Balegamire J, Chevalier Y, Berthezène Y, Boussel L, Douek P, Cormode DP, Wiart M. Multicolor spectral photon counting CT monitors and quantifies therapeutic cells and their encapsulating scaffold in a model of brain damage. Nanotheranostics 2020; 4:129-141. [PMID: 32483519 PMCID: PMC7256015 DOI: 10.7150/ntno.45354] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/04/2020] [Indexed: 12/13/2022] Open
Abstract
Rationale & aim: Various types of cell therapies are currently under investigation for the treatment of ischemic stroke patients. To bridge the gap between cell administration and therapeutic outcome, there is a need for non-invasive monitoring of these innovative therapeutic approaches. Spectral photon counting computed tomography (SPCCT) is a new imaging modality that may be suitable for cell tracking. SPCCT is the next generation of clinical CT that allows the selective visualization and quantification of multiple contrast agents. The aims of this study are: (i) to demonstrate the feasibility of using SPCCT to longitudinally monitor and quantify therapeutic cells, i.e. bone marrow-derived M2-polarized macrophages transplanted in rats with brain damage; and (ii) to evaluate the potential of this approach to discriminate M2-polarized macrophages from their encapsulating scaffold. Methods: Twenty one rats received an intralesional transplantation of bone marrow-derived M2-polarized macrophages. In the first set of experiments, cells were labeled with gold nanoparticles and tracked for up to two weeks post-injection in a monocolor study via gold K-edge imaging. In the second set of experiments, the same protocol was repeated for a bicolor study, in which the labeled cells are embedded in iodine nanoparticle-labeled scaffold. The amount of gold in the brain was longitudinally quantified using gold K-edge images reconstructed from SPCCT acquisition. Animals were sacrificed at different time points post-injection, and ICP-OES was used to validate the accuracy of gold quantification from SPCCT imaging. Results: The feasibility of therapeutic cell tracking was successfully demonstrated in brain-damaged rats with SPCCT imaging. The imaging modality enabled cell monitoring for up to 2 weeks post-injection, in a specific and quantitative manner. Differentiation of labeled cells and their embedding scaffold was also feasible with SPCCT imaging, with a detection limit as low as 5,000 cells in a voxel of 250 × 250 × 250 µm in dimension in vivo. Conclusion: Multicolor SPCCT is an innovative translational imaging tool that allows monitoring and quantification of therapeutic cells and their encapsulating scaffold transplanted in the damaged rat brain.
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Affiliation(s)
- Elisa Cuccione
- CarMeN Laboratory, Institut National de la Santé et de la Recherche Médicale U1060, INRA U1397, Université Lyon 1, INSA Lyon, F-69600 Oullins, France
- VOXCAN, 1 avenue Bourgelat, 69280 Marcy l'Etoile, France
| | - Peter Chhour
- Department of Radiology, University of Pennsylvania, Pennsylvania, United States
| | - Salim Si-Mohamed
- CREATIS, CNRS UMR 5220 - INSERM U1206 - University of Lyon 1 - INSA Lyon, Lyon, France
- Hospices Civils de Lyon, Radiology Department, Lyon, France
| | - Chloé Dumot
- CarMeN Laboratory, Institut National de la Santé et de la Recherche Médicale U1060, INRA U1397, Université Lyon 1, INSA Lyon, F-69600 Oullins, France
| | - Johoon Kim
- Department of Radiology, University of Pennsylvania, Pennsylvania, United States
| | - Violaine Hubert
- CarMeN Laboratory, Institut National de la Santé et de la Recherche Médicale U1060, INRA U1397, Université Lyon 1, INSA Lyon, F-69600 Oullins, France
| | - Claire Crola Da Silva
- CarMeN Laboratory, Institut National de la Santé et de la Recherche Médicale U1060, INRA U1397, Université Lyon 1, INSA Lyon, F-69600 Oullins, France
| | - Marc Vandamme
- VOXCAN, 1 avenue Bourgelat, 69280 Marcy l'Etoile, France
| | | | - Joëlle Balegamire
- LAGEPP, University of Lyon 1, CNRS UMR 5007, 43 bd 11 Novembre, 69622 Villeurbanne, France
| | - Yves Chevalier
- LAGEPP, University of Lyon 1, CNRS UMR 5007, 43 bd 11 Novembre, 69622 Villeurbanne, France
| | - Yves Berthezène
- CREATIS, CNRS UMR 5220 - INSERM U1206 - University of Lyon 1 - INSA Lyon, Lyon, France
- Hospices Civils de Lyon, Radiology Department, Lyon, France
| | - Loïc Boussel
- CREATIS, CNRS UMR 5220 - INSERM U1206 - University of Lyon 1 - INSA Lyon, Lyon, France
- Hospices Civils de Lyon, Radiology Department, Lyon, France
| | - Philippe Douek
- CREATIS, CNRS UMR 5220 - INSERM U1206 - University of Lyon 1 - INSA Lyon, Lyon, France
- Hospices Civils de Lyon, Radiology Department, Lyon, France
| | - David P. Cormode
- Department of Radiology, University of Pennsylvania, Pennsylvania, United States
| | - Marlène Wiart
- CarMeN Laboratory, Institut National de la Santé et de la Recherche Médicale U1060, INRA U1397, Université Lyon 1, INSA Lyon, F-69600 Oullins, France
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28
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Patel S, Rahmani B, Gandhi J, Seyam O, Joshi G, Reid I, Smith NL, Waltzer WC, Khan SA. Revisiting the pineal gland: a review of calcification, masses, precocious puberty, and melatonin functions. Int J Neurosci 2020; 130:464-475. [PMID: 31714865 DOI: 10.1080/00207454.2019.1692838] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: The pineal gland, an endocrine organ of the posterior cranial fossa famously involved in sleep and wakefulness, has continually been a topic of scientific advancement and curiosity. Methods: We review present an up-to-date review including the anatomy, embryology, and physiology of the pineal gland and its ability to secrete hormones including melatonin, pathophysiology of pineal gland tumors, cysts, and calcifications, their clinical presentation including their association with parkinsonism and precocious puberty, and various treatment approaches. Results: Exploring the biochemistry of melatonin, various calcification morphologies, and pineal tumors may uncover a wider role and the exhaustive case study consolidation allows clinicians to carefully review the literature and aid their treatment approaches. Conclusion: It is imperative that clinicians and diagnosticians are able to distinguish manifestations of an overlooked gland.
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Affiliation(s)
- Shrey Patel
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Benjamin Rahmani
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA.,Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | - Omar Seyam
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Gunjan Joshi
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
| | - Inefta Reid
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | | | - Wayne C Waltzer
- Department of Urology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
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Saade C, Najem E, Asmar K, Salman R, El Achkar B, Naffaa L. Intracranial calcifications on CT: an updated review. J Radiol Case Rep 2019; 13:1-18. [PMID: 31558966 DOI: 10.3941/jrcr.v13i8.3633] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Intracranial calcifications are frequently encountered in non-contrast computed tomography scan in both adult and pediatric age groups. They refer to calcifications within the brain parenchyma or vasculature and can be classified into several major categories: physiologic/age-related, dystrophic, congenital disorders/phakomatoses, infectious, vascular, neoplastic, metabolic/endocrine, inflammatory and toxic diseases. In this updated review, we present a wide spectrum of intracranial calcifications from both pediatric and adult populations focusing on their pattern, size and location.
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Affiliation(s)
- Charbel Saade
- Department of Medical Imaging Sciences, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Najem
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karl Asmar
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rida Salman
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Bassam El Achkar
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lena Naffaa
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
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30
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Sergina SN, Ilyukha VA, Morozov AV, Antonova EP, Bruler ES, Volodina AD. Taxonomic and Ethnical Dispersion of the Phenomenon of Pineal Concretions in the Gerontological Context. ADVANCES IN GERONTOLOGY 2019. [DOI: 10.1134/s2079057019020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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31
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Song J. Pineal gland dysfunction in Alzheimer's disease: relationship with the immune-pineal axis, sleep disturbance, and neurogenesis. Mol Neurodegener 2019; 14:28. [PMID: 31296240 PMCID: PMC6624939 DOI: 10.1186/s13024-019-0330-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022] Open
Abstract
Alzheimer’s disease (AD) is a globally common neurodegenerative disease, which is accompanied by alterations to various lifestyle patterns, such as sleep disturbance. The pineal gland is the primary endocrine organ that secretes hormones, such as melatonin, and controls the circadian rhythms. The decrease in pineal gland volume and pineal calcification leads to the reduction of melatonin production. Melatonin has been reported to have multiple roles in the central nervous system (CNS), including improving neurogenesis and synaptic plasticity, suppressing neuroinflammation, enhancing memory function, and protecting against oxidative stress. Recently, reduced pineal gland volume and pineal calcification, accompanied by cognitive decline and sleep disturbances have been observed in AD patients. Here, I review current significant evidence of the contribution of pineal dysfunction in AD to the progress of AD neuropathology. I suggest new insights to understanding the relationship between AD pathogenesis and pineal gland function.
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Affiliation(s)
- Juhyun Song
- Department of Anatomy, Chonnam National University Medical School, Hwasun, 58128, Jeollanam-do, Republic of Korea.
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32
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de Brouwer EJM, Kockelkoren R, De Vis JB, Dankbaar JW, Velthuis BK, Takx RA, De Jonghe A, Emmelot-Vonk MH, Koek HL, de Jong PA. Prevalence and vascular risk factors of basal ganglia calcifications in patients at risk for cerebrovascular disease. J Neuroradiol 2019; 47:337-342. [PMID: 31034898 DOI: 10.1016/j.neurad.2019.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/25/2019] [Accepted: 04/09/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Risk factors for and meaning of basal ganglia calcifications outside Fahr syndrome are poorly understood. We aimed to assess the prevalence of basal ganglia calcifications and the association with vascular risk factors. MATERIALS AND METHODS 1133 patients suspected of acute ischemic stroke from the Dutch acute stroke (DUST) study who underwent thin-slice unenhanced brain CT were analyzed. Basal ganglia calcifications were scored bilaterally as absent, mild (dot), moderate (multiple dots or single artery) and severe (confluent). Uni- and multivariable logistic regression analysis was used to determine possible risk factors (age, gender, history of stroke, smoking, hypertension, diabetes mellitus, hyperlipidemia, body mass index (BMI), renal function and family history of cardiovascular disease under 60 years) for presence of basal ganglia calcifications and ordinal regression analysis for severity of basal ganglia calcifications. RESULTS Mean age was 67.4 years (SD: 13.8), 56.8% were male. 337 (29.7%) patients had basal ganglia calcifications, of which 196 (58%) were mild, 103 (31%) moderate, 38 (11%) severe. In multivariable logistic regression analysis, age (OR: 1.02, 95% CI 1.01-1.03, P < 0.01) and BMI (OR: 0.95, 95% CI 0.91-0.98, p 0.01) were significantly associated with the presence of basal ganglia calcifications. Ordinal regression analysis gave comparable results. Age (OR: 1.02, 95% CI 1.01-1.03, P < 0.01) and BMI (OR: 0.95, 95% CI 0.92-0.99, P 0.01) were significantly associated with severity of basal ganglia calcifications. CONCLUSIONS In this study with patients suspected of acute ischemic stroke, basal ganglia calcifications were common and significantly associated with older age and lower BMI.
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Affiliation(s)
- Esther J M de Brouwer
- Department of Geriatrics, University Medical Center Utrecht, Room B05.2.25, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Remko Kockelkoren
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Jill B De Vis
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Jan Willem Dankbaar
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Richard Ap Takx
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Annemarieke De Jonghe
- Department of Geriatrics, Tergooi hospital, PO box 10016, 1201 DA, Hilversum, The Netherlands
| | - Marielle H Emmelot-Vonk
- Department of Geriatrics, University Medical Center Utrecht, Room B05.2.25, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht, Room B05.2.25, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center Utrecht, Room F01.503, PO Box 85500, 3508 GA, Utrecht, The Netherlands
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Hubert V, Chauveau F, Dumot C, Ong E, Berner LP, Canet-Soulas E, Ghersi-Egea JF, Wiart M. Clinical Imaging of Choroid Plexus in Health and in Brain Disorders: A Mini-Review. Front Mol Neurosci 2019; 12:34. [PMID: 30809124 PMCID: PMC6379459 DOI: 10.3389/fnmol.2019.00034] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/25/2019] [Indexed: 11/18/2022] Open
Abstract
The choroid plexuses (ChPs) perform indispensable functions for the development, maintenance and functioning of the brain. Although they have gained considerable interest in the last years, their involvement in brain disorders is still largely unknown, notably because their deep location inside the brain hampers non-invasive investigations. Imaging tools have become instrumental to the diagnosis and pathophysiological study of neurological and neuropsychiatric diseases. This review summarizes the knowledge that has been gathered from the clinical imaging of ChPs in health and brain disorders not related to ChP pathologies. Results are discussed in the light of pre-clinical imaging studies. As seen in this review, to date, most clinical imaging studies of ChPs have used disease-free human subjects to demonstrate the value of different imaging biomarkers (ChP size, perfusion/permeability, glucose metabolism, inflammation), sometimes combined with the study of normal aging. Although very few studies have actually tested the value of ChP imaging biomarkers in patients with brain disorders, these pioneer studies identified ChP changes that are promising data for a better understanding and follow-up of diseases such as schizophrenia, epilepsy and Alzheimer’s disease. Imaging of immune cell trafficking at the ChPs has remained limited to pre-clinical studies so far but has the potential to be translated in patients for example using MRI coupled with the injection of iron oxide nanoparticles. Future investigations should aim at confirming and extending these findings and at developing translational molecular imaging tools for bridging the gap between basic molecular and cellular neuroscience and clinical research.
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Affiliation(s)
- Violaine Hubert
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
| | - Fabien Chauveau
- CNRS UMR5292, INSERM U1028, BIORAN Team, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Lyon, France.,CNRS, Lyon, France
| | - Chloé Dumot
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France.,HCL, Lyon, France
| | - Elodie Ong
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France.,HCL, Lyon, France
| | | | - Emmanuelle Canet-Soulas
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
| | - Jean-François Ghersi-Egea
- CNRS UMR5292, INSERM U1028, Fluid Team and BIP Facility, Lyon Neuroscience Research Center, Université Claude Bernard Lyon 1, Lyon, France
| | - Marlène Wiart
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France.,CNRS, Lyon, France
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34
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Huang YT, Zhang LH, Li MF, Cheng L, Qu J, Cheng Y, Li X, Zou GY, Zhou HH. Clinical Features of Primary Familial Brain Calcification in 17 Families. Chin Med J (Engl) 2018; 131:2997-3000. [PMID: 30539916 PMCID: PMC6302657 DOI: 10.4103/0366-6999.247218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Yuan-Tao Huang
- Department of Clinical Pharmacology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China
| | - Li-Hua Zhang
- Department of Clinical Pharmacology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China
| | - Mei-Fang Li
- Department of Otorhinolaryngology, The Brain Hospital of Hunan Province, Changsha, Hunan 410007, China
| | - Lin Cheng
- Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China
| | - Jian Qu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Institute of Clinical Pharmacy, Central South University, Changsha, Hunan 410011, China
| | - Yu Cheng
- Department of Clinical Pharmacology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China
| | - Guo-Ying Zou
- Department of Clinical Laboratory, The Brain Hospital of Hunan Province, Changsha, Hunan 410007, China
| | - Hong-Hao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China
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35
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Identification of Tracheobronchial Tree Calcifications Using Molecular Imaging Probes. Clin Nucl Med 2018; 43:e278-e279. [DOI: 10.1097/rlu.0000000000002164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Al-Zaghal A, Mehdizadeh Seraj S, Werner TJ, Gerke O, Høilund-Carlsen PF, Alavi A. Assessment of Physiological Intracranial Calcification in Healthy Adults Using 18F-NaF PET/CT. J Nucl Med 2018; 60:jnumed.118.213678. [PMID: 30002111 DOI: 10.2967/jnumed.118.213678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/18/2018] [Indexed: 11/16/2022] Open
Abstract
The aim of this research study was to determine the role of 18F-Sodium fluoride (NaF) PET/CT imaging in the assessment of physiologic molecular calcification in the intra-cranial structures. We also examined the association of NaF accumulation with age as well as Hounsfield unit (HU) in certain anatomical sites that are known to calcify with normal aging. Methods: A total of 78 healthy subjects from the Cardiovascular Molecular Calcification Assessed by 18F-NaF PET/CT (CAMONA) clinical trial (38 females and 40 males) were included in this retrospective study. The mean age was 45.28 ±14.15 years (21-75). Mean standardized uptake values (SUVmean) was used to measure NaF accumulation in the choroid plexus and epithalamus (pineal gland and habenula). Maximum HU was also measured for each ROI. Correlation analysis was conducted to assess the association between parameters. Results: Mean SUVmean was 0.42 ± 0.26 in the right choroid plexus, 0.39 ±25 in the left choroid plexus, and 0.23±0.08 in the epithalamus. Significant positive correlations were present between NaF uptake and age in the right choroid plexus (r=0.61, P < 0.0001), left choroid plexus (r=0.63, p<0.0001), and epithalamus (r=0.36, P = 0.001). NaF uptake significantly correlated with HU in the right choroid plexus (r=0.52, P < 0.0001), left choroid plexus (r=0.57, p<0.0001), and epithalamus (r=0.25, P = 0.03). Conclusion: NaF could be used in the assessment of physiological calcification in several intracranial structures. We report significant associations between NaF uptake and aging as well as HU in the calcified choroid plexus and epithalamus. Our findings further support the growing interest to utilize NaF for detecting extra-osseous, molecular calcification, and this powerful probe has potential applications in the evaluation of various age-related, neurodegenerative brain processes.
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Affiliation(s)
| | | | | | | | | | - Abass Alavi
- Hospital of the University of Pennsylvania, United States
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37
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Tan DX, Xu B, Zhou X, Reiter RJ. Pineal Calcification, Melatonin Production, Aging, Associated Health Consequences and Rejuvenation of the Pineal Gland. Molecules 2018; 23:E301. [PMID: 29385085 PMCID: PMC6017004 DOI: 10.3390/molecules23020301] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 01/26/2023] Open
Abstract
The pineal gland is a unique organ that synthesizes melatonin as the signaling molecule of natural photoperiodic environment and as a potent neuronal protective antioxidant. An intact and functional pineal gland is necessary for preserving optimal human health. Unfortunately, this gland has the highest calcification rate among all organs and tissues of the human body. Pineal calcification jeopardizes melatonin's synthetic capacity and is associated with a variety of neuronal diseases. In the current review, we summarized the potential mechanisms of how this process may occur under pathological conditions or during aging. We hypothesized that pineal calcification is an active process and resembles in some respects of bone formation. The mesenchymal stem cells and melatonin participate in this process. Finally, we suggest that preservation of pineal health can be achieved by retarding its premature calcification or even rejuvenating the calcified gland.
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Affiliation(s)
- Dun Xian Tan
- Department of Cell Systems & Anatomy, UT Health San Antonio, San Antonio, TX 78229, USA.
| | - Bing Xu
- Department of Cell Systems & Anatomy, UT Health San Antonio, San Antonio, TX 78229, USA.
| | - Xinjia Zhou
- Department of Cell Systems & Anatomy, UT Health San Antonio, San Antonio, TX 78229, USA.
| | - Russel J Reiter
- Department of Cell Systems & Anatomy, UT Health San Antonio, San Antonio, TX 78229, USA.
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Barkovich EJ, Lateef TM, Whitehead MT. Neuroimaging findings in Pallister-Killian syndrome. Neuroradiol J 2017; 31:403-411. [PMID: 29260614 DOI: 10.1177/1971400917744798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pallister-Killian syndrome (PKS) is a rare chromosomal duplication disorder caused by additional copies of the short arm of chromosome 12 (12p). Clinically PKS is characterized by craniofacial dysmorphism with neonatal frontotemporal alopecia, hypertelorism, and low-set ears as well as kyphoscoliosis, severe intellectual disability, epilepsy, and abnormal muscle tone. Comprehensive high-resolution brain MR findings of PKS in childhood have not been previously illustrated in the medical literature. We present detailed neuroimaging findings from a child with PKS and thoroughly review previously reported structural brain abnormalities in this patient population. MRI abnormalities common to PKS include cerebral volume loss, malformations of cortical development, corpus callosum dysgenesis, white matter disease, and craniofacial malformations. In our patient, new findings of perisylvian with occipital polymicrogyria, vermian dysplasia, brachium pontis signal abnormality, dural anomalies, and unilateral atlas assimilation were noted. Micrencephaly and cortical dysplasia provide a likely explanation for severe intellectual disability and epilepsy in this patient population.
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39
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Adams LC, Böker SM, Bender YY, Diederichs G, Fallenberg EM, Wagner M, Hamm B, Makowski MR. Diagnostic accuracy of susceptibility-weighted magnetic resonance imaging for the evaluation of pineal gland calcification. PLoS One 2017; 12:e0172764. [PMID: 28278291 PMCID: PMC5344338 DOI: 10.1371/journal.pone.0172764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 12/13/2022] Open
Abstract
Objectives To determine the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the detection of pineal gland calcifications (PGC) compared to conventional magnetic resonance imaging (MRI) sequences, using computed tomography (CT) as a reference standard. Methods 384 patients who received a 1.5 Tesla MRI scan including SWMR sequences and a CT scan of the brain between January 2014 and October 2016 were retrospectively evaluated. 346 patients were included in the analysis, of which 214 showed PGC on CT scans. To assess correlation between imaging modalities, the maximum calcification diameter was used. Sensitivity and specificity and intra- and interobserver reliability were calculated for SWMR and conventional MRI sequences. Results SWMR reached a sensitivity of 95% (95% CI: 91%-97%) and a specificity of 96% (95% CI: 91%-99%) for the detection of PGC, whereas conventional MRI achieved a sensitivity of 43% (95% CI: 36%-50%) and a specificity of 96% (95% CI: 91%-99%). Detection rates for calcifications in SWMR and conventional MRI differed significantly (95% versus 43%, p<0.001). Diameter measurements between SWMR and CT showed a close correlation (R2 = 0.85, p<0.001) with a slight but not significant overestimation of size (SWMR: 6.5 mm ± 2.5; CT: 5.9 mm ± 2.4, p = 0.02). Interobserver-agreement for diameter measurements was excellent on SWMR (ICC = 0.984, p < 0.0001). Conclusions Combining SWMR magnitude and phase information enables the accurate detection of PGC and offers a better diagnostic performance than conventional MRI with CT as a reference standard.
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Affiliation(s)
- Lisa C. Adams
- Department of Radiology, Charité, Berlin, Germany
- * E-mail:
| | | | | | | | | | | | - Bernd Hamm
- Department of Radiology, Charité, Berlin, Germany
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