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Badea RȘ, Mihăilă-Bâldea S, Ribigan A, Negrilă A, Grecu N, Marinescu AN, Antochi F, Tiu C, Vinereanu D, Popescu BO. PFO-spectrum disorder: two different cerebrovascular diseases in patients with PFO as detected by AI brain imaging software. Front Neurol 2024; 15:1357348. [PMID: 38440117 PMCID: PMC10909929 DOI: 10.3389/fneur.2024.1357348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background Patent foramen ovale (PFO) is a prevalent cardiac remnant of fetal anatomy that may pose a risk factor for stroke in some patients, while others can present with asymptomatic white matter (WM) lesions. The current study aimed to test the hypothesis that patients with a PFO who have a history of stroke or transient ischemic attack, compared to those without such a history, have a different burden and distribution of cerebral WM hyperintensities. Additionally, we tested the association between PFO morphological characteristics and severity of shunt, and their impact on the occurrence of ischemic cerebral vascular events and on the burden of cerebral WM lesions. Patients and methods Retrospective, case-control study that included patients with PFO confirmed by transesophageal echocardiography. Right-to-left shunt size was assessed using transcranial Doppler ultrasound. Cerebral MRIs were analyzed for all participants using the semi-automated Quantib NDTM software for the objective quantification of WM lesions. WM lesions volume was compared between patients with and without a history of stroke. Additionally, the anatomical characteristics of PFOs were assessed to explore their relation to stroke occurrence and WM lesions volume. Results Of the initial 264 patients diagnosed with PFO, 67 met the inclusion criteria and were included in the analysis. Of them, 62% had a history of PFO-related stroke/TIA. Overall burden of WM lesions, including stroke volume, was not significantly different (p = 0.103). However, after excluding stroke volume, WM lesions volume was significantly higher in patients without stroke (0.27 cm3, IQR 0.03-0.60) compared to those with stroke/TIA (0.08 cm3, IQR 0.02-0.18), p = 0.019. Patients with a history of PFO-related stroke/TIA had a tendency to larger PFO sizes by comparison to those without, in terms of length and height, and exhibited greater right-to-left shunt volumes. Discussion We suggest that PFO may be associated with the development of two distinct cerebrovascular conditions (stroke and "silent" WM lesions), each characterized by unique imaging patterns. Further studies are needed to identify better the "at-risk" PFOs and gain deeper insights into their clinical implications.
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Affiliation(s)
- Raluca Ștefania Badea
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Sorina Mihăilă-Bâldea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Department of Cardiology and Cardiovascular Surgery, University and Emergency Hospital, Bucharest, Romania
| | - Athena Ribigan
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Anca Negrilă
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
| | - Nicolae Grecu
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | | | - Florina Antochi
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
| | - Cristina Tiu
- Department of Neurology, University and Emergency Hospital, Bucharest, Romania
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Dragos Vinereanu
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Department of Cardiology and Cardiovascular Surgery, University and Emergency Hospital, Bucharest, Romania
| | - Bogdan Ovidiu Popescu
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Department of Neurology, Colentina Clinical Hospital, Bucharest, Romania
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Sha L, Li Y, Zhang Y, Tang Y, Li B, Chen Y, Chen L. Heart-brain axis: Association of congenital heart abnormality and brain diseases. Front Cardiovasc Med 2023; 10:1071820. [PMID: 37063948 PMCID: PMC10090520 DOI: 10.3389/fcvm.2023.1071820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
Brain diseases are a major burden on human health worldwide, and little is known about how most brain diseases develop. It is believed that cardiovascular diseases can affect the function of the brain, and many brain diseases are associated with heart dysfunction, which is called the heart-brain axis. Congenital heart abnormalities with anomalous hemodynamics are common treatable cardiovascular diseases. With the development of cardiovascular surgeries and interventions, the long-term survival of patients with congenital heart abnormalities continues to improve. However, physicians have reported that patients with congenital heart abnormalities have an increased risk of brain diseases in adulthood. To understand the complex association between congenital heart abnormalities and brain diseases, the paper reviews relevant clinical literature. Studies have shown that congenital heart abnormalities are associated with most brain diseases, including stroke, migraine, dementia, infection of the central nervous system, epilepsy, white matter lesions, and affective disorders. However, whether surgeries or other interventions could benefit patients with congenital heart abnormalities and brain diseases remains unclear because of limited evidence.
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Affiliation(s)
- Leihao Sha
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Yajiao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yunwu Zhang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, School of Medicine, Xiamen University, Xiamen, China
| | - Yusha Tang
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Baichuan Li
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Neurology, Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
- Correspondence: Lei Chen
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Guo X, Wang D, Ying C, Hong Y. Association between brain structures and migraine: A bidirectional Mendelian randomization study. Front Neurosci 2023; 17:1148458. [PMID: 36937660 PMCID: PMC10020331 DOI: 10.3389/fnins.2023.1148458] [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: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Background Accumulating evidence of clinical and neuroimaging studies indicated that migraine is related to brain structural alterations. However, it is still not clear whether the associations of brain structural alterations with migraine are likely to be causal, or could be explained by reverse causality confounding. Methods We carried on a bidirectional Mendelian randomization analysis in order to identify the causal relationship between brain structures and migraine risk. Summary-level data and independent variants used as instruments came from large genome-wide association studies of total surface area and average thickness of cortex (33,992 participants), gray matter volume (8,428 participants), white matter hyperintensities (50,970 participants), hippocampal volume (33,536 participants), and migraine (102,084 cases and 771,257 controls). Results We identified suggestive associations of the decreased surface area (OR = 0.85; 95% CI, 0.75-0.96; P = 0.007), and decreased hippocampal volume (OR = 0.74; 95% CI, 0.55-1.00; P = 0.047) with higher migraine risk. We did not find any significant association of gray matter volume, cortical thickness, or white matter hyperintensities with migraine. No evidence supporting the significant association was found in the reverse MR analysis. Conclusion We provided suggestive evidence that surface area and hippocampal volume are causally associated with migraine risk.
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Affiliation(s)
- Xiaoming Guo
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurosurgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Dingkun Wang
- Department of Neurosurgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Caidi Ying
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Hong
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Yuan Hong,
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The Patent Foramen Ovale and Migraine: Associated Mechanisms and Perspectives from MRI Evidence. Brain Sci 2022; 12:brainsci12070941. [PMID: 35884747 PMCID: PMC9313384 DOI: 10.3390/brainsci12070941] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/10/2022] [Accepted: 07/15/2022] [Indexed: 02/04/2023] Open
Abstract
Migraine is a common neurological disease with a still-unclear etiology and pathogenesis. Patent foramen ovale (PFO) is a kind of congenital heart disease that leads to a right-to-left shunt (RLS). Although previous studies have shown that PFO has an effect on migraine, a clear conclusion about the link between PFO and migraine is lacking. We first summarized the PFO potential mechanisms associated with migraine, including microembolus-triggered cortical spreading depression (CSD), the vasoactive substance hypothesis, impaired cerebral autoregulation (CA), and a common genetic basis. Further, we analyzed the changes in brain structure and function in migraine patients and migraine patients with PFO. We found that in migraine patients with PFO, the presence of PFO may affect the structure of the cerebral cortex and the integrity of white matter, which is mainly locked in subcortical, deep white matter, and posterior circulation, and may lead to changes in brain function, such as cerebellum and colliculus, which are involved in the processing and transmission of pain. In summary, this paper provides neuroimaging evidence and new insights into the correlation between PFO and migraine, which will help to clarify the etiology and pathogenesis of migraine, and aid in the diagnosis and treatment of migraine in the future.
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de Meneses FGA, Lima GD, Nunes M, Hugo Bastos V, Teixeira S. Percolation theory for the recognition of patterns in topographic images of the cortical activity. Med Hypotheses 2019; 125:37-40. [PMID: 30902149 DOI: 10.1016/j.mehy.2019.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/23/2019] [Accepted: 02/03/2019] [Indexed: 11/24/2022]
Abstract
Electroencephalogram (EEG) is one of the mechanisms used to collect complex data. Its use includes evaluating neurological disorders, investigating brain function and correlations between EEG signals and real or imagined movements. The Topographic Image of Cortical Activity (TICA) records obtained by the EEG make it possible to observe, through color discrimination, the cortical areas that represent greater or lesser activity. Percolation Theory (PT) reveals properties on the aspects of fluid spreading from a central point, these properties being related to the aspects of the medium, topological characteristics and ease of penetration of a fluid in materials. The hypothesis presented so far considers that synaptic activities originate in points and spread from them, causing different areas of the brain to interact in a diffusive associative behavior, generating electric and magnetic fields by the currents that spread through the brain tissue and have an effect on the scalp sensors. Brain areas spatially separated create large-scale dynamic networks that are described by functional and effective connectivity. The proposition is that this phenomenon behaves like a fluidic spreading, so we can use the PT, through the topological analysis we detect specific signatures related to neural phenomena that manifest changes in the behavior of synaptic diffusion. This signature must be characterized by the Fractal Dimension (FD) values of the scattering clusters, these values will be used as properties in the k-Nearest Neighbors (kNN) method, an TICA will be categorized according to the degree of similarity to the preexisting patterns. In this context, our hypothesis will consolidate as a more computational resource in the service of medicine and another way that opens with the possibility of analysis and detailed inferences of the brain through TICA that go beyond a simply visual observation, as it happens in the present day.
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Affiliation(s)
- Francisco Gerson A de Meneses
- Neuroinnovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil.
| | - Gildário Dias Lima
- Neuroinnovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Monara Nunes
- Neuroinnovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Hugo Bastos
- Neuroinnovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; Master Program in Biotechnology, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Silmar Teixeira
- Neuroinnovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil; Master Program in Biotechnology, Federal University of Piauí, Parnaíba, Brazil; The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
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