1
|
Pradeep A, Raghavan S, Przybelski SA, Preboske GM, Schwarz CG, Lowe VJ, Knopman DS, Petersen RC, Jack CR, Graff-Radford J, Cogswell PM, Vemuri P. Can white matter hyperintensities based Fazekas visual assessment scales inform about Alzheimer's disease pathology in the population? Alzheimers Res Ther 2024; 16:157. [PMID: 38987827 PMCID: PMC11234605 DOI: 10.1186/s13195-024-01525-5] [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: 03/05/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND White matter hyperintensities (WMH) are considered hallmark features of cerebral small vessel disease and have recently been linked to Alzheimer's disease (AD) pathology. Their distinct spatial distributions, namely periventricular versus deep WMH, may differ by underlying age-related and pathobiological processes contributing to cognitive decline. We aimed to identify the spatial patterns of WMH using the 4-scale Fazekas visual assessment and explore their differential association with age, vascular health, AD imaging markers, namely amyloid and tau burden, and cognition. Because our study consisted of scans from GE and Siemens scanners with different resolutions, we also investigated inter-scanner reproducibility and combinability of WMH measurements on imaging. METHODS We identified 1144 participants from the Mayo Clinic Study of Aging consisting of a population-based sample from Olmsted County, Minnesota with available structural magnetic resonance imaging (MRI), amyloid, and tau positron emission tomography (PET). WMH distribution patterns were assessed on FLAIR-MRI, both 2D axial and 3D, using Fazekas ratings of periventricular and deep WMH severity. We compared the association of periventricular and deep WMH scales with vascular risk factors, amyloid-PET, and tau-PET standardized uptake value ratio, automated WMH volume, and cognition using Pearson partial correlation after adjusting for age. We also evaluated vendor compatibility and reproducibility of the Fazekas scales using intraclass correlations (ICC). RESULTS Periventricular and deep WMH measurements showed similar correlations with age, cardiometabolic conditions score (vascular risk), and cognition, (p < 0.001). Both periventricular WMH and deep WMH showed weak associations with amyloidosis (R = 0.07, p = < 0.001), and none with tau burden. We found substantial agreement between data from the two scanners for Fazekas measurements (ICC = 0.82 and 0.74). The automated WMH volume had high discriminating power for identifying participants with Fazekas ≥ 2 (area under curve = 0.97) and showed poor correlation with amyloid and tau PET markers similar to the visual grading. CONCLUSION Our study investigated risk factors underlying WMH spatial patterns and their impact on global cognition, with no discernible differences between periventricular and deep WMH. We observed minimal impact of amyloidosis on WMH severity. These findings, coupled with enhanced inter-scanner reproducibility of WMH data, suggest the combinability of inter-scanner data assessed by harmonized protocols in the context of vascular contributions to cognitive impairment and dementia biomarker research.
Collapse
Affiliation(s)
| | - Sheelakumari Raghavan
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | - Gregory M Preboske
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Christopher G Schwarz
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Petrice M Cogswell
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
2
|
Pradeep A, Raghavan S, Przybelski SA, Preboske G, Schwarz CG, Lowe VJ, Knopman DS, Petersen RC, Jack CR, Graff-Radford J, Cogswell PM, Vemuri P. Can white matter hyperintensities based Fazekas visual assessment scales inform about Alzheimer's disease pathology in the population? RESEARCH SQUARE 2024:rs.3.rs-4017874. [PMID: 38558965 PMCID: PMC10980106 DOI: 10.21203/rs.3.rs-4017874/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background White matter hyperintensities (WMH) are considered hallmark features of cerebral small vessel disease and have recently been linked to Alzheimer's disease pathology. Their distinct spatial distributions, namely periventricular versus deep WMH, may differ by underlying age-related and pathobiological processes contributing to cognitive decline. We aimed to identify the spatial patterns of WMH using the 4-scale Fazekas visual assessment and explore their differential association with age, vascular health, Alzheimer's imaging markers, namely amyloid and tau burden, and cognition. Because our study consisted of scans from GE and Siemens scanners with different resolutions, we also investigated inter-scanner reproducibility and combinability of WMH measurements on imaging. Methods We identified 1144 participants from the Mayo Clinic Study of Aging consisting of older adults from Olmsted County, Minnesota with available structural magnetic resonance imaging (MRI), amyloid, and tau positron emission tomography (PET). WMH distribution patterns were assessed on FLAIR-MRI, both 2D axial and 3D, using Fazekas ratings of periventricular and deep WMH severity. We compared the association of periventricular and deep WMH scales with vascular risk factors, amyloid-PET and tau-PET standardized uptake value ratio, WMH volume, and cognition using Pearson partial correlation after adjusting for age. We also evaluated vendor compatibility and reproducibility of the Fazekas scales using intraclass correlations (ICC). Results Periventricular and deep WMH measurements showed similar correlations with age, cardiometabolic conditions score (vascular risk), and cognition, (p < 0.001). Both periventricular WMH and deep WMH showed weak associations with amyloidosis (R = 0.07, p = < 0.001), and none with tau burden. We found substantial agreement between data from the two scanners for Fazekas measurements (ICC = 0.78). The automated WMH volume had high discriminating power for identifying participants with Fazekas ≥ 2 (area under curve = 0.97). Conclusion Our study investigates risk factors underlying WMH spatial patterns and their impact on global cognition, with no discernible differences between periventricular and deep WMH. We observed minimal impact of amyloidosis on WMH severity. These findings, coupled with enhanced inter-scanner reproducibility of WMH data, suggest the combinability of inter-scanner data assessed by harmonized protocols in the context of vascular contributions to cognitive impairment and dementia biomarker research.
Collapse
|
3
|
Thomas J, Jezzard P, Webb AJS. Low-frequency oscillations in the brain show differential regional associations with severity of cerebral small vessel disease: a systematic review. Front Neurosci 2023; 17:1254209. [PMID: 37719157 PMCID: PMC10501452 DOI: 10.3389/fnins.2023.1254209] [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: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Background Cerebral small vessel disease (cSVD) is associated with endothelial dysfunction but the pathophysiology is poorly understood. Low-frequency oscillations (LFOs) in the BOLD signal partly reflect cerebrovascular function and have the potential to identify endothelial dysfunction in cSVD. A systematic review was performed to assess the reported relationships between imaging markers of cSVD and LFOs. Methods Medline and EMBASE were searched for original studies reporting an association between LFOs and STRIVE-defined imaging markers of cSVD, including: white matter hyperintensities (WMH), enlarged perivascular spaces, lacunes, CADASIL, and cerebral microbleeds, from inception to September 1, 2022. Variations in LFOs were extracted, where available, on a global, tissue-specific, or regional level, in addition to participant demographics, data acquisition, methods of analysis, and study quality. Where a formal meta-analysis was not possible, differences in the number of studies reporting LFO magnitude by presence or severity of cSVD were determined by sign test. Results 15 studies were included from 841 titles. Studies varied in quality, acquisition parameters, and in method of analysis. Amplitude of low-frequency fluctuation (ALFF) in resting state fMRI was most commonly assessed (12 studies). Across 15 studies with differing markers of cSVD (9 with WMH; 1 with cerebral microbleeds; 1 with lacunar infarcts; 1 with CADASIL; 3 with multiple markers), LFOs in patients with cSVD were decreased in the posterior cortex (22 of 32 occurrences across all studies, p = 0.05), increased in the deep grey nuclei (7 of 7 occurrences across all studies, p = 0.016), and potentially increased in the temporal lobes (9 of 11 occurrences across all studies, p = 0.065). Conclusion Despite limited consensus on the optimal acquisition and analysis methods, there was reasonably consistent regional variation in LFO magnitude by severity of cSVD markers, supporting its potential as a novel index of endothelial dysfunction. We propose a consistent approach to measuring LFOs to characterise targetable mechanisms underlying cSVD.
Collapse
Affiliation(s)
- James Thomas
- Nuffield Department of Clinical Neurosciences, Wolfson Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Peter Jezzard
- FMRIB Division, Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Alastair J. S. Webb
- Nuffield Department of Clinical Neurosciences, Wolfson Centre for Prevention of Stroke and Dementia, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
4
|
Han C, Gao TX, Zhang HD, Ma W, Li Y, Li B, Shen XX, Wang XP, Fu HG, Duan L, Yu XG. Wavelet Analysis of Cerebral Oxygenation Signal Measured by Near-Infrared Spectroscopy in Moyamoya Disease. World Neurosurg 2023; 172:e12-e18. [PMID: 36280048 DOI: 10.1016/j.wneu.2022.10.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Spontaneous low-frequency oscillations (LFOs) have been widely studied in cerebrovascular disease, but little is known about their role in moyamoya disease (MMD). The objective of this study was to assess the value of spontaneous LFOs in MMD based on wavelet analysis of near-infrared spectroscopy signals. METHODS Sixty-four consecutive idiopathic adult patients were prospectively enrolled. The regional tissue oxygenation index (TOI) obtained from continuous near-infrared spectroscopy signals. Five frequency intervals of spontaneous LFOs (I, 0.0095-0.02 Hz; II, 0.02-0.06 Hz; III, 0.06-0.15 Hz; IV, 0.15-0.40 Hz; and V, 0.40-2.00 Hz) were extracted based on wavelet analysis. The data were compared between the patients and healthy control groups. Clinical features, cognitive function, and disease progression of MMD were analyzed using TOI and frequency interval data. RESULTS Compared with the healthy control group, patients with MMD had a higher cerebral TOI in both hemispheres. Based on wavelet analysis, the spontaneous LFO of TOI was found to be significantly lower for patients with MMD in frequency intervals II to IV than that for the controls. The spontaneous LFO of TOI is also related to the Suzuki stages in intervals II to IV, stroke in interval III, and cognitive impairment in intervals III to Ⅳ. CONCLUSIONS There were significant differences in spontaneous LFO between patients with MMD and healthy controls. The change in spontaneous LFO in MMD is related to Suzuki stage, cerebral infarction, and cognitive impairment. This might be an effective method for evaluating the severity and monitoring the progression of MMD.
Collapse
Affiliation(s)
- Cong Han
- Medical School of Chinese PLA, Beijing, China; Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Tian-Xin Gao
- School of Life Science, Beijing Institute of Technology, Beijing, China; Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, The Ministry of Industry and Information Technology, Beijing Institute of Technology, Beijing, China
| | - Hou-Di Zhang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Wei Ma
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Yue Li
- School of Medicine, Tsinghua University, Beijing, China
| | - Bin Li
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Xu-Xuan Shen
- 307 Clinical College of Anhui Medical University, Beijing, China
| | - Xiao-Peng Wang
- 307 Clinical College of Anhui Medical University, Beijing, China
| | - He-Guan Fu
- 307 Clinical College of Anhui Medical University, Beijing, China
| | - Lian Duan
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Xin-Guang Yu
- Medical School of Chinese PLA, Beijing, China; Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
5
|
Heiberg AV, Simonsen SA, Schytz HW, Iversen HK. Cortical hemodynamic response during cognitive Stroop test in acute stroke patients assessed by fNIRS. NeuroRehabilitation 2023; 52:199-217. [PMID: 36641686 DOI: 10.3233/nre-220171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Following acute ischemic stroke (AIS) many patients experience cognitive impairment which interferes neurorehabilitation. Understanding and monitoring pathophysiologic processes behind cognitive symptoms requires accessible methods during testing and training. Functional near-infrared spectroscopy (fNIRS) can assess activational hemodynamic responses in the prefrontal cortex (PFC) and feasibly be used as a biomarker to support stroke rehabilitation. OBJECTIVE Exploring the feasibility of fNIRS as a biomarker during the Stroop Color and Word Test (SCWT) assessing executive function in AIS patients. METHODS Observational study of 21 patients with mild to moderate AIS and 22 healthy age- and sex-matched controls (HC) examined with fNIRS of PFC during the SCWT. Hemodynamic responses were analyzed with general linear modeling. RESULTS The SCWT was performed worse by AIS patients than HC. Neither patients nor HC showed PFC activation, but an inverse activational pattern primarily in superolateral and superomedial PFC significantly lower in AIS. Hemodynamic responses were incoherent to test difficulty and performance. No other group differences or lateralization were found. CONCLUSIONS AIS patients had impaired executive function assessed by the SCWT, while both groups showed an inverse hemodynamic response significantly larger in HC. Investigations assessing the physiology behind inverse hemodynamic responses are warranted before deeming clinical implementation reasonable.
Collapse
Affiliation(s)
- Adam Vittrup Heiberg
- Clinical Stroke Research Unit, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Faculty of Health and MedicalSciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Amalie Simonsen
- Clinical Stroke Research Unit, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Henrik Winther Schytz
- Faculty of Health and MedicalSciences, University of Copenhagen, Copenhagen, Denmark.,Danish Headache Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark
| | - Helle Klingenberg Iversen
- Clinical Stroke Research Unit, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.,Faculty of Health and MedicalSciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
6
|
Niizawa T, Sakuraba R, Kusaka T, Kurihara Y, Sugashi T, Kawaguchi H, Kanno I, Masamoto K. Spatiotemporal analysis of blood plasma and blood cell flow fluctuations of cerebral microcirculation in anesthetized rats. J Cereb Blood Flow Metab 2023; 43:138-152. [PMID: 36138557 PMCID: PMC9875347 DOI: 10.1177/0271678x221125743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 01/28/2023]
Abstract
Cerebral hemodynamics fluctuates spontaneously over broad frequency ranges. However, its spatiotemporal coherence of flow oscillations in cerebral microcirculation remains incompletely understood. The objective of this study was to characterize the spatiotemporal fluctuations of red blood cells (RBCs) and plasma flow in the rat cerebral microcirculation by simultaneously imaging their dynamic behaviors. Comparisons of changes in cross-section diameters between RBC and plasma flow showed dissociations in penetrating arterioles. The results indicate that vasomotion has the least effect on the lateral movement of circulating RBCs, resulting in variable changes in plasma layer thickness. Parenchymal capillaries exhibited slow fluctuations in RBC velocity (0.1 to 0.3 Hz), regardless of capillary diameter fluctuations (<0.1 Hz). Temporal fluctuations and the velocity of RBCs decreased significantly at divergent capillary bifurcations. The results indicate that a transit of RBCs generates flow resistance in the capillaries and that slow velocity fluctuations of the RBCs are subject to a number of bifurcations. In conclusion, the high-frequency oscillation of the blood flow is filtered at the bifurcation through the capillary networks. Therefore, a number of bifurcations in the cerebral microcirculation may contribute to the power of low-frequency oscillations.
Collapse
Affiliation(s)
- Tomoya Niizawa
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
| | - Ruka Sakuraba
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
| | - Tomoya Kusaka
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
| | - Yuika Kurihara
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
| | - Takuma Sugashi
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
- Center for Neuroscience and Biomedical Engineering,
University of Electro-Communications, Tokyo, Japan
| | - Hiroshi Kawaguchi
- Human Informatics and Interaction Research Institute,
National Institute of Advanced Industrial Science and Technology
(AIST), Ibaraki, Japan
| | - Iwao Kanno
- Department of Functional Brain Imaging Research,
National Institute of Radiological Sciences, Chiba, Japan
| | - Kazuto Masamoto
- Faculty of Informatics and Engineering, University of
Electro-Communications, Tokyo, Japan
- Center for Neuroscience and Biomedical Engineering,
University of Electro-Communications, Tokyo, Japan
- Department of Functional Brain Imaging Research,
National Institute of Radiological Sciences, Chiba, Japan
| |
Collapse
|
7
|
Polyakova M, Mueller K, Arelin K, Lampe L, Rodriguez FS, Luck T, Kratzsch J, Hoffmann KT, Riedel-Heller S, Villringer A, Schoenknecht P, Schroeter ML. Increased Serum NSE and S100B Indicate Neuronal and Glial Alterations in Subjects Under 71 Years With Mild Neurocognitive Disorder/Mild Cognitive Impairment. Front Cell Neurosci 2022; 16:788150. [PMID: 35910248 PMCID: PMC9329528 DOI: 10.3389/fncel.2022.788150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mild cognitive impairment (MCI) is considered a pre-stage of different dementia syndromes. Despite diagnostic criteria refined by DSM-5 and a new term for MCI – “mild neurocognitive disorder” (mild NCD) – this diagnosis is still based on clinical criteria. Methods To link mild NCD to the underlying pathophysiology we assessed the degree of white matter hyperintensities (WMH) in the brain and peripheral biomarkers for neuronal integrity (neuron-specific enolase, NSE), plasticity (brain-derived neurotrophic factor, BDNF), and glial function (S100B) in 158 community-dwelling subjects with mild NCD and 82 healthy controls. All participants (63–79 years old) were selected from the Leipzig-population-based study of adults (LIFE). Results Serum S100B levels were increased in mild NCD in comparison to controls (p = 0.007). Serum NSE levels were also increased but remained non-significant after Bonferroni-Holm correction (p = 0.04). Furthermore, age by group interaction was significant for S100B. In an age-stratified sub-analysis, NSE and S100B were higher in younger subjects with mild NCD below 71 years of age. Some effects were inconsistent after controlling for potentially confounding factors. The discriminatory power of the two biomarkers NSE and S100B was insufficient to establish a pathologic threshold for mild NCD. In subjects with mild NCD, WMH load correlated with serum NSE levels (r = 0.20, p = 0.01), independently of age. Conclusion Our findings might indicate the presence of neuronal (NSE) and glial (S100B) injury in mild NCD. Future studies need to investigate whether younger subjects with mild NCD with increased biomarker levels are at risk of developing major NCD.
Collapse
Affiliation(s)
- Maryna Polyakova
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- University Clinic for Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- *Correspondence: Maryna Polyakova
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Katrin Arelin
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Leonie Lampe
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Francisca S. Rodriguez
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Research Group Psychosocial Epidemiology and Public Health, German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Tobias Luck
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Faculty of Applied Social Sciences, University of Applied Sciences Erfurt, Erfurt, Germany
| | - Jürgen Kratzsch
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | | | - Steffi Riedel-Heller
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- Institute of Neuroradiology, University Clinic, Leipzig, Germany
| | - Peter Schoenknecht
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
- University Clinic for Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, University Affiliated Hospital Arnsdorf, Technical University of Dresden, Dresden, Germany
| | - Matthias L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| |
Collapse
|
8
|
Ødegård SS, Torp H, Follestad T, Leth-Olsen M, Støen R, Nyrnes SA. Low frequency cerebral arterial and venous flow oscillations in healthy neonates measured by NeoDoppler. Front Pediatr 2022; 10:929117. [PMID: 36518773 PMCID: PMC9742353 DOI: 10.3389/fped.2022.929117] [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] [Received: 04/26/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A cerebroprotective effect of low frequency oscillations (LFO) in cerebral blood flow (CBF) has been suggested in adults, but its significance in neonates is not known. This observational study evaluates normal arterial and venous cerebral blood flow in healthy neonates using NeoDoppler, a novel Doppler ultrasound system which can measure cerebral hemodynamics continuously. METHOD Ultrasound Doppler data was collected for 2 h on the first and second day of life in 36 healthy term born neonates. LFO (0.04-0.15 Hz) were extracted from the velocity curve by a bandpass filter. An angle independent LFO index was calculated as the coefficient of variation of the filtered curve. Separate analyses were done for arterial and venous signals, and results were related to postnatal age and behavioral state (asleep or awake). RESULTS The paper describes normal physiologic variations of arterial and venous cerebral hemodynamics. Mean (SD) arterial and venous LFO indices (%) were 6.52 (2.55) and 3.91 (2.54) on day one, and 5.60 (1.86) and 3.32 (2.03) on day two. After adjusting for possible confounding factors, the arterial LFO index was estimated to decrease by 0.92 percent points per postnatal day (p < 0.001). The venous LFO index did not change significantly with postnatal age (p = 0.539). Arterial and venous LFO were not notably influenced by behavioral state. CONCLUSION The results indicate that arterial LFO decrease during the first 2 days of life in healthy neonates. This decrease most likely represents normal physiological changes related to the transitional period. A similar decrease for venous LFO was not found.
Collapse
Affiliation(s)
- Siv Steinsmo Ødegård
- Department of Circulation and Medical Imaging (ISB), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Hans Torp
- Department of Circulation and Medical Imaging (ISB), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Turid Follestad
- Department of Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Martin Leth-Olsen
- Department of Circulation and Medical Imaging (ISB), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ragnhild Støen
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Siri Ann Nyrnes
- Department of Circulation and Medical Imaging (ISB), The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
9
|
Cerebral macro- and microcirculatory blood flow dynamics in successfully treated chronic hypertensive patients with and without white mater lesions. Sci Rep 2020; 10:9213. [PMID: 32514031 PMCID: PMC7280202 DOI: 10.1038/s41598-020-66317-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/18/2020] [Indexed: 01/14/2023] Open
Abstract
The mechanisms of high blood pressure (HBP) -related brain pathology progression remain relatively unclear. We investigated whether lowering BP in chronic HBP patients normalizes cerebral perfusion dynamics at resistance vessel and capillary levels. Sixty-seven patients with HBP and 49 age- and sex-matched healthy controls underwent simultaneous recordings of middle cerebral artery blood flow velocity (CBFV), BP, and end-tidal CO2 concentration. Thirty-four controls and 28 patients underwent additional near-infrared spectroscopy recordings (oxygenated [O2Hb] and deoxygenated [HHb] hemoglobin). Degree of microcirculatory white matter lesions was graded by Fazekas scale. Dynamic cerebral autoregulation (dCA) was assessed by transfer function analysis. BP was successfully lowered (patients = 89 ± 15 mm Hg, controls = 87 ± 17), but cerebrovascular resistance was higher in BP patients (p < 0.05). BP-CBFV phase was lower in very low frequency (VLF) (left/right: 48 ± 20°/44 ± 17; controls: 61 ± 20/60 ± 21; p < 0.001) and low frequency (LF) (34 ± 14/35 ± 14; controls: 48 ± 20/44 ± 17; p < 0.05) ranges. Gain was higher in VLF range (in %/ mm Hg 0.56 ± 0.44/0.59 ± 0.49; controls: 0.32 ± 0.29/0.34 ± 0.32; p ≤ 0.005). BP-CBFV phase and gain did not differ across Fazekas groups. Across all patients, the capillary phases and gains (CBFV-[O2Hb], CBFV-[HHb]) were comparable to controls. Successfully treated chronic HBP results in normal brain capillary hemodynamics while the resistance vessel state is disturbed (phase decrease, gain increase).
Collapse
|
10
|
Premilovac D, Blackwood SJ, Ramsay CJ, Keske MA, Howells DW, Sutherland BA. Transcranial contrast-enhanced ultrasound in the rat brain reveals substantial hyperperfusion acutely post-stroke. J Cereb Blood Flow Metab 2020; 40:939-953. [PMID: 32063081 PMCID: PMC7181087 DOI: 10.1177/0271678x20905493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Direct and real-time assessment of cerebral hemodynamics is key to improving our understanding of cerebral blood flow regulation in health and disease states such as stroke. While a number of sophisticated imaging platforms enable assessment of cerebral perfusion, most are limited either spatially or temporally. Here, we applied transcranial contrast-enhanced ultrasound (CEU) to measure cerebral perfusion in real-time through the intact rat skull before, during and after ischemic stroke, induced by intraluminal filament middle cerebral artery occlusion (MCAO). We demonstrate expected decreases in cortical and striatal blood volume, flow velocity and perfusion during MCAO. After filament retraction, blood volume and perfusion increased two-fold above baseline, indicative of acute hyperperfusion. Adjacent brain regions to the ischemic area and the contralateral hemisphere had increased blood volume during MCAO. We assessed our data using wavelet analysis to demonstrate striking vasomotion changes in the ischemic and contralateral cortices during MCAO and reperfusion. In conclusion, we demonstrate the application of CEU for real-time assessment of cerebral hemodynamics and show that the ischemic regions exhibit striking hyperemia post-MCAO. Whether this post-stoke hyperperfusion is sustained long-term and contributes to stroke severity is not known.
Collapse
Affiliation(s)
- Dino Premilovac
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Sarah J Blackwood
- Åstrand Laboratory of Work Physiology, Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Ciaran J Ramsay
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - David W Howells
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Brad A Sutherland
- School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| |
Collapse
|
11
|
Mueller K, Thiel F, Beutner F, Teren A, Frisch S, Ballarini T, Möller HE, Ihle K, Thiery J, Schuler G, Villringer A, Schroeter ML. Brain Damage With Heart Failure: Cardiac Biomarker Alterations and Gray Matter Decline. Circ Res 2020; 126:750-764. [PMID: 31969053 PMCID: PMC7077969 DOI: 10.1161/circresaha.119.315813] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Supplemental Digital Content is available in the text. Rationale: Heart failure (HF) following heart damage leads to a decreased blood flow due to a reduced pump efficiency of the heart muscle. A consequence can be insufficient oxygen supply to the organism including the brain. While HF clearly shows neurological symptoms, such as fatigue, nausea, and dizziness, the implications for brain structure are not well understood. Few studies show regional gray matter decrease related to HF; however, the underlying mechanisms leading to the observed brain changes remain unclear. Objective: To study the relationship between impaired heart function, hampered blood circulation, and structural brain change in a case-control study. Methods and Results: Within a group of 80 patients of the Leipzig Heart Center, we investigated a potential correlation between HF biomarkers and the brain’s gray matter density (GMD) obtained by magnetic resonance imaging. We observed a significant positive correlation between cardiac ejection fraction and GMD across the whole frontal and parietal medial cortex reflecting the consequence of HF onto the brain’s gray matter. Moreover, we also obtained a relationship between GMD and the NT-proBNP (N-terminal prohormone of brain natriuretic peptide)—a biomarker that is used for screening, diagnosis, and prognosis of HF. Here, we found a significant negative correlation between NT-proBNP and GMD in the medial and posterior cingulate cortex but also in precuneus and hippocampus, which are key regions implicated in structural brain changes in dementia. Conclusions: We obtained significant correlations between brain structure and markers of heart failure including ejection fraction and NT-proBNP. A diminished GMD was found with decreased ejection fraction and increased NT-proBNP in wide brain regions including the whole frontomedian cortex as well as hippocampus and precuneus. Our observations might reflect structural brain damage in areas that are related to cognition; however, whether these structural changes facilitate the development of cognitive alterations has to be proven by further longitudinal studies.
Collapse
Affiliation(s)
- Karsten Mueller
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Friederike Thiel
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Frank Beutner
- Leipzig Heart Center, Germany (F.B., A.T., G.S.).,Leipzig Research Centre for Civilization Diseases, Germany (F.B., A.T., J.T., A.V., M.L.S.)
| | - Andrej Teren
- Leipzig Heart Center, Germany (F.B., A.T., G.S.).,Leipzig Research Centre for Civilization Diseases, Germany (F.B., A.T., J.T., A.V., M.L.S.)
| | - Stefan Frisch
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Tommaso Ballarini
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Harald E Möller
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Kristin Ihle
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.)
| | - Joachim Thiery
- Leipzig Heart Center, Germany (F.B., A.T., G.S.).,Leipzig Research Centre for Civilization Diseases, Germany (F.B., A.T., J.T., A.V., M.L.S.).,Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Germany (J.T.)
| | | | - Arno Villringer
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.).,Leipzig Research Centre for Civilization Diseases, Germany (F.B., A.T., J.T., A.V., M.L.S.).,Clinic for Cognitive Neurology, University Hospital Leipzig, Germany (A.V., M.L.S.)
| | - Matthias L Schroeter
- From the Max Planck Institute for Human Cognitive and Brain Sciences, Germany (K.M., F.T., S.F., T.B., H.E.M., K.I., A.V., M.L.S.).,Leipzig Research Centre for Civilization Diseases, Germany (F.B., A.T., J.T., A.V., M.L.S.).,Clinic for Cognitive Neurology, University Hospital Leipzig, Germany (A.V., M.L.S.)
| |
Collapse
|
12
|
Reduced spontaneous low frequency oscillations as measured with functional near-infrared spectroscopy in mild cognitive impairment. Brain Imaging Behav 2019; 13:283-292. [PMID: 29362991 DOI: 10.1007/s11682-018-9827-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Spontaneous low frequency oscillations (LFO) in functional imaging data have gained increased interest in the study of cognitive decline. Persons diagnosed with mild cognitive impairment (MCI) and Alzheimer's disease (AD) display alterations in their amount of LFO in various brain regions. This is commonly interpreted as disruptions in the autoregulation of the cerebral microvascular system. In the present study LFO (0,07-0,11 Hz) were measured with 52-channel near-infrared spectroscopy (NIRS) in 61 healthy elderly persons (70-76 years), 54 MCI subjects (70-76 years) and 25 healthy young controls (21-48 years) during rest over the frontal and the parietal cortex. Both MCI and healthy elderly controls showed less LFO in the frontal cortex as compared to young subjects. For the parietal cortex a decrease in LFO could be observed for the MCI group in comparison to healthy elderly subjects. Correlations of more LFO with worse performance in neuropsychological tests point to compensatory processes. LFO measured with NIRS might be especially suited for longitudinal studies aiming at predicting cognitive decline.
Collapse
|
13
|
Montoro CI, Duschek S, Schuepbach D, Gandarillas M, Reyes del Paso GA. Cerebral blood flow variability in fibromyalgia syndrome: Relationships with emotional, clinical and functional variables. PLoS One 2018; 13:e0204267. [PMID: 30235315 PMCID: PMC6147545 DOI: 10.1371/journal.pone.0204267] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/04/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE This study analyzed variability in cerebral blood flow velocity (CBFV) and its association with emotional, clinical and functional variables and medication use in fibromyalgia syndrome (FMS). METHODS Using transcranial Doppler sonography, CBFV were bilaterally recorded in the anterior (ACA) and middle (MCA) cerebral arteries of 44 FMS patients and 31 healthy individuals during a 5-min resting period. Participants also completed questionnaires assessing pain, fatigue, insomnia, anxiety, depression and health-related quality of life (HRQoL). RESULTS Fast Fourier transformation revealed a spectral profile with four components: (1) a first very low frequency (VLF) component with the highest amplitude at 0.0024 Hz; (2) a second VLF component around 0.01-to-0.025 Hz; (3) a low frequency (LF) component from 0.075-to-0.11 Hz; and (4) a high frequency (HF) component with the lowest amplitude from 0.25-to-0.35 Hz. Compared to controls, FMS patients exhibited lower LF and HF CBFV variability in the MCAs (p < .005) and right ACA (p = .03), but higher variability at the first right MCA (p = .04) and left ACA (p = .005) VLF components. Emotional, clinical and functional variables were inversely related to LF and HF CBFV variability (r≥-.24, p≤.05). However, associations for the first VLF component were positive (r≥.28, p≤.05). While patients´ medication use was associated with lower CBFV variability, comorbid depression and anxiety disorders were unrelated to variability. CONCLUSIONS Lower CBFV variability in the LF and HF ranges were observed in FMS, suggesting impaired coordination of cerebral regulatory systems. CBFV variability was differentially associated with clinical variables as a function of time-scale, with short-term variability being related to better clinical outcomes. CBFV variability analysis may be a promising tool to characterize FMS pathology and it impact on facets of HRQoL.
Collapse
Affiliation(s)
| | - Stefan Duschek
- UMIT—University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
| | - Daniel Schuepbach
- Klinikum am Weissenhof, Zentrum für Psychiatrie Weinsberg, Weinsberg, Germany
- University of Heidelberg, Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg, Germany
| | | | | |
Collapse
|
14
|
Andersen AV, Simonsen SA, Schytz HW, Iversen HK. Assessing low-frequency oscillations in cerebrovascular diseases and related conditions with near-infrared spectroscopy: a plausible method for evaluating cerebral autoregulation? NEUROPHOTONICS 2018; 5:030901. [PMID: 30689678 PMCID: PMC6156398 DOI: 10.1117/1.nph.5.3.030901] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/02/2018] [Indexed: 05/08/2023]
Abstract
BACKGROUND Cerebral autoregulation (CA) is the brain's ability to always maintain an adequate and relatively constant blood supply, which is often impaired in cerebrovascular diseases. Near-infrared spectroscopy (NIRS) examines oxygenated hemoglobin (OxyHb) in the cerebral cortex. Low- and very low-frequency oscillations ( LFOs ≈ 0.1 Hz and VLFOs ≈ 0.05 to 0.01 Hz) in OxyHb have been proposed to reflect CA. AIM To systematically review published results on OxyHb LFOs and VLFOs in cerebrovascular diseases and related conditions measured with NIRS. APPROACH A systematic search was performed in the MEDLINE database, which generated 36 studies relevant for inclusion. RESULTS Healthy people have relatively stable LFOs. LFO amplitude seems to reflect myogenic CA being decreased by vasomotor paralysis in stroke, by smooth muscle damage or as compensatory action in other conditions but can also be influenced by the sympathetic tone. VLFO amplitude is believed to reflect neurogenic and metabolic CA and is lower in stroke, atherosclerosis, and with aging. Both LFO and VLFO synchronizations appear disturbed in stroke, while the former is also altered in internal carotid stenosis and hypertension. CONCLUSION We conclude that amplitudes of LFOs and VLFOs are relatively robust measures for evaluating mechanisms of CA and synchronization analyses can show temporal disruption of CA. Further research and more coherent methodologies are needed.
Collapse
Affiliation(s)
- Adam Vittrup Andersen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
- Address all correspondence to: Adam Vittrup Andersen, E-mail:
| | - Sofie Amalie Simonsen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - Henrik Winther Schytz
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| | - Helle Klingenberg Iversen
- Rigshospitalet, Department of Neurology, Glostrup, Denmark
- University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark
| |
Collapse
|
15
|
Kynast J, Lampe L, Luck T, Frisch S, Arelin K, Hoffmann KT, Loeffler M, Riedel-Heller SG, Villringer A, Schroeter ML. White matter hyperintensities associated with small vessel disease impair social cognition beside attention and memory. J Cereb Blood Flow Metab 2018; 38:996-1009. [PMID: 28685621 PMCID: PMC5999004 DOI: 10.1177/0271678x17719380] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Age-related white matter hyperintensities (WMH) are a manifestation of white matter damage seen on magnetic resonance imaging (MRI). They are related to vascular risk factors and cognitive impairment. This study investigated the cognitive profile at different stages of WMH in a large community-dwelling sample; 849 subjects aged 21 to 79 years were classified on the 4-stage Fazekas scale according to hyperintense lesions seen on individual T2-weighted fluid-attenuated inversion recovery MRI scans. The evaluation of cognitive functioning included seven domains of cognitive performance and five domains of subjective impairment, as proposed by the DSM-5. For the first time, the impact of age-related WMH on Theory of Mind was investigated. Differences between Fazekas groups were analyzed non-parametrically and effect sizes were computed. Effect sizes revealed a slight overall cognitive decline in Fazekas groups 1 and 2 relative to healthy subjects. Fazekas group 3 presented substantial decline in social cognition, attention and memory, although characterized by a high inter-individual variability. WMH groups reported subjective cognitive decline. We demonstrate that extensive WMH are associated with specific impairment in attention, memory, social cognition, and subjective cognitive performance. The detailed neuropsychological characterization of WMH offers new therapeutic possibilities for those affected by vascular cognitive decline.
Collapse
Affiliation(s)
- Jana Kynast
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Leonie Lampe
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Tobias Luck
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,3 Institute for Social Medicine, Occupational Medicine and Public Health, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Stefan Frisch
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,4 Department of Neurology, University Hospital Frankfurt/Goethe University, Frankfurt am Main, Germany
| | - Katrin Arelin
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany
| | - Karl-Titus Hoffmann
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,5 Department of Neuroradiology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Markus Loeffler
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,6 Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- 2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,3 Institute for Social Medicine, Occupational Medicine and Public Health, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,7 Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Matthias L Schroeter
- 1 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,2 LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.,7 Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| |
Collapse
|
16
|
Polak T, Herrmann MJ, Müller LD, Zeller JBM, Katzorke A, Fischer M, Spielmann F, Weinmann E, Hommers L, Lauer M, Fallgatter AJ, Deckert J. Near-infrared spectroscopy (NIRS) and vagus somatosensory evoked potentials (VSEP) in the early diagnosis of Alzheimer’s disease: rationale, design, methods, and first baseline data of the Vogel study. J Neural Transm (Vienna) 2017; 124:1473-1488. [DOI: 10.1007/s00702-017-1781-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 08/23/2017] [Indexed: 01/06/2023]
|
17
|
Kim HJ, Cha J, Lee JM, Shin JS, Jung NY, Kim YJ, Choe YS, Lee KH, Kim ST, Kim JS, Lee JH, Na DL, Seo SW. Distinctive Resting State Network Disruptions Among Alzheimer's Disease, Subcortical Vascular Dementia, and Mixed Dementia Patients. J Alzheimers Dis 2016; 50:709-18. [PMID: 26757039 DOI: 10.3233/jad-150637] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent advances in resting-state functional MRI have revealed altered functional networks in Alzheimer's disease (AD), especially those of the default mode network (DMN) and central executive network (CEN). However, few studies have evaluated whether small vessel disease (SVD) or combined amyloid and SVD burdens affect the DMN or CEN. OBJECTIVE The aim of this study was to evaluate whether SVD or combined amyloid and SVD burdens affect the DMN or CEN. METHODS In this cross-sectional study, we investigated the resting-state functional connectivity within DMN and CEN in 37 Pittsburgh compound-B (PiB)(+) AD, 37 PiB(-) subcortical vascular dementia (SVaD), 13 mixed dementia patients, and 65 normal controls. RESULTS When the resting-state DMN of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(+) AD patients displayed lower functional connectivity in the inferior parietal lobule while the PiB(-) SVaD patients displayed lower functional connectivity in the medial frontal and superior frontal gyri. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the DMN in the posterior cingulate gyrus. When the resting-state CEN connectivity of PiB(+) AD and PiB(-) SVaD patients were compared, the PiB(-) SVaD patients displayed lower functional connectivity in the anterior insular region. Compared to the PiB(-) SVaD or PiB(+) AD, the mixed dementia patients displayed lower functional connectivity within the CEN in the inferior frontal gyrus. CONCLUSIONS Our findings suggest that in PiB(+) AD and PiB(-) SVaD, there is divergent disruptions in resting-state DMN and CEN. Furthermore, patients with combined amyloid and SVD burdens exhibited more disrupted resting-state DMN and CEN than patients with only amyloid or SVD burden.
Collapse
Affiliation(s)
- Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jungho Cha
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Ji Soo Shin
- Pfizer Pharmaceuticals Korea Ltd., Seoul, Republic of Korea
| | - Na-Yeon Jung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Neurology, Pusan National University Hospital, Pusan National University, Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Yearn Seong Choe
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Kyung Han Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University, Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
18
|
Denswil NP, van der Wal AC, Ritz K, de Boer OJ, Aronica E, Troost D, Daemen MJAP. Atherosclerosis in the circle of Willis: Spatial differences in composition and in distribution of plaques. Atherosclerosis 2016; 251:78-84. [PMID: 27288902 DOI: 10.1016/j.atherosclerosis.2016.05.047] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/26/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Intracranial atherosclerosis is one of the main causes of ischemic stroke. However, the characteristics of intracranial arteries and atherosclerosis have rarely been studied. Therefore, we systematically investigated atherosclerotic changes in all arteries of the Circle of Willis (CoW). METHODS Sixty-seven CoWs obtained at autopsy from randomly chosen hospital patients (mean age, 67.3 ± 12.5 years), of which a total of 1220 segments were collected from 22 sites. Atherosclerotic plaques were classified according to the revised American Heart Association classification and were related to local vessel characteristics, such as the presence of an external and internal elastic lamina and the elastic fibre density of the media. RESULTS 181 out of the 1220 segments had advanced plaques (15%), which were mainly observed in large arteries such as the internal carotid, middle cerebral, basilar and vertebral artery. Only 11 out of 1220 segments (1%) showed complicated plaques (p < 0.001). Six of these were intraplaque hemorrhages (IPH) and observed only in patients who had cardiovascular-related events (p = 0.015). The frequency of characteristics such as the external elastic lamina and a high elastin fibre density in the media was most often associated with the vertebral artery. Only 3% (n = 33) of the CoW arteries contained calcification (p < 0.001), which were mostly observed in the vertebral artery (n = 13, 12%). CONCLUSIONS Advanced atherosclerotic plaques in the CoW are relatively scarce and mainly located in the 4 large arteries, and mostly characterized by an early and stable phenotype, a low calcific burden, and a low frequency of IPH.
Collapse
Affiliation(s)
- Nerissa P Denswil
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Allard C van der Wal
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Katja Ritz
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Onno J de Boer
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Eleonora Aronica
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Dirk Troost
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Mat J A P Daemen
- Academic Medical Center, Department Pathology, Cardiovascular Research, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| |
Collapse
|
19
|
Serum BDNF correlates with connectivity in the (pre)motor hub in the aging human brain—a resting-state fMRI pilot study. Neurobiol Aging 2016; 38:181-187. [DOI: 10.1016/j.neurobiolaging.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 10/30/2015] [Accepted: 11/05/2015] [Indexed: 11/19/2022]
|
20
|
Zhang Z, Khatami R. Predominant endothelial vasomotor activity during human sleep: a near-infrared spectroscopy study. Eur J Neurosci 2014; 40:3396-404. [DOI: 10.1111/ejn.12702] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Zhongxing Zhang
- Center for Sleep Medicine and Sleep Research; Clinic Barmelweid; 5017 Barmelweid Switzerland
- Department of Neurology; University Hospital Zurich; Zurich Switzerland
| | - Ramin Khatami
- Center for Sleep Medicine and Sleep Research; Clinic Barmelweid; 5017 Barmelweid Switzerland
- Department of Neurology; University Hospital Zurich; Zurich Switzerland
| |
Collapse
|
21
|
Small vessel disease and the resting functional architecture of the brain. J Cereb Blood Flow Metab 2014; 34:1089-90. [PMID: 24780903 PMCID: PMC4083383 DOI: 10.1038/jcbfm.2014.69] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 03/27/2014] [Indexed: 01/06/2023]
Abstract
Small vessel disease (SVD) is linked to cognitive impairment and dementia, yet little is known regarding functional activation in patients with SVD. Resting fMRI recordings suggest reduced connectivity in prefrontal, parietal and cingulate nodes and reciprocally increased connectivity in cerebellum, alterations which predicted neuropsychological test performance. Together with diffusion tensor tensor imaging studies, these data support of a model of disrupted connectivity as a systems-level approach to the cognitive disturbances seen in SVD.
Collapse
|
22
|
Zweifel C, Dias C, Smielewski P, Czosnyka M. Continuous time-domain monitoring of cerebral autoregulation in neurocritical care. Med Eng Phys 2014; 36:638-45. [DOI: 10.1016/j.medengphy.2014.03.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 02/24/2014] [Accepted: 03/10/2014] [Indexed: 12/26/2022]
|
23
|
Schroeter ML, Sacher J, Steiner J, Schoenknecht P, Mueller K. Serum S100B represents a new biomarker for mood disorders. Curr Drug Targets 2014; 14:1237-48. [PMID: 23701298 PMCID: PMC3821390 DOI: 10.2174/13894501113149990014] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 03/26/2013] [Accepted: 05/17/2013] [Indexed: 01/11/2023]
Abstract
Recently, mood disorders have been discussed to be characterized by glial pathology. The protein S100B, a growth and differentiation factor, is located in, and may actively be released by astro- and oligodendrocytes. This protein is easily assessed in human serum and provides a useful parameter for glial activation or injury. Here, we review studies investigating the glial marker S100B in serum of patients with mood disorders. Studies consistently show that S100B is elevated in mood disorders; more strongly in major depressive than bipolar disorder. Consistent with the glial hypothesis of mood disorders, serum S100B levels interact with age with higher levels in elderly depressed subjects. Successful antidepressive treatment has been associated with serum S100B reduction in major depression, whereas there is no evidence of treatment effects in mania. In contrast to the glial marker S100B, the neuronal marker protein neuron-specific enolase is unaltered in mood disorders. Recently, serum S100B has been linked to specific imaging parameters in the human white matter suggesting a role for S100B as an oligodendrocytic marker protein. In sum, serum S100B can be regarded as a promising in vivo biomarker for mood disorders deepening the understanding of the pathogenesis and plasticity-changes in these disorders. Future longitudinal studies combining serum S100B with other cell-specific serum parameters and multimodal imaging are warranted to further explore this serum protein in the development, monitoring and treatment of mood disorders.
Collapse
Affiliation(s)
- Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany.
| | | | | | | | | |
Collapse
|
24
|
Rickards CA, Tzeng YC. Arterial pressure and cerebral blood flow variability: friend or foe? A review. Front Physiol 2014; 5:120. [PMID: 24778619 PMCID: PMC3985018 DOI: 10.3389/fphys.2014.00120] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 03/13/2014] [Indexed: 01/09/2023] Open
Abstract
Variability in arterial pressure and cerebral blood flow has traditionally been interpreted as a marker of cardiovascular decompensation, and has been associated with negative clinical outcomes across varying time scales, from impending orthostatic syncope to an increased risk of stroke. Emerging evidence, however, suggests that increased hemodynamic variability may, in fact, be protective in the face of acute challenges to perfusion, including significant central hypovolemia and hypotension (including hemorrhage), and during cardiac bypass surgery. This review presents the dichotomous views on the role of hemodynamic variability on clinical outcome, including the physiological mechanisms underlying these patterns, and the potential impact of increased and decreased variability on cerebral perfusion and oxygenation. We suggest that reconciliation of these two apparently discrepant views may lie in the time scale of hemodynamic variability; short time scale variability appears to be cerebroprotective, while mid to longer term fluctuations are associated with primary and secondary end-organ dysfunction.
Collapse
Affiliation(s)
- Caroline A Rickards
- Department of Integrative Physiology, Cardiovascular Research Institute, University of North Texas Health Science Center Fort Worth, TX, USA
| | - Yu-Chieh Tzeng
- Cardiovascular Systems Laboratory, Centre for Translational Physiology, University of Otago Wellington, New Zealand
| |
Collapse
|
25
|
Rayshubskiy A, Wojtasiewicz TJ, Mikell CB, Bouchard MB, Timerman D, Youngerman BE, McGovern RA, Otten ML, Canoll P, McKhann GM, Hillman EMC. Direct, intraoperative observation of ~0.1 Hz hemodynamic oscillations in awake human cortex: implications for fMRI. Neuroimage 2014; 87:323-31. [PMID: 24185013 PMCID: PMC3961585 DOI: 10.1016/j.neuroimage.2013.10.044] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 09/22/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022] Open
Abstract
An almost sinusoidal, large amplitude ~0.1 Hz oscillation in cortical hemodynamics has been repeatedly observed in species ranging from mice to humans. However, the occurrence of 'slow sinusoidal hemodynamic oscillations' (SSHOs) in human functional magnetic resonance imaging (fMRI) studies is rarely noted or considered. As a result, little investigation into the cause of SSHOs has been undertaken, and their potential to confound fMRI analysis, as well as their possible value as a functional biomarker has been largely overlooked. Here, we report direct observation of large-amplitude, sinusoidal ~0.1 Hz hemodynamic oscillations in the cortex of an awake human undergoing surgical resection of a brain tumor. Intraoperative multispectral optical intrinsic signal imaging (MS-OISI) revealed that SSHOs were spatially localized to distinct regions of the cortex, exhibited wave-like propagation, and involved oscillations in the diameter of specific pial arterioles, indicating that the effect was not the result of systemic blood pressure oscillations. fMRI data collected from the same subject 4 days prior to surgery demonstrates that ~0.1 Hz oscillations in the BOLD signal can be detected around the same region. Intraoperative optical imaging data from a patient undergoing epilepsy surgery, in whom sinusoidal oscillations were not observed, is shown for comparison. This direct observation of the '0.1 Hz wave' in the awake human brain, using both intraoperative imaging and pre-operative fMRI, confirms that SSHOs occur in the human brain, and can be detected by fMRI. We discuss the possible physiological basis of this oscillation and its potential link to brain pathologies, highlighting its relevance to resting-state fMRI and its potential as a novel target for functional diagnosis and delineation of neurological disease.
Collapse
Affiliation(s)
- Aleksandr Rayshubskiy
- Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, USA
| | | | | | - Matthew B Bouchard
- Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, USA
| | - Dmitriy Timerman
- Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, USA
| | | | | | - Marc L Otten
- Department of Neurosurgery, Columbia University, USA
| | - Peter Canoll
- Department of Pathology and Cell Biology, Columbia University, USA
| | - Guy M McKhann
- Department of Neurosurgery, Columbia University, USA
| | - Elizabeth M C Hillman
- Laboratory for Functional Optical Imaging, Department of Biomedical Engineering, Columbia University, USA; Department of Radiology, Columbia University, USA.
| |
Collapse
|
26
|
Very-low-frequency oscillations of cerebral hemodynamics and blood pressure are affected by aging and cognitive load. Neuroimage 2014; 85 Pt 1:608-15. [DOI: 10.1016/j.neuroimage.2013.04.107] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/04/2013] [Accepted: 04/26/2013] [Indexed: 11/22/2022] Open
|
27
|
Li Z, Zhang M, Xin Q, Luo S, Cui R, Zhou W, Lu L. Age-related changes in spontaneous oscillations assessed by wavelet transform of cerebral oxygenation and arterial blood pressure signals. J Cereb Blood Flow Metab 2013; 33:692-9. [PMID: 23361392 PMCID: PMC3652694 DOI: 10.1038/jcbfm.2013.4] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The study aims to assess the spontaneous oscillations in elderly subjects based on the wavelet transform of cerebral oxygenation (CO) and arterial blood pressure (ABP) signals. Continuous recordings of near-infrared spectroscopy (NIRS) and ABP signals were obtained from simultaneous measurements in 20 young subjects (age: 27.3 ± 7.1 years) and 15 elderly subjects (age: 70.8 ± 5.1 years) at rest. Using spectral analysis based on wavelet transform, five frequency intervals were identified (I, 0.005 to 0.02 Hz; II, 0.02 to 0.06 Hz; III, 0.06 to 0.15 Hz; IV, 0.15 to 0.40 Hz; and V, 0.40 to 2.0 Hz). The average amplitudes of the Δ[HbO2] and tissue oxygenation index in intervals I to V and the relative amplitudes in intervals IV and V were significantly lower in elderly subjects than in young subjects (P<0.05). In addition, the relative amplitudes of the ABP in interval I were significantly lower in elderly subjects than in young subjects (P=0.016). The present findings suggest the presence of a cerebrovascular degenerative process caused by aging. Spontaneous oscillations in the CO could be used as an indicator of cerebrovascular changes and could be used to identify the risk for cerebrovascular degenerative processes.
Collapse
Affiliation(s)
- Zengyong Li
- Interdisciplinary Division of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China.
| | | | | | | | | | | | | |
Collapse
|
28
|
Kato I, Kusaka T, Nishida T, Koyano K, Nakamura S, Nakamura M, Konishi Y, Kunikata J, Jinnai W, Yasuda S, Okada H, Itoh S, Isobe K. Extrauterine environment influences spontaneous low-frequency oscillations in the preterm brain. Brain Dev 2013; 35:17-25. [PMID: 22534236 DOI: 10.1016/j.braindev.2012.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 02/04/2012] [Accepted: 03/14/2012] [Indexed: 10/28/2022]
Abstract
Low-frequency oscillations in cerebral blood flow that are suggestive of resting-state brain activity have recently been reported, but no study on the development of resting-state brain activity in preterm infants has been performed. The objective of this study was to measure the cerebral blood flow oscillations, which are assumed to represent brain function in the resting state, in preterm and term infants of the same postconceptional age. The subjects were 9 preterm infants who had reached full term (gestational age (GA): 23-34 weeks, postconceptional age: 37-46 weeks) and 10 term infants (GA: 37-40 weeks, postconceptional age: 37-41 weeks). Their changes in concentration of oxyhemoglobin ([oxyHb]) and deoxyhemoglobin ([deoxyHb]) were measured in the parieto-temporal region during quiet sleep using multi-channel near-infrared spectroscopy, and the power spectral densities (PSD) of the oscillations in the concentrations of these molecules were analyzed and compared. The preterm infants displayed a higher proportion of 0.06-0.10 Hz low frequency oscillations of [oxyHb] and [deoxyHb] than the term infants, and the gestational age and the proportion of low frequency oscillations were inversely correlated. These findings suggest that resting-state cerebral blood flow oscillations differ between preterm and term infants, and that the development of circulatory regulation and nerve activity in preterm infants are influenced by the extrauterine environment.
Collapse
Affiliation(s)
- Ikuko Kato
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Identifying the neural correlates of executive functions in early cerebral microangiopathy: a combined VBM and DTI study. J Cereb Blood Flow Metab 2012; 32:1869-78. [PMID: 22781332 PMCID: PMC3463884 DOI: 10.1038/jcbfm.2012.96] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cerebral microangiopathy (CMA) has been associated with executive dysfunction and fronto-parietal neural network disruption. Advances in magnetic resonance imaging allow more detailed analyses of gray (e.g., voxel-based morphometry-VBM) and white matter (e.g., diffusion tensor imaging-DTI) than traditional visual rating scales. The current study investigated patients with early CMA and healthy control subjects with all three approaches. Neuropsychological assessment focused on executive functions, the cognitive domain most discussed in CMA. The DTI and age-related white matter changes rating scales revealed convergent results showing widespread white matter changes in early CMA. Correlations were found in frontal and parietal areas exclusively with speeded, but not with speed-corrected executive measures. The VBM analyses showed reduced gray matter in frontal areas. All three approaches confirmed the hypothesized fronto-parietal network disruption in early CMA. Innovative methods (DTI) converged with results from conventional methods (visual rating) while allowing greater spatial and tissue accuracy. They are thus valid additions to the analysis of neural correlates of cognitive dysfunction. We found a clear distinction between speeded and nonspeeded executive measures in relationship to imaging parameters. Cognitive slowing is related to disease severity in early CMA and therefore important for early diagnostics.
Collapse
|
30
|
Brain perfusion SPECT imaging and acetazolamide challenge in vascular cognitive impairment. Nucl Med Commun 2012; 33:571-80. [PMID: 22495081 DOI: 10.1097/mnm.0b013e328351d583] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cerebrovascular disease is recognized as a common cause of cognitive impairment and dementia, alone or coexisting with other neurodegenerative diseases, mostly Alzheimer's disease. Vascular cognitive impairment (VCI) is a part of the heterogenous disorders group related to cerebral vessel disease. Although age is one of the most important risk factors for VCI, other common cardiovascular risk factors are also involved. By investigating these risk factors, a high proportion of these cognitive disorders can be prevented and/or delayed. Until now, only treatment of midlife arterial hypertension has been recognized as a preventing factor of vascular dementia. Brain MRI is becoming the method of choice to investigate cerebral vascular pathologies. However, this form of morphological imaging remains inadequate and does not provide useful functional information during VCI exploration, despite which functional imaging such as brain perfusion single-photon computed tomography, performed in baseline conditions and/or after an acetazolamide challenge, is underutilized in VCI exploration. The common strategies for VCI screening have not been standardized until now, and therefore further long-term imaging studies are needed to establish early diagnostic protocols. The present review summarizes the potential benefits of brain perfusion single-photon computed tomography imaging and possible scintigraphic quantification of cerebral hemodynamic reserves in investigation of VCI.
Collapse
|
31
|
Kolyva C, Kingston H, Tachtsidis I, Mohanty S, Mishra S, Patnaik R, Maude RJ, Dondorp AM, Elwell CE. Oscillations in cerebral haemodynamics in patients with falciparum malaria. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 765:101-107. [PMID: 22879021 PMCID: PMC4038006 DOI: 10.1007/978-1-4614-4989-8_15] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Spontaneous oscillations in cerebral haemodynamics studied with near-infrared spectroscopy (NIRS), become impaired in several pathological conditions. We assessed the spectral characteristics of these oscillations in 20 patients with falciparum malaria admitted to Ispat General Hospital, Rourkela, India. Monitoring included continuous frontal lobe NIRS recordings within 24 h of admission (Day 0), together with single measurements of a number of clinical and chemical markers recorded on admission. Seven patients returned for follow-up measurements on recovery (FU). A 2,048 sampling-point segment of oxygenated haemoglobin concentration ([ΔHbO(2)]) data was subjected to Fourier analysis per patient, and power spectral density was derived over the very low frequency (VLF: 0.02-0.04 Hz), low frequency (LF: 0.04-0.15 Hz) and high frequency (HF: 0.15-0.4 Hz) bands. At Day 0, VLF spectral power was 21.1 ± 16.4, LF power 7.2 ± 4.6 and HF power 2.6 ± 5.0, with VLF power being statistically significantly higher than LF and HF (P < 0.005). VLF power tended to decrease in the severely ill patients and correlated negatively with heart rate (r = 0.57, P < 0.01), while LF power correlated positively with aural body temperature (r = 0.49, P < 0.05). In all but one of the patients who returned for FU measurements, VLF power increased after recovery. This may be related to autonomic dysfunction in severe malaria, a topic of little research to date. The present study demonstrated that application of NIRS in a resource-poor setting is feasible and has potential as a research tool.
Collapse
Affiliation(s)
- Christina Kolyva
- grid.83440.3b0000000121901201Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT UK
| | - Hugh Kingston
- grid.10223.320000 0004 1937 0490Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Ilias Tachtsidis
- grid.83440.3b0000000121901201Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT UK
| | - Sanjib Mohanty
- grid.440315.7Department of Internal Medicine, Ispat General Hospital, Rourkela, India
| | - Saroj Mishra
- grid.440315.7Department of Internal Medicine, Ispat General Hospital, Rourkela, India
| | - Rajya Patnaik
- grid.440315.7Department of Internal Medicine, Ispat General Hospital, Rourkela, India
| | - Richard J. Maude
- grid.4991.50000 0004 1936 8948Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Arjen M. Dondorp
- grid.10223.320000 0004 1937 0490Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Clare E. Elwell
- grid.83440.3b0000000121901201Department of Medical Physics and Bioengineering, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT UK
| |
Collapse
|
32
|
Schroeter ML, Vogt B, Frisch S, Becker G, Barthel H, Mueller K, Villringer A, Sabri O. Executive deficits are related to the inferior frontal junction in early dementia. Brain 2012; 135:201-15. [PMID: 22184615 PMCID: PMC3267982 DOI: 10.1093/brain/awr311] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 08/22/2011] [Accepted: 09/18/2011] [Indexed: 11/12/2022] Open
Abstract
Executive functions describe a wide variety of higher order cognitive processes that allow the flexible modification of thought and behaviour in response to changing cognitive or environmental contexts. Their impairment is common in neurodegenerative disorders. Executive deficits negatively affect everyday activities and hamper the ability to cope with other deficits, such as memory impairment in Alzheimer's disease or behavioural disorders in frontotemporal lobar degeneration. Our study aimed to characterize the neural correlates of executive functions by relating respective deficits to regional hypometabolism in early dementia. Executive functions were assessed with two classical tests, the Stroop and semantic fluency test and various subtests of the behavioural assessment of the dysexecutive syndrome test battery capturing essential aspects of executive abilities relevant to daily living. Impairments in executive functions were correlated with reductions in brain glucose utilization as measured by [(18)F]fluorodeoxyglucose positron emission tomography and analysed voxelwise using statistical parametric mapping in 54 subjects with early dementia, mainly Alzheimer's disease and frontotemporal lobar degeneration, and its prodromal stages: subjective and mild cognitive impairment. Although the analysis revealed task-specific frontoparietal networks, it consistently showed that hypometabolism in one region in the left lateral prefrontal cortex-the inferior frontal junction area-was related to performance in the various neuropsychological tests. This brain region has recently been related to the three component processes of cognitive control-working memory, task switching and inhibitory control. Group comparisons additionally showed hypometabolism in this area in Alzheimer's disease and frontotemporal lobar degeneration. Our study underlines the importance of the inferior frontal junction area for cognitive control in general and for executive deficits in early dementia.
Collapse
Affiliation(s)
- Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103 Leipzig, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Schecklmann M, Dresler T, Beck S, Jay JT, Febres R, Haeusler J, Jarczok TA, Reif A, Plichta MM, Ehlis AC, Fallgatter AJ. Reduced prefrontal oxygenation during object and spatial visual working memory in unpolar and bipolar depression. Psychiatry Res 2011; 194:378-384. [PMID: 22079657 DOI: 10.1016/j.pscychresns.2011.01.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 01/20/2011] [Accepted: 01/27/2011] [Indexed: 11/15/2022]
Abstract
Altered prefrontal brain activity (e.g. hypofrontality) during cognitive tasks such as working memory is a core neuroimaging marker in unipolar (UNI) and bipolar (BI) depression. The present study investigated for the first time UNI (n=16) and BI patients (n=14) in a working memory task including different processes (storage and matching) and components (object and spatial visual) with functional near-infrared spectroscopy (fNIRS) over the prefrontal cortex. In healthy controls (n=15) comparable to both patient groups, changes of oxygenated and deoxygenated haemoglobin indicated increased ventro-lateral, dorso-lateral prefrontal and superior frontal cortex activity for object and spatial visual working memory storage as compared to the control condition. In contrast, both patient groups showed diminished brain activity in all working memory conditions. Results revealed unspecific deficits that did not allow the differentiation between unipolar and bipolar depression in dependence of working memory processes or components. However, fNIRS can be considered as a valid, easy manageable, low cost and rapid tool for measuring (diminished) prefrontal cortex functions.
Collapse
Affiliation(s)
- Martin Schecklmann
- University of Regensburg, Department of Psychiatry and Psychotherapy, Regensburg, Germany; University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany; University of Würzburg, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany.
| | - Thomas Dresler
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Stefanie Beck
- Charité Universitätsmedizin Berlin, Department of Anesthesiology and Operative Intensive Care Medicine, Berlin, Germany
| | - Johanna T Jay
- Missionsärztliche Klinik Würzburg, Würzburg, Germany
| | - Richard Febres
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Julia Haeusler
- University of Würzburg, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Tomasz A Jarczok
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | - Andreas Reif
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany
| | | | - Ann-Christine Ehlis
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany; University of Tübingen, Department of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Andreas J Fallgatter
- University of Würzburg, Department of Psychiatry, Psychosomatics and Psychotherapy, Würzburg, Germany; University of Tübingen, Department of Psychiatry and Psychotherapy, Tübingen, Germany
| |
Collapse
|
34
|
Obrig H, Steinbrink J. Non-invasive optical imaging of stroke. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2011; 369:4470-94. [PMID: 22006902 DOI: 10.1098/rsta.2011.0252] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The acute onset of a neurological deficit is the key clinical feature of stroke. In most cases, however, pathophysiological changes in the cerebral vasculature precede the event, often by many years. Persisting neurological deficits may also require long-term rehabilitation. Hence, stroke may be considered a chronic disease, and diagnostic and therapeutic efforts must include identification of specific risk factors, and the monitoring of and interventions in the acute and subacute stages, and should aim at a pathophysiologically based approach to optimize the rehabilitative effort. Non-invasive optical techniques have been experimentally used in all three stages of the disease and may complement the established diagnostic and monitoring tools. Here, we provide an overview of studies using the methodology in the context of stroke, and we sketch perspectives of how they may be integrated into the assessment of the highly dynamic pathophysiological processes during the acute and subacute stages of the disease and also during rehabilitation and (secondary) prevention of stroke.
Collapse
Affiliation(s)
- Hellmuth Obrig
- Department of Cognitive Neurology, University Hospital Leipzig, Liebigstraße 16, 04103 Leipzig, Germany.
| | | |
Collapse
|
35
|
Pfurtscheller G, Klobassa DS, Altstatter C, Bauernfeind G, Neuper C. About the Stability of Phase Shifts Between Slow Oscillations Around 0.1 Hz in Cardiovascular and Cerebral Systems. IEEE Trans Biomed Eng 2011; 58:2064-71. [DOI: 10.1109/tbme.2011.2134851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
36
|
Schytz HW, Hansson A, Phillip D, Selb J, Boas DA, Iversen HK, Ashina M. Spontaneous low-frequency oscillations in cerebral vessels: applications in carotid artery disease and ischemic stroke. J Stroke Cerebrovasc Dis 2011; 19:465-74. [PMID: 20864356 DOI: 10.1016/j.jstrokecerebrovasdis.2010.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 12/02/2009] [Indexed: 11/30/2022] Open
Abstract
The etiology behind and physiological significance of spontaneous oscillations in the low-frequency spectrum in both systemic and cerebral vessels remain unknown. Experimental studies have proposed that spontaneous oscillations in cerebral blood flow reflect impaired cerebral autoregulation (CA). Analysis of CA by measurement of spontaneous oscillations in the low-frequency spectrum in cerebral vessels might be a useful tool for assessing risk and investigating different treatment strategies in carotid artery disease (CAD) and stroke. We reviewed studies exploring spontaneous oscillations in the low-frequency spectrum in patients with CAD and ischemic stroke, conditions known to involve impaired CA. Several studies have reported changes in oscillations after CAD and stroke after surgery and over time compared with healthy controls. Phase shift in the frequency domain and correlation coefficients in the time domain are the most frequently used parameters for analyzing spontaneous oscillations in systemic and cerebral vessels. At present, there is no gold standard for analyzing spontaneous oscillations in the low-frequency spectrum, and simplistic models of CA have failed to predict or explain the spontaneous oscillation changes found in CAD and stroke studies. Near-infrared spectroscopy is suggested as a future complementary tool for assessing changes affecting the cortical arterial system.
Collapse
Affiliation(s)
- Henrik W Schytz
- Danish Headache Center, Department of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, Denmark.
| | | | | | | | | | | | | |
Collapse
|
37
|
Cardiovascular responses after brisk finger movement and their dependency on the “eigenfrequency” of the baroreflex loop. Neurosci Lett 2011; 490:31-5. [DOI: 10.1016/j.neulet.2010.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 12/07/2010] [Accepted: 12/08/2010] [Indexed: 11/18/2022]
|
38
|
Tak S, Yoon SJ, Jang J, Yoo K, Jeong Y, Ye JC. Quantitative analysis of hemodynamic and metabolic changes in subcortical vascular dementia using simultaneous near-infrared spectroscopy and fMRI measurements. Neuroimage 2010; 55:176-84. [PMID: 21094685 DOI: 10.1016/j.neuroimage.2010.11.046] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 10/25/2010] [Accepted: 11/13/2010] [Indexed: 10/18/2022] Open
Abstract
Subcortical vascular dementia (SVD) is a form of vascular dementia from small vessel disease with white matter lesions and lacunes. We hypothesized that hemodynamic and metabolic changes in the cortex during a simple motor task may reflect the impaired neurovascular coupling in SVD. We used fMRI and near-infrared spectroscopy (NIRS) simultaneously, which together provided multiple hemodynamic responses as well as a robust estimation of the cerebral metabolic rate of oxygen (CMRO(2)). During the task periods, the oxy-hemoglobin, total-hemoglobin, blood oxygenation level-dependent (BOLD) response, cerebral blood flow (CBF), and CMRO(2) decreased statistically significantly in the primary motor and somatosensory cortices of SVD patients, whereas the oxygen extraction fraction increased when compared with controls. Notably, the flow-metabolism coupling ratio, n representing the ratio of oxygen supply to its utilization, showed a robust reduction in the SVD patient group (n(Control)=1.99 ± 0.23; n(SVD)=1.08 ± 0.24), which implies a loss of metabolic reserve. These results support the pathological small vessel compromise, including an increased vessel stiffness, impaired vascular reactivity, and impaired neurovascular coupling in SVD. In conclusion, simultaneous measurement by NIRS and fMRI can reveal various hemodynamic and metabolic changes and may be used for as an early detection or monitoring of SVD.
Collapse
Affiliation(s)
- Sungho Tak
- Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea
| | | | | | | | | | | |
Collapse
|
39
|
Zweifel C, Castellani G, Czosnyka M, Carrera E, Brady KM, Kirkpatrick PJ, Pickard JD, Smielewski P. Continuous assessment of cerebral autoregulation with near-infrared spectroscopy in adults after subarachnoid hemorrhage. Stroke 2010; 41:1963-8. [PMID: 20651272 DOI: 10.1161/strokeaha.109.577320] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE In patients with subarachnoid hemorrhage, the assessment of cerebral autoregulation aids in prognosis as well as detection of vasospasm. Mx is a validated index of cerebral autoregulation based on measures of cerebral perfusion pressure and mean flow velocity on transcranial Doppler but is impractical for longer-term monitoring. Near-infrared spectroscopy is noninvasive and suitable for continuous monitoring of cerebral tissue oxygenation using the Tissue Oxygenation Index. In this study, we compared near-infrared spectroscopy-based indices of cerebral autoregulation (TOx) with Mx in patients with subarachnoid hemorrhage. METHODS Arterial blood pressure, intracranial pressure, mean flow velocity, and Tissue Oxygenation Index were recorded. Mx and TOx were calculated as moving correlation coefficients between 10-second averaged values of cerebral perfusion pressure and mean flow velocity and between cerebral perfusion pressure and Tissue Oxygenation Index. We also calculated TOxA, the moving correlation coefficient between arterial blood pressure and Tissue Oxygenation Index. RESULTS Fifty-one recording sessions were performed in 27 patients with subarachnoid hemorrhage with a total duration of 62.5 hours. Correlations of Mx and TOx over time varied markedly among individual recordings. However, time-averaging over the entire recording interval in each of the 51 recordings, we found correlations between Mx and TOx and between Mx and TOxA were highly significant. This correlation was even stronger after correction for multiple sampling for each patient, reaching r=0.81 for Mx and TOx and r=0.72 for Mx and TOxA. CONCLUSIONS Near-infrared spectroscopy can be used to continuously assess cerebral autoregulation in adults after subarachnoid hemorrhage.
Collapse
Affiliation(s)
- Christian Zweifel
- Academic Neurosurgical Unit, University of Cambridge Clinical School, Cambridge, UK.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Li Z, Wang Y, Li Y, Wang Y, Li J, Zhang L. Wavelet analysis of cerebral oxygenation signal measured by near infrared spectroscopy in subjects with cerebral infarction. Microvasc Res 2010; 80:142-7. [DOI: 10.1016/j.mvr.2010.02.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 01/24/2010] [Accepted: 02/04/2010] [Indexed: 01/31/2023]
|
41
|
Traumatic brain injury affects the frontomedian cortex--an event-related fMRI study on evaluative judgments. Neuropsychologia 2010; 48:185-93. [PMID: 19747929 DOI: 10.1016/j.neuropsychologia.2009.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 08/18/2009] [Accepted: 09/03/2009] [Indexed: 11/23/2022]
Abstract
Traumatic brain injuries represent the leading cause of death and disability in young adults in industrialized countries. Recently, it has been suggested that dysfunctions of the frontomedian cortex, which enables social cognition, are responsible for clinical deficits in the long-term. To validate this hypothesis, we examined brain activation in seven young adults suffering from diffuse axonal injury during a cognitive task that specifically depends on frontomedian structures, namely evaluative judgments, contrasted with semantic memory retrieval. Brain activation in patients was compared with healthy age and gender matched control subjects using event-related functional magnetic resonance imaging. Evaluative judgments were related to a neural network discussed in the context of self-referential processing and theory of mind. More precisely, the neural network consisted of frontomedian regions, the temporal pole, and the posterior superior temporal gyrus and sulcus/angular gyrus. Patients showed higher activations in this network and the inferior frontal gyrus, whereas healthy control subjects activated more dopaminergic structures, namely the ventral tegmental area, during evaluative judgments. One possible interpretation of the data is that deficits in the ventral tegmental area, and consequently the mesocorticolimbic projection system, have to be compensated for by higher brain activations in the frontomedian and anterior cingulate cortex in patients with diffuse axonal injury. In conclusion, our study supports the hypothesis that traumatic brain injury is characterized by frontomedian dysfunctions, which may be responsible for clinical deficits in the long-term and which might be modified by rehabilitative strategies in the future.
Collapse
|
42
|
Does conscious intention to perform a motor act depend on slow cardiovascular rhythms? Neurosci Lett 2009; 468:46-50. [PMID: 19861147 DOI: 10.1016/j.neulet.2009.10.060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 10/13/2009] [Accepted: 10/20/2009] [Indexed: 11/24/2022]
Abstract
Slow oscillations around 0.1 Hz are characteristic features of both the cardiovascular and central nervous systems. Such oscillation have been reported, e.g. in blood pressure, heart rate, EEG and brain oxygenation. Hence, conscious intention of a motor act may occur only as a result of brain activity changes in frontal and related brain areas, or might be entrained by slow oscillations in the blood pressure. Twenty-six subjects were asked to perform voluntary, self-paced (at free will) brisk finger movements. Some subjects performed self-paced movements in relatively periodic intervals of around 10s at the decreasing slope of the slow 0.1-Hz blood pressure oscillation. Our study reveals the first time that self-paced movements, at least in some subjects, do not stem from "free will" based on brain activity alone, but are influenced by slow blood pressure oscillations.
Collapse
|
43
|
White BR, Snyder AZ, Cohen AL, Petersen SE, Raich-le ME, Schlaggar BL, Culver JP. Resting-state functional connectivity in the human brain revealed with diffuse optical tomography. Neuroimage 2009; 47:148-56. [PMID: 19344773 PMCID: PMC2699418 DOI: 10.1016/j.neuroimage.2009.03.058] [Citation(s) in RCA: 195] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 03/12/2009] [Accepted: 03/20/2009] [Indexed: 11/21/2022] Open
Abstract
Mapping resting-state networks allows insight into the brain's functional architecture and physiology and has rapidly become important in contemporary neuroscience research. Diffuse optical tomography (DOT) is an emerging functional neuroimaging technique with the advantages, relative to functional magnetic resonance imaging (fMRI), of portability and the ability to simultaneously measure both oxy- and deoxyhemoglobin. Previous optical studies have evaluated the temporal features of spontaneous resting brain signals. Herein, we develop techniques for spatially mapping functional connectivity with DOT (fc-DOT). Simultaneous imaging over the motor and visual cortices yielded robust correlation maps reproducing the expected functional neural architecture. The localization of the maps was confirmed with task-response studies and with subject-matched fc-MRI. These fc-DOT methods provide a task-less approach to mapping brain function in populations that were previously difficult to research. Our advances may permit new studies of early childhood development and of unconscious patients. In addition, the comprehensive hemoglobin contrasts of fc-DOT enable innovative studies of the biophysical origin of the functional connectivity signal.
Collapse
Affiliation(s)
- Brian R. White
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Physics, Washington University, St. Louis, MO 63110
| | - Abraham Z. Snyder
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Neurology, Washington University, St. Louis, MO 63110
| | | | - Steven E. Petersen
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Neurology, Washington University, St. Louis, MO 63110
- Department of Anatomy and Neurobiology, Washington University, St. Louis, MO 63110
- Department of Psychology, Washington University, St. Louis, MO 63110
| | - Marcus E. Raich-le
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Neurology, Washington University, St. Louis, MO 63110
- Department of Anatomy and Neurobiology, Washington University, St. Louis, MO 63110
- Department of Biomedical Engineering, Washington University, St. Louis, MO 63110
| | - Bradley L. Schlaggar
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Neurology, Washington University, St. Louis, MO 63110
- Department of Anatomy and Neurobiology, Washington University, St. Louis, MO 63110
- Department of Pediatrics, Washington University, St. Louis, MO 63110
| | - Joseph P. Culver
- Department of Radiology, Washington University, St. Louis, MO 63110
- Department of Physics, Washington University, St. Louis, MO 63110
| |
Collapse
|
44
|
Variability of body weight, pulse pressure and glycaemia strongly predict total mortality in elderly type 2 diabetic patients. The Verona Diabetes Study. Diabetes Metab Res Rev 2009; 24:624-8. [PMID: 18802932 DOI: 10.1002/dmrr.897] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Ageing is characterized by a decreased functional reserve, a concept defined as homeostenosis. We assessed the impact of long-term exposure to the average value (mean) or to the variability (coefficient of variation) of fasting glycaemia, body mass index (BMI) and pulse pressure on total mortality in a cohort of type 2 diabetic patients. METHODS Fasting glycaemia, BMI and pulse pressure values were collected over a period of 3 years in 1 319 type 2 diabetic patients who were subsequently followed up for 10 years. For each patient, the means and the coefficients of variation of fasting glycaemia, BMI and pulse pressure were computed. The adverse impact of these risk factors on total mortality was assessed in patients aged < 65 years (n = 565) and in those aged > or = 65 years (n = 754), separately. RESULTS During the 10 years of follow-up, 438 patients died. In younger diabetic patients, the means of fasting glycaemia [hazard ratio (HR) of III tertile versus I tertile = 2.11, 95% confidence interval (CI): 1.22-3.64], BMI (HR = 1.88, 1.12-3.14) and pulse pressure (HR = 2.36, 1.34-4.16) were independently associated with total mortality, while in older patients they were not. In contrast, the coefficients of variation of glycaemia (HR = 1.56, 1.17-2.08), BMI (HR = 1.34, 1.03-1.75) and pulse pressure (HR = 1.34, 1.03-1.74) independently predicted total mortality only in older patients. CONCLUSIONS Our findings suggest that the variability of fasting glycaemia, body weight and blood pressure (BP) is independently associated with an increased risk of all-cause mortality in older type 2 diabetic patients. Future studies are required to confirm the reproducibility of our findings.
Collapse
|
45
|
Sorond FA, Serrador JM, Jones RN, Shaffer ML, Lipsitz LA. The sit-to-stand technique for the measurement of dynamic cerebral autoregulation. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:21-9. [PMID: 18834658 PMCID: PMC2680703 DOI: 10.1016/j.ultrasmedbio.2008.08.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 07/16/2008] [Accepted: 08/01/2008] [Indexed: 05/08/2023]
Abstract
Measurement of cerebral autoregulation is important for the evaluation and management of a number of clinical disorders that affect cerebral blood flow. We currently lack simple bedside measures that mimic common physiologic stresses. Therefore, we evaluated a new sit-to-stand technique as an alternative method to the frequently-used thigh-cuff technique in healthy volunteers. Continuous middle cerebral artery (MCA) blood flow velocities (BFV) and arterial blood pressure (ABP) were measured in response to standing from a sitting position, or rapid thigh-cuff deflation in 24 healthy subjects (50 +/- 22 y). Autoregulatory index (ARI) was calculated as the BFV response for step changes in ABP using a second-order differential equation with a set of parameters that can be used to grade the performance of autoregulation. Of these 24 subjects, 30% could tolerate only two thigh-cuffs and refused to proceed with the third cuff, whereas none of our subjects had any difficulty with performing the three sit-to-stand trials. The two techniques produced similar changes in mean ABP, but the times to nadir of the blood pressure and BFV were significantly faster for the thigh-cuff. The mean group ARIs were similar between the two techniques. Although between-subjects variability was higher for sit-to-stand ARIs, the within-subject sit-to-stand ARI variability was small. Thus, for the assessment of cerebral autoregulation, the sit-to-stand procedure is well tolerated and produces ARI values that have low within-subject variability. The sit-to-stand technique appears to be a suitable measure of individual ARI values for inferring dynamic cerebral autoregulation.
Collapse
Affiliation(s)
- Farzaneh A Sorond
- Department of Neurology, Stroke Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | | | | | | | | |
Collapse
|
46
|
Schecklmann M, Ehlis AC, Plichta MM, Fallgatter AJ. Functional near-infrared spectroscopy: A long-term reliable tool for measuring brain activity during verbal fluency. Neuroimage 2008; 43:147-55. [DOI: 10.1016/j.neuroimage.2008.06.032] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 05/21/2008] [Accepted: 06/23/2008] [Indexed: 10/21/2022] Open
|
47
|
Peng T, Ainslie PN, Cotter JD, Murrell C, Thomas K, Williams MJA, George K, Shave R, Rowley AB, Payne SJ. The effects of age on the spontaneous low-frequency oscillations in cerebral and systemic cardiovascular dynamics. Physiol Meas 2008; 29:1055-69. [PMID: 18756026 DOI: 10.1088/0967-3334/29/9/005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Although the effects of ageing on cardiovascular control and particularly the response to orthostatic stress have been the subject of many studies, the interaction between the cardiovascular and cerebral regulation mechanisms is still not fully understood. Wavelet cross-correlation is used here to assess the coupling and synchronization between low-frequency oscillations (LFOs) observed in cerebral hemodynamics, as measured using cerebral blood flow velocity (CBFV) and cerebral oxygenation (O2Hb), and systemic cardiovascular dynamics, as measured using heart rate (HR) and arterial blood pressure (ABP), in both old and young healthy subjects undergoing head-up tilt table testing. Statistically significant increases in correlation values are found in the interaction of cerebral and cardiovascular LFOs for young subjects (P<0.01 for HR-ABP, P<0.001 for HR-O2Hb and ABP-O2Hb), but not in old subjects under orthostatic stress. The coupling between the cerebrovascular and wider cardiovascular systems in response to orthostatic stress thus appears to be impaired with ageing.
Collapse
Affiliation(s)
- Tingying Peng
- Department of Engineering Science, Oxford University, Oxford, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Alpha adrenoceptor agonist-induced microcirculatory oscillations are reduced in diabetic neuropathy. Microvasc Res 2008; 76:124-31. [DOI: 10.1016/j.mvr.2008.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2007] [Revised: 04/30/2008] [Accepted: 04/30/2008] [Indexed: 11/21/2022]
|
49
|
Dynamic cerebral autoregulation in carotid stenosis before and after carotid stenting. J Vasc Surg 2008; 48:88-92. [DOI: 10.1016/j.jvs.2008.02.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 01/29/2008] [Accepted: 02/01/2008] [Indexed: 11/20/2022]
|
50
|
Vetri F, Menicucci D, Lapi D, Gemignani A, Colantuoni A. Pial arteriolar vasomotion changes during cortical activation in rats. Neuroimage 2007; 38:25-33. [PMID: 17761439 DOI: 10.1016/j.neuroimage.2007.07.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 05/30/2007] [Accepted: 07/20/2007] [Indexed: 11/15/2022] Open
Abstract
The oscillatory pattern of pial arterioles, i.e. vasomotion, has been described since early 1980s, but the impact of neural activation on such oscillations has never been formally examined. Sciatic nerve stimulation, a well characterized model for studying neurovascular coupling (NVC), leads to a neural activity-related increase of pial arteriolar diameter in the contralateral hindlimb somatosensory cortex. Exploiting such an experimental model, the aim of the present study was to explore vasomotion and its changes during NVC with a novel analytical approach. Indeed, to characterize oscillations, we evaluated the total spectral power in the range 0.02-2.00 Hz and subdivided this frequency interval into seven 50% overlapping frequency bands. Results indicated that only arterioles overlying the stimulated hindlimb cortex showed a significant increase of total power, unlike arterioles overlaying the whisker barrel cortex, used as control for the vascular response specificity. The total power increase was sustained mainly by marked increments in the low frequency range, with two peaks at 0.03 and 0.08 Hz, and by a wide increase in the high frequency range (0.60-2.00 Hz) in the averaged spectrum. These activity-related spectral changes suggest: (i) that it is possible to assess the vascular responses by using total power; (ii) the existence of at least three distinct mechanisms involved in the control of NVC, two with a feedback frequency loop in the low frequency range and another one in the high range; (iii) a potential involvement of vasomotion in NVC. Moreover, these findings highlight the oscillatory nature of the mechanisms controlling NVC.
Collapse
Affiliation(s)
- Francesco Vetri
- Department of Human Physiology G Moruzzi, University of Pisa, Via S Zeno 31, 56127, Pisa, Italy.
| | | | | | | | | |
Collapse
|