1
|
Martins T, de Almeida B, Wu M, Wilckens KA, Minhas D, Ibinson JW, Aizenstein HJ, Santini T, Ibrahim TS. Characterization of pulsations in the brain and cerebrospinal fluid using ultra-high field magnetic resonance imaging. Front Neurosci 2024; 18:1305939. [PMID: 38784099 PMCID: PMC11112101 DOI: 10.3389/fnins.2024.1305939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024] Open
Abstract
The development of innovative non-invasive neuroimaging methods and biomarkers is critical for studying brain disease. Imaging of cerebrospinal fluid (CSF) pulsatility may inform the brain fluid dynamics involved in clearance of cerebral metabolic waste. In this work, we developed a methodology to characterize the frequency and spatial localization of whole brain CSF pulsations in humans. Using 7 Tesla (T) human magnetic resonance imaging (MRI) and ultrafast echo-planar imaging (EPI), in-vivo images were obtained to capture pulsations of the CSF signal. Physiological data were simultaneously collected and compared with the 7 T MR data. The primary components of signal pulsations were identified using spectral analysis, with the most evident frequency bands identified around 0.3, 1.2, and 2.4 Hz. These pulsations were mapped spatially and temporally onto the MR image domain and temporally onto the physiological measures of electrocardiogram and respiration. We identified peaks in CSF pulsations that were distinct from peaks in grey matter and white matter regions. This methodology may provide novel in vivo biomarkers of disrupted brain fluid dynamics.
Collapse
Affiliation(s)
- Tiago Martins
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bruno de Almeida
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kristine A. Wilckens
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Davneet Minhas
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - James W. Ibinson
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tales Santini
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tamer S. Ibrahim
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
2
|
Cai Y, Zhang Y, Leng S, Ma Y, Jiang Q, Wen Q, Ju S, Hu J. The relationship between inflammation, impaired glymphatic system, and neurodegenerative disorders: A vicious cycle. Neurobiol Dis 2024; 192:106426. [PMID: 38331353 DOI: 10.1016/j.nbd.2024.106426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/10/2024] Open
Abstract
The term "glymphatic" emerged roughly a decade ago, marking a pivotal point in neuroscience research. The glymphatic system, a glial-dependent perivascular network distributed throughout the brain, has since become a focal point of investigation. There is increasing evidence suggesting that impairment of the glymphatic system appears to be a common feature of neurodegenerative disorders, and this impairment exacerbates as disease progression. Nevertheless, the common factors contributing to glymphatic system dysfunction across most neurodegenerative disorders remain unclear. Inflammation, however, is suspected to play a pivotal role. Dysfunction of the glymphatic system can lead to a significant accumulation of protein and waste products, which can trigger inflammation. The interaction between the glymphatic system and inflammation appears to be cyclical and potentially synergistic. Yet, current research is limited, and there is a lack of comprehensive models explaining this association. In this perspective review, we propose a novel model suggesting that inflammation, impaired glymphatic function, and neurodegenerative disorders interconnected in a vicious cycle. By presenting experimental evidence from the existing literature, we aim to demonstrate that: (1) inflammation aggravates glymphatic system dysfunction, (2) the impaired glymphatic system exacerbated neurodegenerative disorders progression, (3) neurodegenerative disorders progression promotes inflammation. Finally, the implication of proposed model is discussed.
Collapse
Affiliation(s)
- Yu Cai
- Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Yangqiqi Zhang
- School of Medicine, Southeast University, Nanjing 210009, China
| | - Shuo Leng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009, China
| | - Yuanyuan Ma
- Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USA
| | - Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W.16th Street, Indianapolis, IN 46202-5188, USA
| | - Shenghong Ju
- Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009, China.
| | - Jiani Hu
- Department of Radiology, School of Medicine, Wayne State University, Detroit, MI 48201, USA.
| |
Collapse
|
3
|
Delli Pizzi S, Gambi F, Di Pietro M, Caulo M, Sensi SL, Ferretti A. BOLD cardiorespiratory pulsatility in the brain: from noise to signal of interest. Front Hum Neurosci 2024; 17:1327276. [PMID: 38259340 PMCID: PMC10800549 DOI: 10.3389/fnhum.2023.1327276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Functional magnetic resonance imaging (fMRI) based on the Blood Oxygen Level Dependent (BOLD) contrast has been extensively used to map brain activity and connectivity in health and disease. Standard fMRI preprocessing includes different steps to remove confounds unrelated to neuronal activity. First, this narrative review explores how signal fluctuations due to cardiac and respiratory activity, usually considered as "physiological noise" and regressed out from fMRI time series. However, these signal components bear useful information about some mechanisms of brain functioning (e.g., glymphatic clearance) or cerebrovascular compliance in response to arterial pressure waves. Aging and chronic diseases can cause stiffening of the aorta and other main arteries, with a reduced dampening effect resulting in greater transmission of pressure impulses to the brain. Importantly, the continuous hammering of cardiac pulsations can produce local alterations of the mechanical properties of the small cerebral vessels, with a progressive deterioration that ultimately affects neuronal functionality. Second, the review emphasizes how fMRI can study the brain patterns most affected by cardiac pulsations in health and disease with high spatiotemporal resolution, offering the opportunity to identify much more specific risk markers than systemic factors based on measurements of the vascular compliance of large arteries or other global risk factors. In this regard, modern fast fMRI acquisition techniques allow a better characterization of these pulsatile signal components due to reduced aliasing effects, turning what has been traditionally considered as noise in a signal of interest that can be used to develop novel non-invasive biomarkers in different clinical contexts.
Collapse
Affiliation(s)
- Stefano Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | | | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
| | - Stefano L. Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Institute for Advanced Biomedical Technologies (ITAB), “G. d’Annunzio” University, Chieti, Italy
- UdA-TechLab, Research Center, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
4
|
Väyrynen T, Helakari H, Korhonen V, Tuunanen J, Huotari N, Piispala J, Kallio M, Raitamaa L, Kananen J, Järvelä M, Matias Palva J, Kiviniemi V. Infra-slow fluctuations in cortical potentials and respiration drive fast cortical EEG rhythms in sleeping and waking states. Clin Neurophysiol 2023; 156:207-219. [PMID: 37972532 DOI: 10.1016/j.clinph.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/09/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Infra-slow fluctuations (ISF, 0.008-0.1 Hz) characterize hemodynamic and electric potential signals of human brain. ISFs correlate with the amplitude dynamics of fast (>1 Hz) neuronal oscillations, and may arise from permeability fluctuations of the blood-brain barrier (BBB). It is unclear if physiological rhythms like respiration drive or track fast cortical oscillations, and the role of sleep in this coupling is unknown. METHODS We used high-density full-band electroencephalography (EEG) in healthy human volunteers (N = 21) to measure concurrently the ISFs, respiratory pulsations, and fast neuronal oscillations during periods of wakefulness and sleep, and to assess the strength and direction of their phase-amplitude coupling. RESULTS The phases of ISFs and respiration were both coupled with the amplitude of fast neuronal oscillations, with stronger ISF coupling being evident during sleep. Phases of ISF and respiration drove the amplitude dynamics of fast oscillations in sleeping and waking states, with different contributions. CONCLUSIONS ISFs in slow cortical potentials and respiration together significantly determine the dynamics of fast cortical oscillations. SIGNIFICANCE We propose that these slow physiological phases play a significant role in coordinating cortical excitability, which is a fundamental aspect of brain function.
Collapse
Affiliation(s)
- Tommi Väyrynen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland.
| | - Heta Helakari
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - Vesa Korhonen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - Johanna Tuunanen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - Niko Huotari
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - Johanna Piispala
- MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland; Clinical Neurophysiology, Oulu University Hospital, Oulu 90220, Finland
| | - Mika Kallio
- MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland; Clinical Neurophysiology, Oulu University Hospital, Oulu 90220, Finland
| | - Lauri Raitamaa
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - Janne Kananen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland; Clinical Neurophysiology, Oulu University Hospital, Oulu 90220, Finland
| | - Matti Järvelä
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland
| | - J Matias Palva
- Department of Neuroscience and Biomedical Engineering, Aalto University, 02150 Espoo, Finland; Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Finland; Centre for Cognitive Neuroimaging, University of Glasgow, United Kingdom
| | - Vesa Kiviniemi
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu 90029, Finland; MIPT group to: Research Unit of Health Sciences and Technology (HST), Faculty of Medicine, University of Oulu, Oulu 90220, Finland; Medical Research Center (MRC), Oulu 90220, Finland; Biocenter Oulu, Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu 90220, Finland
| |
Collapse
|
5
|
Elabasy A, Suhonen M, Rajna Z, Hosni Y, Kananen J, Annunen J, Ansakorpi H, Korhonen V, Seppänen T, Kiviniemi V. Respiratory brain impulse propagation in focal epilepsy. Sci Rep 2023; 13:5222. [PMID: 36997658 PMCID: PMC10063583 DOI: 10.1038/s41598-023-32271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Respiratory brain pulsations pertaining to intra-axial hydrodynamic solute transport are markedly altered in focal epilepsy. We used optical flow analysis of ultra-fast functional magnetic resonance imaging (fMRI) data to investigate the velocity characteristics of respiratory brain impulse propagation in patients with focal epilepsy treated with antiseizure medication (ASM) (medicated patients with focal epilepsy; ME, n = 23), drug-naïve patients with at least one seizure (DN, n = 19) and matched healthy control subjects (HC, n = 75). We detected in the two patient groups (ME and DN) several significant alterations in the respiratory brain pulsation propagation velocity, which showed a bidirectional change dominated by a reduction in speed. Furthermore, the respiratory impulses moved more in reversed or incoherent directions in both patient groups vs. the HC group. The speed reductions and directionality changes occurred in specific phases of the respiratory cycle. In conclusion, irrespective of medication status, both patient groups showed incoherent and slower respiratory brain impulses, which may contribute to epileptic brain pathology by hindering brain hydrodynamics.
Collapse
Affiliation(s)
- Ahmed Elabasy
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland.
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland.
| | - Mia Suhonen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland.
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland.
| | - Zalan Rajna
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
| | - Youssef Hosni
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
| | - Janne Kananen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
- Clinical Neurophysiology, Oulu University Hospital, 90029 OYS, Oulu, Finland
| | - Johanna Annunen
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90029, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Member of ERN EpiCARE, 90029, Oulu, Finland
- MRC, Oulu University Hospital, 90029, Oulu, Finland
| | - Hanna Ansakorpi
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90029, Oulu, Finland
| | - Vesa Korhonen
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland
- Oulu Functional NeuroImaging, Diagnostic Radiology, Medical Research Center/HTS, Oulu University Hospital, 90029, Oulu, Finland
| | - Tapio Seppänen
- Center for Machine Vision and Signal Analysis, University of Oulu, 90014, Oulu, Finland
| | - Vesa Kiviniemi
- Medical Imaging, Physics and Technology, University of Oulu, 90029, Oulu, Finland.
| |
Collapse
|
6
|
Kananen J, Järvelä M, Korhonen V, Tuovinen T, Huotari N, Raitamaa L, Helakari H, Väyrynen T, Raatikainen V, Nedergaard M, Ansakorpi H, Jacobs J, LeVan P, Kiviniemi V. Increased interictal synchronicity of respiratory related brain pulsations in epilepsy. J Cereb Blood Flow Metab 2022; 42:1840-1853. [PMID: 35570730 PMCID: PMC9536129 DOI: 10.1177/0271678x221099703] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Respiratory brain pulsations have recently been shown to drive electrophysiological brain activity in patients with epilepsy. Furthermore, functional neuroimaging indicates that respiratory brain pulsations have increased variability and amplitude in patients with epilepsy compared to healthy individuals. To determine whether the respiratory drive is altered in epilepsy, we compared respiratory brain pulsation synchronicity between healthy controls and patients. Whole brain fast functional magnetic resonance imaging was performed on 40 medicated patients with focal epilepsy, 20 drug-naïve patients and 102 healthy controls. Cerebrospinal fluid associated respiratory pulsations were used to generate individual whole brain respiratory synchronization maps, which were compared between groups. Finally, we analyzed the seizure frequency effect and diagnostic accuracy of the respiratory synchronization defect in epilepsy. Respiratory brain pulsations related to the verified fourth ventricle pulsations were significantly more synchronous in patients in frontal, periventricular and mid-temporal regions, while the seizure frequency correlated positively with synchronicity. The respiratory brain synchronicity had a good diagnostic accuracy (ROCAUC = 0.75) in discriminating controls from medicated patients. The elevated respiratory brain synchronicity in focal epilepsy suggests altered physiological effect of cerebrospinal fluid pulsations possibly linked to regional brain water dynamics involved with interictal brain physiology.
Collapse
Affiliation(s)
- Janne Kananen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Matti Järvelä
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Timo Tuovinen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Niko Huotari
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Lauri Raitamaa
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Heta Helakari
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Tommi Väyrynen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Ville Raatikainen
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA.,Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanna Ansakorpi
- Medical Research Center (MRC), Oulu, Finland.,Research Unit of Neuroscience, Neurology, University of Oulu, Oulu, Finland.,Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Julia Jacobs
- Department of Pediatric Neurology and Muscular Disease, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Pierre LeVan
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.,Department of Radiology, Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Vesa Kiviniemi
- Oulu Functional NeuroImaging (OFNI), Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology (MIPT), Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu, Finland
| |
Collapse
|
7
|
Increased very low frequency pulsations and decreased cardiorespiratory pulsations suggest altered brain clearance in narcolepsy. COMMUNICATIONS MEDICINE 2022; 2:122. [PMID: 36193214 PMCID: PMC9525269 DOI: 10.1038/s43856-022-00187-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Narcolepsy is a chronic neurological disease characterized by daytime sleep attacks, cataplexy, and fragmented sleep. The disease is hypothesized to arise from destruction or dysfunction of hypothalamic hypocretin-producing cells that innervate wake-promoting systems including the ascending arousal network (AAN), which regulates arousal via release of neurotransmitters like noradrenalin. Brain pulsations are thought to drive intracranial cerebrospinal fluid flow linked to brain metabolite transfer that sustains homeostasis. This flow increases in sleep and is suppressed by noradrenalin in the awake state. Here we tested the hypothesis that narcolepsy is associated with altered brain pulsations, and if these pulsations can differentiate narcolepsy type 1 from healthy controls. Methods In this case-control study, 23 patients with narcolepsy type 1 (NT1) were imaged with ultrafast fMRI (MREG) along with 23 age- and sex-matched healthy controls (HC). The physiological brain pulsations were quantified as the frequency-wise signal variance. Clinical relevance of the pulsations was investigated with correlation and receiving operating characteristic analysis. Results We find that variance and fractional variance in the very low frequency (MREGvlf) band are greater in NT1 compared to HC, while cardiac (MREGcard) and respiratory band variances are lower. Interestingly, these pulsations differences are prominent in the AAN region. We further find that fractional variance in MREGvlf shows promise as an effective bi-classification metric (AUC = 81.4%/78.5%), and that disease severity measured with narcolepsy severity score correlates with MREGcard variance (R = −0.48, p = 0.0249). Conclusions We suggest that our novel results reflect impaired CSF dynamics that may be linked to altered glymphatic circulation in narcolepsy type 1. The flow of fluid surrounding and inside the human brain is thought to be caused by the movement of brain vessels, breathing and heart rate. These so called brain pulsations are linked to clearing waste from the brain. This process is increased during sleep and suppressed while we are awake. Narcolepsy is a neurological disease where the brain areas regulating being awake and asleep are affected. The diagnosis requires time-consuming hospital tests and is often delayed which has a prolonged negative impact on the patients. Here, we use brain imaging to investigate whether brain pulsations are altered in patients with narcolepsy, and if they can be utilized to differentiate patients with narcolepsy from healthy individuals. We find that narcolepsy affects all brain pulsations, and these findings show promise as an additional diagnostic tool that could help detect the disease earlier. Järvelä et al. investigate if narcolepsy is associated with altered brain pulsations using ultrafast fMRI. They find differences in the brain pulsations between narcolepsy type 1 patients and healthy controls that may link to altered brain clearance in narcolepsy, have diagnostic potential and correlate with the severity of narcolepsy.
Collapse
|
8
|
Poltojainen V, Kemppainen J, Keinänen N, Bode M, Isokangas JM, Kuitunen H, Nikkinen J, Sonkajärvi E, Korhonen V, Tuovinen T, Järvelä M, Huotari N, Raitamaa L, Kananen J, Korhonen T, Tetri S, Kuittinen O, Kiviniemi V. Physiological instability is linked to mortality in primary central nervous system lymphoma: A case-control fMRI study. Hum Brain Mapp 2022; 43:4030-4044. [PMID: 35543292 PMCID: PMC9374894 DOI: 10.1002/hbm.25901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/07/2022] [Accepted: 04/26/2022] [Indexed: 11/07/2022] Open
Abstract
Primary central nervous system lymphoma (PCNSL) is an aggressive brain disease where lymphocytes invade along perivascular spaces of arteries and veins. The invasion markedly changes (peri)vascular structures but its effect on physiological brain pulsations has not been previously studied. Using physiological magnetic resonance encephalography (MREGBOLD ) scanning, this study aims to quantify the extent to which (peri)vascular PCNSL involvement alters the stability of physiological brain pulsations mediated by cerebral vasculature. Clinical implications and relevance were explored. In this study, 21 PCNSL patients (median 67y; 38% females) and 30 healthy age-matched controls (median 63y; 73% females) were scanned for MREGBOLD signal during 2018-2021. Motion effects were removed. Voxel-by-voxel Coefficient of Variation (CV) maps of MREGBOLD signal was calculated to examine the stability of physiological brain pulsations. Group-level differences in CV were examined using nonparametric covariate-adjusted tests. Subject-level CV alterations were examined against control population Z-score maps wherein clusters of increased CV values were detected. Spatial distributions of clusters and findings from routine clinical neuroimaging were compared [contrast-enhanced, diffusion-weighted, fluid-attenuated inversion recovery (FLAIR) data]. Whole-brain mean CV was linked to short-term mortality with 100% sensitivity and 100% specificity, as all deceased patients revealed higher values (n = 5, median 0.055) than surviving patients (n = 16, median 0.028) (p < .0001). After adjusting for medication, head motion, and age, patients revealed higher CV values (group median 0.035) than healthy controls (group median 0.024) around arterial territories (p ≤ .001). Abnormal clusters (median 1.10 × 105 mm3 ) extended spatially beyond FLAIR lesions (median 0.62 × 105 mm3 ) with differences in volumes (p = .0055).
Collapse
Affiliation(s)
- Valter Poltojainen
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Janette Kemppainen
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Nina Keinänen
- Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland
| | - Michaela Bode
- Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | | | - Hanne Kuitunen
- Department of Oncology and Haematology, Oulu University Hospital, Oulu, Finland
| | - Juha Nikkinen
- Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Eila Sonkajärvi
- Department of Anaesthesiology, Oulu University Hospital, Oulu, Finland
| | - Vesa Korhonen
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Timo Tuovinen
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Matti Järvelä
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Niko Huotari
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Lauri Raitamaa
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Janne Kananen
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| | - Tommi Korhonen
- Medical Research Center, University of Oulu/Oulu University Hospital, Oulu, Finland.,Department of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Sami Tetri
- Medical Research Center, University of Oulu/Oulu University Hospital, Oulu, Finland.,Department of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Outi Kuittinen
- Department of Oncology and Haematology, Oulu University Hospital, Oulu, Finland.,Cancer Center, Kuopio University Hospital, Kuopio, Finland.,Faculty of Health Medicine, Institute of Clinical Medicine, University of Eastern Finland, Oulu, Finland
| | - Vesa Kiviniemi
- Oulu Functional Neuroimaging, University of Oulu/Oulu University Hospital, Oulu, Finland.,Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
9
|
Raitamaa L, Huotari N, Korhonen V, Helakari H, Koivula A, Kananen J, Kiviniemi V. Spectral analysis of physiological brain pulsations affecting the BOLD signal. Hum Brain Mapp 2021; 42:4298-4313. [PMID: 34037278 PMCID: PMC8356994 DOI: 10.1002/hbm.25547] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/17/2022] Open
Abstract
Physiological pulsations have been shown to affect the global blood oxygen level dependent (BOLD) signal in human brain. While these pulsations have previously been regarded as noise, recent studies show their potential as biomarkers of brain pathology. We used the extended 5 Hz spectral range of magnetic resonance encephalography (MREG) data to investigate spatial and frequency distributions of physiological BOLD signal sources. Amplitude spectra of the global image signals revealed cardiorespiratory envelope modulation (CREM) peaks, in addition to the previously known very low frequency (VLF) and cardiorespiratory pulsations. We then proceeded to extend the amplitude of low frequency fluctuations (ALFF) method to each of these pulsations. The respiratory pulsations were spatially dominating over most brain structures. The VLF pulsations overcame the respiratory pulsations in frontal and parietal gray matter, whereas cardiac and CREM pulsations had this effect in central cerebrospinal fluid (CSF) spaces and major blood vessels. A quasi‐periodic pattern (QPP) analysis showed that the CREM pulsations propagated as waves, with a spatiotemporal pattern differing from that of respiratory pulsations, indicating them to be distinct intracranial physiological phenomenon. In conclusion, the respiration has a dominant effect on the global BOLD signal and directly modulates cardiovascular brain pulsations.
Collapse
Affiliation(s)
- Lauri Raitamaa
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Niko Huotari
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Vesa Korhonen
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Heta Helakari
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Anssi Koivula
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Janne Kananen
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| | - Vesa Kiviniemi
- Oulu Functional Neuro Imaging Group, Research Unit of Medical Imaging Physics and Technology (MIPT), University of Oulu, Oulu.,Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, Oulu
| |
Collapse
|
10
|
Gallina P, Nicoletti C, Scollato A, Lolli F. The "Glymphatic-Lymphatic System Pathology" and a New Categorization of Neurodegenerative Disorders. Front Neurosci 2021; 15:669681. [PMID: 34093117 PMCID: PMC8172792 DOI: 10.3389/fnins.2021.669681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/14/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Pasquale Gallina
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Neurosurgical Unit, Careggi University Hospital, Florence, Italy
| | - Claudio Nicoletti
- Department of Experimental and Clinical Medicine, Section of Anatomy, University of Florence, Florence, Italy
| | | | - Francesco Lolli
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| |
Collapse
|
11
|
Abstract
Human neuroimaging has had a major impact on the biological understanding of epilepsy and the relationship between pathophysiology, seizure management, and outcomes. This review highlights notable recent advancements in hardware, sequences, methods, analyses, and applications of human neuroimaging techniques utilized to assess epilepsy. These structural, functional, and metabolic assessments include magnetic resonance imaging (MRI), positron emission tomography (PET), and magnetoencephalography (MEG). Advancements that highlight non-invasive neuroimaging techniques used to study the whole brain are emphasized due to the advantages these provide in clinical and research applications. Thus, topics range across presurgical evaluations, understanding of epilepsy as a network disorder, and the interactions between epilepsy and comorbidities. New techniques and approaches are discussed which are expected to emerge into the mainstream within the next decade and impact our understanding of epilepsies. Further, an increasing breadth of investigations includes the interplay between epilepsy, mental health comorbidities, and aberrant brain networks. In the final section of this review, we focus on neuroimaging studies that assess bidirectional relationships between mental health comorbidities and epilepsy as a model for better understanding of the commonalities between both conditions.
Collapse
Affiliation(s)
- Adam M. Goodman
- Department of Neurology, UAB Epilepsy Center, University of Alabama At Birmingham, 312 Civitan International Research Center, Birmingham, AL 35294 USA
| | - Jerzy P. Szaflarski
- Department of Neurology, UAB Epilepsy Center, University of Alabama At Birmingham, 312 Civitan International Research Center, Birmingham, AL 35294 USA
| |
Collapse
|
12
|
Segawa K, Blumenthal Y, Yamawaki Y, Ohtsuki G. A Destruction Model of the Vascular and Lymphatic Systems in the Emergence of Psychiatric Symptoms. BIOLOGY 2021; 10:34. [PMID: 33419067 PMCID: PMC7825436 DOI: 10.3390/biology10010034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/24/2020] [Accepted: 12/31/2020] [Indexed: 01/02/2023]
Abstract
The lymphatic system is important for antigen presentation and immune surveillance. The lymphatic system in the brain was originally introduced by Giovanni Mascagni in 1787, while the rediscovery of it by Jonathan Kipnis and Kari Kustaa Alitalo now opens the door for a new interpretation of neurological diseases and therapeutic applications. The glymphatic system for the exchanges of cerebrospinal fluid (CSF) and interstitial fluid (ISF) is associated with the blood-brain barrier (BBB), which is involved in the maintenance of immune privilege and homeostasis in the brain. Recent notions from studies of postmortem brains and clinical studies of neurodegenerative diseases, infection, and cerebral hemorrhage, implied that the breakdown of those barrier systems and infiltration of activated immune cells disrupt the function of both neurons and glia in the parenchyma (e.g., modulation of neurophysiological properties and maturation of myelination), which causes the abnormality in the functional connectivity of the entire brain network. Due to the vulnerability, such dysfunction may occur in developing brains as well as in senile or neurodegenerative diseases and may raise the risk of emergence of psychosis symptoms. Here, we introduce this hypothesis with a series of studies and cellular mechanisms.
Collapse
Affiliation(s)
- Kohei Segawa
- Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8397, Japan; (K.S.); (Y.Y.)
| | - Yukari Blumenthal
- Urology Department at Cambridge University Hospitals, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road Cambridge, Cambridge CB2 0QQ, UK;
| | - Yuki Yamawaki
- Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8397, Japan; (K.S.); (Y.Y.)
| | - Gen Ohtsuki
- Department of Drug Discovery Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8397, Japan; (K.S.); (Y.Y.)
| |
Collapse
|