1
|
Stipho F, Malek-Ahmadi M. Meta-Analysis of White Matter Hyperintensity Volume Differences Between APOE ε4 Carriers and Noncarriers. Alzheimer Dis Assoc Disord 2024; 38:208-212. [PMID: 38748617 PMCID: PMC11141236 DOI: 10.1097/wad.0000000000000620] [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: 02/27/2024] [Accepted: 04/07/2024] [Indexed: 05/31/2024]
Abstract
Several studies have suggested that white matter hyperintensity volume (WMHV) is increased among apolipoprotein E (APOE) ε4 carriers while others have reported contradictory findings. Although APOE ε4 carriage is associated with greater AD pathology, it remains unclear whether cerebrovascular damage is also associated with APOE ε4 carriage. The aim of this meta-analysis was to determine whether WMHV is associated with APOE ε4 carrier status. 12 studies that were included yielded a total sample size of 16,738 adult subjects (ε4 carrier n = 4,721; ε4 noncarrier n = 12,017). There were no significant differences in WMHV between ε4 carriers and noncarriers (Hedge's g = 0.07; 95% CI (-0.01 to 0.15), P = 0.09). Subgroup analysis of community-based studies (n = 8) indicated a small effect size where ε4 carriers had greater WMHV relative to noncarriers (Hedge's g = 0.09 95% CI (0.02 to 0.16), P = 0.008). Among clinic-based studies (n = 3) there was no significant difference in WMHV by APOE ε4 carrier status (Hedge's g = -0.09, 95% CI (-0.60 to 0.41), P = 0.70). Observed APOE ε4-associated WMHV differences may be context-dependent and may also be confounded by a lack of standardization for WMHV segmentation.
Collapse
Affiliation(s)
- Faissal Stipho
- University of Arizona College of Medicine-Tucson, Tucson, AZ
| | - Michael Malek-Ahmadi
- Banner Alzheimer’s Institute, Phoenix, AZ
- University of Arizona College of Medicine-Phoenix, Dept. of Biomedical Informatics, Phoenix, AZ
| |
Collapse
|
2
|
Mathewson KJ, Beaton EA, Hobbs D, Hall GBC, Schulkin J, Van Lieshout RJ, Saigal S, Schmidt LA. Brain structure and function in the fourth decade of life after extremely low birth weight: An MRI and EEG study. Clin Neurophysiol 2023; 154:85-99. [PMID: 37595482 DOI: 10.1016/j.clinph.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/27/2023] [Accepted: 06/03/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To examine potential long-term effects of extremely low birth weight (ELBW; ≤ 1000 g) on adult brain structure, brain function, and cognitive-behavioral performance. METHODS A subset of survivors from the prospectively-followed McMaster ELBW Cohort (n = 23, MBW = 816 g) and their peers born at normal birth weight (NBW; ≥ 2500 g; n = 14, MBW = 3361 g) provided T1-weighted magnetic resonance imaging (MRI) brain scans, resting electroencephalographic (EEG) recordings, and behavioral responses to a face-processing task in their early thirties. RESULTS Visual discrimination accuracy for human faces, resting EEG alpha power, and long-distance alpha coherence were lower in ELBW survivors than NBW adults, and volumes of white matter hypointensities (WMH) were higher. Across groups, face-processing performance was correlated positively with posterior EEG spectral power and long-distance alpha and theta coherence, and negatively with WMH. The associations between face-processing scores and parietal alpha power and theta coherence were reduced after adjustment for WMH. CONCLUSIONS Electrocortical activity, brain functional connectivity, and higher-order processing ability may be negatively affected by WMH burden, which is greater in adults born extremely preterm. SIGNIFICANCE Decrements in electrocortical activity and behavioral performance in adult ELBW survivors may be partly explained by increased WMH volumes in this vulnerable population.
Collapse
Affiliation(s)
- Karen J Mathewson
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, New Orleans, LA, USA
| | - Diana Hobbs
- Department of Psychology, University of New Orleans, New Orleans, LA, USA; Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoffrey B C Hall
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| | - Jay Schulkin
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA; Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Louis A Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
3
|
Meade CS, Bell RP, Towe SL, Lascola CD, Al‐Khalil K, Gibson MJ. Cocaine use is associated with cerebral white matter hyperintensities in HIV disease. Ann Clin Transl Neurol 2023; 10:1633-1646. [PMID: 37475160 PMCID: PMC10502656 DOI: 10.1002/acn3.51854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/16/2023] [Accepted: 07/09/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND White matter hyperintensities (WMH), a marker of cerebral small vessel disease and predictor of cognitive decline, are observed at higher rates in persons with HIV (PWH). The use of cocaine, a potent central nervous system stimulant, is disproportionately common in PWH and may contribute to WMH. METHODS The sample included of 110 PWH on antiretroviral therapy. Fluid-attenuated inversion recovery (FLAIR) and T1-weighted anatomical MRI scans were collected, along with neuropsychological testing. FLAIR images were processed using the Lesion Segmentation Toolbox. A hierarchical regression model was run to investigate predictors of WMH burden [block 1: demographics; block 2: cerebrovascular disease (CVD) risk; block 3: lesion burden]. RESULTS The sample was 20% female and 79% African American with a mean age of 45.37. All participants had persistent HIV viral suppression, and the median CD4+ T-cell count was 750. Nearly a third (29%) currently used cocaine regularly, with an average of 23.75 (SD = 20.95) days in the past 90. In the hierarchical linear regression model, cocaine use was a significant predictor of WMH burden (β = .28). WMH burden was significantly correlated with poorer cognitive function (r = -0.27). Finally, higher WMH burden was significantly associated with increased serum concentrations of interferon-γ-inducible protein 10 (IP-10) but lower concentrations of myeloperoxidase (MPO); however, these markers did not differ by COC status. CONCLUSIONS WMH burden is associated with poorer cognitive performance in PWH. Cocaine use and CVD risk independently contribute to WMH, and addressing these conditions as part of HIV care may mitigate brain injury underlying neurocognitive impairment.
Collapse
Affiliation(s)
- Christina S. Meade
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth Carolina27710USA
- Brain Imaging and Analysis CenterDuke University Medical CenterDurhamNorth Carolina27710USA
| | - Ryan P. Bell
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth Carolina27710USA
| | - Sheri L. Towe
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth Carolina27710USA
| | - Christopher D. Lascola
- Brain Imaging and Analysis CenterDuke University Medical CenterDurhamNorth Carolina27710USA
- Department of RadiologyDuke University School of MedicineDurhamNorth Carolina27710USA
| | - Kareem Al‐Khalil
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth Carolina27710USA
| | - Matthew J. Gibson
- Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamNorth Carolina27710USA
| |
Collapse
|
4
|
Morris EP, Turney IC, Palms JD, Zaheed AB, Sol K, Amarante E, Beato J, Chesebro AG, Morales CD, Manly JJ, Brickman AM, Zahodne LB. Racial and ethnic differences in the relationship between financial worry and white matter hyperintensities in Latinx, non-Latinx Black, and non-Latinx White older adults. Neurobiol Aging 2023; 129:149-156. [PMID: 37331245 PMCID: PMC10878173 DOI: 10.1016/j.neurobiolaging.2023.05.008] [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: 05/23/2022] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 06/20/2023]
Abstract
Socioeconomic status (SES) is associated with white matter hyperintensities (WMHs) and contributes to racial and ethnic health disparities. However, traditional measures of SES may not accurately represent individual financial circumstances among non-Latinx Black and Latinx older adults due to longstanding structural inequities. This study examined associations between multiple SES indicators (education, income, subjective financial worry) and WMHs across non-Latinx Black, Latinx, and non-Latinx White older adults in the Washington Heights-Inwood Columbia Aging Project (N = 662). Latinx participants reported the lowest SES and greatest financial worry, while Black participants evidenced the most WMHs. Greater financial worry was associated with higher WMHs volume above and beyond education and income, which were not associated with WMHs. However, this association was only evident among Latinx older adults. These results provide evidence for the minority poverty hypothesis and highlight the need for systemic socioeconomic interventions to alleviate brain health disparities in older adulthood.
Collapse
Affiliation(s)
- Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Indira C Turney
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Ketlyne Sol
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Erica Amarante
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Juliet Beato
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Anthony G Chesebro
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Clarissa D Morales
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
5
|
Kindler C, Upadhyay N, Bendella Z, Dorn F, Keil VC, Petzold GC. Independent and additive contribution of white matter hyperintensities and Alzheimer's disease pathology to basal forebrain cholinergic system degeneration. Neuroimage Clin 2023; 39:103477. [PMID: 37478584 PMCID: PMC10387606 DOI: 10.1016/j.nicl.2023.103477] [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: 02/15/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVES Degeneration of the cholinergic basal forebrain nuclei (CBFN) system has been studied extensively in Alzheimer's disease (AD). White matter hyperintensities are a hallmark of aging as well as a common co-morbidity of AD, but their contribution to CBFN degeneration has remained unclear. Therefore, we explored the influence of white matter hyperintensities within cholinergic subcortical-cortical projection pathways on CBFN volumes and regional gray matter volumes in AD and age- and gender-matched controls. METHODS We analyzed magnetic resonance images (MRI) from 42 patients with AD and 87 age- and gender-matched control subjects. We assessed the white matter hyperintensity burden within the cholinergic projection pathways using the Cholinergic Pathways Hyperintensities Scale (CHIPS), and applied probabilistic anatomical maps for the analysis of CBFN volumes, i.e. the Ch1-3 compartment and the Ch4 cell group (nucleus basalis of Meynert), by diffeomorphic anatomical registration using exponentiated lie algebra analysis of voxel-based morphometry. Using multiple linear regression analyses, we explored correlations between regional gray matter volumes and the extent of white matter hyperintensities or CBFN volumes in both groups. RESULTS In AD, all CBFN volumes were significantly smaller than in controls, and white matter hyperintensity burden within the cholinergic projection pathways was not correlated with CBFN volume. In controls, white matter hyperintensity burden within the cholinergic projection pathways was inversely correlated with CBFN volume when corrected for sex and total intracranial volume, but this correlation was no longer significant after correction for age. Voxel-wise multiple linear regression analyses using threshold-free cluster enhancement revealed that in controls, cholinergic pathway hyperintensities correlated with gray matter loss in perisylvian areas, whereas the were no effects in AD. Moreover, we found that CBFN volumes correlated with distinct regional cortical atrophy patterns in both groups. CONCLUSION Our results indicate that white matter hyperintensities and AD pathology contribute independently but additively to the degeneration of cholinergic basal forebrain structures. Whereas AD is primarily associated with CBFN volume loss, cholinergic degeneration associated with white matter hyperintensities appears to involve disruption of cholinergic cortical projection fibers with less pronounced effects on CBFN volumes.
Collapse
Affiliation(s)
- Christine Kindler
- Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127 Bonn, Germany
| | - Neeraj Upadhyay
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127 Bonn, Germany; Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Zeynep Bendella
- Department of Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Franziska Dorn
- Department of Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Vera C Keil
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, VUmc, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gabor C Petzold
- Division of Vascular Neurology, Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, 53127 Bonn, Germany.
| |
Collapse
|
6
|
Ferris JK, Lo BP, Khlif MS, Brodtmann A, Boyd LA, Liew SL. Optimizing automated white matter hyperintensity segmentation in individuals with stroke. FRONTIERS IN NEUROIMAGING 2023; 2:1099301. [PMID: 37554631 PMCID: PMC10406248 DOI: 10.3389/fnimg.2023.1099301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/15/2023] [Indexed: 08/10/2023]
Abstract
White matter hyperintensities (WMHs) are a risk factor for stroke. Consequently, many individuals who suffer a stroke have comorbid WMHs. The impact of WMHs on stroke recovery is an active area of research. Automated WMH segmentation methods are often employed as they require minimal user input and reduce risk of rater bias; however, these automated methods have not been specifically validated for use in individuals with stroke. Here, we present methodological validation of automated WMH segmentation methods in individuals with stroke. We first optimized parameters for FSL's publicly available WMH segmentation software BIANCA in two independent (multi-site) datasets. Our optimized BIANCA protocol achieved good performance within each independent dataset, when the BIANCA model was trained and tested in the same dataset or trained on mixed-sample data. BIANCA segmentation failed when generalizing a trained model to a new testing dataset. We therefore contrasted BIANCA's performance with SAMSEG, an unsupervised WMH segmentation tool available through FreeSurfer. SAMSEG does not require prior WMH masks for model training and was more robust to handling multi-site data. However, SAMSEG performance was slightly lower than BIANCA when data from a single site were tested. This manuscript will serve as a guide for the development and utilization of WMH analysis pipelines for individuals with stroke.
Collapse
Affiliation(s)
- Jennifer K. Ferris
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
| | - Bethany P. Lo
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Mohamed Salah Khlif
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Amy Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Lara A. Boyd
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sook-Lei Liew
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
- Department of Neurology, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
7
|
Association between Serum Amyloid A Level and White Matter Hyperintensity Burden: a Cross-Sectional Analysis in Patients with Acute Ischemic Stroke. Neurol Ther 2022; 12:161-175. [PMID: 36374429 PMCID: PMC9837367 DOI: 10.1007/s40120-022-00415-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION This work aimed to determine the potential link between white matter hyperintensity (WMH) burden and serum amyloid A (SAA) level in patients with acute ischemic stroke. METHODS Consecutive patients with acute large artery atherosclerosis (LAA) stroke between April 2021 and May 2022 were included. WMH volumes (periventricular, deep, and total) were measured using the Fazekas score and a semiautomated volumetric analysis on fluid-attenuated inversion recovery-magnetic resonance imaging. The burdens of WMH were scored to assess the dose-dependent association between SAA and WMH volume. Multivariate regression and a two-piecewise linear regression model were used to evaluate whether SAA levels are an independent predictor of WMH, and to discover the threshold effect or saturation effect of SAA levels with respect to WMH volume. RESULTS The mean age of patients was 63.2 ± 11.5 years, with 65.9% men. The median SAA level was 3.93 mg/L and the total WMH volume of 6.86 cm3. In the multivariable analysis, SAA remained an independent predictor of total WMH volume [β = 0.82, 95% confidence interval (CI) = 0.49-1.07, p < 0.001], periventricular WMH volume (adjusted β = 0.76, 95% CI = 0.46-1.07, p < 0.001), and deep WMH volume (adjusted β = 0.26, 95% CI = 0.06-0.45, p = 0.011) after controlling for confounders. Furthermore, SAA levels were associated with periventricular Fazekas score, deep Fazekas score, and Fazekas grades. Threshold effect and saturation effect analyses demonstrated a nonlinear relationship between SAA levels and periventricular white matter hyperintensity (PVWMH) volumes, with SAA levels (2.12-19.89 mg/L) having significant dose-dependent relationships with periventricular WMH volumes (adjusted β = 1.98, 95% CI = 1.12-2.84, p < 0.001). CONCLUSION SAA level ranging from 2.12 to 19.89 mg/L is dose-dependently associated with periventricular WMH development. These findings point the way forward for future research into the pathophysiology of WMH.
Collapse
|
8
|
Langner SM, Terheyden JH, Geerling CF, Kindler C, Keil VCW, Turski CA, Turski GN, Behning C, Wintergerst MWM, Petzold GC, Finger RP. Structural retinal changes in cerebral small vessel disease. Sci Rep 2022; 12:9315. [PMID: 35662264 PMCID: PMC9166694 DOI: 10.1038/s41598-022-13312-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/16/2022] [Indexed: 01/11/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is an important contributor to cognitive impairment and stroke. Previous research has suggested associations with alterations in single retinal layers. We have assessed changes of all individual retinal layers in CSVD using high-resolution optical coherence tomography (OCT) for the first time. Subjects with recent magnetic resonance imaging (MRI) underwent macular and peripapillary retinal imaging using OCT for this case-control study. Number and volume ratio index (WMRI) of white matter lesions (WML) were determined on MRI. Data were analyzed using multiple linear regression models. 27 CSVD patients and 9 control participants were included. Ganglion cell layer (GCL) volume was significantly reduced in patients with CSVD compared to age-matched controls (p = 0.008). In patients with CSVD, larger foveal outer plexiform layer (OPL) volume and decreased temporal peripapillary retinal nerve fiber layer (RNFL) thickness were significantly associated with a higher WMRI in linear regression when controlling for age (p ≤ 0.033). Decreased foveal GCL volume and temporal-inferior RNFL thickness at Bruch's membrane opening (MRW), and increased temporal MRW were associated with a higher WML burden (p ≤ 0.037). Thus, we identified alterations in several OCT layers in individuals with CSVD (GCL, OPL, MRW and RNFL). Their potential diagnostic value merits further study.
Collapse
Affiliation(s)
- S Magdalena Langner
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Jan H Terheyden
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Clara F Geerling
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany
| | - Christine Kindler
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Vera C W Keil
- Department of Radiology, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Christopher A Turski
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Gabrielle N Turski
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Charlotte Behning
- Institute of Biomedical Statistics, Computer Science and Epidemiology, University Hospital Bonn, Bonn, Germany
| | | | - Gabor C Petzold
- Department of Neurology, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Division of Vascular Neurology, University Hospital Bonn, Bonn, Germany
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.
| |
Collapse
|
9
|
Öcal S, Öcal R, Suna N. Relationship between Helicobacter pylori infection and white matter lesions in patients with migraine. BMC Neurol 2022; 22:187. [PMID: 35597897 PMCID: PMC9123779 DOI: 10.1186/s12883-022-02715-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background/aim White matter lesions (WML) are more frequently observed in migraine patients than in the average population. Associations between Helicobacter pylori (H. pylori) infection and different extraintestinal pathologies have been identified. Here, we aimed to investigate the association between H. pylori infection and WML in patients diagnosed with episodic migraine. Materials and methods A retrospective study was conducted with 526 subjects with a diagnosis of episodic migraine. Hyperintensity of WML had been previously evaluated in these patients with brain magnetic resonance imaging (MRI) examinations. Previous endoscopic gastric biopsy histopathological examination of the same patients and reports on H. pylori findings were recorded. The demographic characteristics of the patients, such as age, gender and chronic systemic diseases such as hypertension and diabetes mellitus (DM) were recorded. Statistical evaluation was made. Results Evaluation was made among 526 migraine patients who met the inclusion criteria, comprising 397 (75.5%) females and 129 (24.5%) males with a mean age of 45.57 ± 13.46 years (range, 18–69 years). WML was detected on brain MRI in 178 (33.8%) patients who were also positive for H. pylori (p < 0.05). Subjects who are H. pylori-positive with migraine, WML were observed at a 2.5-fold higher incidence on brain MRI (odds ratio: 2.562, 95% CI 1.784–3.680). WML was found to be more significant in patients with hypertension and migraine than those without (p < 0.001). Older age was also found to be associated with WML (OR = 1.07, 95% CI: 0.01–0.04, p < 0.001). The age (p < 0.001), H. pylori (p < 0.001), hypertension (p < 0.001), and hypertension + DM (p < 0.05), had significant associations in predicting WML according to the multivariate logistic regression analysis. The presence of hypertension had a higher odds ratio value than the other variables. Conclusion It was concluded that H. pylori infection, as a chronic infection, can be considered a risk factor in developing WML in subjects with migraine. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02715-0.
Collapse
Affiliation(s)
- Serkan Öcal
- Department of Gastroenterology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.
| | - Ruhsen Öcal
- Antalya Training and Research Hospital Department of Neurology, Antalya, Turkey
| | - Nuretdin Suna
- Department of Gastroenterology, Faculty of Medicine, Başkent University, Ankara, Turkey
| |
Collapse
|
10
|
Ong K, Young DM, Sulaiman S, Shamsuddin SM, Mohd Zain NR, Hashim H, Yuen K, Sanders SJ, Yu W, Hang S. Detection of subtle white matter lesions in MRI through texture feature extraction and boundary delineation using an embedded clustering strategy. Sci Rep 2022; 12:4433. [PMID: 35292654 PMCID: PMC8924181 DOI: 10.1038/s41598-022-07843-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
White matter lesions (WML) underlie multiple brain disorders, and automatic WML segmentation is crucial to evaluate the natural disease course and effectiveness of clinical interventions, including drug discovery. Although recent research has achieved tremendous progress in WML segmentation, accurate detection of subtle WML present early in the disease course remains particularly challenging. Here we propose an approach to automatic WML segmentation of mild WML loads using an intensity standardisation technique, gray level co-occurrence matrix (GLCM) embedded clustering technique, and random forest (RF) classifier to extract texture features and identify morphology specific to true WML. We precisely define their boundaries through a local outlier factor (LOF) algorithm that identifies edge pixels by local density deviation relative to its neighbors. The automated approach was validated on 32 human subjects, demonstrating strong agreement and correlation (excluding one outlier) with manual delineation by a neuroradiologist through Intra-Class Correlation (ICC = 0.881, 95% CI 0.769, 0.941) and Pearson correlation (r = 0.895, p-value < 0.001), respectively, and outperforming three leading algorithms (Trimmed Mean Outlier Detection, Lesion Prediction Algorithm, and SALEM-LS) in five of the six established key metrics defined in the MICCAI Grand Challenge. By facilitating more accurate segmentation of subtle WML, this approach may enable earlier diagnosis and intervention.
Collapse
Affiliation(s)
- Kokhaur Ong
- Bioinformatics Institute, A*STAR, Singapore, Singapore.,Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore
| | - David M Young
- Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore.,Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Sarina Sulaiman
- School of Computing, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
| | | | | | - Hilwati Hashim
- Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Kahhay Yuen
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Stephan J Sanders
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Weimiao Yu
- Bioinformatics Institute, A*STAR, Singapore, Singapore. .,Institute of Molecular and Cell Biology, A*STAR, Singapore, Singapore. .,Computational Digital Pathology Laboratory, Bioinformatics Institute (BII), 30 Biopolis Street, #07-46 Matrix, Singapore, 138671, Singapore.
| | - Seepheng Hang
- Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, UTM Skudai, 81310, Johor, Malaysia.
| |
Collapse
|
11
|
Having a stimulating lifestyle is associated with maintenance of white matter integrity with age. Brain Imaging Behav 2022; 16:1392-1399. [PMID: 35038111 PMCID: PMC9107451 DOI: 10.1007/s11682-021-00620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/01/2022]
Abstract
Brain maintenance refers to the fact that some older adults experience few age-related changes in the brain, which helps maintain their cognition. The goal of this study was to assess maintenance of white matter integrity by testing whether reserve proxies, measuring factors associated to a stimulating lifestyle, affect the maintenance of white matter integrity. Another goal was to measure whether maintenance of white matter integrity explains inter-individual differences in working memory (WM). Forty-one cognitively healthy older adults received a structural magnetic resonance imaging (MRI) examination to measure white matter lesions. They completed an n-back WM task with different loads (1- & 2-back), along with a questionnaire on their lifestyle. There was a positive association between age and volume of white matter lesions. This association was no longer found in those with higher scores on reserve proxies. In addition, smaller volumes of white matter lesions were associated with better performance than expected for age in the 1-back WM task. Better WM is associated with the maintenance of white matter integrity in older adults, which in turn is linked to measures reflecting a stimulating lifestyle throughout life.
Collapse
|
12
|
Igwe KC, Lao PJ, Vorburger RS, Banerjee A, Rivera A, Chesebro A, Laing K, Manly JJ, Brickman AM. Automatic quantification of white matter hyperintensities on T2-weighted fluid attenuated inversion recovery magnetic resonance imaging. Magn Reson Imaging 2022; 85:71-79. [PMID: 34662699 PMCID: PMC8818099 DOI: 10.1016/j.mri.2021.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/20/2021] [Accepted: 10/12/2021] [Indexed: 01/03/2023]
Abstract
White matter hyperintensities (WMH) are areas of increased signal visualized on T2-weighted fluid attenuated inversion recovery (FLAIR) brain magnetic resonance imaging (MRI) sequences. They are typically attributed to small vessel cerebrovascular disease in the context of aging. Among older adults, WMH are associated with risk of cognitive decline and dementia, stroke, and various other health outcomes. There has been increasing interest in incorporating quantitative WMH measurement as outcomes in clinical trials, observational research, and clinical settings. Here, we present a novel, fully automated, unsupervised detection algorithm for WMH segmentation and quantification. The algorithm uses a robust preprocessing pipeline, including brain extraction and a sample-specific mask that incorporates spatial information for automatic false positive reduction, and a half Gaussian mixture model (HGMM). The method was evaluated in 24 participants with varying degrees of WMH (4.9-78.6 cm3) from a community-based study of aging and dementia with dice coefficient, sensitivity, specificity, correlation, and bias relative to the ground truth manual segmentation approach performed by two expert raters. Results were compared with those derived from commonly used available WMH segmentation packages, including SPM lesion probability algorithm (LPA), SPM lesion growing algorithm (LGA), and Brain Intensity AbNormality Classification Algorithm (BIANCA). The HGMM algorithm derived WMH values that had a dice score of 0.87, sensitivity of 0.89, and specificity of 0.99 compared to ground truth. White matter hyperintensity volumes derived with HGMM were strongly correlated with ground truth values (r = 0.97, p = 3.9e-16), with no observable bias (-1.1 [-2.6, 0.44], p-value = 0.16). Our novel algorithm uniquely uses a robust preprocessing pipeline and a half-Gaussian mixture model to segment WMH with high agreement with ground truth for large scale studies of brain aging.
Collapse
Affiliation(s)
- Kay C. Igwe
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Patrick J. Lao
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Robert S. Vorburger
- Institute of Applied Simulation, School of Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, 8820, Switzerland
| | - Arit Banerjee
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Andres Rivera
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Anthony Chesebro
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Krystal Laing
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Jennifer J. Manly
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA
| | - Adam M. Brickman
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY, 10032 USA.,Corresponding author Adam M. Brickman, PhD, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, PS Box 16, 630 West 168th Street, New York, NY 10032, Tel: 212 342 1348, Fax: 212 342 1838,
| |
Collapse
|
13
|
Hijazi Z, Yassi N, O'Brien JT, Watson R. The influence of cerebrovascular disease in dementia with Lewy bodies and Parkinson's disease dementia. Eur J Neurol 2021; 29:1254-1265. [PMID: 34923713 DOI: 10.1111/ene.15211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Lewy body dementia (LBD), including dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is a common form of neurodegenerative dementia. The frequency and influence of comorbid cerebrovascular disease is not understood but has potentially important clinical management implications. METHODS A systematic literature search was conducted (Medline and Embase) for studies including participants with DLB and/or PDD assessing cerebrovascular lesions (imaging and pathological studies). They included white matter changes, cerebral amyloid angiopathy (CAA), cerebral microbleeds (CMB), macroscopic infarcts, micro-infarcts and intracerebral haemorrhage. RESULTS Of 4411 articles, 63 studies were included. Cerebrovascular lesions commonly studied included white matter changes (41 studies) and CMB (18 studies). There was an increased severity of white matter changes on magnetic resonance imaging (visualized as white matter hyperintensities, WMH), but not neuropathology, in LBD compared to PD without dementia and age-matched controls. CMB prevalence in DLB was highly variable but broadly similar to Alzheimer's disease (AD) (0-48%), with a lobar predominance. No relationship was found between large cortical or small subcortical infarcts or intracerebral haemorrhage and presence of LBD. CONCLUSION The underlying mechanisms of WMH in LBD require further exploration, as their increased severity in LBD was not supported by neuropathological examination of white matter. CMB in LBD had a similar prevalence as AD. There is a need for larger studies assessing the influence of cerebrovascular lesions on clinical symptoms, disease progression and outcomes.
Collapse
Affiliation(s)
- Zina Hijazi
- Monash University School of Rural Health, Bendigo Hospital, Bendigo, VIC, Australia.,Department of Medicine, Bendigo Hospital, Bendigo, VIC, Australia
| | - Nawaf Yassi
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QC, UK
| | - Rosie Watson
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.,Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| |
Collapse
|
14
|
Farag S, Kenawy FF, Shokri HM, Zakaria M, Aref H, Fahmi N, Khayat N, Shalash A, Nahas NE. The Clinical Characteristics of Patients with Pre-Existing Leukoaraiosis Compared to Those Without Leukoaraiosis in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2021; 30:105956. [PMID: 34217070 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105956] [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: 04/27/2021] [Accepted: 06/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Leukoaraiosis (LA) is a finding in the elderly, that might be asymptomatic or can impact their motor and cognitive functions. We studied the presence of LA in the MRI of patients with AIS and its impact on functional outcome at 3 months. METHODS 500 consecutive patients diagnosed as AIS were enrolled. Medical history included pre-medication by antiplatelets or statins, and vascular risk factors were reported by history and laboratory investigations. Severity of stroke was assessed by NIHSS and stroke outcome was evaluated on discharge and at 3 months by modified Rankin scale (mRS). LA was diagnosed by MRI-FLAIR sequence and delineated from acute infarction by diffusion-weighted image. And accordingly, patients were divided into group A (absent LA) and group B (present LA). RESULTS 460 patients completed the study, with 53% of patients on antiplatelet therapy and 11.7% on statins prior to stroke. The percentage of patients with LA was significantly more than those without LA. Patients with LA showed a significantly higher age, more frequent and longer duration of diabetes and hypertension, ischemic heart disease, previous stroke/TIA and antiplatelet intake. Microbleeds were more and mRS was worse in LA group. CONCLUSION The presence of LA in the background MRI of AIS patients is accompanied by the presence of more risk factors, and unfavorable outcome. Pre-medication with antiplatelets did not prevent the incidence of a new stroke especially in LA group. This might necessitate the identification of some medication for secondary prevention in patients with small vessel disease.
Collapse
Affiliation(s)
- Sherine Farag
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Hossam M Shokri
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Magd Zakaria
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hany Aref
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nagia Fahmi
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Naglaa Khayat
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ali Shalash
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nevine El Nahas
- Neurology dep., Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
15
|
Nichols JB, Malek-Ahmadi M, Tariot PN, Serrano GE, Sue LI, Beach TG. Vascular Lesions, APOE ε4, and Tau Pathology in Alzheimer Disease. J Neuropathol Exp Neurol 2021; 80:240-246. [PMID: 33617650 PMCID: PMC7899190 DOI: 10.1093/jnen/nlaa160] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We sought to determine the associations among cerebral amyloid angiopathy (CAA), white matter rarefaction (WMR), circle of Willis atherosclerosis (CWA), and total microinfarct number with Braak neurofibrillary stage in postmortem individuals with and without Alzheimer disease (AD). Data from 355 cases of autopsied individuals with Braak stage I-VI who had antemortem consensus diagnoses of cognitively unimpaired (n = 183), amnestic mild cognitive impairment (n = 31), and AD dementia (n = 141) were used. The association between Braak stage and vascular lesions were individually assessed using multivariable linear regression that adjusted for age at death, APOE ε4 carrier status, sex, education, and neuritic plaque density. CAA (p = 0.007) and WMR (p < 0.001) were associated with Braak stage, independent of amyloid load; microinfarct number and CWA showed no association. Analyses of the interactions between APOE ε4 carrier status and vascular lesions found that greater WMR and positive ε4 carrier status were associated with higher Braak stages. These results suggest that CAA and WMR are statistically linked to the severity of AD-related NFT pathology. The statistical link between WMR and NFT load may be strengthened by the presence of APOE ε4 carrier status. An additional finding was that Lewy body pathology was most prevalent in higher Braak stages.
Collapse
Affiliation(s)
- Jodie B Nichols
- From the Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona, USA
| | | | | | - Geidy E Serrano
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
16
|
Reas ET, Laughlin GA, Hagler DJ, Lee RR, Dale AM, McEvoy LK. Age and Sex Differences in the Associations of Pulse Pressure With White Matter and Subcortical Microstructure. Hypertension 2021; 77:938-947. [PMID: 33461315 DOI: 10.1161/hypertensionaha.120.16446] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Midlife vascular disease increases risk for dementia and effects of vascular dysfunction on brain health differ between men and women. Elevated pulse pressure, a surrogate for arterial stiffness, contributes to cerebrovascular pathology and white matter damage that may advance cognitive aging; however, it remains unclear how associations between pulse pressure and neural integrity differ by sex and age. This study used restriction spectrum imaging to examine associations between pulse pressure and brain microstructure in community-dwelling women (N=88) and men (N=55), aged 56 to 97 (mean, 76.3) years. Restricted isotropic (presumed intracellular), hindered isotropic (presumed extracellular), neurite density, and free water diffusion were computed in white matter tracts and subcortical regions. After adjustment for age and sex, higher pulse pressure correlated with lower restricted isotropic diffusion in global white matter, with more pronounced associations in parahippocampal cingulum, as well as in thalamus and hippocampus. Subgroup analyses demonstrated stronger correlations between pulse pressure and restricted isotropic diffusion in association fibers for participants ≤75 years than for older participants, with stronger effects for women than men of this age group. Microstructure in parahippocampal cingulum and thalamus differed by pulse pressure level regardless of antihypertensive treatment. Increased pulse pressure may lead to widespread injury to white matter and subcortical structures, with greatest vulnerability for women in late middle to early older age. Restriction spectrum imaging could be useful for monitoring microstructural changes indicative of neuronal loss or shrinkage, demyelination, or inflammation that accompany age-related cerebrovascular dysfunction.
Collapse
Affiliation(s)
- Emilie T Reas
- From the Department of Neurosciences (E.T.R., A.M.D.), University of California, San Diego
| | - Gail A Laughlin
- Department of Family Medicine and Public Health (G.A.L., L.K.M.), University of California, San Diego
| | - Donald J Hagler
- Department of Radiology (D.J.H., R.R.L., A.M.D., L.K.M.), University of California, San Diego
| | - Roland R Lee
- Department of Radiology (D.J.H., R.R.L., A.M.D., L.K.M.), University of California, San Diego.,Radiology Services, VA San Diego Healthcare System (R.R.L.)
| | - Anders M Dale
- From the Department of Neurosciences (E.T.R., A.M.D.), University of California, San Diego.,Department of Radiology (D.J.H., R.R.L., A.M.D., L.K.M.), University of California, San Diego
| | - Linda K McEvoy
- Department of Family Medicine and Public Health (G.A.L., L.K.M.), University of California, San Diego.,Department of Radiology (D.J.H., R.R.L., A.M.D., L.K.M.), University of California, San Diego
| |
Collapse
|
17
|
Litak J, Mazurek M, Kulesza B, Szmygin P, Litak J, Kamieniak P, Grochowski C. Cerebral Small Vessel Disease. Int J Mol Sci 2020; 21:ijms21249729. [PMID: 33419271 PMCID: PMC7766314 DOI: 10.3390/ijms21249729] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/15/2020] [Accepted: 12/17/2020] [Indexed: 01/18/2023] Open
Abstract
Cerebral small vessel disease (CSVD) represents a cluster of various vascular disorders with different pathological backgrounds. The advanced vasculature net of cerebral vessels, including small arteries, capillaries, arterioles and venules, is usually affected. Processes of oxidation underlie the pathology of CSVD, promoting the degenerative status of the epithelial layer. There are several classifications of cerebral small vessel diseases; some of them include diseases such as Binswanger’s disease, leukoaraiosis, cerebral microbleeds (CMBs) and lacunar strokes. This paper presents the characteristics of CSVD and the impact of the current knowledge of this topic on the diagnosis and treatment of patients.
Collapse
Affiliation(s)
- Jakub Litak
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
- Department of Immunology, Medical University of Lublin, 20-093 Lublin, Poland
- Correspondence:
| | - Marek Mazurek
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Bartłomiej Kulesza
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Paweł Szmygin
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Joanna Litak
- St. John’s Cancer Center in Lublin, 20-090 Lublin, Poland;
| | - Piotr Kamieniak
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland; (M.M.); (B.K.); (P.S.); (P.K.)
| | - Cezary Grochowski
- Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
- Laboratory of Virtual Man, Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland
| |
Collapse
|
18
|
Liu Y, Wu L, Yang C, Xian W, Zheng Y, Zhang C, Hong G, Jiang L, Yang Z, Pei Z, Liu J, Chen L. The white matter hyperintensities within the cholinergic pathways and cognitive performance in patients with Parkinson's disease after bilateral STN DBS. J Neurol Sci 2020; 418:117121. [PMID: 32950863 DOI: 10.1016/j.jns.2020.117121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND White matter hyperintensities (WMHs) in the cholinergic pathways are associated with cognitive impairment in Parkinson's disease (PD). This study aimed to investigate the role of WMHs within the cholinergic pathways in cognitive performance following bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with PD. METHODS 38 patients with PD who underwent bilateral STN DBS were assessed using the Cholinergic Pathways Hyperintensities Scale (CHIPS) with magnetic resonance imaging before surgery. Their cognitive statuses were evaluated pre-surgically and 6 months, 1 year, and 2 years post operation. The correlations between the CHIPS score and cognitive performance were analyzed. The differences in cognitive performance before and after the surgery between the high-CHIPS and low-CHIPS groups were also compared. RESULTS The CHIPS score in patients with PD negatively correlated with the general cognition assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) both at baseline and after DBS. No correlation was found between the CHIPS score and the change of MMSE and MoCA scores after DBS. No significant difference was observed in the change in cognitive performance after the surgery between the high and low-CHIPS groups. CONCLUSION The severity of cholinergic WMHs was correlated with the cognition in patients with PD both before and after the STN DBS. However, it does not correlate with the cognitive change in patients with PD after bilateral STN-DBS.
Collapse
Affiliation(s)
- Yanmei Liu
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Lei Wu
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Chao Yang
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Wenbiao Xian
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Yifan Zheng
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Caixia Zhang
- School of Public Health, Sun Yat-sen University, North Campus, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Guixun Hong
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Lulu Jiang
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Zhiyun Yang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China
| | - Zhong Pei
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China
| | - Jinlong Liu
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
| | - Ling Chen
- Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China.
| |
Collapse
|
19
|
Garnier-Crussard A, Bougacha S, Wirth M, André C, Delarue M, Landeau B, Mézenge F, Kuhn E, Gonneaud J, Chocat A, Quillard A, Ferrand-Devouge E, de La Sayette V, Vivien D, Krolak-Salmon P, Chételat G. White matter hyperintensities across the adult lifespan: relation to age, Aβ load, and cognition. ALZHEIMERS RESEARCH & THERAPY 2020; 12:127. [PMID: 33032654 PMCID: PMC7545576 DOI: 10.1186/s13195-020-00669-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
Background White matter hyperintensities (WMH) are very frequent in older adults and associated with worse cognitive performance. Little is known about the links between WMH and vascular risk factors, cortical β-amyloid (Aβ) load, and cognition in cognitively unimpaired adults across the entire lifespan, especially in young and middle-aged adults. Methods One hundred and thirty-seven cognitively unimpaired adults from the community were enrolled (IMAP cohort). Participants underwent (i) a comprehensive neuropsychological assessment of episodic memory, processing speed, working memory, and executive functions; (ii) brain structural T1 and FLAIR MRI scans used for the automatic segmentation of total and regional (frontal, parietal, temporal, occipital, and corpus callosum) WMH; and (iii) a Florbetapir-PET scan to measure cortical Aβ. The relationships of total and regional WMH to age, vascular risk factors, cortical Aβ, and cognition were assessed within the whole sample, but also splitting the sample in two age groups (≤ or > 60 years old). Results WMH increased with age across the adult lifespan, i.e., even in young and middle-aged adults. Systolic blood pressure, diastolic blood pressure, and glycated hemoglobin were all associated with higher WMH before, but not after, adjusting for age and the other vascular risk factors. Higher frontal, temporal, and occipital WMH were associated with greater Aβ, but this association was no longer significant when adjusting for age and vascular risk factors. Higher total and frontal WMH were associated with worse performance in executive functions, with no interactive effect of the age group. In contrast, there was a significant interaction of the age group on the link between WMH and working memory, which was significant within the subgroup of young/middle-aged adults only. Adding cortical Aβ load in the models did not alter the results, and there was no interaction between WMH and Aβ on cognition. Conclusion WMH increased with age and were associated with worse executive functions across the adult lifespan and with worse working memory in young/middle-aged adults. Aβ load was weakly associated with WMH and did not change the relationship found between WMH and executive functions. This study argues for the clinical relevance of WMH across the adult lifespan, even in young and middle-aged adults with low WMH.
Collapse
Affiliation(s)
- Antoine Garnier-Crussard
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Charpennes Hospital, Hospices Civils de Lyon, Lyon, France.,Claude Bernard University Lyon 1, Lyon, France
| | - Salma Bougacha
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Claire André
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Marion Delarue
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Brigitte Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Florence Mézenge
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Elizabeth Kuhn
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Julie Gonneaud
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Anne Chocat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Anne Quillard
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Eglantine Ferrand-Devouge
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Department of General Practice, Normandie Univ, UNIROUEN, Rouen, France.,Rouen University Hospital, Inserm CIC-CRB 1404, F-76 000, Rouen, France
| | - Vincent de La Sayette
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France.,Department of Neurology, CHU de Caen, Caen, France
| | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.,Department of Clinical Research, CHU de Caen, Caen, France
| | - Pierre Krolak-Salmon
- Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Charpennes Hospital, Hospices Civils de Lyon, Lyon, France.,Claude Bernard University Lyon 1, Lyon, France.,Lyon Neuroscience Research Centre, INSERM 1028, CNRS 5292, Lyon, France
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France.
| |
Collapse
|
20
|
Al‐Khazraji BK, Badrov MB, Kadem M, Lingum NR, Birmingham TB, Shoemaker JK. Exploring Cerebrovascular Function in Osteoarthritis: "Heads-up". Physiol Rep 2019; 7:e14212. [PMID: 31660705 PMCID: PMC6817995 DOI: 10.14814/phy2.14212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/26/2019] [Accepted: 07/30/2019] [Indexed: 11/24/2022] Open
Abstract
Individuals with osteoarthritis (OA) are at greater risk of cardiovascular and cerebrovascular incidents; yet, cerebrovascular control remains uncharacterized. Our primary outcome was to acquire cerebrovascular control metrics in patients with OA and compare measures to healthy control adults (CTL) without OA or cardiovascular complications. Our primary covariate was a 10-year risk factor for cardiovascular and stroke incidents, and secondary covariates were other cardiovascular disease risk factors (i.e., body mass index, carotid intima media thickness, and brachial flow-mediated dilation). Our secondary outcomes were to assess anatomical and functional changes that may be related to cerebrovascular reactivity were also acquired such as white matter lesion volume and brief cognitive assessments. In 25 adults (n = 13 CTL, n = 12 OA), under hypercapnia, magnetic resonance imaging (3T) was used to acquire a "Global Cerebrovascular Reactivity" index across the larger intracranial cerebral arteries and white matter lesions, and transcranial Doppler was used for both middle cerebral artery hemodynamic responses to hypercapnia and to assess autoregulation via a sit-to-stand task. Compared to CTL, OA had lower "Global Cerebrovascular Reactivity" index responses to hypercapnia, autoregulatory responses, and greater white matter lesions (P < 0.05). These differences persisted after covarying for the outlined primary and secondary covariates. Patients with OA, in the absence of known cardiovascular disease, can exhibit pre-clinical and impaired (compared to CTL) peripheral and cerebrovascular control metrics.
Collapse
Affiliation(s)
- Baraa K. Al‐Khazraji
- School of Kinesiology, Faculty of Health SciencesWestern UniversityLondonOntarioCanada
- Bone and Joint InstituteWestern UniversityLondonOntarioCanada
| | - Mark B. Badrov
- School of Kinesiology, Faculty of Health SciencesWestern UniversityLondonOntarioCanada
| | - Mason Kadem
- Brain and Mind InstituteWestern UniversityLondonOntarioCanada
| | - Navena R. Lingum
- School of Kinesiology, Faculty of Health SciencesWestern UniversityLondonOntarioCanada
| | - Trevor B. Birmingham
- School of Physical TherapyFaculty of Health SciencesWestern OntarioLondon, OntarioCanada
- Bone and Joint InstituteWestern UniversityLondonOntarioCanada
| | - Joel Kevin Shoemaker
- School of Kinesiology, Faculty of Health SciencesWestern UniversityLondonOntarioCanada
- Bone and Joint InstituteWestern UniversityLondonOntarioCanada
- Department of Physiology and Pharmacology, Schulich School of Medicine and DentistryWestern UniversityLondonOntarioCanada
| |
Collapse
|
21
|
Jian X, Satizabal CL, Smith AV, Wittfeld K, Bis JC, Smith JA, Hsu FC, Nho K, Hofer E, Hagenaars SP, Nyquist PA, Mishra A, Adams HHH, Li S, Teumer A, Zhao W, Freedman BI, Saba Y, Yanek LR, Chauhan G, van Buchem MA, Cushman M, Royle NA, Bryan RN, Niessen WJ, Windham BG, DeStefano AL, Habes M, Heckbert SR, Palmer ND, Lewis CE, Eiriksdottir G, Maillard P, Mathias RA, Homuth G, Valdés-Hernández MDC, Divers J, Beiser AS, Langner S, Rice KM, Bastin ME, Yang Q, Maldjian JA, Starr JM, Sidney S, Risacher SL, Uitterlinden AG, Gudnason VG, Nauck M, Rotter JI, Schreiner PJ, Boerwinkle E, van Duijn CM, Mazoyer B, von Sarnowski B, Gottesman RF, Levy D, Sigurdsson S, Vernooij MW, Turner ST, Schmidt R, Wardlaw JM, Psaty BM, Mosley TH, DeCarli CS, Saykin AJ, Bowden DW, Becker DM, Deary IJ, Schmidt H, Kardia SLR, Ikram MA, Debette S, Grabe HJ, Longstreth WT, Seshadri S, Launer LJ, Fornage M. Exome Chip Analysis Identifies Low-Frequency and Rare Variants in MRPL38 for White Matter Hyperintensities on Brain Magnetic Resonance Imaging. Stroke 2019; 49:1812-1819. [PMID: 30002152 DOI: 10.1161/strokeaha.118.020689] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background and Purpose- White matter hyperintensities (WMH) on brain magnetic resonance imaging are typical signs of cerebral small vessel disease and may indicate various preclinical, age-related neurological disorders, such as stroke. Though WMH are highly heritable, known common variants explain a small proportion of the WMH variance. The contribution of low-frequency/rare coding variants to WMH burden has not been explored. Methods- In the discovery sample we recruited 20 719 stroke/dementia-free adults from 13 population-based cohort studies within the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, among which 17 790 were of European ancestry and 2929 of African ancestry. We genotyped these participants at ≈250 000 mostly exonic variants with Illumina HumanExome BeadChip arrays. We performed ethnicity-specific linear regression on rank-normalized WMH in each study separately, which were then combined in meta-analyses to test for association with single variants and genes aggregating the effects of putatively functional low-frequency/rare variants. We then sought replication of the top findings in 1192 adults (European ancestry) with whole exome/genome sequencing data from 2 independent studies. Results- At 17q25, we confirmed the association of multiple common variants in TRIM65, FBF1, and ACOX1 ( P<6×10-7). We also identified a novel association with 2 low-frequency nonsynonymous variants in MRPL38 (lead, rs34136221; PEA=4.5×10-8) partially independent of known common signal ( PEA(conditional)=1.4×10-3). We further identified a locus at 2q33 containing common variants in NBEAL1, CARF, and WDR12 (lead, rs2351524; Pall=1.9×10-10). Although our novel findings were not replicated because of limited power and possible differences in study design, meta-analysis of the discovery and replication samples yielded stronger association for the 2 low-frequency MRPL38 variants ( Prs34136221=2.8×10-8). Conclusions- Both common and low-frequency/rare functional variants influence WMH. Larger replication and experimental follow-up are essential to confirm our findings and uncover the biological causal mechanisms of age-related WMH.
Collapse
Affiliation(s)
- Xueqiu Jian
- From the Institute of Molecular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (M.F., X.J.)
| | - Claudia L Satizabal
- Department of Neurology, Boston University School of Medicine, MA (C.L.S., S. Seshadri)
| | - Albert V Smith
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases, Site Rostock/Greifswald, Germany (K.W.)
| | - Joshua C Bis
- Cardiovascular Health Research Unit (B.M.P., J.C.B., S.R.H.)
| | - Jennifer A Smith
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | - Fang-Chi Hsu
- Division of Public Health Sciences (F.-C.H., J.D.)
| | - Kwangsik Nho
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis (K.N., S.L.R.)
| | | | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Paul A Nyquist
- Department of Neurology and Neurosurgery (P.A.N., R.F.G.)
| | - Aniket Mishra
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | | | - Shuo Li
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | | | - Wei Zhao
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | | | - Yasaman Saba
- Institute of Molecular Biology and Biochemistry (H.S., Y.S.), Medical University of Graz, Austria
| | - Lisa R Yanek
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Ganesh Chauhan
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, the Netherlands (M.A.v.B.)
| | - Mary Cushman
- Department of Medicine, The University of Vermont Larner College of Medicine, Burlington (M.C.)
| | - Natalie A Royle
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - R Nick Bryan
- Department of Diagnostic Medicine, Dell Medical School at The University of Texas at Austin (R.N.B.)
| | - Wiro J Niessen
- Departments of Radiology and Medical Informatics (W.J.N.).,Department of Medicine, The University of Mississippi School of Medicine, Jackson (W.J.N.)
| | | | - Anita L DeStefano
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Mohamad Habes
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia (M.H.)
| | | | - Nicholette D Palmer
- Department of Biochemistry (D.W.B., N.D.P.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Cora E Lewis
- Department of Epidemiology, The University of Alabama at Birmingham School of Public Health (C.E.L.)
| | - Gudny Eiriksdottir
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Pauline Maillard
- Department of Neurology, UC Davis School of Medicine (C.S.D., P.M.), CA
| | - Rasika A Mathias
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Georg Homuth
- Institute of Genetics and Functional Genomics, University of Greifswald, Germany (G.H.)
| | - Maria Del C Valdés-Hernández
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | | | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology (S.L.)
| | - Kenneth M Rice
- Department of Biostatistics, University of Washington School of Public Health, Seattle (K.M.R.)
| | - Mark E Bastin
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, MA (A.S.B., A.L.D., Q.Y., S.L.)
| | - Joseph A Maldjian
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas (J.A.M.)
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland (S. Sidney)
| | - Shannon L Risacher
- Center for Neuroimaging, Indiana University School of Medicine, Indianapolis (K.N., S.L.R.)
| | | | - Vilmundur G Gudnason
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | - Matthias Nauck
- Institute for Clinical Chemistry and Laboratory Medicine (M.N.)
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Harbor-UCLA Medical Center, Torrance, CA (J.I.R.)
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis (P.J.S.)
| | - Eric Boerwinkle
- Human Genetics Center, The University of Texas Health Science Center at Houston School of Public Health (E.B.)
| | | | - Bernard Mazoyer
- Neurodegeneratives Diseases Institute-CNRS UMR 5293 (B.M.), University of Bordeaux, France
| | | | | | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (D.L.)
| | - Sigurdur Sigurdsson
- Icelandic Heart Association, Kópavogur, Iceland (A.V.S., G.E., S. Sigurdsson, V.G.G.)
| | | | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (S.T.T.)
| | | | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Bruce M Psaty
- Cardiovascular Health Research Unit (B.M.P., J.C.B., S.R.H.)
| | | | - Charles S DeCarli
- Department of Neurology, UC Davis School of Medicine (C.S.D., P.M.), CA
| | | | - Donald W Bowden
- Department of Biochemistry (D.W.B., N.D.P.), Wake Forest School of Medicine, Winston-Salem, NC
| | - Diane M Becker
- Department of Medicine (D.M.B., L.R.Y., R.A.M.), Johns Hopkins School of Medicine, Baltimore, MD
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, United Kingdom (I.J.D., J.M.W., J.M.S., M.d.C.V.-H., M.E.B., N.A.R., S.P.H.)
| | - Helena Schmidt
- Institute of Molecular Biology and Biochemistry (H.S., Y.S.), Medical University of Graz, Austria
| | - Sharon L R Kardia
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (J.A.S., S.L.R.K., W.Z.)
| | - M Arfan Ikram
- Departments of Epidemiology, Radiology and Neurology (M.A.I.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Stéphanie Debette
- Bordeaux Population Health Research Centre U1219, Inserm, France (A.M., G.C., S.D.)
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy (H.J.G.), University Medicine Greifswald, Germany
| | - W T Longstreth
- Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle, WA
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, MA (C.L.S., S. Seshadri)
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, MD (L.J.L.)
| | - Myriam Fornage
- From the Institute of Molecular Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (M.F., X.J.)
| | | |
Collapse
|
22
|
Fornage M, Beecham AH. The emerging genetic landscape of cerebral white matter hyperintensities. Neurology 2019; 92:355-356. [PMID: 30659142 DOI: 10.1212/wnl.0000000000006936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Myriam Fornage
- From the Institute of Molecular Medicine and Human Genetics Center (M.F.), University of Texas Health Science Center at Houston; and John P. Hussman Institute for Human Genomics (A.H.B.), University of Miami, FL.
| | - Ashley H Beecham
- From the Institute of Molecular Medicine and Human Genetics Center (M.F.), University of Texas Health Science Center at Houston; and John P. Hussman Institute for Human Genomics (A.H.B.), University of Miami, FL
| |
Collapse
|
23
|
Wang J, Liang Y, Chen H, Wang W, Wang Y, Liang Y, Zhang Y. Structural changes in white matter lesion patients and their correlation with cognitive impairment. Neuropsychiatr Dis Treat 2019; 15:1355-1363. [PMID: 31190839 PMCID: PMC6534061 DOI: 10.2147/ndt.s194803] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND White matter lesions (WMLs) play a role in cognitive decline and dementia. Little is known about gray matter (GM) changes in WMLs. This study aimed to investigate GM changes in WML patients. MATERIALS AND METHODS Correlations between altered structural volume and cognitive assessment scores were investigated. GM and white matter (WM) changes in 23 WML-vascular dementia (VaD) patients, 22 WML-non-dementia vascular cognitive impairment (VCIND) patients, and 23 healthy control (HC) subjects were examined. Gray matter density (GMD) was calculated by measuring local proportions of GM at thousands of homologous cortical locations. WM volume was obtained by fully automated software using voxel-based morphometry (VBM). RESULTS Widespread GMD was significantly lower in WML patients compared to control subjects in cortical and subcortical regions (p<0.05). Greatest differences were found in the bilateral anterior cingulate cortex, inferior frontal gyrus, insula, angular gyrus, caudate, precentral gyrus, and right middle temporal gyrus, right thalamus. Secondary region of interest (ROI) analysis indicated significantly greater GMD in the bilateral caudate among WML-VCIND patients (n=22) compared to HCs (p<0.05). There was a significant difference in WM volume between WML patients and control subjects (p<0.05). Greatest differences were located in the genu/body/splenium of the corpus callosum and superior corona radiata L, and posterior corona radiata L. There was a significant association between structural changes and cognitive scores (Montreal Cognitive Assessment [MoCA] score) (p<0.05). There was no significant correlation between structural changes and Mini Mental State Examination (MMSE) scores (p>0.05). CONCLUSION GMD and WM volume were changed in WMLs, and the changes were detectable. Correlation between structural changes and cognitive function was promising in understanding the pathological and physiological mechanisms of WMLs.
Collapse
Affiliation(s)
- Jinfang Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China, .,Department of Neurology, General Hospital of The Yang Tze River Shipping, Wuhan Brain Hospital, Wuhan 430000, China
| | - Yi Liang
- Department of Neurology, General Hospital of The Yang Tze River Shipping, Wuhan Brain Hospital, Wuhan 430000, China
| | - Hongyan Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China,
| | - Wanming Wang
- Department of Neurology, General Hospital of The Yang Tze River Shipping, Wuhan Brain Hospital, Wuhan 430000, China
| | - Yanwen Wang
- Department of Neurology, General Hospital of The Yang Tze River Shipping, Wuhan Brain Hospital, Wuhan 430000, China
| | - Ying Liang
- School of Biomedical Engineering, Capital Medical University, Beijing 100050, China
| | - Yumei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China, .,Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China,
| |
Collapse
|
24
|
Diniz PHB, Valente TLA, Diniz JOB, Silva AC, Gattass M, Ventura N, Muniz BC, Gasparetto EL. Detection of white matter lesion regions in MRI using SLIC0 and convolutional neural network. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 167:49-63. [PMID: 29706405 DOI: 10.1016/j.cmpb.2018.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 02/12/2018] [Accepted: 04/17/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND AND OBJECTIVE White matter lesions are non-static brain lesions that have a prevalence rate up to 98% in the elderly population. Because they may be associated with several brain diseases, it is important that they are detected as soon as possible. Magnetic Resonance Imaging (MRI) provides three-dimensional data with the possibility to detect and emphasize contrast differences in soft tissues, providing rich information about the human soft tissue anatomy. However, the amount of data provided for these images is far too much for manual analysis/interpretation, representing a difficult and time-consuming task for specialists. This work presents a computational methodology capable of detecting regions of white matter lesions of the brain in MRI of FLAIR modality. The techniques highlighted in this methodology are SLIC0 clustering for candidate segmentation and convolutional neural networks for candidate classification. METHODS The methodology proposed here consists of four steps: (1) images acquisition, (2) images preprocessing, (3) candidates segmentation and (4) candidates classification. RESULTS The methodology was applied on 91 magnetic resonance images provided by DASA, and achieved an accuracy of 98.73%, specificity of 98.77% and sensitivity of 78.79% with 0.005 of false positives, without any false positives reduction technique, in detection of white matter lesion regions. CONCLUSIONS It is demonstrated the feasibility of the analysis of brain MRI using SLIC0 and convolutional neural network techniques to achieve success in detection of white matter lesions regions.
Collapse
Affiliation(s)
- Pedro Henrique Bandeira Diniz
- Pontifical Catholic University of Rio de Janeiro - PUC - RioR. São Vicente, 225, Gávea, RJ, Rio de Janeiro, 22453-900, Brazil.
| | - Thales Levi Azevedo Valente
- Pontifical Catholic University of Rio de Janeiro - PUC - RioR. São Vicente, 225, Gávea, RJ, Rio de Janeiro, 22453-900, Brazil.
| | - João Otávio Bandeira Diniz
- Federal University of Maranhão - UFMA Applied Computing Group - NCA Av. dos Portugueses, SN, Bacanga, MA, São Luís, 65085-580, Brazil.
| | - Aristófanes Corrêa Silva
- Federal University of Maranhão - UFMA Applied Computing Group - NCA Av. dos Portugueses, SN, Bacanga, MA, São Luís, 65085-580, Brazil.
| | - Marcelo Gattass
- Pontifical Catholic University of Rio de Janeiro - PUC - RioR. São Vicente, 225, Gávea, RJ, Rio de Janeiro, 22453-900, Brazil.
| | - Nina Ventura
- Paulo Niemeyer State Brain Institute - IECR. Lobo Júnior, 2293, Penha -RJ, 21070-060, Brazil.
| | - Bernardo Carvalho Muniz
- Paulo Niemeyer State Brain Institute - IECR. Lobo Júnior, 2293, Penha -RJ, 21070-060, Brazil.
| | | |
Collapse
|
25
|
Moon C, Bendlin BB, Melah KE, Bratzke LC. The association of sleep-disordered breathing and white matter hyperintensities in heart failure patients. Metab Brain Dis 2018; 33:2019-2029. [PMID: 30218440 PMCID: PMC6408271 DOI: 10.1007/s11011-018-0309-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/26/2018] [Indexed: 01/19/2023]
Abstract
Heart failure patients often manifest white matter hyperintensites on brain magnetic resonance imaging (MRI). White matter hyperintnsities have also been linked with cognitive problems in patients with heart failure. Sleep disordered breathing may contribute to structural brain changes in heart failure. The purpose of this study was to test the extent to which the apnea hypopnea index is associated with global and regional white matter hyperintensities, and is a moderating factor in the relationship between age and white matter hyperintensites. A total of 28 HF patients [mean age (SD) = 67.89 (5.8)] underwent T1-weighted and T2FLAIR MRI and a home sleep monitoring study. The apnea hypopnea index cut off of 10 was used to compare between higher and lower risks of sleep disordered breathing. Regression analysis was used to test the association between apnea hypopnea index and both global and regional white matter hyperintensities. The interaction term was entered to identify the moderation effect. Apnea hypopnea index was associated with higher regional white matter hyperintensities but not global white matter hyperintensities. There was a significant interaction between the apnea hypopnea index and age, such that older participants with the apnea hypopnea index ≥10 showed greater regional white matter hyperintensities than those with the apnea hypopnea index <10. The results of this preliminary study indicate that a higher apnea hypopnea index is associated with more white matter hyperintensities. The age-related white matter hyperintensities appear to be exacerbated by apnea hypopnea index in our individuals with heart failure. Future studies are needed to further investigate the underlying mechanisms.
Collapse
Affiliation(s)
- Chooza Moon
- College of Nursing, University of Iowa, 316 CNB, 50 Newton Rd, Iowa City, IA, 52246, USA.
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI, 53705, USA.
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, J5/1 Mezzanine CSC, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Kelsey E Melah
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI, 53705, USA
| | - Lisa C Bratzke
- School of Nursing, University of Wisconsin-Madison, 701 Highland Ave, Madison, WI, 53705, USA
| |
Collapse
|
26
|
Ren XM, Qiu SW, Liu RY, Wu WB, Xu Y, Zhou H. White Matter Lesions Predict Recurrent Vascular Events in Patients with Transient Ischemic Attacks. Chin Med J (Engl) 2018; 131:130-136. [PMID: 29336359 PMCID: PMC5776841 DOI: 10.4103/0366-6999.222341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: White matter lesions (WMLs) are common findings in brain magnetic resonance imaging (MRI) and are strongly associated with stroke incidence, recurrence, and prognosis. However, the relationship between WMLs and transient ischemic attacks (TIAs) is not well established. This study aimed to determine the clinical significance of WMLs in patients with TIA. Methods: A total of 181 consecutive inpatients with first-ever TIA were enrolled. Brain MRIs within 2 days of symptom onset were used to measure WML volumes. Recurrent vascular events within 1 year of TIA onset were assessed. The relationship between WMLs and recurrent risk of vascular events was determined by a multivariate logistic regression. Results: WMLs were identified in 104 patients (57.5%). Age and ratio of hypertension were significantly different between patients with and without WMLs. The incidence of vascular events in patients with WMLs significantly increased in comparison to those without WMLs (21.15% vs. 5.19%, 95% confidence interval [CI]: 1.18–15.20, P = 0.027) after controlling for confounders. Furthermore, distributions of WML loads were found to be different between patients who developed vascular events and those who did not. WML volumes were demonstrated to be correlated with recurrent risks, and the fourth quartile of WML volumes led to an 8.5-fold elevation of recurrent risk of vascular events compared with the first quartile (95% CI: 1.52–47.65, P = 0.015) after adjusting for hyperlipidemia. Conclusion: WMLs occur frequently in patients with TIA and are associated with the high risk of recurrent vascular events, suggesting a predictive neuroimaging marker for TIA outcomes.
Collapse
Affiliation(s)
- Xiao-Mei Ren
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008; Department of Neurology, Yizheng People's Hospital, Yangzhou, Jiangsu 211400, China
| | - Shu-Wei Qiu
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing, Jiangsu 210008, China
| | - Ren-Yuan Liu
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Wen-Bo Wu
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University; Jiangsu Key Laboratory for Molecular Medicine; Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Hong Zhou
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| |
Collapse
|
27
|
Wei C, Zhang S, Liu J, Yuan R, Liu M. Relationship of cardiac biomarkers with white matter hyperintensities in cardioembolic stroke due to atrial fibrillation and/or rheumatic heart disease. Medicine (Baltimore) 2018; 97:e11892. [PMID: 30113487 PMCID: PMC6112985 DOI: 10.1097/md.0000000000011892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
White matter hyperintensities (WMHs), which are common in elderly people and contribute to age-related disability, can coexist with cardiac injury. It remains unclear whether cardiac biomarkers are associated with WMHs.To investigate this question, we prospectively recruited patients with cardioembolic stroke due to atrial fibrillation (AF) and/or rheumatic heart disease (RHD). Four cardiac biomarkers were measured: myoglobin, high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB, and terminal pro-brain natriuretic peptide. WMHs in periventricular and deep white matter were assessed separately.In the entire sample of 171 patients, 120 (70.2%) presented with WMHs, of whom 18 (10.5%) presented with moderate to severe deep white matter hyperintensities (DWMH) and 55 (32.2%) presented with moderate to severe periventricular hyperintensities (PVH). Risk of moderate to severe PVH, after adjusting for confounders, was 2.460-fold higher in patients with high myoglobin levels than in those with low levels, and the risk was 2.608-fold higher in patients with high hs-cTnT levels than in those with low levels. There were no significant associations between any of the 4 cardiac biomarkers and moderate to severe DWMH.This prospective observational study provides new evidence of the potential relationship of cardiac biomarkers with WMHs in patients with cardioembolic stroke due to AF and/or RHD. We found that elevated myoglobin levels and high hs-TnT levels were independently associated with the presence of moderate to severe PVH. Further studies are required to test our findings and explore whether cardiac biomarkers contribute directly to WMHs pathogenesis.
Collapse
|
28
|
Cardiovascular symptoms and longitudinal declines in processing speed differentially predict cerebral white matter lesions in older adults. Arch Gerontol Geriatr 2018; 78:139-149. [PMID: 29960180 DOI: 10.1016/j.archger.2018.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/16/2018] [Accepted: 06/21/2018] [Indexed: 11/23/2022]
Abstract
It is well established that cerebral white matter lesions (WML), present in the majority of older adults, are associated with cardiovascular and cerebrovascular diseases and also with cognitive decline. However, much less is known about how WML are related to other important individual characteristics and about the generality vs. brain region-specificity of WML. In a longitudinal study of 112 community-dwelling adults (age 50-71 years at study entry), we used a machine learning approach to evaluate the relative strength of 52 variables in association with WML burden. Variables included socio-demographic, lifestyle, and health indices-as well as multiple cognitive abilities (modeled as latent constructs using factor analysis)-repeatedly measured at three- to six-year intervals. Greater chronological age, symptoms of cardiovascular disease, and processing speed declines were most strongly linked to elevated WML burden (accounting for ∼49% of variability in WML). Whereas frontal lobe WML burden was associated both with elevated cardiovascular symptoms and declines in processing speed, temporal lobe WML burden was only significantly associated with declines in processing speed. These latter outcomes suggest that age-related WML-cognition associations may be etiologically heterogeneous across fronto-temporal cerebral regions.
Collapse
|
29
|
Harris S, Kurniawan M, Rasyid A, Mesiano T, Hidayat R. Cerebral small vessel disease in Indonesia: Lacunar infarction study from Indonesian Stroke Registry 2012-2014. SAGE Open Med 2018; 6:2050312118784312. [PMID: 29977554 PMCID: PMC6024285 DOI: 10.1177/2050312118784312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 05/24/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND PURPOSE Stroke is the number one cause of morbidity and mortality in Indonesia. Lacunar infarction is one of cerebral small vessel disease spectrum. This study aimed to present stroke epidemiology in Indonesia and risk factors associated with cerebral small vessel disease. METHODS A multicenter prospective cross-sectional study of 18 hospitals in Indonesia was conducted using Stroke Case Report Form from 2012 to 2014. Stroke was diagnosed based on clinical findings confirmed with non-contrast computed tomography of the brain. Subjects were classified into two large groups: ischemic (lacunar and non-lacunar) and hemorrhagic (intracranial and subarachnoid hemorrhage). Other risk factors were assessed on admission. RESULTS We enrolled 5411 patients, of whom 3627 (67.03%) had ischemic stroke and 1784 (32.97%) had hemorrhagic stroke. Male patients were prevalent in both large groups, although found less in subarachnoid hemorrhage group. Among patients with hemorrhagic stroke, 1603 (89.54%) of them had intracerebral hemorrhage and 181 (10.46%) had subarachnoid hemorrhage. From 3627 ischemic stroke patients, 1635 (45.07%) of them had lacunar infarction. We found that age above 55 years old, male gender, hypertension, dyslipidemia, and diabetes were important risk factors associated with lacunar stroke (p < 0.05). CONCLUSION Ischemic stroke was the leading cause of stroke in Indonesia. In total, 45% of the total ischemic stroke patients had lacunar infarction. Important risk factors associated with lacunar infarction were hypertension, dyslipidemia, diabetes, age over 55, and male population.
Collapse
Affiliation(s)
- Salim Harris
- Department of Neurology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Mohammad Kurniawan
- Department of Neurology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Al Rasyid
- Department of Neurology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Taufik Mesiano
- Department of Neurology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Rakhmad Hidayat
- Department of Neurology, Faculty of Medicine, Universitas Indonesia and Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| |
Collapse
|
30
|
Ten Kate M, Sudre CH, den Braber A, Konijnenberg E, Nivard MG, Cardoso MJ, Scheltens P, Ourselin S, Boomsma DI, Barkhof F, Visser PJ. White matter hyperintensities and vascular risk factors in monozygotic twins. Neurobiol Aging 2018; 66:40-48. [PMID: 29505954 DOI: 10.1016/j.neurobiolaging.2018.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/15/2018] [Accepted: 02/04/2018] [Indexed: 11/16/2022]
Abstract
Cerebral white matter hyperintensities (WMHs) have been associated with vascular risk factors, both of which are under genetic influence. We examined in a monozygotic twin sample whether the association between vascular risk and WMHs is influenced by overlapping genetic factors. We included 195 cognitively normal monozygotic twins (age = 70 ± 7 years), including 94 complete pairs. Regional WMH load was estimated using an automated algorithm. Vascular risk was summarized with the Framingham score. The within-twin pair correlation for total WMHs was 0.76 and for Framingham score was 0.77. Within participants, Framingham score was associated with total and periventricular WMHs (r = 0.32). Framingham score in 1 twin was also associated with total WMHs in the co-twin (r = 0.26). Up to 83% of the relation between both traits could be explained by shared genetic effects. In conclusion, monozygotic twins have highly similar vascular risk and WMH burden, confirming a genetic background for these traits. The association between both traits is largely driven by overlapping genetic factors.
Collapse
Affiliation(s)
- Mara Ten Kate
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
| | - Carole H Sudre
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Anouk den Braber
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Elles Konijnenberg
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Michel G Nivard
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - M Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Sébastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Frederik Barkhof
- Translational Imaging Group, Centre for Medical Image Computing (CMIC), University College London, London, UK; Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center, Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
31
|
Russo A, Silvestro M, Tessitore A, Tedeschi G. Functional Neuroimaging Biomarkers in Migraine: Diagnostic, Prognostic and Therapeutic Implications. Curr Med Chem 2018; 26:6236-6252. [PMID: 29623825 DOI: 10.2174/0929867325666180406115427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND In current migraine clinical practice, conventional neuroimaging examinations are often sought to exclude possible causes of secondary headaches or migraineassociated disorders. Contrariwise, although advanced Magnetic Resonance Imaging (MRI) has improved tremendously our understanding of human brain processes in migraine patients, to the state of the art they have not superseded the conventional neuroimaging techniques in the migraine clinical setting. METHODS A comprehensive review was conducted of PubMed citations by entering the keyword "marker" and/or "biomarker" combined with "migraine" and/or "headache". Other keywords included "imaging" or "neuroimaging", "structural" or "functional". The only restriction was English-language publication. The abstracts of all articles meeting these criteria were reviewed, and the full text was retrieved and examined for relevant references. RESULTS Several authors tried to identify imaging biomarkers able to identify different migraine phenotypes or, even better, to follow-up the same migraine patients during the course of the disease, to predict the evolution into more severe phenotypes and, finally, the response to specific treatment. CONCLUSION The identification of diagnostic, prognostic and therapeutic advanced neuroimaging biomarkers in the migraine clinical setting, in order to approach to patients in a more and more rational and "tailored" way, is extremely intriguing and futuristic. Unfortunately, reliable and robust neuroimaging biomarkers are still lacking for migraine, probably due to both not completely understood pathogenesis and clinical and neuroimaging heterogeneity. Although further longitudinal advanced neuroimaging studies, aimed to identify effective neuroimaging biomarkers, are needed, this review aims to collect the main and most recent works on this topic.
Collapse
Affiliation(s)
- Antonio Russo
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcello Silvestro
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Tessitore
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gioacchino Tedeschi
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Campania "Luigi Vanvitelli", Naples, Italy.,MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy.,Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, Italy
| |
Collapse
|
32
|
David JP, Ferrat E, Parisot J, Naga H, Lakroun S, Menasria F, Saddedine S, Natella PA, Paillaud E, Fromentin I, Bastuji-Garin S. White Matter Lesions: Prevalence and Clinical Phenotype in Asymptomatic Individuals Aged ≥50 Years. Dement Geriatr Cogn Disord 2018; 42:159-168. [PMID: 27649085 DOI: 10.1159/000448991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To assess the prevalence of early confluent/confluent white matter lesions (ec/cWMLs) in asymptomatic individuals aged ≥50 years and to identify associated clinical phenotypes. METHODS Cross-sectional analysis of 141 asymptomatic individuals aged ≥50 years assessed at an outpatient department in France. Brain magnetic resonance imaging was rated using the Fazekas scale. Age-adjusted odds ratios (ORs) and 95% confidence intervals were estimated using logistic models to investigate factors associated with ec/cWMLs; independent risk factors were identified by multivariate analysis. RESULTS Median age was 63 years; 53.9% were women, 32.6% had hypertension, and 76.6% had ≥1 cardiovascular risk factors. The prevalence of ec/cWMLs was 26.2%. Apart from age, independent risk factors were family history of cardiovascular event (OR = 5.55; 1.13-27.32) and hypertension (2.47; 1.05-5.81). Patients with ec/cWMLs had lower cognitive dual-task walking speed (1.15; 0.98-1.40), MMSE (1.41; 1.06-1.89), and FAB scores (5.21; 1.49-19.84). The Scheltens score was independently associated with the WML severity score. CONCLUSION ec/cWMLs are common in asymptomatic community-dwelling individuals aged ≥50 years. They are associated with cardiovascular risk factors, impairments in global and executive cognitive function, and Scheltens score elevation.
Collapse
Affiliation(s)
- Jean-Philippe David
- Université Paris Est (UPEC), IMRB, A-TVB DHU, CEpiA EA 7376 (Clinical Epidemiology and Ageing Unit), Créteil, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Fischer FU, Wolf D, Fellgiebel A. Diaschisis-Like Association of Hippocampal Atrophy and Posterior Cingulate Cortex Hypometabolism in Cognitively Normal Elderly Depends on Impaired Integrity of Parahippocampal Cingulum Fibers. J Alzheimers Dis 2017; 60:1285-1294. [DOI: 10.3233/jad-170147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Florian U. Fischer
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Dominik Wolf
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Andreas Fellgiebel
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | | |
Collapse
|
34
|
Beecham A, Dong C, Wright CB, Dueker N, Brickman AM, Wang L, DeCarli C, Blanton SH, Rundek T, Mayeux R, Sacco RL. Genome-wide scan in Hispanics highlights candidate loci for brain white matter hyperintensities. NEUROLOGY-GENETICS 2017; 3:e185. [PMID: 28975155 PMCID: PMC5619914 DOI: 10.1212/nxg.0000000000000185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/01/2017] [Indexed: 12/22/2022]
Abstract
Objective: To investigate genetic variants influencing white matter hyperintensities (WMHs) in the understudied Hispanic population. Methods: Using 6.8 million single nucleotide polymorphisms (SNPs), we conducted a genome-wide association study (GWAS) to identify SNPs associated with WMH volume (WMHV) in 922 Hispanics who underwent brain MRI as a cross-section of 2 community-based cohorts in the Northern Manhattan Study and the Washington Heights–Inwood Columbia Aging Project. Multiple linear modeling with PLINK was performed to examine the additive genetic effects on ln(WMHV) after controlling for age, sex, total intracranial volume, and principal components of ancestry. Gene-based tests of association were performed using VEGAS. Replication was performed in independent samples of Europeans, African Americans, and Asians. Results: From the SNP analysis, a total of 17 independent SNPs in 7 genes had suggestive evidence of association with WMHV in Hispanics (p < 1 × 10−5) and 5 genes from the gene-based analysis with p < 1 × 10−3. One SNP (rs9957475 in GATA6) and 1 gene (UBE2C) demonstrated evidence of association (p < 0.05) in the African American sample. Four SNPs with p < 1 × 10−5 were shown to affect binding of SPI1 using RegulomeDB. Conclusions: This GWAS of 2 community-based Hispanic cohorts revealed several novel WMH-associated genetic variants. Further replication is needed in independent Hispanic samples to validate these suggestive associations, and fine mapping is needed to pinpoint causal variants.
Collapse
Affiliation(s)
- Ashley Beecham
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Chuanhui Dong
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Clinton B Wright
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Nicole Dueker
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Adam M Brickman
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Liyong Wang
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Charles DeCarli
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Susan H Blanton
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Tatjana Rundek
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Richard Mayeux
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| | - Ralph L Sacco
- John T. McDonald Department of Human Genetics (A.B., L.W., S.H.B., R.L.S.), John P Hussman Institute for Human Genomics (A.B., N.D., L.W., S.H.B.), Evelyn F. McKnight Brain Institute (C.D., C.B.W., T.R., R.L.S.), Department of Neurology (C.D., C.B.W., T.R., R.L.S.), and Department of Epidemiology and Public Health (C.B.W., T.R., R.L.S.), Miller School of Medicine, University of Miami, FL; Gertrude H. Sergievsky Center (A.M.B., R.M.), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (A.M.B., R.M.), and Department of Neurology (A.M.B., R.M.), College of Physicians and Surgeons, Columbia University, New York; and Department of Neurology and Center for Neuroscience (C.D.), University of California at Davis, Sacramento
| |
Collapse
|
35
|
Shan Y, Tan S, Wang Y, Li K, Zhang L, Liao S, Zhou L, Deng Z, Hu X, Li H, Men X, Zhang B, Peng L, Kang Z, Zou Y, Lu Z. Risk Factors and Clinical Manifestations of Juxtacortical Small Lesions: A Neuroimaging Study. Front Neurol 2017; 8:497. [PMID: 29018401 PMCID: PMC5614934 DOI: 10.3389/fneur.2017.00497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/05/2017] [Indexed: 01/16/2023] Open
Abstract
Background and objective White matter hyperintensities can be easily identified by brain imaging. Juxtacortical small lesion (JCSL) is a special type of white matter lesion, defined as no greater than 5 mm in diameter and adjacent to the cerebral cortex in location. We notice lately that JCSLs alone may be associated to various neurological symptoms. Here, we design the present study to determine the risk factors for JCSLs and their clinical manifestations in patients in our neurology clinic. Methods 206 participants suffered from neurological disorders and completed magnetic resonance imaging (MRI) examinations were divided into two groups: patients with JCSLs and patients without lesions on MRI. Meanwhile, 129 age- and sex-matched healthy volunteers were also recruited. Laboratory examinations and the phenotypes and distributions of the symptoms of the three groups were compared. Results The serum levels of apoB and homocysteine (HCY) were independently related to the appearance of JCSLs and HCY level was also associated with the number of JCSLs. Patients with JCSLs might present with headache, insomnia, and/or anxiety/depression, which were related with the anatomical locations of the lesions. Conclusion These data suggest that JCSLs are symptomatic and might in result fromarteriole atherosclerosis, which should raise our attention.
Collapse
Affiliation(s)
- Yilong Shan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sha Tan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kui Li
- Department of Physiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Zhang
- Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Siyuan Liao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li Zhou
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhezhi Deng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xueqiang Hu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Haiyan Li
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xuejiao Men
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lisheng Peng
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhuang Kang
- Department of Imaging, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yan Zou
- Department of Imaging, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
36
|
Svärd D, Nilsson M, Lampinen B, Lätt J, Sundgren PC, Stomrud E, Minthon L, Hansson O, van Westen D. The effect of white matter hyperintensities on statistical analysis of diffusion tensor imaging in cognitively healthy elderly and prodromal Alzheimer's disease. PLoS One 2017; 12:e0185239. [PMID: 28934374 PMCID: PMC5608410 DOI: 10.1371/journal.pone.0185239] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/09/2017] [Indexed: 11/20/2022] Open
Abstract
Diffusion tensor imaging (DTI) has been used to study microstructural white matter alterations in a variety of conditions including normal aging and Alzheimer's disease (AD). White matter hyperintensities (WMH) are common in cognitively healthy elderly as well as in AD and exhibit elevated mean diffusivity (MD) and reduced fractional anisotropy (FA). However, the effect of WMH on statistical analysis of DTI estimates has not been thoroughly studied. In the present study we address this in two ways. First, we investigate the effect of WMH on MD and FA in the dorsal and ventral cingulum, the superior longitudinal fasciculus, and the corticospinal tract, by comparing two matched groups of cognitively healthy elderly (n = 21 + 21) with unequal WMH load. Second, we assess the effects of adjusting for WMH load when comparing MD and FA in prodromal AD subjects (n = 83) to cognitively healthy elderly (n = 132) in the abovementioned white matter tracts. Results showed the WMH in cognitively healthy elderly to have a generally large effect on DTI estimates (Cohen’s d = 0.63 to 1.27 for significant differences in MD and −1.06 to −0.69 for FA). These effect sizes were comparable to those of various neurological and psychiatric diseases (Cohen’s d = 0.57 to 2.20 for differences in MD and −1.76 to −0.61 for FA). Adjusting for WMH when comparing DTI estimates in prodromal AD subjects to cognitively healthy elderly improved the explanatory power as well as the outcome of the analysis, indicating that some of the differences in MD and FA were largely driven by unequal WMH load between the groups rather than alterations in normal-appearing white matter (NAWM). Thus, our findings suggest that if the purpose of a study is to compare alterations in NAWM between two groups using DTI it may be necessary to adjust the statistical analysis for WMH.
Collapse
Affiliation(s)
- Daniel Svärd
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
- * E-mail:
| | - Markus Nilsson
- Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - Björn Lampinen
- Medical Radiation Physics, Lund University, Lund, Sweden
| | - Jimmy Lätt
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Pia C. Sundgren
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research, Lund University, Malmoö, Sweden
| | | | - Oskar Hansson
- Clinical Memory Research, Lund University, Malmoö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
37
|
Lin H, Satizabal C, Xie Z, Yang Q, Huan T, Joehanes R, Wen C, Munson PJ, Beiser A, Levy D, Seshadri S. Whole blood gene expression and white matter Hyperintensities. Mol Neurodegener 2017; 12:67. [PMID: 28923099 PMCID: PMC5604498 DOI: 10.1186/s13024-017-0209-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background White matter hyperintensities (WMH) are an important biomarker of cumulative vascular brain injury and have been associated with cognitive decline and an increased risk of dementia, stroke, depression, and gait impairments. The pathogenesis of white matter lesions however, remains uncertain. The characterization of gene expression profiles associated with WMH might help uncover molecular mechanisms underlying WMH. Methods We performed a transcriptome-wide association study of gene expression profiles with WMH in 3248 participants from the Framingham Heart Study using the Affymetrix Human Exon 1.0 ST Array. Results We identified 13 genes that were significantly associated with WMH (FDR < 0.05) after adjusting for age, sex and blood cell components. Many of these genes are involved in inflammation-related pathways. Conclusion Thirteen genes were significantly associated with WMH. Our study confirms the hypothesis that inflammation might be an important factor contributing to white matter lesions. Future work is needed to explore if these gene products might serve as potential therapeutic targets. Electronic supplementary material The online version of this article (10.1186/s13024-017-0209-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Honghuang Lin
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA. .,Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, 72 East Concord Street, B-616, Boston, MA, 02118, USA.
| | - Claudia Satizabal
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, B-602, Boston, MA, 02118, USA
| | - Zhijun Xie
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Tianxiao Huan
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Roby Joehanes
- Mathematical and Statistical Computing Laboratory, Center for Information Technology, National Institute of Health, Bethesda, MD, USA.,Hebrew Senior Life, 1200 Centre Street Room #609, Boston, MA, 02131, USA
| | - Chengping Wen
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Peter J Munson
- Mathematical and Statistical Computing Laboratory, Center for Information Technology, National Institute of Health, Bethesda, MD, USA
| | - Alexa Beiser
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, B-602, Boston, MA, 02118, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Daniel Levy
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Sudha Seshadri
- National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA, USA. .,Department of Neurology, Boston University School of Medicine, 72 East Concord Street, B-602, Boston, MA, 02118, USA.
| |
Collapse
|
38
|
Lin Q, Huang WQ, Ma QL, Lu CX, Tong SJ, Ye JH, Lin HN, Gu L, Yi KH, Cai LL, Tzeng CM. Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7682. [PMID: 28953609 PMCID: PMC5626252 DOI: 10.1097/md.0000000000007682] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Leukoaraiosis (LA) refers to white matter hyperintensities or white matter lesions (WMLs) on magnetic resonance imaging (MRI) scans of the brain; this disease is associated with an increased risk of stroke, dementia, and cognitive decline. The aims of the study are to assess the incidence of LA and its associated risk factors in a Chinese population.A hospital-based cross-sectional study was conducted that included 4683 patients who were 40 years or older. Data collected included age, sex, hypertension, diabetes, smoking, drinking, homocysteine (HCY), and low-density lipoprotein cholesterol (LDL-C) levels in the blood in addition to brain MRI information. We examined the relationship of those putative risk factors with LA, LA occurrence, and LA progression through single-factor and multivariate analyses.Of the total subjects, 58.3% (2731/4683 cases) suffered from LA. LA was more frequent amongst elderly females, particularly in those older than 60, compared to men. The incidence of LA increased with age. Age, sex, hypertension, diabetes, smoking, and HCY levels all were risk factors for LA. Amongst those risk factors, both smoking and high HCY levels were associated with the onset process of LA. Moreover, the multivariate logistic analysis revealed that both drinking and abnormal LDL-C levels were positive regulators in the progression process of LA.This study revealed that the incidence of LA is high in hospitalized patients in China; moreover, age, sex, hypertension, diabetes mellitus, smoking, drinking, and abnormal HCY and LDL-C levels were found to be associated with overall LA risk, LA onset, or LA progression. These results provide insight into strategies for the prevention and treatment of LA.
Collapse
Affiliation(s)
- Qing Lin
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Wen-Qing Huang
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong
| | - Qi-Lin Ma
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Cong-Xia Lu
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Sui-Jun Tong
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Jin-Hu Ye
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Hui-Nuan Lin
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Long Gu
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Ke-Hui Yi
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Liang-Liang Cai
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Chi-Meng Tzeng
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- INNOVA Clinics and TRANSLA Health Group, Yangzhou, Jiangsu, China
| |
Collapse
|
39
|
Wei CC, Zhang ST, Liu JF, Lin J, Yang TT, Zhang SH, Liu M. Association between Fibrinogen and Leukoaraiosis in Patients with Ischemic Stroke and Atrial Fibrillation. J Stroke Cerebrovasc Dis 2017; 26:2630-2637. [PMID: 28823490 DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/15/2017] [Accepted: 06/21/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Leukoaraiosis (LA), a surrogate of cerebral small-vessel diseases (CSVD), has been increasingly recognized because of its high prevalence and strong prognostic value in stroke. But the mechanism of LA is incompletely clarified. Fibrinogen is a crucial role in coagulation cascade and inflammation. There are inconsistent reports on the association of fibrinogen with LA in the general population. We aimed to investigate the association between fibrinogen and LA in patients with stroke and atrial fibrillation (AF), which was not ever reported before. METHODS Patients with ischemic stroke and AF were prospectively and consecutively recruited. Clinico-demographic data and fibrinogen levels were collected within 48 hours from stroke onsets and analyzed according to the presence and distribution of LA (periventricular hyperintensity [PVH] and deep white matter hyperintensity). RESULTS Of 186 patients (34.4% male; mean age, 68.76 ± 12.76 years) enrolled, 134 patients (72.0%) presented with LA. Elevated fibrinogen levels were associated with higher presence of LA (P = .005) and PVH (P = .002). After adjustment for the confounders, the fibrinogen levels were independently correlated with LA and PVH (all P <.05). Patients with elevated fibrinogen levels (≥3.5 g/L) were more likely to present with LA and PVH, with the odds ratios of 14.037 (95% confidence interval [CI] 2.588-76.131) and 12.567 (95% CI 2.572-61.395), respectively. CONCLUSION This study found that fibrinogen was independently and positively associated with LA and PVH in patients with stroke and AF. These results provide further evidence for the key role of fibrinogen in LA, even the total CSVD burden.
Collapse
Affiliation(s)
- Chen-Chen Wei
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Shu-Ting Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jun-Feng Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jing Lin
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ting-Ting Yang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Shi-Hong Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ming Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| |
Collapse
|
40
|
Yoon CW, Choi Y, Jeon S, Lee DH, Yoon BN, Park HK, Rha JH. Is antiplatelet treatment effective at attenuating the progression of white matter hyperintensities? PLoS One 2017; 12:e0176300. [PMID: 28426738 PMCID: PMC5398663 DOI: 10.1371/journal.pone.0176300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
Objective We performed this study to assess the effect of an antiplatelet agent on the progression of white matter hyperintensities (WMH). Methods From August 2003 to May 2005, we consecutively enrolled patients who underwent brain magnetic resonance imaging (MRI) for health check-up purposes and showed no significant findings other than WMH of any degree. Patients were divided into two groups based on whether or not they received antiplatelet therapy. All patients had a follow-up brain MRI after 5 years and WMH volume change was measured using imaging analysis software. To minimize selection bias potentially arising from antiplatelet treatment assignment, analyses were inverse probability weighted. Results Among the 93 patients who met the inclusion criteria, 54 patients (58.1%) were grouped as the antiplatelet group (AG), and the remaining 39 patients (41.9%) as the non-antiplatelet group (NAG). After inverse propensity weighting, all baseline characteristics were similar between the two groups, and antiplatelet treatment did not show any significant effect on the total WMH volume change (p = 0.957). Conclusion Antiplatelet medication may not alter the progression of WMH.
Collapse
Affiliation(s)
- Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Yoonjae Choi
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Seun Jeon
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Dae Hyung Lee
- Center for Clinical Research, Inha University School of Medicine, Incheon, Korea
| | - Byung-Nam Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Hee-Kwon Park
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Joung-Ho Rha
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
41
|
Ferreira JP, Kearney Schwartz A, Watfa G, Zohra L, Felblinger J, Boivin JM, Bracard S, Hossu G, Verger A, Joly L, Zannad F, Rossignol P, Benetos A. Memory Alterations and White Matter Hyperintensities in Elderly Patients With Hypertension: The ADELAHYDE-2 Study. J Am Med Dir Assoc 2017; 18:451.e13-451.e25. [PMID: 28279605 DOI: 10.1016/j.jamda.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The longitudinal ADELAHYDE-2 study aims to identify the factors associated with cognitive impairment/decline and white matter hyperintensities burden. METHODS Longitudinal single-center study comprising two visits separated by approximately 7 years. A total of 131 patients completed the two visits. The primary outcome was global memory composite scale, while the secondary outcome was white matter hyperintensities (WMH/Fazekas scale) load. RESULTS Global memory at visit 2 (V2) was largely influenced by age, smoking status, glycated hemoglobin, and history of stroke already present at visit 1 (V1). These variables accounted for ∼51% of the memory alterations at V2. WMH at V2 was likely influenced by age, left ventricular hypertrophy, diabetes mellitus, carotid intima-media thickness, and body mass index at V1. These findings accounted for ∼37% of the WMH changes at V2. Increase in pulse wave velocity from V1 to V2 showed a trend for association with memory deterioration (adjusted estimates = 0.06; P = .067), whereas smoking and increase in systolic blood pressure (trend) were associated with an increment in WMH (adjusted estimates = 0.49; P = .047 and adjusted estimates = 0.01; P = .08, respectively). On the other hand, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers and statins (trend) were likely to be protective (adjusted estimates for angiotensin-converting enzyme inhibitor/angiotensin receptor blockers = -0.49; P = .049, and adjusted estimates for statins = -0.46; P = .055). CONCLUSIONS Several readily identifiable factors are associated with memory deterioration and WMH, many of which are potentially modifiable. Interventions aimed to control these risk factors need to be tested prospectively in order to assess their cognitive protective value.
Collapse
Affiliation(s)
- João Pedro Ferreira
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Anna Kearney Schwartz
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Service de Gériatrie, CHRU de Nancy, Nancy, France
| | | | - Lamiral Zohra
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Jacques Felblinger
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM, U947, IADI, Nancy, F-54000, France, Département de Neuroradiologie Diagnostique et Interventionnelle, Pôle Imagerie, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Jean-Marc Boivin
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France
| | - Serge Bracard
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Département de Neuroradiologie Diagnostique et Interventionnelle, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Gabriella Hossu
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France; U947, INSERM, Nancy, France
| | - Antoine Verger
- CHRU Nancy, Nuclear Medicine & Nancyclotep Experimental Imaging Platform, Nancy, France
| | - Laure Joly
- Service de Gériatrie, CHRU de Nancy, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France
| | - Athanase Benetos
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM U1116, Université de Lorraine, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France; Service de Gériatrie, CHRU de Nancy, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France.
| |
Collapse
|
42
|
Maggio P, Altamura C, Lupoi D, Paolucci M, Altavilla R, Tibuzzi F, Passarelli F, Arpesani R, Di Giambattista G, Grasso RF, Luppi G, Fiacco F, Silvestrini M, Pasqualetti P, Vernieri F. The Role of White Matter Damage in the Risk of Periprocedural Diffusion-Weighted Lesions after Carotid Artery Stenting. Cerebrovasc Dis Extra 2017; 7:1-8. [PMID: 28125807 PMCID: PMC5340215 DOI: 10.1159/000452717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/10/2016] [Indexed: 12/27/2022] Open
Abstract
Background White matter hyperintensities (WMH) are a common finding in aged individuals affected by carotid artery disease and are a risk factor for first-ever and recurrent stroke. We investigated if white matter damage increases the risk of brain microembolism during carotid artery stenting (CAS), as evaluated by the appearance of new areas of restricted diffusion on diffusion-weighted images (DWI). Methods We evaluated 47 patients with severe internal carotid artery (ICA) stenosis undergoing CAS, comparing preprocedural clinical, ultrasound and radiological characteristics. WMH volume was computed on FLAIR images before CAS. After CAS, the DWI scan was looked over for areas of restricted diffusion (DWI lesions). A first univariate analysis was adopted to compare groups according to the occurrence of DWI lesions. Then, the variable DWI lesion was modelled by means of a logistic regression model. Results Seventeen patients developed at least 1 DWI lesion after CAS. Compared with non-DWI, DWI patients were more commonly treated in the left ICA (p = 0.007) and had a more severe WMH damage (p = 0.027). Indeed, the risk of a DWI lesion was higher in left versus right stenosis (OR = 9.0, 95% CI 1.9-42.7, p = 0.005) and increased for each log-unit of WMH lesion load (OR = 7.05, 95% CI 1.07-46.49, p = 0.042). A WMH lesion load of at least 5.25 cm3 had a 50% probability of occurrence of a new DWI lesion. Conclusions Treated side and preexisting white matter damage are risk conditions for brain microembolism during CAS. This should be taken into account to optimize severe carotid artery disease management.
Collapse
Affiliation(s)
- Paola Maggio
- Neurology Unit, ASST Bergamo Est, Azienda Ospedaliera Bolognini, Seriate, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
White matter hyperintensities on brain magnetic resonance imaging: comparison of early-onset and late-onset restless legs syndrome. Sleep Med 2016; 25:4-7. [DOI: 10.1016/j.sleep.2016.06.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/08/2016] [Accepted: 06/29/2016] [Indexed: 11/23/2022]
|
44
|
Moroni F, Ammirati E, Magnoni M, D'Ascenzo F, Anselmino M, Anzalone N, Rocca MA, Falini A, Filippi M, Camici PG. Carotid atherosclerosis, silent ischemic brain damage and brain atrophy: A systematic review and meta-analysis. Int J Cardiol 2016; 223:681-687. [PMID: 27568989 DOI: 10.1016/j.ijcard.2016.08.234] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/01/2016] [Accepted: 08/12/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The widespread use of brain imaging has led to increased recognition of subclinical brain abnormalities, including white matter hyperintensities (WMH) and silent brain infarctions (SBI), which have a vascular origin, and have been associated to a high risk of stroke, disability and dementia. Carotid atherosclerosis (CA) may be causative in the development of WMH, SBI and eventually brain atrophy. Aim of the present systematic review and meta-analysis was to assess the existing evidence linking CA to WMH, SBI and brain atrophy. METHODS The relation between CA and WMH, SBI and brain atrophy was investigated through the systematic search of online databases up to September 2015 and manual searching of references and related citations. Pooled estimates were calculated by random-effects model, using restricted maximum likelihood method with inverse variance weighting method. RESULTS Of the 3536 records identified, fifteen were included in the systematic review and 9 were found to be eligible for the meta-analysis. CA was significantly associated with the presence of WMH (Odds Ratio, OR 1.42, confidence interval, CI 1.22-1.66, p<0.0001) and of SBI (OR 1.89, CI 1.46-2.45, p<0.0001). No meta-analysis could be performed for the relation between CA and brain atrophy due to the lack of suitable studies. CONCLUSIONS CA was found to be associated to WMH and SBI. While no causative association can be inferred from the available data, the presence of carotid plaque may be considered a significant risk factor for subclinical cerebral damage.
Collapse
Affiliation(s)
- Francesco Moroni
- Cardiothoracic Department, San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy.
| | - Enrico Ammirati
- Cardiothoracic Department, San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy; Cardiovascular and Thoracic Department, AO Niguarda Ca' Granda, Milan, Italy
| | - Marco Magnoni
- Cardiothoracic Department, San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza", University of Turin, Turin, Italy
| | - Matteo Anselmino
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza", University of Turin, Turin, Italy
| | - Nicoletta Anzalone
- Department of Neuroradiology, CERMAC, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, CERMAC, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo G Camici
- Cardiothoracic Department, San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy
| |
Collapse
|
45
|
Guoqing Z, Fang S, Lihui D, Bing Y, Qiaoling P, Yingting W, Jinxia L. Cerebral white matter lesions and silent cerebral infarcts in postmenopausal women with polycystic ovary syndrome. Gynecol Endocrinol 2016; 32:655-658. [PMID: 26941198 DOI: 10.3109/09513590.2016.1149812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The association between polycystic ovary syndrome (PCOS) and cardiovascular disease remains unclear. Our objective was to examine the relation of PCOS with cerebrovascular disease measured by brain magnetic resonance imaging (MRI) as white matter lesions (WMLs) and silent cerebral infarcts (SCIs). METHODS Seventy postmenopausal women with PCOS and 140 controls participated in the case-control, cross-sectional study. Clinical, anthropometric, hormonal and metabolic parameters were measured. WMLs and SCIs were evaluated by brain MRI. RESULTS Compared with controls, postmenopausal women with PCOS had higher mean body mass index, larger waist hip ratio, higher level of low-density lipoprotein cholesterol, free androgen index and lower sex hormone-binding globulin level. The PCOS group had a significantly higher prevalence of WMLs (40% versus 22%, p = 0.009), and SCIs (17% versus 7%, p = 0.032) compared to the control group. CONCLUSIONS Postmenopausal women with PCOS are associated with WMLs and SCIs.
Collapse
Affiliation(s)
- Zhou Guoqing
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Sun Fang
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Duan Lihui
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Yan Bing
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Peng Qiaoling
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Wang Yingting
- a Department of Geriatric Neurology , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China and
| | - Liu Jinxia
- b Department of Gynecology and Obstetrics , Jinling Hospital, Nanjing University School of Medicine , Nanjing , China
| |
Collapse
|
46
|
Huang WQ, Ye HM, Li FF, Yi KH, Zhang Y, Cai LL, Lin HN, Lin Q, Tzeng CM. Analysis of genetic polymorphisms associated with leukoaraiosis in the southern Chinese population: A case-control study. Medicine (Baltimore) 2016; 95:e3857. [PMID: 27583843 PMCID: PMC5008527 DOI: 10.1097/md.0000000000003857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Leukoaraiosis (LA) is a frequent neuroimaging finding commonly observed on brain MRIs of elderly people with prevalence ranging from 50% to 100%. Multiple susceptibility genes or genetic risk factors for LA have been identified in subjects of European descent. Here, we report the first replication study on several common and novel genetic variations in the Chinese population. In this study, a total of 244 subjects (201 LA patients and 43 controls) were enrolled according to our new and strict definition for LA. Subsequently, 6 genetic variants at 5 genes, rs3744028 in TRIM65, rs1055129 in TRIM47, rs1135889 in FBF1, rs1052053 in PMF1, and rs1801133 (C677T) and rs1801131(A1298C) in MTHFR, were selected for genotyping using polymerase chain reaction (PCR)-based pyrosequencing and restriction fragment length polymorphism (RFLP) together with capillary electrophoresis (CE) and agarose gel electrophoresis. Finally, Pearson's χ and multivariate logistic regression tests were used to examine the associations between the genotypes and LA. Among these candidate polymorphisms, except for rs1052053 and rs1801131, rs1135889 (P = 0.012) showed significant associations with LA in the dominant model, and the other 3 SNPs, rs3744028 (P = 0.043), rs1055129 (P = 0.038), and rs1801133 (P = 0.027), showed significant associations with LA in the recessive model. However, these differences no longer remained significant after adjusting for age, gender, hypertension, and diabetes mellitus and applying Bonferroni correction or Sidak correction for multiple testing. These results suggest that the above-mentioned genetic variants are not associated with LA risk. In summary, the study did not replicate the susceptibility of rs3744028, rs1055129, and rs1135889 at the Chr17q25 locus for LA nor did it find any other significant results for rs1052053, rs1801133, and rs1801131 in the Chinese population. It strongly indicated the ethnic differences in the genetics of LA. However, the associations of rs3744028 (TRIM65), rs1055129 (TRIM47), rs1135889 (FBF1), and rs1801133 (MTHFR) with LA before Bonferroni correction and Sidak correction for multiple testing are worth highlighting. Thus, we believe that a genome-wide association study and candidate gene association studies are needed to reassess the previous findings and screen novel risk genes for LA in China.
Collapse
Affiliation(s)
- Wen-Qing Huang
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
| | - Hui-Ming Ye
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
- Maternity and Child Health Hospital, Xiamen, Fujian, China
| | - Fang-Fang Li
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
| | - Ke-Hui Yi
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian
| | - Ya Zhang
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
| | - Liang-Liang Cai
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
| | - Hui-Nuan Lin
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
- INNOVA Cell: TDx Clinics and TRANSLA Health Group, China
| | - Qing Lin
- Translational Medicine Research Center
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian
- Correspondence: Chi-Meng Tzeng, Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, China (e-mail: ); Qing Lin, Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (e-mail: )
| | - Chi-Meng Tzeng
- Translational Medicine Research Center
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation
- INNOVA Cell: TDx Clinics and TRANSLA Health Group, China
- Correspondence: Chi-Meng Tzeng, Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, China (e-mail: ); Qing Lin, Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (e-mail: )
| |
Collapse
|
47
|
Driscoll I, Gaussoin SA, Wassertheil-Smoller S, Limacher M, Casanova R, Yaffe K, Resnick SM, Espeland MA. Obesity and Structural Brain Integrity in Older Women: The Women's Health Initiative Magnetic Resonance Imaging Study. J Gerontol A Biol Sci Med Sci 2016; 71:1216-1222. [PMID: 26961581 DOI: 10.1093/gerona/glw023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Midlife obesity has been linked to age-related brain atrophy and risk of dementia, but the relationships are less clear for older individuals. These associations may be explained by changes in appetite or metabolism in the dementia prodrome; thus, prospective studies with adequate follow-up are needed. We examined the associations that obesity (body mass index, BMI) and change in BMI over an average of 6.6 (1.0-9.1) years have with global and regional brain and white matter lesion volumes in a sample of 1,366 women aged 65-80. METHODS Least square means for regional brain volumes and white matter lesion loads for women grouped by BMI and changes in BMI were generated from multivariable linear models with and without adjustment for demographic and health covariates. RESULTS Both global obesity and increase in BMI were associated with lower cerebrospinal fluid and higher specific brain volumes (ps < .05), after controlling for diabetes and other cerebrovascular disease risk factors. Obesity, but not change in BMI, predicted lower lesion loads for the total, parietal, and occipital white matter (ps < .05). CONCLUSIONS Obesity in this cohort is associated with less brain atrophy and lower ischemic lesion loads. The findings are consistent with our previous report of worse cognitive performance in association with weight loss (probably not due to frailty) in this cohort and in line with the idea of the "obesity paradox" as differences in dementia risk vary across time, whereby midlife obesity seems to be a predictor of dementia, whereas weight loss seems to be a better predictor at older ages.
Collapse
Affiliation(s)
- Ira Driscoll
- Psychology Department, University of Wisconsin-Milwaukee.
| | - Sarah A Gaussoin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Ramon Casanova
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristine Yaffe
- Department of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
48
|
Abstract
With 16.9 million people who suffered a first-ever stroke in 2010 worldwide, stroke is a very common vascular disease. Epidemiologic studies have played an essential role in assessing this burden and in detecting the risk factors for stroke. Primary prevention of these risk factors, primarily hypertension, smoking, diabetes, and atrial fibrillation, has reduced the incidence in high-income countries. However, stroke remains a major cause of death and disability, and therefore research should be continued. Subarachnoid hemorrhages are less prevalent than strokes but have an even higher risk of death. Similar to stroke, epidemiologic studies identified smoking and hypertension as its most important risk factors, together with excessive alcohol intake. Although rare, arterial dissections, CADASIL, arteriovenous malformations, venous sinus thrombosis, moyamoya disease, and vasculitis can lead to serious symptoms. The burden and risk factors of those rare diseases are more challenging to assess. Whenever possible, they should be recognized in a timely manner for their increased risk of stroke, but most often they are diagnosed only at the time of stroke. Some cerebrovascular abnormalities do not result in immediate symptoms. This subclinical cerebrovascular disease includes silent infarcts, white-matter lesions, and microbleeds, and is incidentally found by neuroimaging. These lesions are not innocent, as several epidemiologic studies have associated subclinical cerebrovascular disease with an increased risk of stroke, cognitive decline, dementia, and death.
Collapse
Affiliation(s)
- M L P Portegies
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - P J Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
49
|
Ikram MA, van der Lugt A, Niessen WJ, Koudstaal PJ, Krestin GP, Hofman A, Bos D, Vernooij MW. The Rotterdam Scan Study: design update 2016 and main findings. Eur J Epidemiol 2015; 30:1299-315. [PMID: 26650042 PMCID: PMC4690838 DOI: 10.1007/s10654-015-0105-7] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/25/2015] [Indexed: 12/20/2022]
Abstract
Imaging plays an essential role in research on neurological diseases in the elderly. The Rotterdam Scan Study was initiated as part of the ongoing Rotterdam Study with the aim to elucidate the causes of neurological disease by performing imaging of the brain in a prospective population-based setting. Initially, in 1995 and 1999, random subsamples of participants from the Rotterdam Study underwent neuroimaging, whereas from 2005 onwards MRI has been implemented into the core protocol of the Rotterdam Study. In this paper, we discuss the background and rationale of the Rotterdam Scan Study. Moreover, we describe the imaging protocol, image post-processing techniques, and the main findings to date. Finally, we provide recommendations for future research, which will also be topics of investigation in the Rotterdam Scan Study.
Collapse
Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Aad van der Lugt
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wiro J Niessen
- Biomedical Imaging Group Rotterdam, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Gabriel P Krestin
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
50
|
Fan Y, Lan L, Zheng L, Ji X, Lin J, Zeng J, Huang R, Sun J. Spontaneous white matter lesion in brain of stroke-prone renovascular hypertensive rats: a study from MRI, pathology and behavior. Metab Brain Dis 2015; 30:1479-86. [PMID: 26387009 DOI: 10.1007/s11011-015-9722-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
Hypertension is considered one of the most important controllable risk factors for white matter lesion (WML). Our previous work found that stroke-prone renovascular hypertensive rats (RHRSP) displayed a high rate of WML. This study aimed to investigate the WML in RHRSP from MRI, pathology and behavior. RHRSP model was established by two-kidney, two-clipmethod and kept for 20 weeks. WML was decteted by magnetic resonance imaging (MRI) and loyez staining. Cognition was tested by morris water maze (MWM). Vascular changes were observed by HE staining on brain and carotid sections. Ultrastucture of blood brain barrier (BBB) were observed by transmission electron microscope. Immunofluorescence was used to detect albumin leakage and cell proliferation. T(2)-weighted MRI scans of RHRSP displayed diffuse, confluent white-matter hyperintensities. Pathological examination of the same rat showed marked vacuoles, disappearence of myelin and nerve fibers in white matter, supporting the neuroimaging findings. Spatial learning and memory impairment were observed in RHRSP. The small arteries in brain exhibited fibrinoid necrosis, hyalinosis and vascular remodeling. BBB disruption and plasma albumin leakage into vascular wall was observed in RHRSP. Increased cell proliferation in subventricular zone was seen in RHRSP. RHRSP demonstrated spontaneous WML and cognitive impairment. Hypertensive small vessel lesions and BBB disruption might paly causative factors for the onset and development of WML. The characteristic features of WML in RHRSP suggested it a valid animal model for WML.
Collapse
Affiliation(s)
- Yuhua Fan
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China.
| | - Linfang Lan
- Department of Medicine and Therapeutics, Chinese University of Hongkong, Hongkong, China
| | - Lu Zheng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Xiaotan Ji
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jing Lin
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jinsheng Zeng
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Ruxun Huang
- Department of Neurology, First Affiliated Hospital Sun Yat-Sen University, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department National Key Discipline, Guangzhou, 510080, China
| | - Jian Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.
| |
Collapse
|