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Schmitzer L, Kaczmarz S, Göttler J, Hoffmann G, Kallmayer M, Eckstein HH, Hedderich DM, Kufer J, Zimmer C, Preibisch C, Hyder F, Sollmann N. Macro- and microvascular contributions to cerebral structural alterations in patients with asymptomatic carotid artery stenosis. J Cereb Blood Flow Metab 2024:271678X241238935. [PMID: 38506325 DOI: 10.1177/0271678x241238935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Atherosclerosis can underly internal carotid artery stenosis (ICAS), a major risk factor for ischemic stroke, as well as small vessel disease (SVD). This study aimed to investigate hemodynamics and structural alterations associated with SVD in ICAS patients. 28 patients with unilateral asymptomatic ICAS and 30 age-matched controls underwent structural (T1-/T2-weighted and diffusion tensor imaging [DTI]) and hemodynamic (pseudo-continuous arterial spin labeling and dynamic susceptibility contrast) magnetic resonance imaging. SVD-related alterations were assessed using free water (FW), FW-corrected DTI, and peak-width of skeletonized mean diffusivity (PSMD). Furthermore, cortical thickness, cerebral blood flow (CBF), and capillary transit time heterogeneity (CTH) were analyzed. Ipsilateral to the stenosis, cortical thickness was significantly decreased in the posterior dorsal cingulate cortex (p = 0.024) and temporal pole (p = 0.028). ICAS patients exhibited elevated PSMD (p = 0.005), FW (p < 0.001), and contralateral alterations in FW-corrected DTI metrics. We found significantly lateralized CBF (p = 0.011) and a tendency for lateralized CTH (p = 0.067) in the white matter (WM) related to ICAS. Elevated PSMD and FW may indicate a link between SVD and WM changes. Contralateral alterations were seen in FW-corrected DTI, whereas hemodynamic and cortical changes were mainly ipsilateral, suggesting SVD might influence global brain changes concurrent with ICAS-related hemodynamic alterations.
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Affiliation(s)
- Lena Schmitzer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stephan Kaczmarz
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Philips GmbH Market DACH, Hamburg, Germany
| | - Jens Göttler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Gabriel Hoffmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Kallmayer
- Department for Vascular and Endovascular Surgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dennis Martin Hedderich
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Kufer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Neurology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Fahmeed Hyder
- Department of Radiology & Biomedical Imaging, Magnetic Resonance Research Center (MRRC), Yale University, New Haven, CT, USA
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
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Liu X, Xu D, Zhong X, Ren J, Wang H, Yu M, Gao L, Xu H. Altered Callosal Morphology and Connectivity in Asymptomatic Carotid Stenosis. J Magn Reson Imaging 2024; 59:998-1007. [PMID: 37334908 DOI: 10.1002/jmri.28872] [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: 02/25/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Carotid stenosis, even in the clinically asymptomatic stage, causes cognitive impairment, silent lesions, and hemispheric changes. The corpus callosum (CC) is crucial for hemispheric cortical integration and specialization. PURPOSE To examine if CC morphology and connectivity relate to cognitive decline and lesion burden in asymptomatic carotid stenosis (ACS). STUDY TYPE Retrospective, cross-sectional. POPULATION 33 patients with unilaterally severe (70%) ACS and 28 demographically and comorbidity-matched controls. A publicly available healthy adult lifespan (ages between 18 and 80; n = 483) MRI dataset was also included. FIELD STRENGTH/SEQUENCE A 3.0 T; T1 MPRAGE and diffusion weighted gradient echo-planar imaging sequences. ASSESSMENT Structural MRI and multidomain cognitive data were obtained. Midsagittal CC area, circularity, thickness, integrity, and probabilistic tractography were calculated and correlated with cognitive tests and white matter hyperintensity. Fractional anisotropy, mean diffusivity (MD), and radial diffusivity were determined from DTI. STATISTICAL TESTS Independent two-sample t-tests, χ2 tests, Mann-Whitney U, locally weighted scatterplot smoothing (LOWESS) curve fit, and Pearson correlation. A P value < 0.05 was considered statistically significant. RESULTS Patients with ACS demonstrated significant reductions in callosal area, circularity, and thickness compared to controls. The callosal atrophy was significantly correlated with white matter hyperintensity size (r = -0.629, P < 0.001). Voxel-wise analysis of diffusion measures in the volumetric CC showed that ACS patients exhibited significantly lower fractional anisotropy and higher MD and radial diffusivity in the genu and splenium of the CC than controls. Further lifespan trajectory analysis showed that although the midsagittal callosal area, circularity, and thickness exhibited age-related decreases, the values in the ACS patients were significantly lower in all age groups. DATA CONCLUSION Midsagittal callosal atrophy and connectivity reflect the load of silent lesions and the severity of cognitive decline, respectively, suggesting that CC degeneration has potential to serve as an early marker in ACS. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Xitong Liu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Dan Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Xiaoli Zhong
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Jinxia Ren
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Huan Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China
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Fan C, Xu D, Mei H, Zhong X, Ren J, Ma J, Ruan Z, Lv J, Liu X, Wang H, Gao L, Xu H. Hemispheric coupling between structural and functional asymmetries in clinically asymptomatic carotid stenosis with cognitive impairment. Brain Imaging Behav 2024; 18:192-206. [PMID: 37985612 DOI: 10.1007/s11682-023-00823-0] [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] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
Advanced carotid stenosis is a known risk factor for ischemic stroke and vascular dementia, and it is associated with multidomain cognitive impairment as well as asymmetric alterations in hemispheric structure and function. Here we introduced a novel measure-the asymmetry index of amplitude of low-frequency fluctuations (ALFF_AI)-derived from resting-state functional magnetic resonance imaging. This measure captures the hemispheric asymmetry of intrinsic brain activity using high-dimensional registration. We aimed to investigate functional brain asymmetric alterations in patients with severe asymptomatic carotid stenosis (SACS). Furthermore, we extended the analyses of ALFF_AI to different frequencies to detect frequency-specific alterations. Finally, we examined the coupling between hemispheric asymmetric structure and function and the relationship between these results and cognitive tests, as well as the white matter hyperintensity burden. SACS patients presented significantly decreased ALFF_AI in several clusters, including the visual, auditory, parahippocampal, Rolandic, and superior parietal regions. At low frequencies (0.01-0.25 Hz), the ALFF_AI exhibited prominent group differences as frequency increased. Further structure-function coupling analysis indicated that SACS patients had lower coupling in the lateral prefrontal, superior medial frontal, middle temporal, superior parietal, and striatum regions but higher coupling in the lateral occipital regions. These findings suggest that, under potential hemodynamic burden, SACS patients demonstrate asymmetric hemispheric configurations of intrinsic activity patterns and a decoupling between structural and functional asymmetries.
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Affiliation(s)
- Chenhong Fan
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
- The Interventional Diagnostic and Therapeutic Center, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Dan Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Hao Mei
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Xiaoli Zhong
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Jinxia Ren
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Jiaojiao Ma
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Zhao Ruan
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Jinfeng Lv
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Xitong Liu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Huan Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China.
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, 430071, Wuhan City, Hubei Province, China.
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Murdaugh DL, Milner D, Cardenas CE, Heinzman KA, Cooper CA, Tabb JN, Bhatia S, McDonald AM. Volumetric brain assessment of long-term head and neck cancer survivors. Radiother Oncol 2024; 191:110068. [PMID: 38142935 PMCID: PMC10922648 DOI: 10.1016/j.radonc.2023.110068] [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: 07/17/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Radiation therapy (RT) for locally advanced head and neck cancer (HNC) often exposes subcortical brain structures to radiation. We performed this study to assess region-specific brain volumetrics in a population of long term HNC survivors. METHODS AND MATERIALS Forty HNC survivors were enrolled at a mean of 6.4 years from completion of RT. Patients underwent a research MRI protocol that included a 3D T1- weighted whole-brain scan on a 3 Tesla MRI scanner. Voxel based morphometry was performed using the Computational Anatomy Toolbox with the Neuromorphometrics atlas. Healthy controls from the Human Connectome Project were used as a comparison cohort. Study participants also completed a comprehensive neurocognitive assessment. RESULTS The final study cohort consisted of 38 participants after excluding 2 participants due to image quality. HNC survivors displayed widespread reduction in gray matter (GM) brain region volumes that included bilateral medial frontal cortex, temporal lobe, hippocampus, supplemental motor area, and cerebellum. Greater radiation exposure was associated with reduced GM volume in the left ventral diencephalon (r = -0.512, p = 0.003). Associations between cognition and regional GM volumes were identified for motor coordination and bilateral cerebellum (left, r = 0.444, p = 0.009; right, r = 0.372, p = 0.030), confrontation naming and left amygdala (r = 0.382, p = 0.026), verbal memory and bilateral thalamus (left, r = 0.435, p = 0.010; right, r = 0.424, p = 0.012), right amygdala (r = 0.339, p = 0.050), and right putamen (r = 0.364, p = 0.034). CONCLUSIONS Reductions in GM were observed within this cohort of primarily non-nasopharyngeal HNC survivors as compared to a control sample. GM volumes were associated with performance in multiple cognitive domains. Results of this exploratory study support the need for investigation of anatomic brain changes as an important translational corollary to cognitive problems among HNC survivors.
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Affiliation(s)
- Donna L Murdaugh
- University of Alabama at Birmingham, Department of Radiation Oncology, United States; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, United States; University of Alabama at Birmingham, Department of Pediatrics, United States
| | - Desmin Milner
- University of Alabama at Birmingham, Department of Radiology, United States
| | - Carlos E Cardenas
- University of Alabama at Birmingham, Department of Radiation Oncology, United States
| | - Katherine A Heinzman
- University of Alabama at Birmingham, Department of Radiation Oncology, United States; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, United States
| | - Courtney A Cooper
- University of Alabama at Birmingham, Department of Radiation Oncology, United States; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, United States
| | - Jazmyne N Tabb
- Brookwood Baptist Medical Center, Birmingham, AL, United States
| | - Smita Bhatia
- University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, United States; University of Alabama at Birmingham, Department of Pediatrics, United States
| | - Andrew M McDonald
- University of Alabama at Birmingham, Department of Radiation Oncology, United States; University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, United States.
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5
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Huang Z, Xia X, Guan S, Gong G, Luo Y, Shi L, Zhang J, Meng X. Neuroimaging anomalies in asymptomatic middle cerebral artery steno-occlusive disease with normal-appearing white matter. Front Neurol 2023; 14:1206786. [PMID: 37693758 PMCID: PMC10484479 DOI: 10.3389/fneur.2023.1206786] [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: 05/26/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023] Open
Abstract
Background Asymptomatic chronic cerebrovascular steno-occlusive disease is common, but the cognitive function and alterations in the brain's structural and functional profiles have not been well studied. This study aimed to reveal whether and how patients with asymptomatic middle cerebral artery (MCA) steno-occlusive disease and normal-appearing white matter differ in brain structural and functional profiles from normal controls and their correlations with cognitive function. Methods In all, 26 patients with asymptomatic MCA steno-occlusive disease and 22 healthy controls were compared for neurobehavioral assessments, brain volume, cortical thickness, fiber connectivity density (FiCD) value, and resting-state functional connectivity (FC) using multimodal MRI. We also investigated the associations between abnormal cortical thicknesses, FiCD values, and functional connectivities with the neurobehavioral assessments. Results Patients performed worse on memory tasks (Auditory Verbal Learning Test-Huashan version) compared with healthy controls. Patients were divided into two groups: the right group (patients with right MCA steno-occlusive disease) and the left group (patients with left MCA steno-occlusive disease). The left group showed significant cortical thinning in the left superior parietal lobule, while the right group showed significant cortical thinning in the right superior parietal lobule and caudal portion of the right middle frontal gyrus. Increased FiCD values in the superior frontal region of the left hemisphere were observed in the left group. In addition, a set of interhemispheric and intrahemispheric FC showed a significant decrease or increase in both the left and right groups. Many functional connectivity profiles were positively correlated with cognitive scores. No correlation was found between cortical thickness, FiCD values, and cognitive scores. Conclusion Even if the patients with MCA steno-occlusive disease were asymptomatic and had normal-appearing white matter, their cognitive function and structural and functional profiles had changed, especially the FC. Alterations in FC may be an important mechanism underlying the neurodegenerative process in patients with asymptomatic MCA steno-occlusive disease before structural changes occur, so FC assessment may promote the detection of network alterations, which may be used as a biomarker of disease progression and therapeutic efficacy evaluation in these patients.
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Affiliation(s)
- Zhaodi Huang
- Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xiaona Xia
- Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Shuai Guan
- Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, Guangdong, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, Guangdong, China
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Juntao Zhang
- GE Healthcare, Precision Health Institution, Shanghai, China
| | - Xiangshui Meng
- Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
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Ren J, Xu D, Mei H, Zhong X, Yu M, Ma J, Fan C, Lv J, Xiao Y, Gao L, Xu H. Asymptomatic carotid stenosis is associated with both edge and network reconfigurations identified by single-subject cortical thickness networks. Front Aging Neurosci 2023; 14:1091829. [PMID: 36711201 PMCID: PMC9878604 DOI: 10.3389/fnagi.2022.1091829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/26/2022] [Indexed: 01/15/2023] Open
Abstract
Background and purpose Patients with asymptomatic carotid stenosis, even without stroke, are at high risk for cognitive impairment, and the neuroanatomical basis remains unclear. Using a novel edge-centric structural connectivity (eSC) analysis from individualized single-subject cortical thickness networks, we aimed to examine eSC and network measures in severe (> 70%) asymptomatic carotid stenosis (SACS). Methods Twenty-four SACS patients and 24 demographically- and comorbidities-matched controls were included, and structural MRI and multidomain cognitive data were acquired. Individual eSC was estimated via the Manhattan distances of pairwise cortical thickness histograms. Results In the eSC analysis, SACS patients showed longer interhemispheric but shorter intrahemispheric Manhattan distances seeding from left lateral temporal regions; in network analysis the SACS patients had a decreased system segregation paralleling with white matter hyperintensity burden and recall memory. Further network-based statistic analysis identified several eSC and subgraph features centred around the Perisylvian regions that predicted silent lesion load and cognitive tests. Conclusion We conclude that SACS exhibits abnormal eSC and a less-optimized trade-off between physical cost and network segregation, providing a reference and perspective for identifying high-risk individuals.
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Affiliation(s)
- Jinxia Ren
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Dan Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hao Mei
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaoli Zhong
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiaojiao Ma
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chenhong Fan
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jinfeng Lv
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yaqiong Xiao
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,*Correspondence: Lei Gao, ✉
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China,Haibo Xu, ✉
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Baradaran H, Sarrami AH, Gupta A. Asymptomatic Carotid Disease and Cognitive Impairment: What Is the Evidence? Front Neurol 2021; 12:741500. [PMID: 34867724 PMCID: PMC8636319 DOI: 10.3389/fneur.2021.741500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/25/2021] [Indexed: 11/23/2022] Open
Abstract
The development of cognitive dysfunction and dementia is a complex, multifactorial process. One of the contributors to various types of cognitive dysfunction is carotid atherosclerosis which can frequently be seen in asymptomatic individuals. There are a number of different manifestations of asymptomatic carotid atherosclerosis including arterial stiffness, carotid intima-media thickening, flow-limiting stenosis, and complex, atherosclerotic plaque. Each of these forms of atherosclerosis may contribute to cerebral parenchymal damage, contributing to cognitive dysfunction. In this review article, we will discuss each of these forms of carotid atherosclerosis, present the potential mechanistic underpinnings behind an association, and then review the scientific evidence supporting potential associations to cognitive dysfunction and dementia.
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Affiliation(s)
- Hediyeh Baradaran
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States
| | - Amir Hossein Sarrami
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, United States
| | - Ajay Gupta
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States.,Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States
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Gao L, Xiao Y, Xu H. Gray matter asymmetry in asymptomatic carotid stenosis. Hum Brain Mapp 2021; 42:5665-5676. [PMID: 34498785 PMCID: PMC8559457 DOI: 10.1002/hbm.25645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/16/2022] Open
Abstract
Even clinically “asymptomatic” carotid stenosis is associated with multidomain cognitive impairment, gray matter (GM) atrophy, and silent lesion. However, the links between them remain unclear. Using structural MRI data, we examined GM asymmetry index (AI) and white matter hyperintensity (WMH) in 24 patients with severe asymptomatic carotid stenosis (SACS), 24 comorbidity‐matched controls, and independent samples of 84 elderly controls and 22 young adults. As compared to controls, SACS patients showed worse verbal memories, higher WMH burden, and right‐lateralized GM in posterior middle temporal and mouth‐somatomotor regions. These clusters extended to pars triangularis, lateral temporal, and cerebellar regions, when compared with young adults. Further, a full‐path of WMH burden (X), GM volume (atrophy, M1), AI (asymmetry, M2), and neuropsychological variables (Y) through a serial mediation model was analyzed. This analysis identified that left‐dominated GM atrophy and right‐lateralized asymmetry in the posterior middle temporal cortex mediated the relationship between WMH burden and recall memory in SACS patients. These results suggest that the unbalanced hemispheric atrophy in the posterior middle temporal cortex is crucial to mediating relationship between WMH burden and verbal recall memories, which may underlie accelerated aging and cognitive deterioration in patients with SACS and other vascular cognitive impairment.
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Affiliation(s)
- Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan City, Hubei Province, China
| | - Yaqiong Xiao
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan City, Hubei Province, China
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Wang P, Cai H, Luo R, Zhang Z, Zhang D, Zhang Y. Measurement of Cortical Atrophy and Its Correlation to Memory Impairment in Patients With Asymptomatic Carotid Artery Stenosis Based on VBM-DARTEL. Front Aging Neurosci 2021; 13:620763. [PMID: 34295237 PMCID: PMC8289738 DOI: 10.3389/fnagi.2021.620763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Severe carotid artery stenosis (CAS) can lead to atrophy of gray matter (GM) and memory impairment; however, the underlying mechanism is unknown. Thus, we aimed to identify memory impairment and GM atrophy and explore the possible correlation between them in patients with asymptomatic severe CAS. Methods Twenty-four patients with asymptomatic severe CAS and 10 healthy controls completed the mini-mental state examination (MMSE) and clinical memory scale (CMS) and underwent 7T magnetic resonance imaging (MRI) scan. Field intensity inhomogeneities were corrected. Images were processed using VBM8, and GM images were flipped. First, 11 flipped and 10 non-flipped images of patients with unilateral CAS and 5 flipped and 5 non-flipped images of controls were pre-processed using DARTEL algorithm and analyzed using an analysis of variance (ANOVA). Second, flipped and non-flipped images of unilateral patients were similarly pre-processed and analyzed using the paired t-test. Third, pre-processed non-flipped GM images and CMS scores of 24 patients were analyzed by multiple regression analysis. Nuisance variables were corrected accordingly. Results Basic information was well matched between patients and controls. MMSE scores of patients were in the normal range; however, memory function was significantly reduced (all P < 0.05). GM volumes of patients were significantly reduced in the anterior circulation regions. The stenosis-side hemispheres showed greater atrophy. GM volumes of the left pars opercularis, pars triangularis, and middle frontal gyrus were strongly positively correlated with the total scores of CMS (all r > 0.7, P = 0.001). Additionally, the left middle frontal gyrus was strongly positively correlated with associative memory (r = 0.853, P = 0.001). The left pars opercularis was moderately positively correlated with semantic memory (r = 0.695, P = 0.001). Conclusion Patients with asymptomatic CAS suffer from memory impairment. Bilateral anterior circulation regions showed extensive atrophy. The hemisphere with stenosis showed severer atrophy. Memory impairment in patients may be related to atrophy of the left frontal gyrus and atrophy of different regions may result in different memory impairments.
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Affiliation(s)
- Peijiong Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Husule Cai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Rutao Luo
- Department of Neurosurgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Dong Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yan Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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10
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Gao L, Ruan Z, Xiao Y, Xu H. Surface-based Cortical Morphometry, White Matter Hyperintensity, and Multidomain Cognitive Performance in Asymptomatic Carotid Stenosis. Neuroscience 2021; 467:16-27. [PMID: 34022325 DOI: 10.1016/j.neuroscience.2021.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 12/27/2022]
Abstract
Carotid stenosis is a major contributor to vascular dementia. Recent studies suggest that even clinically "asymptomatic" carotid stenosis is linked with cognitive decline and neuroimaging changes. Here we examined surface-based cortical morphometry, white matter hyperintensity (WMH), and multidomain cognitive performance in unilateral severe (>70% narrowing) asymptomatic carotid stenosis (SACS). We included 24 SACS patients (19 males/5 females; 64.25 ± 7.18 years) and 24 comorbidities-matched controls (19 males/5 females; 67.16 ± 6.10 years), and measured cortical thickness, sulcal depth, gyrification, cortical complexity, and WMH loads with structural MRI images. The SACS patients exhibited: (1) thinner cortex in bilateral somatosensory/motor, bilateral inferior frontal, bilateral fusiform, and left lateral temporal areas; (2) shallower sulci in left lateral temporal, parietal, insular and somatosensory/motor areas; (3) both hyper- and hypo-gyrification in lateral temporal and frontal cortices; (4) lower complexity (fractal dimension) in left insular and right superior temporal areas. Further association analyses showed that the cortical alterations were significantly correlated with verbal memory and WMH burden in SACS. These results suggest that SACS patients present a left-dominated damage tendency, especially in the Perisylvian cortices that span across several large-scale systems of somatosensory/motor and language. Our findings also provide cortical anatomy evidence for cognitive impairment in SACS, suggesting a neuroanatomical predisposition to dementia and cerebrovascular events.
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Affiliation(s)
- Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Zhao Ruan
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Yaqiong Xiao
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen 518057, China
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China.
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11
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Malucelli A, Skoch A, Ostry S, Tomek A, Urbanova B, Martinkovic L, Buksakowska I, Mohapl M, Netuka D, Hort J, Sroubek J, Vrana J, Moravec T, Bartos R, Sames M, Hajek M, Horinek D. Magnetic resonance markers of bilateral neuronal metabolic dysfunction in patients with unilateral internal carotid artery occlusion. MAGMA (NEW YORK, N.Y.) 2021; 34:141-151. [PMID: 32594274 DOI: 10.1007/s10334-020-00864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate cerebral hemodynamic, metabolic and anatomic changes occurring in patients with unilateral occlusion of the internal carotid artery (ICA). MATERIALS AND METHODS Twenty-two patients with unilateral occlusion of ICA and twenty age and sex matched healthy subjects were included in the study. Single voxel proton magnetic resonance spectroscopy (1H-MRS) of the centrum semiovale, semi-automated hippocampal volumetry in T1-weighted scans and transcranial Doppler examination (TCD) with calculation of Breath Holding Index (BHI) were performed in both groups. Metabolic, anatomic, and hemodynamic features were compared between the two groups. RESULTS The N-acetylaspartate (NAA)/choline (Cho) ratio was significantly lower in both hemispheres of enrolled patients compared to controls (p = 0.005 for the side with occlusion, p = 0.04 for the side without occlusion). The hippocampus volume was significantly reduced bilaterally in patients compared to healthy subjects (p = 0.049). A statistically significant difference in BHI values was observed between the side with occlusion and without occlusion (p = 0.037) of the patients, as well as between BHI values of the side with occlusion and healthy volunteers (p = 0.014). DISCUSSION Patients with unilateral ICA occlusion have reduced NAA/Cho ratio in the white matter of both hemispheres and have bilateral atrophy of hippocampus. The alteration of hemodynamics alone cannot explain these changes.
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Affiliation(s)
- Alberto Malucelli
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic.
| | - Antonin Skoch
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Svapotluk Ostry
- Department of Neurology, Ceske Budejovice Hospital, Ceske Budejovice, Czech Republic
| | - Ales Tomek
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Barbora Urbanova
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Lukas Martinkovic
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Irena Buksakowska
- Department of Radiology, University Hospital Motol, Prague, Czech Republic
| | - Milan Mohapl
- Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic
| | - David Netuka
- Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic
| | - Jakub Hort
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Jan Sroubek
- Department of Neurosurgery, Hospital Na Homolce, Prague, Czech Republic
| | - Jiri Vrana
- Department of Radiology, Central Military Hospital, Prague, Czech Republic
| | - Tomas Moravec
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Robert Bartos
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic
| | - Martin Sames
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic
| | - Milan Hajek
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Daniel Horinek
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
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12
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Zhang W, Qing Z, Hu Y, Shao M, Lu J, Wang J, Li M, Zhang X, Nedelska Z, Hort J, Wang Z, Qiao T, Zhang B. Thalamic Atrophy Plays a Crucial Role in the Effect of Asymptomatic Carotid Stenosis on Cognitive Impairment. Clin Interv Aging 2020; 15:2083-2094. [PMID: 33192055 PMCID: PMC7654547 DOI: 10.2147/cia.s273185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/21/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Our objectives were to assess the abnormalities of subcortical nuclei by combining volume and shape analyses and potential association with cognitive impairment. Patients and Methods Twenty-nine patients with severe ACS of the unilateral internal carotid artery and 31 controls were enrolled between January 2017 to August 2018. All participants underwent a comprehensive neuropsychological evaluation, blood lipid biochemical measurements, and structural magnetic resonance imaging (MRI) to measure subcortical volumes and sub-regional shape deformations. Basic statistics, correction for multiple comparisons. Seventeen ACS patients underwent carotid endarterectomy (CEA) within one week after baseline measurements, cognitive assessments and MRI scans were repeated 6 months after CEA. Results The ACS patients had higher apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio and worse performance in all cognitive domains than controls. Moreover, the ACS patients showed more profound thalamic atrophy assessed by shape and volume analysis, especially in the medial dorsal thalamus. No significant differences were found in other subcortical nuclei after multiple comparisons correction. At baseline, thalamic atrophy correlated with cognitive impairment and ApoB/ApoA1 ratio. Furthermore, mediation analysis at baseline showed that the association of carotid intima-media thickness with executive functioning was mediated by thalamic volume. After CEA, cognitive improvement and increase in the bilateral medial dorsal thalamic volume were observed. Conclusion Our study identified the distinct atrophy of subcortical nuclei and their association with cognition in patients with ACS. Assessments of the thalamus by volumetric and shape analysis may provide an early marker for cerebral ischemia and reperfusion after CEA.
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Affiliation(s)
- Wen Zhang
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Zhao Qing
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Yongwei Hu
- Department of Vascular and Interventional Radiology, Wujin People's Hospital Affiliated to Jiangsu University, Changzhou, People's Republic of China
| | - Mingran Shao
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Jiaming Lu
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Junxia Wang
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Ming Li
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Xin Zhang
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Zuzana Nedelska
- Department of Neurology, Memory Clinic, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Jakub Hort
- Department of Neurology, Memory Clinic, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Zhishun Wang
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Tong Qiao
- Department of Vascular Surgery, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Bing Zhang
- Department of Radiology, Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
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13
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Song Y, Cao C, Xu Q, Gu S, Wang F, Huang X, Xu S, Wu E, Huang JH. Piperine Attenuates TBI-Induced Seizures via Inhibiting Cytokine-Activated Reactive Astrogliosis. Front Neurol 2020; 11:431. [PMID: 32655468 PMCID: PMC7325955 DOI: 10.3389/fneur.2020.00431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/22/2020] [Indexed: 12/18/2022] Open
Abstract
Peppers have been used in clinics for a long time and its major component, piperine (PPR), has been proven to be effective in the treatment of seizures. The purpose of this study was to investigate the effects of piperine on early seizures in mice after a traumatic brain injury (TBI) and to explore the mechanism of the drug against the development on TBI. Specific-pathogen-free-grade mice were randomly divided into six dietary groups for a week: control group, TBI group, three piperine groups (low PPR group with 10 mg/kg PPR, medium PPR group with 20 mg/kg PPR, and high PPR group with 40 mg/kg PPR), and a positive control group (200 mg/kg valproate). Except for the control group, all the other groups used Feeney free weight falling method to establish the TBI of closed brain injury in mice, and the corresponding drugs were continuously injected intraperitoneally for 7 days after the brain injury. The results from behavior and electroencephalogram showed that piperine attenuated the subthreshold dose of pentylenetetrazole-induced seizures compared with the TBI group. The western blot results showed that the expression levels of inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were reduced by piperine. The immunostaining results showed that the brain-derived neurotrophic factor (BDNF) was also reduced by piperine. In addition, positive cell counts of astrocytic fibrillary acidic protein (GFAP) in immuno-fluorescence showed that they were also reduced. Our data show that piperine treatment can reduce the degree of cerebral edema, down-regulate TNF-α, IL-1β, and BDNF, decrease the reactivity of GFAP in the hippocampus, and inhibit TBI-induced seizures.
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Affiliation(s)
- Yabei Song
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Caiyun Cao
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qiuyue Xu
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Simeng Gu
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
- Department of Psychology, School of Medicine, Jiangsu University, Zhenjiang, China
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Fushun Wang
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Xi Huang
- Department of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shijun Xu
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Erxi Wu
- Department of Neurosurgery, Baylor Scott & White Health, Temple, TX, United States
- Department of Surgery, College of Medicine, Texas A&M University, Temple, TX, United States
| | - Jason H. Huang
- Department of Neurosurgery, Baylor Scott & White Health, Temple, TX, United States
- Department of Surgery, College of Medicine, Texas A&M University, Temple, TX, United States
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14
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Gao L, Wang T, Qian T, Xiao F, Bai L, Zhang J, Xu H. Severe asymptomatic carotid stenosis is associated with robust reductions in homotopic functional connectivity. Neuroimage Clin 2019; 24:102101. [PMID: 31835289 PMCID: PMC6911862 DOI: 10.1016/j.nicl.2019.102101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 10/05/2019] [Accepted: 11/18/2019] [Indexed: 12/01/2022]
Abstract
Severe (>70% narrowing) asymptomatic carotid stenosis (SACS) is associated with cognitive impairment and future strokes, and connectivity basis for the remote brain consequences is poorly understood. Here we explored homotopic connectivity and parenchymal lesions measured by multimodal magnetic resonance imaging (MRI) parameters in patients with SACS. Twenty-four patients with SACS (19 males/5 females; 64.25 ± 7.18 years), 24 comorbidities-matched controls (19 males/5 females; 67.16 ± 6.10 years), and an independent sample of elderly healthy controls (39 females/45 males; 57.92 ± 4.94 years) were included. Homotopic functional connectivity (FC) of resting-state functional MRI and structural connectivity (SC) of deterministic tractography were assessed. Arterial spin labeling based cerebral perfusion, susceptibility weighted imaging based microhemorrhagic lesions, and T2-weighted white matter hyperintensities were also quantified. Significant and robust homotopic reductions (validated by the independent dataset and support vector machine-based machine learning) were identified in the Perisylvian fissure in patients with SACS (false discovery rate corrected, voxel p < 0.05). These involved regions span across several large-scale brain systems, which include the somatomotor, salience, dorsal attention, and orbitofrontal-limbic networks. This significantly reduced homotopic FC can be partially explained by the corrected white matter hyperintensity size. Further association analyses suggest that the decreased homotopic FC in these brain regions is most closely associated with delayed memory recall, sensorimotor processing, and other simple cognitive functions. Together, these results suggest that SACS predominately affects the lower-order brain systems, while higher-order systems, especially the topographies of default mode network, are least impacted initially, but may serve as a hallmark precursor to vascular dementia. Thus, assessment of homotopic FC may provide a means of noninvasively tracking the progression of downstream brain damage following asymptomatic carotid stenosis.
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Affiliation(s)
- Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province 430071, China
| | - Tao Wang
- Department of Neurology, the First College of Clinical Medical Science, China Three Gorges University, Yichang, China; Department of Neurology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province 430071, China
| | - Tianyi Qian
- MR Collaboration, Siemens Healthcare China, Beijing, China
| | - Feng Xiao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province 430071, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province 430071, China.
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province 430071, China.
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15
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Nickel A, Kessner S, Niebuhr A, Schröder J, Malherbe C, Fischer F, Heinze M, Cheng B, Fiehler J, Pinnschmidt H, Larena-Avellaneda A, Gerloff C, Thomalla G. Cortical thickness and cognitive performance in asymptomatic unilateral carotid artery stenosis. BMC Cardiovasc Disord 2019; 19:154. [PMID: 31238977 PMCID: PMC6593546 DOI: 10.1186/s12872-019-1127-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/07/2019] [Indexed: 11/22/2022] Open
Abstract
Background We investigated changes of cortical thickness and its association with cognitive performance in patients with high-grade carotid artery stenosis without ischemic brain lesions. Methods We studied 25 patients with unilateral carotid artery stenosis ≥50% and 25 age-matched controls. All subjects underwent T1-weighted MRI, and cortical thickness was measured in 33 regions of interest in each hemisphere, as well as in brain regions belonging to the vascular territory of the middle cerebral artery (MCA). General linear mixed models were fitted to the dependent variable cortical thickness. Cognitive assessment comprised the Stroop Test and Trail Making Test B. Results In the linear mixed model, presence of carotid stenosis had no effect on cortical thickness. There was a significant interaction of stenosis and region with a trend towards lower cortical thickness in the MCA region on the side of carotid stenosis. Patients with carotid stenosis performed significantly worse on the Stroop test than controls, but there was no correlation with cortical thickness. Conclusion In patients with carotid stenosis without ischemic brain lesions, neither a clear pattern of reduced cortical thickness nor an association of cortical thickness with cognitive function was observed. Our data do not support the hypothesized association of cortical thinning and cognitive impairment in carotid stenosis. Electronic supplementary material The online version of this article (10.1186/s12872-019-1127-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alina Nickel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. .,Klinik und Poliklinik für Neurologie Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Simon Kessner
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Niebuhr
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Schröder
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Caroline Malherbe
- Center for Experimental Medicine, Institute of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Felix Fischer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marlene Heinze
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Neuroradiological diagnostics and intervention, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans Pinnschmidt
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Axel Larena-Avellaneda
- Department of Vascular Medicine, University Heart Center Hamburg GmbH (UHZ), Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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16
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Schaare HL, Kharabian Masouleh S, Beyer F, Kumral D, Uhlig M, Reinelt JD, Reiter AMF, Lampe L, Babayan A, Erbey M, Roebbig J, Schroeter ML, Okon-Singer H, Müller K, Mendes N, Margulies DS, Witte AV, Gaebler M, Villringer A. Association of peripheral blood pressure with gray matter volume in 19- to 40-year-old adults. Neurology 2019; 92:e758-e773. [PMID: 30674602 DOI: 10.1212/wnl.0000000000006947] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 10/15/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To test whether elevated blood pressure (BP) relates to gray matter (GM) volume (GMV) changes in young adults who had not previously been diagnosed with hypertension (systolic BP [SBP]/diastolic BP [DBP] ≥140/90 mm Hg). METHODS We associated BP with GMV from structural 3T T1-weighted MRI of 423 healthy adults between 19 and 40 years of age (mean age 27.7 ± 5.3 years, 177 women, SBP/DBP 123.2/73.4 ± 12.2/8.5 mm Hg). Data originated from 4 previously unpublished cross-sectional studies conducted in Leipzig, Germany. We performed voxel-based morphometry on each study separately and combined results in image-based meta-analyses (IBMA) to assess cumulative effects across studies. Resting BP was assigned to 1 of 4 categories: (1) SBP <120 and DBP <80 mm Hg, (2) SBP 120-129 or DBP 80-84 mm Hg, (3) SBP 130-139 or DBP 85-89 mm Hg, (4) SBP ≥140 or DBP ≥90 mm Hg. RESULTS IBMA yielded the following results: (1) lower regional GMV was correlated with higher peripheral BP; (2) lower GMV was found with higher BP when comparing individuals in subhypertensive categories 3 and 2, respectively, to those in category 1; (3) lower BP-related GMV was found in regions including hippocampus, amygdala, thalamus, frontal, and parietal structures (e.g., precuneus). CONCLUSION BP ≥120/80 mm Hg was associated with lower GMV in regions that have previously been related to GM decline in older individuals with manifest hypertension. Our study shows that BP-associated GM alterations emerge continuously across the range of BP and earlier in adulthood than previously assumed. This suggests that treating hypertension or maintaining lower BP in early adulthood might be essential for preventing the pathophysiologic cascade of asymptomatic cerebrovascular disease to symptomatic end-organ damage, such as stroke or dementia.
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Affiliation(s)
- H Lina Schaare
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany.
| | - Shahrzad Kharabian Masouleh
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Frauke Beyer
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Deniz Kumral
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Marie Uhlig
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Janis D Reinelt
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Andrea M F Reiter
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Leonie Lampe
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Anahit Babayan
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Miray Erbey
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Josefin Roebbig
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Matthias L Schroeter
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Hadas Okon-Singer
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Karsten Müller
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Natacha Mendes
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Daniel S Margulies
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - A Veronica Witte
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Michael Gaebler
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
| | - Arno Villringer
- From the Department of Neurology (H.L.S., S.K.M., F.B., D.K., M.U., J.D.R., A.M.F.R., L.L., A.B., M.E., J.R., M.L.S., A.V.W., M.G., A.V.), Max Planck Research Group for Neuroanatomy & Connectivity (N.M., D.S.M.), and Nuclear Magnetic Resonance Group (K.M.), Max Planck Institute for Human Cognitive and Brain Sciences; International Max Planck Research School NeuroCom (H.L.S., M.U.), Leipzig; MindBrainBody Institute at Berlin School of Mind and Brain (D.K., A.B., M.E., M.G., A.V.), Charité & Humboldt Universität zu Berlin; Lifespan Developmental Neuroscience (A.M.F.R.), Technische Universität Dresden; Leipzig Research Centre for Civilization Diseases (LIFE) (M.L.S., M.G., A.V.), Clinic for Cognitive Neurology (M.L.S., A.V.), and Collaborative Research Centre 1052 'Obesity Mechanisms,' Subproject A1, Faculty of Medicine (F.B., A.V.W., A.V.), University of Leipzig, Germany; Department of Psychology (H.O.-S.), University of Haifa, Israel; and Center for Stroke Research Berlin (A.V.), Charité-Universitätsmedizin Berlin, Germany
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Su JB, Xi SD, Zhou SY, Zhang X, Jiang SH, Xu B, Chen L, Lei Y, Gao C, Gu YX. Microstructural damage pattern of vascular cognitive impairment: a comparison between moyamoya disease and cerebrovascular atherosclerotic disease. Neural Regen Res 2019; 14:858-867. [PMID: 30688272 PMCID: PMC6375028 DOI: 10.4103/1673-5374.249234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Moyamoya disease and cerebrovascular atherosclerotic disease are both chronic ischemic diseases with similar presentations of vascular cognitive impairment. The aim of the present study was to investigate the patterns of microstructural damage associated with vascular cognitive impairment in the two diseases. The study recruited 34 patients with moyamoya disease (age 43.9 ± 9.2 years; 20 men and 14 women, 27 patients with cerebrovascular atherosclerotic disease (age: 44.6 ± 7.6 years; 17 men and 10 women), and 31 normal controls (age 43.6 ± 7.3 years; 18 men and 13 women) from Huashan Hospital of Fudan University in China. Cognitive function was assessed using the Mini-Mental State Examination, long-term delayed recall of Auditory Verbal Learning Test, Trail Making Test Part B, and the Symbol Digit Modalities Test. Single-photon emission-computed tomography was used to examine cerebral perfusion. Voxel-based morphometry and tract-based spatial statistics were performed to identify regions of gray matter atrophy and white matter deterioration in patients and normal controls. The results demonstrated that the severity of cognitive impairment was similar between the two diseases in all tested domains. Patients with moyamoya disease and those with cerebrovascular atherosclerotic disease suffered from disturbed supratentorial hemodynamics. Gray matter atrophy in bilateral middle cingulate cortex and parts of the frontal gyrus was prominent in both diseases, but in general, was more severe and more diffuse in those with moyamoya disease. White matter deterioration was significant for both diseases in the genu and body of corpus callosum, in the anterior and superior corona radiation, and in the posterior thalamic radiation, but in moyamoya disease, it was more diffuse and more severe. Vascular cognitive impairment was associated with regional microstructural damage, with a potential link between, gray and white matter damage. Overall, these results provide insight into the pathophysiological nature of vascular cognitive impairment. This study was approved by the Institutional Review Board in Huashan Hospital, China (approval No. 2014-278). This study was registered with ClinicalTrials.gov on December 2, 2014 with the identifier NCT02305407.
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Affiliation(s)
- Jia-Bin Su
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Si-Da Xi
- Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Yi Zhou
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Shen-Hong Jiang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Bin Xu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Liang Chen
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu Lei
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Chao Gao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu-Xiang Gu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
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18
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Nyitrai G, Spisák T, Spisák Z, Gajári D, Diószegi P, Kincses TZ, Czurkó A. Stepwise occlusion of the carotid arteries of the rat: MRI assessment of the effect of donepezil and hypoperfusion-induced brain atrophy and white matter microstructural changes. PLoS One 2018; 13:e0198265. [PMID: 29851990 PMCID: PMC5979036 DOI: 10.1371/journal.pone.0198265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 05/16/2018] [Indexed: 12/31/2022] Open
Abstract
Bilateral common carotid artery occlusion (BCCAo) in the rat is a widely used animal model of vascular dementia and a valuable tool for preclinical pharmacological drug testing, although the varying degrees of acute focal ischemic lesions it induces could interfere with its translational value. Recently, a modification to the BCCAo model, the stepwise occlusion of the two carotid arteries, has been introduced. To acquire objective translatable measures, we used longitudinal multimodal magnetic resonance imaging (MRI) to assess the effects of semi-chronic (8 days) donepezil treatment in this model, with half of the Wistar rats receiving the treatment one week after the stepwise BCCAo. With an ultrahigh field MRI, we measured high-resolution anatomy, diffusion tensor imaging, cerebral blood flow measurements and functional MRI in response to whisker stimulation, to evaluate both the structural and functional effects of the donepezil treatment and stepwise BCCAo up to 5 weeks post-occlusion. While no large ischemic lesions were detected, atrophy in the striatum and in the neocortex, along with widespread white matter microstructural changes, were found. Donepezil ameliorated the transient drop in the somatosensory BOLD response in distant cortical areas, as detected 2 weeks after the occlusion but the drug had no effect on the long term structural changes. Our results demonstrate a measurable functional MRI effect of the donepezil treatment and the importance of diffusion MRI and voxel based morphometry (VBM) analysis in the translational evaluation of the rat BCCAo model.
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Affiliation(s)
- Gabriella Nyitrai
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
- * E-mail:
| | - Tamás Spisák
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
| | - Zsófia Spisák
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
| | - Dávid Gajári
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
| | - Pálma Diószegi
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
| | - Tamás Zsigmond Kincses
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
- Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - András Czurkó
- Preclinical Imaging Center, Pharmacology and Drug Safety Research, Gedeon Richter Plc., Budapest, Hungary
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19
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Dani M, Brooks D, Edison P. Suspected non-Alzheimer's pathology - Is it non-Alzheimer's or non-amyloid? Ageing Res Rev 2017; 36:20-31. [PMID: 28235659 DOI: 10.1016/j.arr.2017.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/04/2017] [Accepted: 02/16/2017] [Indexed: 01/10/2023]
Abstract
Neurodegeneration, the progressive loss of neurons, is a major process involved in dementia and age-related cognitive impairment. It can be detected clinically using currently available biomarker tests. Suspected Non-Alzheimer Pathology (SNAP) is a biomarker-based concept that encompasses a group of individuals with neurodegeneration, but no evidence of amyloid deposition (thereby distinguishing it from Alzheimer's disease (AD)). These individuals may often have a clinical diagnosis of AD, but their clinical features, genetic susceptibility and progression can differ significantly, carrying crucial implications for precise diagnostics, clinical management, and efficacy of clinical drug trials. SNAP has caused wide interest in the dementia research community, because it is still unclear whether it represents distinct pathology separate from AD, or whether in some individuals, it could represent the earliest stage of AD. This debate has raised pertinent questions about the pathways to AD, the need for biomarkers, and the sensitivity of current biomarker tests. In this review, we discuss the biomarker and imaging trials that first recognized SNAP. We describe the pathological correlates of SNAP and comment on the different causes of neurodegeneration. Finally, we discuss the debate around the concept of SNAP, and further unanswered questions that are emerging.
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