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Wu H, Shi J, Sun X, Lu M, Liao A, Li Y, Xiao L, Zhou C, Dong W, Geng Z, Yuan L, Guo R, Chen M, Cheng X, Zhu W. Predictive effect of net water uptake on futile recanalisation in patients with acute large-vessel occlusion stroke. Clin Radiol 2024; 79:e599-e606. [PMID: 38310056 DOI: 10.1016/j.crad.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/03/2023] [Accepted: 01/06/2024] [Indexed: 02/05/2024]
Abstract
AIM To determine whether net water uptake (NWU) based on automated software evaluation could predict futile recanalisation in patients with acute anterior circulation large-vessel occlusion (LVO). MATERIALS AND METHODS Patients with acute anterior circulation LVO undergoing mechanical thrombectomy in Jinling Hospital were evaluated retrospectively. NWU and other baseline data were evaluated by performing univariate and multivariate analyses. The primary endpoint was 90-day modified Rankin scale score ≥3. A nomogram to predict poor clinical outcomes was developed based on multivariate logistic regression analysis. RESULTS Overall, 135 patients who underwent thrombectomy with a TICI grade ≥2b were enrolled. In multivariate logistic regression analysis, the following factors were identified as independent predictors of futile recanalisation: age (odds ratio [OR]: 1.055, 95 % confidence interval [CI]: 1.004-1.110, p=0.035), female (OR: 0.289, 95 % CI: 0.098-0.850, p=0.024), hypertension (OR: 3.182, 95 % CI: 1.160-8.728, p=0.025), high blood glucose level (OR: 1.36, 95 % CI: 1.087-1.701, p=0.007), admission National Institutes of Health Stroke Scale score (OR: 1.082, 95 % CI: 1.003-1.168, p=0.043), and NWU (OR: 1.312, 95 % CI: 1.038-1.659, p=0.023). CONCLUSIONS NWU based on Alberta Stroke Program Early Computed Tomography (CT) Score (ASPECTS) could be used to predict the occurrence of futile recanalisation in patients with acute anterior circulation LVO ischaemic stroke.
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Affiliation(s)
- H Wu
- Department of Neurology, Third People's Hospital of Yancheng, Yancheng 224001, Jiangsu, China; Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - J Shi
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - X Sun
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - M Lu
- Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - A Liao
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - Y Li
- Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, Jiangsu, China
| | - L Xiao
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - C Zhou
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - W Dong
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - Z Geng
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - L Yuan
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - R Guo
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China
| | - M Chen
- Department of Neurology, Third People's Hospital of Yancheng, Yancheng 224001, Jiangsu, China
| | - X Cheng
- Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China.
| | - W Zhu
- Department of Neurology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing 210002, Jiangsu, China.
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Yu Y, Zhang N, Xiang B, Ding N, Liu J, Huang J, Zhao M, Zhao Y, Wang Y, Ma Z. In vivo characterization of cerebrovascular impairment induced by amyloid β peptide overload in glymphatic clearance system using swept-source optical coherence tomography. NEUROPHOTONICS 2023; 10:015005. [PMID: 36817752 PMCID: PMC9933996 DOI: 10.1117/1.nph.10.1.015005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
SIGNIFICANCE Antiamyloid β ( A β ) immunotherapy is a promising therapeutic strategy for Alzheimer's disease (AD) but generates large amounts of soluble A β peptides that could overwhelm the clearance pathway, leading to serious side effects. Direct implications of A β in glymphatic drainage transport for cerebral vasculature and tissue are not well known. Studies are needed to resolve this issue and pave the way to better monitoring abnormal vascular events that may occur in A β -modifying therapies for AD. AIM The objective is to characterize the modification of cerebral vasculature and tissue induced by soluble A β abundantly present in the glymphatic clearance system. APPROACH A β 1 - 42 peptide was injected intracerebroventricularly and swept-source optical coherence tomography (SS-OCT) was used to monitor the progression of changes in the brain microvascular network and tissue in vivo over 14 days. Parameters reflecting vascular morphology and structure as well as tissue status were quantified and compared before treatment. RESULTS Vascular perfusion density, vessel length, and branch density decreased sharply and persistently following peptide administration. In comparison, vascular average diameter and vascular tortuosity were moderately increased at the late stage of monitoring. Endpoint density gradually increased, and the global optical attenuation coefficient value decreased significantly over time. CONCLUSIONS A β burden in the glymphatic system directly contributes to cerebrovascular structural and morphological abnormalities and global brain tissue damage, suggesting severe deleterious properties of soluble cerebrospinal fluid- A β . We also show that OCT can be used as an effective tool to monitor cerebrovascular dynamics and tissue property changes in response to therapeutic treatments in drug discovery research.
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Affiliation(s)
- Yao Yu
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao, China
| | - Ning Zhang
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
| | - Ben Xiang
- Northeastern University, College of Information Science and Engineering, Shenyang, China
| | - Ning Ding
- Northeastern University, College of Information Science and Engineering, Shenyang, China
| | - Jian Liu
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao, China
| | - Jiangmei Huang
- First Hospital of Qinhuangdao, Department of Pathology, Qinhuangdao, China
| | - Min Zhao
- First Hospital of Qinhuangdao, Department of Pathology, Qinhuangdao, China
| | - Yuqian Zhao
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
| | - Yi Wang
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao, China
| | - Zhenhe Ma
- Northeastern University at Qinhuangdao, School of Control Engineering, Qinhuangdao, China
- Hebei Key Laboratory of Micro-Nano Precision Optical Sensing and Measurement Technology, Qinhuangdao, China
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Achkasova KA, Moiseev AA, Yashin KS, Kiseleva EB, Bederina EL, Loginova MM, Medyanik IA, Gelikonov GV, Zagaynova EV, Gladkova ND. Nondestructive label-free detection of peritumoral white matter damage using cross-polarization optical coherence tomography. Front Oncol 2023; 13:1133074. [PMID: 36937429 PMCID: PMC10017731 DOI: 10.3389/fonc.2023.1133074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/27/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction To improve the quality of brain tumor resections, it is important to differentiate zones with myelinated fibers destruction from tumor tissue and normal white matter. Optical coherence tomography (OCT) is a promising tool for brain tissue visualization and in the present study, we demonstrate the ability of cross-polarization (CP) OCT to detect damaged white matter and differentiate it from normal and tumor tissues. Materials and methods The study was performed on 215 samples of brain tissue obtained from 57 patients with brain tumors. The analysis of the obtained OCT data included three stages: 1) visual analysis of structural OCT images; 2) quantitative assessment based on attenuation coefficients estimation in co- and cross-polarizations; 3) building of color-coded maps with subsequent visual analysis. The defining characteristics of structural CP OCT images and color-coded maps were determined for each studied tissue type, and then two classification tests were passed by 8 blinded respondents after a training. Results Visual assessment of structural CP OCT images allows detecting white matter areas with damaged myelinated fibers and differentiate them from normal white matter and tumor tissue. Attenuation coefficients also allow distinguishing all studied brain tissue types, while it was found that damage to myelinated fibers leads to a statistically significant decrease in the values of attenuation coefficients compared to normal white matter. Nevertheless, the use of color-coded optical maps looks more promising as it combines the objectivity of optical coefficient and clarity of the visual assessment, which leads to the increase of the diagnostic accuracy of the method compared to visual analysis of structural OCT images. Conclusions Alteration of myelinated fibers causes changes in the scattering properties of the white matter, which gets reflected in the nature of the received CP OCT signal. Visual assessment of structural CP OCT images and color-coded maps allows differentiating studied tissue types from each other, while usage of color-coded maps demonstrates higher diagnostic accuracy values in comparison with structural images (F-score = 0.85-0.86 and 0.81, respectively). Thus, the results of the study confirm the potential of using OCT as a neuronavigation tool during resections of brain tumors.
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Affiliation(s)
- Ksenia A. Achkasova
- Research institute of experimental oncology and biomedical technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- *Correspondence: Ksenia A. Achkasova,
| | - Alexander A. Moiseev
- Laboratory of Highly Sensitive Optical Measurements, Institute of Applied Physics of Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Konstantin S. Yashin
- Department of oncology and neurosurgery, University clinic, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Elena B. Kiseleva
- Research institute of experimental oncology and biomedical technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Evgenia L. Bederina
- Department of pathology, University clinic, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Maria M. Loginova
- Research institute of experimental oncology and biomedical technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Igor A. Medyanik
- Department of oncology and neurosurgery, University clinic, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Grigory V. Gelikonov
- Laboratory of Highly Sensitive Optical Measurements, Institute of Applied Physics of Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Elena V. Zagaynova
- Research institute of experimental oncology and biomedical technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
- Lobachevsky State University, Nizhny Novgorod, Russia
| | - Natalia D. Gladkova
- Research institute of experimental oncology and biomedical technologies, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
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Evaluation of Mannitol Intervention Effects on Ischemic Cerebral Edema in Mice Using Swept Source Optical Coherence Tomography. PHOTONICS 2022. [DOI: 10.3390/photonics9020081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cerebral edema is a serious complication of ischemic cerebrovascular disease and mannitol is a commonly used dehydrating agent for relieving cerebral edema. However, the edema state and surrounding vascular perfusion level during mannitol treatment remains unclear, which affects the clinical application of the medicine. In this paper, we demonstrated the role of swept-source optical coherence tomography (OCT) in the evaluation of mannitol efficacy using mouse models. The OCT-based angiography and attenuation imaging technology were used to obtain the cerebral vascular perfusion level and cerebral edema state at different times. Vascular parameters and edema parameters were quantified and compared. Experimental results show that mannitol can significantly reduce the water content in the central region of edema, effectively inhibiting the rapid growth of the edema area, and restoring cerebral blood flow. On average, the edema area decreased by 33% after 2 h, and the vascular perfusion density increased by 12% after 5 h. This work helps to provide a valuable theoretical basis and research ideas for the clinical treatment of cerebral edema.
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Giron A, Cox C, MacKay B. Techniques for Imaging Vascular Supply of Peripheral Nerves. J Brachial Plex Peripher Nerve Inj 2021; 16:e24-e30. [PMID: 34316297 PMCID: PMC8302262 DOI: 10.1055/s-0041-1731280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
Few studies have been developed to map the vascular structures feeding peripheral nerves, with the majority using cadaveric models and inadequate sample sizes. Preliminary evidence, while limited, indicates that the mapping of these vessels may allow or preclude certain procedures in nerve reconstruction due to the location of essential arterial inflow to the vasa nervorum. This review evaluates the evidence regarding historical, current, and emerging techniques for visualizing these vascular structures in vivo and considers their potential application in peripheral nerve vasculature.
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Affiliation(s)
- Alec Giron
- Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center School of Medicine Lubbock, Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas, United Sates
| | - Cameron Cox
- Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, Texas, United States
| | - Brendan MacKay
- Department of Orthopaedic Surgery, Texas Tech Health Sciences Center, Lubbock, Texas, United Sates
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Pénzes M, Túrós D, Máthé D, Szigeti K, Hegedűs N, Rauscher AÁ, Tóth P, Ivic I, Padmanabhan P, Pál G, Dobolyi Á, Gyimesi M, Málnási-Csizmadia A. Direct myosin-2 inhibition enhances cerebral perfusion resulting in functional improvement after ischemic stroke. Theranostics 2020; 10:5341-5356. [PMID: 32373216 PMCID: PMC7196296 DOI: 10.7150/thno.42077] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/03/2020] [Indexed: 12/29/2022] Open
Abstract
Acute ischemic stroke treatment faces an unresolved obstacle as capillary reperfusion remains insufficient after thrombolysis and thrombectomy causing neuronal damage and poor prognosis. Hypoxia-induced capillary constriction is mediated by actomyosin contraction in precapillary smooth muscle cells (SMCs) therefore smooth muscle myosin-2 could be an ideal target with potentially high impact on reperfusion of capillaries. Methods: The myosin-2 inhibitor para-aminoblebbistatin (AmBleb) was tested on isolated human and rat arterioles to assess the effect of AmBleb on vasodilatation. Transient middle cerebral artery occlusion (MCAO) was performed on 38 male Wistar rats followed by local administration of AmBleb into the ischemic brain area. Development of brain edema and changes in cerebrovascular blood flow were assessed using MRI and SPECT. We also tested the neurological deficit scores and locomotor asymmetry of the animals for 3 weeks after the MCAO operation. Results: Our results demonstrate that AmBleb could achieve full relaxation of isolated cerebral arterioles. In living animals AmBleb recovered cerebral blood flow in 32 out of the 65 affected functional brain areas in MCAO operated rats, whereas only 8 out of the 67 affected areas were recovered in the control animals. Animals treated with AmBleb also showed significantly improved general and focal deficit scores in neurological functional tests and showed significantly ameliorated locomotor asymmetry. Conclusion: Direct inhibition of smooth muscle myosin by AmBleb in pre-capillary SMCs significantly contribute to the improvement of cerebral blood reperfusion and brain functions suggesting that smooth muscle myosin inhibition may have promising potential in stroke therapies as a follow-up treatment of physical or chemical removal of the occluding thrombus.
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