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Kaur A, Fouad MH, Pozzebon C, Behlouli H, Rajah MN, Pilote L. Sex Differences in the Association Between Vascular Risk Factors and Cognitive Decline: A UK Biobank Study. JACC. ADVANCES 2024; 3:100930. [PMID: 39130034 PMCID: PMC11312777 DOI: 10.1016/j.jacadv.2024.100930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 08/13/2024]
Abstract
Background Age-related cognitive decline is accelerated by vascular risk factors for cerebral small vessel disease. However, the association of vascular risk factors with cerebral small vessel disease contributing to the sex differences in cognitive decline remains unclear. Objectives The purpose of this study was to evaluate sex differences in cognitive decline and the association between vascular risk factors and cognitive decline by sex. Methods We used data from the UK Biobank (>55 years of age; n = 19,067) to assess cognitive tests (executive function, processing speed, and memory) while adjusting for baseline measurements to examine how vascular risk factors affect cognition. A univariate regression analysis was used to assess sex differences at the first time point (2014). A repeated measure analysis with a mixed effect model was used to determine cognitive decline (between 2014 and 2019). Any significant interaction between vascular risk factors and sex was investigated. Results Females had lower scores in all 3 domains at the first cognitive tests (2014). We found a significant sex-by-time interaction over a 5-year period in matrix pattern completion (P = 0.03). After adjusting for vascular risk factors, this interaction was reduced (P = 0.08). High low-density lipoprotein, low education, and high blood pressure had a greater effect on the rate of cognitive decline in the executive function for females compared to males for the sex∗vascular risk factor interaction (P < 0.05). Conclusions The rate of cognitive decline did not differ significantly between males and females. However, the impact of several vascular risk factors on cognitive decline was greater in females than in males.
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Affiliation(s)
- Amanpreet Kaur
- Department of Medicine, McGill University Health center, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Canada
| | - Moustafa H. Fouad
- Department of Medicine, McGill University Health center, Montreal, Canada
| | - Chelsea Pozzebon
- Department of Medicine, McGill University Health center, Montreal, Canada
| | - Hassan Behlouli
- Centre for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Canada
| | - M. Natasha Rajah
- Department of Psychology, Faculty of Arts, Toronto Metropolitan University, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine & Health Sciences, McGill University, Montreal, Canada
| | - Louise Pilote
- Department of Medicine, McGill University Health center, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Canada
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Silva AR, Santos I, Fernandes C, Silva C, Pereira D, Galego O, Queiroz H, Almeida MDR, Baldeiras I, Santo G. The relevance of the socio-emotional deficits in cerebral small vessels disease (CSVD): An exploratory study with sporadic CSVD and CADASIL patients. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100186. [PMID: 38162294 PMCID: PMC10757198 DOI: 10.1016/j.cccb.2023.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/03/2023] [Accepted: 09/25/2023] [Indexed: 01/03/2024]
Abstract
Background Cerebral Small Vessels Disease (CSVD) is categorized in different forms, the most common being the sporadic form and a genetic variant - Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Amongst the most frequent clinical manifestations are the neuropsychological changes of cognitive, behavioral, and emotional nature, whose features are still under debate. Objective This exploratory study aimed to compare the neuropsychological profile of a sporadic CSVD sample and a CADASIL sample with an age, education, and gender matched control group, between the ages of 30-65 YO (total sample mean age=51.16; SD=4.31). Methods 20 patients with sporadic CSVD, 20 patients with CADASIL and 20 matched controls completed a neuropsychological assessment battery. Global cognitive state, processing speed, working memory, attention, executive dysfunction, episodic memory, social cognition, impulsivity, apathy, alexithymia, depression, and anxiety were measured. White matter hyperintensities (WMH) volume were quantified and measured as lesion burden. Results The cognitive differences found between the clinical groups combined (after confirming no differences between the two clinical groups) and matched controls were restricted to speed processing scores (d = 0.32 95 % CI [.12-.47]). The socio-emotional and behavioral profile revealed significantly higher levels of depression (d = 0.21, 95 % CI [.16-.33]). and anxiety (d = 0.25 95 % CI [.19-.32]) in CADASIL and sporadic CSVD groups, and the same for the alexithymia score (d = 0.533 95 % CI [.32-.65]) were the clinical groups revealed impoverished emotional processing compared to controls. WMH only significantly correlated with the cognitive changes and age. Conclusions In our study, CADASIL and sporadic cSVD patients combined, present multiple emotional-behavioral symptoms - alexithymia, anxiety, depression, and in a lower extent apathy and impulsivity - suggesting for the presence of emotion dysregulation behaviors, present independently of age and of the presence of cognitive deficits. Despite of the small sample size that could underpower some findings, this exploratory research supported that these symptoms may have a significant impact in disease monitoring, progression, and prognosis, requiring further investigation regarding their neurophysiological substrates.
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Affiliation(s)
- Ana Rita Silva
- CINEICC – Center for Research in Neuropsychology and Cognitive Behavioral Interventions of the University of Coimbra, Colegio Novo Street, N/A, Coimbra 3000-115, Portugal
| | - Irina Santos
- Neurology Department, Academic and Clinical Centre – Coimbra University Hospitals, Coimbra, Portugal
| | - Carolina Fernandes
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
| | - Cristiana Silva
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
| | - Daniela Pereira
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | - Orlando Galego
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | - Henrique Queiroz
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | | | - Inês Baldeiras
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Gustavo Santo
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
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Hotz I, Deschwanden PF, Liem F, Mérillat S, Malagurski B, Kollias S, Jäncke L. Performance of three freely available methods for extracting white matter hyperintensities: FreeSurfer, UBO Detector, and BIANCA. Hum Brain Mapp 2022; 43:1481-1500. [PMID: 34873789 PMCID: PMC8886667 DOI: 10.1002/hbm.25739] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 11/11/2021] [Accepted: 11/26/2021] [Indexed: 11/07/2022] Open
Abstract
White matter hyperintensities (WMH) of presumed vascular origin are frequently found in MRIs of healthy older adults. WMH are also associated with aging and cognitive decline. Here, we compared and validated three algorithms for WMH extraction: FreeSurfer (T1w), UBO Detector (T1w + FLAIR), and FSL's Brain Intensity AbNormality Classification Algorithm (BIANCA; T1w + FLAIR) using a longitudinal dataset comprising MRI data of cognitively healthy older adults (baseline N = 231, age range 64-87 years). As reference we manually segmented WMH in T1w, three-dimensional (3D) FLAIR, and two-dimensional (2D) FLAIR images which were used to assess the segmentation accuracy of the different automated algorithms. Further, we assessed the relationships of WMH volumes provided by the algorithms with Fazekas scores and age. FreeSurfer underestimated the WMH volumes and scored worst in Dice Similarity Coefficient (DSC = 0.434) but its WMH volumes strongly correlated with the Fazekas scores (rs = 0.73). BIANCA accomplished the highest DSC (0.602) in 3D FLAIR images. However, the relations with the Fazekas scores were only moderate, especially in the 2D FLAIR images (rs = 0.41), and many outlier WMH volumes were detected when exploring within-person trajectories (2D FLAIR: ~30%). UBO Detector performed similarly to BIANCA in DSC with both modalities and reached the best DSC in 2D FLAIR (0.531) without requiring a tailored training dataset. In addition, it achieved very high associations with the Fazekas scores (2D FLAIR: rs = 0.80). In summary, our results emphasize the importance of carefully contemplating the choice of the WMH segmentation algorithm and MR-modality.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of PsychologyUniversity of ZurichZurichSwitzerland
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of ZurichZurichSwitzerland
| | | | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of ZurichZurichSwitzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of ZurichZurichSwitzerland
| | - Brigitta Malagurski
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of ZurichZurichSwitzerland
| | - Spyros Kollias
- Department of NeuroradiologyUniversity Hospital ZurichZurichSwitzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of PsychologyUniversity of ZurichZurichSwitzerland
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of ZurichZurichSwitzerland
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Hotz I, Deschwanden PF, Mérillat S, Liem F, Kollias S, Jäncke L. Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study. Neuroimage Clin 2021; 32:102884. [PMID: 34911190 PMCID: PMC8633374 DOI: 10.1016/j.nicl.2021.102884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Markers of cerebral small vessel disease (CSVD) have previously been associated with age-related cognitive decline. Using longitudinal data of cognitively healthy, older adults (N = 216, mean age at baseline = 70.9 years), we investigated baseline status and change in white matter hyperintensities (WMH) (total, periventricular, deep), normal appearing white matter (NAWM), brain parenchyma volume (BPV) and processing speed over seven years as well as the impact of different covariates by applying latent growth curve (LGC) models. Generally, we revealed a complex pattern of associations between the different CSVD markers. More specifically, we observed that changes of deep WMH (dWMH), as compared to periventricular WMH (pWMH), were more strongly related to the changes of other CSVD markers and also to baseline processing speed performance. Further, the number of lacunes rather than their volume reflected the severity of CSVD. With respect to the studied covariates, we revealed that higher education had a protective effect on subsequent total WMH, pWMH, lacunar number, NAWM volume, and processing speed performance. The indication of antihypertensive drugs was associated with lower lacunar number and volume at baseline and the indication of antihypercholesterolemic drugs came along with higher processing speed performance at baseline. In summary, our results confirm previous findings, and extend them by providing information on true within-person changes, relationships between the different CSVD markers and brain-behavior associations. The moderate to strong associations between changes of the different CSVD markers indicate a common pathological relationship and, thus, support multidimensional treatment strategies.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
| | - Pascal Frédéric Deschwanden
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Spyridon Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
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5
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Zhào H, Liu Y, Xia Z, Xie H, Huang Y. Diagnosis and Assessment of Apathy in Elderly Chinese Patients With Cerebral Small Vessel Disease. Front Psychiatry 2021; 12:688685. [PMID: 34413797 PMCID: PMC8368720 DOI: 10.3389/fpsyt.2021.688685] [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: 03/31/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The study aimed to estimate the frequency of apathy in Chinese patients with cerebral small vessel disease (CSVD) and investigate the relationship between apathy and neuroimaging markers of CSVD. Methods: A total of 150 CSVD aged patients were recruited for a cross-sectional observational study. Following the new revised version of diagnostic criteria for apathy (DCA), each patient was evaluated successively by the neuropsychiatric inventory (NPI-apathy), geriatric depression scale (GDS), and caregiver burden scale (CBS). The MRI presence of lacunes, white matter hyperintensities, cerebral microbleeds, and perivascular spaces were rated independently. Furthermore, presence of all these MRI markers were summed in a score of 0-4 representing all CSVD features combined. Results: According to the DCA, we found that the frequency of apathy in Chinese Alzheimer's disease patients reached 37.33%, with lack of and diminished goal-directed activities in the dimension of behavior/cognition. We did not find a close relationship between apathy and depression. Caregiver burden was positively correlated with apathy severity. Apathy, but not depression, was positively associated with total CSVD burden, rather than a separate MRI marker of CSVD. Conclusion: As a key component of neuropsychiatric symptoms, apathy was common in Chinese elderly with CSVD, more attention should be paid to apathy in clinical practice of CSVD.
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Affiliation(s)
- Hóngyi Zhào
- Department of Neurology, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Psychiatry, NO 984 Hospital of People's Liberation Army, Beijing, China
| | - Yu Liu
- Department of Neurology, NO 984 Hospital of People's Liberation Army, Beijing, China
| | - Zhenxi Xia
- Department of Neurology, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hongyang Xie
- Department of Neurology, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yonghua Huang
- Department of Neurology, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
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Li B, Ohtomo R, Thunemann M, Adams SR, Yang J, Fu B, Yaseen MA, Ran C, Polimeni JR, Boas DA, Devor A, Lo EH, Arai K, Sakadžić S. Two-photon microscopic imaging of capillary red blood cell flux in mouse brain reveals vulnerability of cerebral white matter to hypoperfusion. J Cereb Blood Flow Metab 2020; 40:501-512. [PMID: 30829101 PMCID: PMC7026840 DOI: 10.1177/0271678x19831016] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 01/15/2023]
Abstract
Despite the importance of understanding the regulation of microvascular blood flow in white matter, no data on subcortical capillary blood flow parameters are available, largely due to the lack of appropriate imaging methods. To address this knowledge gap, we employed two-photon microscopy using a far-red fluorophore Alexa680 and photon-counting detection to measure capillary red blood cell (RBC) flux in both cerebral gray and white matter, in isoflurane-anesthetized mice. We have found that in control animals, baseline capillary RBC flux in the white matter was significantly higher than in the adjacent cerebral gray matter. In response to mild hypercapnia, RBC flux in the white matter exhibited significantly smaller fractional increase than in the gray matter. Finally, during global cerebral hypoperfusion, RBC flux in the white matter was reduced significantly in comparison to the controls, while RBC flux in the gray matter was preserved. Our results suggest that blood flow in the white matter may be less efficiently regulated when challenged by physiological perturbations as compared to the gray matter. Importantly, the blood flow in the white matter may be more susceptible to hypoperfusion than in the gray matter, potentially exacerbating the white matter deterioration in brain conditions involving global cerebral hypoperfusion.
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Affiliation(s)
- Baoqiang Li
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ryo Ohtomo
- Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Martin Thunemann
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Stephen R Adams
- Department of Pharmacology, University of California, San Diego, La Jolla, CA, USA
| | - Jing Yang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Buyin Fu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Mohammad A Yaseen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Chongzhao Ran
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Jonathan R Polimeni
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - David A Boas
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Anna Devor
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Eng H Lo
- Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Ken Arai
- Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Sava Sakadžić
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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7
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Denver P, D’Adamo H, Hu S, Zuo X, Zhu C, Okuma C, Kim P, Castro D, Jones MR, Leal C, Mekkittikul M, Ghadishah E, Teter B, Vinters HV, Cole GM, Frautschy SA. A Novel Model of Mixed Vascular Dementia Incorporating Hypertension in a Rat Model of Alzheimer's Disease. Front Physiol 2019; 10:1269. [PMID: 31708792 PMCID: PMC6821690 DOI: 10.3389/fphys.2019.01269] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/19/2019] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) and mixed dementia (MxD) comprise the majority of dementia cases in the growing global aging population. MxD describes the coexistence of AD pathology with vascular pathology, including cerebral small vessel disease (SVD). Cardiovascular disease increases risk for AD and MxD, but mechanistic synergisms between the coexisting pathologies affecting dementia risk, progression and the ultimate clinical manifestations remain elusive. To explore the additive or synergistic interactions between AD and chronic hypertension, we developed a rat model of MxD, produced by breeding APPswe/PS1ΔE9 transgenes into the stroke-prone spontaneously hypertensive rat (SHRSP) background, resulting in the SHRSP/FAD model and three control groups (FAD, SHRSP and non-hypertensive WKY rats, n = 8-11, both sexes, 16-18 months of age). After behavioral testing, rats were euthanized, and tissue assessed for vascular, neuroinflammatory and AD pathology. Hypertension was preserved in the SHRSP/FAD cross. Results showed that SHRSP increased FAD-dependent neuroinflammation (microglia and astrocytes) and tau pathology, but plaque pathology changes were subtle, including fewer plaques with compact cores and slightly reduced plaque burden. Evidence for vascular pathology included a change in the distribution of astrocytic end-foot protein aquaporin-4, normally distributed in microvessels, but in SHRSP/FAD rats largely dissociated from vessels, appearing disorganized or redistributed into neuropil. Other evidence of SVD-like pathology included increased collagen IV staining in cerebral vessels and PECAM1 levels. We identified a plasma biomarker in SHRSP/FAD rats that was the only group to show increased Aqp-4 in plasma exosomes. Evidence of neuron damage in SHRSP/FAD rats included increased caspase-cleaved actin, loss of myelin and reduced calbindin staining in neurons. Further, there were mitochondrial deficits specific to SHRSP/FAD, notably the loss of complex II, accompanying FAD-dependent loss of mitochondrial complex I. Cognitive deficits exhibited by FAD rats were not exacerbated by the introduction of the SHRSP phenotype, nor was the hyperactivity phenotype associated with SHRSP altered by the FAD transgene. This novel rat model of MxD, encompassing an amyloidogenic transgene with a hypertensive phenotype, exhibits several features associated with human vascular or "mixed" dementia and may be a useful tool in delineating the pathophysiology of MxD and development of therapeutics.
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Affiliation(s)
- Paul Denver
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Heather D’Adamo
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shuxin Hu
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Xiaohong Zuo
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Cansheng Zhu
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Chihiro Okuma
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Peter Kim
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Daniel Castro
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Mychica R. Jones
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Carmen Leal
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Marisa Mekkittikul
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Elham Ghadishah
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Bruce Teter
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Harry V. Vinters
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Gregory Michael Cole
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
| | - Sally A. Frautschy
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Geriatric Research Education and Clinical Center, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
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Caruso P, Signori R, Moretti R. Small vessel disease to subcortical dementia: a dynamic model, which interfaces aging, cholinergic dysregulation and the neurovascular unit. Vasc Health Risk Manag 2019; 15:259-281. [PMID: 31496716 PMCID: PMC6689673 DOI: 10.2147/vhrm.s190470] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/14/2019] [Indexed: 12/14/2022] Open
Abstract
Background Small vessels have the pivotal role for the brain’s autoregulation. The arteriosclerosis-dependent alteration of the brain perfusion is one of the major determinants in small vessel disease. Endothelium distress can potentiate the flow dysregulation and lead to subcortical vascular dementia (sVAD). sVAD increases morbidity and disability. Epidemiological studies have shown that sVAD shares with cerebrovascular disease most of the common risk factors. The molecular basis of this pathology remains controversial. Purpose To detect the possible mechanisms between small vessel disease and sVAD, giving a broad vision on the topic, including pathological aspects, clinical and laboratory findings, metabolic process and cholinergic dysfunction. Methods We searched MEDLINE using different search terms (“vascular dementia”, “subcortical vascular dementia”, “small vessel disease”, “cholinergic afferents”, etc). Publications were selected from the past 20 years. Searches were extended to Embase, Cochrane Library, and LILIACS databases. All searches were done from January 1, 1998 up to January 31, 2018. Results A total of 560 studies showed up, and appropriate studies were included. Associations between traditional vascular risk factors have been isolated. We remarked that SVD and white matter abnormalities are seen frequently with aging and also that vascular and endothelium changes are related with age; the changes can be accelerated by different vascular risk factors. Vascular function changes can be heavily influenced by genetic and epigenetic factors. Conclusion Small vessel disease and the related dementia are two pathologies that deserve attention for their relevance and impact in clinical practice. Hypertension might be a historical problem for SVD and SVAD, but low pressure might be even more dangerous; CBF regional selective decrease seems to be a critical factor for small vessel disease-related dementia. In those patients, endothelium damage is a super-imposed condition. Several issues are still debatable, and more research is needed.
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Affiliation(s)
- Paola Caruso
- Department of Medical, Surgical and Health Sciences, Neurology Clinic, University of Trieste, Trieste, Italy
| | - Riccardo Signori
- Department of Medical, Surgical and Health Sciences, Neurology Clinic, University of Trieste, Trieste, Italy
| | - Rita Moretti
- Department of Medical, Surgical and Health Sciences, Neurology Clinic, University of Trieste, Trieste, Italy
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Matić TB, Toncev G, Gavrilović A, Aleksić D. Suffering from Cerebral Small Vessel Disease with and without Metabolic Syndrome. Open Med (Wars) 2019; 14:479-484. [PMID: 31231684 PMCID: PMC6572407 DOI: 10.1515/med-2019-0051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/01/2019] [Indexed: 12/24/2022] Open
Abstract
Background Cerebral small vessel disease (CSVD) and metabolic syndrome were separately associated with cognitive impairment and depression. However, whether metabolic syndrome adds to cognitive impairment and depression in patients who already have CSVD remained unanswered. Objective The aim of our study was to investigate the association of metabolic syndrome with cognitive impairment and depression in patients with CSVD who have lacunar lesions or white matter hyperintensities. Methods This prospective cohort study was conducted at Neurology Clinic, Clinical Center, Kragujevac, Serbia. Main outcomes of the study were cognitive assessment, and assessment of depression among hospitalized patients with or without CSVD. Results The study included 74 inpatients, 25 of them having lacunary infarctions, 24 with the white matter hyperintensities, and 25 control patients without CSVD. The CSVD was accompanied by impairment of cognition and depression, the patients with lacunary lesions being more cognitively impaired and more depressive than the patients with the white matter hyperintensities. The patients with CSVD who also had metabolic syndrome were more cognitively impaired and depressed than the patients with CSVD alone. Conclusions In conclusion, our study showed that metabolic syndrome is associated with further worsening of already impaired cognition and existing depression in patients with CSVD.
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Affiliation(s)
- Tatjana Bošković Matić
- Clinical Center Kragujevac, Clinic of neurology, Zmaj Jovina 30, 34000 Kragujevac, Serbia
| | - Gordana Toncev
- University of Kragujevac, Faculty of Medical Sciences, and Clinical Center, Kragujevac, Serbia
| | - Aleksandar Gavrilović
- University of Kragujevac, Faculty of Medical Sciences, and Clinical Center, Kragujevac, Serbia
| | - Dejan Aleksić
- University of Kragujevac, Faculty of Medical Sciences, and Clinical Center, Kragujevac, Serbia
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10
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Mimenza-Alvarado A, Aguilar-Navarro SG, Yeverino-Castro S, Mendoza-Franco C, Ávila-Funes JA, Román GC. Neuroimaging Characteristics of Small-Vessel Disease in Older Adults with Normal Cognition, Mild Cognitive Impairment, and Alzheimer Disease. Dement Geriatr Cogn Dis Extra 2018; 8:199-206. [PMID: 29928288 PMCID: PMC6006607 DOI: 10.1159/000488705] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/23/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Cerebral small-vessel disease (SVD) represents the most frequent type of vascular brain lesions, often coexisting with Alzheimer disease (AD). By quantifying white matter hyperintensities (WMH) and hippocampal and parietal atrophy, we aimed to describe the prevalence and severity of SVD among older adults with normal cognition (NC), mild cognitive impairment (MCI), and probable AD and to describe associated risk factors. Methods This study included 105 older adults evaluated with magnetic resonance imaging and clinical and neuropsychological tests. We used the Fazekas scale (FS) for quantification of WMH, the Scheltens scale (SS) for hippocampal atrophy, and the Koedam scale (KS) for parietal atrophy. Logistic regression models were performed to determine the association between FS, SS, and KS scores and the presence of NC, MCI, or probable AD. Results Compared to NC subjects, SVD was more prevalent in MCI and probable AD subjects. After adjusting for confounding factors, logistic regression showed a positive association between higher scores on the FS and probable AD (OR = 7.6, 95% CI 2.7–20, p < 0.001). With the use of the SS and KS (OR = 4.5, 95% CI 3.5–58, p = 0.003 and OR = 8.9, 95% CI 1–72, p = 0.04, respectively), the risk also remained significant for probable AD. Conclusions These results suggest an association between severity of vascular brain lesions and neurodegeneration.
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Affiliation(s)
- Alberto Mimenza-Alvarado
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara G Aguilar-Navarro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sara Yeverino-Castro
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - César Mendoza-Franco
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Alberto Ávila-Funes
- Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston Methodist Hospital, Houston, Texas, USA
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11
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Zhou H, Tang Y, Yuan Z. White matter asymmetries in patients with cerebral small vessel disease. J Integr Neurosci 2018. [DOI: 10.3233/jin-170037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Hua Zhou
- School of Information Science and Engineering, Central South University, Changsha, Hunan 410083, P. R. China
- South China Institute of Software Engineering, Guangzhou, 510990, P. R. China
- School of Basic Medical Science Central South University, Changsha, Hunan 410083, P. R. China
| | - Yan Tang
- School of Information Science and Engineering, Central South University, Changsha, Hunan 410083, P. R. China
| | - Zhi Yuan
- South China Institute of Software Engineering, Guangzhou, 510990, P. R. China
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12
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The Evolving Interconnectedness of 3 Fields of Study. TOPICS IN GERIATRIC REHABILITATION 2018. [DOI: 10.1097/tgr.0000000000000170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Li M, Meng Y, Wang M, Yang S, Wu H, Zhao B, Wang G. Cerebral gray matter volume reduction in subcortical vascular mild cognitive impairment patients and subcortical vascular dementia patients, and its relation with cognitive deficits. Brain Behav 2017; 7:e00745. [PMID: 28828207 PMCID: PMC5561307 DOI: 10.1002/brb3.745] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/19/2017] [Accepted: 04/29/2017] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Subcortical vascular mild cognitive impairment (svMCI) is the predementia stage of subcortical vascular dementia (SVaD). The aim of this research is to explore and compare cerebral gray matter (GM) volume reduction in svMCI patients and SVaD patients, and to investigate the relationship between cerebral GM volume reduction and cognitive deficits. METHODS Thirty one svMCI patients, 29 SVaD patients, and 31 healthy controls were recruited in our research. They conducted neuropsychological tests and brain structural magnetic resonance imaging (MRI) examination. To detect cerebral GM volume reduction in svMCI patients and SVaD patients, we used statistical parametric mapping 8-voxel-based morphometry 8 (SPM8-VBM8) method to analyze MRI data. To detect the relationship between cerebral GM volume reduction and cognitive deficits, multiple linear regression analysis was used. RESULTS Compared with healthy controls, svMCI patients showed cerebral GM volume reduction in hippocampus and parahippocampal gyrus, insula and superior temporal gyrus. Compared with healthy controls, SVaD patients exhibited more atrophy which encompasses all of these areas plus anterior and middle cingulate, inferior temporal gyrus, orbitofrontal cortex, and superior frontal gyrus. In svMCI patients, cerebral GM volume reduction correlated with memory loss, attention dysfunction, and language dysfunction; in SVaD patients, besides those cognitive deficits, cerebral GM volume reduction correlated with more cognitive impairments, including executive dysfunction, neuropsychiatric symptom, and depression. CONCLUSIONS Our findings prove that both svMCI patients and SVaD patients exhibit cerebral GM volume reduction and there may exist a hierarchy between svMCI and SVaD, and cerebral GM volume reduction in both svMCI patients and SVaD patients correlates with cognitive deficits, which can help us understand the mechanism of cognitive impairments in svMCI patients and SVaD patients, and diagnose SVaD at its early stage.
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Affiliation(s)
- Maoyu Li
- Department of Neurology Shandong Provincial Hospital Affiliated to Shandong University Jinan Shandong China
| | - Yao Meng
- Department of Neurology Shandong Provincial Hospital Affiliated to Shandong University Jinan Shandong China
| | - Minzhong Wang
- Department of Neurology Shandong Provincial Hospital Affiliated to Shandong University Jinan Shandong China
| | - Shuang Yang
- Department of Magnetic Resonance Imaging Shandong Medical Imaging Research Institute Affiliated to Shandong University Jinan Shandong China
| | - Hui Wu
- Department of Neurology Shandong Provincial Hospital Affiliated to Shandong University Jinan Shandong China
| | - Bin Zhao
- Department of Magnetic Resonance Imaging Shandong Medical Imaging Research Institute Affiliated to Shandong University Jinan Shandong China
| | - Guangbin Wang
- Department of Magnetic Resonance Imaging Shandong Medical Imaging Research Institute Affiliated to Shandong University Jinan Shandong China
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Jorgensen DR, Rosano C, Novelli EM. Can Neuroimaging Markers of Vascular Pathology Explain Cognitive Performance in Adults With Sickle Cell Anemia? A review of the Literature. Hemoglobin 2017; 40:381-387. [PMID: 27689914 DOI: 10.1080/03630269.2016.1242493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Adults with homozygous sickle cell anemia have, on average, lower cognitive function than unaffected controls. The mechanisms underlying cognitive deterioration in this population are poorly understood, but cerebral small vessel disease (CSVD) is likely to be implicated. We conducted a systematic review using the Prisma Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of articles that included both measures of cognitive function and magnetic resonance imaging (MRI) neuroimaging markers of small vessel disease. While all five studies we identified reported small vessel disease by MRI, only two of them found a significant relationship between structural changes and cognitive performance. Differences in methodologies and small sample sizes likely accounted for the discrepancies between the studies. We conclude that while MRI is a valuable tool to identify markers of CSVD in this population, larger studies are needed to definitely establish a link between MRI-detectable abnormalities and cognitive function in sickle cell anemia.
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Affiliation(s)
- Dana R Jorgensen
- a Department of Epidemiology , University of Pittsburgh School of Public Health , Pittsburgh , PA , USA
| | - Caterina Rosano
- a Department of Epidemiology , University of Pittsburgh School of Public Health , Pittsburgh , PA , USA
| | - Enrico M Novelli
- b Adult Sickle Cell Program, Division of Hematology/Oncology , University of Pittsburgh , Pittsburgh , PA , USA
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15
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Hammers DB, Atkinson TJ, Dalley BCA, Suhrie KR, Beardmore BE, Burrell LD, Horn KP, Rasmussen KM, Foster NL, Duff K, Hoffman JM. Relationship between 18F-Flutemetamol uptake and RBANS performance in non-demented community-dwelling older adults. Clin Neuropsychol 2017; 31:531-543. [PMID: 28077020 DOI: 10.1080/13854046.2016.1278039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with mild cognitive impairment and Alzheimer's disease (AD); however, relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS. METHODS Twenty-seven nondemented community-dwelling adults over the age of 65 underwent 18F-Flutemetamol amyloid- positron emission tomography imaging, along with cognitive testing using the RBANS and select behavioral measures. Partial correlation coefficients were used to identify relationships between the imaging and behavioral markers. RESULTS After controlling for age and education, amyloid deposition and RBANS Indexes of Immediate Memory, Delayed Memory, and Total Scale score were significantly correlated (p's < .001, r's = -.73 to -.77, d's = 2.13-2.39), with greater amyloid burden being associated with lower RBANS scores. The Delayed Memory Index was particularly highly associated with 18F-Flutemetamol binding (r2 = .59, p < .001, d = 2.39). Neither 18F-Flutemetamol binding nor RBANS performance was significantly correlated with levels of depression, subjective cognitive difficulties, or premorbid intellect. CONCLUSIONS Because of the limited use of amyloid imaging in clinical settings due to high cost and lack of reimbursement, these findings suggest that in particular RBANS Delayed Memory Index may be a cost-efficient tool to identify early signs of AD pathology, and its use may enlighten clinical decision-making regarding potential progression to dementia due to AD.
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Affiliation(s)
- Dustin B Hammers
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Taylor J Atkinson
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Bonnie C A Dalley
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Kayla R Suhrie
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Britney E Beardmore
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Lance D Burrell
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kevin P Horn
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kelli M Rasmussen
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Norman L Foster
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Kevin Duff
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - John M Hoffman
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
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16
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Xu X, Chan QL, Hilal S, Goh WK, Ikram MK, Wong TY, Cheng CY, Chen CLH, Venketasubramanian N. Cerebral microbleeds and neuropsychiatric symptoms in an elderly Asian cohort. J Neurol Neurosurg Psychiatry 2017; 88:7-11. [PMID: 27261503 DOI: 10.1136/jnnp-2016-313271] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/05/2016] [Accepted: 05/07/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Neuropsychiatric symptoms (NPS) are commonly found in patients with cerebral small vessel disease such as white matter hyperintensities and lacunar infarcts. However, the association between cerebral microbleeds (CMBs) and NPS has not been examined. Hence the present study sought to investigate the relation between CMBs and NPS in an elderly population. METHODS This is a cross-sectional study of elderly Asians living in the community, who were assessed on a comprehensive neuropsychological battery and underwent clinical examinations as well as brain MRI scans. The 12-item neuropsychiatric inventory (NPI) was administered to a reliable informant. Total scores for individual symptoms and for NPI global performance were calculated and compared across three groups: no CMB, presence of 1 CMB and presence of multiple CMBs, controlling for demographics, vascular risk factors and other MRI markers. RESULTS A total of 802 participants were included in the analysis. Participants with multiple CMBs had higher NPI total score compared to those with no CMB (1.06 vs 2.66, p=0.03). On individual symptom scores, higher score on depression (0.16 vs 0.53, p=0.02) and disinhibition (0.01 vs 0.14, p=0.04) was found in those elderly with multiple CMBs, independent of demographic and vascular risk factors, history of stroke, and other small vessel and large vessel disease markers. CONCLUSIONS The presence of multiple CMBs is associated with high global neuropsychiatric disorder burden, in particular symptoms of depression and disinhibition. Future studies are recommended to investigate the importance of CMBs in the pathogenesis and longitudinal progression of neuropsychiatric disorders in the general elderly population.
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Affiliation(s)
- Xin Xu
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.,Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Qun Lin Chan
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.,Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.,Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Win King Goh
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.,Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Mohammad Kamran Ikram
- Departments of Epidemiology & Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Tien Yin Wong
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Christopher Li-Hsian Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore.,Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Narayanaswamy Venketasubramanian
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.,Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore
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18
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Gupta A, Bhatnagar S. Vasoregression: A Shared Vascular Pathology Underlying Macrovascular And Microvascular Pathologies? OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2016; 19:733-53. [PMID: 26669709 DOI: 10.1089/omi.2015.0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vasoregression is a common phenomenon underlying physiological vessel development as well as pathological microvascular diseases leading to peripheral neuropathy, nephropathy, and vascular oculopathies. In this review, we describe the hallmarks and pathways of vasoregression. We argue here that there is a parallel between characteristic features of vasoregression in the ocular microvessels and atherosclerosis in the larger vessels. Shared molecular pathways and molecular effectors in the two conditions are outlined, thus highlighting the possible systemic causes of local vascular diseases. Our review gives us a system-wide insight into factors leading to multiple synchronous vascular diseases. Because shared molecular pathways might usefully address the diagnostic and therapeutic needs of multiple common complex diseases, the literature analysis presented here is of broad interest to readership in integrative biology, rational drug development and systems medicine.
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Affiliation(s)
- Akanksha Gupta
- 1 Computational and Structural Biology Laboratory, Division of Biotechnology, Netaji Subhas Institute of Technology , Dwarka, New Delhi, India .,2 Department of Biotechnology, IMS Engineering College , Ghaziabad, India
| | - Sonika Bhatnagar
- 1 Computational and Structural Biology Laboratory, Division of Biotechnology, Netaji Subhas Institute of Technology , Dwarka, New Delhi, India
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Chen Z, Li W, Sun W, Xiao L, Dai Q, Cao Y, Han Y, Zhu W, Xu G, Liu X. Correlation study between small vessel disease and early neurological deterioration in patients with mild/moderate acute ischemic stroke. Int J Neurosci 2016; 127:579-585. [DOI: 10.1080/00207454.2016.1214825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Kotani H, Matsuno M, Nakagawa H. Fundamental study of functional changes to female brain induced by pregnancy and childbirth. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:7986-9. [PMID: 26738145 DOI: 10.1109/embc.2015.7320245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In this study, we investigated variations in a women's cognitive function during a time of pregnancy and childbearing. Volunteers were composed of 114 healthy women ranging in age from 23-43 years with an average age of 31.8 years (SD=4.3). Further, 79 were pregnant and 35 were not pregnant. All the pregnant women were expecting their first child and continued with the cognitive function analysis after their childbearing was concluded. We instructed the pregnant women to carry out five kinds of tests: simple reaction, SR; choice reaction, CR; working memory, WM; one card learning, OC; and divided attention, DA using card games through a cognitive function test called "CogHealth", and compared them to a nonpregnant group. In the results of the four measurement tasks (SR, CR, WM, and DA), there were no significant differences across the three groups in the responses with the tasks. However, the response times relating to the OC learning in the postnatal women were significantly smaller, as contrasted with the times for the pregnant and the nonpregnant women (F(2,144)=4.248, P <; 0.05). Furthermore, we compared their cognitive functions between pregnant and postnatal states in corresponding volunteers in the responses with the same tasks. We also demonstrated the fact that postnatal women responded more quickly to tasks in the OC (t(32)=2.95, P <; 0.01) and the WM (t(32)=3.03, P <; 0.01) categories than responses to performing the tasks during their pregnancy. Our findings support the idea that the functions of pregnant/postnatal women are not failing, or rather postnatal women are more responsive in their reaction times with their memories by 2.7-6.2%, than the responses in both pregnant and nonpregnant women.
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Kaiser D, Weise G, Möller K, Scheibe J, Pösel C, Baasch S, Gawlitza M, Lobsien D, Diederich K, Minnerup J, Kranz A, Boltze J, Wagner DC. Spontaneous white matter damage, cognitive decline and neuroinflammation in middle-aged hypertensive rats: an animal model of early-stage cerebral small vessel disease. Acta Neuropathol Commun 2014; 2:169. [PMID: 25519173 PMCID: PMC4279586 DOI: 10.1186/s40478-014-0169-8] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 11/25/2014] [Indexed: 12/11/2022] Open
Abstract
Introduction Cerebral small vessel disease (cSVD) is one of the most prevalent neurological disorders. The progressive remodeling of brain microvessels due to arterial hypertension or other vascular risk factors causes subtle, but constant cognitive decline through to manifest dementia and substantially increases the risk for stroke. Preliminary evidence suggests the contribution of the immune system to disease initiation and progression, but a more detailed understanding is impaired by the unavailability of appropriate animal models. Here, we introduce the spontaneously hypertensive rat (SHR) as a model for early onset cSVD and unveiled substantial immune changes in conjunction with brain abnormalities that resemble clinical findings. Results In contrast to age-matched normotensive Wistar Kyoto (WKY) rats, male SHR exhibited non-spatial memory deficits. Magnetic resonance imaging showed brain atrophy and a reduction of white matter volumes in SHR. Histological analyses confirmed white matter demyelination and unveiled a circumscribed blood brain barrier dysfunction in conjunction with micro- and macrogliosis in deep cortical regions. Flow cytometry and histological analyses further revealed substantial disparities in cerebral CD45high leukocyte counts and distribution patterns between SHR and WKY. SHR showed lower counts of T cells in the choroid plexus and meningeal spaces as well as decreased interleukin-10 levels in the cerebrospinal fluid. On the other hand, both T and NK cells were significantly augmented in the SHR brain microvasculature. Conclusions Our results indicate that SHR share behavioral and neuropathological characteristics with human cSVD patients and further undergird the relevance of immune responses for the initiation and progression of cSVD. Electronic supplementary material The online version of this article (doi:10.1186/s40478-014-0169-8) contains supplementary material, which is available to authorized users.
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Baker JG, Williams AJ, Wack DS, Miletich RS. Correlation of cognition and SPECT perfusion: easy Z score and SPM analysis of a pilot sample with cerebral small vessel disease. Dement Geriatr Cogn Disord 2014; 36:290-9. [PMID: 23969991 DOI: 10.1159/000339587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS To associate neuropsychology test performance with perfusion on single-photon emission computed tomography (SPECT) among 12 patients with cerebral small vessel disease. METHODS The easy Z score imaging system (eZIS) was used to compare patient images to those of normal controls. Scores from neuropsychological tests commonly used to screen for dementia were associated with SPECT resting perfusion image values using the statistical parametric mapping (SPM) program. RESULTS Immediate Memory and Delayed Memory index scores, as well as memory subtests of the Repeatable Battery for Assessment of Neuropsychological Status showed cluster- and voxelwise positive correlations with hypoperfusion in frontal, temporal and cerebellar regions. Negative correlations, primarily in frontal regions, were interpreted as compensatory hyperperfusion. CONCLUSION eZIS and SPM analyses of SPECT images showed perfusion correlations with neuropsychological tests with small vessel disease.
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Affiliation(s)
- John G Baker
- Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, N.Y., USA
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Yeom KW, Lober RM, Barnes PD, Campen CJ. Reduced cerebral arterial spin-labeled perfusion in children with neurofibromatosis type 1. AJNR Am J Neuroradiol 2013; 34:1823-8. [PMID: 23764727 DOI: 10.3174/ajnr.a3649] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Neurofibromatosis type 1 is associated with increased risk for stroke, cerebral vasculopathy, and neurocognitive deficits, but underlying hemodynamic changes in asymptomatic children remain poorly understood. We hypothesized that children with neurofibromatosis type 1 have decreased cerebral blood flow. MATERIALS AND METHODS Arterial spin-labeled CBF was measured in 14 children with neurofibromatosis type 1 (median age, 9.7 years; mean, 10.2 years; range, 22 months to 18 years) and compared with age-matched control subjects on 3T MR imaging. Three-dimensional pseudocontinuous spin-echo arterial spin-labeled technique was used. Measurements were obtained at cortical gray matter of bilateral cerebral hemispheres and centrum semiovale by use of the ROI method. Comparison by Mann-Whitney test was used, with Bonferroni-adjusted P values ≤.004 judged as significant. RESULTS We identified 7 of 12 areas with significantly diminished arterial spin-labeled CBF in patients with neurofibromatosis type 1 compared with control subjects. These areas included the anterior cingulate gyrus (P = .001), medial frontal cortex (P = .004), centrum semiovale (P = .004), temporo-occipital cortex (P = .002), thalamus (P = .001), posterior cingulate gyrus (P = .002), and occipital cortex (P = .001). Among patients with neurofibromatosis type 1, there were no significant differences in these regions on the basis of the presence of neurofibromatosis type 1 spots or neurocognitive deficits. CONCLUSIONS Reduced cerebral perfusion was seen in children with neurofibromatosis type 1, particularly in the posterior circulation and the vascular borderzones of the middle and posterior cerebral arteries.
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