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Tang J, Pahlavian SH, Joe E, Gamez MT, Zhao T, Ma S, Jin J, Cen SY, Chui H, Yan L. Assessment of arterial pulsatility of cerebral perforating arteries using 7T high-resolution dual-VENC phase-contrast MRI. Magn Reson Med 2024; 92:605-617. [PMID: 38440807 PMCID: PMC11186522 DOI: 10.1002/mrm.30073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/24/2024] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE Directly imaging the function of cerebral perforating arteries could provide valuable insight into the pathology of cerebral small vessel diseases (cSVD). Arterial pulsatility has been identified as a useful biomarker for assessing vascular dysfunction. In this study, we investigate the feasibility and reliability of using dual velocity encoding (VENC) phase-contrast MRI (PC-MRI) to measure the pulsatility of cerebral perforating arteries at 7 T. METHODS Twenty participants, including 12 young volunteers and 8 elder adults, underwent high-resolution 2D PC-MRI scans with VENCs of 20 cm/s and 40 cm/s at 7T. The sensitivity of perforator detection and the reliability of pulsatility measurement of cerebral perforating arteries using dual-VENC PC-MRI were evaluated by comparison with the single-VENC data. The effects of temporal resolution in the PC-MRI acquisition and aging on the pulsatility measurements were investigated. RESULTS Compared to the single VENCs, dual-VENC PC-MRI provided improved sensitivity of perforator detection and more reliable pulsatility measurements. Temporal resolution impacted the pulsatility measurements, as decreasing temporal resolution led to an underestimation of pulsatility. Elderly adults had elevated pulsatility in cerebral perforating arteries compared to young adults, but there was no difference in the number of detected perforators between the two age groups. CONCLUSION Dual-VENC PC-MRI is a reliable imaging method for the assessment of pulsatility of cerebral perforating arteries, which could be useful as a potential imaging biomarker of aging and cSVD.
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Affiliation(s)
- Jianing Tang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States
| | - Soroush Heidari Pahlavian
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Elizabeth Joe
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Maria Tereza Gamez
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Tianrui Zhao
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States
| | - Samantha Ma
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- Siemens Medical Solutions USA, Los Angeles, California, United States
| | - Jin Jin
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- Siemens Medical Solutions USA, Los Angeles, California, United States
| | - Steven Yong Cen
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Helena Chui
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Lirong Yan
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
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Dempsey S, Safaei S, Holdsworth SJ, Maso Talou GD. Measuring global cerebrovascular pulsatility transmission using 4D flow MRI. Sci Rep 2024; 14:12604. [PMID: 38824230 PMCID: PMC11144255 DOI: 10.1038/s41598-024-63312-4] [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: 02/09/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024] Open
Abstract
Pulse wave encephalopathy (PWE) is hypothesised to initiate many forms of dementia, motivating its identification and risk assessment. As candidate pulsatility based biomarkers for PWE, pulsatility index and pulsatility damping have been studied and, currently, do not adequately stratify risk due to variability in pulsatility and spatial bias. Here, we propose a locus-independent pulsatility transmission coefficient computed by spatially tracking pulsatility along vessels to characterise the brain pulse dynamics at a whole-organ level. Our preliminary analyses in a cohort of 20 subjects indicate that this measurement agrees with clinical observations relating blood pulsatility with age, heart rate, and sex, making it a suitable candidate to study the risk of PWE. We identified transmission differences between vascular regions perfused by the basilar and internal carotid arteries attributed to the identified dependence on cerebral blood flow, and some participants presented differences between the internal carotid perfused regions that were not related to flow or pulsatility burden, suggesting underlying mechanical differences. Large populational studies would benefit from retrospective pulsatility transmission analyses, providing a new comprehensive arterial description of the hemodynamic state in the brain. We provide a publicly available implementation of our tools to derive this coefficient, built into pre-existing open-source software.
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Affiliation(s)
- Sergio Dempsey
- Auckland Bioengineering Institute, University of Auckland, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand.
| | - Soroush Safaei
- Auckland Bioengineering Institute, University of Auckland, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand
| | - Samantha J Holdsworth
- Mātai Medical Research Institute, Tairāwhiti Gisborne, New Zealand
- Department of Anatomy and Medical Imaging - Faculty of Medical and Health Sciences & Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Gonzalo D Maso Talou
- Auckland Bioengineering Institute, University of Auckland, Level 6, 70 Symonds Street, Auckland, 1010, New Zealand
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Reed KS, Frescoln AM, Keleher Q, Brellenthin AG, Kohut ML, Lefferts WK. Effects of aerobic exercise training on cerebral pulsatile hemodynamics in middle-aged adults with elevated blood pressure/stage 1 hypertension. J Appl Physiol (1985) 2024; 136:1376-1387. [PMID: 38601998 DOI: 10.1152/japplphysiol.00689.2023] [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: 09/27/2023] [Revised: 03/13/2024] [Accepted: 03/29/2024] [Indexed: 04/12/2024] Open
Abstract
Mechanisms behind the protective effects of aerobic exercise on brain health remain elusive but may be vascular in origin and relate to cerebral pulsatility. This pilot study investigated the effects of 12-wk aerobic exercise training on cerebral pulsatility and its vascular contributors (large artery stiffness, characteristic impedance) in at-risk middle-aged adults. Twenty-eight inactive middle-aged adults with elevated blood pressure or stage 1 hypertension were assigned to either moderate/vigorous aerobic exercise training (AET) for 3 days/wk or no-exercise control (CON) group. Middle cerebral artery (MCA) pulsatility index (PI), large artery (i.e., aorta, carotid) stiffness, and characteristic impedance were assessed via Doppler and tonometry at baseline, 6, and 12 wk, whereas cardiorespiratory fitness (V̇o2peak) was assessed via incremental exercise test and cognitive function via computerized battery at baseline and 12 wk. V̇o2peak increased 6% in AET and decreased 4% in CON (P < 0.05). Proximal aortic compliance increased (P = 0.04, partial η2 = 0.14) and aortic characteristic impedance decreased (P = 0.02, partial η2 = 0.17) with AET but not CON. Cerebral pulsatility showed a medium-to-large effect size increase with AET, although not statistically significant (P = 0.07, partial η2 = 0.11) compared with CON. Working memory reaction time improved with AET but not CON (P = 0.02, partial η2 = 0.20). Our data suggest 12-wk AET elicited improvements in central vascular hemodynamics (e.g., proximal aortic compliance and characteristic impedance) along with apparent, paradoxical increases in cerebral pulsatile hemodynamics.NEW & NOTEWORTHY We identify differential central versus cerebrovascular responses to 12 wk of aerobic exercise training in middle-aged adults. Although proximal aortic compliance and characteristic impedance improved after 12 wk of exercise, cerebral pulsatility tended to unexpectedly increase. These data suggest short-term aerobic exercise training may lead to more immediate benefits in the central vasculature, whereas longer duration exercise training may be required for beneficial changes in pulsatility within the cerebrovasculature.
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Affiliation(s)
- Krista S Reed
- Department of Kinesiology, Iowa State University, Ames, Iowa, United States
| | - Abby M Frescoln
- Department of Kinesiology, Iowa State University, Ames, Iowa, United States
| | - Quinn Keleher
- Department of Kinesiology, Iowa State University, Ames, Iowa, United States
| | | | - Marian L Kohut
- Department of Kinesiology, Iowa State University, Ames, Iowa, United States
| | - Wesley K Lefferts
- Department of Kinesiology, Iowa State University, Ames, Iowa, United States
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Yamada S, Otani T, Ii S, Ito H, Iseki C, Tanikawa M, Watanabe Y, Wada S, Oshima M, Mase M. Modeling cerebrospinal fluid dynamics across the entire intracranial space through integration of four-dimensional flow and intravoxel incoherent motion magnetic resonance imaging. Fluids Barriers CNS 2024; 21:47. [PMID: 38816737 PMCID: PMC11138021 DOI: 10.1186/s12987-024-00552-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Bidirectional reciprocal motion of cerebrospinal fluid (CSF) was quantified using four-dimensional (4D) flow magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) MRI. To estimate various CSF motions in the entire intracranial region, we attempted to integrate the flow parameters calculated using the two MRI sequences. To elucidate how CSF dynamics deteriorate in Hakim's disease, an age-dependent chronic hydrocephalus, flow parameters were estimated from the two MRI sequences to assess CSF motion in the entire intracranial region. METHODS This study included 127 healthy volunteers aged ≥ 20 years and 44 patients with Hakim's disease. On 4D flow MRI for measuring CSF motion, velocity encoding was set at 5 cm/s. For the IVIM MRI analysis, the diffusion-weighted sequence was set at six b-values (i.e., 0, 50, 100, 250, 500, and 1000 s/mm2), and the biexponential IVIM fitting method was adapted. The relationships between the fraction of incoherent perfusion (f) on IVIM MRI and 4D flow MRI parameters including velocity amplitude (VA), absolute maximum velocity, stroke volume, net flow volume, and reverse flow rate were comprehensively evaluated in seven locations in the ventricles and subarachnoid spaces. Furthermore, we developed a new parameter for fluid oscillation, the Fluid Oscillation Index (FOI), by integrating these two measurements. In addition, we investigated the relationship between the measurements and indices specific to Hakim's disease and the FOIs in the entire intracranial space. RESULTS The VA on 4D flow MRI was significantly associated with the mean f-values on IVIM MRI. Therefore, we estimated VA that could not be directly measured on 4D flow MRI from the mean f-values on IVIM MRI in the intracranial CSF space, using the following formula; e0.2(f-85) + 0.25. To quantify fluid oscillation using one integrated parameter with weighting, FOI was calculated as VA × 10 + f × 0.02. In addition, the FOIs at the left foramen of Luschka had the strongest correlations with the Evans index (Pearson's correlation coefficient: 0.78). The other indices related with Hakim's disease were significantly associated with the FOIs at the cerebral aqueduct and bilateral foramina of Luschka. FOI at the cerebral aqueduct was also elevated in healthy controls aged ≥ 60 years. CONCLUSIONS We estimated pulsatile CSF movements in the entire intracranial CSF space in healthy individuals and patients with Hakim's disease using FOI integrating VA from 4D flow MRI and f-values from IVIM MRI. FOI is useful for quantifying the CSF oscillation.
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Affiliation(s)
- Shigeki Yamada
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
- Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, Tokyo, Japan.
| | - Tomohiro Otani
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Satoshi Ii
- Department of Mechanical Engineering, School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
- Faculty of System Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Hirotaka Ito
- Medical System Research & Development Center, FUJIFILM Corporation, Tokyo, Japan
| | - Chifumi Iseki
- Department of Behavioural Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata, Japan
| | - Motoki Tanikawa
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Shiga, Japan
| | - Shigeo Wada
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Marie Oshima
- Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Mitsuhito Mase
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, Kawasumi 1, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan
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Coverdale NS, Champagne AA, Allen MD, Tremblay JC, Ethier TS, Fernandez-Ruiz J, Marshall RA, MacPherson REK, Pyke KE, Cook DJ, Olver TD. Brain atrophy, reduced cerebral perfusion, arterial stiffening, and wall thickening with aging coincide with stimulus-specific changes in fMRI-BOLD responses. Am J Physiol Regul Integr Comp Physiol 2024; 326:R346-R356. [PMID: 38406844 DOI: 10.1152/ajpregu.00270.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
The aim of this study was to investigate how aging affects blood flow and structure of the brain. It was hypothesized older individuals would have lower gray matter volume (GMV), resting cerebral blood flow (CBF0), and depressed responses to isometabolic and neurometabolic stimuli. In addition, increased carotid-femoral pulse-wave velocity (PWV), carotid intima-media thickness (IMT), and decreased brachial flow-mediated dilation (FMD) would be associated with lower CBF0, cerebrovascular reactivity (CVR), and GMV. Brain scans (magnetic resonance imaging) and cardiovascular examinations were conducted in young (age = 24 ± 3 yr, range = 22-28 yr; n = 13) and old (age = 71 ± 4 yr; range = 67-82 yr, n = 14) participants, and CBF0, CVR [isometabolic % blood oxygen level-dependent (BOLD) in response to a breath hold (BH)], brain activation patterns during a working memory task (neurometabolic %BOLD response to N-back trial), GMV, PWV, IMT, and FMD were measured. CBF0 and to a lesser extent CVRBH were lower in the old group (P ≤ 0.050); however, the increase in the %BOLD response to the memory task was not blunted (P ≥ 0.2867). Age-related differential activation patterns during the working memory task were characterized by disinhibition of the default mode network in the old group (P < 0.0001). Linear regression analyses revealed PWV, and IMT were negatively correlated with CBF0, CVRBH, and GMV across age groups, but within the old group alone only the relationships between PWV-CVRBH and IMT-GMV remained significant (P ≤ 0.0183). These findings suggest the impacts of age on cerebral %BOLD responses are stimulus specific, brain aging involves alterations in cerebrovascular and possibly neurocognitive control, and arterial stiffening and wall thickening may serve a role in cerebrovascular aging.NEW & NOTEWORTHY Cerebral perfusion was lower in old versus young adults. %Blood oxygen level-dependent (BOLD) responses to an isometabolic stimulus and gray matter volume were decreased in old versus young adults and associated with arterial stiffening and wall thickening. The increased %BOLD response to a neurometabolic stimulus appeared unaffected by age; however, the old group displayed disinhibition of the default mode network during the stimulus. Thus, age-related alterations in cerebral %BOLD responses were stimulus specific and related to arterial remodeling.
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Affiliation(s)
- Nicole S Coverdale
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Allen A Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Matti D Allen
- Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Ontario, Canada
| | - Joshua C Tremblay
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Tarrah S Ethier
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, México
| | - Rory A Marshall
- Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
- Department of Biomedical Sciences, Western College of Veterinary Medicine, the University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rebecca E K MacPherson
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Kyra E Pyke
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Douglas J Cook
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
- Department of Surgery, Queen's University, Kingston, Ontario, Canada
| | - T Dylan Olver
- Department of Biomedical Sciences, Western College of Veterinary Medicine, the University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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6
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Luisi CA, Witter TL, Nikoubashman O, Wiesmann M, Steinseifer U, Neidlin M. Evaluating the accuracy of cerebrovascular computational fluid dynamics modeling through time-resolved experimental validation. Sci Rep 2024; 14:8194. [PMID: 38589554 PMCID: PMC11001858 DOI: 10.1038/s41598-024-58925-8] [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: 11/01/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024] Open
Abstract
Accurate modeling of cerebral hemodynamics is crucial for better understanding the hemodynamics of stroke, for which computational fluid dynamics (CFD) modeling is a viable tool to obtain information. However, a comprehensive study on the accuracy of cerebrovascular CFD models including both transient arterial pressures and flows does not exist. This study systematically assessed the accuracy of different outlet boundary conditions (BCs) comparing CFD modeling and an in-vitro experiment. The experimental setup consisted of an anatomical cerebrovascular phantom and high-resolution flow and pressure data acquisition. The CFD model of the same cerebrovascular geometry comprised five sets of stationary and transient BCs including established techniques and a novel BC, the phase modulation approach. The experiment produced physiological hemodynamics consistent with reported clinical results for total cerebral blood flow, inlet pressure, flow distribution, and flow pulsatility indices (PI). The in-silico model instead yielded time-dependent deviations between 19-66% for flows and 6-26% for pressures. For cerebrovascular CFD modeling, it is recommended to avoid stationary outlet pressure BCs, which caused the highest deviations. The Windkessel and the phase modulation BCs provided realistic flow PI values and cerebrovascular pressures, respectively. However, this study shows that the accuracy of current cerebrovascular CFD models is limited.
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Affiliation(s)
- Claudio A Luisi
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - Tom L Witter
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - Omid Nikoubashman
- Clinic for Diagnostic and Interventional Neuroradiology, Medical Faculty, RWTH Aachen University, Pauwelstr. 30, 52074, Aachen, Germany
| | - Martin Wiesmann
- Clinic for Diagnostic and Interventional Neuroradiology, Medical Faculty, RWTH Aachen University, Pauwelstr. 30, 52074, Aachen, Germany
| | - Ulrich Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - Michael Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany.
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Voss HU, Razlighi QR. Pulsatility analysis of the circle of Willis. AGING BRAIN 2024; 5:100111. [PMID: 38495808 PMCID: PMC10940807 DOI: 10.1016/j.nbas.2024.100111] [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: 09/26/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose To evaluate the phenomenological significance of cerebral blood pulsatility imaging in aging research. Methods N = 38 subjects from 20 to 72 years of age (24 females) were imaged with ultrafast MRI with a sampling rate of 100 ms and simultaneous acquisition of pulse oximetry data. Of these, 28 subjects had acceptable MRI and pulse data, with 16 subjects between 20 and 28 years of age, and 12 subjects between 61 and 72 years of age. Pulse amplitude in the circle of Willis was assessed with the recently developed method of analytic phase projection to extract blood volume waveforms. Results Arteries in the circle of Willis showed pulsatility in the MRI for both the young and old age groups. Pulse amplitude in the circle of Willis significantly increased with age (p = 0.01) but was independent of gender, heart rate, and head motion during MRI. Discussion and conclusion Increased pulse wave amplitude in the circle of Willis in the elderly suggests a phenomenological significance of cerebral blood pulsatility imaging in aging research. The physiologic origin of increased pulse amplitude (increased pulse pressure vs. change in arterial morphology vs. re-shaping of pulse waveforms caused by the heart, and possible interaction with cerebrospinal fluid pulsatility) requires further investigation.
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Affiliation(s)
- Henning U. Voss
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Cornell MRI Facility, College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - Qolamreza R. Razlighi
- Quantitative Neuroimaging Laboratory, Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA
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8
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Douglas AJM, Talbot JS, Perkins D, Dawkins TG, Oliver JL, Lloyd RS, Ainslie PN, McManus A, Pugh CJA, Lord RN, Stembridge M. The influence of maturation and sex on intracranial blood velocities during exercise in children. J Appl Physiol (1985) 2024; 136:451-459. [PMID: 38126090 DOI: 10.1152/japplphysiol.00478.2023] [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: 07/12/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
Cerebral blood velocity (CBv) increases in response to moderate exercise in humans, but the magnitude of change is smaller in children compared with postpubertal adolescents and adults. Whether sex differences exist in the anterior or posterior CBv response to exercise across pubertal development remains to be determined. We assessed middle cerebral artery (MCAv) and posterior cerebral artery (PCAv) blood velocity via transcranial Doppler in 38 prepubertal (18 males) and 48 postpubertal (23 males) with cerebrovascular and cardiorespiratory measures compared at baseline and ventilatory threshold. At baseline, MCAv was higher in both sexes pre- versus postpuberty. Females demonstrated a greater MCAv (P < 0.001) than their male counterparts (prepubertal females; 78 ± 11 cm·s-1 vs. prepubertal males; 72 ± 8 cm·s-1, and postpubertal females; 68 ± 10 cm·s-1 vs. postpubertal males; 62 ± 7 cm·s-1). During exercise, MCAv remained higher in postpubertal females versus males (81 ± 15 cm·s-1 vs. 73 ± 11 cm·s-1), but there were no differences in prepuberty. The relative increase in PCAv was greater in post- versus prepubertal females (51 ± 9 cm·s-1 vs. 45 ± 11 cm·s-1; P = 0.032) but was similar in males and females. Our findings suggest that biological sex alters anterior cerebral blood velocities at rest in both pre- and postpubertal youth, but the response to submaximal exercise is only influenced by sex postpuberty.NEW & NOTEWORTHY Cerebral blood velocity (CBv) in the anterior circulation was higher in females compared with males irrespective of maturational stage, but not in the posterior circulation. In response to exercise, females demonstrated a greater CBv compared with males, especially post-peak height velocity (post-PHV) where the CBv response to exercise was more pronounced. Our findings suggest that both CBv at rest and in response to acute submaximal exercise are altered by biological sex in a maturity-dependent manner.
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Affiliation(s)
- Andrew J M Douglas
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jack S Talbot
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Dean Perkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Tony G Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jon L Oliver
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealandy, AUT University, Auckland, New Zealand
| | - Rhodri S Lloyd
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Youth Physical Development Centre, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sports Performance Research Institute New Zealandy, AUT University, Auckland, New Zealand
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Waikato, New Zealand
| | - Philip N Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ali McManus
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Christopher J A Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Rachel N Lord
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Centre for Health, Activity and Wellbeing Research, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Mike Stembridge
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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Allison EY, Al-Khazraji BK. Cerebrovascular adaptations to habitual resistance exercise with aging. Am J Physiol Heart Circ Physiol 2024; 326:H772-H785. [PMID: 38214906 DOI: 10.1152/ajpheart.00625.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/13/2024]
Abstract
Resistance training (RT) is associated with improved metabolism, bone density, muscular strength, and lower risk of osteoporosis, sarcopenia, and cardiovascular disease. Although RT imparts many physiological benefits, cerebrovascular adaptations to chronic RT are not well defined. Participation in RT is associated with greater resting peripheral arterial diameters, improved endothelial function, and general cardiovascular health, whereas simultaneously linked to reductions in central arterial compliance. Rapid blood pressure fluctuations during resistance exercise, combined with reduced arterial compliance, could lead to cerebral microvasculature damage and subsequent cerebral hypoperfusion. Reductions in cerebral blood flow (CBF) accompany normal aging, where chronic reductions in CBF are associated with changes in brain structure and function, and increased risk of neurodegeneration. It remains unclear whether reductions in arterial compliance with RT relate to subclinical cerebrovascular pathology, or if such adaptations require interpretation in the context of RT specifically. The purpose of this narrative review is to synthesize literature pertaining to cerebrovascular adaptations to RT at different stages of the life span. This review also aims to identify gaps in the current understanding of the long-term impacts of RT on cerebral hemodynamics and provide a mechanistic rationale for these adaptations as they relate to aging, cerebral vasculature, and overall brain health.
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Affiliation(s)
- Elric Y Allison
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Baraa K Al-Khazraji
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
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10
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Reeve EH, Barnes JN, Moir ME, Walker AE. Impact of arterial stiffness on cerebrovascular function: a review of evidence from humans and preclincal models. Am J Physiol Heart Circ Physiol 2024; 326:H689-H704. [PMID: 38214904 DOI: 10.1152/ajpheart.00592.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/08/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
With advancing age, the cerebral vasculature becomes dysfunctional, and this dysfunction is associated with cognitive decline. However, the initiating cause of these age-related cerebrovascular impairments remains incompletely understood. A characteristic feature of the aging vasculature is the increase in stiffness of the large elastic arteries. This increase in arterial stiffness is associated with elevated pulse pressure and blood flow pulsatility in the cerebral vasculature. Evidence from both humans and rodents supports that increases in large elastic artery stiffness are associated with cerebrovascular impairments. These impacts on cerebrovascular function are wide-ranging and include reductions in global and regional cerebral blood flow, cerebral small vessel disease, endothelial cell dysfunction, and impaired perivascular clearance. Furthermore, recent findings suggest that the relationship between arterial stiffness and cerebrovascular function may be influenced by genetics, specifically APOE and NOTCH genotypes. Given the strength of the evidence that age-related increases in arterial stiffness have deleterious impacts on the brain, interventions that target arterial stiffness are needed. The purpose of this review is to summarize the evidence from human and rodent studies, supporting the role of increased arterial stiffness in age-related cerebrovascular impairments.
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Affiliation(s)
- Emily H Reeve
- Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
| | - Jill N Barnes
- Department of Kinesiology University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - M Erin Moir
- Department of Kinesiology University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Ashley E Walker
- Department of Human Physiology, University of Oregon, Eugene, Oregon, United States
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11
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Xie L, Zhang Y, Hong H, Xu S, Cui L, Wang S, Li J, Liu L, Lin M, Luo X, Li K, Zeng Q, Zhang M, Zhang R, Huang P. Higher intracranial arterial pulsatility is associated with presumed imaging markers of the glymphatic system: An explorative study. Neuroimage 2024; 288:120524. [PMID: 38278428 DOI: 10.1016/j.neuroimage.2024.120524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Arterial pulsation has been suggested as a key driver of paravascular cerebrospinal fluid flow, which is the foundation of glymphatic clearance. However, whether intracranial arterial pulsatility is associated with glymphatic markers in humans has not yet been studied. METHODS Seventy-three community participants were enrolled in the study. 4D phase-contrast magnetic resonance imaging (MRI) was used to quantify the hemodynamic parameters including flow pulsatility index (PIflow) and area pulsatility index (PIarea) from 13 major intracerebral arterial segments. Three presumed neuroimaging markers of the glymphatic system were measured: including dilation of perivascular space (PVS), diffusivity along the perivascular space (ALPS), and volume fraction of free water (FW) in white matter. We explored the relationships between PIarea, PIflow, and the presumed glymphatic markers, controlling for related covariates. RESULTS PIflow in the internal carotid artery (ICA) C2 segment (OR, 1.05; 95 % CI, 1.01-1.10, per 0.01 increase in PI) and C4 segment (OR, 1.05; 95 % CI, 1.01-1.09) was positively associated with the dilation of basal ganglia PVS, and PIflow in the ICA C4 segment (OR, 1.06, 95 % CI, 1.02-1.10) was correlated with the dilation of PVS in the white matter. ALPS was associated with PIflow in the basilar artery (β, -0.273, p, 0.046) and PIarea in the ICA C2 (β, -0.239, p, 0.041) and C7 segments (β, -0.238, p, 0.037). CONCLUSIONS Intracranial arterial pulsatility was associated with presumed neuroimaging markers of the glymphatic system, but the results were not consistent across different markers. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Linyun Xie
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Yao Zhang
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Hui Hong
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Shan Xu
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Lei Cui
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Shuyue Wang
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Jixuan Li
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Lingyun Liu
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Miao Lin
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Xiao Luo
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Kaicheng Li
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Qingze Zeng
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Minming Zhang
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Ruiting Zhang
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Peiyu Huang
- Department of Radiology, The 2nd Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China.
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12
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Miller LR, Bickel MA, Tarantini S, Runion ME, Matacchiera Z, Vance ML, Hibbs C, Vaden H, Nagykaldi D, Martin T, Bullen EC, Pinckard J, Kiss T, Howard EW, Yabluchanskiy A, Conley SM. IGF1R deficiency in vascular smooth muscle cells impairs myogenic autoregulation and cognition in mice. Front Aging Neurosci 2024; 16:1320808. [PMID: 38425784 PMCID: PMC10902040 DOI: 10.3389/fnagi.2024.1320808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Cerebrovascular pathologies contribute to cognitive decline during aging, leading to vascular cognitive impairment and dementia (VCID). Levels of circulating insulin-like growth factor 1 (IGF-1), a vasoprotective hormone, decrease during aging. Decreased circulating IGF-1 in animal models leads to the development of VCID-like symptoms, but the cellular mechanisms underlying IGF-1-deficiency associated pathologies in the aged cerebrovasculature remain poorly understood. Here, we test the hypothesis that vascular smooth muscle cells (VSMCs) play an integral part in mediating the vasoprotective effects of IGF-1. Methods We used a hypertension-based model of cerebrovascular dysfunction in mice with VSMC-specific IGF-1 receptor (Igf1r) deficiency and evaluated the development of cerebrovascular pathologies and cognitive dysfunction. Results VSMC-specific Igf1r deficiency led to impaired cerebral myogenic autoregulation, independent of blood pressure changes, which was also associated with impaired spatial learning and memory function as measured by radial arm water maze and impaired motor learning measured by rotarod. In contrast, VSMC-specific IGF-1 receptor knockdown did not lead to cerebral microvascular rarefaction. Discussion These studies suggest that VSMCs are key targets for IGF-1 in the context of cerebrovascular health, playing a role in vessel stability alongside other cells in the neurovascular unit, and that VSMC dysfunction in aging likely contributes to VCID.
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Affiliation(s)
- Lauren R. Miller
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Marisa A. Bickel
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Stefano Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Megan E. Runion
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Zoe Matacchiera
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michaela L. Vance
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Clara Hibbs
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Hannah Vaden
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Domonkos Nagykaldi
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Teryn Martin
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Elizabeth C. Bullen
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jessica Pinckard
- Division of Comparative Medicine, Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Tamas Kiss
- Pediatric Center, Semmelweis University, Budapest, Hungary
- Eötvös Loránd Research Network and Semmelweis University Cerebrovascular and Neurocognitive Disorders Research Group, Budapest, Hungary
| | - Eric W. Howard
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Shannon M. Conley
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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13
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Wu CH, Kuo Y, Ling YH, Wang YF, Fuh JL, Lirng JF, Wu HM, Wang SJ, Chen SP. Dynamic changes in glymphatic function in reversible cerebral vasoconstriction syndrome. J Headache Pain 2024; 25:17. [PMID: 38317074 PMCID: PMC10840154 DOI: 10.1186/s10194-024-01726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The pathophysiology of the reversible cerebral vasoconstriction syndrome (RCVS) remains enigmatic and the role of glymphatics in RCVS pathophysiology has not been evaluated. We aimed to investigate RCVS glymphatic dynamics and its clinical correlates. METHODS We prospectively evaluated the glymphatic function in RCVS patients, with RCVS subjects and healthy controls (HCs) recruited between August 2020 and November 2023, by calculating diffusion-tensor imaging along the perivascular space (DTI-ALPS) index under a 3-T MRI. Clinical and vascular (transcranial color-coded duplex sonography) investigations were conducted in RCVS subjects. RCVS participants were separated into acute (≤ 30 days) and remission (≥ 90 days) groups by disease onset to MRI interval. The time-trend, acute stage and longitudinal analyses of the DTI-ALPS index were conducted. Correlations between DTI-ALPS index and vascular and clinical parameters were performed. Bonferroni correction was applied to vascular investigations (q = 0.05/11). RESULTS A total of 138 RCVS patients (mean age, 46.8 years ± 11.8; 128 women) and 42 HCs (mean age, 46.0 years ± 4.5; 35 women) were evaluated. Acute RCVS demonstrated lower DTI-ALPS index than HCs (p < 0.001) and remission RCVS (p < 0.001). A continuously increasing DTI-ALPS trend after disease onset was demonstrated. The DTI-ALPS was lower when the internal carotid arteries resistance index and six-item Headache Impact test scores were higher. In contrast, during 50-100 days after disease onset, the DTI-ALPS index was higher when the middle cerebral artery flow velocity was higher. CONCLUSIONS Glymphatic function in patients with RCVS exhibited a unique dynamic evolution that was temporally coupled to different vascular indices and headache-related disabilities along the disease course. These findings may provide novel insights into the complex interactions between glymphatic transport, vasomotor control and pain modulation.
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Grants
- V112C-113 & V112E-004-1 (to SJW); V110C-102, VGH-111-C-158, V112C-053 & V112D67-001-MY3-1 (to SPC); V112B-007, V111B-032, V109B-009 (to CHW) Taipei Veterans General Hospital
- V112C-113 & V112E-004-1 (to SJW); V110C-102, VGH-111-C-158, V112C-053 & V112D67-001-MY3-1 (to SPC); V112B-007, V111B-032, V109B-009 (to CHW) Taipei Veterans General Hospital
- V112C-113 & V112E-004-1 (to SJW); V110C-102, VGH-111-C-158, V112C-053 & V112D67-001-MY3-1 (to SPC); V112B-007, V111B-032, V109B-009 (to CHW) Taipei Veterans General Hospital
- CI-112-2, CI-111-2, CI-109-3 (to CHW) Yen Tjing Ling Medical Foundation
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49 -037 -MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075 -086-MY3 & 112-2321-B-075-007 (to SJW); 111-2314-B-075 -025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49 -037 -MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075 -086-MY3 & 112-2321-B-075-007 (to SJW); 111-2314-B-075 -025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- NSTC 108-2314-B-010-022 -MY3, 110-2326-B-A49A-501-MY3 & 112-2314-B-A49 -037 -MY3 (to SPC); 110-2321-B-010-005-, 111-2321-B-A49-004, 111-2321-B-A49-011, 111-2314-B-A49-069-MY3, 111-2314-B-075 -086-MY3 & 112-2321-B-075-007 (to SJW); 111-2314-B-075 -025 -MY3 & 110-2314-B-075-005 (to CHW) National Science and Technology Council
- MOHW107-TDU-B-211-123001, MOHW 108-TDU-B-211-133001 and MOHW112-TDU-B-211-144001 (to SJW) Ministry of Health and Welfare
- VGHUST-112-G1-2-1 (to SJW) Veterans General Hospitals and University System of Taiwan Joint Research Program
- Professor Tsuen CHANG’s Scholarship Program from Medical Scholarship Foundation In Memory Of Professor Albert Ly-Young Shen
- Vivian W. Yen Neurological Foundation
- Brain Research Center, National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan
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Affiliation(s)
- Chia-Hung Wu
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
| | - Yu Kuo
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
- Department of Nuclear Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
| | - Yu-Hsiang Ling
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
| | - Yen-Feng Wang
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, Taiwan
| | - Jong-Ling Fuh
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, Taiwan
| | - Jiing-Feng Lirng
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
| | - Hsiu-Mei Wu
- Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan
| | - Shuu-Jiun Wang
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, Taiwan.
| | - Shih-Pin Chen
- School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, Taiwan.
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St., Taipei, Taiwan.
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Taipei, Taiwan.
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14
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Kedia N, McDowell MM, Yang J, Wu J, Friedlander RM, Kainerstorfer JM. Pulsatile microvascular cerebral blood flow waveforms change with intracranial compliance and age. NEUROPHOTONICS 2024; 11:015003. [PMID: 38250664 PMCID: PMC10799239 DOI: 10.1117/1.nph.11.1.015003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024]
Abstract
Significance Diffuse correlation spectroscopy (DCS) is an optical method to measure relative changes in cerebral blood flow (rCBF) in the microvasculature. Each heartbeat generates a pulsatile signal with distinct morphological features that we hypothesized to be related to intracranial compliance (ICC). Aim We aim to study how three features of the pulsatile rCBF waveforms: the augmentation index (AIx), the pulsatility index, and the area under the curve, change with respect to ICC. We describe ICC as a combination of vascular compliance and extravascular compliance. Approach Since patients with Chiari malformations (CM) (n = 30 ) have been shown to have altered extravascular compliance, we compare the morphology of rCBF waveforms in CM patients with age-matched healthy control (n = 30 ). Results AIx measured in the supine position was significantly less in patients with CM compared to healthy controls (p < 0.05 ). Since physiologic aging also leads to changes in vessel stiffness and intravascular compliance, we evaluate how the rCBF waveform changes with respect to age and find that the AIx feature was strongly correlated with age (R healthy subjects = - 0.63 , R preoperative CM patient = - 0.70 , and R postoperative CM patients = - 0.62 , p < 0.01 ). Conclusions These results suggest that the AIx measured in the cerebral microvasculature using DCS may be correlated to changes in ICC.
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Affiliation(s)
- Nikita Kedia
- University of Pittsburgh School of Medicine, Department of Neurological Surgery, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Michael M. McDowell
- University of Pittsburgh School of Medicine, Department of Neurological Surgery, Pittsburgh, Pennsylvania, United States
| | - Jason Yang
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Jingyi Wu
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
| | - Robert M. Friedlander
- University of Pittsburgh School of Medicine, Department of Neurological Surgery, Pittsburgh, Pennsylvania, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
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15
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Chen W, Song X, Wei H, Fu M, Chen S, Wei C, Zheng Z, Wu J, Li R. Variations of arterial compliance and vascular resistance due to plaque or infarct in a single vascular territory of the middle cerebral artery. Quant Imaging Med Surg 2023; 13:7802-7813. [PMID: 38106282 PMCID: PMC10722046 DOI: 10.21037/qims-23-222] [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: 03/14/2023] [Accepted: 09/06/2023] [Indexed: 12/19/2023]
Abstract
Background Arterial compliance (AC) and vascular resistance (VR) are crucial for the regulation capacity of the vascular system. However, alterations of these features and hemodynamics due to atherosclerosis in a single intracranial artery territory have not been extensively investigated. Thus this study aimed to examine the AC, VR, and hemodynamic variations due to plaque and infarction in the middle cerebral artery (MCA). Methods Patients with symptomatic MCA atherosclerosis were recruited. Both sides of the MCA were assessed and then classified according to the following scheme: group 0, without plaque; group 1, with plaque but without infarct; group 2, with plaque and infarct in the supplying territories. Data on AC, VR, blood flow, and pulsatility index (PI) were obtained based on 4D flow magnetic resonance imaging (MRI) and the Windkessel model. Results A total of 63 patients were recruited. After 17 MCAs were excluded (occlusion, n=6; poor image quality, n=11), datasets on 109 MCAs were finally collected and classified into group 0 (n=39), group 1 (n=40), and group 2 (n=30). From groups 0 to 2, there was a decrease in AC (0.0060±0.0031 vs. 0.0052±0.0029 vs. 0.0026±0.0020 mL/mmHg) and an increase in VR [28.65±16.11 vs. 42.59±27.53 vs. 63.21±40.37 mmHg/(mL/s)]. Compared to group 1, group 2 had significantly decreased AC (0.0052±0.0029 vs. 0.0026±0.0020 mL/mmHg; P=0.003) and increased VR [42.59±27.53 vs. 63.21±40.37 mmHg/(mL/s); P=0.021]. From group 0 to group 2, there was a decrease in blood flow (179.29±73.57 vs. 125.11±59.04 vs. 92.05±48.79 mL/min; P<0.001). The PI varied significantly among the 3 groups (0.86±0.20 vs. 1.12±0.50 vs. 0.79±0.16; P<0.001), with group 1 having the highest PI. Conclusions With the occurrence of plaque and infarct, AC and blood flow progressively decrease while VR increases. The PI was the highest in the group with plaque and without infarct. Assessments of vascular function and hemodynamics in a single artery territory can clarify comprehensive alterations in the cerebral vascular system (CVS).
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Affiliation(s)
- Wenwen Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Xiaowei Song
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hanyu Wei
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Mingzhu Fu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Shuo Chen
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Chenming Wei
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhuozhao Zheng
- Department of Radiology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jian Wu
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- IDG/McGovern Institute for Brain Research at Tsinghua University, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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16
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Marôco JL, Rosenberg AJ, Grigoriadis G, Lefferts EC, Fernhall B, Baynard T. Older females but not males exhibit increases in cerebral blood velocity, despite similar pulsatility increases after high-intensity resistance exercise. Am J Physiol Heart Circ Physiol 2023; 325:H909-H916. [PMID: 37594485 DOI: 10.1152/ajpheart.00349.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 08/19/2023]
Abstract
Sex differences in resting cerebral hemodynamics decline with aging. Given that acute resistance exercise (RE) is a hypertensive challenge, it may reveal sex-dependent abnormalities in cerebral hemodynamics. Thus, we hypothesized that cerebral blood velocity and pulsatility responses to RE would be sex-dependent in older adults. Fourteen older females and 11 males (50-68 yr) completed a high-intensity unilateral isokinetic knee flexion/extension exercise. Measurements were collected at baseline, immediately, 5- and 30-min post-RE. Blood pressure was measured via finger photoplethysmography. Mean middle cerebral artery blood velocity (MCAv) and pulsatility were assessed via transcranial Doppler ultrasound. Carotid pulsatility was obtained via duplex ultrasound. MCAv increased immediately after RE in older females [mean difference (d) = 6.02, 95% CI: 1.66 to 10.39 cm/s, P < 0.001] but not in males (d = -0.72, 95% CI: -3.83 to 5.27 cm/s, P = 0.99), followed by similar reductions 5-min post-RE in older females (d = -4.40, 95% CI: -8.81 to -0.10 cm/s, P = 0.045) and males (d = -6.41, 95% CI: -11.19 to -1.62 cm/s, P = 0.003). MCAv pulsatility increased similarly in older females (d = 0.24, 95% CI: 0.11 to 0.40, P < 0.001) and males (d = 0.38, 95% CI: 0.20 to 0.53, P < 0.001), persisting 5-min post-RE. Older females showed smaller increases in carotid pulsatility immediately after RE (d = 0.18, 95% CI: 0.03 to 0.38, P = 0.01) than males (d = 0.48, 95% CI: 0.26 to 0.68, P < 0.001). An exercise-mediated hypertensive stimulus revealed differential sex responses in MCAv and carotid pulsatility but not in cerebral pulsatility. Cerebral pulsatility findings suggest a similar sex susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus in older adults.NEW & NOTEWORTHY Sex differences in resting cerebral hemodynamics decline with advancing age as females experience larger reductions in cerebral blood velocity and steeper pulsatility increases than males. However, an exercise-mediated hypertensive stimulus might reveal sex differences in cerebral hemodynamics not apparent at rest. Following high-intensity resistance exercise, older females but not males exhibit increases in cerebral blood velocity, despite similar increases in cerebral pulsatility. The susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus appears similar between sexes.
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Affiliation(s)
- João L Marôco
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Alexander J Rosenberg
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
- Department of Physiology, Midwestern University, Downers Grove, Illinois, United States
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
- Clinical Vascular Research Laboratory, College of Human Sciences, Iowa State University, Ames, Iowa, United States
| | - Bo Fernhall
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Tracy Baynard
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
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17
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Owashi KP, Capel C, Balédent O. Cerebral arterial flow dynamics during systole and diastole phases in young and older healthy adults. Fluids Barriers CNS 2023; 20:65. [PMID: 37705096 PMCID: PMC10500860 DOI: 10.1186/s12987-023-00467-8] [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: 03/12/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Since arterial flow is the leading actor in neuro-fluids flow dynamics, it might be interesting to assess whether it is meaningful to study the arterial flow waveform in more detail and whether this provides new important information. Few studies have focused on determining the influence of heart rate variation over time on the arterial flow curve. Therefore, this study aimed to evaluate cerebral arterial flow waveforms at extracranial and intracranial compartments in young and elderly healthy adults, also considering systole and diastole phases. METHODS Cine phase-contrast magnetic resonance imaging (CINE-PC MRI) was performed on twenty-eight healthy young volunteers (HYV) and twenty healthy elderly volunteers (HEV) to measure arterial blood flows at the extracranial and intracranial planes. A semi-automated protocol using MATLAB scripts was implemented to identify the main representative points in the arterial flow waveforms. Representative arterial profiles were estimated for each group. Moreover, the effects of age and sex on flow times, amplitude-related parameters, and parameters related to systole and diastole phases were evaluated at the extracranial and intracranial compartments. Student's t-test or Wilcoxon's test (depending on the normality of the distribution) was used to detect significant differences. RESULTS In HYVs, significant differences were observed between extracranial and intracranial levels in parameters related to the AP1 amplitude. Besides the detected differences in pulsatility index (extracranial: 0.92 ± 0.20 vs. 1.28 ± 0.33; intracranial: 0.79 ± 0.15 vs. 1.14 ± 0.18, p < .001) and average flow (715 ± 136 vs. 607 ± 125 ml/min, p = .008) between HYV and HEV, differences in the amplitude value of the arterial flow profile feature points were also noted. Contrary to systole duration (HYV: 360 ± 29 ms; HEV: 364 ± 47 ms), diastole duration presented higher inter-individual variability in both populations (HYV: 472 ± 145 ms; HEV: 456 ± 106 ms). Our results also showed that, with age, it is mainly the diastolic phase that changes. Although no significant differences in duration were observed between the two populations, the mean flow value in the diastolic phase was significantly lower in HEV (extracranial: 628 ± 128 vs. 457 ± 111 ml/min; intracranial: 599 ± 121 vs. 473 ± 100 ml/min, p < .001). No significant differences were observed in the arterial flow parameters evaluated between females and males in either HYV or HEV. CONCLUSION Our study provides a novel contribution on the influence of the cardiac cycle phases on cerebral arterial flow. The main contribution in this study concerns the identification of age-related alterations in cerebral blood flow, which occur mainly during the diastolic phase. Specifically, we observed that mean flow significantly decreases with age during diastole, whereas mean flow during systole is consistent.
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Affiliation(s)
| | - Cyrille Capel
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France
- Neurosurgery Department, Amiens Picardy University Medical Center, Amiens, France
| | - Olivier Balédent
- CHIMERE UR 7516, Jules Verne University of Picardy, Amiens, France
- Medical Image Processing Department, Amiens Picardy University Medical Center, Amiens, France
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18
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Nazeri A, Dehkharghanian T, Lindsay KE, LaMontagne P, Shimony JS, Benzinger TL, Sotiras A. The Spatial Patterns and Determinants of Cerebrospinal Fluid Circulation in the Human Brain. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.13.553149. [PMID: 37645835 PMCID: PMC10462043 DOI: 10.1101/2023.08.13.553149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The circulation of cerebrospinal fluid (CSF) is essential for maintaining brain homeostasis and clearance, and impairments in its flow can lead to various brain disorders. Recent studies have shown that CSF circulation can be interrogated using low b-value diffusion magnetic resonance imaging (low-b dMRI). Nevertheless, the spatial organization of intracranial CSF flow dynamics remains largely elusive. Here, we developed a whole-brain voxel-based analysis framework, termed CSF pseudo-diffusion spatial statistics (C Ψ SS ), to examine CSF mean pseudo-diffusivity (M Ψ ), a measure of CSF flow magnitude derived from low-b dMRI. We showed that intracranial CSF M Ψ demonstrates characteristic covariance patterns by employing seed-based correlation analysis. Importantly, we applied non-negative matrix factorization analysis to further elucidate the covariance patterns of CSF M Ψ in a hypothesis-free, data-driven way. We identified distinct CSF spaces that consistently displayed unique pseudo-diffusion characteristics across multiple imaging datasets. Our study revealed that age, sex, brain atrophy, ventricular anatomy, and cerebral perfusion differentially influence M Ψ across these CSF spaces. Notably, individuals with anomalous CSF flow patterns displayed incidental findings on multimodal neuroradiological examinations. Our work sets forth a new paradigm to study CSF flow, with potential applications in clinical settings.
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Affiliation(s)
- Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Kevin E. Lindsay
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Pamela LaMontagne
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Aristeidis Sotiras
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Institute of Informatics, Washington University School of Medicine, St. Louis, MO, USA
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19
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Djurić B, Žikić K, Nestorović Z, Lepojević-Stefanović D, Milošević N, Žikić D. Using the photoplethysmography method to monitor age-related changes in the cardiovascular system. Front Physiol 2023; 14:1191272. [PMID: 37538374 PMCID: PMC10394700 DOI: 10.3389/fphys.2023.1191272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction: Aging is a physiological process characterized by progressive changes in all organ systems. In the last few decades, the elderly population has been growing, so the scientific community is focusing on the investigation of the aging process, all in order to improve the quality of life in elderly. One of the biggest challenges in studying the impact of the aging on the human body represents the monitoring of the changes that inevitably occur in arterial blood vessels. Therefore, the medical community has invested a great deal of effort in studying and discovering new methods and tools that could be used to monitor the changes in arterial blood vessels caused by the aging process. The goal of our research was to develop a new diagnostic method using a photoplethysmographic sensor and to examine the impact of the aging process on the cardiovascular system in adults. Long-term recorded arterial blood flow waveforms were analyzed using detrended fluctuation analysis. Materials and Methods: The study included 117 respondents, aged 20-70 years. The waveform of the arterial blood flow was recorded for 5 min, with an optical sensor placed above the left common carotid artery, simultaneously with a single-channel ECG. For each cardiac cycle, the blood flow amplitude was determined, and a new time series was formed, which was analyzed non-linearly (DFA method). The values of the scalar coefficients α 1 and α 2, particularly their ratio (α 1/α 2) were obtained, which were then monitored in relation to the age of the subjects. Result: The values of the scalar ratio (α 1/α 2) were significantly different between the subjects older and younger than 50 years. The value of the α 1/α 2 decreased exponentially with the aging. In the population of middle-aged adults, this ratio had a value around 1, in young adults the value was exclusively higher than 1 and in older adults the value was exclusively lower than 1. Conclusion: The results of this study indicated that the aging led to a decrease in the α 1/α 2 in the population of healthy subjects. With this non-invasive method, changes in the cardiovascular system due to aging can be detected and monitored.
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Affiliation(s)
- Biljana Djurić
- Institute of Physiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Žikić
- Faculty of Physics, University of Belgrade, Belgrade, Serbia
| | - Zorica Nestorović
- Institute of Biophysics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Nebojša Milošević
- Institute of Biophysics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dejan Žikić
- Institute of Biophysics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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20
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Luisi CA, Amiri A, Büsen M, Sichermann T, Nikoubashman O, Wiesmann M, Steinseifer U, Müller M, Neidlin M. Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup. Cardiovasc Eng Technol 2023; 14:393-403. [PMID: 36814059 PMCID: PMC10412675 DOI: 10.1007/s13239-023-00660-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration. METHODS We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions. RESULTS Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data. CONCLUSION The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.
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Affiliation(s)
- C A Luisi
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - A Amiri
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Büsen
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - T Sichermann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - O Nikoubashman
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Wiesmann
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - U Steinseifer
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - M Müller
- Clinic for Diagnostic and Interventional Neuroradiology, University Hospital Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Neidlin
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Medical Faculty, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany.
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21
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Roberts GS, Peret A, Jonaitis EM, Koscik RL, Hoffman CA, Rivera-Rivera LA, Cody KA, Rowley HA, Johnson SC, Wieben O, Johnson KM, Eisenmenger LB. Normative Cerebral Hemodynamics in Middle-aged and Older Adults Using 4D Flow MRI: Initial Analysis of Vascular Aging. Radiology 2023; 307:e222685. [PMID: 36943077 PMCID: PMC10140641 DOI: 10.1148/radiol.222685] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 03/23/2023]
Abstract
Background Characterizing cerebrovascular hemodynamics in older adults is important for identifying disease and understanding normal neurovascular aging. Four-dimensional (4D) flow MRI allows for a comprehensive assessment of cerebral hemodynamics in a single acquisition. Purpose To establish reference intracranial blood flow and pulsatility index values in a large cross-sectional sample of middle-aged (45-65 years) and older (>65 years) adults and characterize the effect of age and sex on blood flow and pulsatility. Materials and Methods In this retrospective study, patients aged 45-93 years (cognitively unimpaired) underwent cranial 4D flow MRI between March 2010 and March 2020. Blood flow rates and pulsatility indexes from 13 major arteries and four venous sinuses and total cerebral blood flow were collected. Intraobserver and interobserver reproducibility of flow and pulsatility measures was assessed in 30 patients. Descriptive statistics (mean ± SD) of blood flow and pulsatility were tabulated for the entire group and by age and sex. Multiple linear regression and linear mixed-effects models were used to assess the effect of age and sex on total cerebral blood flow and vessel-specific flow and pulsatility, respectively. Results There were 759 patients (mean age, 65 years ± 8 [SD]; 506 female patients) analyzed. For intra- and interobserver reproducibility, median intraclass correlation coefficients were greater than 0.90 for flow and pulsatility measures across all vessels. Regression coefficients β ± standard error from multiple linear regression showed a 4 mL/min decrease in total cerebral blood flow each year (age β = -3.94 mL/min per year ± 0.44; P < .001). Mixed effects showed a 1 mL/min average annual decrease in blood flow (age β = -0.95 mL/min per year ± 0.16; P < .001) and 0.01 arbitrary unit (au) average annual increase in pulsatility over all vessels (age β = 0.011 au per year ± 0.001; P < .001). No evidence of sex differences was observed for flow (β = -1.60 mL/min per male patient ± 1.77; P = .37), but pulsatility was higher in female patients (sex β = -0.018 au per male patient ± 0.008; P = .02). Conclusion Normal reference values for blood flow and pulsatility obtained using four-dimensional flow MRI showed correlations with age. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Steinman in this issue.
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Affiliation(s)
- Grant S. Roberts
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Anthony Peret
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Erin M. Jonaitis
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Rebecca L. Koscik
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Carson A. Hoffman
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Leonardo A. Rivera-Rivera
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Karly A. Cody
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Howard A. Rowley
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Sterling C. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Oliver Wieben
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Kevin M. Johnson
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
| | - Laura B. Eisenmenger
- From the Department of Medical Physics (G.S.R., L.A.R.R., O.W.,
K.M.J.), Department of Radiology (A.P., C.A.H., H.A.R., O.W., K.M.J., L.B.E.),
Wisconsin Alzheimer’s Institute (E.M.J., R.L.K., S.C.J.), and Wisconsin
Alzheimer’s Disease Research Center (E.M.J., L.A.R.R., K.A.C., S.C.J.),
University of Wisconsin School of Medicine and Public Health, 600 Highland Ave,
Madison, WI 53792-3252; and Geriatric Research Education and Clinical Center,
William S. Middleton Memorial Veterans Hospital, Madison, Wis (S.C.J.)
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22
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van den Kerkhof M, van der Thiel MM, Postma AA, van Oostenbrugge RJ, Kroon AA, Jansen JFA, Backes WH. Hypertension Correlates With Stronger Blood Flow Pulsatility in Small Perforating Cerebral Arteries Assessed With 7 Tesla Magnetic Resonance Imaging. Hypertension 2023; 80:802-810. [PMID: 36722349 DOI: 10.1161/hypertensionaha.122.19866] [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] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hypertension alters the structure and function of cerebral blood vessels, and is an important risk factor for stroke and cerebral small vessel disease (cSVD). However, the pathophysiological process is not yet well understood. This study aimed to investigate the relationship between the pulsatility measures in small perforating arteries and hypertension, since hypertension-induced arterial stiffening may lead to a higher blood flow pulsatility and lower damping. METHODS We examined 28 patients with essential hypertension and 25 age- and sex-matched healthy controls (mean age: 63.4, range: 43-81 years, 26 males). Blood flow velocity waveforms were acquired in the lenticulostriate arteries (LSAs) and the middle cerebral artery using phase-contrast MRI at 7 Tesla. Several cSVD markers were scored. The velocity and pulsatility measures were compared between the hypertensives and controls. RESULTS A higher pulsatility index (PI) in the LSAs and a lower damping factor (DF) was found in the hypertensive compared to the normotensive group (P=0.015, P=0.015, respectively), but no association was found for the PI in the middle cerebral artery. Higher systolic and mean arterial pressures were associated with higher PI in the LSA and DF. For diastolic blood pressure, only an association with a lower DF was found. Adjusting for cSVD score did not alter these relationships. CONCLUSIONS This study shows a higher PI in the LSAs and a lower DF in subjects with hypertension, independent of cSVD presence. This supports the hypothesis that hypertension-induced arterial remodeling may alter the intracerebral blood flow velocity profiles, which could eventually contribute to cerebral tissue damage. REGISTRATION URL: https://trialsearch.who.int/; Unique identifier: NL7537 and NL8798.
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Affiliation(s)
- Marieke van den Kerkhof
- Department of Radiology and Nuclear Medicine (M.v.d.K., M.M.v.d.T., A.A.P., J.F.A.J., W.H.B.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands
| | - Merel M van der Thiel
- Department of Radiology and Nuclear Medicine (M.v.d.K., M.M.v.d.T., A.A.P., J.F.A.J., W.H.B.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands.,Department of Psychiatry and Neuropsychology (M.M.v.d.T.), Maastricht University, The Netherlands
| | - Alida A Postma
- Department of Radiology and Nuclear Medicine (M.v.d.K., M.M.v.d.T., A.A.P., J.F.A.J., W.H.B.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands
| | - Robert J van Oostenbrugge
- Department of Neurology (R.J.v.O.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands.,Cardiovascular Research Institute Maastricht (R.J.v.O., A.A.K., W.H.B.), Maastricht University, The Netherlands
| | - Abraham A Kroon
- Department of Internal Medicine (A.A.K.), Maastricht University Medical Center, The Netherlands.,Cardiovascular Research Institute Maastricht (R.J.v.O., A.A.K., W.H.B.), Maastricht University, The Netherlands
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine (M.v.d.K., M.M.v.d.T., A.A.P., J.F.A.J., W.H.B.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, the Netherlands (J.F.A.J.)
| | - Walter H Backes
- Department of Radiology and Nuclear Medicine (M.v.d.K., M.M.v.d.T., A.A.P., J.F.A.J., W.H.B.), Maastricht University Medical Center, The Netherlands.,School for Mental Health and Neuroscience (M.v.d.K., M.M.v.d.T., A.A.P., R.J.v.O., J.F.A.J., W.H.B.), Maastricht University, The Netherlands.,Cardiovascular Research Institute Maastricht (R.J.v.O., A.A.K., W.H.B.), Maastricht University, The Netherlands
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23
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Steinman DA. Comprehensive Atlases of Intracranial Blood Flow Rates: A Hard Nut Finally Cracks? Radiology 2023; 307:e230381. [PMID: 36943083 DOI: 10.1148/radiol.230381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- David A Steinman
- From the University of Toronto, 5 King's College Rd, Toronto, ON, Canada M5S 3G8
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24
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Yamada S, Hiratsuka S, Otani T, Ii S, Wada S, Oshima M, Nozaki K, Watanabe Y. Usefulness of intravoxel incoherent motion MRI for visualizing slow cerebrospinal fluid motion. Fluids Barriers CNS 2023; 20:16. [PMID: 36899412 PMCID: PMC9999497 DOI: 10.1186/s12987-023-00415-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/15/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND In the cerebrospinal fluid (CSF) dynamics, the pulsations of cerebral arteries and brain is considered the main driving force for the reciprocating bidirectional CSF movements. However, measuring these complex CSF movements on conventional flow-related MRI methods is difficult. We tried to visualize and quantify the CSF motion by using intravoxel incoherent motion (IVIM) MRI with low multi-b diffusion-weighted imaging. METHODS Diffusion-weighted sequence with six b values (0, 50, 100, 250, 500, and 1000 s/mm2) was performed on 132 healthy volunteers aged ≥ 20 years and 36 patients with idiopathic normal pressure hydrocephalus (iNPH). The healthy volunteers were divided into three age groups (< 40, 40 to < 60, and ≥ 60 years). In the IVIM analysis, the bi-exponential IVIM fitting method using the Levenberg-Marquardt algorithm was adapted. The average, maximum, and minimum values of ADC, D, D*, and fraction of incoherent perfusion (f) calculated by IVIM were quantitatively measured in 45 regions of interests in the whole ventricles and subarachnoid spaces. RESULTS Compared with healthy controls aged ≥ 60 years, the iNPH group had significantly lower mean f values in all the parts of the lateral and 3rd ventricles, whereas significantly higher mean f value in the bilateral foramina of Luschka. In the bilateral Sylvian fossa, which contain the middle cerebral bifurcation, the mean f values increased gradually with increasing age, whereas those were significantly lower in the iNPH group. In the 45 regions of interests, the f values in the bilateral foramina of Luschka were the most positively correlated with the ventricular size and indices specific to iNPH, whereas that in the anterior part of the 3rd ventricle was the most negatively correlated with the ventricular size and indices specific to iNPH. Other parameters of ADC, D, and D* were not significantly different between the two groups in any locations. CONCLUSIONS The f value on IVIM MRI is useful for evaluating small pulsatile complex motion of CSF throughout the intracranial CSF spaces. Patients with iNPH had significantly lower mean f values in the whole lateral ventricles and 3rd ventricles and significantly higher mean f value in the bilateral foramina of Luschka, compared with healthy controls aged ≥ 60 years.
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Affiliation(s)
- Shigeki Yamada
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, 1 Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan. .,Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan. .,Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto, Japan. .,Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, Tokyo, Japan.
| | | | - Tomohiro Otani
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Satoshi Ii
- Faculty of System Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Shigeo Wada
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Marie Oshima
- Interfaculty Initiative in Information Studies/Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Shiga, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Shiga, Japan
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25
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van den Kerkhof M, Jansen JFA, van Oostenbrugge RJ, Backes WH. 1D versus 3D blood flow velocity and pulsatility measurements of lenticulostriate arteries at 7T MRI. Magn Reson Imaging 2023; 96:144-150. [PMID: 36473545 DOI: 10.1016/j.mri.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE 7T MRI enables measurements of blood flow velocity waveforms in small, perforating cerebral arteries. As these vessels can be tortuous, acquisition methods sensitive to flow in only one direction may not be sufficient to accurately determine the dynamic blood flow velocity. In this study, we compared 1D with 3D velocity encoding to measure the blood flow velocity and pulsatility in the lenticulostriate arteries (LSAs). METHODS Blood flow velocity waveforms were measured in the LSAs of 18 subjects (age range: 20-74 years) using prospectively gated single-slice phase contrast (PC) MRI at 7T. For each subject, blood flow velocity waveforms were acquired in a single slice with one velocity encoding as well as three orthogonal velocity encodings. The peak velocity and pulsatility index (PI) were determined in the largest, perpendicularly planned LSA, one obliquely planned LSA and three smaller LSAs. The peak velocity and PI were compared between 1D and 3D measurements using Bland-Altman analysis, with the 95% limits of agreement (LOA) taken into account. RESULTS For the largest, perpendicularly planned LSA, the peak velocity was slightly lower (0.2 cm/s, 1.7%) for 1D compared to 3D measurements, with an LOA range from the mean difference of (-0.27;0.27). The PI was slightly higher (0.01, 1.6%) for the 1D measurement, and an LOA range from the mean difference in PI of (-0.045;0.045). The obliquely planned LSA and three smaller LSAs demonstrated larger deviations (range mean percentage difference: 3.9-8.2%). CONCLUSION 1D velocity encoding using 2D PC MRI provides sufficiently accurate dynamic velocity and pulsatility measurements in slices perpendicularly planned to single, large LSAs compared to 3D velocity encoding, while increasing errors are obtained with obliquely planned slices. A greater error is indicated when measuring multiple (possibly tortuous or obliquely planned) smaller LSAs in one scan using one-directional single-slice PC MRI.
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Affiliation(s)
- Marieke van den Kerkhof
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Electrical Engineering, University of Eindhoven, PO Box 513, 5600 MB Eindhoven, the Netherlands
| | - Robert J van Oostenbrugge
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; School for Cardiovascular Diseases, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
| | - Walter H Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; School for Cardiovascular Diseases, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands.
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26
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van den Kerkhof M, van der Thiel MM, van Oostenbrugge RJ, Postma AA, Kroon AA, Backes WH, Jansen JF. Impaired damping of cerebral blood flow velocity pulsatility is associated with the number of perivascular spaces as measured with 7T MRI. J Cereb Blood Flow Metab 2023; 43:937-946. [PMID: 36704826 DOI: 10.1177/0271678x231153374] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Arterial walls stiffen with age, cardiovascular risk factors, and various vascular diseases, which may lead to less damping of the arterial blood flow pulse, subsequent microvascular damage, and enlarged perivascular spaces (PVS). However, the exact interplay between these processes is unclear. This study aimed to investigate the relation between blood flow velocity pulsatility in the small lenticulostriate arteries and their supplying middle cerebral artery and the respective damping factor (DF), with the number of MRI-visible PVS in elderly subjects. Blood flow velocity waveforms were obtained in 45 subjects (median age [range]: 64 [48-81] years, 47% male) using 7T MRI. PVS were scored in the basal ganglia (BG) and centrum semiovale (CSO). Spearman correlation analyses were used to determine associations of the blood flow pulsatility and the DF, with PVS score, adjusted for age and sex. We found a significant association between a lower DF and a higher number of PVS in the BG (rs = -0.352, P = 0.021), but not in the CSO. This finding supports the supposed pathophysiological mechanism in which excessive kinetic energy deposition leads to damage of small perforating arteries and contributes to the enlargement of PVS at the level of the BG, but possible other pathways might also be of influence.
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Affiliation(s)
- Marieke van den Kerkhof
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Merel M van der Thiel
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Robert J van Oostenbrugge
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Alida A Postma
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Abraham A Kroon
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Walter H Backes
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jacobus Fa Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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27
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Vikner T, Karalija N, Eklund A, Malm J, Lundquist A, Gallewicz N, Dahlin M, Lindenberger U, Riklund K, Bäckman L, Nyberg L, Wåhlin A. 5-Year Associations among Cerebral Arterial Pulsatility, Perivascular Space Dilation, and White Matter Lesions. Ann Neurol 2022; 92:871-881. [PMID: 36054261 PMCID: PMC9804392 DOI: 10.1002/ana.26475] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE High cerebral arterial pulsatility index (PI), white matter lesions (WMLs), enlarged perivascular spaces (PVSs), and lacunar infarcts are common findings in the elderly population, and considered indicators of small vessel disease (SVD). Here, we investigate the potential temporal ordering among these variables, with emphasis on determining whether high PI is an early or delayed manifestation of SVD. METHODS In a population-based cohort, 4D flow MRI data for cerebral arterial pulsatility was collected for 159 participants at baseline (age 64-68), and for 122 participants at follow-up 5 years later. Structural MRI was used for WML and PVS segmentation, and lacune identification. Linear mixed-effects (LME) models were used to model longitudinal changes testing for pairwise associations, and latent change score (LCS) models to model multiple relationships among variables simultaneously. RESULTS Longitudinal 5-year increases were found for WML, PVS, and PI. Cerebral arterial PI at baseline did not predict changes in WML or PVS volume. However, WML and PVS volume at baseline predicted 5-year increases in PI. This was shown for PI increases in relation to baseline WML and PVS volumes using LME models (R ≥ 0.24; p < 0.02 and R ≥ 0.23; p < 0.03, respectively) and LCS models ( β = 0.28; p = 0.015 and β = 0.28; p = 0.009, respectively). Lacunes at baseline were unrelated to PI. INTERPRETATION In healthy older adults, indicators of SVD are related in a lead-lag fashion, in which the expression of WML and PVS precedes increases in cerebral arterial PI. Hence, we propose that elevated PI is a relatively late manifestation, rather than a risk factor, for cerebral SVD. ANN NEUROL 2022;92:871-881.
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Affiliation(s)
- Tomas Vikner
- Department of Radiation SciencesUmeå UniversityUmeåSweden
| | - Nina Karalija
- Department of Radiation SciencesUmeå UniversityUmeåSweden
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
| | - Anders Eklund
- Department of Radiation SciencesUmeå UniversityUmeåSweden
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
| | - Jan Malm
- Department of Clinical Science, NeurosciencesUmeå UniversityUmeåSweden
| | - Anders Lundquist
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
- Department of Statistics, USBEUmeå UniversityUmeåSweden
| | | | - Magnus Dahlin
- Department of Radiation SciencesUmeå UniversityUmeåSweden
| | - Ulman Lindenberger
- Center for Lifespan PsychologyMax Planck Institute for Human DevelopmentBerlinGermany
- Max PlanckUCL Centre for Computational Psychiatry and Ageing ResearchBerlinGermany
- Max PlanckUCL Centre for Computational Psychiatry and Ageing ResearchLondonUK
| | - Katrine Riklund
- Department of Radiation SciencesUmeå UniversityUmeåSweden
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
| | - Lars Bäckman
- Ageing Research CenterKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Lars Nyberg
- Department of Radiation SciencesUmeå UniversityUmeåSweden
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
- Department of Integrative Medical Biology (IMB)Umeå UniversityUmeåSweden
| | - Anders Wåhlin
- Department of Radiation SciencesUmeå UniversityUmeåSweden
- Umeå Center for Functional Brain Imaging (UFBI)Umeå UniversityUmeåSweden
- Department of Applied Physics and ElectronicsUmeå UniversityUmeåSweden
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28
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Liu L, Wu Y, Zhang K, Meng R, Duan J, Zhou C, Ji X. Anatomy imaging and hemodynamics research on the cerebral vein and venous sinus among individuals without cranial sinus and jugular vein diseases. Front Neurosci 2022; 16:999134. [PMID: 36238084 PMCID: PMC9551167 DOI: 10.3389/fnins.2022.999134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/12/2022] [Indexed: 11/15/2022] Open
Abstract
In recent years, imaging technology has allowed the visualization of intracranial and extracranial vascular systems. However, compared with the cerebral arterial system, the relative lack of image information, individual differences in the anatomy of the cerebral veins and venous sinuses, and several unique structures often cause neurologists and radiologists to miss or over-diagnose. This increases the difficulty of the clinical diagnosis and treatment of cerebral venous system diseases. This review focuses on applying different imaging methods to the normal anatomical morphology of the cerebral venous system and special structural and physiological parameters, such as hemodynamics, in people without cranial sinus and jugular vein diseases and explores its clinical significance. We hope this study will reinforce the importance of studying the cerebral venous system anatomy and imaging data and will help diagnose and treat systemic diseases.
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Affiliation(s)
- Lu Liu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yan Wu
- Department of Emergency, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Kaiyuan Zhang
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jiangang Duan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Chen Zhou
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
- *Correspondence: Chen Zhou,
| | - Xunming Ji
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
- Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China
- Xunming Ji,
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29
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Sherman SR, Lefferts WK, Lefferts EC, Grigoriadis G, Lima NS, Fernhall B, Baynard T, Rosenberg AJ. The effect of aging on carotid artery wall mechanics during maximal resistance exercise. Eur J Appl Physiol 2022; 122:2477-2488. [PMID: 36008691 DOI: 10.1007/s00421-022-05016-z] [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: 03/08/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Age-related stiffening of the large elastic arteries (e.g., common carotid artery [CCA]) may impair wall dynamics (i.e., strain) and amplify transmission of pulsatile blood flow into the brain with large increases in pressure that occur during maximal resistance exercise (RE). The purpose of this study was to compare CCA arterial wall dynamics, central hemodynamics, and cerebral blood velocity responses during maximal RE between young and older adults. METHODS Thirty-one young (YA; 26 ± 5 yrs; 23.8 ± 3.3 kg/m2) and 25 older adults (OA; 60 ± 6 yrs; 30.0 ± 5.5 kg/m2) performed a unilateral maximal isokinetic knee flexion/extension exercise protocol (i.e., maximal RE). All measures were recorded at baseline and during the last 10 s of maximal RE. Common carotid artery strain, CCA strain time to peak, and CCA strain rate (i.e., variables of arterial wall dynamics) were analyzed using 2D speckle tracking software from circumferential ultrasound images. Transcranial Doppler was used to measure right middle cerebral artery (MCA) blood velocity. Non-invasive arterial blood pressure measurements were obtained using finger photoplethysmography. RESULTS Older adults had greater reductions in CCA strain time to peak from baseline to maximal RE (345 ± 39 to 242 ± 52 ms) than YA (308 ± 35 to 247 ± 42 ms; interaction effect, p < 0.01). MCA velocity was similar between YA and OA during maximal RE (p = 0.48), despite a greater arterial pressor response in OA (p < 0.01). CONCLUSION These data suggest cerebral blood velocity responds similarly during maximal RE among OA compared to YA, despite subtle age-related differences in the pressor and extracranial vascular response during maximal RE.
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Affiliation(s)
- Sara R Sherman
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Wesley K Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Clinical Vascular Research Laboratory, Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Clinical Vascular Research Laboratory, Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Natalia S Lima
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Tracy Baynard
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexander J Rosenberg
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. .,Cerebral and Cardiovascular Physiology Laboratory, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, USA. .,Department of Physiology, Midwestern University, Downers Grove, IL, USA.
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30
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Macaulay TR, Hegarty A, Yan L, Duncan D, Pa J, Kutch JJ, La Rocca M, Lane CJ, Schroeder ET. Effects of a 12-Week Periodized Resistance Training Program on Resting Brain Activity and Cerebrovascular Function: A Nonrandomized Pilot Trial. Neurosci Insights 2022; 17:26331055221119441. [PMID: 35983377 PMCID: PMC9379950 DOI: 10.1177/26331055221119441] [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: 01/02/2022] [Accepted: 07/27/2022] [Indexed: 01/26/2023] Open
Abstract
Resistance training is a promising strategy to promote healthy cognitive aging; however, the brain mechanisms by which resistance training benefits cognition have yet to be determined. Here, we examined the effects of a 12-week resistance training program on resting brain activity and cerebrovascular function in 20 healthy older adults (14 females, mean age 69.1 years). In this single group clinical trial, multimodal 3 T magnetic resonance imaging was performed at 3 time points: baseline (preceding a 12-week control period), pre-intervention, and post-intervention. Along with significant improvements in fluid cognition (d = 1.27), 4 significant voxelwise clusters were identified for decreases in resting brain activity after the intervention (Cerebellum, Right Middle Temporal Gyrus, Left Inferior Parietal Lobule, and Right Inferior Parietal Lobule), but none were identified for changes in resting cerebral blood flow. Using a separate region of interest approach, we provide estimates for improved cerebral blood flow, compared with declines over the initial control period, in regions associated with cognitive impairment, such as hippocampal blood flow (d = 0.40), and posterior cingulate blood flow (d = 0.61). Finally, resistance training had a small countermeasure effect on the age-related progression of white matter lesion volume (rank-biserial = -0.22), a biomarker of cerebrovascular disease. These proof-of-concept data support larger trials to determine whether resistance training can attenuate or even reverse salient neurodegenerative processes.
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Affiliation(s)
- Timothy R Macaulay
- Division of Biokinesiology and Physical
Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles,
CA, USA,Timothy R Macaulay, Division of
Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of
Southern California, 1540 E. Alcazar Street, CHP149, Los Angeles, CA 90089, USA.
| | - Amy Hegarty
- Division of Biokinesiology and Physical
Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles,
CA, USA
| | - Lirong Yan
- Mark and Mary Stevens Neuroimaging and
Informatics Institute, Department of Neurology, Keck School of Medicine, University
of Southern California, Los Angeles, CA, USA
| | - Dominique Duncan
- Mark and Mary Stevens Neuroimaging and
Informatics Institute, Department of Neurology, Keck School of Medicine, University
of Southern California, Los Angeles, CA, USA
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and
Informatics Institute, Department of Neurology, Keck School of Medicine, University
of Southern California, Los Angeles, CA, USA
| | - Jason J Kutch
- Division of Biokinesiology and Physical
Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles,
CA, USA
| | - Marianna La Rocca
- Mark and Mary Stevens Neuroimaging and
Informatics Institute, Department of Neurology, Keck School of Medicine, University
of Southern California, Los Angeles, CA, USA,Department of Preventive Medicine, Keck
School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christianne J Lane
- Dipartimento Interateneo di Fisica,
Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - E Todd Schroeder
- Division of Biokinesiology and Physical
Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles,
CA, USA
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31
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Tallon CM, Talbot JS, Smith KJ, Lewis N, Nowak-Flück D, Stembridge M, Ainslie P, McManus AM. Dynamic onset response of the internal carotid artery to hypercapnia is blunted in children compared with adults. Physiol Rep 2022; 10:e15406. [PMID: 36017901 PMCID: PMC9413871 DOI: 10.14814/phy2.15406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/24/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022] Open
Abstract
Intracranial blood velocity reactivity to a steady‐state hypercapnic stimulus has been shown to be similar in children and adults, but the onset response to hypercapnia is slower in the child. Given the vasodilatory effect of hypercapnia on the cerebrovasculature, assessment of vessel diameter, and blood flow are vital to fully elucidate whether the temporal hypercapnic response differs in children versus adults. Assessment of internal carotid artery (ICA) vessel diameter (ICAd), blood velocity (ICAv), volumetric blood flow (QICA), and shear rate (ICASR) in response to a 4 min hypercapnic challenge was completed in children (n = 14, 8 girls; 9.8 ± 0.7 years) and adults (n = 17, 7 females; 24.7 ± 1.8 years). The dynamic onset responses of partial pressure of end‐tidal CO2 (PETCO2), QICA, ICAv, and ICASR to hypercapnia were modeled, and mean response time (MRT) was computed. Following 4 min of hypercapnia, ICA reactivity and ICAd were comparable between the groups. Despite a similar MRT in PETCO2 in children and adults, children had slower QICA (children 108 ± 60 s vs. adults 66 ± 37 s; p = 0.023), ICAv (children 120 ± 52 s vs. adults 52 ± 31 s; p = 0.001), and ICASR (children 90 ± 27 s vs. adults 47 ± 36 s; p = 0.001) MRTs compared with adults. This is the first study to show slower hypercapnic hyperemic kinetic responses of the ICA in children. The mechanisms determining these differences and the need to consider the duration of hypercapnic exposure when assessing CVR in children should be considered in future studies.
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Affiliation(s)
- Christine M Tallon
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jack S Talbot
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Kurt J Smith
- Cerebrovascular Health, Exercise, and Environmental Research Sciences Laboratory, School of Exercise Science and Physical Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Nia Lewis
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Daniela Nowak-Flück
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Mike Stembridge
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Philip Ainslie
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Ali M McManus
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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32
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Zeller NP, Miller KB, Zea RD, Howery AJ, Labrecque L, Aaron SE, Brassard P, Billinger SA, Barnes JN. Sex-specific effects of cardiorespiratory fitness on age-related differences in cerebral hemodynamics. J Appl Physiol (1985) 2022; 132:1310-1317. [PMID: 35446599 PMCID: PMC9126221 DOI: 10.1152/japplphysiol.00782.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
There is a positive association between cardiorespiratory fitness and cognitive health, but the interaction between cardiorespiratory fitness and aging on cerebral hemodynamics is unclear. These potential interactions are further influenced by sex differences. The purpose of this study was to determine the sex-specific relationships between cardiorespiratory fitness, age, and cerebral hemodynamics in humans. Measurements of unilateral middle cerebral artery blood velocity (MCAv) and cerebral pulsatility index obtained using transcranial Doppler ultrasound and cardiorespiratory fitness [maximal oxygen consumption (V̇o2max)] obtained from maximal incremental exercise tests were retrieved from study records at three institutions. A total of 153 healthy participants were included in the analysis (age = 42 ± 20 yr, range = 18-83 yr). There was no association between V̇o2max and MCAv in all participants (P = 0.20). The association between V̇o2max and MCAv was positive in women, but no longer significant after age adjustment (univariate: P = 0.01; age-adjusted: P = 0.45). In addition, there was no association between V̇o2max and MCAv in men (univariate: P = 0.25, age-adjusted: P = 0.57). For V̇o2max and cerebral pulsatility index, there were significant negative associations in all participants (P < 0.001), in men (P < 0.001) and women (P < 0.001). This association remained significant when adjusting for age in women only (P = 0.03). In summary, higher cardiorespiratory fitness was associated with a lower cerebral pulsatility index in all participants, and the significance remained only in women when adjusting for age. Future studies are needed to determine the sex-specific impact of cardiorespiratory fitness improvements on cerebrovascular health.NEW & NOTEWORTHY We present data pooled from three institutions to study the impact of age, sex, and cardiorespiratory fitness on cerebral hemodynamics. Cardiorespiratory fitness was positively associated with middle cerebral artery blood velocity in women, but not in men. Furthermore, cardiorespiratory fitness was inversely associated with cerebral pulsatility index in both men and women, which remained significant in women when adjusting for age. These data suggest a sex-specific impact of cardiorespiratory fitness on resting cerebral hemodynamics.
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Affiliation(s)
- Niklaus P Zeller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kathleen B Miller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ryan D Zea
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna J Howery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut, Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, Québec, Canada
| | - Stacey E Aaron
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Québec, Canada.,Research Center of the Institut, Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Quebec City, Québec, Canada
| | - Sandra A Billinger
- Department of Physical Therapy, Rehabilitation Science and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas.,University of Kansas Alzheimer's Disease Research Center, Fairway, Kansas
| | - Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin
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33
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Perosa V, Arts T, Assmann A, Mattern H, Speck O, Oltmer J, Heinze HJ, Düzel E, Schreiber S, Zwanenburg JJM. Pulsatility Index in the Basal Ganglia Arteries Increases with Age in Elderly with and without Cerebral Small Vessel Disease. AJNR Am J Neuroradiol 2022; 43:540-546. [PMID: 35332021 PMCID: PMC8993201 DOI: 10.3174/ajnr.a7450] [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: 10/01/2021] [Accepted: 01/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral small vessel disease contributes to stroke and cognitive impairment and interacts with Alzheimer disease pathology. Because of the small dimensions of the affected vessels, in vivo characterization of blood flow properties is challenging but important to unravel the underlying mechanisms of the disease. MATERIALS AND METHODS A 2D phase-contrast sequence at 7T MR imaging was used to assess blood flow velocity and the pulsatility index of the perforating basal ganglia arteries. We included patients with cerebral amyloid angiopathy (n = 8; identified through the modified Boston criteria), hypertensive arteriopathy (n = 12; identified through the presence of strictly deep or mixed cerebral microbleeds), and age- and sex-matched controls (n = 28; no cerebral microbleeds). RESULTS Older age was related to a greater pulsatility index, irrespective of cerebral small vessel disease. In hypertensive arteriopathy, there was an association between lower blood flow velocity of the basal ganglia and the presence of peri-basal ganglia WM hyperintensities. CONCLUSIONS Our results suggest that age might be the driving factor for altered cerebral small vessel hemodynamics. Furthermore, this study puts cerebral small vessel disease downstream pathologies in the basal ganglia region in relation to blood flow characteristics of the basal ganglia microvasculature.
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Affiliation(s)
- V Perosa
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- J. Philip Kistler Stroke Research Center (V.P.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - T Arts
- Department of Radiology (T.A., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Assmann
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
| | | | - O Speck
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Leibniz-Institute for Neurobiology (O.S., H.-J.H.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
| | - J Oltmer
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
| | - H-J Heinze
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Leibniz-Institute for Neurobiology (O.S., H.-J.H.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
| | - E Düzel
- Institute of Cognitive Neurology and Dementia Research (E.D.), Ottovon-Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
- Institute of Cognitive Neuroscience (E.D.), University College London, London, UK
| | - S Schreiber
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
| | - J J M Zwanenburg
- Department of Radiology (T.A., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands
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34
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NAKAMURA N, KUBO T, MURAOKA I. Effects of changes in large arterial compliance and small arterial buffer function with resistance training on cerebral blood flow pulsatility. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.19.04300-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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35
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Fico BG, Miller KB, Rivera-Rivera LA, Corkery AT, Pearson AG, Eisenmann NA, Howery AJ, Rowley HA, Johnson KM, Johnson SC, Wieben O, Barnes JN. The Impact of Aging on the Association Between Aortic Stiffness and Cerebral Pulsatility Index. Front Cardiovasc Med 2022; 9:821151. [PMID: 35224051 PMCID: PMC8863930 DOI: 10.3389/fcvm.2022.821151] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/14/2022] [Indexed: 01/25/2023] Open
Abstract
The central arteries dampen the pulsatile forces from myocardial contraction, limiting the pulsatility that reaches the cerebral vasculature, although there are limited data on this relationship with aging in humans. The purpose of this study was to determine the association between aortic stiffness and cerebral artery pulsatility index in young and older adults. We hypothesized that cerebral pulsatility index would be associated with aortic stiffness in older adults, but not in young adults. We also hypothesized that both age and aortic stiffness would be significant predictors for cerebral pulsatility index. This study included 23 healthy older adults (aged 62 ± 6 years) and 33 healthy young adults (aged 25 ± 4 years). Aortic stiffness was measured using carotid-femoral pulse wave velocity (cfPWV), while cerebral artery pulsatility index in the internal carotid arteries (ICAs), middle cerebral arteries (MCAs), and basilar artery were assessed using 4D Flow MRI. Cerebral pulsatility index was calculated as (maximum flow - minimum flow) / mean flow. In the combined age group, there was a positive association between cfPWV and cerebral pulsatility index in the ICAs (r = 0.487; p < 0.001), MCAs (r = 0.393; p = 0.003), and basilar artery (r = 0.576; p < 0.001). In young adults, there were no associations between cfPWV and cerebral pulsatility index in any of the arteries of interest (ICAs: r = 0.253; p = 0.156, MCAs: r = -0.059; p = 0.743, basilar artery r = 0.171; p = 0.344). In contrast, in older adults there was a positive association between cfPWV and cerebral pulsatility index in the MCAs (r = 0.437; p = 0.037) and basilar artery (r = 0.500; p = 0.015). However, the relationship between cfPWV and cerebral pulsatility index in the ICAs of the older adults did not reach the threshold for significance (r = 0.375; p = 0.078). In conclusion, age and aortic stiffness are significant predictors of cerebral artery pulsatility index in healthy adults. This study highlights the importance of targeting aortic stiffness in our increasingly aging population to reduce the burden of age-related changes in cerebral hemodynamics.
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Affiliation(s)
- Brandon G. Fico
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Kathleen B. Miller
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Leonardo A. Rivera-Rivera
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States,Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Adam T. Corkery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Andrew G. Pearson
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Nicole A. Eisenmann
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Anna J. Howery
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States
| | - Howard A. Rowley
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States,Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Kevin M. Johnson
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States,Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States,Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veteran's Hospital, Madison, WI, United States
| | - Oliver Wieben
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jill N. Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, United States,*Correspondence: Jill N. Barnes
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36
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Abstract
Alterations in cerebral blood flow are common in several neurological diseases among the elderly including stroke, cerebral small vessel disease, vascular dementia, and Alzheimer's disease. 4D flow magnetic resonance imaging (MRI) is a relatively new technique to investigate cerebrovascular disease, and makes it possible to obtain time-resolved blood flow measurements of the entire cerebral arterial venous vasculature and can be used to derive a repertoire of hemodynamic biomarkers indicative of cerebrovascular health. The information that can be obtained from one single 4D flow MRI scan allows both the investigation of aberrant flow patterns at a focal location in the vasculature as well as estimations of brain-wide disturbances in blood flow. Such focal and global hemodynamic biomarkers show the potential of being sensitive to impending cerebrovascular disease and disease progression and can also become useful during planning and follow-up of interventions aiming to restore a normal cerebral circulation. Here, we describe 4D flow MRI approaches for analyzing the cerebral vasculature. We then survey key hemodynamic biomarkers that can be reliably assessed using the technique. Finally, we highlight cerebrovascular diseases where one or multiple hemodynamic biomarkers are of central interest.
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Affiliation(s)
- Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Clinical Science and Neurosciences, Umeå University, Umeå, Sweden
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37
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van Tuijl RJ, Ruigrok YM, Geurts LJ, van der Schaaf IC, Biessels GJ, Rinkel GJE, Velthuis BK, Zwanenburg JJM. Does the Internal Carotid Artery Attenuate Blood-Flow Pulsatility in Small Vessel Disease? A 7 T 4D-Flow MRI Study. J Magn Reson Imaging 2022; 56:527-535. [PMID: 34997655 PMCID: PMC9546379 DOI: 10.1002/jmri.28062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background Increased cerebral blood‐flow pulsatility is associated with cerebral small vessel disease (cSVD). Reduced pulsatility attenuation over the internal carotid artery (ICA) could be a contributing factor to the development of cSVD and could be associated with intracranial ICA calcification (iICAC). Purpose To compare pulsatility, pulsatility attenuation, and distensibility along the ICA between patients with cSVD and controls and to assess the association between iICAC and pulsatility and distensibility. Study Type Retrospective, explorative cross‐sectional study. Subjects A total of 17 patients with cSVD, manifested as lacunar infarcts or deep intracerebral hemorrhage, and 17 age‐ and sex‐matched controls. Field Strength/Sequence Three‐dimensional (3D) T1‐weighted gradient echo imaging and 4D phase‐contrast (PC) MRI with a 3D time‐resolved velocity encoded gradient echo sequence at 7 T. Assessment Blood‐flow velocity pulsatility index (vPI) and arterial distensibility were calculated for seven ICA segments (C1–C7). iICAC presence and volume were determined from available brain CT scans (acquired as part of standard clinical care) in patients with cSVD. Statistical Tests Independent t‐tests and linear mixed models. The threshold for statistically significance was P < 0.05 (two tailed). Results The cSVD group showed significantly higher ICA vPI and significantly lower distensibility compared to controls. Controls showed significant attenuation of vPI over the carotid siphon (−4.9% ± 3.6%). In contrast, patients with cSVD showed no attenuation, but a significant increase of vPI (+6.5% ± 3.1%). iICAC presence and volume correlated positively with vPI (r = 0.578) in patients with cSVD and negatively with distensibility (r = −0.386). Conclusion Decreased distensibility and reduced pulsatility attenuation are associated with increased iICAC and may contribute to cSVD. Confirmation in a larger prospective study is required. Evidence Level 2 Technical Efficacy Stage 2
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Affiliation(s)
- Rick J van Tuijl
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Ynte M Ruigrok
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Lennart J Geurts
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Irene C van der Schaaf
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Gabriël J E Rinkel
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Birgitta K Velthuis
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
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38
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Holloway PM. Novel, Emerging Chip Models of the Blood-Brain Barrier and Future Directions. Methods Mol Biol 2022; 2492:193-224. [PMID: 35733046 DOI: 10.1007/978-1-0716-2289-6_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of microfluidic chips is now allowing for more advanced modelling of the blood-brain barrier (BBB) in vitro, recapitulating heterotypic interactions, 3D architecture, and physiological flow. This chapter will give an introduction to these new technologies and how they are being applied to model the BBB and neurovascular unit (NVU). A foundational understanding of the fluid dynamics germane to the effective use of these chips will be set and an overview of how physical phenomena at the microscale can be exploited to enable new possibilities to control the cell culture environment. The four main approaches to construct microfluidic blood vessel mimetics will be discussed with examples of how these techniques are being applied to model the BBB and more recently to study specific neurovascular disease processes. Finally, practical guidance will be given for researchers wishing to adopt these new techniques along with a summary of the challenges, limitations faced, and new opportunities opened up by these advanced cell culture systems.
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Affiliation(s)
- Paul M Holloway
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
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39
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Yong KW, Janmaleki M, Pachenari M, Mitha AP, Sanati-Nezhad A, Sen A. Engineering a 3D human intracranial aneurysm model using liquid-assisted injection molding and tuned hydrogels. Acta Biomater 2021; 136:266-278. [PMID: 34547516 DOI: 10.1016/j.actbio.2021.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 12/30/2022]
Abstract
Physiologically relevant intracranial aneurysm (IA) models are crucially required to facilitate testing treatment options for IA. Herein, we report the development of a new in vitro tissue-engineered platform, which recapitulates the microenvironment, structure, and cellular complexity of native human IA. A new modified liquid-assisted injection molding technique was developed to fabricate a three-dimensional hollow IA model with clinically relevant IA dimensions within a mechanically tuned Gelatin Methacryloyl (GelMA) hydrogel. An endothelium lining was created inside the IA model by culturing human umbilical vein endothelial cells over pre-cultured human brain vascular smooth muscle cells. These cellularized IA models were subjected to medium perfusion at flow rates between 6.3 and 15.75 mL/min for inducing biomimetic vessel wall shear stress (10-25 dyn/cm2) to the cells for ten days. Both cell types maintained their secretome profiles and showed more than 96% viability, demonstrating the biocompatibility of the hydrogel during perfusion cell culture at such flow rates. Based on the characterized viscoelastic properties of the GelMA hydrogel and with the aid of a fluid-structure interaction model, the capability of the IA model in predicting the response of the IA to different fluid flow profiles was mathematically shown. With physiologically relevant behavior, our developed in vitro human IA model could allow researchers to better understand the pathophysiology and treatment of IA. STATEMENT OF SIGNIFICANCE: A three-dimensional intracranial aneurysm (IA) tissue model recapitulating the microenvironment, structure, and cellular complexity of native human IA was developed. • An endothelium lining was created inside the IA model over pre-cultured human brain vascular smooth muscle cells over at least 10-day successful culture. • The cells maintained their secretome profiles, demonstrating the biocompatibility of hydrogel during a long-term perfusion cell culture. • The IA model showed its capability in predicting the response of IA to different fluid flow profiles. • The cells in the vessel region behaved differently from cells in the aneurysm region due to alteration in hemodynamic shear stress. • The IA model could allow researchers to better understand the pathophysiology and treatment options of IA.
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40
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Arts T, Onkenhout LP, Amier RP, van der Geest R, van Harten T, Kappelle J, Kuipers S, van Osch MJP, van Bavel ET, Biessels GJ, Zwanenburg JJM. Non-Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries With MRI. J Magn Reson Imaging 2021; 55:1785-1794. [PMID: 34792263 PMCID: PMC9298760 DOI: 10.1002/jmri.27989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background Damping of heartbeat‐induced pressure pulsations occurs in large arteries such as the aorta and extends to the small arteries and microcirculation. Since recently, 7 T MRI enables investigation of damping in the small cerebral arteries. Purpose To investigate flow pulsatility damping between the first segment of the middle cerebral artery (M1) and the small perforating arteries using magnetic resonance imaging. Study Type Retrospective. Subjects Thirty‐eight participants (45% female) aged above 50 without history of heart failure, carotid occlusive disease, or cognitive impairment. Field Strength/Sequence 3 T gradient echo (GE) T1‐weighted images, spin‐echo fluid‐attenuated inversion recovery images, GE two‐dimensional (2D) phase‐contrast, and GE cine steady‐state free precession images were acquired. At 7 T, T1‐weighted images, GE quantitative‐flow, and GE 2D phase‐contrast images were acquired. Assessment Velocity pulsatilities of the M1 and perforating arteries in the basal ganglia (BG) and semi‐oval center (CSO) were measured. We used the damping index between the M1 and perforating arteries as a damping indicator (velocity pulsatilityM1/velocity pulsatilityCSO/BG). Left ventricular stroke volume (LVSV), mean arterial pressure (MAP), pulse pressure (PP), and aortic pulse wave velocity (PWV) were correlated with velocity pulsatility in the M1 and in perforating arteries, and with the damping index of the CSO and BG. Statistical Tests Correlations of LVSV, MAP, PP, and PWV with velocity pulsatility in the M1 and small perforating arteries, and correlations with the damping indices were evaluated with linear regression analyses. Results PP and PWV were significantly positively correlated to M1 velocity pulsatility. PWV was significantly negatively correlated to CSO velocity pulsatility, and PP was unrelated to CSO velocity pulsatility (P = 0.28). PP and PWV were uncorrelated to BG velocity pulsatility (P = 0.25; P = 0.68). PWV and PP were significantly positively correlated with the CSO damping index. Data Conclusion Our study demonstrated a dynamic damping of velocity pulsatility between the M1 and small cerebral perforating arteries in relation to proximal stress. Level of Evidence 4 Technical Efficacy Stage 1
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Affiliation(s)
- Tine Arts
- Department of Radiology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Laurien P Onkenhout
- Department of Radiology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Raquel P Amier
- Department of Cardiology, Amsterdam Medical Center Location Vu, Amsterdam, The Netherlands
| | - Rob van der Geest
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Thijs van Harten
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap Kappelle
- Department of Neurology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne Kuipers
- Department of Neurology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Matthijs J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ed T van Bavel
- Amsterdam UMC, University of Amsterdam, Biomedical Engineering and Physics, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaco J M Zwanenburg
- Department of Radiology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Lee WJ, Jung KH, Nam HW, Lee YS. Effect of obstructive sleep apnea on cerebrovascular compliance and cerebral small vessel disease. PLoS One 2021; 16:e0259469. [PMID: 34767578 PMCID: PMC8589195 DOI: 10.1371/journal.pone.0259469] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
Reduced cerebrovascular compliance is the major mechanism of cerebral small vessel disease (SVD). Obstructive sleep apnea (OSA) also promotes SVD development, but the underlying mechanism was not elucidated. We investigated the association among OSA, cerebrovascular compliance, and SVD parameters. This study retrospectively included individuals ≥ 50 years of age, underwent overnight polysomnographic (PSG) for the evaluation of OSA, and performed MRI and transcranial Doppler (TCD) within 12 months of interval without a neurological event between the evaluations. TCD parameters for the cerebrovascular compliance included middle cerebral artery pulsatility index (MCA PI) and mean MCA resistance index ratio (MRIR). SVD parameters included white matter hyperintensity (WMH) volume, number of lacunes, enlarged perivascular space (ePVS) score, and the presence of microbleeds or lacunes. Ninety-seven individuals (60.8% male, mean age 70.0±10.5 years) were included. MRIR was associated with higher respiratory distress index (B = 0.003; 95% confidence interval [CI] 0.001-0.005; P = 0.021), while MCA PI was not associated with any of the PSG markers for OSA severity. Apnea-hypopnea index was associated with the log-transformed total WMH volume (B = 0.008; 95% confidence interval [CI] 0.001-0.016; P = 0.020), subcortical WMH volume (B = 0.015; 95% CI 0.007-0.022; P<0.001), total ePVS score (B = 0.024; 95% CI 0.003-0.045; P = 0.026), and centrum semiovale ePVS score (B = 0.026; 95% CI 0.004-0.048; P = 0.019), and oxygen-desaturation index with periventricular WMH volume, independently from age, MCA PI, and MRIR. This study concluded that OSA is associated with reduced cerebrovascular compliance and also with SVD independently from cerebrovascular compliance. Underlying pathomechanistic link might be region specific.
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Affiliation(s)
- Woo-Jin Lee
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Keun-Hwa Jung
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Hyun-Woo Nam
- Department of Neurology, College of Medicine Seoul National University, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
| | - Yong-Seok Lee
- Department of Neurology, College of Medicine Seoul National University, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
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Sun A, Wang H. Editorial for "Non-Invasive Assessment of Damping of Blood Flow Velocity Pulsatility in Cerebral Arteries with 7 T MRI". J Magn Reson Imaging 2021; 55:1795-1796. [PMID: 34751470 DOI: 10.1002/jmri.27988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Aiqi Sun
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - He Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.,Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.,Human Phenome Institute, Fudan University, Shanghai, China
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Wu CH, Lirng JF, Wu HM, Ling YH, Wang YF, Fuh JL, Lin CJ, Ling K, Wang SJ, Chen SP. Blood-Brain Barrier Permeability in Patients With Reversible Cerebral Vasoconstriction Syndrome Assessed With Dynamic Contrast-Enhanced MRI. Neurology 2021; 97:e1847-e1859. [PMID: 34504032 DOI: 10.1212/wnl.0000000000012776] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Blood-brain barrier (BBB) disruption has been proposed to be important in the pathogenesis of reversible cerebral vasoconstriction syndrome (RCVS), but not all patients present an identifiable macroscopic BBB disruption; that is, visible contrast leakage on contrast-enhanced T2 fluid-attenuated inversion recovery imaging. This study aimed to evaluate microscopic BBB permeability and its dynamic change in patients with RCVS. METHODS This prospective cohort implemented 3T dynamic contrast-enhanced MRI. We measured microscopic BBB permeability by determining the whole-brain and white matter hyperintensity (WMH) Ktrans values and evaluated the correlation of whole-brain Ktrans permeability with clinical and vascular measures in transcranial color-coded sonography. RESULTS In total, 176 patients (363 scans) were analyzed and separated into acute (≦30 days) and remission (≧90 days) groups based on the onset-to-examination time. Whole-brain Ktrans values were similar between patients with and without macroscopic BBB disruption in either acute or remission stage. The whole-brain Ktrans was significantly decreased (p < 0.001) from acute to remission stages. The WMH Ktrans was significantly higher than mirror references and decreased from acute to remission stages (p < 0.001). Whole-brain Ktrans correlated with mean pulsatility index (r s = 0.5, p = 0.029), mean resistance index (r s = 0.662, p = 0.002), and distal-to-proximal ratio of resistance index (r s = 0.801, p < 0.001) of M1 segment of middle cerebral arteries at around 10-15 days after onset. The time-trend curve of whole-brain Ktrans depicted dynamic changes during disease course, similar to temporal trends of vasoconstrictions and WMH. DISCUSSION Patients with RCVS presented increased microscopic brain permeability during acute stage, even without discernible macroscopic BBB disruption. The dynamic changes in BBB permeability may be related to impaired cerebral microvascular compliance and WMH formation.
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Affiliation(s)
- Chia-Hung Wu
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jiing-Feng Lirng
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiu-Mei Wu
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Hsiang Ling
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Feng Wang
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ling Fuh
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chung-Jung Lin
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kan Ling
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Pin Chen
- From the Department of Radiology (C.-H.W., J.-F.L., H.-M.W., C.-J.L., K.L.), Department of Neurology, Neurological Institute (Y.-H.L., Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), and Division of Translational Research, Department of Medical Research (S.-P.C.), Taipei Veterans General Hospital; and Institute of Clinical Medicine (C.-H.W., S.-P.C.), School of Medicine (C.-H.W., J.-F.L., H.-M.W., Y.-H.L., Y.-F.W., J.-L.F., C.-J.L., K.L., S.-J.W., S.-P.C.), and Brain Research Center (Y.-F.W., J.-L.F., S.-J.W., S.-P.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Björnfot C, Garpebring A, Qvarlander S, Malm J, Eklund A, Wåhlin A. Assessing cerebral arterial pulse wave velocity using 4D flow MRI. J Cereb Blood Flow Metab 2021; 41:2769-2777. [PMID: 33853409 PMCID: PMC8504412 DOI: 10.1177/0271678x211008744] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Intracranial arterial stiffening is a potential early marker of emerging cerebrovascular dysfunction and could be mechanistically involved in disease processes detrimental to brain function via several pathways. A prominent consequence of arterial wall stiffening is the increased velocity at which the systolic pressure pulse wave propagates through the vasculature. Previous non-invasive measurements of the pulse wave propagation have been performed on the aorta or extracranial arteries with results linking increased pulse wave velocity to brain pathology. However, there is a lack of intracranial "target-organ" measurements. Here we present a 4D flow MRI method to estimate pulse wave velocity in the intracranial vascular tree. The method utilizes the full detectable branching structure of the cerebral vascular tree in an optimization framework that exploits small temporal shifts that exists between waveforms sampled at varying depths in the vasculature. The method is shown to be stable in an internal consistency test, and of sufficient sensitivity to robustly detect age-related increases in intracranial pulse wave velocity.
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Affiliation(s)
- Cecilia Björnfot
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Cecilia Björnfot, Department of Radiation Sciences, Umeå University, Umeå SE 901 87, Sweden.
| | | | - Sara Qvarlander
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
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45
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Lefferts WK, Rosenberg AJ, Schroeder EC, Grigoriadis G, Sandroff BM, Motl RW, Baynard T. Assessment of Cerebrovascular Dynamics and Cognitive Function with Acute Aerobic Exercise in Persons with Multiple Sclerosis. Int J MS Care 2021; 23:162-169. [PMID: 34483755 DOI: 10.7224/1537-2073.2020-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Cognitive dysfunction in multiple sclerosis (MS) may partially stem from inadequate cerebral blood flow. Cerebral blood flow and cognitive function improve with aerobic exercise in healthy adults. The effect of aerobic exercise on cerebrovascular hemodynamics and cognitive performance in persons with MS is unclear. The acute effect of aerobic exercise versus quiet rest on cerebrovascular hemodynamics and cognitive performance in relapsing-remitting MS was examined. Methods Sixteen adults with relapsing-remitting MS underwent cerebrovascular hemodynamics and cognitive performance testing before, 2 minutes after, and 30 minutes after aerobic exercise (20-minute treadmill walking, 60% peak oxygen consumption) and a time-matched seated control. Brachial blood pressure was obtained via an oscillometric cuff. Right middle cerebral artery (MCA) blood velocity was measured via transcranial Doppler and used to calculate mean velocity, pulsatility index (PI), and conductance. Carotid artery stiffness was measured via ultrasonography and tonometry. Cognitive performance (accuracy, reaction time) was assessed using a modified flanker task. Results Exercise elicited significant increases in mean pressure and carotid artery stiffness and decreases in MCA conductance at 2 minutes after exercise, which subsided by 30 minutes (P < .05). Exercise did not significantly alter MCA PI. Flanker reaction time decreased during posttesting in both conditions (P < .05). There were no condition × time interactions for cognitive performance. Conclusions Persons with MS seem resilient to exercise-induced acute changes in MCA PI despite transient carotid stiffening, potentially via reductions in MCA conductance. These data suggest that changes in cognitive performance after acute aerobic exercise are not directly related to transient cerebrovascular responses in persons with MS.
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MacDonald ME, Pike GB. MRI of healthy brain aging: A review. NMR IN BIOMEDICINE 2021; 34:e4564. [PMID: 34096114 DOI: 10.1002/nbm.4564] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/08/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
We present a review of the characterization of healthy brain aging using MRI with an emphasis on morphology, lesions, and quantitative MR parameters. A scope review found 6612 articles encompassing the keywords "Brain Aging" and "Magnetic Resonance"; papers involving functional MRI or not involving imaging of healthy human brain aging were discarded, leaving 2246 articles. We first consider some of the biogerontological mechanisms of aging, and the consequences of aging in terms of cognition and onset of disease. Morphological changes with aging are reviewed for the whole brain, cerebral cortex, white matter, subcortical gray matter, and other individual structures. In general, volume and cortical thickness decline with age, beginning in mid-life. Prevalent silent lesions such as white matter hyperintensities, microbleeds, and lacunar infarcts are also observed with increasing frequency. The literature regarding quantitative MR parameter changes includes T1 , T2 , T2 *, magnetic susceptibility, spectroscopy, magnetization transfer, diffusion, and blood flow. We summarize the findings on how each of these parameters varies with aging. Finally, we examine how the aforementioned techniques have been used for age prediction. While relatively large in scope, we present a comprehensive review that should provide the reader with sound understanding of what MRI has been able to tell us about how the healthy brain ages.
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Affiliation(s)
- M Ethan MacDonald
- Department of Electrical and Software Engineering, University of Calgary, Calgary, Alberta, Canada
- Departments of Radiology and Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
- Healthy Brain Aging Laboratory, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - G Bruce Pike
- Departments of Radiology and Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada
- Healthy Brain Aging Laboratory, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Mohammadi H, Vincent T, Peng K, Nigam A, Gayda M, Fraser S, Joanette Y, Lesage F, Bherer L. Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study. Hum Brain Mapp 2021; 42:3760-3776. [PMID: 33991155 PMCID: PMC8288102 DOI: 10.1002/hbm.25463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/16/2022] Open
Abstract
Recent studies have reported that optical indices of cerebral pulsatility are associated with cerebrovascular health in older adults. Such indices, including cerebral pulse amplitude and the pulse relaxation function (PRF), have been previously applied to quantify global and regional cerebral pulsatility. The aim of the present study was to determine whether these indices are modulated by cardiovascular status and whether they differ between individuals with low or high cardiovascular risk factors (LCVRF and HCVRF) and coronary artery disease (CAD). A total of 60 older adults aged 57-79 were enrolled in the study. Participants were grouped as LCVRF, HCVRF, and CAD. Participants were asked to walk freely on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data. Low-intensity, short-duration walking was used to test whether a brief cardiovascular challenge could increase the difference of pulsatility indices with respect to cardiovascular status. Results indicated that CAD individuals have higher global cerebral pulse amplitude compared with the other groups. Walking reduced global cerebral pulse amplitude and PRF in all groups but did not increase the difference across the groups. Instead, walking extended the spatial distribution of cerebral pulse amplitude to the anterior prefrontal cortex when CAD was compared to the CVRF groups. Further research is needed to determine whether cerebral pulse amplitude extracted from data acquired with NIRS, which is a noninvasive, inexpensive method, can provide an index to characterize the cerebrovascular status associated with CAD.
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Affiliation(s)
- Hanieh Mohammadi
- Laboratory of Optical and Molecular ImagingBiomedical Engineering Institute, Polytechnique MontrealQuebecCanada
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Thomas Vincent
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Ke Peng
- Center for Pain and the BrainBoston Children's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Research CenterUniversity of Montreal Health CentreMontrealQuebecCanada
| | - Anil Nigam
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Mathieu Gayda
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Yves Joanette
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Faculty of MedicineUniversity of MontrealMontrealQuebecCanada
| | - Frédéric Lesage
- Laboratory of Optical and Molecular ImagingBiomedical Engineering Institute, Polytechnique MontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Louis Bherer
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
- Faculty of MedicineUniversity of MontrealMontrealQuebecCanada
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Kristiansen M, Lindén C, Qvarlander S, Wåhlin A, Ambarki K, Hallberg P, Eklund A, Jóhannesson G. Feasibility of MRI to assess differences in ophthalmic artery blood flow rate in normal tension glaucoma and healthy controls. Acta Ophthalmol 2021; 99:e679-e685. [PMID: 33210819 PMCID: PMC8451810 DOI: 10.1111/aos.14673] [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: 06/26/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 11/30/2022]
Abstract
Purpose To examine feasibility of phase‐contrast magnetic resonance imaging (PCMRI) and to assess blood flow rate in the ophthalmic artery (OA) in patients with normal tension glaucoma (NTG) compared with healthy controls. Methods Sixteen patients with treated NTG and 16 age‐ and sex‐matched healthy controls underwent PCMRI using a 3‐Tesla scanner and ophthalmological examinations. OA blood flow rate was measured using a 2D PCMRI sequence with a spatial resolution of 0.35 mm2. Results The blood flow rate in the NTG group was 9.6 ± 3.9 ml/min [mean ± SD] compared with 11.9 ± 4.8 ml/min in the control group. Resistance Index (RI) and Pulsatility Index (PI) were 0.73 ± 0.08 and 1.36 ± 0.29, respectively, in the NTG group and 0.68 ± 0.13 and 1.22 ± 0.40, respectively, in the healthy group. The mean visual field index (VFI) was 46% ± 25 for the worse NTG eyes. The measured differences observed between the NTG group and the control group in blood flow rate (p = 0.12), RI (p = 0.18) and PI (p = 0.27) were non‐significant. Conclusions This case–control study, using PCMRI, showed a slight, but non‐significant, reduction in OA blood flow rate in the NTG patients compared with the healthy controls. These results indicate that blood flow may be of importance in the pathogenesis of NTG. Considering that only a limited portion of the total OA blood flow supplies the ocular system and the large inter‐individual differences, a larger study or more advanced PCMRI technique might give the answer.
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Affiliation(s)
- Martin Kristiansen
- Department of Clinical Sciences Ophthalmology Umeå University Umeå Sweden
| | - Christina Lindén
- Department of Clinical Sciences Ophthalmology Umeå University Umeå Sweden
| | - Sara Qvarlander
- Department of Radiation Sciences Biomedical Engineering Umeå University Umeå Sweden
- Centre for Biomedical Engineering and Physics Umeå University Umeå Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences Biomedical Engineering Umeå University Umeå Sweden
- Centre for Biomedical Engineering and Physics Umeå University Umeå Sweden
- Umeå Center for Functional Brain Imaging Umeå University Umeå Sweden
| | - Khalid Ambarki
- Department of Radiation Sciences Biomedical Engineering Umeå University Umeå Sweden
- Centre for Biomedical Engineering and Physics Umeå University Umeå Sweden
| | - Per Hallberg
- Centre for Biomedical Engineering and Physics Umeå University Umeå Sweden
- Dept. of Applied Physics and Electronics Umeå University Umeå Sweden
| | - Anders Eklund
- Department of Radiation Sciences Biomedical Engineering Umeå University Umeå Sweden
- Centre for Biomedical Engineering and Physics Umeå University Umeå Sweden
| | - Gauti Jóhannesson
- Department of Clinical Sciences Ophthalmology Umeå University Umeå Sweden
- Wallenberg Center for Molecular Medicine Umeå University Umeå Sweden
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49
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Abstract
The blood-brain barrier (BBB) is one of the most selective endothelial barriers. An understanding of its cellular, morphological, and biological properties in health and disease is necessary to develop therapeutics that can be transported from blood to brain. In vivo models have provided some insight into these features and transport mechanisms adopted at the brain, yet they have failed as a robust platform for the translation of results into clinical outcomes. In this article, we provide a general overview of major BBB features and describe various models that have been designed to replicate this barrier and neurological pathologies linked with the BBB. We propose several key parameters and design characteristics that can be employed to engineer physiologically relevant models of the blood-brain interface and highlight the need for a consensus in the measurement of fundamental properties of this barrier.
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Affiliation(s)
- Cynthia Hajal
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Baptiste Le Roi
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Roger D Kamm
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Ben M Maoz
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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50
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Vikner T, Eklund A, Karalija N, Malm J, Riklund K, Lindenberger U, Bäckman L, Nyberg L, Wåhlin A. Cerebral arterial pulsatility is linked to hippocampal microvascular function and episodic memory in healthy older adults. J Cereb Blood Flow Metab 2021; 41:1778-1790. [PMID: 33444091 PMCID: PMC8217890 DOI: 10.1177/0271678x20980652] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Microvascular damage in the hippocampus is emerging as a central cause of cognitive decline and dementia in aging. This could be a consequence of age-related decreases in vascular elasticity, exposing hippocampal capillaries to excessive cardiac-related pulsatile flow that disrupts the blood-brain barrier and the neurovascular unit. Previous studies have found altered intracranial hemodynamics in cognitive impairment and dementia, as well as negative associations between pulsatility and hippocampal volume. However, evidence linking features of the cerebral arterial flow waveform to hippocampal function is lacking. We used a high-resolution 4D flow MRI approach to estimate global representations of the time-resolved flow waveform in distal cortical arteries and in proximal arteries feeding the brain in healthy older adults. Waveform-based clustering revealed a group of individuals featuring steep systolic onset and high amplitude that had poorer hippocampus-sensitive episodic memory (p = 0.003), lower whole-brain perfusion (p = 0.001), and weaker microvascular low-frequency oscillations in the hippocampus (p = 0.035) and parahippocampal gyrus (p = 0.005), potentially indicating compromised neurovascular unit integrity. Our findings suggest that aberrant hemodynamic forces contribute to cerebral microvascular and hippocampal dysfunction in aging.
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Affiliation(s)
- Tomas Vikner
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Nina Karalija
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany.,Max Planck, UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany.,Max Planck, UCL Centre for Computational Psychiatry and Ageing Research, London, UK
| | - Lars Bäckman
- Ageing Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lars Nyberg
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology (IMB), Umeå University, Umeå, Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
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