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Grössinger D, Spann SM, Stollberger R, Pfeuffer J, Koten JW, Wood G. Real-time fMRI neurofeedback of the anterior insula using arterial spin labelling. Eur J Neurosci 2024. [PMID: 39193617 DOI: 10.1111/ejn.16502] [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: 09/23/2022] [Revised: 07/02/2024] [Accepted: 07/28/2024] [Indexed: 08/29/2024]
Abstract
Arterial spin labelling (ASL) is the only non-invasive technique that allows absolute quantification of perfusion and is increasingly used in brain activation studies. Contrary to the blood oxygen level-dependent (BOLD) effect ASL measures the cerebral blood flow (CBF) directly. However, the ASL signal has a lower signal-to-noise ratio (SNR), than the BOLD signal, which constrains its utilization in neurofeedback studies. If successful, ASL neurofeedback can be used to aid in the rehabilitation of health conditions with impaired blood flow, for example, stroke. We provide the first ASL-based neurofeedback study incorporating a double-blind, sham-controlled design. A pseudo-continuous ASL (pCASL) approach with background suppression and 3D GRASE readout was combined with a real-time post-processing pipeline. The real-time pipeline allows to monitor the ASL signal and provides real-time feedback on the neural activity to the subject. In total 41 healthy adults (19-56 years) divided into three groups underwent a neurofeedback-based emotion imagery training of the left anterior insula. Two groups differing only in the explicitness level of instruction received real training and a third group received sham feedback. Only those participants receiving real feedback with explicit instruction showed significantly higher absolute CBF values in the trained region during neurofeedback than participants receiving sham feedback. However, responder analyses of percent signal change values show no differences in activation between the three groups. Persisting limitations, such as the lower SNR, confounding effects of arterial transit time and partial volume effects still impact negatively the implementation of ASL neurofeedback.
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Affiliation(s)
| | - Stefan M Spann
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
| | - Rudolf Stollberger
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Josef Pfeuffer
- Siemens Healthcare, Application Development, Erlangen, Germany
| | | | - Guilherme Wood
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
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Hu Y, Shi W, Jiang D, Zhao L, Lu H, Wu D, Lin Z. MR Assessment of Acute Changes of Cerebral Perfusion, Metabolism, and Blood-Brain Barrier Permeability in Response to Aerobic Exercise. J Magn Reson Imaging 2024. [PMID: 39096314 DOI: 10.1002/jmri.29544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND It remains unclear how a single bout of exercise affects brain perfusion, oxygen metabolism, and blood-brain barrier (BBB) permeability. Addressing this unresolved issue is essential to understand the acute changes in cerebral physiology induced by aerobic exercise. PURPOSE To dynamically monitor the acute changes in cerebral physiology subsequent to a single aerobic exercise training session using noninvasive MRI measurements. STUDY TYPE Prospective. POPULATION Twenty-three healthy participants (18-35 years, 10 females/13 males) were enrolled and divided into 10-minute exercising (N = 10) and 20-minute exercising (N = 13) groups. FIELD STRENGTH/SEQUENCE 3.0 T/Phase Contrast (PC) MRI (gradient echo), T2-Relaxation-Under-Spin-Tagging (TRUST) MRI (gradient echo EPI), Water-Extraction-with-Phase-Contrast-Arterial-Spin-Tagging (WEPCAST) MRI (gradient echo EPI) and T1-weighted magnetization-prepared-rapid-acquisition-of-gradient-echo (MPRAGE) (gradient echo). ASSESSMENT A baseline MR measurement plus four repeated MR measurements immediately after 10 or 20 minutes moderate running exercise. MR measurements included cerebral blood flow (CBF) as measured by PC MRI, venous oxygenation (Yv) and cerebral metabolic rate of oxygen (CMRO2) as assessed by TRUST MRI, water extraction fraction (E), and BBB permeability-surface-area product (PS) as determined by WEPCAST MRI. STATISTICAL TESTS The time dependence of the physiological parameters was studied with a linear mixed-effect model. Additionally, pairwise t-tests comparison of the physiological parameters at each time point was conducted. A P-value of <0.05 was considered statistically significant. RESULTS There was an initial drop (8.22 ± 2.60%) followed by a recovery in CBF after exercise, while Yv revealed a significant decrease (6.37 ± 0.92%), i.e., an increased oxygen extraction, and returned to baseline at later time points. CMRO2 showed a trend of increase (5.68 ± 3.04%) and a significant interaction between time and group. In addition, E increased significantly (3.86% ± 0.89) and returned to baseline level at later time points, while PS remained elevated (13.33 ± 4.79%). DATA CONCLUSION A single bout of moderate aerobic exercise can induce acute alterations in cerebral perfusion, metabolism, and BBB permeability. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yizhe Hu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wen Shi
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dengrong Jiang
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Li Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hanzhang Lu
- The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zixuan Lin
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
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Falcon C, Montesinos P, Václavů L, Kassinopoulos M, Minguillon C, Fauria K, Cascales‐Lahoz D, Contador J, Fernández‐Lebrero A, Navalpotro I, Puig‐Pijoan A, Grau‐Rivera O, Kollmorgen G, Quijano‐Rubio C, Molinuevo JL, Zetterberg H, Blennow K, Suárez‐Calvet M, Van Osch MJP, Sanchez‐Gonzalez J, Gispert JD. Time-encoded ASL reveals lower cerebral blood flow in the early AD continuum. Alzheimers Dement 2024; 20:5183-5197. [PMID: 38958557 PMCID: PMC11350027 DOI: 10.1002/alz.14059] [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: 12/21/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION Cerebral blood flow (CBF) is reduced in cognitively impaired (CI) Alzheimer's disease (AD) patients. We checked the sensitivity of time-encoded arterial spin labeling (te-ASL) in measuring CBF alterations in individuals with positive AD biomarkers and associations with relevant biomarkers in cognitively unimpaired (CU) individuals. METHODS We compared te-ASL with single-postlabel delay (PLD) ASL in measuring CBF in 59 adults across the AD continuum, classified as CU amyloid beta (Aβ) negative (-), CU Aβ positive (+), and CI Aβ+. We sought associations of CBF with biomarkers of AD, cerebrovascular disease, synaptic dysfunction, neurodegeneration, and cognition in CU participants. RESULTS te-ASL was more sensitive at detecting CBF reduction in the CU Aβ+ and CI Aβ+ groups. In CU participants, lower CBF was associated with altered biomarkers of Aβ, tau, synaptic dysfunction, and neurodegeneration. DISCUSSION CBF reduction occurs early in the AD continuum. te-ASL is more sensitive than single-PLD ASL at detecting CBF changes in AD. HIGHLIGHTS Lower CBF can be detected in CU subjects in the early AD continuum. te-ASL is more sensitive than single-PLD ASL at detecting CBF alterations in AD. CBF is linked to biomarkers of AD, synaptic dysfunction, and neurodegeneration.
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Affiliation(s)
- Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Centro de Investigación Biomédica en Red de BioingenieríaBiomateriales y Nanomedicina (CIBER‐BBN)Instituto de Salud Carlos IIIMadridSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
| | | | - Lena Václavů
- Department of Radiology, C. J. Gorter MRI CenterLeiden University Medical CenterLeidenNetherlands
| | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)Instituto de Salud Carlos IIIMadridSpain
| | - Diego Cascales‐Lahoz
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - José Contador
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - Aida Fernández‐Lebrero
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - Irene Navalpotro
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - Albert Puig‐Pijoan
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - Oriol Grau‐Rivera
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)Instituto de Salud Carlos IIIMadridSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | | | | | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
| | - Henrik Zetterberg
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska Academy at University of GothenburgMölndalSweden
- UK Dementia Research Institute at University College London (UCL)LondonUK
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- Hong Kong Center for Neurodegenerative DiseasesClear Water BayHong KongChina
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Kaj Blennow
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyThe Sahlgrenska Academy at University of GothenburgMölndalSweden
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)Instituto de Salud Carlos IIIMadridSpain
- Servei de NeurologiaHospital del MarPg. Marítim de la BarcelonetaBarcelonaSpain
| | - Matthias J. P. Van Osch
- Department of Radiology, C. J. Gorter MRI CenterLeiden University Medical CenterLeidenNetherlands
| | | | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Centro de Investigación Biomédica en Red de BioingenieríaBiomateriales y Nanomedicina (CIBER‐BBN)Instituto de Salud Carlos IIIMadridSpain
- Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento SaludableHospital del Mar Research InstituteBarcelonaSpain
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Ferreira R, Bastos-Leite AJ. Arterial spin labelling magnetic resonance imaging and perfusion patterns in neurocognitive and other mental disorders: a systematic review. Neuroradiology 2024; 66:1065-1081. [PMID: 38536448 PMCID: PMC11150205 DOI: 10.1007/s00234-024-03323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/24/2024] [Indexed: 04/18/2024]
Abstract
We reviewed 33 original research studies assessing brain perfusion, using consensus guidelines from a "white paper" issued by the International Society for Magnetic Resonance in Medicine Perfusion Study Group and the European Cooperation in Science and Technology Action BM1103 ("Arterial Spin Labelling Initiative in Dementia"; https://www.cost.eu/actions/BM1103/ ). The studies were published between 2011 and 2023 and included participants with subjective cognitive decline plus; neurocognitive disorders, including mild cognitive impairment (MCI), Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD), dementia with Lewy bodies (DLB) and vascular cognitive impairment (VCI); as well as schizophrenia spectrum disorders, bipolar and major depressive disorders, autism spectrum disorder, attention-deficit/hyperactivity disorder, panic disorder and alcohol use disorder. Hypoperfusion associated with cognitive impairment was the major finding across the spectrum of cognitive decline. Regional hyperperfusion also was reported in MCI, AD, frontotemporal dementia phenocopy syndrome and VCI. Hypoperfused structures found to aid in diagnosing AD included the precunei and adjacent posterior cingulate cortices. Hypoperfused structures found to better diagnose patients with FTLD were the anterior cingulate cortices and frontal regions. Hypoperfusion in patients with DLB was found to relatively spare the temporal lobes, even after correction for partial volume effects. Hyperperfusion in the temporal cortices and hypoperfusion in the prefrontal and anterior cingulate cortices were found in patients with schizophrenia, most of whom were on medication and at the chronic stage of illness. Infratentorial structures were found to be abnormally perfused in patients with bipolar or major depressive disorders. Brain perfusion abnormalities were helpful in diagnosing most neurocognitive disorders. Abnormalities reported in VCI and the remaining mental disorders were heterogeneous and not generalisable.
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Affiliation(s)
- Rita Ferreira
- Faculty of Medicine, University of Porto, Porto, Portugal
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Koziarz A, Koziarz F, Shen R, Gopee-Ramanan P, Black SE, Worsley D, Chan IYM, Streiner DL, Zukotynski KA. Diagnostic Accuracy of SPECT for Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis. Clin Nucl Med 2024:00003072-990000000-01188. [PMID: 38914012 DOI: 10.1097/rlu.0000000000005328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
PURPOSE This study examines the diagnostic accuracy of brain perfusion SPECT for mild traumatic brain injury (mTBI). PATIENTS AND METHODS A systematic review and meta-analysis was performed according to PRISMA guidelines (PROSPERO: CRD42023484636). Five databases were searched for studies evaluating brain perfusion SPECT in adult patients with mTBI (GCS 13-15). Study quality was assessed using a modified QUADAS-2 tool. A meta-analysis was performed to pool proportions of hypoperfusion abnormalities across brain lobes. RESULTS Of 4735 records, 22 studies (5 longitudinal [40% high quality], 17 cross-sectional [24% high quality]) were included totaling 800 patients (mean age, 37.4 ± 12.6 years; 36.4% female). Meta-analysis of proportions indicated that the frontal lobe most frequently showed hypoperfusion on brain perfusion SPECT (pooled proportion 40.1% [95% confidence interval, 31.2% to 49.8%], 99/254, I2 = 54.5%), followed by the temporal lobe (26.1% [95% confidence interval, 19.9% to 33.6%], 68/254, I2 = 30.7%). Several studies found that hypoperfusion abnormalities were associated with neuropsychological findings. Also, brain perfusion SPECT could detect abnormalities not seen on MRI. Abnormalities in perfusion on brain perfusion SPECT may be more readily detected with a quantitative assessment compared with a visual assessment alone, although there appears to be no consensus on the optimal method for image interpretation. Evidence evaluating the sensitivity and specificity of brain perfusion SPECT for mTBI was limited. Using the GRADE framework, the evidence was rated as low. CONCLUSIONS Although perfusion abnormalities can be seen in patients with mTBI, commonly in the frontal and temporal lobes, the findings are nonspecific and may derive from various factors. Ultimately, brain perfusion SPECT provides additional information for mTBI, but the final added value for the detection of mTBI is unknown.
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Affiliation(s)
- Alex Koziarz
- From the Department of Medical Imaging, McMaster University, Hamilton, Ontario, Canada
| | - Frank Koziarz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Rui Shen
- Center for Bioethics, Harvard Medical School, Boston, MA
| | | | | | - Daniel Worsley
- Department of Nuclear Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Ian Y M Chan
- Department of Diagnostic Imaging, Trillium Health Partners, Mississauga, Ontario, Canada
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Pasternak M, Mirza SS, Luciw N, Mutsaerts HJMM, Petr J, Thomas D, Cash D, Bocchetta M, Tartaglia MC, Mitchell SB, Black SE, Freedman M, Tang‐Wai D, Rogaeva E, Russell LL, Bouzigues A, van Swieten JC, Jiskoot LC, Seelaar H, Laforce R, Tiraboschi P, Borroni B, Galimberti D, Rowe JB, Graff C, Finger E, Sorbi S, de Mendonça A, Butler C, Gerhard A, Sanchez‐Valle R, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Levin J, Otto M, Santana I, Strafella AP, MacIntosh BJ, Rohrer JD, Masellis M. Longitudinal cerebral perfusion in presymptomatic genetic frontotemporal dementia: GENFI results. Alzheimers Dement 2024; 20:3525-3542. [PMID: 38623902 PMCID: PMC11095434 DOI: 10.1002/alz.13750] [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: 09/21/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Effective longitudinal biomarkers that track disease progression are needed to characterize the presymptomatic phase of genetic frontotemporal dementia (FTD). We investigate the utility of cerebral perfusion as one such biomarker in presymptomatic FTD mutation carriers. METHODS We investigated longitudinal profiles of cerebral perfusion using arterial spin labeling magnetic resonance imaging in 42 C9orf72, 70 GRN, and 31 MAPT presymptomatic carriers and 158 non-carrier controls. Linear mixed effects models assessed perfusion up to 5 years after baseline assessment. RESULTS Perfusion decline was evident in all three presymptomatic groups in global gray matter. Each group also featured its own regional pattern of hypoperfusion over time, with the left thalamus common to all groups. Frontal lobe regions featured lower perfusion in those who symptomatically converted versus asymptomatic carriers past their expected age of disease onset. DISCUSSION Cerebral perfusion is a potential biomarker for assessing genetic FTD and its genetic subgroups prior to symptom onset. HIGHLIGHTS Gray matter perfusion declines in at-risk genetic frontotemporal dementia (FTD). Regional perfusion decline differs between at-risk genetic FTD subgroups . Hypoperfusion in the left thalamus is common across all presymptomatic groups. Converters exhibit greater right frontal hypoperfusion than non-converters past their expected conversion date. Cerebral hypoperfusion is a potential early biomarker of genetic FTD.
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Zhao MY, Tong E, Duarte Armindo R, Fettahoglu A, Choi J, Bagley J, Yeom KW, Moseley M, Steinberg GK, Zaharchuk G. Short- and Long-Term MRI Assessed Hemodynamic Changes in Pediatric Moyamoya Patients After Revascularization. J Magn Reson Imaging 2024; 59:1349-1357. [PMID: 37515518 DOI: 10.1002/jmri.28902] [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: 06/04/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change following a vasodilation challenge. Decreased CVR is associated with a higher stroke risk in patients with cerebrovascular diseases. While revascularization can improve CVR and reduce this risk in adult patients with vasculopathy such as those with Moyamoya disease, its impact on hemodynamics in pediatric patients remains to be elucidated. Arterial spin labeling (ASL) is a quantitative MRI technique that can measure CBF, CVR, and arterial transit time (ATT) non-invasively. PURPOSE To investigate the short- and long-term changes in hemodynamics after bypass surgeries in patients with Moyamoya disease. STUDY TYPE Longitudinal. POPULATION Forty-six patients (11 months-18 years, 28 females) with Moyamoya disease. FIELD STRENGTH/SEQUENCE 3-T, single- and multi-delay ASL, T1-weighted, T2-FLAIR, 3D MRA. ASSESSMENT Imaging was performed 2 weeks before and 1 week and 6 months after surgical intervention. Acetazolamide was employed to induce vasodilation during the imaging procedure. CBF and ATT were measured by fitting the ASL data to the general kinetic model. CVR was computed as the percentage change in CBF. The mean CBF, ATT, and CVR values were measured in the regions affected by vasculopathy. STATISTICAL TESTS Pre- and post-revascularization CVR, CBF, and ATT were compared for different regions of the brain. P-values <0.05 were considered statistically significant. RESULTS ASL-derived CBF in flow territories affected by vasculopathy significantly increased after bypass by 41 ± 31% within a week. At 6 months, CBF significantly increased by 51 ± 34%, CVR increased by 68 ± 33%, and ATT was significantly reduced by 6.6 ± 2.9%. DATA CONCLUSION There may be short- and long-term improvement in the hemodynamic parameters of pediatric Moyamoya patients after bypass surgery. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Rui Duarte Armindo
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Neuroradiology, Hospital Beatriz Ângelo, Lisbon, Portugal
| | - Ates Fettahoglu
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jason Choi
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Jacob Bagley
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Kristen W Yeom
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Michael Moseley
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, USA
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Padrela B, Mahroo A, Tee M, Sneve MH, Moyaert P, Geier O, Kuijer JPA, Beun S, Nordhøy W, Zhu YD, Buck MA, Hoinkiss DC, Konstandin S, Huber J, Wiersinga J, Rikken R, de Leeuw D, Grydeland H, Tippett L, Cawston EE, Ozturk-Isik E, Linn J, Brandt M, Tijms BM, van de Giessen EM, Muller M, Fjell A, Walhovd K, Bjørnerud A, Pålhaugen L, Selnes P, Clement P, Achten E, Anazodo U, Barkhof F, Hilal S, Fladby T, Eickel K, Morgan C, Thomas DL, Petr J, Günther M, Mutsaerts HJMM. Developing blood-brain barrier arterial spin labelling as a non-invasive early biomarker of Alzheimer's disease (DEBBIE-AD): a prospective observational multicohort study protocol. BMJ Open 2024; 14:e081635. [PMID: 38458785 DOI: 10.1136/bmjopen-2023-081635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Loss of blood-brain barrier (BBB) integrity is hypothesised to be one of the earliest microvascular signs of Alzheimer's disease (AD). Existing BBB integrity imaging methods involve contrast agents or ionising radiation, and pose limitations in terms of cost and logistics. Arterial spin labelling (ASL) perfusion MRI has been recently adapted to map the BBB permeability non-invasively. The DEveloping BBB-ASL as a non-Invasive Early biomarker (DEBBIE) consortium aims to develop this modified ASL-MRI technique for patient-specific and robust BBB permeability assessments. This article outlines the study design of the DEBBIE cohorts focused on investigating the potential of BBB-ASL as an early biomarker for AD (DEBBIE-AD). METHODS AND ANALYSIS DEBBIE-AD consists of a multicohort study enrolling participants with subjective cognitive decline, mild cognitive impairment and AD, as well as age-matched healthy controls, from 13 cohorts. The precision and accuracy of BBB-ASL will be evaluated in healthy participants. The clinical value of BBB-ASL will be evaluated by comparing results with both established and novel AD biomarkers. The DEBBIE-AD study aims to provide evidence of the ability of BBB-ASL to measure BBB permeability and demonstrate its utility in AD and AD-related pathologies. ETHICS AND DISSEMINATION Ethics approval was obtained for 10 cohorts, and is pending for 3 cohorts. The results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Beatriz Padrela
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Amnah Mahroo
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Mervin Tee
- National University Health System, Singapore
| | - Markus H Sneve
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Paulien Moyaert
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Oliver Geier
- Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
| | - Joost P A Kuijer
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Soetkin Beun
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Wibeke Nordhøy
- Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
| | - Yufei David Zhu
- Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Mareike A Buck
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Bremen, Bremen, Germany
| | | | - Simon Konstandin
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Jörn Huber
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Julia Wiersinga
- Department of Internal Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Roos Rikken
- Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | | | - Håkon Grydeland
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Lynette Tippett
- The University of Auckland School of Psychology, Auckland, New Zealand
| | - Erin E Cawston
- The University of Auckland Department of Pharmacology and Clinical Pharmacology, Auckland, New Zealand
| | - Esin Ozturk-Isik
- Bogazici University Institute of Biomedical Engineering, Istanbul, Turkey
| | - Jennifer Linn
- Department of Neurology, Faculty of Medicine, Babylon, Iraq
- Department of Neurology, Technische Universität Dresden, Dresden, Germany
| | - Moritz Brandt
- Department of Neurology, Faculty of Medicine, Babylon, Iraq
- Department of Neurology, Technische Universität Dresden, Dresden, Germany
| | - Betty M Tijms
- Neurology, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | | | - Majon Muller
- Department of Internal Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Anders Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Kristine Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Atle Bjørnerud
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Lene Pålhaugen
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
- University of Oslo, Oslo, Norway
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Patricia Clement
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Eric Achten
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Udunna Anazodo
- Lawson Health Research Institute, London, Ontario, Canada
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
- University College London, London, UK
| | - Saima Hilal
- National University Health System, Singapore
- Department of Pharmacology, National University of Singapore, Singapore
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
- University of Oslo, Oslo, Norway
| | - Klaus Eickel
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Applied Sciences Bremerhaven, Bremerhaven, Germany
| | - Catherine Morgan
- The University of Auckland School of Psychology, Auckland, New Zealand
| | - David L Thomas
- Department of Brain Repair and Rehabilitation, University College London, London, UK
| | - Jan Petr
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Matthias Günther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Bremen, Bremen, Germany
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
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9
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Chen Z, Liu W, Balu N, Chen L, Ortega D, Huang X, Hatsukami TS, Yang J, Yuan C. Associations of Intracranial Artery Length and Branch Number on Time-of-Flight MRA With Cognitive Impairment in Hypertensive Older Males. J Magn Reson Imaging 2024. [PMID: 38263621 DOI: 10.1002/jmri.29242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Hypertension-induced impairment of the cerebral artery network contributes to cognitive impairment. Characterizing the structure and function of cerebral arteries may facilitate the understanding of hypertension-related pathological mechanisms and lead to the development of new indicators for cognitive impairment. PURPOSE To investigate the associations between morphological features of the intracranial arteries distal to the circle of Willis on time-of-flight MRA (TOF-MRA) and cognitive performance in a hypertensive cohort. STUDY TYPE Prospective observational study. POPULATION 189 hypertensive older males (mean age 64.9 ± 7.2 years). FIELD STRENGTH/SEQUENCE TOF-MRA sequence with a 3D spoiled gradient echo readout and arterial spin labeling perfusion imaging sequence with a 3D stack-of-spirals fast spin echo readout at 3T. ASSESSMENT The intracranial arteries were segmented from TOF-MRA and the total length of distal arteries (TLoDA) and number of arterial branches (NoB) were calculated. The mean gray matter cerebral blood flow (GM-CBF) was extracted from arterial spin labeling perfusion imaging. The cognitive level was assessed with short-term and long-term delay-recall auditory verbal learning test (AVLT) scores, and with montreal cognitive assessment. STATISTICAL TESTS Univariable and multivariable linear regression were used to analyze the associations between TLoDA, NoB, GM-CBF and the cognitive assessment scores, with P < 0.05 indicating significance. RESULTS TLoDA (r = 0.314) and NoB (r = 0.346) were significantly correlated with GM-CBF. Multivariable linear regression analyses showed that TLoDA and NoB, but not GM-CBF (P = 0.272 and 0.141), were significantly associated with short-term and long-term delay-recall AVLT scores. These associations remained significant after adjusting for GM-CBF. DATA CONCLUSION The TLoDA and NoB of distal intracranial arteries on TOF-MRA are significantly associated with cognitive impairment in hypertensive subjects. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Zhensen Chen
- 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
- Vascular Imaging Lab, Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Wenjin Liu
- Department of Nephrology, Clinical Medical College, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, China
- Yangzhou Institute of Precision Medicine for Kidney Diseases, Yangzhou, China
| | - Niranjan Balu
- Vascular Imaging Lab, Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Li Chen
- Department of Electrical and Computer Engineering, University of Washington, Seattle, Washington, USA
| | - Dakota Ortega
- Vascular Imaging Lab, Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Xiaoqin Huang
- Department of Nephrology, The First People's Hospital of Yancheng, Yancheng, China
| | - Thomas S Hatsukami
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Junwei Yang
- Center for Kidney Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chun Yuan
- Vascular Imaging Lab, Department of Radiology, University of Washington, Seattle, Washington, USA
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10
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Kashyap S, Oliveira ÍAF, Uludağ K. Feasibility of high-resolution perfusion imaging using arterial spin labeling MRI at 3 Tesla. Front Physiol 2024; 14:1271254. [PMID: 38235379 PMCID: PMC10791866 DOI: 10.3389/fphys.2023.1271254] [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: 08/02/2023] [Accepted: 11/27/2023] [Indexed: 01/19/2024] Open
Abstract
Cerebral blood flow (CBF) is a critical physiological parameter of brain health, and it can be non-invasively measured with arterial spin labeling (ASL) MRI. In this study, we evaluated and optimized whole-brain, high-resolution ASL as an alternative to the low-resolution ASL employed in the routine assessment of CBF in both healthy participants and patients. Two high-resolution protocols (i.e., pCASL and FAIR-Q2TIPS (PASL) with 2 mm isotropic voxels) were compared to a default clinical pCASL protocol (3.4 × 3.4 × 4 mm 3), all of whom had an acquisition time of ≈ 5 min. We assessed the impact of high-resolution acquisition on reducing partial voluming and improving sensitivity to the perfusion signal, and evaluated the effectiveness of z-deblurring on the ASL data. We compared the quality of whole-brain ASL acquired using three available head coils with differing number of receive channels (i.e., 20, 32, and 64ch). We found that using higher coil counts (32 and 64ch coils as compared to 20ch) offers improved signal-to-noise ratio (SNR) and acceleration capabilities that are beneficial for ASL imaging at 3 Tesla (3 T). The inherent reduction in partial voluming effects with higher resolution acquisitions improves the resolving power of perfusion without impacting the sensitivity. In conclusion, our results suggest that high-resolution ASL (2 to 2.5 mm isotropic voxels) has the potential to become a new standard for perfusion imaging at 3 T and increase its adoption into clinical research and cognitive neuroscience applications.
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Affiliation(s)
- Sriranga Kashyap
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
| | | | - Kâmil Uludağ
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
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11
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Kalchev E, Georgiev R, Ivanova D. A novel 5-stage visual rating scale for global arterial spin labeling perfusion assessment in the brain: Simplifying evaluation for clinical implementation. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100200. [PMID: 38235314 PMCID: PMC10791566 DOI: 10.1016/j.cccb.2024.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/27/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
Objectives The aim of this study was to develop and validate a visual rating scale for evaluating global arterial spin labeling (ASL) perfusion changes in the brain, with potential applications in a variety of conditions that impact general brain blood supply and perfusion. Methods We employed a five-stage scale (0 being normal and 4 indicating the most severe perfusion decline) to assess 156 patients using a 3D pulsed ASL technique. Three radiologists independently reviewed the images, and inter-rater reliability of the visual rating scale was evaluated. Results The ASL stages showed a consistent distribution among the patients. The inter-rater reliability among the three radiologists, as measured by the Intraclass Correlation Coefficient (ICC), was 0.982. Conclusion Our findings suggest that this visual rating scale can be effectively implemented in everyday practice to evaluate global perfusion changes in the context of cardiovascular diseases, cerebrovascular diseases, cerebral small vessel disease, and other conditions that alter brain vascularization and perfusion. Further research is needed to explore the full range of clinical applications and to refine the scale for optimal utility.
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Affiliation(s)
- Emilian Kalchev
- Department of Diagnostic Imaging, St Marina University Hospital, Varna, Bulgaria
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, Medical University of Varna, Bulgaria
| | - Radoslav Georgiev
- Department of Diagnostic Imaging, St Marina University Hospital, Varna, Bulgaria
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, Medical University of Varna, Bulgaria
| | - Darina Ivanova
- Department of Diagnostic Imaging, St Marina University Hospital, Varna, Bulgaria
- Department of Diagnostic Imaging, Interventional Radiology and Radiotherapy, Medical University of Varna, Bulgaria
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12
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Zhao MY, Tong E, Armindo RD, Woodward A, Yeom KW, Moseley ME, Zaharchuk G. Measuring Quantitative Cerebral Blood Flow in Healthy Children: A Systematic Review of Neuroimaging Techniques. J Magn Reson Imaging 2024; 59:70-81. [PMID: 37170640 PMCID: PMC10638464 DOI: 10.1002/jmri.28758] [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: 02/03/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/13/2023] Open
Abstract
Cerebral blood flow (CBF) is an important hemodynamic parameter to evaluate brain health. It can be obtained quantitatively using medical imaging modalities such as magnetic resonance imaging and positron emission tomography (PET). Although CBF in adults has been widely studied and linked with cerebrovascular and neurodegenerative diseases, CBF data in healthy children are sparse due to the challenges in pediatric neuroimaging. An understanding of the factors affecting pediatric CBF and its normal range is crucial to determine the optimal CBF measuring techniques in pediatric neuroradiology. This review focuses on pediatric CBF studies using neuroimaging techniques in 32 articles including 2668 normal subjects ranging from birth to 18 years old. A systematic literature search was conducted in PubMed, Embase, and Scopus and reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We identified factors (such as age, gender, mood, sedation, and fitness) that have significant effects on pediatric CBF quantification. We also investigated factors influencing the CBF measurements in infants. Based on this review, we recommend best practices to improve CBF measurements in pediatric neuroimaging. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Rui Duarte Armindo
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Neuroradiology, Hospital Beatriz Ângelo, Loures, Lisbon, Portugal
| | - Amanda Woodward
- Lane Medical Library, Stanford University, Stanford, CA, USA
| | - Kristen W. Yeom
- Department of Radiology, Stanford University, Stanford, CA, USA
| | | | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
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13
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Thompson CK, Walenski M. Measurement matters for assessing the role of chronically altered perfusion in post-stroke aphasia. Brain Commun 2023; 6:fcad341. [PMID: 38162903 PMCID: PMC10757447 DOI: 10.1093/braincomms/fcad341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024] Open
Abstract
This scientific commentary refers to 'Cerebral perfusion in post-stroke aphasia and its relationship to residual language abilities', by Ivanova et al. (https://doi.org/10.1093/braincomms/fcad252).
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Affiliation(s)
- Cynthia K Thompson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
- Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University, Evanston, IL, USA
| | - Matthew Walenski
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
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14
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van Nieuwkerk AC, Hemelrijk KI, Bron EE, Leeuwis AE, Majoie CBLM, Daemen MJAP, Moonen JEF, de Sitter A, Bouma BJ, van der Flier WM, Baan J, Piek JJ, Biessels GJ, Delewi R. Cardiac output, cerebral blood flow and cognition in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation: design and rationale of the CAPITA study. Neth Heart J 2023; 31:461-470. [PMID: 37910335 PMCID: PMC10667193 DOI: 10.1007/s12471-023-01826-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Approximately one-third of patients with symptomatic severe aortic valve stenosis who are scheduled for transcatheter aortic valve implantation (TAVI) have some degree of cognitive impairment. TAVI may have negative cognitive effects due to periprocedural micro-emboli inducing cerebral infarction. On the contrary, TAVI may also have positive cognitive effects due to increases in cardiac output and cerebral blood flow (CBF). However, studies that systematically assess these effects are scarce. Therefore, the main aim of this study is to assess cerebral and cognitive outcomes in patients with severe aortic valve stenosis undergoing TAVI. STUDY DESIGN In the prospective CAPITA (CArdiac OutPut, Cerebral Blood Flow and Cognition In Patients With Severe Aortic Valve Stenosis Undergoing Transcatheter Aortic Valve Implantation) study, cerebral and cognitive outcomes are assessed in patients undergoing TAVI. One day before and 3 months after TAVI, patients will undergo echocardiography (cardiac output, valve function), brain magnetic resonance imaging (CBF, structural lesions) and extensive neuropsychological assessment. To assess longer-term effects of TAVI, patients will again undergo echocardiography and neuropsychological assessment 1 year after the procedure. The co-primary outcome measures are change in CBF (in ml/100 g per min) and change in global cognitive functioning (Z-score) between baseline and 3‑month follow-up. Secondary objectives include change in cardiac output, white matter hyperintensities and other structural brain lesions. (ClinicalTrials.gov identifier NCT05481008) CONCLUSION : The CAPITA study is the first study designed to systematically assess positive and negative cerebral and cognitive outcomes after TAVI. We hypothesise that TAVI improves cardiac output, CBF and cognitive functioning.
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Affiliation(s)
- Astrid C van Nieuwkerk
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Kimberley I Hemelrijk
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther E Bron
- Biomedical Imaging Group Rotterdam, Department of Radiology & Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anna E Leeuwis
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Old Age Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam Neurosciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mat J A P Daemen
- Department of Pathology, Amsterdam University Medical Center, Locations AMC and VUmc, University of Amsterdam, Amsterdam, The Netherlands
| | - Justine E F Moonen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Alexandra de Sitter
- Department of Radiology and Nuclear Medicine, Amsterdam Neurosciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Berto J Bouma
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Jan Baan
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan J Piek
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center, Utrecht, The Netherlands
| | - Ronak Delewi
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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15
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van Kraaij SJW, Borghans L, Klaassen ES, Gal P, van der Grond J, Tripp K, Winrow C, Glasser C, Groeneveld GJ. Randomized placebo-controlled crossover study to assess tolerability and pharmacodynamics of zagociguat, a soluble guanylyl cyclase stimulator, in healthy elderly. Br J Clin Pharmacol 2023; 89:3606-3617. [PMID: 37488930 DOI: 10.1111/bcp.15861] [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: 03/13/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023] Open
Abstract
AIMS Dysfunction of nitric oxide-soluble guanylate cyclase (sGC)-cyclic guanosine monophosphate signalling is implicated in the pathophysiology of cognitive impairment. Zagociguat is a central nervous system (CNS) penetrant sGC stimulator designed to amplify nitric oxide-cyclic guanosine monophosphate signalling in the CNS. This article describes a phase 1b study evaluating the safety and pharmacodynamic effects of zagociguat. METHODS In this randomized crossover study, 24 healthy participants aged ≥65 years were planned to receive 15 mg zagociguat or placebo once daily for 2 15-day periods separated by a 27-day washout. Adverse events, vital signs, electrocardiograms and laboratory tests were conducted to assess safety. Pharmacokinetics of zagociguat were evaluated in blood and cerebrospinal fluid (CSF). Pharmacodynamic assessments included evaluation of cerebral blood flow, CNS tests, pharmaco-electroencephalography, passive leg movement and biomarkers in blood, CSF and brain. RESULTS Twenty-four participants were enrolled; 12 participants completed both treatment periods, while the other 12 participants completed only 1 treatment period. Zagociguat was well-tolerated and penetrated the blood-brain barrier, with a CSF/free plasma concentration ratio of 0.45 (standard deviation 0.092) measured 5 h after the last dose of zagociguat on Day 15. Zagociguat induced modest decreases in blood pressure. No consistent effects of zagociguat on other pharmacodynamic parameters were detected. CONCLUSION Zagociguat was well-tolerated and induced modest blood pressure reductions consistent with other sGC stimulators. No clear pharmacodynamic effects of zagociguat were detected. Studies in participants with proven reduced cerebral blood flow or CNS function may be an avenue for further evaluation of the compound.
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Affiliation(s)
- Sebastiaan J W van Kraaij
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Surgery, Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | - Pim Gal
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Surgery, Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ken Tripp
- Cyclerion Therapeutics, Cambridge, Massachusetts, USA
| | | | - Chad Glasser
- Cyclerion Therapeutics, Cambridge, Massachusetts, USA
| | - Geert Jan Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Surgery, Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
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16
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Andre JB, Oztek MA, Anzai Y, Wilson GJ, Mossa-Basha M, Hippe DS, Hoff MN, Cross DJ, Minoshima S. Evaluation of 3-dimensional stereotactic surface projection rendering of arterial spin labeling data in a clinical cohort. J Neuroimaging 2023; 33:933-940. [PMID: 37695098 DOI: 10.1111/jon.13153] [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: 05/01/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND AND PURPOSE To assess the feasibility of 3-dimensional stereotactic surface projection (3D-SSP) as applied to arterial spin labeling (ASL) in a clinical pilot study. METHODS A retrospective sample of 10 consecutive patients who underwent ASL as part of a clinically indicated MR examination was collected during this pilot study. Five additional subjects with normal cerebral perfusion served as a control group. Following voxel-wise M0-correction, cerebral blood flow (CBF) quantification, and stereotactic anatomic standardization, voxel-wise CBF from an individual's ASL dataset was extracted to a set of predefined surface pixels (3D-SSP). A normal database was created from averaging the extracted CBF datasets of the control group. Patients' datasets were compared individually with the normal database by calculating a Z-score on a pixel-by-pixel basis and were displayed in 3D-SSP views for visual inspection. Independent, two-expert reader assessment, using a 3-point scale, compared standard quantitative CBF images to the 3D-SSP maps. RESULTS Patterns and severities of regionally reduced CBF were identified, by both independent readers, in the 3D-SSP maps. Reader assessment demonstrated preference for 3D-SSP over traditionally displayed standard quantitative CBF images in three of four evaluated imaging metrics (p = .026, .031, and .013, respectively); 3D-SSP maps were never found to be inferior to the standard quantitative CBF images. CONCLUSIONS Three-dimensional SSP maps are feasible in a clinical population and enable quantitative data extraction and localization of perfusion abnormalities by means of stereotactic coordinates in a condensed display. The proposed method is a promising approach for interpreting cerebrovascular pathophysiology.
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Affiliation(s)
- Jalal B Andre
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Murat Alp Oztek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Yoshimi Anzai
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Gregory J Wilson
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Daniel S Hippe
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Michael N Hoff
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Donna J Cross
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Satoshi Minoshima
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
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17
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Macionis V. Neurovascular Compression-Induced Intracranial Allodynia May Be the True Nature of Migraine Headache: an Interpretative Review. Curr Pain Headache Rep 2023; 27:775-791. [PMID: 37837483 DOI: 10.1007/s11916-023-01174-7] [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] [Accepted: 09/15/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW Surgical deactivation of migraine trigger sites by extracranial neurovascular decompression has produced encouraging results and challenged previous understanding of primary headaches. However, there is a lack of in-depth discussions on the pathophysiological basis of migraine surgery. This narrative review provides interpretation of relevant literature from the perspective of compressive neuropathic etiology, pathogenesis, and pathophysiology of migraine. RECENT FINDINGS Vasodilation, which can be asymptomatic in healthy subjects, may produce compression of cranial nerves in migraineurs at both extracranial and intracranial entrapment-prone sites. This may be predetermined by inherited and acquired anatomical factors and may include double crush-type lesions. Neurovascular compression can lead to sensitization of the trigeminal pathways and resultant cephalic hypersensitivity. While descending (central) trigeminal activation is possible, symptomatic intracranial sensitization can probably only occur in subjects who develop neurovascular entrapment of cranial nerves, which can explain why migraine does not invariably afflict everyone. Nerve compression-induced focal neuroinflammation and sensitization of any cranial nerve may neurogenically spread to other cranial nerves, which can explain the clinical complexity of migraine. Trigger dose-dependent alternating intensity of sensitization and its synchrony with cyclic central neural activities, including asymmetric nasal vasomotor oscillations, may explain the laterality and phasic nature of migraine pain. Intracranial allodynia, i.e., pain sensation upon non-painful stimulation, may better explain migraine pain than merely nociceptive mechanisms, because migraine cannot be associated with considerable intracranial structural changes and consequent painful stimuli. Understanding migraine as an intracranial allodynia could stimulate research aimed at elucidating the possible neuropathic compressive etiology of migraine and other primary headaches.
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Bollack A, Pemberton HG, Collij LE, Markiewicz P, Cash DM, Farrar G, Barkhof F. Longitudinal amyloid and tau PET imaging in Alzheimer's disease: A systematic review of methodologies and factors affecting quantification. Alzheimers Dement 2023; 19:5232-5252. [PMID: 37303269 DOI: 10.1002/alz.13158] [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: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 06/13/2023]
Abstract
Deposition of amyloid and tau pathology can be quantified in vivo using positron emission tomography (PET). Accurate longitudinal measurements of accumulation from these images are critical for characterizing the start and spread of the disease. However, these measurements are challenging; precision and accuracy can be affected substantially by various sources of errors and variability. This review, supported by a systematic search of the literature, summarizes the current design and methodologies of longitudinal PET studies. Intrinsic, biological causes of variability of the Alzheimer's disease (AD) protein load over time are then detailed. Technical factors contributing to longitudinal PET measurement uncertainty are highlighted, followed by suggestions for mitigating these factors, including possible techniques that leverage shared information between serial scans. Controlling for intrinsic variability and reducing measurement uncertainty in longitudinal PET pipelines will provide more accurate and precise markers of disease evolution, improve clinical trial design, and aid therapy response monitoring.
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Affiliation(s)
- Ariane Bollack
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Hugh G Pemberton
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, UK
- GE Healthcare, Amersham, UK
- UCL Queen Square Institute of Neurology, London, UK
| | - Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Pawel Markiewicz
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - David M Cash
- UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at University College London, London, UK
| | | | - Frederik Barkhof
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, UK
- UCL Queen Square Institute of Neurology, London, UK
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
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Zhao MY, Armindo RD, Gauden AJ, Yim B, Tong E, Moseley M, Steinberg GK, Zaharchuk G. Revascularization improves vascular hemodynamics - a study assessing cerebrovascular reserve and transit time in Moyamoya patients using MRI. J Cereb Blood Flow Metab 2023; 43:138-151. [PMID: 36408536 PMCID: PMC10638998 DOI: 10.1177/0271678x221140343] [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: 07/28/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022]
Abstract
Cerebrovascular reserve (CVR) reflects the capacity of cerebral blood flow (CBF) to change. Decreased CVR implies poor hemodynamics and is linked to a higher risk for stroke. Revascularization has been shown to improve CBF in patients with vasculopathy such as Moyamoya disease. Dynamic susceptibility contrast (DSC) can measure transit time to evaluate patients suspected of stroke. Arterial spin labeling (ASL) is a non-invasive technique for CBF, CVR, and arterial transit time (ATT) measurements. Here, we investigate the change in hemodynamics 4-12 months after extracranial-to-intracranial direct bypass in 52 Moyamoya patients using ASL with single and multiple post-labeling delays (PLD). Images were collected using ASL and DSC with acetazolamide. CVR, CBF, ATT, and time-to-maximum (Tmax) were measured in different flow territories. Results showed that hemodynamics improved significantly in regions affected by arterial occlusions after revascularization. CVR increased by 16 ± 11% (p < 0.01) and 25 ± 13% (p < 0.01) for single- and multi-PLD ASL, respectively. Transit time measured by multi-PLD ASL and post-vasodilation DSC reduced by 13 ± 7% (p < 0.01) and 9 ± 5% (p < 0.01), respectively. For all regions, ATT correlated significantly with Tmax (R2 = 0.59, p < 0.01). Thus, revascularization improved CVR and decreased transit times. Multi-PLD ASL can serve as an effective and non-invasive modality to examine vascular hemodynamics in Moyamoya patients.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Rui Duarte Armindo
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Neuroradiology, Hospital Beatriz Ângelo, Loures, Lisbon, Portugal
| | - Andrew J Gauden
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Benjamin Yim
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Michael Moseley
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
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20
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Ivanova MV, Pappas I, Inglis B, Pracar AL, Herron TJ, Baldo JV, Kayser AS, D’Esposito M, Dronkers NF. Cerebral perfusion in post-stroke aphasia and its relationship to residual language abilities. Brain Commun 2023; 6:fcad252. [PMID: 38162898 PMCID: PMC10757451 DOI: 10.1093/braincomms/fcad252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/26/2023] [Accepted: 09/28/2023] [Indexed: 01/03/2024] Open
Abstract
Stroke alters blood flow to the brain resulting in damaged tissue and cell death. Moreover, the disruption of cerebral blood flow (perfusion) can be observed in areas surrounding and distal to the lesion. These structurally preserved but suboptimally perfused regions may also affect recovery. Thus, to better understand aphasia recovery, the relationship between cerebral perfusion and language needs to be systematically examined. In the current study, we aimed to evaluate (i) how stroke affects perfusion outside of lesioned areas in chronic aphasia and (ii) how perfusion in specific cortical areas and perilesional tissue relates to language outcomes in aphasia. We analysed perfusion data from a large sample of participants with chronic aphasia due to left hemisphere stroke (n = 43) and age-matched healthy controls (n = 25). We used anatomically defined regions of interest that covered the frontal, parietal, and temporal areas of the perisylvian cortex in both hemispheres, areas typically known to support language, along with several control regions not implicated in language processing. For the aphasia group, we also looked at three regions of interest in the perilesional tissue. We compared perfusion levels between the two groups and investigated the relationship between perfusion levels and language subtest scores while controlling for demographic and lesion variables. First, we observed that perfusion levels outside the lesioned areas were significantly reduced in frontal and parietal regions in the left hemisphere in people with aphasia compared to the control group, while no differences were observed for the right hemisphere regions. Second, we found that perfusion in the left temporal lobe (and most strongly in the posterior part of both superior and middle temporal gyri) and inferior parietal areas (supramarginal gyrus) was significantly related to residual expressive and receptive language abilities. In contrast, perfusion in the frontal regions did not show such a relationship; no relationship with language was also observed for perfusion levels in control areas and all right hemisphere regions. Third, perilesional perfusion was only marginally related to language production abilities. Cumulatively, the current findings demonstrate that blood flow is reduced beyond the lesion site in chronic aphasia and that hypoperfused neural tissue in critical temporoparietal language areas has a negative impact on behavioural outcomes. These results, using perfusion imaging, underscore the critical and general role that left hemisphere posterior temporal regions play in various expressive and receptive language abilities. Overall, the study highlights the importance of exploring perfusion measures in stroke.
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Affiliation(s)
- Maria V Ivanova
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Ioannis Pappas
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA 90033, USA
| | - Ben Inglis
- Henry H. Wheeler, Jr. Brain Imaging Center, University of California, Berkeley, CA 94720, USA
| | - Alexis L Pracar
- Department of Psychology, University of California, Berkeley, CA 94720, USA
| | - Timothy J Herron
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Juliana V Baldo
- Research Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Andrew S Kayser
- Division of Neurology, San Francisco VA Health Care System, San Francisco, CA 94121, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mark D’Esposito
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Neurology Service, VA Northern California Health Care System, Martinez, CA 94553, USA
| | - Nina F Dronkers
- Department of Psychology, University of California, Berkeley, CA 94720, USA
- Depertment of Neurology, University of California, Davis, CA 95817, USA
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21
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Dounavi ME, Mak E, Swann P, Low A, Muniz-Terrera G, McKeever A, Pope M, Williams GB, Wells K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie K, Su L, Ritchie CW, O’Brien JT. Differential association of cerebral blood flow and anisocytosis in APOE ε4 carriers at midlife. J Cereb Blood Flow Metab 2023; 43:1672-1684. [PMID: 37132287 PMCID: PMC10581239 DOI: 10.1177/0271678x231173587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/04/2023]
Abstract
Cerebral hemodynamic alterations have been observed in apolipoprotein ε4 (APOE4) carriers at midlife, however the physiological underpinnings of this observation are poorly understood. Our goal was to investigate cerebral blood flow (CBF) and its spatial coefficient of variation (CoV) in relation to APOE4 and a measure of erythrocyte anisocytosis (red blood cell distribution width - RDW) in a middle-aged cohort. Data from 563 participants in the PREVENT-Dementia study scanned with 3 T MRI cross-sectionally were analysed. Voxel-wise and region-of-interest analyses within nine vascular regions were run to detect areas of altered perfusion. Within the vascular regions, interaction terms between APOE4 and RDW in predicting CBF were examined. Areas of hyperperfusion in APOE4 carriers were detected mainly in frontotemporal regions. The APOE4 allele differentially moderated the association between RDW and CBF, an association which was more prominent in the distal vascular territories (p - [0.01, 0.05]). The CoV was not different between the considered groups. We provide novel evidence that in midlife, RDW and CBF are differentially associated in APOE4 carriers and non-carriers. This association is consistent with a differential hemodynamic response to hematological alterations in APOE4 carriers.
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Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Peter Swann
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Anna McKeever
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Marianna Pope
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences and Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Katie Wells
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Brian Lawlor
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- Division of Brain Science, Imperial College Healthcare NHS Trust, UK
| | - Clare Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - John T O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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22
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Zhao MY, Dahlen A, Ramirez NJ, Moseley M, Van Haren K, Zaharchuk G. Effect of vitamin D supplementation on cerebral blood flow in male patients with adrenoleukodystrophy. J Neurosci Res 2023; 101:1086-1097. [PMID: 36967233 DOI: 10.1002/jnr.25187] [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: 03/22/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023]
Abstract
One-third of boys with X-linked adrenoleukodystrophy (ALD) develop inflammatory demyelinating lesions, typically at the splenium. These lesions share similarities with multiple sclerosis, including cerebral hypoperfusion and links to vitamin D insufficiency. We hypothesized that increasing vitamin D levels would increase cerebral blood flow (CBF) in ALD boys. We conducted an exploratory analysis of vitamin D supplementation and CBF using all available data from participants enrolled in a recent single-arm interventional study of vitamin D supplementation in boys with ALD. We measured whole brain and splenium CBF using arterial spin labeling (ASL) from three study time points (baseline, 6 months, and 12 months). We used linear generalized estimating equations to evaluate CBF changes between time points and to test for an association between CBF and vitamin D. ASL data were available for 16 participants, aged 2-22 years. Mean vitamin D levels increased by 72.7% (p < .001) after 6 months and 88.6% (p < .01) after 12 months. Relative to baseline measures, mean CBF of the whole brain (6 months: +2.5%, p = .57; 12 months: +6.1%, p = .18) and splenium (6 months: +1.2%, p = .80; 12 months: +7.4%, p = .058) were not significantly changed. Vitamin D levels were positively correlated with CBF in the splenium (slope = .59, p < .001). In this exploratory analysis, we observed a correlation between vitamin D levels and splenial CBF in ALD boys. We confirm the feasibility of measuring CBF in this brain region and population, but further work is needed to establish a causal role for vitamin D in modulating CBF.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, California, Stanford, USA
| | - Alex Dahlen
- Quantitative Sciences Unit, Stanford University School of Medicine, California, Stanford, USA
| | | | - Michael Moseley
- Department of Radiology, Stanford University, California, Stanford, USA
| | - Keith Van Haren
- Department of Neurology and Neurological Sciences, Stanford University, California, Stanford, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, California, Stanford, USA
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23
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Chatha G, Dhaliwal T, Castle-Kirszbaum MD, Amukotuwa S, Lai L, Kwan E. The utility of arterial spin labelled perfusion-weighted magnetic resonance imaging in measuring the vascularity of high grade gliomas - A prospective study. Heliyon 2023; 9:e17615. [PMID: 37519684 PMCID: PMC10372548 DOI: 10.1016/j.heliyon.2023.e17615] [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: 11/28/2022] [Revised: 04/13/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Background Dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) currently remains the gold standard technique for measuring cerebral perfusion in glioma diagnosis and surveillance. Arterial spin labelling (ASL) PWI is a non-invasive alternative that does not require gadolinium contrast administration, although it is yet to be applied in widespread clinical practice. This study aims to assess the utility of measuring signal intensity in ASL PWI in predicting glioma vascularity by measuring maximal tumour signal intensity in patients based on pre-operative imaging and comparing this to maximal vessel density on histopathology. Methods Pseudocontinuous ASL (pCASL) and DSC images were acquired pre-operatively in 21 patients with high grade gliomas. The maximal signal intensity within the gliomas over a region of interest of 100 mm2 was measured and also normalised to the contralateral cerebral cortex (nTBF-C), and cerebellum (nTBF-Cb). Maximal vessel density per 1 mm2 was determined on histopathology using CD31 and CD34 immunostaining on all participants. Results Using ASL, statistically significant correlation was observed between maximal signal intensity (p < 0.05) and nTBF-C (p < 0.05) to maximal vessel density based on histopathology. Although a positive trend was also observed nTBF-Cb, this did not reach statistical significance. Using DSC, no statistically significant correlation was found between signal intensity, nTBF-C and nTBF-Cb. There was no correlation between maximal signal intensity between ASL and DSC. Average vessel density did not correlate with age, sex, previous treatment, or IDH status. Conclusions ASL PWI imaging is a reliable marker of evaluating the vascularity of high grade gliomas and may be used as an adjunct to DSC PWI.
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Affiliation(s)
- Gurkirat Chatha
- Department of Neurosurgery, Monash Health, Melbourne, Australia
| | | | - Mendel David Castle-Kirszbaum
- Department of Neurosurgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | | | - Leon Lai
- Department of Neurosurgery, Monash Health, Melbourne, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Edward Kwan
- Department of Pathology, Monash Health, Melbourne, Australia
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24
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Ivanova MV, Pappas I. Understanding recovery of language after stroke: insights from neurovascular MRI studies. FRONTIERS IN LANGUAGE SCIENCES 2023; 2:1163547. [PMID: 38162928 PMCID: PMC10757818 DOI: 10.3389/flang.2023.1163547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Stroke causes a disruption in blood flow to the brain that can lead to profound language impairments. Understanding the mechanisms of language recovery after stroke is crucial for the prognosis and effective rehabilitation of people with aphasia. While the role of injured brain structures and disruptions in functional connectivity have been extensively explored, the relationship between neurovascular measures and language recovery in both early and later stages has not received sufficient attention in the field. Fully functioning healthy brain tissue requires oxygen and nutrients to be delivered promptly via its blood supply. Persistent decreases in blood flow after a stroke to the remaining non-lesioned tissue have been shown to contribute to poor language recovery. The goal of the current paper is to critically examine stroke studies looking at the relationship between different neurovascular measures and language deficits and mechanisms of language recovery via changes in neurovascular metrics. Measures of perfusion or cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) provide complementary approaches to understanding neurovascular mechanisms post stroke by capturing both cerebral metabolic demands and mechanical vascular properties. While CBF measures indicate the amount of blood delivered to a certain region and serve as a proxy for metabolic demands of that area, CVR indices reflect the ability of the vasculature to recruit blood flow in response to a shortage of oxygen, such as when one is holding their breath. Increases in CBF during recovery beyond the site of the lesion have been shown to promote language gains. Similarly, CVR changes, when collateral vessels are recruited to help reorganize the flow of blood in hypoperfused regions, have been related to functional recovery post stroke. In the current review, we highlight the main findings in the literature investigating neurovascular changes in stroke recovery with a particular emphasis on how language abilities can be affected by changes in CBF and CVR. We conclude by summarizing existing methodological challenges and knowledge gaps that need to be addressed in future work in this area, outlining a promising avenue of research.
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Affiliation(s)
- Maria V. Ivanova
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Ioannis Pappas
- USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
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25
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Moyaert P, Beun S, Achten E, Clement P. Effect of Acetylcholinesterase Inhibitors on Cerebral Perfusion and Cognition: A Systematic Review. J Alzheimers Dis 2023:JAD221125. [PMID: 37182871 DOI: 10.3233/jad-221125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Perfusion imaging has the potential to identify neurodegenerative disorders in a preclinical stage. However, to correctly interpret perfusion-derived parameters, the impact of perfusion modifiers should be evaluated. OBJECTIVE In this systematic review, the impact of acute and chronic intake of four acetylcholinesterase inhibitors (AChEIs) on cerebral perfusion in adults was investigated: physostigmine, donepezil, galantamine, and rivastigmine. RESULTS Chronic AChEI treatment results in an increase of cerebral perfusion in treatment-responsive patients with Alzheimer's disease, dementia with Lewy bodies, and Parkinson's disease dementia in the frontal, parietal, temporal, and occipital lobes, as well as the cingulate gyrus. These effects appear to be temporary, dose-related, and consistent across populations and different AChEI types. On the contrary, further perfusion decline was reported in patients not receiving AChEIs or not responding to the treatment. CONCLUSION AChEIs appear to be a potential perfusion modifier in neurodegenerative patients. More research focused on quantitative perfusion in both patients with and without a cholinergic deficit is needed to draw conclusions on whether AChEI intake should be considered when analyzing perfusion data.
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Affiliation(s)
- Paulien Moyaert
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
- Lawson Health Research Institute, London, Ontario, Canada
| | - Soetkin Beun
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Eric Achten
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Patricia Clement
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
- Department of Medical Imaging, Ghent University Hospital, Ghent, Belgium
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26
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Lindner T, Bolar DS, Achten E, Barkhof F, Bastos-Leite AJ, Detre JA, Golay X, Günther M, Wang DJJ, Haller S, Ingala S, Jäger HR, Jahng GH, Juttukonda MR, Keil VC, Kimura H, Ho ML, Lequin M, Lou X, Petr J, Pinter N, Pizzini FB, Smits M, Sokolska M, Zaharchuk G, Mutsaerts HJMM. Current state and guidance on arterial spin labeling perfusion MRI in clinical neuroimaging. Magn Reson Med 2023; 89:2024-2047. [PMID: 36695294 PMCID: PMC10914350 DOI: 10.1002/mrm.29572] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Abstract
This article focuses on clinical applications of arterial spin labeling (ASL) and is part of a wider effort from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group to update and expand on the recommendations provided in the 2015 ASL consensus paper. Although the 2015 consensus paper provided general guidelines for clinical applications of ASL MRI, there was a lack of guidance on disease-specific parameters. Since that time, the clinical availability and clinical demand for ASL MRI has increased. This position paper provides guidance on using ASL in specific clinical scenarios, including acute ischemic stroke and steno-occlusive disease, arteriovenous malformations and fistulas, brain tumors, neurodegenerative disease, seizures/epilepsy, and pediatric neuroradiology applications, focusing on disease-specific considerations for sequence optimization and interpretation. We present several neuroradiological applications in which ASL provides unique information essential for making the diagnosis. This guidance is intended for anyone interested in using ASL in a routine clinical setting (i.e., on a single-subject basis rather than in cohort studies) building on the previous ASL consensus review.
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Affiliation(s)
- Thomas Lindner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Ghent University, Ghent, Belgium
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands; Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, UK
| | | | - John A. Detre
- Department of Neurology, University of Pennsylvania, Philadelphia PA USA
| | - Xavier Golay
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthias Günther
- (1) University Bremen, Germany; (2) Fraunhofer MEVIS, Bremen, Germany; (3) mediri GmbH, Heidelberg, Germany
| | - Danny JJ Wang
- Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles CA USA
| | - Sven Haller
- (1) CIMC - Centre d’Imagerie Médicale de Cornavin, Place de Cornavin 18, 1201 Genève 1201 Genève (2) Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (3) Faculty of Medicine of the University of Geneva, Switzerland. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, P. R. China
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hans R Jäger
- UCL Queen Square Institute of Neuroradiology, University College London, London, UK
| | - Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Meher R. Juttukonda
- (1) Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown MA USA (2) Department of Radiology, Harvard Medical School, Boston MA USA
| | - Vera C. Keil
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical sciences, University of Fukui, Fukui, JAPAN
| | - Mai-Lan Ho
- Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA
| | - Maarten Lequin
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine | University Medical Center Utrecht & Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Jan Petr
- (1) Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany (2) Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Nandor Pinter
- Dent Neurologic Institute, Buffalo, NY, USA. University at Buffalo Neurosurgery, Buffalo, NY, USA
| | - Francesca B. Pizzini
- Radiology Institute, Dept. of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Marion Smits
- (1) Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands (2) The Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Magdalena Sokolska
- Department of Medical Physics and Biomedical Engineering University College London Hospitals NHS Foundation Trust, UK
| | | | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, The Netherlands
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27
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Sanders AM, Richard G, Kolskår K, Ulrichsen KM, Alnaes D, Beck D, Dørum ES, Engvig A, Lund MJ, Nordhøy W, Pedersen ML, Rokicki J, Nordvik JE, Westlye LT. Associations between everyday activities and arterial spin labeling-derived cerebral blood flow: A longitudinal study in community-dwelling elderly volunteers. Hum Brain Mapp 2023; 44:3377-3393. [PMID: 36947581 PMCID: PMC10171542 DOI: 10.1002/hbm.26287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
Cerebral blood flow (CBF) is critical for brain metabolism and function. Age-related changes in CBF are associated with increased risk of neurocognitive disorders and vascular events such as stroke. Identifying correlates and positive modifiers of age-related changes in CBF before the emergence of incipient clinical decline may inform public health advice and clinical practice. Former research has been inconclusive regarding the association between regular physical activity and CBF, and there is a lack of studies on the association between level of everyday activities and CBF, in older adults. To investigate these relationships, 118 healthy community-dwelling adults (65-89 years) underwent pseudo-continuous arterial spin labeling (ASL) MRI, neurocognitive, physical, and activity assessments at baseline. Eighty-six participants completed a follow-up ASL MRI, on average 506 (SD = 113) days after the baseline scan. Cross-sectional analysis revealed credible evidence for positive associations between time spent on low intensity physical activity and CBF in multiple cortical and subcortical regions, time spent on moderate to vigorous intensity physical activity and accumbens CBF, participation in social activity and CBF in multiple cortical regions, and between reading and thalamic CBF, indicating higher regional CBF in more active adults. Longitudinal analysis revealed anecdotal evidence for an interaction between time and baseline level of gardening on occipital and parietal CBF, and baseline reading on pallidum CBF, indicating more change in CBF in adults with lower level of activity. The findings support that malleable lifestyle factors contribute to healthy brain aging, with relevance for public health guidelines.
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Affiliation(s)
- Anne-Marthe Sanders
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Geneviève Richard
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Kolskår
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Kristine M Ulrichsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Dag Alnaes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo New University College, Oslo, Norway
| | - Dani Beck
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erlend S Dørum
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Sunnaas Rehabilitation Hospital HT, Nesodden, Norway
| | - Andreas Engvig
- Section for Preventive Cardiology, Department of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Martina Jonette Lund
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wibeke Nordhøy
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Physics and Computational Radiology, Div. of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Mads L Pedersen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jaroslav Rokicki
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Jan Egil Nordvik
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian Directorate of Health, Oslo, Norway
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
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28
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Khalil AA, Tanritanir AC, Grittner U, Kirilina E, Villringer A, Fiebach JB, Mekle R. Reproducibility of cerebral perfusion measurements using BOLD delay. Hum Brain Mapp 2023; 44:2778-2789. [PMID: 36840928 PMCID: PMC10089099 DOI: 10.1002/hbm.26244] [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: 12/03/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/26/2023] Open
Abstract
BOLD delay is an emerging, noninvasive method for assessing cerebral perfusion that does not require the use of intravenous contrast agents and is thus particularly suited for longitudinal monitoring. In this study, we assess the reproducibility of BOLD delay using data from 136 subjects with normal cerebral perfusion scanned on two separate occasions with scanners, sequence parameters, and intervals between scans varying between subjects. The effects of various factors on the reproducibility of BOLD delay, defined here as the differences in BOLD delay values between the scanning sessions, were investigated using a linear mixed model. Reproducibility was additionally assessed using the intraclass correlation coefficient of BOLD delay between sessions. Reproducibility was highest in the posterior cerebral artery territory. The mean BOLD delay test-retest difference after accounting for the aforementioned factors was 1.2 s (95% CI = 1.0 to 1.4 s). Overall, BOLD delay shows good reproducibility, but care should be taken when interpreting longitudinal BOLD delay changes that are either very small or are located in certain brain regions.
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Affiliation(s)
- Ahmed A Khalil
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Ayse C Tanritanir
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany.,Charité - Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Evgeniya Kirilina
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Center for Cognitive Neuroscience Berlin, Free University, Berlin, Germany
| | - Arno Villringer
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Wang X, Bishop C, O'Callaghan J, Gayhoor A, Albani J, Theriault W, Chappell M, Golay X, Wang D, Becerra L. MRI assessment of cerebral perfusion in clinical trials. Drug Discov Today 2023; 28:103506. [PMID: 36690177 DOI: 10.1016/j.drudis.2023.103506] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
Neurodegenerative mechanisms affect the brain through a variety of processes that are reflected as changes in brain structure and physiology. Although some biomarkers for these changes are well established, others are at different stages of development for use in clinical trials. One of the most challenging biomarkers to harmonize for clinical trials is cerebral blood flow (CBF). There are several magnetic resonance imaging (MRI) methods for quantifying CBF without the use of contrast agents, in particular arterial spin labeling (ASL) perfusion MRI, which has been increasingly applied in clinical trials. In this review, we present ASL MRI techniques, including strategies for implementation across multiple imaging centers, levels of confidence in assessing disease progression and treatment effects, and details of image analysis.
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Affiliation(s)
| | | | | | | | | | | | - Michael Chappell
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham
| | - Xavier Golay
- MR Neurophysics and Translational Neuroscience, Queen Square UCL Institute of Neurology, University College London; Gold Standard Phantoms
| | - Danny Wang
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California (USC)
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30
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Nair P, Prasad K, Balasundaram P, Vibha D, Nand Dwivedi S, Gaikwad SB, Srivastava AK, Verma V. Multimodal imaging of the aging brain: Baseline findings of the LoCARPoN study. AGING BRAIN 2023; 3:100075. [PMID: 37180873 PMCID: PMC10173278 DOI: 10.1016/j.nbas.2023.100075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
We quantified and investigated multimodal brain MRI measures in the LoCARPoN Study due to lack of normative data among Indians. A total of 401 participants (aged 50-88 years) without stroke or dementia completed MRI investigation. We assessed 31 brain measures in total using four brain MRI modalities, including macrostructural (global & lobar volumes, white matter hyperintensities [WMHs]), microstructural (global and tract-specific white matter fractional anisotropy [WM-FA] and mean diffusivity [MD]) and perfusion measures (global and lobar cerebral blood flow [CBF]). The absolute brain volumes of males were significantly larger than those of females, but such differences were relatively small (<1.2% of intracranial volume). With increasing age, lower macrostructural brain volumes, lower WM-FA, greater WMHs, higher WM-MD were found (P = 0.00018, Bonferroni threshold). Perfusion measures did not show significant differences with increasing age. Hippocampal volume showed the greatest association with age, with a reduction of approximately 0.48%/year. This preliminary study augments and provides insight into multimodal brain measures during the nascent stages of aging among the Indian population (South Asian ethnicity). Our findings establish the groundwork for future hypothetical testing studies.
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Affiliation(s)
- Pallavi Nair
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
- Department of Neurology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
- Corresponding author at: Director’s Cell, Rajendra Institute of Medical Sciences, Ranchi 834009, Jharkhand, India.
| | - Parthiban Balasundaram
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
- Department of Neuroradiology, Kings College Hospital, London, UK
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sada Nand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Achal K. Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Verma
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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31
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Farag MM, Ghazal HAELR, Ibrahim A, Hammad B. Near-infrared spectroscopy measured cerebral oxygenation in full-term infants during transition: an observational study. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2022. [DOI: 10.1186/s43054-022-00149-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Brain is one of the most sensitive organs to hypoxia during resuscitation. NIRS-measured cerebral oxygenation is an evolving brain monitoring tool for neonatal resuscitation.
Methods
We undertook a prospective observational study for monitoring of cerebral oxygenation and peripheral preductal saturation at 1, 5, and 10 min after birth. Fractional tissue oxygen extraction was calculated as well. In addition to studying factors affecting cerebral oxygenation at those points in time. For the current cohort, cerebral oxygenation centile charts were provided at those time points. This work was registered in the cinicaltrial.gov NCT05158881.
Results
Sixty healthy term neonates were enrolled to define reference ranges and centile charts of cerebral oxygenation at 1, 5, and 10 min after birth. The strongest correlations between cerebral oxygenation metrics and peripheral preductal saturation were at 5 min after birth with r value = 0.628. Using logistic regression analysis to determine the most significant factors affecting NIRS-measured crSO2 in healthy full-term neonates, we found that the mode of delivery was the most significant factor with OR = 4.000 (1.367–11.703) at 5 min and 8.726 (2.517–30.25) at 10 min.
Conclusions
Normal values for NIRS may help to identify infants with cerebral oxygenation below a certain value indicating regional hypoxia at certain time points and can guide neonatal resuscitation interventions. Caesarean section is the most significant factor affecting cerebral oxygenation during the transition of healthy full-term neonates.
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Wirestam R, Lundberg A, Chakwizira A, van Westen D, Knutsson L, Lind E. Test-retest analysis of cerebral oxygen extraction estimates in healthy volunteers: comparison of methods based on quantitative susceptibility mapping and dynamic susceptibility contrast magnetic resonance imaging. Heliyon 2022; 8:e12364. [PMID: 36590544 PMCID: PMC9801129 DOI: 10.1016/j.heliyon.2022.e12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/18/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Background Estimation of the oxygen extraction fraction (OEF) by quantitative susceptibility mapping (QSM) magnetic resonance imaging (MRI) is promising but requires systematic evaluation. Extraction of OEF-related information from the tissue residue function in dynamic susceptibility contrast MRI (DSC-MRI) has also been proposed. In this study, whole-brain OEF repeatability was investigated, as well as the relationships between QSM-based OEF and DSC-MRI-based parameters, i.e., mean transit time (MTT) and an oxygen extraction index, referred to as apparent OEF (AOEF). Method Test-retest data were obtained from 20 healthy volunteers at 3 T. QSM maps were reconstructed from 3D gradient-echo MRI phase data, using morphology-enabled dipole inversion. DSC-MRI was accomplished using gradient-echo MRI at a temporal resolution of 1.24 s. Results The whole-brain QSM-based OEF was (40.4±4.8) % and, in combination with a previously published cerebral blood flow (CBF) estimate, this corresponds to a cerebral metabolic rate of oxygen level of CMRO2 = 3.36 ml O2/min/100 g. The intra-class correlation coefficient [ICC(2,1)] for OEF test-retest data was 0.73. The MTT-versus-OEF and AOEF-versus-OEF relationships showed correlation coefficients of 0.61 (p = 0.004) and 0.52 (p = 0.019), respectively. Discussion QSM-based OEF showed a convincing absolute level and good test-retest results in terms of the ICC. Moderate to good correlations between QSM-based OEF and DSC-MRI-based parameters were observed. The present results constitute an indicator of the level of robustness that can be achieved without applying extraordinary resources in terms of MRI equipment, imaging protocol, QSM reconstruction, and OEF analysis.
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Affiliation(s)
- Ronnie Wirestam
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Anna Lundberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Arthur Chakwizira
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Danielle van Westen
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
- Image and Function, Skåne University Hospital, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Emelie Lind
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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33
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Drew PJ. Neurovascular coupling: motive unknown. Trends Neurosci 2022; 45:809-819. [PMID: 35995628 PMCID: PMC9768528 DOI: 10.1016/j.tins.2022.08.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 12/13/2022]
Abstract
In the brain, increases in neural activity drive changes in local blood flow via neurovascular coupling. The common explanation for increased blood flow (known as functional hyperemia) is that it supplies the metabolic needs of active neurons. However, there is a large body of evidence that is inconsistent with this idea. Baseline blood flow is adequate to supply oxygen needs even with elevated neural activity. Neurovascular coupling is irregular, absent, or inverted in many brain regions, behavioral states, and conditions. Increases in respiration can increase brain oxygenation without flow changes. Simulations show that given the architecture of the brain vasculature, areas of low blood flow are inescapable and cannot be removed by functional hyperemia. As discussed in this article, potential alternative functions of neurovascular coupling include supplying oxygen for neuromodulator synthesis, brain temperature regulation, signaling to neurons, stabilizing and optimizing the cerebral vascular structure, accommodating the non-Newtonian nature of blood, and driving the production and circulation of cerebrospinal fluid (CSF).
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Affiliation(s)
- Patrick J Drew
- Center for Neural Engineering, Departments of Engineering Science and Mechanics, Neurosurgery, Biology, and Biomedical Engineering, The Pennsylvania State University, W-317 Millennium Science Complex, University Park, PA 16802, USA.
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34
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Troudi A, Tensaouti F, Baudou E, Péran P, Laprie A. Arterial Spin Labeling Perfusion in Pediatric Brain Tumors: A Review of Techniques, Quality Control, and Quantification. Cancers (Basel) 2022; 14:cancers14194734. [PMID: 36230655 PMCID: PMC9564035 DOI: 10.3390/cancers14194734] [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: 09/12/2022] [Revised: 09/24/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI) technique for measuring cerebral blood flow (CBF). This noninvasive technique has added a new dimension to the study of several pediatric tumors before, during, and after treatment, be it surgery, radiotherapy, or chemotherapy. However, ASL has three drawbacks, namely, a low signal-to-noise-ratio, a minimum acquisition time of 3 min, and limited spatial summarize current resolution. This technique requires quality control before ASL-CBF maps can be extracted and before any clinical investigations can be conducted. In this review, we describe ASL perfusion principles and techniques, summarize the most recent advances in CBF quantification, report technical advances in ASL (resting-state fMRI ASL, BOLD fMRI coupled with ASL), set out guidelines for ASL quality control, and describe studies related to ASL-CBF perfusion and qualitative and semi-quantitative ASL weighted-map quantification, in healthy children and those with pediatric brain tumors.
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Affiliation(s)
- Abir Troudi
- Toulouse Neuro Imaging Center (ToNIC), INSERM-University of Toulouse Paul Sebatier, 31300 Toulouse, France
- Correspondence: (A.T.); (A.L.)
| | - Fatima Tensaouti
- Toulouse Neuro Imaging Center (ToNIC), INSERM-University of Toulouse Paul Sebatier, 31300 Toulouse, France
- Radiation Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, 31300 Toulouse, France
| | - Eloise Baudou
- Toulouse Neuro Imaging Center (ToNIC), INSERM-University of Toulouse Paul Sebatier, 31300 Toulouse, France
- Pediatric Neurology Department, Children’s Hospital, Toulouse University Hospital, 31300 Toulouse, France
| | - Patrice Péran
- Toulouse Neuro Imaging Center (ToNIC), INSERM-University of Toulouse Paul Sebatier, 31300 Toulouse, France
| | - Anne Laprie
- Toulouse Neuro Imaging Center (ToNIC), INSERM-University of Toulouse Paul Sebatier, 31300 Toulouse, France
- Radiation Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, 31300 Toulouse, France
- Correspondence: (A.T.); (A.L.)
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35
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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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Upadhyay N, Schörkmaier T, Maurer A, Claus J, Scheef L, Daamen M, Martin JA, Stirnberg R, Radbruch A, Attenberger U, Stöcker T, Boecker H. Regional cortical perfusion increases induced by a 6-month endurance training in young sedentary adults. Front Aging Neurosci 2022; 14:951022. [PMID: 36034125 PMCID: PMC9407250 DOI: 10.3389/fnagi.2022.951022] [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: 05/23/2022] [Accepted: 07/15/2022] [Indexed: 12/02/2022] Open
Abstract
Physical inactivity is documented as a health risk factor for chronic diseases, accelerated aging, and cognitive impairment. Physical exercise, on the other hand, plays an important role in healthy aging by promoting positive muscular, cardiovascular, and central nervous system adaptions. Prior studies on the effects of exercise training on cerebral perfusion have focused largely on elderly cohorts or patient cohorts, while perfusion effects of exercise training in young sedentary adults have not yet been fully assessed. Therefore, the present study examined the physiological consequence of a 6-month endurance exercise training on brain perfusion in 28 young sedentary adults randomly assigned to an intervention group (IG; regular physical exercise) or a control group (CG; without physical exercise). The IG performed an extensive running interval training three times per week over 6 months. Performance diagnostics and MRI were performed every 2 months, and training intensity was adapted individually. Brain perfusion measurements with pseudo-continuous arterial spin labeling were analyzed using the standard Oxford ASL pipeline. A significant interaction effect between group and time was found for right superior temporal gyrus (STG) perfusion, driven by an increase in the IG and a decrease in the CG. Furthermore, a significant time effect was observed in the right middle occipital region in the IG only. Perfusion increases in the right STG, in the ventral striatum, and in primary motor areas were significantly associated with increases in maximum oxygen uptake (VO2max). Overall, this study identified region-specific increases in local perfusion in a cohort of young adults that partly correlated with individual performance increases, hence, suggesting exercise dose dependency. Respective adaptations in brain perfusion are discussed in the context of physical exercise-induced vascular plasticity.
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Affiliation(s)
- Neeraj Upadhyay
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | | | - Angelika Maurer
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Jannik Claus
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Lukas Scheef
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Marcel Daamen
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Jason A. Martin
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | | | - Alexander Radbruch
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Tony Stöcker
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Physics and Astronomy, University of Bonn, Bonn, Germany
| | - Henning Boecker
- Clinical Functional Imaging Group, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
- *Correspondence: Henning Boecker,
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Hafdi M, Mutsaerts HJMM, Petr J, Richard E, van Dalen JW. Atherosclerotic risk is associated with cerebral perfusion - A cross-sectional study using arterial spin labeling MRI. Neuroimage Clin 2022; 36:103142. [PMID: 35970112 PMCID: PMC9400119 DOI: 10.1016/j.nicl.2022.103142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Arterial spin labeling (ASL) magnetic resonance imaging (MRI) may be a promising technique to evaluate the presence of cerebral atherosclerosis. We tested whether the new and easily calculated ASL MRI parameter for vascular and tissue signal distribution - 'spatial coefficient of variation' (ASL-sCoV) - is a better radiological marker for atherosclerotic risk than the more conventional markers of white matter hyperintensity (WMH) volume and cerebral blood flow (ASL-CBF). METHODS Participants of the preDIVA trial (n = 195), aged 72-80 years with systolic hypertension (>140 mmHg) underwent two MRI scans two to three years apart. WMH volume was derived from 3D FLAIR-MRI; gray matter ASL-CBF and ASL-sCoV from ASL-MRI. Atherosclerotic risk was operationalized as 10-year cardiovascular risk by the Systematic COronary Risk Evaluation Older Persons (SCORE O.P) and calculated at baseline and follow-up. Data were analyzed using linear regression. RESULTS ASL-CBF was associated with atherosclerotic risk scores at baseline (standardized-beta = -0.26, 95 %CI = -0.40 to -0.13, p < 0.001) but not at follow-up (standardized-beta = -0.14, 95 %CI = -0.33 to 0.04, p = 0.12). ASL-sCoV was associated with atherosclerotic risk scores at both time points (baseline standardized-beta = 0.23, 95 %CI = 0.10 to 0.36, p < 0.0001, follow-up standardized beta = 0.20, 95 %CI = 0.03 to 0.36, p = 0.02). WMH volume was not associated with atherosclerotic risk scores at either time-point. There were no longitudinal associations between changes in MRI parameters and baseline atherosclerotic risk scores. CONCLUSIONS Our findings suggest that ASL-sCoV correlates better with atherosclerotic risk than the more conventional markers ASL-CBF and WMH volume. Our data reaffirm that non-invasive imaging with MRI is highly informative and could provide additional information about cerebrovascular damage.
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Affiliation(s)
- Melanie Hafdi
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands,Corresponding author at: Amsterdam University Medical Centre, Department of Neurology Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam University Medical Center, Amsterdam, The Netherlands,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Willem van Dalen
- Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Zhao MY, Fan AP, Chen DYT, Ishii Y, Khalighi MM, Moseley M, Steinberg GK, Zaharchuk G. Using arterial spin labeling to measure cerebrovascular reactivity in Moyamoya disease: Insights from simultaneous PET/MRI. J Cereb Blood Flow Metab 2022; 42:1493-1506. [PMID: 35236136 PMCID: PMC9274857 DOI: 10.1177/0271678x221083471] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cerebrovascular reactivity (CVR) reflects the CBF change to meet different physiological demands. The reference CVR technique is PET imaging with vasodilators but is inaccessible to most patients. DSC can measure transit time to evaluate patients suspected of stroke, but the use of gadolinium may cause side-effects. Arterial spin labeling (ASL) is a non-invasive MRI technique for CBF measurements. Here, we investigate the effectiveness of ASL with single and multiple post labeling delays (PLD) to replace PET and DSC for CVR and transit time mapping in 26 Moyamoya patients. Images were collected using simultaneous PET/MRI with acetazolamide. CVR, CBF, arterial transit time (ATT), and time-to-maximum (Tmax) were measured in different flow territories. Results showed that CVR was lower in occluded regions than normal regions (by 68 ± 12%, 52 ± 5%, and 56 ± 9%, for PET, single- and multi-PLD PCASL, respectively, all p < 0.05). Multi-PLD PCASL correlated slightly higher with PET (CCC = 0.36 and 0.32 in affected and unaffected territories respectively). Vasodilation caused ATT to reduce by 4.5 ± 3.1% (p < 0.01) in occluded regions. ATT correlated significantly with Tmax (R2 > 0.35, p < 0.01). Therefore, multi-PLD ASL is recommended for CVR studies due to its high agreement with the reference PET technique and the capability of measuring transit time.
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Affiliation(s)
- Moss Y Zhao
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Audrey P Fan
- Department of Biomedical Engineering, University of California Davis, Davis, CA, USA.,Department of Neurology, University of California Davis, Davis, CA, USA
| | - David Yen-Ting Chen
- Department of Medical Imaging, Taipei Medical University - Shuan-Ho Hospital, New Taipei City.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Yosuke Ishii
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Michael Moseley
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
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Walenski M, Chen Y, Litcofsky KA, Caplan D, Kiran S, Rapp B, Parrish TB, Thompson CK. Perilesional Perfusion in Chronic Stroke-Induced Aphasia and Its Response to Behavioral Treatment Interventions. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:345-363. [PMID: 35685084 PMCID: PMC9169892 DOI: 10.1162/nol_a_00068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/02/2022] [Indexed: 05/28/2023]
Abstract
Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments in chronic aphasia, particularly in perilesional tissue. Abnormal perfusion in this region may also serve as a biomarker for predicting functional improvements with behavioral treatment interventions. Using pseudo-continuous arterial spin labeling in magnetic resonance imaging (MRI), we examined perfusion in chronic aphasia, in perilesional rings in the left hemisphere and their right hemisphere homologues. In the left hemisphere we found a gradient pattern of decreasing perfusion closer to the lesion. The opposite pattern was found in the right hemisphere, with significantly increased perfusion close to the lesion homologue. Perfusion was also increased in the right hemisphere lesion homologue region relative to the surrounding tissue. We next examined changes in perfusion in two groups: one group who underwent MRI scanning before and after three months of a behavioral treatment intervention that led to significant language gains, and a second group who was scanned twice at a three-month interval without a treatment intervention. For both groups, there was no difference in perfusion over time in either the left or the right hemisphere. Moreover, within the treatment group pre-treatment perfusion scores did not predict treatment response; neither did pre-treatment perfusion predict post-treatment language performance. These results indicate that perfusion is chronically abnormal in both hemispheres, but chronically abnormal perfusion did not change in response to our behavioral treatment interventions, and did not predict responsiveness to language treatment.
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Affiliation(s)
- Matthew Walenski
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
| | - Yufen Chen
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Evanston, IL
| | - Kaitlyn A. Litcofsky
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL
| | - David Caplan
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston, MA
| | - Swathi Kiran
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Speech, Language, and Hearing, College of Health & Rehabilitation, Boston University, Boston, MA
| | - Brenda Rapp
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Cognitive Science, Krieger School of Arts & Sciences, Johns Hopkins University, Baltimore, MD
| | - Todd B. Parrish
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Evanston, IL
| | - Cynthia K. Thompson
- Center for the Neurobiology of Language Recovery, Northwestern University, Evanston, IL
- Department of Communication Sciences and Disorders, School of Communication, Northwestern University, Evanston, IL
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Evanston, IL
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Sen S, An H, Sollman M, Oakes J, Eron J, Robertson K, Powers W. Reduction in cerebral oxygen metabolism in subcortical regions may be a biomarker of cognitive decline in people living with human immunodeficiency virus. Eur J Neurol 2022; 29:1062-1074. [PMID: 34821434 DOI: 10.1111/ene.15196] [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: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2 ) in whole brain, white matter, gray matter and lenticular nuclei were studied in people living with human immunodeficiency virus (PLHIV) as well as HIV-associated neurocognitive disorder (HAND). METHODS Treatment-naïve PLHIV underwent neurocognitive assessment and magnetic resonance (MR) measurement of rCBF and rCMRO2 with repeat after 12 months of antiretroviral therapy (ART). Age- and sex-matched controls underwent single MR measurements. Regional CBF and rCMRO2 were compared amongst symptomatic, asymptomatic, normal HAND and controls using analysis of variance. Longitudinal analysis of HAND worsening (≥1 category) was assessed after 12 months of ART and correlated with rCBF and rCMRO2 measured by MR imaging using the paired-sample t test. RESULTS Thirty PLHIV completed baseline and 12-month assessments (29 with rCMRO2 measurement). At baseline HAND assessment, 13% had no cognitive impairment, 27% had asymptomatic neurocognitive impairment, 60% had mild neurocognitive disorder and none had HIV-associated dementia. At 12 months, 13% had no cognitive impairment, 20% had asymptomatic neurocognitive impairment, 50% had mild neurocognitive disorder and 17% had HIV-associated dementia. In those without HAND worsening (N = 21) rCMRO2 remained stable and in those with HAND worsening (N = 8) rCMRO2 measurement declined from baseline to 12 months in white matter (2.05 ± 0.40 to 1.73 ± 0.51, p = 0.03) and lenticular nuclei (4.32 ± 0.39 to 4.00 ± 0.51, p = 0.05). CONCLUSIONS In recently diagnosed PLHIV, no association was found between rCBF or rCMRO2 and cognitive impairment at baseline. There was a reduction in rCMRO2 in those with worsening of cognitive function at 12 months on ART. Reduction in rCMRO2 may be a biomarker of cognitive decline in PLHIV.
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Affiliation(s)
- Souvik Sen
- Prisma Health/University of South Carolina, Columbia, South Carolina, USA
| | - Hongyu An
- Washington University, Saint Louis, Missouri, USA
| | - Myriam Sollman
- Prisma Health/University of South Carolina, Columbia, South Carolina, USA
| | - Jonathan Oakes
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joseph Eron
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kevin Robertson
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - William Powers
- University of North Carolina, Chapel Hill, North Carolina, USA
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Woods JG, Wong EC, Boyd EC, Bolar DS. VESPA ASL: VElocity and SPAtially Selective Arterial Spin Labeling. Magn Reson Med 2022; 87:2667-2684. [PMID: 35061920 DOI: 10.1002/mrm.29159] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/25/2021] [Accepted: 12/22/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Spatially selective arterial spin labeling (ASL) perfusion MRI is sensitive to arterial transit times (ATT) that can result in inaccurate perfusion quantification when ATTs are long. Velocity-selective ASL is robust to this effect because blood is labeled within the imaging region, allowing immediate label delivery. However, velocity-selective ASL cannot characterize ATTs, which can provide important clinical information. Here, we introduce a novel pulse sequence, called VESPA ASL, that combines velocity-selective and pseudo-continuous ASL to simultaneously label different pools of arterial blood for robust cerebral blood flow (CBF) and ATT measurement. METHODS The VESPA ASL sequence is similar to velocity-selective ASL, but the velocity-selective labeling is made spatially selective, and pseudo-continuous ASL is added to fill the inflow time. The choice of inflow time and other sequence settings were explored. VESPA ASL was compared to multi-delay pseudo-continuous ASL and velocity-selective ASL through simulations and test-retest experiments in healthy volunteers. RESULTS VESPA ASL is shown to accurately measure CBF in the presence of long ATTs, and ATTs < TI can also be measured. Measurements were similar to established ASL techniques when ATT was short. When ATT was long, VESPA ASL measured CBF more accurately than multi-delay pseudo-continuous ASL, which tended to underestimate CBF. CONCLUSION VESPA ASL is a novel and robust approach to simultaneously measure CBF and ATT and offers important advantages over existing methods. It fills an important clinical need for noninvasive perfusion and transit time imaging in vascular diseases with delayed arterial transit.
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Affiliation(s)
- Joseph G Woods
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Eric C Wong
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Emma C Boyd
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA.,Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Divya S Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California, USA
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Ueda Y, Tanaka Y, Hara S, Inaji M, Ishii K, Maehara T, Nariai T. Differences in cerebral blood flow measurement using arterial spin labeling MRI between patients with moyamoya disease and patients with arteriosclerotic cerebrovascular disease. Acta Radiol 2022; 64:311-319. [PMID: 35037475 DOI: 10.1177/02841851211069245] [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: 11/16/2022]
Abstract
BACKGROUND It is unclear whether the accuracy of arterial spin labeling (ASL) magnetic resonance imaging (MRI) is the same between moyamoya disease (MMD), which is known to have markedly elevated cerebral blood volume (CBV), and atherosclerotic intracranial arterial stenosis (AS), which has relatively less elevated CBV. PURPOSE To investigate how the differences in hemodynamics affect measurement of ASL-cerebral blood flow (CBF) using ASL for patients with MMD and AS. MATERIAL AND METHODS Fourteen MMD and ten AS patients were evaluated with ASL-MRI, magnetic resonance angiography (MRA), and 15O-gas positron emission computed tomography (PET). The regional CBF values of ASL using two post-labeling delays (PLDs; 1525 ms and 2525 ms) were compared with the PET-derived CBF, CBV, and mean transit time (MTT). Corresponding anterior circulation results were evaluated by flow territory map-based analysis. RESULTS The correlation between the ASL-CBF values (2525 ms) and PET-CBF declined in the MMD group (r = 0.28; P < 0.01), while the AS group showed good correlation (r = 0.77; P < 0.01). In the MMD group, the ASL-CBF values (2525 ms) overestimated the PET-CBF values as the regional CBV values increased (r = 0.35; P < 0.01). When the regions of interest were divided into two subgroups according to the degree of arterial stenosis by MRA, the correlation coefficient between the ASL-CBF (2525 ms) and PET-CBF values improved (mild stenosis: r = 0.36; P = 0.06; severe stenosis: r = 0.51; P < 0.01). CONCLUSION The accuracy of CBF measurements using ASL-MRI differed between patients with MMD and AS. The prominent increase of CBV and the degree of arterial stenosis may have affected the accuracy of ASL-CBF in patients with MMD.
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Affiliation(s)
- Yasuhiro Ueda
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoji Tanaka
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shoko Hara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Ultra-long-TE arterial spin labeling reveals rapid and brain-wide blood-to-CSF water transport in humans. Neuroimage 2021; 245:118755. [PMID: 34826596 PMCID: PMC7612938 DOI: 10.1016/j.neuroimage.2021.118755] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/20/2022] Open
Abstract
The study of brain clearance mechanisms is an active area of research. While we know that the cerebrospinal fluid (CSF) plays a central role in one of the main existing clearance pathways, the exact processes for the secretion of CSF and the removal of waste products from tissue are under debate. CSF is thought to be created by the exchange of water and ions from the blood, which is believed to mainly occur in the choroid plexus. This exchange has not been thoroughly studied in vivo. We propose a modified arterial spin labeling (ASL) MRI sequence and image analysis to track blood water as it is transported to the CSF, and to characterize its exchange from blood to CSF. We acquired six pseudo-continuous ASL sequences with varying labeling duration (LD) and post-labeling delay (PLD) and a segmented 3D-GRASE readout with a long echo train (8 echo times (TE)) which allowed separation of the very long-T2 CSF signal. ASL signal was observed at long TEs (793 ms and higher), indicating presence of labeled water transported from blood to CSF. This signal appeared both in the CSF proximal to the choroid plexus and in the subarachnoid space surrounding the cortex. ASL signal was separated into its blood, gray matter and CSF components by fitting a triexponential function with T2s taken from literature. A two-compartment dynamic model was introduced to describe the exchange of water through time and TE. From this, a water exchange time from the blood to the CSF (Tbl->CSF) was mapped, with an order of magnitude of approximately 60 s.
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Gupta SK, Rutherford N, Dolja-Gore X, Watson T, Nair BR. Regional changes with global brain hypometabolism indicates a physiological triage phenomenon and can explain shared pathophysiological events in Alzheimer's & small vessel diseases and delirium. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021; 11:492-506. [PMID: 35003887 PMCID: PMC8727878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 10/09/2021] [Indexed: 06/14/2023]
Abstract
While reduced global brain metabolism is known in aging, Alzheimer's disease (AD), small vessel disease (SVD) and delirium, explanation of regional brain metabolic (rBM) changes is a challenge. We hypothesized that this may be explained by "triage phenomenon", to preserve metabolic supply to vital brain areas. We studied changes in rBM in 69 patients with at least 5% decline in global brain metabolism during active lymphoma. There was significant decline in the rBM of the inferior parietal, precuneus, superior parietal, lateral occipital, primary visual cortices (P<0.001) and in the right lateral prefrontal cortex (P=0.01). Some areas showed no change; multiple areas had significantly increased rBM (e.g. medial prefrontal, anterior cingulate, pons, cerebellum and mesial temporal cortices; P<0.001). We conclude the existence of a physiological triage phenomenon and argue a new hypothetical model to explain the shared events in the pathophysiology of aging, AD, SVD and delirium.
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Affiliation(s)
- Sandeep K Gupta
- Department of Nuclear Medicine & PET, John Hunter and Calvary Mater Hospitals, Hunter Medical Research Institute (HMRI), University of NewcastleNewcastle, NSW, Australia
| | - Natalie Rutherford
- Department of Nuclear Medicine & PET, John Hunter and Calvary Mater Hospitals, Hunter Medical Research Institute (HMRI), University of NewcastleNewcastle, NSW, Australia
| | - Xenia Dolja-Gore
- Research Centre for Generational Health and Ageing (RCGHA), Faculty of Health and Medicine, University of NewcastleNewcastle, NSW, Australia
| | - Tahne Watson
- Department of Nuclear Medicine & PET, John Hunter and Calvary Mater Hospitals, Hunter Medical Research Institute (HMRI), University of NewcastleNewcastle, NSW, Australia
| | - Balakrishnan R Nair
- School of Medicine and Public Health, University of NewcastleNewcastle, NSW, Australia
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Spatial variation of perfusion MRI reflects cognitive decline in mild cognitive impairment and early dementia. Sci Rep 2021; 11:23325. [PMID: 34857793 PMCID: PMC8639710 DOI: 10.1038/s41598-021-02313-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/09/2021] [Indexed: 12/03/2022] Open
Abstract
Cerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer’s dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer’s disease.
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Cote S, Butler R, Michaud V, Lavallee E, Croteau E, Mendrek A, Lepage J, Whittingstall K. The regional effect of serum hormone levels on cerebral blood flow in healthy nonpregnant women. Hum Brain Mapp 2021; 42:5677-5688. [PMID: 34480503 PMCID: PMC8559491 DOI: 10.1002/hbm.25646] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Sex hormones estrogen (EST) and progesterone (PROG) have received increased attention for their important physiological action outside of reproduction. While studies have shown that EST and PROG have significant impacts on brain function, their impact on the cerebrovascular system in humans remains largely unknown. To address this, we used a multi-modal magnetic resonance imaging (MRI) approach to investigate the link between serum hormones in the follicular phase and luteal phase of the menstrual cycle (MC) with measures of cerebrovascular function (cerebral blood flow [CBF]) and structure (intracranial artery diameter). Fourteen naturally cycling women were recruited and assessed at two-time points of their MC. CBF was derived from pseudo-continuous arterial spin labeling while diameters of the internal carotid and basilar artery was assessed using time of flight magnetic resonance angiography, blood samples were performed after the MRI. Results show that PROG and EST had opposing and spatially distinct effects on CBF: PROG correlated negatively with CBF in anterior brain regions (r = -.86, p < .01), while EST correlations were positive, yet weak and most prominent in posterior areas (r = .78, p < .01). No significant correlations between either hormone or intracranial artery diameter were observed. These results show that EST and PROG have opposing and regionally distinct effects on CBF and that this relationship is likely not due to interactions with large intracranial arteries. Considering that CBF in healthy women appears tightly linked to their current hormonal state, future studies should consider assessing MC-related hormone fluctuations in the design of functional MRI studies in this population.
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Affiliation(s)
- Samantha Cote
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Russell Butler
- Faculty of Arts and Sciences, Department of Computer ScienceBishop's UniversitySherbrookeQuebecCanada
| | - Vincent Michaud
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
| | - Eric Lavallee
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Etienne Croteau
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Sherbrooke Molecular Imaging Center (CIMS), Sherbrooke University Hospital Research Center (CR‐CHUS)SherbrookeQuebecCanada
| | - Adrianna Mendrek
- Faculty of Arts and Sciences, Department of PsychologyBishop's UniversitySherbrookeQuebecCanada
| | - Jean‐Francois Lepage
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Faculty of Medicine and Health Sciences, Department of PediatricsUniversity of SherbrookeSherbrookeQuebecCanada
| | - Kevin Whittingstall
- Faculty of Medicine and Health Sciences, Department of Nuclear Medicine and RadiobiologyUniversity of SherbrookeSherbrookeQuebecCanada
- Department of Diagnostic RadiologyUniversity of SherbrookeSherbrookeQuebecCanada
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Ssali T, Anazodo UC, Narciso L, Liu L, Jesso S, Richardson L, Günther M, Konstandin S, Eickel K, Prato F, Finger E, St Lawrence K. Sensitivity of arterial Spin labeling for characterization of longitudinal perfusion changes in Frontotemporal dementia and related disorders. NEUROIMAGE-CLINICAL 2021; 35:102853. [PMID: 34697009 PMCID: PMC9421452 DOI: 10.1016/j.nicl.2021.102853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
This study demonstrates the value of ASL for longitudinal monitoring of perfusion in FTD patients. Good agreement was found in repeat measures of CBF in patients and controls. Transit times were not a significant source of error for the selected post labeling delay (2 s).
Background Advances in the understanding of the pathophysiology of frontotemporal dementia (FTD) and related disorders, along with the development of novel candidate disease modifying treatments, have stimulated the need for tools to assess the efficacy of new therapies. While perfusion imaging by arterial spin labeling (ASL) is an attractive approach for longitudinal imaging biomarkers of neurodegeneration, sources of variability between sessions including arterial transit times (ATT) and fluctuations in resting perfusion can reduce its sensitivity. Establishing the magnitude of perfusion changes that can be reliably detected is necessary to delineate longitudinal perfusion changes related to disease processes from the effects of these sources of error. Purpose To assess the feasibility of ASL for longitudinal monitoring of patients with FTD by quantifying between-session variability of perfusion on a voxel-by-voxel basis. Methods and materials ASL data were collected in 13 healthy controls and 8 patients with FTD or progressive supra-nuclear palsy. Variability in cerebral blood flow (CBF) by single delay pseudo-continuous ASL (SD-pCASL) acquired one month apart were quantified by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Additionally, CBF by SD-pCASL and ATT by low-resolution multiple inversion time ASL (LowRes-pCASL) were compared to Hadamard encoded sequences which are able to simultaneously measure CBF and ATT with improved time-efficiency. Results Agreement of grey-matter perfusion between sessions was found for both patients and controls (CV = 10.8% and 8.3% respectively) with good reliability for both groups (ICC > 0.6). Intensity normalization to remove day-to-day fluctuations in resting perfusion reduced the CV by 28%. Less than 5% of voxels had ATTs above the chosen post labelling delay (2 s), indicating that the ATT was not a significant source of error. Hadamard-encoded perfusion imaging yielded systematically higher CBF compared to SD-pCASL, but produced similar transit-time measurements. Power analysis revealed that SD-pCASL has the sensitivity to detect longitudinal changes as low as 10% with as few as 10 patient participants. Conclusion With the appropriate labeling parameters, SD-pCASL is a promising approach for assessing longitudinal changes in CBF associated with FTD.
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Affiliation(s)
- Tracy Ssali
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada.
| | - Udunna C Anazodo
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Lucas Narciso
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Linshan Liu
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Sarah Jesso
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Lauryn Richardson
- Lawson Health Research Institute, London, Canada; St. Joseph's Health Care, London, Canada
| | - Matthias Günther
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; University Bremen, Bremen, Germany
| | - Simon Konstandin
- Fraunhofer Institute for Medical Image Computing MEVIS, Bremen, Germany; Mediri GmbH, Heidelberg, Germany
| | | | - Frank Prato
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
| | - Elizabeth Finger
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada; Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Keith St Lawrence
- Lawson Health Research Institute, London, Canada; Department of Medical Biophysics, Western University, London, Canada
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Ramanaidu V, Mustapha AWMM, Noor MHM, Abdullah N. Estimation of time of death using brain parenchyma attenuation in post mortem computed tomography of brain – In malaysian setting. FORENSIC IMAGING 2021. [DOI: 10.1016/j.fri.2021.200470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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49
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Zhang Y, Ma H, Lv X, Han Q. Multimodal MRI Analysis of Brain Metabolism in Maintenance Hemodialysis Patients Based on Cognitive Computing. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7231658. [PMID: 34422245 PMCID: PMC8371624 DOI: 10.1155/2021/7231658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022]
Abstract
This paper investigates cognitive computation of brain metabolism in maintenance hemodialysis patients with multimodal MRI therapy assessment. This paper constructs a cross-individual emotion recognition method using dynamic sample entropy pattern learning. The cross-individual emotion recognition was carried out on subjects using the EEG emotion dataset SEED. The experimental results show that the proposed dynamic sample entropy-based pattern learning has better performance in cross-individual emotion recognition and exhibits better generalization and generalization ability when compared with the results of existing related studies. The constructed cognitive computing method for cross-individual emotion state recognition achieves optimization and innovation of EEG emotion pattern recognition, which can effectively predict people's mental emotion state from EEG signals. We also explore the value of diffusion-weighted magnetic resonance imaging and dynamic enhanced magnetic resonance imaging-based volumetric measurements in assessing the efficacy of neoadjuvant therapy in maintenance hemodialysis patients. We analyze and compare the results of different studies to find the best multimodal MRI to assess the efficacy of neoadjuvant therapy in maintenance hemodialysis patients. The use of ADC value growth rates to assess neoadjuvant efficacy provides the best diagnostic efficacy and allows the screening of patients who respond well to neoadjuvant therapy while avoiding the impact of two different b-value combinations commonly used to assess neoadjuvant efficacy.
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Affiliation(s)
- Yan Zhang
- Magnetic Resonance Room of Imaging Department, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi 721001, China
| | - Hui Ma
- Department of Radiology, Baoji Hi-Tech Hospital, Baoji, Shaanxi 721000, China
| | - Xinguang Lv
- Magnetic Resonance Room of Imaging Department, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi 721001, China
| | - Qinjun Han
- Foreign College of Baoji University of Arts and Sciences, Baoji, Shaanxi 721000, China
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Memel M, Staffaroni AM, Cobigo Y, Casaletto KB, Fonseca C, Bettcher BM, Yassa MA, Elahi FM, Wolf A, Rosen HJ, Kramer JH. APOE moderates the effect of hippocampal blood flow on memory pattern separation in clinically normal older adults. Hippocampus 2021; 31:845-857. [PMID: 33835624 PMCID: PMC8295213 DOI: 10.1002/hipo.23327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/25/2021] [Accepted: 03/07/2021] [Indexed: 11/10/2022]
Abstract
Pattern separation, the ability to differentiate new information from previously experienced similar information, is highly sensitive to hippocampal structure and function and declines with age. Functional MRI studies have demonstrated hippocampal hyperactivation in older adults compared to young, with greater task-related activation associated with worse pattern separation performance. The current study was designed to determine whether pattern separation was sensitive to differences in task-free hippocampal cerebral blood flow (CBF) in 130 functionally intact older adults. Given prior evidence that apolipoprotein E e4 (APOE e4) status moderates the relationship between CBF and episodic memory, we predicted a stronger negative relationship between hippocampal CBF and pattern separation in APOE e4 carriers. An interaction between APOE group and right hippocampal CBF was present, such that greater right hippocampal CBF was related to better lure discrimination in noncarriers, whereas the effect reversed directionality in e4 carriers. These findings suggest that neurovascular changes in the medial temporal lobe may underlie memory deficits in cognitively normal older adults who are APOE e4 carriers.
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Affiliation(s)
- Molly Memel
- San Francisco VA Medical Center, San Francisco, California
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Yann Cobigo
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Corrina Fonseca
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Brianne M. Bettcher
- Department of Neurology, University of Colorado Anschutz Medical Campus, CU Alzheimer’s and Cognition Center, Aurora, Colorado
| | - Michael A. Yassa
- Department of Neurobiology and Behavior and Center for the Neurobiology of Learning and Memory, University of California, Irvine, California
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Amy Wolf
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
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