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Shi F, Sha L, Li H, Tang Y, Huang L, Liu H, Li X, Li L, Yang W, Kang D, Chen L. Recent progress in patent foramen ovale and related neurological diseases: A narrative review. Front Neurol 2023; 14:1129062. [PMID: 37051056 PMCID: PMC10084837 DOI: 10.3389/fneur.2023.1129062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/20/2023] [Indexed: 03/29/2023] Open
Abstract
Patent foramen ovale (PFO) is a common congenital cardiac abnormality when the opening of the interatrial septum is not closed in adulthood. This abnormality affects 25% of the general population. With the development of precision medicine, an increasing number of clinical studies have reported that PFO is closely related to various neurological diseases such as stroke, migraine, obstructive sleep apnea, and decompression syndrome. It has also been suggested that PFO closure could be effective for preventing and treating these neurological diseases. Therefore, increasing attention has been given to the prevention, diagnosis, and treatment of PFO-related neurological diseases. By reviewing existing literature, this article focuses on the pathogenesis, epidemiology, and clinical characteristics of PFO-related neurological diseases, as well as the prevention and treatment of different neurological diseases to discuss, and aims to provide current progress for this field and decision-making evidence for clinical practice.
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Affiliation(s)
- Fanfan Shi
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Leihao Sha
- Department of Neurology and Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Hua Li
- Department of Neurology and Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Yusha Tang
- Department of Neurology and Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
| | - Litao Huang
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Huizhen Liu
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Xu Li
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Li
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Wenjie Yang
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Deying Kang
- Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Chen
- Department of Neurology and Joint Research Institution of Altitude Health, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Lei Chen
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Zamproni LN, Rubert MCS, Zétola VF, Mader-Joaquim MJ, Lange MC. Cognitive impairment and antiphospholipid syndrome: is paradoxical embolism the rule? Neurol Res 2013; 35:890-4. [DOI: 10.1179/1743132813y.0000000237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Laura N Zamproni
- Neurology Division Hospital de Clínicas from Universidade Federal do Paraná, Curitiba, Brazil
| | - Mauren C S Rubert
- Neurology Division Hospital de Clínicas from Universidade Federal do Paraná, Curitiba, Brazil
| | - Viviane F Zétola
- Neurology Division Hospital de Clínicas from Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Marcos C Lange
- Neurology Division Hospital de Clínicas from Universidade Federal do Paraná, Curitiba, Brazil
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Kim SJ, Shin HY, Ha YS, Kim JW, Kang KW, Na DL, Bang OY. Paradoxical embolism as a cause of silent brain infarctions in healthy subjects: the ICONS study (Identification of the Cause of Silent Cerebral Infarction in Healthy Subjects). Eur J Neurol 2012; 20:353-60. [DOI: 10.1111/j.1468-1331.2012.03864.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/06/2012] [Indexed: 12/20/2022]
Affiliation(s)
- S. J. Kim
- Department of Neurology, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
| | - H. Y. Shin
- Center for Health Promotion, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
| | - Y. S. Ha
- Department of Neurology; Wonkwang University; Jeonbuk; South Korea
| | - J. W. Kim
- Department of Radiology, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
| | - K. W. Kang
- Department of Neurology, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
| | - D. L. Na
- Department of Neurology, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
| | - O. Y. Bang
- Department of Neurology, Samsung Medical Center; Sungkyunkwan University; Seoul; South Korea
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Agustin SJU, Yumul MP, Kalaw AJL, Teo BC, Eng J, Phua Z, Singh R, Gan RN, Venketasubramanian N. Effects of Posture on Right-to-Left Shunt Detection by Contrast Transcranial Doppler. Stroke 2011; 42:2201-5. [DOI: 10.1161/strokeaha.110.609875] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sherwin Joy U. Agustin
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Maricar P. Yumul
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Angelito Jonas L. Kalaw
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Boon Choon Teo
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Johnny Eng
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Ziqun Phua
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Rajinder Singh
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Robert N. Gan
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
| | - Narayanaswamy Venketasubramanian
- From the Research Department (S.J.U.A., A.J.L.K.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology and Psychiatry (M.P.Y.), University Of Santo Tomas Hospital, Manila, Philippines; Neurodiagnostic Laboratory (B.C.T., J.E., Z.P.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Department of Neurology (R.S.), National Neuroscience Institute Tan Tock Seng Hospital Campus, Singapore; Lundbeck International Clinical Research (R
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Mills S, Cain J, Purandare N, Jackson A. Biomarkers of cerebrovascular disease in dementia. Br J Radiol 2008; 80 Spec No 2:S128-45. [PMID: 18445743 DOI: 10.1259/bjr/79217686] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There is increasing recognition that cerebrovascular disease contributes significantly to the development and progression of patients with dementia. The concepts of pure vascular and pure degenerative dementia have been replaced with a recognition that, in many patients, there is a spectrum of neurodegenerative and vascular processes. This is supported by preliminary studies showing response to vascular therapeutics and ventriculo-peritoneal shunting in patients with Alzheimer's disease. This article examines the imaging biomarkers that are available for the characterization of microvascular abnormality in the ageing brain, with particular reference to microvascular angiopathy, cerebral embolic disease, orthostatic hypotension and abnormalities of Monro-Kellie homeostasis.
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Affiliation(s)
- S Mills
- Division of Imaging Science, University of Manchester, Wolfson Molecular Imaging Centre, 27 Palatine Rd, Withington, Manchester, UK
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Clinical and brain magnetic resonance imaging follow-up after percutaneous closure of patent foramen ovale in patients with cryptogenic stroke. Am J Cardiol 2008; 101:1051-5. [PMID: 18359330 DOI: 10.1016/j.amjcard.2007.11.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 11/13/2007] [Accepted: 11/13/2007] [Indexed: 11/17/2022]
Abstract
Patent foramen ovale (PFO) closure is reported to result in fewer episodes of clinically manifest recurrent cerebral ischemia than medical treatment. We evaluated by means of magnetic resonance imaging (MRI) whether silent cerebral ischemic episodes are also decreased by PFO closure. Seventy-one patients with PFO were selected for percutaneous closure of PFO at our center. All had PFO with large right-to-left shunt documented by transcranial Doppler ultrasound and transesophageal echocardiography, > or =1 previous stroke or transient ischemic attack with MRI documentation at the index event, and no alternative cause for cerebral ischemia. MRI studies were performed in all patients 24 hours before the procedure and at 1-year follow-up (or before in the case of a suspected new neurologic event). Eight patients (11%) had >1 clinical event before the procedure. Comparing the 2 MRI studies before the procedure, silent ischemic lesions were observed in 14 other patients (20%). Thus, considering clinical and silent events together, >1 event was present at baseline in 22 patients (31%). After PFO closure (follow-up 16 +/- 7 months), 1 recurrent neurologic event occurred (1%, p = 0.02 vs preprocedural clinical events); however, urgent brain MRI results were negative. Moreover, only 1 patient showed 1 new silent lesion at brain MRI at follow-up (1%, p <0.001 vs preprocedural silent brain lesions). Considering clinical and silent events, relapses occurred in 2 patients only (p <0.001 vs before procedure). Recurrent events were limited to those with incomplete PFO closure at postprocedural transcranial Doppler ultrasound (p = 0.02). In conclusion, percutaneous PFO closure results in few clinical or silent events after 1-year follow-up, especially when complete PFO closure is successfully accomplished.
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