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Park JW, Kim JT, Lee JS, Kim BJ, Yoo J, Han JH, Kim BJ, Kim CK, Kim JG, Baik SH, Park JM, Kang K, Lee SJ, Park H, Cha JK, Park TH, Lee K, Lee J, Hong KS, Lee BC, Kim DE, Choi JC, Kwon JH, Shin DI, Sohn SI, Lee SH, Ryu WS, Lee J, Bae HJ. Brain Frailty and Outcomes of Acute Minor Ischemic Stroke With Large-Vessel Occlusion. J Clin Neurol 2024; 20:175-185. [PMID: 38171505 PMCID: PMC10921043 DOI: 10.3988/jcn.2023.0181] [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: 05/19/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND AND PURPOSE The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO). METHODS This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0-5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all-cause mortality within 1 year. RESULTS In total, 1,067 patients (age=67.2±13.1 years [mean±SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional-hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1-year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1-year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1-year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03-1.71) and stroke (aHR=1.32, 95% CI=1.00-1.75). CONCLUSIONS The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.
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Affiliation(s)
- Je-Woo Park
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Joon Kim
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Joonsang Yoo
- Department of Neurology, Yongin Severance Hospital, Yongin, Korea
| | - Jung Hoon Han
- Department of Neurology, Korea University Guro Hospital, Seoul, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Seoul, Korea
| | - Jae Guk Kim
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Kyusik Kang
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Soo Joo Lee
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
| | - Hyungjong Park
- Department of Neurology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, Korea
| | - Tai Hwan Park
- Department of Neurology, Seoul Medical Center, Seoul, Korea
| | - Kyungbok Lee
- Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Medical Center, Daegu, Korea
| | - Keun-Sik Hong
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jay Chol Choi
- Department of Neurology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Dong-Ick Shin
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea
| | - Sung Il Sohn
- Department of Neurology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Sang-Hwa Lee
- Department of Neurology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Wi-Sun Ryu
- Artificial Intelligence Research Center, JLK Inc., Seoul, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University, Seoul, Korea
| | - Hee-Joon Bae
- Department of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
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Bown CW, Khan OA, Liu D, Remedios SW, Pechman KR, Terry JG, Nair S, Davis LT, Landman BA, Gifford KA, Hohman TJ, Carr JJ, Jefferson AL. Enlarged perivascular space burden associations with arterial stiffness and cognition. Neurobiol Aging 2023; 124:85-97. [PMID: 36446680 PMCID: PMC9957942 DOI: 10.1016/j.neurobiolaging.2022.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Enlarged perivascular spaces (ePVS) are difficult to quantify, and their etiologies and consequences are poorly understood. Vanderbilt Memory and Aging Project participants (n = 327, 73 ± 7 years) completed 3T brain MRI to quantify ePVS volume and count, longitudinal neuropsychological assessment, and cardiac MRI to quantify aortic stiffness. Linear regressions related (1) PWV to ePVS burden and (2) ePVS burden to cross-sectional and longitudinal neuropsychological performance adjusting for key demographic and medical factors. Higher aortic stiffness related to greater basal ganglia ePVS volume (β = 7.0×10-5, p = 0.04). Higher baseline ePVS volume was associated with worse baseline information processing (β = -974, p = 0.003), executive function (β = -81.9, p < 0.001), and visuospatial performances (β = -192, p = 0.02) and worse longitudinal language (β = -54.9, p = 0.05), information processing (β = -147, p = 0.03), executive function (β = -10.9, p = 0.03), and episodic memory performances (β = -10.6, p = 0.02). Results were similar for ePVS count. Greater arterial stiffness relates to worse basal ganglia ePVS burden, suggesting cardiovascular aging as an etiology. ePVS burden is associated with adverse cognitive trajectory, emphasizing the clinical relevance of ePVS.
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Affiliation(s)
- Corey W Bown
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omair A Khan
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Samuel W Remedios
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Kimberly R Pechman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James G Terry
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sangeeta Nair
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bennett A Landman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John Jeffrey Carr
- Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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3
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Mun J, Kang HM, Jung J, Park C. Role of hydrogen sulfide in cerebrovascular alteration during aging. Arch Pharm Res 2019; 42:446-454. [DOI: 10.1007/s12272-019-01135-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/19/2019] [Indexed: 01/06/2023]
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4
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Zhu H, Li Z, Lv J, Zhao R. Effects of cerebral small vessel disease on the outcome of patients with ischemic stroke caused by large artery atherosclerosis. Neurol Res 2018. [PMID: 29543130 DOI: 10.1080/01616412.2018.1446283] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Hui Zhu
- Medical College, Qingdao University, Qingdao, China
| | - Zhixing Li
- Medical College, Qingdao University, Qingdao, China
| | - Jinglei Lv
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Renliang Zhao
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China
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5
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Zhou D, Meng R, Li SJ, Ya JY, Ding JY, Shang SL, Ding YC, Ji XM. Advances in chronic cerebral circulation insufficiency. CNS Neurosci Ther 2017; 24:5-17. [PMID: 29143463 DOI: 10.1111/cns.12780] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/30/2022] Open
Abstract
Chronic cerebral circulation insufficiency (CCCI) may not be an independent disease; rather, it is a pervasive state of long-term cerebral blood flow insufficiency caused by a variety of etiologies, and considered to be associated with either occurrence or recurrence of ischemic stroke, vascular cognitive impairment, and development of vascular dementia, resulting in disability and mortality worldwide. This review summarizes the features and recent progress of CCCI, mainly focusing on epidemiology, experimental research, pathophysiology, etiology, clinical manifestations, imaging presentation, diagnosis, and potential therapeutic regimens. Some research directions are briefly discussed as well.
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Affiliation(s)
- Da Zhou
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Meng
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Si-Jie Li
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
| | - Jing-Yuan Ya
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jia-Yue Ding
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shu-Ling Shang
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Chuan Ding
- Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xun-Ming Ji
- Departments of Neurology and Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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6
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Xu X, Wang B, Ren C, Hu J, Greenberg DA, Chen T, Xie L, Jin K. Age-related Impairment of Vascular Structure and Functions. Aging Dis 2017; 8:590-610. [PMID: 28966804 PMCID: PMC5614324 DOI: 10.14336/ad.2017.0430] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/30/2017] [Indexed: 12/12/2022] Open
Abstract
Among age-related diseases, cardiovascular and cerebrovascular diseases are major causes of death. Vascular dysfunction is a key characteristic of these diseases wherein age is an independent and essential risk factor. The present work will review morphological alterations of aging vessels in-depth, which includes the discussion of age-related microvessel loss and changes to vasculature involving the capillary basement membrane, intima, media, and adventitia as well as the accompanying vascular dysfunctions arising from these alterations.
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Affiliation(s)
- Xianglai Xu
- 1Zhongshan Hospital, Fudan University, Shanghai 200032, China.,2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | - Brian Wang
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | - Changhong Ren
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA.,4Institute of Hypoxia Medicine, Xuanwu Hospital, Capital Medical University. Beijing, China
| | - Jiangnan Hu
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
| | | | - Tianxiang Chen
- 6Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Liping Xie
- 3Department of Urology, the First Affiliated Hospital, Zhejiang University, Zhejiang Province, China
| | - Kunlin Jin
- 2Department of Pharmacology and Neuroscience, University of North Texas Health Science Center at Fort Worth, TX 76107, USA
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7
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Tang H, Gao Y, Zhang Q, Nie K, Zhu R, Gao L, Feng S, Wang L, Zhao J, Huang Z, Zhang Y, Wang L. Chronic cerebral hypoperfusion independently exacerbates cognitive impairment within the pathopoiesis of Parkinson's disease via microvascular pathologys. Behav Brain Res 2017; 333:286-294. [PMID: 28578987 DOI: 10.1016/j.bbr.2017.05.061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
To date, the role of microvascular pathology and chronic cerebral hypoperfusion (CHH) in the development of mild cognitive impairment in Parkinson's disease (PD-MCI) is unclear. Here, we investigated how the combined injury through interaction of CHH and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity act as an exacerbating element to damagae cognitive fuction in a mouse model. In the present study, C57BL/6 mice underwent MPTP injection. Subjects were classified into a PD with normal cognitive performance (PDCN) group or a PD-MCI group using the Morris Water Maze test. Further, CHH was induced by stenosis of the bilateral common carotid arteries (BCCAs). Consequently, the animals were divided into 7 groups: they are control, sham, BCCAs, PDCN, PD-MCI, PDCN+BCCAs and PD-MCI+BCCAs. The Morris Water Maze test, open field test, histological investigation and western blotting were performed to analyze cerebral microvascular impairment in each group. The results showed that CHH and MPTP injection caused spatial memory and behavioral impairment, accompanied by microvascular impairment and down-regulation of ZO-1 and Occludin at the protein level compared to the control group. The above injuries were synergistically exacerbated in the PDCN+BCCAs group and the PD-MCI+BCCAs group, which paralleled the elevated expression of p-MAPK and p-Akt. In short, our data demonstrate that CHH and MPTP caused cognitive and microvascular impairment separately. Moreover, CHH may exacerbate cognitive impairment in a mouse model of PD. The study provides a new opportunity for understanding the pathogenesis of PD-MCI.
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Affiliation(s)
- Hongmei Tang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China; Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China
| | - Yuyuan Gao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Qingxi Zhang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Kun Nie
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Ruiming Zhu
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Liang Gao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Shujun Feng
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Limin Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Jiehao Zhao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Zhiheng Huang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China.
| | - Lijuan Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute,106 Zhongshan Er Road, Guangzhou, 510080, China.
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8
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Haley MJ, Lawrence CB. The blood-brain barrier after stroke: Structural studies and the role of transcytotic vesicles. J Cereb Blood Flow Metab 2017; 37:456-470. [PMID: 26823471 PMCID: PMC5322831 DOI: 10.1177/0271678x16629976] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/19/2015] [Accepted: 01/08/2016] [Indexed: 01/14/2023]
Abstract
Blood-brain barrier breakdown worsens ischaemic damage, but it is unclear how molecules breach the blood-brain barrier in vivo. Using the obese ob/ob mouse as a model of enhanced blood-brain barrier breakdown, we investigated how stroke-induced structural changes to the microvasculature related to blood-brain barrier permeability. Ob/ob mice underwent middle cerebral artery occlusion, followed by 4 or 24 h reperfusion. Blood-brain barrier integrity was assessed using IgG and horseradish peroxidase staining, and blood-brain barrier structure by two-dimensional and three-dimensional electron microscopy. At 4 and 24 h post-stroke, ob/ob mice had increased ischaemic damage and blood-brain barrier breakdown compared to ob/- controls, and vessels from both genotypes showed astrocyte end-foot swelling and increased endothelial vesicles. Ob/ob mice had significantly more endothelial vesicles at 4 h in the striatum, where blood-brain barrier breakdown was most severe. Both stroke and genotype had no effect on tight junction structure visualised by electron microscopy, or protein expression in isolated microvessels. Astrocyte swelling severity did not correlate with tissue outcome, being unaffected by genotype or reperfusion times. However, the rare instances of vessel lumen collapse were always associated with severe astrocyte swelling in two-dimensional and three-dimensional electron microscopy. Endothelial vesicles were therefore the best spatial and temporal indicators of blood-brain barrier breakdown after cerebral ischaemia.
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Affiliation(s)
- Michael J Haley
- Faculty of Life Sciences, University of Manchester, Manchester, UK
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9
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Wang D, Lin Q, Su S, Liu K, Wu Y, Hai J. URB597 improves cognitive impairment induced by chronic cerebral hypoperfusion by inhibiting mTOR-dependent autophagy. Neuroscience 2016; 344:293-304. [PMID: 28042028 DOI: 10.1016/j.neuroscience.2016.12.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/19/2022]
Abstract
Chronic cerebral hypoperfusion (CCH) is associated with various ischemic cerebrovascular diseases that are characterized by cognitive impairment. The role of autophagy in cognitive dysfunction under conditions of CCH is poorly understood. To address this issue, the present study investigated the effect of the fatty acid amide hydrolase (FAAH) inhibitor URB597 on autophagy and cognition in a CCH model as well as the underlying mechanisms. Cognitive function was evaluated with the Morris water maze and by assessing long-term potentiation (LTP). The expression of autophagy-related proteins and mammalian target of rapamycin (mTOR) signaling pathway components was evaluated by immunofluorescence and western blot analyses, and ultrastructural changes were examined by transmission electron microscopy (EM). URB597 improved cognitive impairment by inhibiting CCH-induced autophagy, which was associated with mTOR signaling. Moreover, the ultrastructural deterioration resulting from CCH was improved by chronic treatment with URB597. These findings indicate that URB597 modulates autophagy in an mTOR-dependent manner, and mitigates neuronal damage and cognitive deterioration caused by CCH.
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Affiliation(s)
- Dapeng Wang
- Department of Neurosurgery, Tong Ji Hospital, Tong Ji University School of Medicine, Shanghai 200065, China
| | - Qi Lin
- Department of Pharmacy, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shaohua Su
- Department of Neurosurgery, Tong Ji Hospital, Tong Ji University School of Medicine, Shanghai 200065, China
| | - Kejia Liu
- Department of Cell Biology, Key Laboratory of Education Ministry for Cell Differentiation and Apoptosis, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yifang Wu
- Department of Neurosurgery, Tong Ji Hospital, Tong Ji University School of Medicine, Shanghai 200065, China
| | - Jian Hai
- Department of Neurosurgery, Tong Ji Hospital, Tong Ji University School of Medicine, Shanghai 200065, China.
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Uranova NA, Zimina IS, Vikhreva OV, Krukov NO, Rachmanova VI, Orlovskaya DD. Ultrastructural damage of capillaries in the neocortex in schizophrenia. World J Biol Psychiatry 2010; 11:567-78. [PMID: 20109113 DOI: 10.3109/15622970903414188] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Neuroimaging studies showed lowered blood flow, glucose metabolic rates and hypoactivation of the prefrontal cortex (PFC) in patients with schizophrenia. The aim of the study was to clear up whether there are abnormalities in the microvasculature in the neocortex in schizophrenia. METHODS Capillaries were studied in PFC (BA 10) and visual cortex (VC) (BA 17) by electron microscopy and morphometry in 26 schizophrenia cases and 26 normal controls. Capillary diameter and areas of capillaries and of pericapillary astrocytic end-feet were estimated in layers I-II of the prefrontal and visual cortices. RESULTS Ultrastructural abnormalities of capillaries in schizophrenia included thickening, deformation of basal lamina, vacuolation of cytoplasm of endothelial cells, basal lamina and astrocytic end-feet, swelling of astrocytic end-feet, of pericapillary oligodendrocytes and signs of activation of microglial cells in both PFC and VC. Capillary diameter and area did not differ significantly between the groups. Area of astrocytic end-feet was significantly higher in PFC (+49%, P<0.001) and in VC (+29%, P<0.01) in schizophrenic group and in different clinical subgroups as compared to controls. CONCLUSIONS Ultrastructural abnormalities of capillaries and of pericapillary cellular environment found suggest that blood-brain barrier dysfunction might contribute to the pathogenesis of cortical lesions in schizophrenia.
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Affiliation(s)
- Natalya A Uranova
- Laboratory of Clinical Neuropathology, Mental Health Research Center, Russian Academy of Medical Sciences, Zagorodnoe shosse 2, Moscow, Russia.
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11
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Shin JS, Hyun SY, Kim DH, Lee S, Jung JW, Choi JW, Ko KH, Kim JM, Ryu JH. Chronic hypoperfusion increases claudin-3 immunoreactivity in rat brain. Neurosci Lett 2008; 445:144-8. [PMID: 18782597 DOI: 10.1016/j.neulet.2008.08.082] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2008] [Revised: 08/23/2008] [Accepted: 08/25/2008] [Indexed: 10/21/2022]
Abstract
Chronic hypoperfusion-induced changes in blood-brain barrier (BBB) tight junction components have not been well studied. In the present study, we investigated the temporal profiles of claudin-3 (a BBB tight junction element) and myleoperoxidase (MPO, a marker of neutrophil infiltration) in the cortical and thalamic regions of rat brain subjected to chronic cerebral hypoperfusion. Chronic cerebral hypoperfusion was induced by an occlusion of two common carotid arteries and the immunoreactivity of claudin-3 or MPO was determined at 1, 2, 3, or 6 weeks after the occlusion. A typical pattern of BBB breakdown was observed from 2 weeks of the occlusion in cortical and thalamic regions based on Evans Blue leakage. Claudin-3 immunoreactivity was increased only in cortical regions after 2 weeks of occlusion. However, after 3 weeks of occlusion, marked increases in claudin-3 immunoreactivity were observed in both cortical and thalamic regions (P<0.05), which persisted for at least 6 weeks after the occlusion despite a slight reduction. In contrast, MPO immunoreactivity was increased only in the thalamic regions after 2 weeks of occlusion. But the pattern of MPO immunoreactivity at 3 and 6 weeks after the occlusion was same as claudin-3. At these time points, MPO immunoreactivity was significantly increased in both cortical and thalamic regions (P<0.05). These results show that chronic cerebral hypoperfusion increases the immunoreactivity of claudin-3 and neutrophil infiltration in cortical and thalamic regions of the brain, and demonstrate changes in BBB tight junction status during chronic cerebral hypoperfusion.
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Affiliation(s)
- Jin Seon Shin
- Department of Oriental Pharmaceutical Science and Kyunghee East-West Pharmaceutical Institute, College of Pharmacy, Kyung Hee University, Hoeki-dong, Dongdaemoon-Ku, Seoul 130-701, Republic of Korea
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Wang C, Mao Y, Zhu JH, Zhou LF. The Department of Neurosurgery at Shanghai Huashan Hospital. Neurosurgery 2008; 62:947-52; discussion 952-3. [PMID: 18496201 DOI: 10.1227/01.neu.0000318181.80040.99] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The Department of Neurosurgery at Shanghai HuaShan Hospital is one of the oldest neurosurgical departments in China and is also one of the country's leading academic neurosurgery programs. The department was established in 1953 under the direction of Yuquan Shi, one of the pioneers and founders of neurosurgery in China, and is currently directed by Liang-Fu Zhou. The HuaShan Neurosurgical Group Hospital and the Shanghai HuaShan Institution of Neurosurgery were established in 2000. The department currently has 67 faculty and 450 beds distributed among one main hospital (HuaShan Hospital) and seven affiliates. More than 8000 neurosurgical procedures are performed annually. The Shanghai Emergency Center of Neurosurgery is also maintained by the department. The Department of Neurosurgery at HuaShan Hospital will continue to grow in strength and position as one of the leaders in the field of neurosurgery.
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Affiliation(s)
- Chen Wang
- Shanghai Clinical Center of Neurosurgery, Shanghai Neurosurgical Emergency Center, Department of Neurosurgery, HuaShan Hospital, Shanghai Medical College, FuDan University, Shanghai, China.
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