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Araújo JAA, Gomes TC, Lima VCN, Silva YBD, Lino Junior RDS, Vinaud MC. Oxfendazole Nitazoxanide combination in experimental neurocysticercosis - Anti-inflammatory and cysticidal effects. Exp Parasitol 2024; 262:108764. [PMID: 38677580 DOI: 10.1016/j.exppara.2024.108764] [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: 08/28/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
Neurocysticercosis (NCC) is a parasitic infection caused by the larval stage of the pork tapeworm, Taenia solium. The complications of NCC include seizures, headaches, cognitive impairment, and focal neurological deficits. In addition to antiparasitic drugs and surgery, the management of NCC includes the use of corticosteroids to reduce inflammation and control symptoms. The traditional treatment with albendazole and praziquantel has not been altered over 30 years and present several side effects. There are other anti-helminthic drugs such as oxfendazole and nitazoxanide that may show efficacy in NCC treatment. The aim of this study was to determine the histopathologic aspects of experimental NCC after in vivo treatment with the combination of oxfendazole and nitazoxanide. Balb/c mice were infected with T. crassiceps cysticerci and divided into groups of 10 animals each that received a single dose through gavage as follows: group treated with NaCl 0.9% (control group); group treated by monotherapy of the anti-helminthic drugs, 30 mg/kg in single dose of oxfendazole (OXF) or nitazoxanide (NTZ); and groups treated with the combination of the drugs (OXF/NTZ group). Macroscopic and microscopic analysis were performed. There was greater presence of final stage cysticerci after treatment. The microscopic analysis of the general pathological processes showed that the monotherapy with all treatment groups induced higher perivasculitis than what was observed in the control group. In contrast, the combination treatment showed a lower observation of PMN and MN inflammatory infiltration in comparison to the other treatments and to the control one. These results show that indeed the association of benzimidazole derivatives which present both anti-helminthic and anti-inflammatory properties with other cysticidal drugs are beneficial for the NCC treatment in which the aim is to destroy parasite without inducing inflammatory damage in the brain tissue.
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Affiliation(s)
- Jefferson Aber Alves Araújo
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil
| | - Taynara Cristina Gomes
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil
| | - Vanessa Cindy Neres Lima
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil
| | - Yngrid Batista da Silva
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil
| | - Ruy de Souza Lino Junior
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil
| | - Marina Clare Vinaud
- Tropical Pathology and Public Health Institute, Federal University of Goias, Goiânia, Goiás, CEP: 74605-050, Brazil.
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Wei H, Jiang H, Zhou Y, Xiao X, Zhou C, Ji X. Cerebral venous congestion alters brain metabolite profiles, impairing cognitive function. J Cereb Blood Flow Metab 2023; 43:1857-1872. [PMID: 37309740 PMCID: PMC10676144 DOI: 10.1177/0271678x231182244] [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] [Received: 07/26/2022] [Revised: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023]
Abstract
Vascular cognitive impairment (VCI) represents the second most common cause of dementia after Alzheimer's disease, and pathological changes in cerebral vascular structure and function are pivotal causes of VCI. Cognitive impairment caused by arterial ischemia has been extensively studied the whole time; the influence of cerebral venous congestion on cognitive impairment draws doctors' attention in recent clinical practice, but the underlying neuropathophysiological alterations are not completely understood. This study elucidated the specific pathogenetic role of cerebral venous congestion in cognitive-behavioral deterioration and possible electrophysiological mechanisms. Using cerebral venous congestion rat models, we found these rats exhibited decreased long-term potentiation (LTP) in the hippocampal dentate gyrus and impaired spatial learning and memory. Based on untargeted metabolomics, N-acetyl-L-cysteine (NAC) deficiency was detected in cerebral venous congestion rats; supplementation with NAC appeared to ameliorate synaptic deficits, rescue impaired LTP, and mitigate cognitive impairment. In a cohort of cerebral venous congestion patients, NAC levels were decreased; NAC concentration was negatively correlated with subjective cognitive decline (SCD) score but positively correlated with mini-mental state examination (MMSE) score. These findings provide a new perspective on cognitive impairment and support further exploration of NAC as a therapeutic target for the prevention and treatment of VCI.
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Affiliation(s)
- Huimin Wei
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Huimin Jiang
- Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Yifan Zhou
- Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Xuechun Xiao
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Chen Zhou
- Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Xunming Ji
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Beijing Institute of Brain Disorders, Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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3
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Malan L, van Wyk R, von Känel R, Ziemssen T, Vilser W, Nilsson PM, Magnusson M, Jujic A, Mak D, Steyn F, Malan NT. The chronic stress risk phenotype mirrored in the human retina as a neurodegenerative condition. Stress 2023:1-43. [PMID: 37154816 DOI: 10.1080/10253890.2023.2210687] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
The brain is the key organ that orchestrates the stress response which translates to the retina. The retina is an extension of the brain and retinal symptoms in subjects with neurodegenerative diseases substantiated the eye as a window to the brain. The retina is used in this study to determine whether chronic stress reflects neurodegenerative signs indicative of neurodegenerative conditions. A 3-year prospective cohort (n = 333; aged 46 ± 9 years) was stratified into stress-phenotype cases (n = 212) and controls (n = 121) by applying the Malan stress-phenotype index. Neurodegenerative risk markers included ischemia (astrocytic S100 calcium-binding protein B/S100B); 24h blood pressure, proteomics; inflammation (tumor-necrosis-factor-α/TNF-α); neuronal damage (neuron-specific-enolase); anti-apoptosis of retinal-ganglion-cells (beta-nerve-growth-factor), astrocytic activity (glial-fibrillary-acidic-protein); hematocrit (viscosity) and retinal follow-up data [vessels; stress-optic-neuropathy]. Stress-optic-neuropathy risk was calculated from two indices: a newly derived diastolic-ocular-perfusion-pressure cut-point ≥68 mmHg relating to the stress-phenotype; combined with an established cup-to-disc ratio cut-point ≥0.3. Higher stress-optic-neuropathy (39% vs. 17%) and hypertension (73% vs. 16%) prevalence was observed in the stress-phenotype cases vs. controls. Elevated diastolic-ocular-perfusion-pressure, indicating hypoperfusion, was related to arterial narrowing and trend for ischemia increases in the stress-phenotype. Ischemia in the stress-phenotype at baseline, follow-up and 3-yr changes was related to consistent inflammation (TNF-α and cytokine-interleukin-17-receptor-A), neuron-specific-enolase increases, consistent apoptosis (chitinase 3-like-1, low beta-nerve-growth-factor), glial-fibrillary-acidic-protein decreases, elevated viscosity, vein widening as risk marker of endothelial dysfunction in the blood-retinal-barrier, lower vein count, and elevated stress-optic-neuropathy. The stress-phenotype and related neurodegenerative signs of ongoing brain ischemia, apoptosis and endothelial dysfunction compromised blood-retinal-barrier permeability and optic nerve integrity. In fact, the stress-phenotype could identify persons at high risk of neurodegeneration to indicate a neurodegenerative condition.
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Affiliation(s)
- Leoné Malan
- Technology Transfer and Innovation-Support Office; Private Bag X1290, North-West University, Potchefstroom 2520, South Africa
| | - Roelof van Wyk
- Surgical Ophthalmologist; 85 Peter Mokaba Street, Potchefstroom, South Africa
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich; University of Zurich; Zurich Switzerland
| | - Tjalf Ziemssen
- Autonomic and Neuroendocrinological Laboratory Dresden, University Hospital Carl Gustav Carus; Technische Universität Dresden, Germany
| | - Walthard Vilser
- Institute of Biomedical Engineering and informatics; Technical University Ilmenau, Germany
- Department of Pediatrics and Adolescent Medicine, Section Neonatalogy; University Hospital, Jena, Germany
| | - Peter M Nilsson
- Department of Clinical Sciences, Lund University; Malmö, Sweden
| | - Martin Magnusson
- Department of Clinical Sciences, Lund University; Malmö, Sweden
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa
- Department of Cardiology; Skåne University Hospital, Malmö, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University; Malmö Sweden
| | - Amra Jujic
- Department of Clinical Sciences, Lund University; Malmö, Sweden
| | - Daniel Mak
- Centre for Regenerative Medicine and Health; Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong, SAR, People's Republic of China
| | - Faans Steyn
- Statistical Consultation Services; North-West University, Potchefstroom, South Africa
| | - Nico T Malan
- Technology Transfer and Innovation-Support Office; Private Bag X1290, North-West University, Potchefstroom 2520, South Africa
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Rana V, Kim E, Rana S, Janigian RH, Bakaeva T, Saade C. Pediatric Central Retinal Vein Occlusion Secondary to Concurrent Mechanisms of Optic Neuritis and Antiphospholipid Syndrome. JOURNAL OF VITREORETINAL DISEASES 2023; 7:245-248. [PMID: 37188213 PMCID: PMC10170615 DOI: 10.1177/24741264231153614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Purpose: To report a pediatric case of optic neuritis with subsequent development of central retinal vein occlusion (CRVO). Methods: A case and its findings were analyzed. Results: A 16-year-old boy presented with painful vision loss in the left eye, an afferent pupillary defect, and optic disc edema. Magnetic resonance imaging showed optic nerve enhancement and contrast-enhancing cerebral white-matter lesions, consistent with optic neuritis and demyelinating disease. He received intravenous methylprednisolone followed by a prednisone taper. At the 3-week follow-up, the visual acuity (VA) in the left eye had worsened and fundoscopic examination showed a new CRVO. A hypercoagulable workup showed antiphospholipid syndrome, which was treated with warfarin. He received intravitreal antivascular endothelial growth factor treatment with subsequent improvement in VA and resolution of the macular edema. Conclusions: This case describes an unusual mechanism for CRVO via a combination of optic disc edema from optic neuritis and hypercoagulability from antiphospholipid syndrome. It is important to recognize this complication of optic disc edema and the necessary workup for a pediatric CRVO.
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Affiliation(s)
- Viren Rana
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Eric Kim
- Warren Alpert Medical School, Providence, RI, USA
| | - Shivani Rana
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Robert H. Janigian
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Tatiana Bakaeva
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Celine Saade
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Wiedmann M, Skattør T, Stray-Pedersen A, Romundstad L, Antal EA, Marthinsen PB, Sørvoll IH, Leiknes Ernstsen S, Lund CG, Holme PA, Johansen TO, Brunborg C, Aamodt AH, Schultz NH, Skagen K, Skjelland M. Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series. Front Neurol 2021; 12:721146. [PMID: 34393988 PMCID: PMC8363077 DOI: 10.3389/fneur.2021.721146] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was the rapid and severe progression of disease in spite of maximum treatment efforts, resulting in fatal outcome in for 4 out of 5 patients. All cases had received ChAdOx1 nCov-19 vaccine 1–2 weeks earlier and developed a characteristic syndrome thereafter. The rapid progressive clinical course and high fatality rate of CVT in combination with thrombocytopenia in such a cluster and in otherwise healthy adults is a recent phenomenon. Cerebral autopsy findings were those of venous hemorrhagic infarctions and thrombi in dural venous sinuses, including thrombus material apparently rich in thrombocytes, leukocytes and fibrin. Vessel walls were free of inflammation. Extra-cerebral manifestations included leech-like thrombi in large veins, fibrin clots in small venules and scattered hemorrhages on skin and membranes. CVT with thrombocytopenia after adenovirus vectored COVID-19 vaccination is a new clinical syndrome that needs to be recognized by clinicians, is challenging to treat and seems associated with a high mortality rate.
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Affiliation(s)
- Markus Wiedmann
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Thor Skattør
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Arne Stray-Pedersen
- Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway
| | - Luis Romundstad
- Department of Anesthesiology and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen-Ann Antal
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Pål Bache Marthinsen
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Ingvild Hausberg Sørvoll
- Norwegian National Unit for Platelet Immunology at University Hospital of North Norway, Tromsø, Norway
| | - Siw Leiknes Ernstsen
- Norwegian National Unit for Platelet Immunology at University Hospital of North Norway, Tromsø, Norway
| | | | - Pål Andre Holme
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway.,Department of Haematology, Oslo University Hospital, Oslo, Norway
| | | | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | | | - Nina Haagenrud Schultz
- Department of Haematology, Oslo University Hospital, Oslo, Norway.,Department of Haematology, Akershus University Hospital, Lillestrøm, Norway
| | - Karolina Skagen
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Mona Skjelland
- Faculty of Medicine, Institute of Clinical Medicine, University in Oslo, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
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6
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Lalou AD, Czosnyka M, Czosnyka ZH, Krishnakumar D, Pickard JD, Higgins NJ. Coupling of CSF and sagittal sinus pressure in adult patients with pseudotumour cerebri. Acta Neurochir (Wien) 2020; 162:1001-1009. [PMID: 31832847 PMCID: PMC7156361 DOI: 10.1007/s00701-019-04095-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Pseudotumour cerebri syndrome (PTCS including idiopathic intracranial hypertension) is characterised by the symptoms and signs of raised cerebrospinal fluid pressure (CSFp) in the absence of ventricular dilatation or an intracranial mass lesion. Its aetiology is unknown in the majority of cases but there is much evidence for impaired CSF absorption. Traditionally, sagittal sinus pressure has been considered to be independent of CSF pressure in adults. However, the discovery of stenoses of intracranial venous sinuses and introduction of venous sinus stenting has highlighted the importance of the venous drainage in PTCS. In this study, we have explored the relationship between CSFp and SSp before and during a CSF infusion test and during CSF drainage. MATERIALS AND METHODS Ten patients (9 females:1 male) with PTCS underwent infusion studies in parallel with direct retrograde cerebral venography. Both SSp and CSFp were recorded at a baseline and during CSFp elevation in a course of a CSF infusion test. The drainage of CSF after the CSF infusion was performed in 7 patients. In 5 cases, jugular venous pressure was also measured. RESULTS CSFp and SSp including their amplitudes correlated significantly and strongly both at baseline (R = 0.96; p = 0.001) and during infusion (R = 0.92; p = 0.0026). During drainage, this correlation was maintained until SSp reached a stable value, whereas CSFp continued to decrease. CONCLUSIONS In this series of ten patients with PTCS, CSFp and SSp were coupled, both at baseline and during infusion. The implications of such coupling for the calculation of CSF outflow resistance are discussed.
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Affiliation(s)
- Afroditi-Despina Lalou
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, UK.
| | - Marek Czosnyka
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, UK
| | - Zofia H Czosnyka
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, UK
| | - Deepa Krishnakumar
- Department of Paediatric Neurology, Cambridge University Hospital, Cambridge, UK
| | - John D Pickard
- Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge University Hospital, Cambridge, UK
| | - Nick J Higgins
- Department of Radiology, Addenbrooke's Hospital, Cambridge, UK
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7
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Meyer H, Zimmermann S, Hissbach J, Klusmann D, Hampe W. Selection and academic success of medical students in Hamburg, Germany. BMC MEDICAL EDUCATION 2019; 19:23. [PMID: 30651098 PMCID: PMC6335698 DOI: 10.1186/s12909-018-1443-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/26/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND Student selection at Hamburg medical school is based on the combination of a natural science knowledge test (HAM-Nat) and pre-university educational attainment. METHOD Of the 1565 medical students enrolled in Hamburg from 2012 to 2015 about half were admitted by an entrance test, half by quotas. First, we analysed sociodemographic determinants of entrance test performance. Then, we used regression analysis to describe the interplay of variables in the prediction of study outcome, the role of sociodemographic factors, and differences in the calibration of educational attainment specific to German federal states. RESULTS Better performance in the entrance test was associated with age over 21, male gender, German nationality, first language German and both parents holding an academic degree - effect sizes were small. No differences were found for the birthplaces of parents (a proxy for migration background). Study outcome differed considerably among admission paths: Students admitted by entrance test or the quota for excellent pre-university educational attainment performed markedly better during the first 3 terms than students admitted by the waiting list quota and the quota for foreign students. Gender differences in study outcome were slight with better performance by males. The relation of pre-university educational attainment to study outcome was moderated by the federal state in which secondary schooling took place. Methods for the equating of state-specific grades are explored. The predictive validity of the HAM-Nat after correction for range restriction was r = .31. The relatively low value of this coefficient may be attributed to 3 factors: 1. self-selection of applicants which leads to a validity-enhancing effect that is not revealed by the predictor-outcome correlation, 2. reduction of variance due to a high selection ratio, and 3. high test difficulty, exceeding the demands of the medical curriculum. CONCLUSION The HAM-Nat achieves a small amount of incremental validity over pre-university educational attainment. This effect, obtained from correlational analysis, underestimates the validity of the test, because it does not reflect the role of self-selection and other validity enhancing features of the selection process.
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Affiliation(s)
- Hubertus Meyer
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr, 52, 20246 Hamburg, Germany
| | - Stefan Zimmermann
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr, 52, 20246 Hamburg, Germany
| | - Johanna Hissbach
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr, 52, 20246 Hamburg, Germany
| | - Dietrich Klusmann
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr, 52, 20246 Hamburg, Germany
| | - Wolfgang Hampe
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr, 52, 20246 Hamburg, Germany
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8
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Marchetti G, Ziliotto N, Meneghetti S, Baroni M, Lunghi B, Menegatti E, Pedriali M, Salvi F, Bartolomei I, Straudi S, Manfredini F, Voltan R, Basaglia N, Mascoli F, Zamboni P, Bernardi F. Changes in expression profiles of internal jugular vein wall and plasma protein levels in multiple sclerosis. Mol Med 2018; 24:42. [PMID: 30134823 PMCID: PMC6085618 DOI: 10.1186/s10020-018-0043-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background Multiple sclerosis (MS) is an inflammatory, demyelinating and degenerative disorder of the central nervous system (CNS). Several observations support interactions between vascular and neurodegenerative mechanisms in multiple sclerosis (MS). To investigate the contribution of the extracranial venous compartment, we analysed expression profiles of internal jugular vein (IJV), which drains blood from CNS, and related plasma protein levels. Methods We studied a group of MS patients (n = 19), screened by echo-color Doppler and magnetic resonance venography, who underwent surgical reconstruction of IJV for chronic cerebrospinal venous insufficiency (CCSVI). Microarray-based transcriptome analysis was conducted on specimens of IJV wall from MS patients and from subjects undergoing carotid endarterectomy, as controls. Protein levels were determined by multiplex assay in: i) jugular and peripheral plasma from 17 MS/CCSVI patients; ii) peripheral plasma from 60 progressive MS patients, after repeated sampling and iii) healthy individuals. Results Of the differentially expressed genes (≥ 2 fold-change, multiple testing correction, P < 0.05), the immune-related CD86 (8.5 fold-change, P = 0.002) emerged among the up regulated genes (N = 409). Several genes encoding HOX transcription factors and histones potentially regulated by blood flow, were overexpressed. Smooth muscle contraction and cell adhesion processes emerged among down regulated genes (N = 515), including the neuronal cell adhesion L1CAM as top scorer (5 fold-change, P = 5 × 10− 4). Repeated measurements in jugular/peripheral plasma and overtime in peripheral plasma showed conserved individual plasma patterns for immune-inflammatory (CCL13, CCL18) and adhesion (NCAM1, VAP1, SELL) proteins, despite significant variations overtime (SELL P < 0.0001). Both age and MS disease phenotypes were determinants of VAP1 plasma levels. Data supported cerebral related-mechanisms regulating ANGPT1 levels, which were remarkably lower in jugular plasma and correlated in repeated assays but not between jugular/peripheral compartments. Conclusions This study provides for the first time expression patterns of the IJV wall, suggesting signatures of altered vascular mRNA profiles in MS disease also independently from CCSVI. The combined transcriptome-protein analysis provides intriguing links between IJV wall transcript alteration and plasma protein expression, thus highlighting proteins of interest for MS pathophysiology. Electronic supplementary material The online version of this article (10.1186/s10020-018-0043-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giovanna Marchetti
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, via Fossato di Mortara n 74, 44121, Ferrara, Italy.
| | - Nicole Ziliotto
- Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Silvia Meneghetti
- Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Marcello Baroni
- Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Barbara Lunghi
- Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Erica Menegatti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Massimo Pedriali
- Department of Experimental and Diagnostic Medicine, Sant'Anna University- Hospital, Ferrara, Italy
| | - Fabrizio Salvi
- Center for Immunological and Rare Neurological Diseases, Bellaria Hospital, IRCCS of Neurological Sciences, Bologna, Italy
| | - Ilaria Bartolomei
- Center for Immunological and Rare Neurological Diseases, Bellaria Hospital, IRCCS of Neurological Sciences, Bologna, Italy
| | - Sofia Straudi
- Department of Neurosciences and Rehabilitation, Sant'Anna University- Hospital, Ferrara, Italy
| | - Fabio Manfredini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, via Fossato di Mortara n 74, 44121, Ferrara, Italy
| | - Rebecca Voltan
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Nino Basaglia
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, via Fossato di Mortara n 74, 44121, Ferrara, Italy
| | - Francesco Mascoli
- Unit of Vascular and Endovascular Surgery, S. Anna University-Hospital, Ferrara, Italy
| | - Paolo Zamboni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Francesco Bernardi
- Department of Life Science and Biotechnology, University of Ferrara, Ferrara, Italy
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9
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Tong LS, Guo ZN, Ou YB, Yu YN, Zhang XC, Tang J, Zhang JH, Lou M. Cerebral venous collaterals: A new fort for fighting ischemic stroke? Prog Neurobiol 2017; 163-164:172-193. [PMID: 29199136 DOI: 10.1016/j.pneurobio.2017.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/03/2017] [Accepted: 11/28/2017] [Indexed: 12/13/2022]
Abstract
Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae. Further exploration of the multi-faceted function of cerebral venous system may add new implications for stroke outcome prediction and future therapeutic decision-making. In this review, we emphasize the anatomical and functional characteristics of the cerebral venous system and illustrate its necessity in facilitating the arterial infusion and maintaining the cerebral perfusion in the pathological stroke content. We then summarize the recent critical clinical studies that underscore the associations between cerebral venous collateral and outcome of ischemic stroke with advanced imaging techniques. A novel three-level venous system classification is proposed to demonstrate the distinct characteristics of venous collaterals in the setting of ischemic stroke. Finally, we discuss the current directions for assessment of cerebral venous collaterals and provide future challenges and opportunities for therapeutic strategies in the light of these new concepts.
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Affiliation(s)
- Lu-Sha Tong
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China; Departments of Physiology, Loma Linda University, School of Medicine, CA, USA
| | - Zhen-Ni Guo
- Department of Neurology, The First Affiliated Hospital of Jilin University, Changchun, China; Departments of Physiology, Loma Linda University, School of Medicine, CA, USA
| | - Yi-Bo Ou
- Department of Neurosurgery, Tong-ji Hospital, Wuhan, China; Departments of Physiology, Loma Linda University, School of Medicine, CA, USA
| | - Yan-Nan Yu
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xiao-Cheng Zhang
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Jiping Tang
- Department of Anesthesiology, Loma Linda University, School of Medicine, CA, USA
| | - John H Zhang
- Departments of Physiology, Loma Linda University, School of Medicine, CA, USA.
| | - Min Lou
- Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
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10
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Ma M, Chen JY, Plowey ED, Fischbein N, Iv M. Tumefactive demyelination associated with developmental venous anomaly: Report of two cases. Clin Imaging 2017; 43:194-198. [PMID: 28364723 DOI: 10.1016/j.clinimag.2017.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/25/2017] [Indexed: 11/18/2022]
Abstract
We present two cases of tumefactive demyelination (TD) occurring in close association with a developmental venous anomaly (DVA). Our purpose is to describe the association between demyelinating lesions and venous anomalies, as only one case of TD associated with a DVA has been published in the literature. Appropriate recognition of this "do not touch" lesion may avoid invasive and potentially harmful procedures such as biopsy or resection.
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Affiliation(s)
- Mingming Ma
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States.
| | - James Y Chen
- Department of Radiology, University of California San Diego, San Diego, CA
| | - Edward D Plowey
- Department of Pathology, Stanford University Medical Center, Stanford, CA, United States
| | - Nancy Fischbein
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States
| | - Michael Iv
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States
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11
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Sisó S, Marco-Salazar P, Moore PF, Sturges BK, Vernau W, Wisner ER, Bollen AW, Dickinson PJ, Higgins RJ. Canine Nervous System Lymphoma Subtypes Display Characteristic Neuroanatomical Patterns. Vet Pathol 2016; 54:53-60. [DOI: 10.1177/0300985816658101] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Primary and secondary nervous system involvement occurs in 4% and 5%–12%, respectively, of all canine non-Hodgkin lymphomas. The recent new classification of canine malignant lymphomas, based on the human World Health Organization classification, has been endorsed with international acceptance. This histological and immunocytochemical classification provides a unique opportunity to study the histologic anatomic distribution patterns in the central and peripheral nervous system of these defined lymphoma subtypes. In this study, we studied a cohort of 37 dogs with lymphoma, which at necropsy had either primary (n = 1, 2.7%) or secondary (n = 36; 97.3%) neural involvement. These T- (n = 16; 43.2%) or B-cell (n = 21; 56.8%) lymphomas were further classified into 12 lymphoma subtypes, with predominant subtypes including peripheral T-cell lymphoma (PTCL) or diffuse large B-cell lymphoma (DLBCL), respectively. This systematic study identified 6 different anatomically based histologically defined patterns of lymphoma infiltration in the nervous system of dogs. Different and distinct combinations of anatomical patterns correlated with specific lymphoma subtypes. Lymphoma infiltration within the meningeal, perivascular, and periventricular compartments were characteristic of DLBCL, whereas peripheral nerve involvement was a frequent feature of PTCL. Similarly cell counts above 64 cells/μL in cerebrospinal samples correlated best with marked meningeal and periventricular lymphoma infiltration histologically. Prospective studies are needed in order to confirm the hypothesis that these combinations of histological neuroanatomic patterns reflect targeting of receptors specific for the lymphoma subtypes at these various sites.
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Affiliation(s)
- S. Sisó
- Departments of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - P. Marco-Salazar
- Centro VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - P. F. Moore
- Departments of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - B. K. Sturges
- Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - W. Vernau
- Departments of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - E. R. Wisner
- Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - A. W. Bollen
- Neuropathology Division, Department of Pathology, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - P. J. Dickinson
- Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - R. J. Higgins
- Departments of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
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12
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van Geemen D, Smeets MWJ, van Stalborch AMD, Woerdeman LAE, Daemen MJAP, Hordijk PL, Huveneers S. F-actin-anchored focal adhesions distinguish endothelial phenotypes of human arteries and veins. Arterioscler Thromb Vasc Biol 2014; 34:2059-67. [PMID: 25012130 DOI: 10.1161/atvbaha.114.304180] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Vascular endothelial-cadherin- and integrin-based cell adhesions are crucial for endothelial barrier function. Formation and disassembly of these adhesions controls endothelial remodeling during vascular repair, angiogenesis, and inflammation. In vitro studies indicate that vascular cytokines control adhesion through regulation of the actin cytoskeleton, but it remains unknown whether such regulation occurs in human vessels. We aimed to investigate regulation of the actin cytoskeleton and cell adhesions within the endothelium of human arteries and veins. APPROACH AND RESULTS We used an ex vivo protocol for immunofluorescence in human vessels, allowing detailed en face microscopy of endothelial monolayers. We compared arteries and veins of the umbilical cord and mesenteric, epigastric, and breast tissues and find that the presence of central F-actin fibers distinguishes the endothelial phenotype of adult arteries from veins. F-actin in endothelium of adult veins as well as in umbilical vasculature predominantly localizes cortically at the cell boundaries. By contrast, prominent endothelial F-actin fibers in adult arteries anchor mostly to focal adhesions containing integrin-binding proteins paxillin and focal adhesion kinase and follow the orientation of the extracellular matrix protein fibronectin. Other arterial F-actin fibers end in vascular endothelial-cadherin-based endothelial focal adherens junctions. In vitro adhesion experiments on compliant substrates demonstrate that formation of focal adhesions is strongly induced by extracellular matrix rigidity, irrespective of arterial or venous origin of endothelial cells. CONCLUSIONS Our data show that F-actin-anchored focal adhesions distinguish endothelial phenotypes of human arteries from veins. We conclude that the biomechanical properties of the vascular extracellular matrix determine this endothelial characteristic.
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Affiliation(s)
- Daphne van Geemen
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Michel W J Smeets
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Anne-Marieke D van Stalborch
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Leonie A E Woerdeman
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Mat J A P Daemen
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Peter L Hordijk
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.)
| | - Stephan Huveneers
- From the Department of Molecular Cell Biology, Sanquin Research and Swammerdam Institute for Life Sciences, Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (D.v.G., M.W.J.S., A.-M.D.v.S., P.L.H., S.H.); Department of Plastic and Reconstructive Surgery, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands (L.A.E.W.); and Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M.J.A.P.D.).
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13
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Facchini L, Bellin A, Toro E. A mathematical model for filtration and macromolecule transport across capillary walls. Microvasc Res 2014; 94:52-63. [DOI: 10.1016/j.mvr.2014.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/23/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
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14
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Zivadinov R. Is there a link between the extracranial venous system and central nervous system pathology? BMC Med 2013; 11:259. [PMID: 24344725 PMCID: PMC3866248 DOI: 10.1186/1741-7015-11-259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 12/05/2013] [Indexed: 11/12/2022] Open
Abstract
The extracranial venous system is complex and variable between individuals. Until recently, these variations were acknowledged as developmental variants and were not considered pathological findings. However, in the last decade, the presence and severity of uni- or bi-lateral jugular venous reflux (JVR) was linked to several central nervous system (CNS) disorders such as transient global amnesia, transient monocular blindness, cough headache, primary exertional headache and, most recently, to Alzheimer's disease. The most recent introduction of a composite criteria-based vascular condition named chronic cerebrospinal venous insufficiency (CCSVI), which was originally linked to multiple sclerosis, increased the interest in better understanding the role of the extracranial venous system in the pathophysiology of CNS disorders. The ultimate cause-consequence relationship between these conditions and CNS disorders has not been firmly established and further research is needed. The purpose of this article collection in BMC Medicine and BMC Neurology is to synthesize current concepts and most recent findings concerning the evaluation, etiology, pathophysiology and clinical relevance of the potential involvement of the extracranial venous system in the pathology of multiple CNS disorders and in aging.
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Affiliation(s)
- Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
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