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Luo BL, He SP, Zhang YF, Yang QW, Zhuang JC, Zhu RJ, Zheng YQ, Su HM. Correlation between matrix metalloproteinase-2, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinases-1 and white matter hyperintensities in patients with cerebral small vessel disease based on cranial magnetic resonance 3D imaging. Magn Reson Imaging 2024; 113:110213. [PMID: 39053592 DOI: 10.1016/j.mri.2024.110213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/17/2024] [Accepted: 07/20/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the correlation between serum levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinases-1 (TIMP-1) levels and their ratios with the severity of white matter hyperintensities (WMHs) in patients with cerebral small vessel disease (CSVD). METHODS This cross-sectional study was done on a prospective cohort of patients with CSVD. Qualitative and quantitative analyses of WMHs were performed using Fazekas grading and lesion prediction algorithm (LPA) methods. Biomarkers MMP-2, MMP-9, and TIMP-1 were measured to explore their correlation with the severity of WMHs. RESULTS The sample consisted of 144 patients with CSVD. There were 63 male and 81 female patients, with an average age of 67.604 ± 8.727 years. Among these, 58.33% presented with white matter hyperintensities at Fazekas grading level 1, with an average total template volume of WMHs of 4.305 mL. MMP-2 (P = 0.025), MMP-9 (P = 0.008), TIMP-1 (P = 0.026), and age (P = 0.007) were identified as independent correlates of WMHs based on Fazekas grading. Independent correlates of the total template volume of WMHs included MMP-2 (P = 0.023), TIMP-1 (P = 0.046), age (P = 0.047), systolic blood pressure (P = 0.047), and homocysteine (Hcy) (P = 0.014). In addition, age (P = 0.003; P < 0.001), interleukin-6 (IL-6) (P < 0.001; P = 0.044), Hcy (P < 0.001; P < 0.001), glycated hemoglobin (HbA1c) (P = 0.016; P = 0.043), and chronic kidney disease (P < 0.001; P < 0.001) were associated with both WMHs Fazekas grading and the total template volume of WMHs. CONCLUSION Serum levels of MMP-9, MMP-2, and TIMP-1 were independently associated with the Fazekas grading, while serum TIMP-1 and MMP-2 levels were independently related to the total template volume of WMHs. The association of TIMP-1 and MMP-2 with the severity of CSVD-related WMHs suggests their potential role as disease-related biomarkers. However, further research is required to uncover the specific mechanisms underlying these interactions.
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Affiliation(s)
- Bei-Lin Luo
- The Graduate School of Fujian Medical University, Fuzhou 350000, China; Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
| | - Shun-Po He
- Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
| | - Yi-Fen Zhang
- The Graduate School of Fujian Medical University, Fuzhou 350000, China; Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
| | - Qing-Wei Yang
- The Graduate School of Fujian Medical University, Fuzhou 350000, China; Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China.
| | - Jing-Cong Zhuang
- Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China.
| | - Ren-Jing Zhu
- Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
| | - Ya-Qin Zheng
- Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
| | - Hua-Mei Su
- Department of Neurology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, Fujian, China
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Zhang T, Lv H, Zhao X, Zeng N, Hui Y, Chen S, Wu N, Xu M, Wu Y, Xing A, Shi H, Zhang S, Liang X, Wang Y, Wu S, Cui L, Wang Z, Liu Y. Serum uric acid is associated with midbrain enlarged perivascular spaces: Results from Multi-modality Medical imaging sTudy bAsed on KaiLuan Study (META-KLS). Prog Neuropsychopharmacol Biol Psychiatry 2024; 133:111000. [PMID: 38580007 DOI: 10.1016/j.pnpbp.2024.111000] [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: 12/07/2023] [Revised: 03/15/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Serum uric acid (SUA) is a major cause of cardiovascular and cerebrovascular diseases. Whether and to what extent the excess risk of enlarged perivascular spaces (EPVS) conferred by SUA is unknown. The study was conducted to investigate the association between SUA and EPVS in different brain regions. METHODS Data are from Multi-modality medical imaging study based on Kailuan study (META-KLS) in this cross-sectional study. Participants were divided into five groups based on SUA levels, and EPVS in basal ganglia (BG), centrum semiovale (CSO) and midbrain (MB) was systematically assessed and divided into Low and High group. Odds ratio (OR) and 95% confidence intervals (95% CIs) for high EPVS outcomes were estimated using multivariable logistic regression analysis. Restricted cubic spline (RCS) was used to further investigate dose-response relationship. RESULTS A total of 1014 participants aged 25-83 years from 11 centers were enrolled in the study. In the multivariable-adjusted model, SUA, as an independent risk factor, correlated positively with high degree of MB-EPVS (OR, 1.002; 95% CI, 1.000 to 1.004; p = 0.023) in general population. In addition, RCS further demonstrated the linear association between SUA and MB-EPVS (p = 0.072). No association was found between SUA and BG-EPVS or CSO-EPVS. CONCLUSION SUA was an independent risk factor of MB-EPVS. High SUA levels were more predictive of increased risk occurrence of high degree of MB-EPVS, supporting a linear association between SUA and MB-EPVS and further indicating that SUA may play an important role in cerebral small vessel disease. TRIAL REGISTRATION The KaiLuan Study and META-KLS were registered online (ChiCTR2000029767 on chictr.org.cn and NCT05453877 on Clinicaltrials.gov, respectively).
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Affiliation(s)
- Tong Zhang
- Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinyu Zhao
- Clinical Epidemiology & EBM Unit, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Na Zeng
- School of Public Health, Peking University, Beijing, China
| | - Ying Hui
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuohua Chen
- Department of Cardiovascular Lab, Kailuan General Hospital, Tangshan, Hebei, China
| | - Ning Wu
- Department of Medical Imaging, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Mingze Xu
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Beijing Intelligent Brain Cloud Inc, Beijing, China
| | - YunTao Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Huijing Shi
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shun Zhang
- Department of Psychiatry, Kailuan Mental Health Center, Tangshan, Hebei, China
| | - Xiaoliang Liang
- Department of Psychiatry, Kailuan Mental Health Center, Tangshan, Hebei, China
| | - Yongxin Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of MR, Kailuan General Hospital, Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Liufu Cui
- Department of Rheumatology and Immunology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Yanying Liu
- Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Xu C, Xia J, Qiang Y, Wu Y. Relationship between burden of cerebral small vessel disease on imaging and cognitive impairment of COPD patients. J Neurosci Methods 2024; 410:110218. [PMID: 38996845 DOI: 10.1016/j.jneumeth.2024.110218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVE This study aims to explore the relationship between the burden of cerebral small vessel disease (CSVD) on imaging and cognitive impairment (CI) in patients with chronic obstructive pulmonary disease (COPD). METHODS The study included 118 COPD patients admitted to Changxing People's Hospital between July 2020 and July 2023. All patients received a 1.5 T MRI of the brain and pulmonary function tests. A cognitive function assessment was conducted via the Montreal Cognitive Assessment (MoCA) scale, and patients were divided into two groups. The relationship between the MoCA and CSVD burden score was analyzed by Pearson correlation, and to identify risk factors, multiple logistic regression analysis was performed. RESULTS The study showed a negative correlation between the MoCA and CSVD burden score in COPD patients (r=-0.479, P<0.001). Multiple logistic regression analysis found that age (OR=2.264, 95 % CI: 1.426-3.596, P<0.001), COPD grade (OR=3.139, 95 % CI: 2.012-4.898, P<0.001), as well as CSVD burden score (OR=5.336, 95 % CI: 1.191-23.900, P<0.001) were the independent risk factors for CI in COPD patients (P<0.05). CONCLUSION When screening for cognitive impairment in COPD patients, the CSVD burden score can be used in conjunction with cognitive assessment scales to make judgments.
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Affiliation(s)
- Chentao Xu
- Department of Radiology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Jinjin Xia
- Department of Neurology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Yanfei Qiang
- Department of Respiration, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
| | - Yingzhe Wu
- Department of Radiology, Changxing People's Hospital, Huzhou, Zhejiang 313100, China.
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Wang S, Yang S, Liang D, Qin W, Yang L, Li X, Hu W. Association between enlarged perivascular spaces in basal ganglia and cerebral perfusion in elderly people. Front Neurol 2024; 15:1428867. [PMID: 39036638 PMCID: PMC11259966 DOI: 10.3389/fneur.2024.1428867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
Background and objective Enlarged perivascular spaces in basal ganglia (BG-EPVS) are considered an imaging marker of cerebral small vessel disease (CSVD), but its pathogenesis and pathophysiological process remain unclear. While decreased cerebral perfusion is linked to other CSVD markers, the relationship between BG-EPVS and cerebral perfusion remains ambiguous. This study aimed to explore this association. Methods Elderly individuals with severe BG-EPVS (n = 77) and age/sex-matched controls (n = 89) underwent head CT perfusion imaging. The cerebral perfusion parameters including mean transit time (MTT), time to maximum (TMAX), cerebral blood flow (CBF), and cerebral blood volume (CBV) were quantitatively measured by symmetric regions of interest plotted in the basal ganglia region. Point-biserial correlation and logistics regression analysis were performed to investigate the association between BG-EPVS and cerebral perfusion. Results There were no significant differences in MTT, TMAX, or CBF between BG-EPVS group and control group. CBV was significantly lower in the BG-EPVS group (p = 0.035). Point-biserial correlation analysis showed a negative correlation between BG-EPVS and CBV (r = -0.198, p = 0.011). BG-EPVS group and control group as the dependent variable, binary logistics regression analysis showed that CBV was not an independent risk factor for severe BG-EPVS (p = 0.448). All enrolled patients were divided into four groups according to the interquartile interval of CBV. The ordered logistic regression analysis showed severe BG-EPVS was an independent risk factor for decreased CBV after adjusting for confounding factors (OR = 2.142, 95%CI: 1.211-3.788, p = 0.009). Conclusion Severe BG-EPVS is an independent risk factor for decreased CBV in the elderly, however, the formation of BG-EPVS is not solely dependent on changes in CBV in this region. This finding provides information about the pathophysiological consequence caused by severe BG-EPVS.
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Affiliation(s)
- Simeng Wang
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuna Yang
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dong Liang
- Department of Neurology, Affiliated Hospital of Heze Medical College, Heze, Shandong, China
| | - Wei Qin
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lei Yang
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuanting Li
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wenli Hu
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Li C, Wang J, Han X, Li Y, Liu K, Zhao M, Gong T, Hou T, Wang Y, Cong L, Song L, Du Y. Development and validation of a diagnostic model for cerebral small vessel disease among rural older adults in China. Front Neurol 2024; 15:1388653. [PMID: 39036632 PMCID: PMC11258008 DOI: 10.3389/fneur.2024.1388653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/26/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives Cerebral small vessel disease (CSVD) visible on MRI can be asymptomatic. We sought to develop and validate a model for detecting CSVD in rural older adults. Methods This study included 1,192 participants in the MRI sub-study within the Multidomain Interventions to Delay Dementia and Disability in Rural China. Total sample was randomly divided into training set and validation set. MRI markers of CSVD were assessed following the international criteria, and total CSVD burden was assessed on a scale from 0 to 4. Logistic regression analyses were used to screen risk factors and develop the diagnostic model. A nomogram was used to visualize the model. Model performance was assessed using the area under the receiver-operating characteristic curve (AUC), calibration plot, and decision curve analysis. Results The model included age, high blood pressure, white blood cell count, neutrophil-to-lymphocyte ratio (NLR), and history of cerebral infarction. The AUC was 0.71 (95% CI, 0.67-0.76) in the training set and 0.69 (95% CI, 0.63-0.76) in the validation set. The model showed high coherence between predicted and observed probabilities in both the training and validation sets. The model had higher net benefits than the strategy assuming all participants either at high risk or low risk of CSVD for probability thresholds ranging 50-90% in the training set, and 65-98% in the validation set. Conclusion A model that integrates routine clinical factors could detect CSVD in older adults, with good discrimination and calibration. The model has implication for clinical decision-making.
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Affiliation(s)
- Chunyan Li
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jiafeng Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Xiaodong Han
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Keke Liu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Mingqing Zhao
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Tao Gong
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
| | - Tingting Hou
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Yongxiang Wang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Lin Cong
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Lin Song
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Yifeng Du
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
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Yu M, Wang Y, Yang S, Mei J, Liu Z, Zhang L, Xie W, Geng Z, Liu B, Wang H, Qu P, Niu N. Elucidating the Relationship between Neutrophil-Lymphocyte Ratio and Plaque Composition in Patients with Drug-Eluting Stent Restenosis by Virtual Histology-Intravascular Ultrasound. J Cardiovasc Dev Dis 2024; 11:211. [PMID: 39057631 PMCID: PMC11276828 DOI: 10.3390/jcdd11070211] [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: 03/21/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Background: In-stent Restenosis (ISR) is a major factor influencing the prognosis and revascularization of target lesions. The plaque composition is unclear; therefore, it is critical to investigate ISR composition to identify clinical intervention markers. (2) Methods: This study was conducted on 36 patients with drug-eluting stent restenosis. The patients were classified into a Low Neutrophil-Lymphocyte Ratio (L-NLR) and High Neutrophil-Lymphocyte Ratio (H-NLR) according to the median NLR level of 36 patients. Discrepancies in the current information such as baseline data, biochemical examination, cardiac ultrasound data, etc., were examined to identify the underlying risk factors, and a multifactorial linear regression analysis of plaque properties was conducted. (3) Results: NLR = 2.64 was utilized to classify 18 patients into the L-NLR group and 18 patients into the H-NLR group. There were statistically significant differences in age, a pre-percutaneous coronary intervention (PCI) SYNTAX II score, a C-reactive protein (CRP), interleukin (IL)-6, plaque loading, a fibro-lipid tissue area, calcified nubs, and virtual histology-thin fibrous cap atherosclerotic (VH-TCFA). The significant impacts of variations in age, neutrophil-lymphocyte ratio (NLR) levels, and IL-6 levels on the plaque stress and percentage of the fibro-lipid tissue in virtual histology-intravascular ultrasound (VH-IVUS) were identified through multifactorial linear regression. (4) Conclusions: The high NLR group demonstrated increased myocardial injury severity, consistent with higher SYNTAX II scores, a higher plaque burden, and higher proportions of vulnerable components. NLR proved to be a risk factor for both the plaque load and the proportion of the fibro-lipid tissue in ISR.
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Affiliation(s)
- Ming Yu
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Yuxing Wang
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Song Yang
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Jiajie Mei
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Zhenzhu Liu
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Lijiao Zhang
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Wenli Xie
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Zhaohong Geng
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Baole Liu
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Hongyan Wang
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
| | - Peng Qu
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
- Department of Medicine, Dalian University of Technology, Dalian 116081, China
| | - Nan Niu
- The First Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, China; (M.Y.)
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Chen BA, Lee WJ, Meng LC, Lin YC, Chung CP, Hsiao FY, Chen LK. Sex-specific implications of inflammation in covert cerebral small vessel disease. BMC Neurol 2024; 24:220. [PMID: 38937678 PMCID: PMC11210151 DOI: 10.1186/s12883-024-03730-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The relationship between inflammation and covert cerebral small vessel disease (SVD) with regards to sex difference has received limited attention in research. We aim to unravel the intricate associations between inflammation and covert SVD, while also scrutinizing potential sex-based differences in these connections. METHODS Non-stroke/dementia-free study population was from the I-Lan longitudinal Aging Study. Severity and etiology of SVD were assessed by 3T-MRI in each participant. Systemic and vascular inflammatory-status was determined by the circulatory levels of high-sensitivity C-reactive protein (hsCRP) and homocysteine, respectively. Sex-specific multivariate logistic regression to calculate odds ratios (ORs) and interaction models to scrutinize women-to-men ratios of ORs (RORs) were used to evaluate the potential impact of sex on the associations between inflammatory factors and SVD. RESULTS Overall, 708 participants (62.19 ± 8.51 years; 392 women) were included. Only women had significant associations between homocysteine levels and covert SVD, particularly in arteriosclerosis/lipohyalinosis SVD (ORs[95%CI]: 1.14[1.03-1.27] and 1.15[1.05-1.27] for more severe and arteriosclerosis/lipohyalinosis SVD, respectively). Furthermore, higher circulatory levels of homocysteine were associated with a greater risk of covert SVD in women compared to men, as evidenced by the RORs [95%CI]: 1.14[1.01-1.29] and 1.14[1.02-1.28] for more severe and arteriosclerosis/lipohyalinosis SVD, respectively. No significant associations were found between circulatory hsCRP levels and SVD in either sex. CONCLUSION Circulatory homocysteine is associated with covert SVD of arteriosclerosis/lipohyalinosis solely in women. The intricacies underlying the sex-specific effects of homocysteine on SVD at the preclinical stage warrant further investigations, potentially leading to personalized/tailored managements. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Bo-An Chen
- Department of Neurology, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ju Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan
| | - Lin-Chieh Meng
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Chin Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Ping Chung
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
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Zhang P, Cui D, Zhang P, Wang H, Hao Y, Ma J, Li Q, Zhang A, Li D, Li X. Correlation between blood inflammatory indices and carotid intima-media thickness in the middle-aged and elderly adults. J Stroke Cerebrovasc Dis 2024; 33:107715. [PMID: 38608824 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107715] [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: 02/06/2024] [Revised: 03/31/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the correlations between carotid intima-media thickness (IMT) and systemic immune inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte (NLR) ratio. MATERIALS AND METHODS This was a cross-sectional study enrolling a total of 582 middle-aged and elderly patients. The correlations between SII, PLR, and NLR with IMT were assessed using logistic regression models, which were subsequently incorporated into the underlying models with traditional risk factors and their predictive values for IMT. RESULTS NLR exhibited a significant correlation with IMT in the simple regression analysis (β = 0.01, 95 %CI= 0.00-0.02, p < 0.05). After controlling for potential confounding variables in the multivariate analysis, the association between NLR and both Maximum IMT [β = 0.04, 95 %CI = 0.02-0.07, p = 0.0006] and Mean IMT [β = 0.05, 95 %CI = 0.02-0.07, p = 0.0001] remained statistically significant. Additionally, PLR was found to be a significant independent predictor of Maximum IMT [β = 0.04, 95 % CI =0.00-0.07, p = 0.0242] and Mean IMT [β = 0.04, 95 % CI = 0.01-0.07, p = 0.0061]. Similarly, SII was identified as an independent predictor of Maximum IMT [β = 1.87, 95 % CI =1.24, p = 0.0003]. The study found a significant positive correlation between Maximum IMT and the levels NLR, PLR, and SII. Specifically, in the Maximum IMT group, higher quartiles of NLR, PLR, and SII were associated with increased odds ratios (OR) for elevated IMT levels, with statistically significant results for NLR (Q4vsQ1: OR 3.87, 95 % CI 1.81-8.29), PLR (Q4vsQ1: OR 2.84, 95 % CI 1.36-5.95), and SII (Q4vsQ1: OR 2.64, 95 % CI 1.30-5.37). Finally, the inclusion of NLR, PLR, and NLR+PLR+SII in the initial model with traditional risk factors resulted in a marginal improvement in the predictive ability for Maximum IMT, as evidenced by the net reclassification index (p < 0.05). CONCLUSIONS This study discovered a positive correlation between SII, PLR, NLR, and IMT, which are likely to emerge as new predictors for IMT thickening. These findings lay a theoretical reference for future predictive research and pathophysiological research on carotid intima-media thickening.
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Affiliation(s)
- Pangpang Zhang
- Clinical Medical College, Jining Medical University, Jining, China
| | - Dehua Cui
- Department of Neurology, Chengwu County People's Hospital, Jining, China
| | - Peng Zhang
- Clinical Medical College, Jining Medical University, Jining, China
| | - Hongjun Wang
- Ultrasonic Diagnosis Deparment, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Yongnan Hao
- Department of Emergency Stroke, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Jinfeng Ma
- Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Qiuhua Li
- Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Aimei Zhang
- Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Daojing Li
- Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining, China
| | - Xiang Li
- Department of Rehabilitation, the Affiliated Hospital of Jining Medical University, Jining, China.
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Ma J, Xie H, Yuan C, Shen J, Chen J, Chen Q, Liu J, Tong Q, Sun J. The gut microbial signatures of patients with lacunar cerebral infarction. Nutr Neurosci 2024; 27:620-636. [PMID: 37538045 DOI: 10.1080/1028415x.2023.2242121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Emerging evidence revealed that gut microbial dysbiosis is involved in the pathogenesis of multiple neurological diseases, but there is little available data on the relationship between gut microbiota and lacunar cerebral infarction (LCI). METHODS Fecal samples from acute LCI patients (n = 65) and matched healthy controls (n = 65) were collected. The compositions and potential functions of the gut microbiota were estimated. RESULTS The results showed that there were significant gut microbial differences between LCI and control groups. Patients with LCI had higher abundances of genus Lactobacillus, Streptococcus, Veillonella, Acidaminococcus, Bacillus, Peptoclostridium, Intestinibacter, Alloscardovia and Cloacibacillus but lower proportions of genus Agathobacter and Lachnospiraceae_UCG-004. Investigating further these microbes such as Lactobacillus and Veillonella were correlated with clinical signs. Moreover, we found that 9 gene functions of gut microbiota were different between LCI patients and controls, which were associated with amino acid metabolism and inflammatory signal transduction. Notably, four optimal microbial markers were determined, and the combination of Streptococcus, Lactobacillus, Agathobacter, Lachnospiraceae_UCG-004 and the three risk factors achieved an area under the curve (AUC) value of 0.854 to distinguish LCI from controls. CONCLUSION These findings revealed the characterizing of gut microbiota in LCI patients and provided potential microbial biomarkers for clinical diagnosis of LCI.
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Affiliation(s)
- Jiaying Ma
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Huijia Xie
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Chengxiang Yuan
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jie Shen
- Department of Neurology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaxin Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qionglei Chen
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Qiuling Tong
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jing Sun
- Department of Geriatrics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
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10
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Cheng Y, Zhu H, Liu C, Li L, Lin F, Guo Y, Gu C, Sun D, Gao Y, He G, Sun S, Xue S. Systemic immune-inflammation index upon admission correlates to post-stroke cognitive impairment in patients with acute ischemic stroke. Aging (Albany NY) 2024; 16:8810-8821. [PMID: 38771141 PMCID: PMC11164514 DOI: 10.18632/aging.205839] [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: 11/27/2023] [Accepted: 04/09/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND The purpose of this prospective study was to evaluate the association of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), with PSCI in patients with acute ischemic stroke (AIS). METHODS First-onset AIS patients were consecutively included from January 1, 2022 to March 1, 2023. The baseline information was collected at admission. Fasting blood was drawn the next morning. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) 3 months after onset. Logistic regression analysis was performed to explore the correlation between SII, SIRI, and PSCI. Receiver operating characteristic (ROC) was conducted to evaluate the predictive ability of SII. RESULTS 332 participants were recruited, and 193 developed PSCI. Compared with patients without PSCI, the patients with PSCI had higher SII (587.75 (337.42, 988.95) vs. 345.66 (248.44, 572.89), P<0.001) and SIRI (1.59 (0.95, 2.84) vs. 1.02 (0.63, 1.55), P=0.007). SII and SIRI negatively correlated with MoCA scores (both P<0.05). The multivariable logistic regression analysis indicated that SII was independently associated with PSCI (P<0.001), while SIRI was not. The optimal cutoff for SII to predict PSCI was 676.83×109/L. CONCLUSIONS A higher level of SII upon admission was independently correlated to PSCI three months later in AIS patients.
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Affiliation(s)
- Yongqing Cheng
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
| | - Honghong Zhu
- Department of Rheumatology and Immunology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Changxia Liu
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Lei Li
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Fangjia Lin
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Yan Guo
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Cong Gu
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Dingming Sun
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Yang Gao
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Guojun He
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Shifu Sun
- Department of Neurology, The Yancheng Clinical College of Xuzhou Medical University, The First People’s Hospital of Yancheng, Yancheng 224000, Jiangsu, China
| | - Shouru Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
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11
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Zhu HH, Wang YC, He LC, Luo HY, Zong C, Yang YH, Wu JH, Song B, Gao Y, Xu YM, Li YS. Novel inflammatory and insulin resistance indices provide a clue in cerebral amyloid angiopathy. Sci Rep 2024; 14:11474. [PMID: 38769356 PMCID: PMC11106308 DOI: 10.1038/s41598-024-62280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/15/2024] [Indexed: 05/22/2024] Open
Abstract
This study investigated the correlation of newly identified inflammatory and insulin resistance indices with cerebral amyloid angiopathy (CAA), and explored their potential to differentiate CAA from hypertensive arteriopathy (HA). We retrospectively analyzed 514 consecutive patients with cerebral small vessel disease (CSVD)-related haemorrhage, comparing the differences in novel inflammatory and insulin resistance indices between patients with CAA and HA. Univariate regression, LASSO and multivariate regression were used to screen variables and construct a classification diagnosis nomogram. Additionally, these biomarkers were explored in patients with mixed haemorrhagic CSVD. Inflammatory indices were higher in CAA patients, whereas insulin resistance indices were higher in HA patients. Further analysis identified neutrophil-to-lymphocyte ratio (NLR, OR 1.17, 95% CI 1.07-1.30, P < 0.001), and triglyceride-glucose index (TyG, OR = 0.56, 95% CI 0.36-0.83, P = 0.005) as independent factors for CAA. Therefore, we constructed a CAA prediction nomogram without haemorrhagic imaging markers. The nomogram yielded an area under the curve (AUC) of 0.811 (95% CI 0.764-0.865) in the training set and 0.830 (95% CI 0.718-0.887) in the test set, indicating an ability to identify high-risk CAA patients. These results show that CSVD patients can be phenotyped using novel inflammatory and insulin resistance indices, potentially allowing identification of high-risk CAA patients without haemorrhagic imaging markers.
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Affiliation(s)
- Hang-Hang Zhu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Yun-Chao Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Liu-Chang He
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Hai-Yang Luo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Ce Zong
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Ying-Hao Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Jing-Hao Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Yuan Gao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China
| | - Yu-Ming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China.
| | - Yu-Sheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, China.
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12
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Cai J, Zeng X, Huang X, Dong H, Liu J, Lin J, Xie M, Wei X. Relationship of neutrophil/lymphocyte ratio with cerebral small vessel disease and its common imaging markers. Immun Inflamm Dis 2024; 12:e1228. [PMID: 38578037 PMCID: PMC10996379 DOI: 10.1002/iid3.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/27/2023] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND High neutrophil/lymphocyte ratio (NLR) is associated with poor prognosis in ischemic stroke. However, the role of NLR in cerebral small vessel disease (CSVD) is controversial. Herein, we evaluated the value of NLR in identifying CSVD and its relationship with the common imaging markers of CSVD. METHODS A total of 667 patients were enrolled in this study, including 368 in the CSVD group and 299 in the non-CSVD group. Clinical, laboratory, and imaging data were collected. The relationship of NLR with CSVD and common imaging markers of CSVD were analyzed with univariate and multivariate logistic regression analysis. The predictive value of NLR was assessed with the receiver operating characteristic curve. RESULTS NLR (odds ratio [OR] = 1.929, 95% confidence interval [CI] = 1.599-2.327, p < .001) was an independent risk factor for CSVD. NLR was also independently associated with moderate to severe white matter hyperintensity (WMH) (OR = 2.136, 95% CI = 1.768-2.580, p < .001), moderate to severe periventricular WMH (OR = 2.138, 95% CI = 1.771-2.579, p < .001), and moderate to severe deep WMH (OR = 1.654, 95% CI = 1.438-1.902, p < .001), moderately to severely enlarged perivascular spaces (EPVS) (OR = 1.248, 95% CI = 1.110-1.402, p < .001), moderately to severely EPVS in the basal ganglia (OR = 1.136, 95% CI = 1.012-1.275, p = .030), and moderately to severely EPVS in the centrum semiovale (OR = 1.140, 95% CI = 1.027-1.266, p = .014). However, NLR was not statistically significantly associated with lacune. The optimal cutoff point of NLR in predicting CSVD was 2.47, with sensitivity and specificity of 84.2% and 66.9%, respectively (p < .01). The diagnostic effect was maximized when NLR was combined with other risk factors. CONCLUSIONS NLR is an independent risk factor for CSVD and is independently associated with common imaging markers of CSVD. NLR may serve as a valid and convenient biomarker for assessing CSVD.
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Affiliation(s)
- Jiangping Cai
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Xiaoyi Zeng
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Xiaojin Huang
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Hansheng Dong
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Junyi Liu
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Jie Lin
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Meirong Xie
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
| | - Xiaolan Wei
- Department of NeurologyThe First Hospital of Quanzhou Affiliated to Fujian Medical UniversityFujianChina
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13
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Karvelas N, Oh B, Wang E, Cobigo Y, Tsuei T, Fitzsimons S, Younes K, Ehrenberg A, Geschwind MD, Schwartz D, Kramer JH, Ferguson AR, Miller BL, Silbert LC, Rosen HJ, Elahi FM. Enlarged perivascular spaces are associated with white matter injury, cognition and inflammation in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Brain Commun 2024; 6:fcae071. [PMID: 38495305 PMCID: PMC10943571 DOI: 10.1093/braincomms/fcae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/18/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
Enlarged perivascular spaces have been previously reported in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, but their significance and pathophysiology remains unclear. We investigated associations of white matter enlarged perivascular spaces with classical imaging measures, cognitive measures and plasma proteins to better understand what enlarged perivascular spaces represent in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and whether radiographic measures of enlarged perivascular spaces would be of value in future therapeutic discovery studies for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Twenty-four individuals with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and 24 age- and sex-matched controls were included. Disease status was determined based on the presence of NOTCH3 mutation. Brain imaging measures of white matter hyperintensity, brain parenchymal fraction, white matter enlarged perivascular space volumes, clinical and cognitive measures as well as plasma proteomics were used in models. White matter enlarged perivascular space volumes were calculated via a novel, semiautomated pipeline, and levels of 7363 proteins were quantified in plasma using the SomaScan assay. The relationship of enlarged perivascular spaces with global burden of white matter hyperintensity, brain atrophy, functional status, neurocognitive measures and plasma proteins was modelled with linear regression models. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy and control groups did not exhibit differences in mean enlarged perivascular space volumes. However, increased enlarged perivascular space volumes in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy were associated with increased white matter hyperintensity volume (β = 0.57, P = 0.05), Clinical Dementia Rating Sum-of-Boxes score (β = 0.49, P = 0.04) and marginally with decreased brain parenchymal fraction (β = -0.03, P = 0.10). In interaction term models, the interaction term between cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy disease status and enlarged perivascular space volume was associated with increased white matter hyperintensity volume (β = 0.57, P = 0.02), Clinical Dementia Rating Sum-of-Boxes score (β = 0.52, P = 0.02), Mini-Mental State Examination score (β = -1.49, P = 0.03) and marginally with decreased brain parenchymal fraction (β = -0.03, P = 0.07). Proteins positively associated with enlarged perivascular space volumes were found to be related to leukocyte migration and inflammation, while negatively associated proteins were related to lipid metabolism. Two central hub proteins were identified in protein networks associated with enlarged perivascular space volumes: CXC motif chemokine ligand 8/interleukin-8 and C-C motif chemokine ligand 2/monocyte chemoattractant protein 1. The levels of CXC motif chemokine ligand 8/interleukin-8 were also associated with increased white matter hyperintensity volume (β = 42.86, P = 0.03), and levels of C-C motif chemokine ligand 2/monocyte chemoattractant protein 1 were further associated with decreased brain parenchymal fraction (β = -0.0007, P < 0.01) and Mini-Mental State Examination score (β = -0.02, P < 0.01) and increased Trail Making Test B completion time (β = 0.76, P < 0.01). No proteins were associated with all three studied imaging measures of pathology (brain parenchymal fraction, enlarged perivascular spaces, white matter hyperintensity). Based on associations uncovered between enlarged perivascular space volumes and cognitive functions, imaging and plasma proteins, we conclude that white matter enlarged perivascular space volumes may capture pathologies contributing to chronic brain dysfunction and degeneration in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
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Affiliation(s)
- Nikolaos Karvelas
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Bradley Oh
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Earnest Wang
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Yann Cobigo
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Torie Tsuei
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Stephen Fitzsimons
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Kyan Younes
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94304, USA
| | - Alexander Ehrenberg
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
- Innovative Genomics Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Michael D Geschwind
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Daniel Schwartz
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Adam R Ferguson
- Department of Neurological surgery, Brain and Spinal Injury Center (BASIC), Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94110, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA 94121, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Lisa C Silbert
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, OR 97239, USA
- Portland Veterans Affairs Health Care System, Portland, OR 97239, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Fanny M Elahi
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
- James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY 10468, USA
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14
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Li B, Gu Z, Wang W, Du B, Wu C, Li B, Wang T, Yin G, Gao X, Chen J, Bi X, Zhang H, Sun X. The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events. BMC Neurol 2024; 24:86. [PMID: 38438839 PMCID: PMC10910845 DOI: 10.1186/s12883-024-03591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The global prevalence of VCI has increased steadily in recent years, but diagnostic biomarkers for VCI in patients with non-disabling ischemic cerebrovascular incidents (NICE) remain indefinite. The primary objective of this research was to investigate the relationship between peripheral serological markers, white matter damage, and cognitive function in individuals with NICE. METHODS We collected clinical data, demographic information, and medical history from 257 patients with NICE. Using the MoCA upon admission, patients were categorized into either normal cognitive function (NCF) or VCI groups. Furthermore, they were classified as having mild white matter hyperintensity (mWMH) or severe WMH based on Fazekas scores. We then compared the levels of serological markers between the cognitive function groups and the WMH groups. RESULTS Among 257 patients with NICE, 165 were male and 92 were female. Lymphocyte count (OR = 0.448, P < 0.001) and LDL-C/HDL-C (OR = 0.725, P = 0.028) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age and inflammation markers but a lower MoCA score, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.765, P < 0.001) and LDL-C/HDL-C (AUC = 0.740, P < 0.001) had an acceptable diagnostic value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups. CONCLUSION Lymphocyte count, LDL-C/HDL-C were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.
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Affiliation(s)
- Binghan Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhengsheng Gu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Weisen Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bingying Du
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chenghao Wu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bin Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Tianren Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ge Yin
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xin Gao
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jingjing Chen
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hailing Zhang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
| | - Xu Sun
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
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Hu X, Xiao Z, Shen Y, Yang W, Wang P, Li P, Wang Z, Pu M, Zhao L, Xie P, Li Q. SERPINA3: A novel inflammatory biomarker associated with cerebral small vessel disease burden in ischemic stroke. CNS Neurosci Ther 2024; 30:e14472. [PMID: 37721405 PMCID: PMC10916418 DOI: 10.1111/cns.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Inflammation has emerged as a prominent risk factor for cerebral small vessel disease (CSVD). However, the specific association between various inflammatory biomarkers and the development of CSVD remains unclear. Serine proteinase inhibitor A3 (SERPINA3), Matrix metalloproteinase-9 (MMP-9), Tissue inhibitor metalloproteinase-1 (TIMP-1), Monocyte Chemoattractant Protein-1 (MCP-1) are several inflammatory biomarkers that are potentially involved in the development of CSVD. In this present study, we aimed to investigate the relationship between candidate molecules and CSVD features. METHOD The concentration of each biomarker was measured in 79 acute ischemic stroke patients admitted within 72 h after symptom onset. The associations between blood levels of inflammatory markers and CSVD score were investigated, as well as each CSVD feature, including white matter hyperintensities (WMH), lacunes, and enlarged perivascular spaces (EPVS). RESULTS The mean age was 69.0 ± 11.8 years, and 65.8% of participants were male. Higher SERPINA3 level (>78.90 ng/mL) was significantly associated with larger WMH volume and higher scores on Fazekas's scale in all three models. Multiple regression analyses revealed the linear association between absolute WMH burden and SERPINA3 level, especially in model 3 (β = 0.14; 95% confidence interval [CI], 0.04-0.24; p = 0.008 ). Restricted cubic spline regression demonstrated a dose-response relationship between SERPINA3 level and larger WMH volume (p nonlineariy = 0.0366 and 0.0378 in model 2 and mode 3, respectively). Using a receiving operating characteristic (ROC) curve, plasma SERPINA3 level of 64.15 ng/mL distinguished WMH >7.8 mL with the highest sensitivity and specificity (75.92% and 60%, respectively, area under curve [AUC] = 0.668, p = 0.0102). No statistically significant relationship has been found between other candidate biomarkers and CSVD features. CONCLUSION In summary, among four inflammatory biomarkers that we investigated, SERPINA3 level at baseline was associated with WMH severity, which revealed a novel biomarker for CSVD and validated its relationship with inflammation and endothelial dysfunction.
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Affiliation(s)
- Xiao Hu
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Zhong‐Song Xiao
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yi‐Qing Shen
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Wen‐Song Yang
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Peng Wang
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Pei‐Zheng Li
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Zi‐Jie Wang
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Department of NeurologyThe Second Hospital of Anhui Medical UniversityHefeiChina
| | - Ming‐Jun Pu
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Li‐Bo Zhao
- Department of NeurologyYongchuan Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing Key Laboratory of Cerebrovascular Disease ResearchChongqingChina
| | - Peng Xie
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Qi Li
- Department of NeurologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional DiseasesThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Department of NeurologyThe Second Hospital of Anhui Medical UniversityHefeiChina
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Zhilan T, Zengyu Z, Pengpeng J, Hualan Y, Chao L, Yan X, Zimin G, Shuangxing H, Weiwei L. Salidroside promotes pro-angiogenesis and repair of blood brain barrier via Notch/ITGB1 signal path in CSVD Model. J Adv Res 2024:S2090-1232(24)00081-X. [PMID: 38417575 DOI: 10.1016/j.jare.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/05/2023] [Accepted: 02/25/2024] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Salidroside (SAL), extracted from Rhodiola rosea, has been widely used in coronary heart disease and myocardial ischemia for decades. Previous studies have demonstrated that SAL could reduce arteriosclerosis, and thus combat ischemic brain damage. However, the in-depth function of the salidroside in Cerebral Small Vascular Disease (CSVD) has not been discovered, and related molecular mechanism is still unclear. OBJECTIVES The present study aims to explore the effects of salidroside in angiogenesis as well as repair of blood brain barrier (BBB) and its possible mechanisms. METHODS We established a rat model of SHR via 2-vessel gradual occlusion (SHR-2VGO) to mimic the CSVD. Subsequently, the MRI, pathomorphism, as well as Morriss water maze test were conducted to determine CSVD-related indicators. 8 weeks post-surgery, animals were randomly administered SAL, DAPT, ATN161 or saline.The aim was to explore the protective effects of SAL in CSVD as well as its possible mechanism. RESULTS Here we found that SAL could attenuate cerebral hypoperfusion-induced BBB disruption, promote the pro-angiogenesis through enhancing the cell budding. Further investigations demonstrated that SAL could significantly increase the expression of Notch1, Hes1, Hes5, and ITGB1. In addition, we confirmed that SAL could activate Notch signal path, and then up-regulate ITGB1 to promote pro-angiogenesis and thus protect BBB from disruption. CONCLUSION The aforementioned findings demonstrated that SAL could protect BBB integrity through Notch-ITGB1 signaling path in CSVD, which indicated that SAL could be a potential medicine candidate for CSVD treatment.
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Affiliation(s)
- Tu Zhilan
- Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
| | - Zhang Zengyu
- Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China; Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Jin Pengpeng
- Department of Chronic Disease Management, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
| | - Yang Hualan
- Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
| | - Li Chao
- Vasculocardiology Department, Change County Hospital of Traditional Chinese Medicine, Shandong Province 261300, China
| | - Xi Yan
- Department of Radiology, Shanghai TCM-Integrated Hospital, 200082 Shanghai, China
| | - Guo Zimin
- Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
| | - Hou Shuangxing
- Department of Neurology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China.
| | - Li Weiwei
- Institute of Pediatrics, Children's Hospital of Fudan University, Fudan University, Shanghai 201102, China.
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Xu M, Li J, Xu B, Zheng Q, Sun W. Association of coagulation markers with the severity of white matter hyperintensities in cerebral small vessel disease. Front Neurol 2024; 15:1331733. [PMID: 38390599 PMCID: PMC10883156 DOI: 10.3389/fneur.2024.1331733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Background and purpose This study aimed to explore the correlation and causal relationship between fibrinogen, D-dimer, and the severity of cerebral white matter hyperintensity (MMH). Methods A retrospective analysis of 120 patients with cerebral small vessel disease (CSVD) confirmed by head MRI attending the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from August 2021 to February 2023 was performed. According to the Fazekas scale score, the patients were divided into 42 cases in the mild group, 44 cases in the moderate group, and 34 cases in the severe group. The levels of fibrinogen and D-dimer were compared among the three groups; the correlations between fibrinogen, D-dimer, and WMH severity were further analyzed; and independent risk factors for WMH severity were explored using the multivariate ordered logistic regression analysis. Furthermore, a two-sample Mendelian randomization (MR) analysis was performed to investigate the genetically predicted effect of fibrinogen and D-dimer on WMH. Results As the severity of WMH increased, the levels of D-dimer and fibrinogen also gradually increased, and the results showed a positive correlational association, with significant differences within the groups (all p < 0.05); the multivariate ordered logistic regression model showed that after adjusting for the relevant covariates, D-dimer (OR = 5.998, 95% CI 2.213-16.252, p < 0.001) and fibrinogen (OR = 9.074, 95% CI 4.054-20.311, p < 0.001) remained independent risk factors for the severity of WMH. In the MR study, the random-effect inverse variance weighted (IVW) model showed that increased levels of genetically predicted D-dimer (OR, 1.01; 95% confidence interval 0.95-1.06; p = 0.81) and fibrinogen (OR, 1.91; 95% confidence interval 0.97-3.78; p = 0.06) were not associated with increased risk of WMH. The authors did not obtain strong evidence of a direct causal relationship between D-dimer, fibrinogen, and WMH. Conclusion In this retrospective-based study, the authors found possible associations between D-dimer, fibrinogen, and WMH, but there was no obvious causal evidence. Further efforts are still needed to investigate the pathophysiology between D-dimer, fibrinogen, and WMH.
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Affiliation(s)
- Mingyuan Xu
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingjing Li
- Yichang Traditional Chinese Medicine Hospital, Yichang, China
| | - Bu Xu
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qin Zheng
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wenjun Sun
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
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Wan H, Liu Q, Chen C, Dong W, Wang S, Shi W, Li C, Ren J, Wang Z, Cui T, Shao X. An Integrative Nomogram for Identifying Cognitive Impairment Using Seizure Type and Cerebral Small Vessel Disease Neuroimaging Markers in Patients with Late-Onset Epilepsy of Unknown Origin. Neurol Ther 2024; 13:107-125. [PMID: 38019380 PMCID: PMC10787714 DOI: 10.1007/s40120-023-00566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Cognitive impairment (CI) is a common comorbidity in patients with late-onset epilepsy of unknown origin (LOEU). However, limited data are available on effective screening methods for CI at an early stage. We aimed to develop and internally validate a nomogram for identifying patients with LOEU at risk of CI and investigate the potential moderating effect of education on the relationship between periventricular white matter hyperintensities (PVHs) and cognitive function. METHODS We retrospectively reviewed the clinical data of 61 patients aged ≥ 55 years diagnosed with LOEU. The main outcome was CI, reflected as an adjusted Montreal Cognition Assessment score of < 26 points. A nomogram based on a multivariable logistic regression model was constructed. Its discriminative ability, calibration, and clinical applicability were tested using calibration plots, the area under the curve (AUC), and decision curves. Internal model validation was conducted using the bootstrap method. The moderating effect of education on the relationship between PVH and cognitive function was examined using hierarchical linear regression. RESULTS Forty-four of 61 (72.1%) patients had CI. A nomogram incorporating seizure type, total cerebral small vessel disease burden score, and PVH score was built to identify the risk factors for CI. The AUC of the model was 0.881 (95% confidence interval: 0.771-0.994) and 0.78 (95% confidence interval: 0.75-0.8) after internal validation. Higher educational levels blunted the negative impact of PVH on cognitive function. CONCLUSION Our nomogram provides a convenient tool for identifying patients with LOEU who are at risk of CI. Moreover, our findings demonstrate the importance of education for these patients.
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Affiliation(s)
- Huijuan Wan
- Department of Neurology, First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, People's Republic of China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Qi Liu
- Department of Neurology, First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Chao Chen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Wenyu Dong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Shengsong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Weixiong Shi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Chengyu Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Jiechuan Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Zhanxiang Wang
- Department of Neurosurgery and Department of Neuroscience, Fujian Key Laboratory of Brain Tumors Diagnosis and Precision Treatment, Xiamen Key Laboratory of Brain Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, People's Republic of China
| | - Tao Cui
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China
| | - Xiaoqiu Shao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China.
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Guo X, Liu Z, Yuan W, Wei A, Luo G. Electroencephalographic power spectrum changes in cerebral small vessel disease combined with cognitive dysfunction and its relationship with neutrophil/lymphocyte ratio and its clinical value - a pilot study. Front Neurol 2024; 14:1300240. [PMID: 38283675 PMCID: PMC10820721 DOI: 10.3389/fneur.2023.1300240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Objective The study aimed to explore the changes in the electrical power spectrum of the brain and its correlation with neutrophil/lymphocyte ratio (NLR) in patients with cognitively impaired cerebral small vessel disease (CSVD) and to explore its clinical application. Methods A total of 61 patients with CSVD who attended the People's Hospital of Shaanxi Province from September 2021 to September 2022 were divided into the group with cognitive impairment (cerebral small vascular with cognitive impairment, CSVCI group, n = 29) and the group without cognitive impairment (CSVD group, n = 32) based on the Montreal Cognitive Assessment Scale (MoCA) score, while 20 healthy subjects were recruited as the control group (healthy control, HC group). EEG was performed in the three groups, and the difference in whole brain quantitative EEG power spectral density (PSD) was calculated and compared between the three groups. Results The PSD values in the δ and θ bands of the CSVCI group were higher than those of the CSVD group, while the PSD values in the α band were lower than those of the CSVD and HC groups. In addition, PSD values in the δ-band in the CSVD group were lower than those in the HC group (all p < 0.05). Multifactorial logistic regression showed that reduced α-band global average PSD and low years of education were independent risk factors for cognitive impairment in patients with CSVD (p < 0.05). In patients with cerebral small-vessel disease, α-band PSD was positively and δ-band PSD negatively correlated with MoCA score, and paraventricular, deep white matter, and total Fazekas scores were negatively correlated with MoCA score. Furthermore, θ-band PSD is positively correlated with NLR (all p < 0.05). Conclusion EEG activity was slowed down in patients with CSVD with cognitive impairment. The α-band global mean PSD values independently affected the occurrence of cognitive impairment in CSVD patients beyond the Fazekas score. NLR may be one of the mechanisms leading to the slowing down of the EEG, which can be used as an objective indicator for the early prediction of cognitive impairment but still needs to be clarified by further studies.
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Affiliation(s)
- Xiaomin Guo
- Department of Neurology, The People’s Hospital of Shaanxi Province, Xi’an, China
| | - Zongwei Liu
- First Institute of Oceanography, Ministry of Natural Resources, Qingdao, China
| | - Weishuai Yuan
- First Institute of Oceanography, Ministry of Natural Resources, Qingdao, China
| | - Aiqin Wei
- Department of Neurology, The People’s Hospital of Shaanxi Province, Xi’an, China
| | - Guogang Luo
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Nam KW, Kwon HM, Jeong HY, Park JH, Min K. Monocyte to high-density lipoprotein cholesterol ratio is associated with cerebral small vessel diseases. BMC Neurol 2024; 24:18. [PMID: 38178033 PMCID: PMC10765827 DOI: 10.1186/s12883-023-03524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Inflammation is a major pathological mechanism underlying cerebrovascular disease. Recently, a new inflammatory marker based on the ratio between monocyte count and high-density lipoprotein (HDL) cholesterol has been proposed. In this study, we evaluated the relationship between monocyte-to-HDL cholesterol ratio (MHR) and cerebral small vessel disease (cSVD) lesions in health check-up participants. METHODS This study was a retrospective cross-sectional study based on a registry that prospectively collected health check-up participants between 2006 and 2013. Three cSVD subtypes were measured on brain magnetic resonance imaging. White matter hyperintensity (WMH) volume, and lacunes and cerebral microbleeds (CMBs) were quantitatively and qualitatively measured, respectively. The MHR was calculated according to the following formula: MHR = monocyte counts (× 103/μL) / HDL cholesterol (mmol/L). RESULTS In total, 3,144 participants were evaluated (mean age: 56 years, male sex: 53.9%). In multivariable analyzes adjusting for confounders, MHR was significantly associated with WMH volume [β = 0.099, 95% confidence interval (CI) = 0.025 to 0.174], lacune [adjusted odds ratio (aOR) = 1.43, 95% CI = 1.07-1.91], and CMB (aOR = 1.51, 95% CI = 1.03-2.19). In addition, MHR showed a positive quantitative relationship with cSVD burden across all three subtypes: WMH (P < 0.001), lacunes (P < 0.001), and CMBs (P < 0.001). CONCLUSIONS High MHR was closely associated with cSVD in health check-up participants. Because these associations appear across all cSVD subtypes, inflammation appears to be a major pathological mechanism in the development of various cSVDs.
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Affiliation(s)
- Ki-Woong Nam
- Department of Neurology, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, South Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, South Korea.
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea.
| | - Kyungha Min
- Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, South Korea
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Yu T, Zhang H, Yan YM, Liu YN, Huang XF, Qiao S, Yang Q, Li P, Jiang RC, Ma DC. Correlation of idiopathic benign paroxysmal positional vertigo with cerebral small vessel disease. Am J Emerg Med 2023; 74:140-145. [PMID: 37837822 DOI: 10.1016/j.ajem.2023.09.048] [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: 07/25/2023] [Revised: 08/24/2023] [Accepted: 09/17/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) is the most prevalent form of peripheral vertigo, with vascular lesions being one of its suspected causes. The older adults are particularly vulnerable to BPPV. Cerebral small vessel disease (CSVD), on the other hand, is a clinical condition that results from damage of cerebral small vessels. Vascular involvement resulting from age-related risk factors and proinflammatory state may act as the underlying factor linking both BPPV and CSVD. AIM The objective of this study is to explore the potential correlation between BPPV and CSVD by examining whether individuals aged 50 and older with BPPV exhibit a greater burden of CSVD. MATERIALS AND METHODS This retrospective study included patients aged 50 years and older who had been diagnosed with BPPV. A control group consisting of patients diagnosed with idiopathic facial neuritis (IFN) during the same time period was also included. The burden of cerebral white matter hyperintensities (WMHs) was evaluated using the Fazekas scale. An ordinal regression analysis was conducted to investigate the potential correlation between BPPV and WMHs. RESULTS The study included a total of 101 patients diagnosed with BPPV and 116 patients with IFN. Patients with BPPV were found to be significantly more likely (OR = 2.37, 95% CI 1.40-4.03, p = 0.001) to have a higher Fazekas score compared to the control group. Brain infarctions, hypertension, and age were all identified as significant predictors of white matter hyperplasia on MRI, with OR of 9.9 (95% CI 4.21-24.84, P<0.001), 2.86 (95% CI 1.67-5.0, P<0.001), and 1.18 (95% CI 1.13-1.22, P<0.001) respectively. CONCLUSION Our findings suggest that vascular impairment caused by age-related risk factors and proinflammatory status may be contributing factors to the development of BPPV in individuals aged 50 and above, as we observed a correlation between the suffering of BPPV and the severity of WMHs.
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Affiliation(s)
- Ting Yu
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Hui Zhang
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Yong-Mei Yan
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Yan-Ni Liu
- Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Xiao-Feng Huang
- Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Sen Qiao
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Qi Yang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Peng Li
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China
| | - Ruo-Chen Jiang
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China
| | - Dai-Chao Ma
- The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China.
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Zhang T, Cao Y, Zhao J, Yao J, Liu G. Assessing the causal effect of genetically predicted metabolites and metabolic pathways on stroke. J Transl Med 2023; 21:822. [PMID: 37978512 PMCID: PMC10655369 DOI: 10.1186/s12967-023-04677-4] [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: 09/13/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Stroke is a common neurological disorder that disproportionately affects middle-aged and elderly individuals, leading to significant disability and mortality. Recently, human blood metabolites have been discovered to be useful in unraveling the underlying biological mechanisms of neurological disorders. Therefore, we aimed to evaluate the causal relationship between human blood metabolites and susceptibility to stroke. METHODS Summary data from genome-wide association studies (GWASs) of serum metabolites and stroke and its subtypes were obtained separately. A total of 486 serum metabolites were used as the exposure. Simultaneously, 11 different stroke phenotypes were set as the outcomes, including any stroke (AS), any ischemic stroke (AIS), large artery stroke (LAS), cardioembolic stroke (CES), small vessel stroke (SVS), lacunar stroke (LS), white matter hyperintensities (WMH), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), transient ischemic attack (TIA), and brain microbleeds (BMB). A two-sample Mendelian randomization (MR) study was conducted to investigate the causal effects of serum metabolites on stroke and its subtypes. The inverse variance-weighted MR analyses were conducted as causal estimates, accompanied by a series of sensitivity analyses to evaluate the robustness of the results. Furthermore, a reverse MR analysis was conducted to assess the potential for reverse causation. Additionally, metabolic pathway analysis was performed using the web-based MetOrigin. RESULTS After correcting for the false discovery rate (FDR), MR analysis results revealed remarkable causative associations with 25 metabolites. Further sensitivity analyses confirmed that only four causative associations involving three specific metabolites passed all sensitivity tests, namely ADpSGEGDFXAEGGGVR* for AS (OR: 1.599, 95% CI 1.283-1.993, p = 2.92 × 10-5) and AIS (OR: 1.776, 95% CI 1.380-2.285, p = 8.05 × 10-6), 1-linoleoylglycerophosph-oethanolamine* for LAS (OR: 0.198, 95% CI 0.091-0.428, p = 3.92 × 10-5), and gamma-glutamylmethionine* for SAH (OR: 3.251, 95% CI 1.876-5.635, p = 2.66 × 10-5), thereby demonstrating a high degree of stability. Moreover, eight causative associations involving seven other metabolites passed both sensitivity tests and were considered robust. The association result of one metabolite (glutamate for LAS) was considered non-robust. As for the remaining metabolites, we speculate that they may potentially possess underlying causal relationships. Notably, no common metabolites emerged from the reverse MR analysis. Moreover, after FDR correction, metabolic pathway analysis identified 40 significant pathways across 11 stroke phenotypes. CONCLUSIONS The identified metabolites and their associated metabolic pathways are promising circulating metabolic biomarkers, holding potential for their application in stroke screening and preventive strategies within clinical settings.
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Affiliation(s)
- Tianlong Zhang
- Department of Critical Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Yina Cao
- Department of Neurology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jianqiang Zhao
- Department of Cardiology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jiali Yao
- Department of Critical Care Medicine, Jinhua Hospital Affiliated to Zhejiang University, Jinhua, Zhejiang, China.
| | - Gang Liu
- Department of Infection Control, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
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Cifù A, Janes F, Mio C, Domenis R, Pessa ME, Garbo R, Curcio F, Valente M, Fabris M. Brain Endothelial Cells Activate Neuroinflammatory Pathways in Response to Early Cerebral Small Vessel Disease (CSVD) Patients' Plasma. Biomedicines 2023; 11:3055. [PMID: 38002055 PMCID: PMC10669613 DOI: 10.3390/biomedicines11113055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The pathogenesis of cerebral small vessel disease (CSVD) is largely unknown. Endothelial disfunction has been suggested as the turning point in CSVD development. In this study, we tested the effect of plasma from CSVD patients on human cerebral microvascular endothelial cells with the aim of describing the pattern of endothelial activation. Plasma samples from three groups of young subjects have been tested: PTs (subjects affected by early stage CSVD); CTRLs (control subjects without abnormalities at MRI scanning); BDs (blood donors). Human Brain Endothelial Cells 5i (HBEC5i) were treated with plasma and total RNA was extracted. RNAs were pooled to reduce gene expression-based variability and NGS analysis was performed. Differentially expressed genes were highlighted comparing PTs, CTRLs and BDs with HBEC5i untreated cells. No significantly altered pathway was evaluated in BD-related treatment. Regulation of p38 MAPK cascade (GO:1900744) was the only pathway altered in CTRL-related treatment. Indeed, 36 different biological processes turned out to be deregulated after PT treatment of HBEC5i, i.e., the cytokine-mediated signaling pathway (GO:0019221). Endothelial cells activate inflammatory pathways in response to stimuli from CSVD patients' plasma, suggesting the pathogenetic role of neuroinflammation from the early asymptomatic phases of cerebrovascular disease.
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Affiliation(s)
- Adriana Cifù
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
| | - Francesco Janes
- Department of Head, Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (M.E.P.); (R.G.)
| | - Catia Mio
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
| | - Rossana Domenis
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
| | - Maria Elena Pessa
- Department of Head, Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (M.E.P.); (R.G.)
| | - Riccardo Garbo
- Department of Head, Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (M.E.P.); (R.G.)
- Neurology Unit of Gorizia-Monfalcone, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), 34100 Gorizia, Italy
| | - Francesco Curcio
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
| | - Mariarosaria Valente
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
- Department of Head, Neck and Neuroscience, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (M.E.P.); (R.G.)
| | - Martina Fabris
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (A.C.); (C.M.); (R.D.); (F.C.); (M.V.); (M.F.)
- Institute of Clinical Pathology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
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Connolly DM, Madden LA, Edwards VC, D'Oyly TJ, Harridge SDR, Smith TG, Lee VM. Early Human Pathophysiological Responses to Exertional Hypobaric Decompression Stress. Aerosp Med Hum Perform 2023; 94:738-749. [PMID: 37726900 DOI: 10.3357/amhp.6247.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
INTRODUCTION: Consistent blood biomarkers of hypobaric (altitude) decompression stress remain elusive. Recent laboratory investigation of decompression sickness risk at 25,000 ft (7620 m) enabled evaluation of early pathophysiological responses to exertional decompression stress.METHODS: In this study, 15 healthy men, aged 20-50 yr, undertook 2 consecutive (same-day) ascents to 25,000 ft (7620 m) for 60 and 90 min, breathing 100% oxygen, each following 1 h of prior denitrogenation. Venous blood was sampled at baseline (T0), immediately after the second ascent (T8), and next morning (T24). Analyses encompassed whole blood hematology, endothelial microparticles, and soluble markers of cytokine response, endothelial function, inflammation, coagulopathy, oxidative stress, and brain insult, plus cortisol and creatine kinase.RESULTS: Acute hematological effects on neutrophils (mean 72% increase), eosinophils (40% decrease), monocytes (37% increase), and platelets (7% increase) normalized by T24. Consistent elevation (mean five-fold) of the cytokine interleukin-6 (IL-6) at T8 was proinflammatory and associated with venous gas emboli (microbubble) load. Levels of C-reactive protein and complement peptide C5a were persistently elevated at T24, the former by 100% over baseline. Additionally, glial fibrillary acidic protein, a sensitive marker of traumatic brain injury, increased by a mean 10% at T24.CONCLUSIONS: This complex composite environmental stress, comprising the triad of hyperoxia, decompression, and moderate exertion at altitude, provoked pathophysiological changes consistent with an IL-6 cytokine-mediated inflammatory response. Multiple persistent biomarker disturbances at T24 imply incomplete recovery the day after exposure. The elevation of glial fibrillary acidic protein similarly implies incomplete resolution following recent neurological insult.Connolly DM, Madden LA, Edwards VC, D'Oyly TJ, Harridge SDR, Smith TG, Lee VM. Early human pathophysiological responses to exertional hypobaric decompression stress. Aerosp Med Hum Perform. 2023; 94(10):738-749.
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25
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Del Brutto OH, Mera RM, Rumbea DA, Del Brutto VJ. Systemic immune-inflammation index and progression of white matter hyperintensities of presumed vascular origin. A longitudinal population study in community-dwelling older adults living in rural Ecuador. J Neurol Sci 2023; 452:120741. [PMID: 37515846 DOI: 10.1016/j.jns.2023.120741] [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: 03/30/2023] [Revised: 07/01/2023] [Accepted: 07/23/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Information on the association between the systemic immune-inflammation index (SII) and white matter hyperintensities (WMH) of presumed vascular origin is confined to cross-sectional studies. We sought to evaluate the impact of SII on WMH progression in community-dwelling older adults. METHODS Following a longitudinal prospective study design, participants of a population-based cohort received baseline blood tests to calculate the SII (platelets x neutrophils / lymphocytes x 109 L) together with clinical interviews and brain MRIs. Participants with follow-up brain MRI were included in the analysis. Poisson regression models adjusted for demographics and cardiovascular risk factors were fitted to assess the incidence rate ratio of WMH progression by levels of the SII. RESULTS Across 246 study participants (mean age: 65.5 ± 5.9 years; 55% women), the mean SII was 434.7 ± 193.8 × 109 L, and WMH progression was found in 101 (41%) individuals after a mean of 7.3 ± 1.5 years. A multivariate Poisson regression model showed increased WMH progression rate among individuals in the fourth quartile of the SII compared with those in the first quartile (IRR: 1.87; 95% C.I.: 1.02-3.41). CONCLUSIONS Study results provided novel evidence of an independent association between the SII and WMH progression. The SII may be able to identify individuals at high risk of WMH progression.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
| | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
| | - Denisse A Rumbea
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Victor J Del Brutto
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
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Chuang SY, Hsu YC, Chou KW, Chang KS, Wong CH, Hsu YH, Cheng HM, Chen CW, Chen PY. Neutrophil-Lymphocyte Ratio as a Predictor of Cerebral Small Vessel Disease in a Geriatric Community: The I-Lan Longitudinal Aging Study. Brain Sci 2023; 13:1087. [PMID: 37509017 PMCID: PMC10377025 DOI: 10.3390/brainsci13071087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/09/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Cerebral Small Vessel Disease (CSVD) frequently affects the elderly, with inflammation playing a crucial role in related health complications, including dementia, stroke, and SVD. Studies, including animal experiments, indicate a strong link between inflammation and SVD progression. The Neutrophil-Lymphocyte Ratio (NLR) serves as a possible biomarker for ongoing inflammatory risks. A total of 720 adults aged 50 years or older from the community-based I-Lan Longitudinal Aging Study were included in this study. General linear regression and ordinally logistic regression analyses were performed to evaluate the association between NLR and CSVD. We further examined the presence of lacune, microbleed, and white matter hyperintensity (WMH) on brain MRI, which were used to construct a combined CSVD score. The NLR was positively associated with WMH (adjusted r = 0.109, p = 0.003), microbleed (adjusted r = 0.102, p = 0.006), and lacune (adjusted r = 0.100, p = 0.008). After adjustments for smoking, drinking, and physical activity in the ordinal logistic regression analysis, age, gender, brachial Systolic Blood Pressure (SBP), fasting glucose, LDL-cholesterol, and Hs-CRP were compared among subjects with low tertile (T1), medium tertile (T2) and high tertile (T3) NLR. The results showed that T2 vs. T1 had an odds ratio of 1.23 (0.86-1.77); and T3 vs. T1 had an odds ratio of 1.87 (1.29-2.71) of CSVD scores in four groups (zero (reference group), one, two, and three or more). NLR could be used to assess the state of inflammation in cerebral vessels. A significant and positive correlation between NLR and CSVD was verified in this study. However, the practical clinical application of NLR in CSVD patients and prognosis prediction should be validated through more scientific attempts.
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Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institute, Miaoli 36001, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University School of Medicine, Taipei 30010, Taiwan
| | - Yin-Chen Hsu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi 61363, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Kuang-Wei Chou
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 11008, Taiwan
| | - Kuo-Song Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 11008, Taiwan
- Mackay Junior College of Medicine, Nursing, and Management, Taipei 11260, Taiwan
| | - Chiong-Hee Wong
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 11008, Taiwan
| | - Ya-Hui Hsu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 11008, Taiwan
| | - Hao-Min Cheng
- Institute of Public Health, National Yang Ming Chiao Tung University School of Medicine, Taipei 30010, Taiwan
- Department of Internal Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 31254, Taiwan
- Center for Evidence-Based Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Chien-Wei Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi 61363, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Pang-Yen Chen
- Institute of Public Health, National Yang Ming Chiao Tung University School of Medicine, Taipei 30010, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 11008, Taiwan
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27
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Inoue Y, Shue F, Bu G, Kanekiyo T. Pathophysiology and probable etiology of cerebral small vessel disease in vascular dementia and Alzheimer's disease. Mol Neurodegener 2023; 18:46. [PMID: 37434208 PMCID: PMC10334598 DOI: 10.1186/s13024-023-00640-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/28/2023] [Indexed: 07/13/2023] Open
Abstract
Vascular cognitive impairment and dementia (VCID) is commonly caused by vascular injuries in cerebral large and small vessels and is a key driver of age-related cognitive decline. Severe VCID includes post-stroke dementia, subcortical ischemic vascular dementia, multi-infarct dementia, and mixed dementia. While VCID is acknowledged as the second most common form of dementia after Alzheimer's disease (AD) accounting for 20% of dementia cases, VCID and AD frequently coexist. In VCID, cerebral small vessel disease (cSVD) often affects arterioles, capillaries, and venules, where arteriolosclerosis and cerebral amyloid angiopathy (CAA) are major pathologies. White matter hyperintensities, recent small subcortical infarcts, lacunes of presumed vascular origin, enlarged perivascular space, microbleeds, and brain atrophy are neuroimaging hallmarks of cSVD. The current primary approach to cSVD treatment is to control vascular risk factors such as hypertension, dyslipidemia, diabetes, and smoking. However, causal therapeutic strategies have not been established partly due to the heterogeneous pathogenesis of cSVD. In this review, we summarize the pathophysiology of cSVD and discuss the probable etiological pathways by focusing on hypoperfusion/hypoxia, blood-brain barriers (BBB) dysregulation, brain fluid drainage disturbances, and vascular inflammation to define potential diagnostic and therapeutic targets for cSVD.
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Affiliation(s)
- Yasuteru Inoue
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Francis Shue
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Guojun Bu
- SciNeuro Pharmaceuticals, Rockville, MD 20850 USA
| | - Takahisa Kanekiyo
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
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28
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Feng G, Yang M, Xu L, Liu Y, Yu J, Zang Y, Shen S, Zheng X. Combined effects of high sensitivity C-reactive protein and triglyceride-glucose index on risk of cardiovascular disease among middle-aged and older Chinese: Evidence from the China Health and Retirement Longitudinal Study. Nutr Metab Cardiovasc Dis 2023; 33:1245-1253. [PMID: 37095018 DOI: 10.1016/j.numecd.2023.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/15/2023] [Accepted: 04/01/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND AND AIMS High sensitivity C-reactive protein (hsCRP) and triglyceride glucose (TyG) index were proved to be independent risk factors of cardiovascular disease (CVD). However, individual hsCRP or TyG index might not provide sufficient predictive value on CVD risk. The current study aimed to evaluate the cumulative effect of hsCRP and TyG index on CVD risk prospectively. METHODS AND RESULTS A total of 9626 participants were enrolled in the analysis. The TyG index was calculated as ln(triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The primary outcome was new-onset CVD events (cardiac events or stroke), and the secondary outcomes were new-onset cardiac events and stroke, separately. Participants were divided into 4 groups through the median of hsCRP and TyG index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportion hazard models. From 2013 to 2018, 1730 participants experienced CVD (570 stroke and 1306 cardiac events). Linear associations were found between hsCRP, TyG index, hsCRP/TyG ratio and CVD (all p < 0.05). Compared to participants with low hsCRP/low TyG index, multivariable adjusted HRs (95% CIs) for those with high hsCRP/high TyG index were 1.17 (1.03-1.37) for CVD. No interaction of hsCRP and TyG index was found on CVD (p-interaction ≥0.05). Furthermore, adding hsCRP and TyG index simultaneously to conventional risk model improved risk reclassification for CVD, stroke and cardiac events (all p < 0.05). CONCLUSION The present study suggested combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese.
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Affiliation(s)
- Guijuan Feng
- The First Affiliated Hospital of Kangda College of Nanjing Medical University, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, 222000, China
| | - Man Yang
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Lingkai Xu
- Department of Acute Infectious Disease Control and Immunization Program, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China
| | - Yaqi Liu
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China
| | - Jia Yu
- Department of Acute Infectious Disease Control and Immunization Program, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China
| | - Yuhan Zang
- Department of Health Promotion and Chronic Non-Communicable Disease Control, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China
| | - Suwen Shen
- Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China.
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China.
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29
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Zhao J, Wang X, Yu M, Zhang S, Li Q, Liu H, Zhang J, Cai R, Lu C, Li S. The Relevance of Serum Macrophage Migration Inhibitory Factor Level and Executive Function in Patients with White Matter Hyperintensity in Cerebral Small Vessel Disease. Brain Sci 2023; 13:brainsci13040616. [PMID: 37190581 DOI: 10.3390/brainsci13040616] [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: 02/10/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
(1) Objective: To investigate the relationship between serum macrophage migration inhibitory factor (MIF) level and white matter hyperintensity (WMH) and executive function (EF) in cerebral small vascular disease (CSVD), and assess the impact and predictive value of MIF level and Fazekas scores in CSVD-related cognitive impairment (CI) (CSVD-CI); (2) Methods: A total of 117 patients with WMH admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2022 were enrolled. According to the Montreal cognitive assessment (MoCA) scale, subjects were divided into a normal cognitive group and an impaired group. All subjects required serum MIF level, 3.0 T MRI, and neuropsychological evaluation to investigate the risk factors for CDVD-CI, analyze the correlation between MIF level, WMH, and EF, and to analyze the diagnostic value of MIF and WMH degree in predicting CSVD-CI; (3) Results: 1. Fazekas score and MIF level were the risk factors of CSVD-CI. 2. The Fazekas score was negatively correlated with MoCA score, positively correlated with Stroop C-Time, Stroop C-Mistake, Stroop interference effects (SIE)-Time, SIE-Mistake, and color trails test (CTT) interference effects (CIE) (B-A). 3. The MIF level was positively correlated with Fazekas score, Stroop C-Time, SIE-Time, CTT B-Time, and CIE (B-A), and negatively correlated with MoCA score. 4. Fazekas score and MIF level were significant factors for diagnosing CSVD-CI; (4) Conclusion: The Fazekas score and MIF level may be the risk factors of CSVD-CI, and they are closely correlated to CI, especially the EF, and they have diagnostic value for CSVD-CI.
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Affiliation(s)
- Jianhua Zhao
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Xiaoting Wang
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Miao Yu
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Shiyun Zhang
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Qiong Li
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Hao Liu
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Jian Zhang
- Imaging Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Ruiyan Cai
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Chengbiao Lu
- Sino-UK Joint Laboratory of Brain Function and Injury of Henan Province, Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang 453003, China
| | - Shaomin Li
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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30
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Negative correlation between serum pyruvate kinase M2 and cognitive function in patients with cerebral small vessel disease. Clin Neurol Neurosurg 2023; 225:107586. [PMID: 36641992 DOI: 10.1016/j.clineuro.2023.107586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Cerebral small vessel disease (CSVD) is one of the main contributing factors to vascular cognitive impairment (VCI), with an increasing incidence rate. However, the genesis of CSVD cognitive impairment remains unknown. Inflammation and metabolic disorders are considered important pathogenesis of CSVD. In addition to acting as the key regulator of aerobic glycolysis, pyruvate kinase muscle isozyme 2 (PKM2) is a proinflammatory mediator transcriptional activator that can promote an inflammatory response. This study explored whether serum PKM2 is associated with cognitive impairment in CSVD patients. METHODS The demographic data, history of risk factors, laboratory data, and cognitive function scale assessment of 219 CSVD patients were analyzed, and the correlation between the CSVD clinical data and neuroimaging parameters with serum PKM2 was further explored. The serum PKM2 level was determined by enzyme-linked immunosorbent assay using the collected serum samples. Insulin resistance (IR) was assessed with reference to the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). HOMA-IR was calculated using the formula HOMA-IR = fasting plasma glucose (FPG, mmol/L) × fasting insulin (FINS, μU/mL)/22.5. A binomial logistic regression model was referred to infer the risk factors for VCI, and the ability of serum PKM2 to diagnose VCI was assessed by using a ROC curve. RESULTS Serum PKM2 level was positively correlated with HOMA-IR (r = 0.206, P = 0.002), negatively correlated with MMSE and MOCA on the cognitive scale in CSVD patients, and higher in CSVD patients with white matter hyperintensities (WMH) (P < 0.001). When compared with patients without cognitive impairment, the serum PKM2 levels were elevated in cases with suspected dementia, mild dementia, mild to moderate dementia, and moderate to severe dementia, and the differences were statistically significant (P < 0.05). Serum PKM2 levels were correlated with cognitive screening test scores in CSVD. CONCLUSION The present findings indicated that the serum PKM2 level was positively correlated with HOMA-IR, WMH, and enlarged perivascular spaces and negatively correlated with cognitive function in CSVD patients.
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Bonakdarpour B, Takarabe C. Brain Networks, Clinical Manifestations, and Neuroimaging of Cognitive Disorders: The Role of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), and Other Advanced Neuroimaging Tests. Clin Geriatr Med 2023; 39:45-65. [PMID: 36404032 DOI: 10.1016/j.cger.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In this article, we briefly discuss imaging modalities used in clinical settings for neuroanatomical characterization and for diagnosis of the underlying disease. We then discuss how each neuroimaging tool can be used in the context of clinical syndromes. The major underlying causes relevant to our discussion include Alzheimer disease, Lewy body disease, cerebrovascular disease, frontotemporal degeneration, autoimmune diseases, and systemic or metabolic derangements.
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Affiliation(s)
- Borna Bonakdarpour
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine.
| | - Clara Takarabe
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine
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Kamchatnov PR, Abusueva BA, Khanmurzaeva SB, Mityaeva EV, Chipova DT, Malashenkov ND. [Results of evaluation of the effectiveness of the drug Cellex in patients with small vessel disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:67-74. [PMID: 36719121 DOI: 10.17116/jnevro202312301167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To study the effect of the drug Cellex on the severity of cognitive impairment in patients with small vessel disease (SVD). MATERIAL AND METHODS A non-interventional observational controlled prospective observational study in parallel groups was conducted. 118 patients with CHEM who received unified therapy were under observation. Group 1 consisted of 40 patients who, in addition to basic therapy, received 10 injections of Cellex subcutaneously (0.2 ml 1 time/day), group 2 - 39 patients who received 2 courses of injections of Cellex subcutaneously (0.1 ml 1 time/day) with an interval of one month, patients 3-both groups (n=39) received only basic therapy. The examination included an assessment of the clinical status and neuropsychological testing (the MOS questionnaire and the clock drawing test - TRCH), analysis of the results of MRI of the brain. The blood levels of homocysteine (HC), C-reactive protein (CRP), asymmetric dimethylarginin (ADMA), and von Willebrand factor (FW) were determined in dynamics. RESULTS A statistically significant improvement in the performance of the MoCA and TRP questionnaire tests in groups 1 and 2 was demonstrated, with a more pronounced and persistent effect in patients who received repeated courses of treatment. Clinical improvement was accompanied by normalization of the concentration of studied markers of inflammation (CRP) and endothelial dysfunction (HC, ADMA, FW) in the blood, while the dynamics was most pronounced in patients of group 2. The treatment was characterized by good tolerability, low frequency and insignificant severity of adverse events. CONCLUSION The drug Cellex has demonstrated significant effectiveness in the treatment of patients with SVD with cognitive impairment, against the background of treatment, there was a decrease in markers of inflammation and endothelial dysfunction, therapy was characterized by good tolerability.
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Affiliation(s)
- P R Kamchatnov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - B A Abusueva
- Dagestan State Medical University, Makhachkala, Russia
| | | | - E V Mityaeva
- Turgenev Oryol State University. Medical Institute, Orel, Russia
| | - D T Chipova
- City Clinical Hospital No. 1, Nalchik, Russia
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Xiao Y, Teng Z, Xu J, Qi Q, Guan T, Jiang X, Chen H, Xie X, Dong Y, Lv P. Systemic Immune-Inflammation Index is Associated with Cerebral Small Vessel Disease Burden and Cognitive Impairment. Neuropsychiatr Dis Treat 2023; 19:403-413. [PMID: 36852257 PMCID: PMC9960781 DOI: 10.2147/ndt.s401098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE This study sought to explore the associations of the systemic immune-inflammation index (SII) with total cerebral small vessel disease (CSVD) burden and cognitive impairment. METHODS We enrolled 201 patients in the retrospective study with complete clinical and laboratory data. The SII was calculated as platelet count × neutrophil count/lymphocyte count. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Total CSVD burden was assessed based on magnetic resonance imaging. We performed logistic regression models, Spearman correlation, and mediation analysis to evaluate the associations of SII with CSVD burden and cognitive impairment. RESULTS After adjustment for confounding factors in the multivariate binary logistic regression model, elevated SII (odds ratio [OR], 3.263; 95% confidence interval [CI], 1.577-6.752; P = 0.001) or severe CSVD burden (OR, 2.794; 95% CI, 1.342-5.817; P = 0.006) was significantly associated with the risk of cognitive impairment. Correlation analyses revealed that SII levels were negatively associated with MMSE scores (rs = -0.391, P < 0.001), and positively associated with the total CSVD burden score (rs = 0.361, P < 0.001). Moreover, SII was significantly related to the severity of the CSVD burden (OR, 2.674; 95% CI, 1.359-5.263; P = 0.004). The multivariable-adjusted odds ratios (95% CI) in highest tertile versus lowest tertile of SII were 8.947 (3.315-24.145) for cognitive impairment and 4.945 (2.063-11.854) for severe CSVD burden, respectively. The effect of higher SII on cognitive impairment development was partly mediated by severe CSVD burden. CONCLUSION Elevated SII is associated with severe CSVD burden and cognitive impairment. The mediating role of severe CSVD burden suggests that higher SII may contribute to cognitive impairment through aggravating CSVD burden.
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Affiliation(s)
- Yining Xiao
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Zhenjie Teng
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Jing Xu
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Qianqian Qi
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Tianyuan Guan
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Xin Jiang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Huifang Chen
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Xiaohua Xie
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.,Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, People's Republic of China.,Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, Hebei, People's Republic of China
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Liu L, Zhang X, Jiang N, Liu Y, Wang Q, Jiang G, Li X, Zhao L, Zhai Q. Plasma Lipoprotein-Associated Phospholipase A2 Affects Cognitive Impairment in Patients with Cerebral Microbleeds. Neuropsychiatr Dis Treat 2023; 19:635-646. [PMID: 36987525 PMCID: PMC10040165 DOI: 10.2147/ndt.s401603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose The plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory biomarker of cerebral microbleeds (CMBs) and may be related to the occurrence, development, and prognosis of cognitive impairment. The present study aimed to investigate the impact of plasma Lp-PLA2 level on the cognitive impairment in patients with CMBs. Methods In this study, 213 patients with CMBs confirmed by 3.0 T brain magnetic resonance imaging (MRI) were analyzed. Lp-PLA2 levels were determined by magnetic particle chemiluminescence immunoassay technology, and cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The cognitive functions of patients with CMBs were divided into three groups according to the MoCA scale, including normal cognition (NC), mild cognitive impairment (MCI), and moderate-severe cognitive impairment (MSCI). Clinical, laboratory and radiological data of the three groups were analysed. The relationship between plasma Lp-PLA2 and MoCA score in patients with CMBs was investigated through rank correlation analysis and multivariate regression analysis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of Lp-PLA2. Results CMBs were detected in 213 (30.2%) of 705 patients who underwent 3.0 T MRI. Multiple comparisons showed that plasma Lp-PLA2 in patients with CMBs with normal cognitive scores was significantly lower than that in the other two groups with cognitive impairment (p < 0.05). In the single factor correlation analysis, high level of plasma Lp-PLA2 was negatively correlated with the decrease of MoCA score in patients with CMBs (r =-0.389, p < 0.01). Multivariate regression analysis showed that high plasma Lp-PLA2 was an independent risk factor for a low MoCA score in patients with CMBs (odds ratio [OR]=1.014; 95% confidence interval [CI], 1.002-1.026; p=0.025). Conclusion A high level of plasma Lp-PLA2 is positively correlated with the generation of cognitive impairment in patients with CMBs and negatively correlated with the degree of impairment. Plasma Lp-PLA2 is an important indicator of cognitive impairment in patients with CMBs and may provide a therapeutic target for preventing CMB-induced cognitive impairment.
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Affiliation(s)
- Lu Liu
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Xiaojiu Zhang
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
- Department of Neurology, Hongze People’s Hospital, Huai’an, Jiangsu, People’s Republic of China
| | - Nan Jiang
- Department of Neurology, Lianshui PEople’s Hospital Affiliated to Kangda College of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Yufeng Liu
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Qing Wang
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Guanghui Jiang
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Xuejing Li
- Rehabilitation Centre, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
| | - Liandong Zhao
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
- Correspondence: Liandong Zhao; Qijin Zhai, Email ;
| | - Qijin Zhai
- Department of Neurology, Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, Jiangsu, People’s Republic of China
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Song Y, Luo Y, Zhang F, Ma Y, Lou J, Li H, Liu Y, Mi W, Cao J. Systemic immune-inflammation index predicts postoperative delirium in elderly patients after surgery: a retrospective cohort study. BMC Geriatr 2022; 22:730. [PMID: 36064357 PMCID: PMC9446812 DOI: 10.1186/s12877-022-03418-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Postoperative delirium (POD) is a common complication among elderly patients after surgery. It is unclear whether the systemic immune-inflammation index (SII) can be a predictor of POD. We explored the prognostic value of the SII in predicting POD in elderly patients undergoing non-neurosurgery and non-cardiac surgery in a large retrospective cohort. Methods We enrolled elderly patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019. Univariate and multivariate logistic regression analyses were performed to explore the correlation between POD and the SII value as both a continuous and categorical variable. Then, propensity score matching (PSM) analysis was applied to eliminate the confounding effect of covariates and prove our results. Subgroup analyses were then performed to discover the association between the SII and POD in different subgroups. Results A total of 29,608 patients with a median age of 70 years (IQR: 67–74) were enrolled in the retrospective cohort. The cut-off value of the SII was 650, which was determined by the receiver operating characteristic (ROC) curve. The ORs of an SII value > 650 was 2.709 (95% CI:2.373–3.092, P < 0.001), 1.615 (95% CI:1.384–1.882, P < 0.001), 1.855 (95% CI:1.602–2.146, P < 0.001), and 1.302 (95% CI:1.106–1.531, P = 0.001) for prediction of POD in univariate model and three multivariate regression models. After PSM, the OR of an SII value > 650 was 1.301 (95% CI: 1.062–1.598, P = 0.011). The subgroup analysis indicated that the SII indicates a significantly increased risk of POD in patients with Hb < 130 g/L, 4*109/L < WBC ≤ 10*109/L, albumin < 39 g/L, or duration of MAP < 60 mmHg ≥ 5 min. The SII was found to be a useful prognostic predictor of POD for patients of different ages, sexes, and ASA classifications. Conclusions The SII had a predictive value for POD in patients undergoing non-neurosurgery and non-cardiac surgery. As an index generated from routine blood tests, the SII has advantages regarding cost and time. After further validation, the SII may provide a new option for POD prediction. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03418-4.
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Affiliation(s)
- Yuxiang Song
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Yungen Luo
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China.,Medical School of Chinese People's Liberation Army, Beijing, China
| | - Faqiang Zhang
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Yulong Ma
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Jingsheng Lou
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Hao Li
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Yanhong Liu
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Weidong Mi
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China.
| | - Jiangbei Cao
- Department of Anesthesiology, The First Medical Center of Chinese, PLA General Hospital, Beijing, China.
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Liu X, Sun P, Yang J, Fan Y. Biomarkers involved in the pathogenesis of cerebral small-vessel disease. Front Neurol 2022; 13:969185. [PMID: 36119691 PMCID: PMC9475115 DOI: 10.3389/fneur.2022.969185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Cerebral small-vessel disease (CSVD) has been found to have a strong association with vascular cognitive impairment (VCI) and functional loss in elderly patients. At present, the diagnosis of CSVD mainly relies on brain neuroimaging markers, but they cannot fully reflect the overall picture of the disease. Currently, some biomarkers were found to be related to CSVD, but the underlying mechanisms remain unclear. We aimed to systematically review and summarize studies on the progress of biomarkers related to the pathogenesis of CSVD, which is mainly the relationship between these indicators and neuroimaging markers of CSVD. Concerning the pathophysiological mechanism of CSVD, the biomarkers of CSVD have been described as several categories related to sporadic and genetic factors. Monitoring of biomarkers might contribute to the early diagnosis and progression prediction of CSVD, thus providing ideas for better diagnosis and treatment of CSVD.
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Ye Z, Hu T, Wang J, Xiao R, Liao X, Liu M, Sun Z. Systemic immune-inflammation index as a potential biomarker of cardiovascular diseases: A systematic review and meta-analysis. Front Cardiovasc Med 2022; 9:933913. [PMID: 36003917 PMCID: PMC9393310 DOI: 10.3389/fcvm.2022.933913] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several studies have investigated the value of the systemic immune-inflammation index (SII) for predicting cardiovascular disease (CVD), but the results were inconsistent. Therefore, a meta-analysis and systematic review were conducted to assess the correlation between SII and risk of CVD. Materials and methods Two investigators systematically searched PubMed, Embase, Web of Science, Cochrane library, and CINAHL databases to identify all studies that examined the association between SII levels and CVD. The risk estimates of CVD for people with high SII compared to those with low SII levels and the weighted mean difference (WMD) between the CVD and control groups were pooled using fixed- or random-effects models based on the heterogeneity test. We used the Newcastle-Ottawa Scale to assess the risk of bias in eligible studies, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was applied to rate the certainty of evidence. Results A total of 13 studies with 152,996 participants were included for analysis. The overall pooled results showed that higher SII was significantly associated with an increased risk of CVD (HR = 1.39, 95%CI: 1.20–1.61, P < 0.001). This increased risk could be observed in almost all CVD subtypes, including ischemic stroke (HR = 1.31, 95%CI: 1.06–1.63, P = 0.013), hemorrhagic stroke (HR = 1.22, 95%CI: 1.10–1.37, P < 0.001), myocardial infarction (HR = 1.11, 95%CI: 1.01–1.23, P = 0.027), and peripheral arterial disease (HR = 1.51, 95%CI: 1.18–1.93, P = 0.001). There were no significant but still similar trends in venous thrombosis (HR = 4.65, 95%CI: 0.66–32.71, P = 0.122), cerebral small vessel disease (HR = 1.09, 95%CI: 0.95–1.25, P = 0.233), and acute coronary syndrome (HR = 1.08, 95%CI: 0.96–1.22, P = 0.200). Furthermore, the pooled results showed that SII levels at the onset of CVD were significantly higher than that in the general population (WMD = 355.2, 95%CI: 234.8–475.6, P < 0.001), which was consistent across different CVD subtypes. The GRADE assessment suggested that the quality of current evidence from observational studies was low or very low. Conclusion This study indicated that SII may be a potential biomarker for CVD development and elevated SII is associated with an increased risk of CVD. However, the quality of evidence is generally low. Additional well-designed studies are necessary to determine the optimal cutoff value and to characterize the benefited population.
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Affiliation(s)
- Zhen Ye
- Hengyang Medical School, University of South China, Hengyang, China
| | - Tingyi Hu
- Department of Emergency Medicine, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jin Wang
- Hengyang Medical School, University of South China, Hengyang, China
| | - Ruoyi Xiao
- Hengyang Medical School, University of South China, Hengyang, China
| | - Xibei Liao
- Hengyang Medical School, University of South China, Hengyang, China
| | - Mengsi Liu
- Hengyang Medical School, University of South China, Hengyang, China
| | - Zhen Sun
- Hengyang Medical School, University of South China, Hengyang, China
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Gao Y, Li D, Lin J, Thomas AM, Miao J, Chen D, Li S, Chu C. Cerebral small vessel disease: Pathological mechanisms and potential therapeutic targets. Front Aging Neurosci 2022; 14:961661. [PMID: 36034144 PMCID: PMC9412755 DOI: 10.3389/fnagi.2022.961661] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebral small vessel disease (CSVD) represents a diverse cluster of cerebrovascular diseases primarily affecting small arteries, capillaries, arterioles and venules. The diagnosis of CSVD relies on the identification of small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, and microbleeds using neuroimaging. CSVD is observed in 25% of strokes worldwide and is the most common pathology of cognitive decline and dementia in the elderly. Still, due to the poor understanding of pathophysiology in CSVD, there is not an effective preventative or therapeutic approach for CSVD. The most widely accepted approach to CSVD treatment is to mitigate vascular risk factors and adopt a healthier lifestyle. Thus, a deeper understanding of pathogenesis may foster more specific therapies. Here, we review the underlying mechanisms of pathological characteristics in CSVD development, with a focus on endothelial dysfunction, blood-brain barrier impairment and white matter change. We also describe inflammation in CSVD, whose role in contributing to CSVD pathology is gaining interest. Finally, we update the current treatments and preventative measures of CSVD, as well as discuss potential targets and novel strategies for CSVD treatment.
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Affiliation(s)
- Yue Gao
- Department of Neurointervention and Neurological Intensive Care, Dalian Municipal Central Hospital, Dalian, China
| | - Di Li
- Department of Neurointervention and Neurological Intensive Care, Dalian Municipal Central Hospital, Dalian, China
| | - Jianwen Lin
- Department of Neurology, Dalian Municipal Central Hospital, Dalian, China
| | - Aline M. Thomas
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institution, Baltimore, MD, United States
| | - Jianyu Miao
- Department of Neurology, Dalian Municipal Central Hospital, Dalian, China
| | - Dong Chen
- Department of Neurosurgery, Dalian Municipal Central Hospital, Dalian, China
| | - Shen Li
- Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Chengyan Chu
- Department of Neurology, Dalian Municipal Central Hospital, Dalian, China
- *Correspondence: Chengyan Chu,
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Hou L, Zhang S, Qi D, Jia T, Wang H, Zhang W, Wei S, Xue C, Wang P. Correlation between neutrophil/lymphocyte ratio and cognitive impairment in cerebral small vessel disease patients: A retrospective study. Front Neurol 2022; 13:925218. [PMID: 35989913 PMCID: PMC9391025 DOI: 10.3389/fneur.2022.925218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objective The blood neutrophil/lymphocyte ratio (NLR) is an objective and convenient parameter of systemic inflammation. Elevated NLR is associated with an increased risk of mild cognitive impairment (CI) in the elderly. However, few data are available on the impact of the NLR on CI in patients with cerebral small vessel disease (CSVD). Methods A total of 66 CSVD subjects with CI and 81 CSVD subjects without CI were evaluated in this study. Clinical, laboratory, radiological, and cognitive parameters were collected. The NLR was obtained with the absolute neutrophil count being divided by the absolute lymphocyte count in fasting blood samples. Logistic regression analysis was performed to evaluate the factors associated with CI. Receiver operating characteristic curves were illustrated to predict factors associated with CI in patients with CSVD. Results The NLR of the CI group was significantly higher than that of subjects without CI (2.59 vs. 2.21, P = 0.003). In multivariate analysis, NLR was positively correlated to the CI (OR: 1.43, 95% CI: 1.05–1.96, P = 0.024). It was suggested that the optimum NLR cutoff point for CI was 1.89 with 69.7% sensitivity and 59.3% specificity. Subjects with NLR ≥ 1.89 showed higher possibilities of CI compared to those with NLR < 1.89 (OR: 3.38, 95% CI: 1.62–7.07). Conclusions Correlations were found between NLR and CI. Patients with CSVD who have higher NLR might have an increased risk of CI.
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Affiliation(s)
- Lan Hou
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
- Baoding City Key Laboratory of Neurological Diseases, Baoding, China
| | - Shuhan Zhang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Dandan Qi
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Tongle Jia
- Baoding City Key Laboratory of Neurological Diseases, Baoding, China
- Department of Neurosurgery, Baoding No.1 Central Hospital, Baoding, China
| | - Huan Wang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Wei Zhang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Shuyan Wei
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
| | - Conglong Xue
- Department of General Surgery, Baoding No.1 Central Hospital, Baoding, China
| | - Pei Wang
- Department of Neurology, Baoding No.1 Central Hospital, Baoding, China
- Baoding City Key Laboratory of Neurological Diseases, Baoding, China
- *Correspondence: Pei Wang
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Yao S, Ding K, Liu S, Zhang Q, Li W, Tang L, Yu S, Pang L, Yin X, Cheng H. The Managing Cancer and Living Meaningfully (CALM) Intervention Alleviates Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer by Modulating Pan-Immune-Inflammation Values. Integr Cancer Ther 2022; 21:15347354221140498. [DOI: 10.1177/15347354221140498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: The number of patients with breast cancer is increasing worldwide, resulting in a growing number of patients with chemotherapy-related cognitive impairment (CRCI), which seriously affects their quality of life. CRCI is associated with inflammatory factors and systemic inflammatory markers such as pan-immune-inflammation value (PIV) and monocyte-to-lymphocyte ratio (MLR), which can reflect the level of inflammation in the body. While the Managing Cancer and Living Meaningfully (CALM) intervention has been demonstrated to alleviate CRCI in patients with breast cancer, the specific mechanism remains unclear. Objective: This study evaluated the impact of the CALM intervention on systemic inflammation. Methods: Ninety patients with breast cancer with CRCI were enrolled and randomized into care as usual (CAU) and CALM intervention groups. All patients were assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), Mini-Mental State Exam (MMSE), and Functional Assessment of Cancer Therapy-Breast (FACT-B) before and after the CAU/CALM intervention. The blood levels of inflammatory markers were also analyzed before and after the intervention. Results: Compared to the CAU group, the CALM group showed significantly improved cognitive function and significantly decreased PIV ( P < .05). PIV was significantly negatively correlated with FACT-Cog ( P < .05). The levels of other inflammatory markers, including MLR, neutrophil-to-lymphocyte ratio (NLR), granulocyte-to-lymphocyte ratio (GLR), and systemic immune-inflammation index (SII), were also reduced in the CALM group. Conclusion: PIV is an important marker of inflammation. The CALM intervention may improve the cognitive function of patients by regulating the systemic inflammation marker PIV through the neuroimmune axis.
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Affiliation(s)
- Senbang Yao
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ke Ding
- Department of Radiation Oncology, Fuyang Cancer Hospital, Fuyang, Anhui, China
| | - Shaochun Liu
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qianqian Zhang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wen Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lingxue Tang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Sheng Yu
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Lulian Pang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiangxiang Yin
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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