1
|
Tang X, Jiang L, Luo Y, Fan H, Song L, Liu P, Chen Y. Leukoaraiosis and acute ischemic stroke. Eur J Neurosci 2021; 54:6202-6213. [PMID: 34331366 DOI: 10.1111/ejn.15406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
Ischaemic stroke is characterized by high morbidity, high disability rate, high mortality and high recurrence rate, which can have a grave impact on the quality of life of the patients and consequently becomes an economic burden on their families and society. With the developments in imaging technology in recent years, patients with acute cerebral infarction are predominantly more likely to be diagnosed with leukoaraiosis (LA). LA is a common degenerative disease of the nervous system, which is related to cognitive decline, depression, abnormal gait, ischaemic stroke and atherosclerosis. The aetiology of LA is not clear and there is no gold standard for imaging assessment. Related studies have shown that LA has an adverse effect on the prognosis of cerebral infarction, but some experts have contrary beliefs. Hence, we undertook the present review of the literature on the mechanism and the effect of LA on the prognosis of patients with acute ischaemic stroke.
Collapse
Affiliation(s)
- Xiaojia Tang
- Department of Rehabilitation Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou City, China
| | - Li Jiang
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou City, China
| | - Yuhan Luo
- Health Management Center, People's Hospital of Deyang City, Deyang City, China
| | - Hongyang Fan
- Department of Neurology, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang City, China
| | - Lilong Song
- Department of Neurology, Shanghai Fourth People's Hospital, Shanghai City, China
| | - Peipei Liu
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou City, China
| | - Yingzhu Chen
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou City, China
| |
Collapse
|
2
|
Ren XM, Qiu SW, Liu RY, Wu WB, Xu Y, Zhou H. White Matter Lesions Predict Recurrent Vascular Events in Patients with Transient Ischemic Attacks. Chin Med J (Engl) 2018; 131:130-136. [PMID: 29336359 PMCID: PMC5776841 DOI: 10.4103/0366-6999.222341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: White matter lesions (WMLs) are common findings in brain magnetic resonance imaging (MRI) and are strongly associated with stroke incidence, recurrence, and prognosis. However, the relationship between WMLs and transient ischemic attacks (TIAs) is not well established. This study aimed to determine the clinical significance of WMLs in patients with TIA. Methods: A total of 181 consecutive inpatients with first-ever TIA were enrolled. Brain MRIs within 2 days of symptom onset were used to measure WML volumes. Recurrent vascular events within 1 year of TIA onset were assessed. The relationship between WMLs and recurrent risk of vascular events was determined by a multivariate logistic regression. Results: WMLs were identified in 104 patients (57.5%). Age and ratio of hypertension were significantly different between patients with and without WMLs. The incidence of vascular events in patients with WMLs significantly increased in comparison to those without WMLs (21.15% vs. 5.19%, 95% confidence interval [CI]: 1.18–15.20, P = 0.027) after controlling for confounders. Furthermore, distributions of WML loads were found to be different between patients who developed vascular events and those who did not. WML volumes were demonstrated to be correlated with recurrent risks, and the fourth quartile of WML volumes led to an 8.5-fold elevation of recurrent risk of vascular events compared with the first quartile (95% CI: 1.52–47.65, P = 0.015) after adjusting for hyperlipidemia. Conclusion: WMLs occur frequently in patients with TIA and are associated with the high risk of recurrent vascular events, suggesting a predictive neuroimaging marker for TIA outcomes.
Collapse
Affiliation(s)
- Xiao-Mei Ren
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008; Department of Neurology, Yizheng People's Hospital, Yangzhou, Jiangsu 211400, China
| | - Shu-Wei Qiu
- Jiangsu Key Laboratory for Molecular Medicine, Nanjing, Jiangsu 210008, China
| | - Ren-Yuan Liu
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Wen-Bo Wu
- Department of Radiology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University; Jiangsu Key Laboratory for Molecular Medicine; Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Hong Zhou
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| |
Collapse
|
3
|
He JR, Zhang Y, Lu WJ, Liang HB, Tu XQ, Ma FY, Yang GY, Zeng LL. Age-Related Frontal Periventricular White Matter Hyperintensities and miR-92a-3p Are Associated with Early-Onset Post-Stroke Depression. Front Aging Neurosci 2017; 9:328. [PMID: 29051732 PMCID: PMC5633610 DOI: 10.3389/fnagi.2017.00328] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/22/2017] [Indexed: 01/13/2023] Open
Abstract
Objective: To explore the correlationship among white matter hyperintensities (WMHs), miR-92a-3p and early-onset post-stroke depression (PSD). Methods: We recruited consecutively 238 patients with acute cerebral infarction and MRI examination in the Department of neurology, Ruijin hospital, Shanghai Jiaotong University School of Medicine. The diagnosis of early-onset PSD was made in accordance with DSM-IV criteria for depression in 2 weeks after stroke. Clinical information and assessments of stroke severity were recorded on admission. The analysis of plasma miR-92a-3p was performed using quantitative PCR at the same time. WMHs were evaluated by the Fazekas and Scheltens visual rating scales. The relationship among WMHs, miR-92a-3p and PSD were analyzed by SPSS 22.0 software. Results: Logistic regression demonstrated that periventricular WMHs (PVWMHs) in frontal caps was an independent risk factor with early-onset PSD (OR = 1.579, 95% CI: 1.040-2.397, p = 0.032). The age and numbers of lacunes were related to frontal PVWMHs. Plasma miR-92a-3p in the PSD group was higher compared with the non-depressed group. Receiver operating curve analysis revealed that miR-92a-3p could predict early-onset PSD with 90% sensitivity and 90% specificity. The higher miR-92a-3p trended toward association with greater frontal PVWMHs. Conclusion: Acute ischemic stroke patients with frontal PVWMHs or a high plasma miR-92a-3p at baseline were more likely to develop early-onset PSD. MiR-92a-3p might be involved in the white matter impairment and post-stroke depression.
Collapse
Affiliation(s)
- Ji-Rong He
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Neurology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Zhang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Jing Lu
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huai-Bin Liang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan-Qiang Tu
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei-Yue Ma
- Department of Neurology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guo-Yuan Yang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Li Zeng
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Lin Q, Huang WQ, Ma QL, Lu CX, Tong SJ, Ye JH, Lin HN, Gu L, Yi KH, Cai LL, Tzeng CM. Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7682. [PMID: 28953609 PMCID: PMC5626252 DOI: 10.1097/md.0000000000007682] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Leukoaraiosis (LA) refers to white matter hyperintensities or white matter lesions (WMLs) on magnetic resonance imaging (MRI) scans of the brain; this disease is associated with an increased risk of stroke, dementia, and cognitive decline. The aims of the study are to assess the incidence of LA and its associated risk factors in a Chinese population.A hospital-based cross-sectional study was conducted that included 4683 patients who were 40 years or older. Data collected included age, sex, hypertension, diabetes, smoking, drinking, homocysteine (HCY), and low-density lipoprotein cholesterol (LDL-C) levels in the blood in addition to brain MRI information. We examined the relationship of those putative risk factors with LA, LA occurrence, and LA progression through single-factor and multivariate analyses.Of the total subjects, 58.3% (2731/4683 cases) suffered from LA. LA was more frequent amongst elderly females, particularly in those older than 60, compared to men. The incidence of LA increased with age. Age, sex, hypertension, diabetes, smoking, and HCY levels all were risk factors for LA. Amongst those risk factors, both smoking and high HCY levels were associated with the onset process of LA. Moreover, the multivariate logistic analysis revealed that both drinking and abnormal LDL-C levels were positive regulators in the progression process of LA.This study revealed that the incidence of LA is high in hospitalized patients in China; moreover, age, sex, hypertension, diabetes mellitus, smoking, drinking, and abnormal HCY and LDL-C levels were found to be associated with overall LA risk, LA onset, or LA progression. These results provide insight into strategies for the prevention and treatment of LA.
Collapse
Affiliation(s)
- Qing Lin
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Wen-Qing Huang
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong
| | - Qi-Lin Ma
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Cong-Xia Lu
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Sui-Jun Tong
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Jin-Hu Ye
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Hui-Nuan Lin
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Long Gu
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Ke-Hui Yi
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Liang-Liang Cai
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Chi-Meng Tzeng
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- INNOVA Clinics and TRANSLA Health Group, Yangzhou, Jiangsu, China
| |
Collapse
|
5
|
Lucatelli P, Montisci R, Sanfilippo R, Sacconi B, Suri JS, Catalano C, Saba L. Is there an association between leukoaraiosis volume and diabetes? J Neuroradiol 2016; 43:273-9. [DOI: 10.1016/j.neurad.2015.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 11/22/2015] [Accepted: 11/23/2015] [Indexed: 10/22/2022]
|
6
|
Tran T, Cotlarciuc I, Yadav S, Hasan N, Bentley P, Levi C, Worrall BB, Meschia JF, Rost N, Sharma P. Candidate-gene analysis of white matter hyperintensities on neuroimaging. J Neurol Neurosurg Psychiatry 2016; 87:260-6. [PMID: 25835038 PMCID: PMC4789815 DOI: 10.1136/jnnp-2014-309685] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/11/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND White matter hyperintensities (WMH) are a common radiographic finding and may be a useful endophenotype for small vessel diseases. Given high heritability of WMH, we hypothesised that certain genotypes may predispose individuals to these lesions and consequently, to an increased risk of stroke, dementia and death. We performed a meta-analysis of studies investigating candidate genes and WMH to elucidate the genetic susceptibility to WMH and tested associated variants in a new independent WMH cohort. We assessed a causal relationship of WMH to methylene tetrahydrofolate reductase (MTHFR). METHODS Database searches through March 2014 were undertaken and studies investigating candidate genes in WMH were assessed. Associated variants were tested in a new independent ischaemic cohort of 1202 WMH patients. Mendelian randomization was undertaken to assess a causal relationship between WMH and MTHFR. RESULTS We identified 43 case-control studies interrogating eight polymorphisms in seven genes covering 6,314 WMH cases and 15,461 controls. Fixed-effects meta-analysis found that the C-allele containing genotypes of the aldosterone synthase CYP11B2 T(-344)C gene polymorphism were associated with a decreased risk of WMH (OR=0.61; 95% CI, 0.44 to 0.84; p=0.003). Using mendelian randomisation the association among MTHFR C677T, homocysteine levels and WMH, approached, but did not reach, significance (expected OR=1.75; 95% CI, 0.90-3.41; observed OR=1.68; 95% CI, 0.97-2.94). Neither CYP11B2 T(-344)C nor MTHFR C677T were significantly associated when tested in a new independent cohort of 1202 patients with WMH. CONCLUSIONS There is a genetic basis to WMH but anonymous genome wide and exome studies are more likely to provide novel loci of interest.
Collapse
Affiliation(s)
- Theresa Tran
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL) and Ashford & St Peters NHS Foundation Trust, London, UK Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Ioana Cotlarciuc
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL) and Ashford & St Peters NHS Foundation Trust, London, UK
| | - Sunaina Yadav
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Nazeeha Hasan
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Paul Bentley
- Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| | - Christopher Levi
- Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia, USA
| | - James F Meschia
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Natalia Rost
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL) and Ashford & St Peters NHS Foundation Trust, London, UK Imperial College Cerebrovascular Research Unit (ICCRU), Imperial College London, London, UK
| |
Collapse
|
7
|
Gao Y, Wei S, Song B, Qin J, Fang H, Ji Y, Zhang R, Sun S, Xu Y. Homocysteine Level Is Associated with White Matter Hyperintensity Locations in Patients with Acute Ischemic Stroke. PLoS One 2015; 10:e0144431. [PMID: 26641086 PMCID: PMC4671668 DOI: 10.1371/journal.pone.0144431] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/18/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE The relationship between plasma level of total homocysteine (tHcy) and white matter hyperintensities (WMHs), especially in patients with acute ischemic stroke (AIS), is controversial. The present study investigated the association between these two as well as WMH locations in a large cohort of patients with AIS. METHODS Consecutive patients were reviewed from a prospective ischemic stroke database. Clinical data, including tHcy level and WMHs, were assessed. WMHs were assessed using the Fazekas scale and Age-Related White Matter Changes (ARWMC) visual grading scale. The association between tHcy and WMH locations was investigated by using multivariate logistic regression analyses. RESULTS A total of 923 out of 1,205 patients were examined. The average age was 58.9 ± 11.9 years; 31.6% were female. Elevated tHcy level was significantly associated with WMHs. For the highest tHcy quartile, the odds ratio (OR) (95% confidence interval; CI) was 1.891 (1.257; 2.843) according to the Fazekas scale and 1.781 (1.185; 2.767) according to the ARWMC scale when compared to the lowest quartile. However, in a subgroup analysis, only WMHs in the periventricular area and left or right frontal areas were found to be independently associated with tHcy level. For the highest tHcy quartile, the OR (95% CI) was 1.761 (1.172; 2.648) for the periventricular WMHs, 1.768 (1.134; 2.756)for the left frontal WMHs, and 1.890 (1.206; 2.960)for the right frontal WMHs. CONCLUSIONS In patients with AIS, plasma tHcy level is related to WMHs, especially WMHs distributed within the periventricular and frontal areas.
Collapse
Affiliation(s)
- Yuan Gao
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Sen Wei
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Bo Song
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Jie Qin
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Hui Fang
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Yan Ji
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Rui Zhang
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Shilei Sun
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| | - Yuming Xu
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University at Zhengzhou, Henan, China
| |
Collapse
|
8
|
Szolnoki Z, Szekeres M, Szaniszlo I, Balda G, Bodor A, Kondacs A, Mandi Y, Somogyvari F. Decreased Number of Mitochondria in Leukoaraiosis. Arch Med Res 2015; 46:604-8. [PMID: 26577272 DOI: 10.1016/j.arcmed.2015.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/02/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Leukoaraiosis (LA), one of the most frequent causes of an age-associated cognitive decline, can be associated with a poor quality of life, leading overall to far-reaching public health problems. Chronic hypoxia of the white matter of the brain may be a factor triggering this entity. LA may develop as a consequence of chronically insufficient cellular energy production and the accumulation of free radicals. METHODS In this context, after hypothesizing that the number of healthy mitochondria can be crucial in this complex process, a case-control LA study was carried out in which we analyzed the numbers of deleted and non-deleted mitochondria (the common D-loop deletion) per white blood cell. A total of 234 patients with LA and 123 MRI alteration-free subjects served as a control group. RESULTS Interestingly, it emerged that the ratio of deleted relative to non-deleted mitochondria is strongly associated with the risk of LA. The calculated K ratio in the LA group was significantly lower than the K ratio in the controls (LA: K 0.37 95% CI 0.05; controls: K 0.48, 95% CI 0.076, p < 0.001). CONCLUSIONS Our study suggests that the ratio of the dmDNA and mDNA can be of great importance in the pathogenesis of LA.
Collapse
Affiliation(s)
- Zoltan Szolnoki
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary.
| | - Marta Szekeres
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Istvan Szaniszlo
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary
| | - Gyorgy Balda
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary
| | - Anita Bodor
- Department of Pathology, Réthy Pál County Hospital, Békéscsaba, Hungary
| | - Andras Kondacs
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary
| | - Yvette Mandi
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Ferenc Somogyvari
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| |
Collapse
|
9
|
Te M, Zhao E, Xingyue Z, Qinjian S, Chuanqiang Q. Leukoaraiosis with mild cognitive impairment. Neurol Res 2015; 37:410-4. [DOI: 10.1179/1743132815y.0000000028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
10
|
Cho Y, Kim JO, Lee JH, Park HM, Jeon YJ, Oh SH, Bae J, Park YS, Kim OJ, Kim NK. Association of reduced folate carrier-1 (RFC-1) polymorphisms with ischemic stroke and silent brain infarction. PLoS One 2015; 10:e0115295. [PMID: 25659099 PMCID: PMC4319782 DOI: 10.1371/journal.pone.0115295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 11/23/2014] [Indexed: 11/19/2022] Open
Abstract
Stroke is the second leading cause of death in the world and in South Korea. Ischemic stroke and silent brain infarction (SBI) are complex, multifactorial diseases influenced by multiple genetic and environmental factors. Moderately elevated plasma homocysteine levels are a major risk factor for vascular diseases, including stroke and SBI. Folate and vitamin B12 are important regulators of homocysteine metabolism. Reduced folate carrier (RFC), a bidirectional anion exchanger, mediates folate delivery to a variety of cells. We selected three known RFC-1 polymorphisms (-43C>T, 80A>G, 696T>C) and investigated their relationship to cerebral infarction in the Korean population. We used the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to analyze associations between the three RFC-1 polymorphisms, disease status, and folate and homocysteine levels in 584 ischemic stroke patients, 353 SBI patients, and 505 control subjects. The frequencies of the RFC-1 -43TT, 80GG, and 696CC genotypes differed significantly between the stroke and control groups. The RFC-1 80A>G substitution was also associated with small artery occlusion and SBI. In a gene-environment analysis, the RFC-1 -43C>T, 80A>G, and 696T>C polymorphisms in the ischemic stroke group had combined effects with all environmental factors. In summary, we found that the RFC-1 -43C>T, 80A>G, and 696T>C polymorphisms may be risk factors for ischemic stroke.
Collapse
Affiliation(s)
- Yunkyung Cho
- Department of Internal Medicine, CHA Gangnam Medical Center, School of Medicine, CHA University, Seoul 135–081, South Korea
| | - Jung O Kim
- Institute for Clinical Research, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Jeong Han Lee
- Department of Emergency Medicine, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Hye Mi Park
- Institute for Clinical Research, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Young Joo Jeon
- Institute for Clinical Research, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Seung Hun Oh
- Department of Neurology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Jinkun Bae
- Department of Emergency Medicine, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
| | - Young Seok Park
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University, Cheongju 361–711, South Korea
| | - Ok Joon Kim
- Department of Neurology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
- * E-mail: (NKK); (OJK)
| | - Nam Keun Kim
- Institute for Clinical Research, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 463–712, South Korea
- * E-mail: (NKK); (OJK)
| |
Collapse
|
11
|
|
12
|
Interaction of white matter hyperintensities (WMHs) and apolipoprotein E (APOE) genotypes on cognition in patients with amnestic mild cognitive impairment (aMCI). Arch Gerontol Geriatr 2013; 57:292-7. [PMID: 23688406 DOI: 10.1016/j.archger.2013.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 02/12/2013] [Accepted: 04/18/2013] [Indexed: 11/23/2022]
Abstract
The clinical implications of WMHs in aMCI are inconclusive. Moreover, clinical interactions between APOE genotypes and WMHs remain unclear. This study was conducted to investigate the relationship between WMHs and cognitive functions and how this relationship interacted with APOE genotype in people with aMCI. This study included a total of 1472 patients with aMCI from the Clinical Research Center for Dementia of South Korea (CREDOS) and divided them into 3 groups according to the severity of WMHs as assessed by visual ratings of brain magnetic resonance images. The associations of WMHs with the various cognitive domains and with APOE epsilon 4 (ɛ4) status were evaluated. After multivariable adjustments, the severity of WMHs was independently associated with semantic/phonemic verbal fluency and Stroop test-color reading, while APOE ɛ4 status was associated with verbal and visual memory-immediate, delayed recall, and recognition. Moreover, there were interaction between WMHs and APOE ɛ4 status in semantic verbal fluency (animal, P=0.033; supermarket, P=0.047)/Stroop test-color reading (P=0.024). WMHs independently deleteriously affected frontal executive functions in aMCI patients, regardless of APOE ɛ4 presence. Furthermore, APOE ɛ4 possession caused a rapid decline in frontal executive functions with the increase in the WMHs severity (vs. absence), suggesting that WMHs and APOE ɛ4 genotypes synergistically contribute to frontal executive dysfunctions in aMCI.
Collapse
|
13
|
Fernández-Gamba A, Leal MC, Maarouf CL, Richter-Landsberg C, Wu T, Morelli L, Roher AE, Castaño EM. Collapsin response mediator protein-2 phosphorylation promotes the reversible retraction of oligodendrocyte processes in response to non-lethal oxidative stress. J Neurochem 2012; 121:985-95. [PMID: 22443207 DOI: 10.1111/j.1471-4159.2012.07742.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The extension of processes of oligodendrocyte (OLG) and their precursor cells are crucial for migration, axonal contact and myelination. Here we show that a non-lethal oxidative stress induced by 3-nitropropionic acid (3-NP) elicited a rapid shortening of processes (~24%) in primary OLGs and in oligodendroglial cell line (OLN-93) cells (~36%) as compared with vehicle-exposed cells. This was reversible and prevented by antioxidants. Proteomics of OLG lysates with and without 3-NP treatment yielded collapsin response mediator protein 2 (CRMP-2) as a candidate effector molecule. Inhibition of rho kinase was sufficient to prevent process retraction in both OLGs and OLN-93 cells. Oxidative stress increased phosphorylation of CRMP-2 at T555 that was completely prevented by Y27632. Moreover, transfection of OLN-93 cells with the mutant CRMP-2 T555A which cannot be phosphorylated by rho kinase, prevented process shortening induced by 3-NP as compared with wild-type CRMP-2. Our results suggest a role for endogenous reactive oxygen species in a pathway that regulates OLG process extension. The vulnerability of late myelinated neurons in the adult brain and the presence of white matter pathology in human dementias warrant the study of this oligodendroglial pathway in the early stages of neurodegenerative conditions characterized by oxidative stress.
Collapse
Affiliation(s)
- Agata Fernández-Gamba
- Fundación Instituto Leloir-Instituto de Investigaciones Bioquímicas de Buenos Aires, CONICET, Buenos Aires, Argentina
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Does l-arginine supplementation play a role in cerebral small vessels disease? Implication in the treatment of leukoaraiosis. Med Hypotheses 2011; 77:671-3. [DOI: 10.1016/j.mehy.2011.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 07/04/2011] [Indexed: 11/17/2022]
|
15
|
Pokrovskiy MV, Korokin MV, Tsepeleva SA, Pokrovskaya TG, Gureev VV, Konovalova EA, Gudyrev OS, Kochkarov VI, Korokina LV, Dudina EN, Babko AV, Terehova EG. Arginase inhibitor in the pharmacological correction of endothelial dysfunction. Int J Hypertens 2011; 2011:515047. [PMID: 21747978 PMCID: PMC3124670 DOI: 10.4061/2011/515047] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 04/25/2011] [Indexed: 11/20/2022] Open
Abstract
THIS PAPER IS ABOUT A WAY OF CORRECTION OF ENDOTHELIAL DYSFUNCTION WITH THE INHIBITOR OF ARGINASE: L-norvaline. There is an imbalance between vasoconstriction and vasodilatation factors of endothelium on the basis of endothelial dysfunction. Among vasodilatation agents, nitrogen oxide plays the basic role. Amino acid L-arginine serves as a source of molecules of nitrogen oxide in an organism. Because of the high activity of arginase enzyme which catalyzes the hydrolysis of L-arginine into ornithine and urea, the bioavailability of nitrogen oxide decreases. The inhibitors of arginase suppress the activity of the given enzyme, raising and production of nitrogen oxide, preventing the development of endothelial dysfunction.
Collapse
Affiliation(s)
- Mihail V Pokrovskiy
- Department of Pharmacology and Pharmaceutical Sciences, Belgorod State University, 85 Pobeda Street, Belgorod 308015, Russia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Szolnoki Z, Kondacs A, Mandi Y, Bodor A, Somogyvari F. A homozygous genetic variant of mitochondrial uncoupling protein 4 affects the occurrence of leukoaraiosis. Acta Neurol Scand 2011; 123:352-7. [PMID: 20545631 DOI: 10.1111/j.1600-0404.2010.01391.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We hypothesized that an appropriate balance of the mitochondrial energy production is essential in the maintenance of the glia cells in the brain. The aim of this study was to examine the roles of the rs10807344 and rs2270450 genetic variants of mitochondrial uncoupling protein 4 in the development of vascular demyelinization of the white matter of the brain, referred to as leukoaraiosis (LA). The mUCPs are presumed to be of great importance in the regulation of the mitochondrial membrane potential (MMP) and the cellular energy metabolism. MATERIALS AND METHODS An analysis was performed on the clinical and genetic data on 401 LA patients without infarction and on 451 neuroimaging alteration-free subjects. After univariate statistical approaches, logistic regression models were also used to adjust differences in significant clinical factors between the patients and controls. RESULTS The rs10807344 CC genotype proved to exert a protective effect on the occurrence of LA (neuroimaging alteration-free controls: 57.7%, LA group: 44.9%, P < 0.0002; adjusted OR: 0.41, 95% CI: 0.2-0.68, P < 0.005). CONCLUSION The present findings indirectly raise the possibility that a shift or imbalance in the finely regulated MMP may play a role in the development of LA.
Collapse
Affiliation(s)
- Z Szolnoki
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary.
| | | | | | | | | |
Collapse
|
17
|
Isordia-Salas I, Leaños-Miranda A, Borrayo-Sánchez G. The Glu298ASP polymorphism of the endothelial nitric oxide synthase gene is associated with premature ST elevation myocardial infarction in Mexican population. Clin Chim Acta 2010; 411:553-7. [DOI: 10.1016/j.cca.2010.01.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2009] [Revised: 01/08/2010] [Accepted: 01/08/2010] [Indexed: 11/28/2022]
|
18
|
Han IB, Kim OJ, Ahn JY, Oh D, Hong SP, Huh R, Chung SS, Kim NK. Association of methylenetetrahydrofolate reductase (MTHFR 677C>T and 1298A>C) polymorphisms and haplotypes with silent brain infarction and homocysteine levels in a Korean population. Yonsei Med J 2010; 51:253-60. [PMID: 20191019 PMCID: PMC2824873 DOI: 10.3349/ymj.2010.51.2.253] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 06/08/2009] [Accepted: 07/01/2009] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Methylenetetrahydrofolate reductase (MTHFR) is the main regulatory enzyme for homocysteine metabolism. In the present study, we evaluated whether the MTHFR 677C>T and 1298A>C gene polymorphisms are associated with SBI and plasma homocysteine concentration in a Korean population. MATERIALS AND METHODS We enrolled 264 patients with SBI and 234 healthy controls in South Korea. Fasting plasma total homocysteine (tHcy) concentrations were measured, and genotype analysis of the MTHFR gene was carried out. RESULTS The plasma tHcy levels were significantly higher in patients with SBI than in healthy controls. Despite a significant association between the MTHFR 677TT genotype and hyperhomocysteinemia, the MTHFR 677C>T genotypes did not appear to influence susceptibility to SBI. However, odds ratios of the 1298AC and 1298AC + CC genotypes for the 1298AA genotype were significantly different between SBI patients and normal controls. The frequencies of 677C-1298A and 677C-1298C haplotypes were significantly higher in the SBI group than in the control group. CONCLUSION This study demonstrates that the MTHFR 1298A>C polymorphism is a risk factor for SBI in a Korean population. The genotypes of 677C>T and 1298A>C polymorphisms interact additively, and increase the risk of SBI in Korean subjects.
Collapse
Affiliation(s)
- In Bo Han
- Department of Neurosurgery, School of Medicine, CHA University, Seongnam, Korea
- Institute for Clinical Research, School of Medicine, CHA University, Seongnam, Korea
| | - Ok Joon Kim
- Department of Neurology, School of Medicine, CHA University, Seongnam, Korea
| | - Jung Yong Ahn
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Doyeun Oh
- Institute for Clinical Research, School of Medicine, CHA University, Seongnam, Korea
| | | | - Ryoong Huh
- Department of Neurosurgery, School of Medicine, CHA University, Seongnam, Korea
| | - Sang Sup Chung
- Department of Neurosurgery, School of Medicine, CHA University, Seongnam, Korea
| | - Nam Keun Kim
- Institute for Clinical Research, School of Medicine, CHA University, Seongnam, Korea
| |
Collapse
|
19
|
Polymorphisms of the NOS3 gene in Southern Chilean subjects with coronary artery disease and controls. Clin Chim Acta 2010; 411:258-62. [DOI: 10.1016/j.cca.2009.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 11/13/2009] [Accepted: 11/15/2009] [Indexed: 12/20/2022]
|
20
|
Huang YH, Zhang WW, Lin L, Feng J, Zhao XX, Guo WH, Wei W. Could changes in arterioles impede the perivascular drainage of interstitial fluid from the cerebral white matter in leukoaraiosis? Neuropathol Appl Neurobiol 2009; 36:237-47. [PMID: 19889176 DOI: 10.1111/j.1365-2990.2009.01049.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS Leukoaraiosis (LA) is the increase in fluid in cerebral white matter with hyperintensity on T2-weighted MR imaging that occurs in 25% of individuals over 65 years of age and in Alzheimer's disease. Age, hypertension, diabetes mellitus and cardiac disease are the major risk factors for LA. Ischaemia is considered to be the cause of LA, but the aim of the present study is to assess whether changes in arterioles in LA could impede perivascular lymphatic drainage of interstitial fluid from the cerebral white matter. METHODS We quantified arteriolosclerosis and immunohistochemical changes in the extracellular matrix in arterioles of cerebral white matter in 20 hypertension autopsy cases with LA and in 10 controls. RESULTS The ratio of the area immunoreactive for collagen types I, III, V and VI to the cross-sectional area of arterioles was significantly higher in LA patients compared with controls (P < 0.001). Changes were observed in collagen IV and laminin. The walls of white matter arterioles in LA were significantly thicker (P < 0.01), and lumina were significantly smaller (P < 0.01). Arterioles had a significantly higher sclerotic index [1 - (internal/external diameter)] in LA than in adjacent cortex or control white matter (P < 0.01). CONCLUSIONS Our results show that thickening and sclerosis of the walls of arterioles in cerebral white matter in LA are associated with the accumulation of extracellular matrix components. Although these changes may result in decreased perfusion, they could also impede perivascular lymphatic drainage of interstitial fluid from white matter in LA.
Collapse
Affiliation(s)
- Y H Huang
- Department of Neurology, Beijing Military General Hospital, Dongsi, Beijing, China
| | | | | | | | | | | | | |
Collapse
|
21
|
Price CC, Garrett KD, Jefferson AL, Cosentino S, Tanner JJ, Penney DL, Swenson R, Giovannetti T, Bettcher BM, Libon DJ. Leukoaraiosis severity and list-learning in dementia. Clin Neuropsychol 2009; 23:944-61. [PMID: 19370451 DOI: 10.1080/13854040802681664] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In patients with dementia, leukoaraiosis (LA) was hypothesized to result in differential patterns of impairment on a verbal serial list-learning test. Using a visual rating scale, 144 dementia patients with ischemic scores <4 were re-categorized as having mild (n = 73), moderate (n = 44), or severe LA (n = 27). Mild LA was predicted to be associated with an amnestic list-learning profile, while severe LA was predicted to be associated with a dysexecutive profile. List-learning performances were standardized to a group of healthy older adults (n = 24). Analyses were conducted on a set of four factors derived from the list-learning paradigm, as well as error scores. Data indicate that LA severity is an important marker for understanding list learning in dementia.
Collapse
Affiliation(s)
- Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, Florida, 32610, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Evaluation of the genetic variants of kinesin motor protein in ischemic stroke. J Stroke Cerebrovasc Dis 2009; 18:360-2. [PMID: 19717019 DOI: 10.1016/j.jstrokecerebrovasdis.2009.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 12/31/2008] [Accepted: 01/06/2009] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The kinesin light-chain 1 genetic variants G56836C, A185C, and C406T were earlier found to amplify the development of leukoaraiosis in hypertensive smokers. These 3 variants were presumed to affect the function of the mitochondria, thereby giving rise to sensitivity to a chronic ischemic state. We have now extended our investigations to examine how the above genetic variants affect the occurrence of ischemic stroke. METHODS Genetic and clinical data on 650 ischemic stroke and 340 neuroimaging alteration-free subjects were analyzed. Univariate and logistic regression approaches were used. RESULTS None of the above genetic variants proved to be risk factors of ischemic stroke, either alone or in combination with other clinical factors. CONCLUSION The examined 3 genetic variants seem to influence the responses of the glial cells to a slight chronic hypoxia state, rather than the mechanisms resulting in cerebral infarcts themselves.
Collapse
|
23
|
Kölsch H, Lütjohann D, Jessen F, Popp J, Hentschel F, Kelemen P, Friedrichs S, Maier TAW, Heun R. RXRA gene variations influence Alzheimer's disease risk and cholesterol metabolism. J Cell Mol Med 2009; 13:589-98. [PMID: 19374686 PMCID: PMC3822518 DOI: 10.1111/j.1582-4934.2009.00383.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cholesterol metabolism is altered in Alzheimer's disease (AD). The nuclear hormone receptor Retinoic X Receptor a (RXRa) is a member of the nuclear ligand-activated transcription factor family. RXRs are key regulators of cholesterol synthesis and thus cholesterol metabolism. We performed a systematic screen for gene variants in the RXRA gene. The effect of these gene variants on the risk of AD was investigated in 405 AD patients (mean age: 74.27 +/- 9.37 years; female 78.6%) and 347 controls (mean age: 73.26 +/- 8.37 years; female 57.2%). Furthermore, the influence of RXRA gene variants on CSF and plasma levels of cholesterol, lathosterol and 24S-hydroxycholesterol were evaluated. One of the identified seven SNPs in RXRA influenced AD risk in our single marker analysis (rs3132293: P= 0.006). Haplotype analysis identified a three-marker haplotype (TGC) consisting of rs3118570, rs1536475 and rs3132293, which decreased the risk of AD (P= 0.009). The single marker rs3132293 (P= 0.026) and the TGC haplotype (P= 0.026) influenced CSF lathosterol levels in non-demented controls, and cholesterol levels in the combined sample comprising AD patients and controls (Rs3132293: P= 0.050; TGC haplotype: P= 0.035). 24S-Hydroxycholesterol CSF and plasma levels were also influenced by rs3132293 (CSF: P= 0.004; plasma: P= 0.001) and the TGC haplotype (CSF: P= 0.004; plasma: P= 0.002); this effect was most pronounced in AD patients (rs3132293: CSF: P= 0.009, plasma: P= 0.002; TGC haplotype: CSF: P= 0.019, plasma: P= 0.005). Our results suggest that RXRA gene variants might act as risk factor for AD via an influence on cerebral cholesterol metabolism.
Collapse
Affiliation(s)
- Heike Kölsch
- Department of Psychiatry, University of Bonn, Bonn, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Godin O, Tzourio C, Maillard P, Alpérovitch A, Mazoyer B, Dufouil C. Apolipoprotein E genotype is related to progression of white matter lesion load. Stroke 2009; 40:3186-90. [PMID: 19644067 DOI: 10.1161/strokeaha.109.555839] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between white matter lesions (WMLs) and the apolipoprotein E genotype has been controversial from cross-sectional studies and no longitudinal finding has been reported. We investigated whether the apolipoprotein E genotype influences baseline and evolution over 4-year follow-up of WML volumes in a population-based sample of 1779 nondemented subjects aged 65 to 80 years old at enrollment. METHODS The sample consisted of 3C-Dijon study participants who had 2 cerebral MRIs, at entry and at 4-year follow-up. WML volumes were estimated using a fully automatic procedure. We performed analysis of covariance to evaluate the relationship between apolipoprotein E genotype and WML load and progression. RESULTS Multivariable analyses showed that epsilon4epsilon4 individuals had both significantly higher WML volume at baseline and higher WML increase over 4-year follow-up than noncarriers and heterozygous of the epsilon4 allele for apolipoprotein E genotype. CONCLUSION These findings suggest it might be important to take into account WML severity when assessing the relationship between apolipoprotein E and dementia.
Collapse
Affiliation(s)
- Ophélia Godin
- Inserm Unit 708 Neuroepidemiology, Hôpital la Salpétrière, Paris, France.
| | | | | | | | | | | |
Collapse
|
25
|
A homozygous genetic variant of mitochondrial uncoupling protein 4 exerts protection against the occurrence of multiple sclerosis. Neuromolecular Med 2009; 11:101-5. [PMID: 19536655 DOI: 10.1007/s12017-009-8071-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Accepted: 05/31/2009] [Indexed: 01/06/2023]
Abstract
Multiple sclerosis (MS), which results in damage of the white matter at multiple foci, poses a far-reaching public health problem in view of the burden it imposes on the affected young and middle-aged. Some previous data suggested that roles could be played in the demyelinization of the white matter of the brain by the malfunctioning of the mitochondria and mitochondria-associated reactive oxygen species. In this context, we hypothesized that the finely tuned dynamic stability of the mitochondrial membrane potential (MMP), which is the main mirror of the functional state of the mitochondria, is essential for the intact nature of the glia cells in the brain. Setting out from this, our aim in this study was to examine how the rs10807344 and rs2270450 genetic variants of mitochondrial uncoupling protein 4 (mUCP4) can give rise to the development of MS, since mUCP4 is presumed to be of great importance in the regulation of the MMP and cellular energy metabolism. The clinical and genetic data on 120 relapsing-remitting MS patients and 250 neuroimaging alteration-free subjects were analyzed. The rs10807344 CC genotype proved to exert a protective effect against the occurrence of MS (neuroimaging alteration-free controls, 58%; MS group, 33%; P < 0.0000089; OR, 0.32; 95% CI: 0.2-0.56, P < 0.005). The present findings indirectly raise the possibility that a shift or imbalance in the finally regulated MMP plays a role in the development of MS.
Collapse
|
26
|
Saidi S, Mallat SG, Almawi WY, Mahjoub T. Association between renin-angiotensin-aldosterone system genotypes and haplotypes and risk of ischemic stroke of atherosclerotic etiology. Acta Neurol Scand 2009; 119:356-63. [PMID: 19473121 DOI: 10.1111/j.1600-0404.2008.01105.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The association of renin C-4063T and angiotensinogen (AGT) T174M, AGT M235T and AGT A-6G polymorphisms with ischemic stroke of atherosclerotic etiology was investigated in 329 Tunisian patients with stroke and 444 controls. MATERIALS AND METHODS Genotyping was performed using PCR-RFLP and the contributions of polymorphisms to the risk of stroke were analyzed using haplotype and multivariate regression analysis. RESULTS AGT 235T and AGT-6G allele and AGT 235T/T, AGT-6A/G and AGT-6G/G genotype frequencies were higher in patients. Linkage disequilibrium (LD) was noted for AGT174T with AGT235M and AGT(-6)A in patients, while AGT235M was in LD with AGT(-6)A in controls and AGT235T was in LD with AGT(-6)G in both groups. The AGT 174T/235T/-6A and AGT 174T/235M/-6G haplotypes were positively and negatively associated with stroke respectively. Multivariate regression analysis identified AGT 174T/235M/-6A, AGT 174T/235T/-6G, AGT 174T/235T/-6A and AGT 174M/235T/-6A haplotypes to be significantly associated with an increased risk of stroke. CONCLUSIONS Renin-angiotensin-aldosterone system polymorphisms influence the risk of atherosclerotic stroke in Tunisians.
Collapse
Affiliation(s)
- S Saidi
- Research Unit of Hematological and Autoimmune Diseases, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | | | | | | |
Collapse
|
27
|
Szolnoki Z, Kondacs A, Mandi Y, Somogyvari F. Gene–environmental effects behind leukoaraiosis: a silent genetic variant of the kinesin protein can be activated in a subject with poorly controlled long-lasting hypertension. Clin Biochem 2009; 42:630-3. [DOI: 10.1016/j.clinbiochem.2008.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 11/05/2008] [Accepted: 11/07/2008] [Indexed: 11/16/2022]
|
28
|
Smith JA, Turner ST, Sun YV, Fornage M, Kelly RJ, Mosley TH, Jack CR, Kullo IJ, Kardia SLR. Complexity in the genetic architecture of leukoaraiosis in hypertensive sibships from the GENOA Study. BMC Med Genomics 2009; 2:16. [PMID: 19351393 PMCID: PMC2679055 DOI: 10.1186/1755-8794-2-16] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Accepted: 04/07/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Subcortical white matter hyperintensity on magnetic resonance imaging (MRI) of the brain, referred to as leukoaraiosis, is associated with increased risk of stroke and dementia. Hypertension may contribute to leukoaraiosis by accelerating the process of arteriosclerosis involving penetrating small arteries and arterioles in the brain. Leukoaraiosis volume is highly heritable but shows significant inter-individual variability that is not predicted well by any clinical covariates (except for age) or by single SNPs. METHODS As part of the Genetics of Microangiopathic Brain Injury (GMBI) Study, 777 individuals (74% hypertensive) underwent brain MRI and were genotyped for 1649 SNPs from genes known or hypothesized to be involved in arteriosclerosis and related pathways. We examined SNP main effects, epistatic (gene-gene) interactions, and context-dependent (gene-environment) interactions between these SNPs and covariates (including conventional and novel risk factors for arteriosclerosis) for association with leukoaraiosis volume. Three methods were used to reduce the chance of false positive associations: 1) false discovery rate (FDR) adjustment for multiple testing, 2) an internal replication design, and 3) a ten-iteration four-fold cross-validation scheme. RESULTS Four SNP main effects (in F3, KITLG, CAPN10, and MMP2), 12 SNP-covariate interactions (including interactions between KITLG and homocysteine, and between TGFB3 and both physical activity and C-reactive protein), and 173 SNP-SNP interactions were significant, replicated, and cross-validated. While a model containing the top single SNPs with main effects predicted only 3.72% of variation in leukoaraiosis in independent test samples, a multiple variable model that included the four most highly predictive SNP-SNP and SNP-covariate interactions predicted 11.83%. CONCLUSION These results indicate that the genetic architecture of leukoaraiosis is complex, yet predictive, when the contributions of SNP main effects are considered in combination with effects of SNP interactions with other genes and covariates.
Collapse
Affiliation(s)
- Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Yan V Sun
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Myriam Fornage
- Human Genetics Center and Institute of Molecular Medicine, University of Texas-Houston Health Science Center, Houston, TX, USA
| | - Reagan J Kelly
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Clifford R Jack
- Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Iftikhar J Kullo
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Sharon LR Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
29
|
Moe KT, Woon FP, De Silva DA, Wong P, Koh TH, Kingwell B, Chin-Dusting J, Wong MC. Association of acute ischemic stroke with the MTHFR C677T polymorphism but not with NOS3 gene polymorphisms in a Singapore population. Eur J Neurol 2008; 15:1309-14. [DOI: 10.1111/j.1468-1331.2008.02308.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
30
|
Szolnoki Z, Kondacs A, Mandi Y, Somogyvari F. Characteristic imprint of single nucleotide polymorphisms in multiple sclerosis. J Mol Neurosci 2008; 38:166-72. [PMID: 18720029 DOI: 10.1007/s12031-008-9142-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Accepted: 08/04/2008] [Indexed: 11/29/2022]
Abstract
Although the main pathomechanism of multiple sclerosis (MS) is not known, an autoimmune response against the myelin basic proteins (MBPs) is presumed to be involved in its evolution and propagation. In this study, we examined whether the nucleotide sequences of the 3' untranslated regions (UTRs) of the DNAs encoding the MBP are characteristic of MS. These genetic regions are presumed to be responsible for the transport and localization of the mRNAs encoding the MBP in the glia cells, thereby influencing the building up of the myelin sheaths of the glia cells. The DNA region involving nucleotides 710-1540 of the UTRs of the MBPs was sequenced and analyzed in 52 relapsing-remitting MS patients, in 52 neuroimaging alteration-free controls, and in 45 healthy volunteers. Although the examined UTRs exhibited a wide range of sequence variations in both the MS and the control subjects, we found a typical distribution of single nucleotide polymorphisms (SNPs) along the examined DNA sequence in the MS patients, which was different from that in the controls. We could distinguish two genetic regions: region A--nucleotide positions 851-896 and B--nucleotide positions 897-1540, in the UTRs. Subjects with SNPs in region A but without SNPs in region B occurred significantly more frequently in the MS group than in the control group (30.8% versus 3.85%, p < 0.0002848, OR 11.11, 95% CI--2.4-51.4, p < 0.0004). The distribution pattern of the SNPs in the UTRs seems to be highly characteristic of relapsing-remitting MS. These findings call attention to the possible roles of the UTRs of the MBPs in the development of MS.
Collapse
Affiliation(s)
- Zoltan Szolnoki
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary.
| | | | | | | |
Collapse
|
31
|
Cerebral small vessel disease: genetic risk assessment for prevention and treatment. Mol Diagn Ther 2008; 12:145-56. [PMID: 18510378 DOI: 10.1007/bf03256279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cerebrovascular disease is a major burden to individuals and their communities worldwide. Stroke is one of the leading causes of death and disability, and the prevention and treatment of stroke can be improved with a better understanding of its causation. Cerebral small vessel disease (SVD) is a subset of cerebrovascular disease, and has an equally large impact on an individual's quality of life. Although many risk factors are involved, we propose that genetics has a significant role in the pathogenesis of SVD through a complex interplay of environmental and multigenetic factors. Advances in molecular technology have enabled the human genome to be investigated both at a population and, more recently, an individual level. A better understanding of the molecular basis of SVD will enable the development of therapies to help in its prevention and treatment. This review assesses the molecular genetics underlying cerebral SVD.
Collapse
|
32
|
Szolnoki Z, Kondacs A, Mandi Y, Somogyvari F. A genetic variant in cytoskeleton motors amplifies susceptibility to leukoaraiosis in hypertensive smokers: gene-environmental interactions behind vascular white matter demyelinization. J Mol Neurosci 2008; 33:173-9. [PMID: 17917076 DOI: 10.1007/s12031-007-0062-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 11/30/1999] [Accepted: 06/25/2007] [Indexed: 10/23/2022]
Abstract
One of the most frequent causes of an age-associated cognitive decline is the vascular white matter demyelinization of the brain referred to as leukoaraiosis (LA). The wide range of severity of the cognitive decline caused by LA can have numerous deleterious effects on the quality of life, leading overall to far-reaching public health problems. Besides clinical risk factors such as hypertension and advanced age, genetic susceptibility factors are presumed to be of great importance in the development of LA. The protein kinesin, which is the main motor protein in the trafficking system of the mitochondria, can undergo functional damage under the circumstances of chronic hypoxia. This may give rise to a slowly developing metabolic crisis in the glia cells, a phenomenon hypothesized to account for the evolution of LA. Setting out from this assumption, we examined how the kinesin light-chain 1 (KNS2) G56836C single nucleotide polymorphism in intron 13 affects the susceptibility to LA. This genetic variant was found to be associated with cognitive disturbances and neurodegeneration, and it was presumed to affect the function of kinesin. The association analysis of the above genetic variant was performed in 229 patients with LA and 264 neuroimaging alteration-free controls. The KNS2 56836CC variant increased the risk of LA 7.76-fold in hypertensive smokers as compared with those not carrying this variant. This finding may be useful in everyday clinical practice by indicating the need for stricter preventive measures in CC carriers.
Collapse
Affiliation(s)
- Zoltan Szolnoki
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary.
| | | | | | | |
Collapse
|
33
|
A cytoskeleton motor protein genetic variant may exert a protective effect on the occurrence of multiple sclerosis: the janus face of the kinesin light-chain 1 56836CC genetic variant. Neuromolecular Med 2007; 9:335-9. [PMID: 17999208 DOI: 10.1007/s12017-007-8014-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 08/28/2007] [Indexed: 01/11/2023]
Abstract
Although the main pathomechanism of multiple sclerosis (MS) is not known, an autoimmune response is presumed to involve its evolution and propagation. In this study, we examined how the kinesin light-chain 1 (KLC1) G56836C (rs8702) single nucleotide polymorphism (SNP) in intron 13 affects the occurrence of MS. This genetic variant was found to be associated with cognitive disturbances and neurodegeneration, and it was presumed to affect the kinesin function. Kinesin serves as a main cytoskeleton motor protein by carrying mitochondria and the molecular apparatus of myelin basic protein synthesis. The present association analysis of this genetic variant was performed in 102 relapsing-remitting MS patients and in 207 neuroimaging alteration-free controls. The KLC1 56836CC variant proved to exert a significant protective effect on the occurrence of MS (2.0% vs. 9.7%, P < 0.02; crude OR: 0.19, 95% CI: 0.04-0.82, P < 0.05; adjusted OR: 0.21, 95% CI: 0.018-0.88, P < 0.05). Our results draw attention to possible roles of the cytoskeleton in MS.
Collapse
|
34
|
Szolnoki Z, Kondacs A, Mandi Y, Somogyvari F. Evaluation of the roles of the A185C and C406T kinesin light-chain 1 variants in the development of leukoaraiosis. Neurosci Lett 2007; 429:101-4. [PMID: 17977659 DOI: 10.1016/j.neulet.2007.09.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Revised: 09/06/2007] [Accepted: 09/30/2007] [Indexed: 10/22/2022]
Abstract
Vascular white matter demyelinization of the brain is referred to as leukoaraiosis (LA). This frequent age-associated entity leads to a cognitive decline or dementia. The background of LA has been hypothesized to be a chronic hypoxia-induced functional cytoskeleton malfunction. Setting out from this assumption, we earlier found that the kinesin light-chain 1 (KNS2) cytoskeleton motor protein 56836CC single nucleotide polymorphism conferred a risk of LA in hypertensive smokers. The aim of the present study was to extend our observations as to how the KNS2 A185C and C406T single nucleotide polymorphisms in the 5'-untranslated sequence region affect the susceptibility to LA. These two latter variants were presumed to influence the transcription of the KNS2 mRNA by locating in a function-enhancer region. An association analysis of these genetic variants was conducted on 242 patients with LA and 251 neuroimaging alteration-free controls. The KNS2 AA185-406TT haplotype increased the risk of LA 3.56-fold in hypertensive smokers as compared with those not carrying the KNS2 AA185-406TT genotype, which was similar to our previous findings for the KNS2 56836CC intron variant. Moreover, the three homozygous KNS2 variants (56936CC-AA185-406TT) coincided to an extent of 82.2%. Overall, although the 56836CC intron variant appears to be the most important of the three kinesin variants as regards the development of LA, the contribution of the AA185-406TT haplotype to the unfavorable phenotype of LA cannot be ruled out. The present finding supports the involvement of the cytoskeleton in the development of vascular white matter damage, thereby opening up novel fields in the research into LA.
Collapse
Affiliation(s)
- Zoltan Szolnoki
- Department of Cerebrovascular Diseases, Pándy Kálmán County Hospital, Gyula, Hungary.
| | | | | | | |
Collapse
|