1
|
Xu LL, Yang S, Zhou LQ, Chu YH, Pang XW, You YF, Zhang H, Zhang LY, Zhu LF, Chen L, Shang K, Xiao J, Wang W, Tian DS, Qin C. Bruton's tyrosine kinase inhibition ameliorated neuroinflammation during chronic white matter ischemia. J Neuroinflammation 2024; 21:195. [PMID: 39097747 PMCID: PMC11297596 DOI: 10.1186/s12974-024-03187-4] [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: 02/08/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024] Open
Abstract
Chronic cerebral hypoperfusion (CCH), a disease afflicting numerous individuals worldwide, is a primary cause of cognitive deficits, the pathogenesis of which remains poorly understood. Bruton's tyrosine kinase inhibition (BTKi) is considered a promising strategy to regulate inflammatory responses within the brain, a crucial process that is assumed to drive ischemic demyelination progression. However, the potential role of BTKi in CCH has not been investigated so far. In the present study, we elucidated potential therapeutic roles of BTK in both in vitro hypoxia and in vivo ischemic demyelination model. We found that cerebral hypoperfusion induced white matter injury, cognitive impairments, microglial BTK activation, along with a series of microglia responses associated with inflammation, oxidative stress, mitochondrial dysfunction, and ferroptosis. Tolebrutinib treatment suppressed both the activation of microglia and microglial BTK expression. Meanwhile, microglia-related inflammation and ferroptosis processes were attenuated evidently, contributing to lower levels of disease severity. Taken together, BTKi ameliorated white matter injury and cognitive impairments induced by CCH, possibly via skewing microglia polarization towards anti-inflammatory and homeostatic phenotypes, as well as decreasing microglial oxidative stress damage and ferroptosis, which exhibits promising therapeutic potential in chronic cerebral hypoperfusion-induced demyelination.
Collapse
Affiliation(s)
- Lu-Lu Xu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Luo-Qi Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yun-Hui Chu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Wei Pang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yun-Fan You
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hang Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lu-Yang Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Li-Fang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lian Chen
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ke Shang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Xiao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dai-Shi Tian
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Chuan Qin
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Vascular Aging, Tongji Hospital of Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Laboratory of Neurological Diseases of the Chinese Ministry of Education, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
2
|
Pang XW, Chu YH, Zhou LQ, Chen M, You YF, Tang Y, Yang S, Zhang H, Xiao J, Deng G, Wang W, Shang K, Qin C, Tian DS. Trem2 deficiency attenuates microglial phagocytosis and autophagic-lysosomal activation in white matter hypoperfusion. J Neurochem 2023; 167:489-504. [PMID: 37823326 DOI: 10.1111/jnc.15987] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/23/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023]
Abstract
Chronic cerebral hypoperfusion leads to sustained demyelination and a unique response of microglia. Triggering receptor expressed on myeloid cells 2 (Trem2), which is expressed exclusively on microglia in the central nervous system (CNS), plays an essential role in microglial response in various CNS disorders. However, the specific role of Trem2 in chronic cerebral hypoperfusion has not been elucidated. In this study, we investigated the specific role of Trem2 in a mouse model of chronic cerebral hypoperfusion induced by bilateral carotid artery stenosis (BCAS). Our results showed that chronic hypoperfusion induced white matter demyelination, microglial phagocytosis, and activation of the microglial autophagic-lysosomal pathway, accompanied by an increase in Trem2 expression. After Trem2 knockout, we observed attenuation of white matter lesions and microglial response. Trem2 deficiency also suppressed microglial phagocytosis and relieved activation of the autophagic-lysosomal pathway, leading to microglial polarization towards anti-inflammatory and homeostatic phenotypes. Furthermore, Trem2 knockout inhibited lipid droplet accumulation in microglia in vitro. Collectively, these findings suggest that Trem2 deficiency ameliorated microglial phagocytosis and autophagic-lysosomal activation in hypoperfusion-induced white matter injury, and could be a promising target for the treatment of chronic cerebral hypoperfusion.
Collapse
Affiliation(s)
- Xiao-Wei Pang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Hui Chu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Luo-Qi Zhou
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Man Chen
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Yun-Fan You
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Tang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Yang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Hang Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Xiao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Deng
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Shang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Chuan Qin
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| | - Dai-Shi Tian
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Neural Injury and Functional Reconstruction, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
3
|
de Havenon A, Parasuram NR, Crawford AL, Mazurek MH, Chavva IR, Yadlapalli V, Iglesias JE, Rosen MS, Falcone GJ, Payabvash S, Sze G, Sharma R, Schiff SJ, Safdar B, Wira C, Kimberly WT, Sheth KN. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. J Am Heart Assoc 2023; 12:e029242. [PMID: 37218590 PMCID: PMC10381997 DOI: 10.1161/jaha.122.029242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/27/2023] [Indexed: 05/24/2023]
Abstract
Background White matter hyperintensity (WMH) on magnetic resonance imaging (MRI) of the brain is associated with vascular cognitive impairment, cardiovascular disease, and stroke. We hypothesized that portable magnetic resonance imaging (pMRI) could successfully identify WMHs and facilitate doing so in an unconventional setting. Methods and Results In a retrospective cohort of patients with both a conventional 1.5 Tesla MRI and pMRI, we report Cohen's kappa (κ) to measure agreement for detection of moderate to severe WMH (Fazekas ≥2). In a subsequent prospective observational study, we enrolled adult patients with a vascular risk factor being evaluated in the emergency department for a nonstroke complaint and measured WMH using pMRI. In the retrospective cohort, we included 33 patients, identifying 16 (49.5%) with WMH on conventional MRI. Between 2 raters evaluating pMRI, the interrater agreement on WMH was strong (κ=0.81), and between 1 rater for conventional MRI and the 2 raters for pMRI, intermodality agreement was moderate (κ=0.66, 0.60). In the prospective cohort we enrolled 91 individuals (mean age, 62.6 years; 53.9% men; 73.6% with hypertension), of which 58.2% had WMHs on pMRI. Among 37 Black and Hispanic individuals, the Area Deprivation Index was higher (versus White, 51.8±12.9 versus 37.9±11.9; P<0.001). Among 81 individuals who did not have a standard-of-care MRI in the preceding year, we identified WMHs in 43 of 81 (53.1%). Conclusions Portable, low-field imaging could be useful for identifying moderate to severe WMHs. These preliminary results introduce a novel role for pMRI outside of acute care and the potential role for pMRI to reduce disparities in neuroimaging.
Collapse
Affiliation(s)
- Adam de Havenon
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
| | | | - Anna L. Crawford
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Mercy H. Mazurek
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Isha R. Chavva
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | | | - Juan E. Iglesias
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
- Computer Science and Artificial Intelligence LabMassachusetts Institute of TechnologyCambridgeMAUSA
- Center for Biomedical ImagingMassachusetts General Hospital and Harvard Medical SchoolDepartment of Physics, Harvard UniversityBostonMAUSA
| | - Matthew S. Rosen
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
| | - Guido J. Falcone
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Seyedmehdi Payabvash
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
- Department of RadiologyYale University School of MedicineNew HavenCOUSA
| | - Gordon Sze
- Department of RadiologyYale University School of MedicineNew HavenCOUSA
| | - Richa Sharma
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
| | - Steven J. Schiff
- Department of NeurosurgeryYale University School of MedicineNew HavenCOUSA
| | - Basmah Safdar
- Department of Emergency MedicineYale University School of MedicineNew HavenCOUSA
| | - Charles Wira
- Department of Emergency MedicineYale University School of MedicineNew HavenCOUSA
| | - William T. Kimberly
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
| | - Kevin N. Sheth
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
| |
Collapse
|
4
|
Reddy BS, Naik D, Sakalecha AK, L YU, Uhasai K, Mannan V J. Role of Magnetic Resonance Imaging in Morphometric Alterations of Corpus Callosum in Stroke Patients. Cureus 2023; 15:e35332. [PMID: 36974258 PMCID: PMC10038770 DOI: 10.7759/cureus.35332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Corpus callosum plays a role in interhemispheric integration, language, intelligence, and creativity of individuals, hence variations in corpus callosum size are seen in various neurological diseases such as Alzheimer's and bipolar affective disorder. While the dimensions differ based on gender, age, and ethnicity, pathological variations are seen with some diseases such as vascular dementia, leukoaraiosis, stroke, and carotid artery stenosis. This study was conducted to compare the morphometric alterations of the corpus callosum between normal subjects and stroke patients using magnetic resonance imaging (MRI). METHODS This was a case-control study conducted on 84 subjects divided into cases and control groups. The widths of the genu, body & splenium, and anterior-posterior (AP) diameter of the corpus callosum were measured and the values were compared among the two groups. Student's t-test and regression analysis were utilized for the analysis of data and p<0.05 was considered statistically significant. RESULTS Sixteen patients (19.04%) belonged to the age range of 18-40 years, 32 (38.09%) belonged to the age range of 41-60 years and 36 (42.8%) belonged to the age group of >60 years. There was no discrepancy between cases and controls or between the age groups. The mean width of genu, body & splenium, and AP diameter was compared between normal individuals and stroke patients. It was noted to be significantly lesser in cases than in controls. The morphometric indices i.e., width of genu, body & splenium, and AP diameter of the corpus callosum in cases versus controls were noted to be 9.8 ± 1.2 vs. 10.27 ± 0.3 mm, p=0.12; 5.1±0.9 vs. 5.3±0.24 mm, p=0.25; 12.11 ± 9.65 vs. 12.52 ± 13.9 mm, p=0.04 (significant) and 71.22±3.1 vs. 72.32±1.2, p=0.23, respectively. CONCLUSION This study showed that patients with stroke have a significant reduction in morphometric indices i.e., width of genu, body & splenium, and the AP diameter of the corpus callosum when compared to normal individuals.
Collapse
|
5
|
Relationship of size of corpus callosum with white matter changes in elderly population; A retrospective analytical cross-sectional study. Ann Med Surg (Lond) 2022; 84:104953. [DOI: 10.1016/j.amsu.2022.104953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/23/2022] [Accepted: 11/12/2022] [Indexed: 11/21/2022] Open
|
6
|
Guo Y, Ortug A, Sadberry R, Rezayev A, Levman J, Shiohama T, Takahashi E. Symptom-Related Differential Neuroimaging Biomarkers in Children with Corpus Callosum Abnormalities. Cereb Cortex 2021; 31:4916-4932. [PMID: 34289021 DOI: 10.1093/cercor/bhab131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/23/2023] Open
Abstract
We aimed to identify symptom-related neuroimaging biomarkers for patients with dysgenesis of the corpus callosum (dCC) by summarizing neurological symptoms reported in clinical evaluations and correlating them with retrospectively collected structural/diffusion brain magnetic resonance imaging (MRI) measures from 39 patients/controls (mean age 8.08 ± 3.98). Most symptoms/disorders studied were associated with CC abnormalities. Total brain (TB) volume was related to language, cognition, muscle tone, and metabolic/endocrine abnormalities. Although white matter (WM) volume was not related to symptoms studied, gray matter (GM) volume was related to cognitive, behavioral, and metabolic/endocrine disorders. Right hemisphere (RH) cortical thickness (CT) was linked to language abnormalities, while left hemisphere (LH) CT was linked to epilepsy. While RH gyrification index (GI) was not related to any symptoms studied, LH GI was uniquely related to cognitive disorders. Between patients and controls, GM volume and LH/RH CT were significantly greater in dCC patients, while WM volume and LH/RH GI were significantly greater in controls. TB volume and diffusion indices for tissue microstructures did not show differences between the groups. In summary, our brain MRI-based measures successfully revealed differential links to many symptoms. Specifically, LH GI abnormality can be a predictor for dCC patients, which is uniquely associated with the patients' symptom. In addition, patients with CC abnormalities had normal TB volume and overall tissue microstructures, with potentially deteriorated mechanisms to expand/fold the brain, indicated by GI.
Collapse
Affiliation(s)
- Yurui Guo
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alpen Ortug
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Rodney Sadberry
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Department of Behavioral Neuroscience, Northeastern University, Boston, MA 02215, USA
| | - Arthur Rezayev
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Department of Biology, Boston University, Boston, MA 02215, USA
| | - Jacob Levman
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Department of Mathematics, Statistics and Computer Science, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada
| | - Tadashi Shiohama
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.,Department of Pediatrics, Chiba University Hospital, Chiba 2608670, Japan
| | - Emi Takahashi
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|
7
|
Wang Z, Bai L, Liu Q, Wang S, Sun C, Zhang M, Zhang Y. Corpus callosum integrity loss predicts cognitive impairment in Leukoaraiosis. Ann Clin Transl Neurol 2020; 7:2409-2420. [PMID: 33119959 PMCID: PMC7732249 DOI: 10.1002/acn3.51231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/24/2020] [Accepted: 10/06/2020] [Indexed: 12/29/2022] Open
Abstract
Objective To investigate regional white matter fibers loss in Leukoaraiosis (LA) and its relationship with cognitive impairments. Methods Fifty‐six participants with LA and 38 healthy controls underwent clinical evaluations and MR scans. Participants with LA were classified as cognitively normal (LA‐NC, n = 18), vascular cognitive impairment of none dementia (LA‐VCIND, n = 24), and vascular dementia (LA‐VaD, n = 14) by Mini‐Mental State Examination and Clinical Dementia Rating. Cognitive domains including visual‐spatial, naming, attention, language, abstraction, memory, and orientation were assessed. With the use of Tract‐based spatial statistics, mean fractional anisotropy (FA) of major white matter fiber tracts were compared between LA and controls and among LA groups with varying levels of cognitive impairments. Regression analyses were performed to evaluate relationships between FA values and cognitive performance. Results Participants showed significant FA reduction in the corpus callosum (CC), bilateral corona radiata, anterior limb of the internal capsule, external capsule, posterior thalamic radiation, and superior longitudinal fasciculus compared to controls and across LA groups. The LA‐VaD group showed consistent damage in the body and genu of CC compared to the LA‐NC and LA‐VCIND groups. A positive correlation between visual‐spatial and FA reduction in right anterior corona radiates in LA‐VCIND and body of CC in LA‐ VaD. Interpretation We found regional fiber loss in the CC across the cognitive spectrum in patients with LA and correlations between FA and visuospatial impairment in the anterior corona radiata in patients with LA‐VCIND and in the body of CC in patients with LA‐VaD.
Collapse
Affiliation(s)
- Zhuonan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lijun Bai
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Qi Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shan Wang
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Chuanzhu Sun
- The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yumei Zhang
- Department of Rehabilitation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| |
Collapse
|
8
|
Morphometric Alterations in the Corpus Callosum of Stroke Patients by Magnetic Resonance Imaging. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.62599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Khan M, Heiser H, Bernicchi N, Packard L, Parker JL, Edwardson MA, Silver B, Elisevich KV, Henninger N. Leukoaraiosis Predicts Short-term Cognitive But not Motor Recovery in Ischemic Stroke Patients During Rehabilitation. J Stroke Cerebrovasc Dis 2019; 28:1597-1603. [PMID: 30940427 DOI: 10.1016/j.jstrokecerebrovasdis.2019.02.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Leukoaraiosis has been shown to impact functional outcomes after acute ischemic stroke. However, its association with domain specific recovery after ischemic stroke is uncertain. We sought to determine whether pre-existing leukoaraiosis is associated with short-term motor and cognitive recovery after stroke. METHODS We retrospectively studied ischemic stroke patients admitted to acute inpatient rehabilitation (AIR) between January 2013 and September 2015. Patient baseline characteristics, infarct volume, prestroke modified Rankin Scale, stroke cause, rehabilitation length of stay, and Functional Independence Measure (FIM) scores were recorded. Leukoaraiosis severity was graded on brain magnetic resonance imaging using the Fazekas scale. Multiple linear regression was used to determine factors independently associated with the total, cognitive, and motor FIM scores at AIR discharge, respectively. RESULTS Of 1600 ischemic stroke patients screened, 109 patients were included in the final analysis. After adjustment, the initial National Institute of Health Stroke Scale (β -0.541, confidence interval [CI] -0.993 to -0.888; P = 0.020) and pre-existing leukoaraiosis severity (β -1.448, CI -2.861 to -0.034; P = 0.045) independently predicted the total FIM score. Domain specific analysis showed that infarct volume (β -0.012, CI -0.019 to -0.005; P = 0.002) and leukoaraiosis severity (β -0.822, CI -1.223 to -0.410; P = 0.0001) independently predicted FIM cognitive scores at discharge from AIR. Leukoaraiosis did not predict FIM motor score (P = 0.17). CONCLUSIONS Leukoaraiosis severity is an independent predictor of total and cognitive, but not motor FIM scores after AIR for acute ischemic stroke. This highlights that leukoaraiosis affects poststroke recovery in a domain specific fashion, information that may aid counseling of patients and families as well as tailor rehabilitative efforts.
Collapse
Affiliation(s)
- Muhib Khan
- Department of Clinical Neuroscience, Spectrum Health, College of Human Medicine, Michigan State University, MI; College of Human Medicine, Michigan State University, MI.
| | | | | | - Laurel Packard
- Department of Nursing Administration, Spectrum Health, MI
| | | | | | - Brian Silver
- Department of Neurology, University of Massachusetts Medical School, MA
| | - Kost V Elisevich
- Department of Clinical Neuroscience, Spectrum Health, College of Human Medicine, Michigan State University, MI; College of Human Medicine, Michigan State University, MI
| | - Nils Henninger
- Department of Neurology, University of Massachusetts Medical School, MA; Department of Psychiatry, University of Massachusetts Medical School, MA
| |
Collapse
|
10
|
Frey BM, Petersen M, Mayer C, Schulz M, Cheng B, Thomalla G. Characterization of White Matter Hyperintensities in Large-Scale MRI-Studies. Front Neurol 2019; 10:238. [PMID: 30972001 PMCID: PMC6443932 DOI: 10.3389/fneur.2019.00238] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/22/2019] [Indexed: 01/18/2023] Open
Abstract
Background: White matter hyperintensities of presumed vascular origin (WMH) are a common finding in elderly people and a growing social malady in the aging western societies. As a manifestation of cerebral small vessel disease, WMH are considered to be a vascular contributor to various sequelae such as cognitive decline, dementia, depression, stroke as well as gait and balance problems. While pathophysiology and therapeutical options remain unclear, large-scale studies have improved the understanding of WMH, particularly by quantitative assessment of WMH. In this review, we aimed to provide an overview of the characteristics, research subjects and segmentation techniques of these studies. Methods: We performed a systematic review according to the PRISMA statement. One thousand one hundred and ninety-six potentially relevant articles were identified via PubMed search. Six further articles classified as relevant were added manually. After applying a catalog of exclusion criteria, remaining articles were read full-text and the following information was extracted into a standardized form: year of publication, sample size, mean age of subjects in the study, the cohort included, and segmentation details like the definition of WMH, the segmentation method, reference to methods papers as well as validation measurements. Results: Our search resulted in the inclusion and full-text review of 137 articles. One hundred and thirty-four of them belonged to 37 prospective cohort studies. Median sample size was 1,030 with no increase over the covered years. Eighty studies investigated in the association of WMH and risk factors. Most of them focussed on arterial hypertension, diabetes mellitus type II and Apo E genotype and inflammatory markers. Sixty-three studies analyzed the association of WMH and secondary conditions like cognitive decline, mood disorder and brain atrophy. Studies applied various methods based on manual (3), semi-automated (57), and automated segmentation techniques (75). Only 18% of the articles referred to an explicit definition of WMH. Discussion: The review yielded a large number of studies engaged in WMH research. A remarkable variety of segmentation techniques was applied, and only a minority referred to a clear definition of WMH. Most addressed topics were risk factors and secondary clinical conditions. In conclusion, WMH research is a vivid field with a need for further standardization regarding definitions and used methods.
Collapse
Affiliation(s)
- Benedikt M Frey
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marvin Petersen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Mayer
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Schulz
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
11
|
Koundal S, Liu X, Sanggaard S, Mortensen K, Wardlaw J, Nedergaard M, Benveniste H, Lee H. Brain Morphometry and Longitudinal Relaxation Time of Spontaneously Hypertensive Rats (SHRs) in Early and Intermediate Stages of Hypertension Investigated by 3D VFA-SPGR MRI. Neuroscience 2019; 404:14-26. [PMID: 30690138 DOI: 10.1016/j.neuroscience.2019.01.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 02/03/2023]
Abstract
Cerebral small vessel disease(s) (SVD) results from pathological changes of the small blood vessels in the brain and is common in older people. The diagnostic features by which SVD manifests in brain includes white matter hyperintensities, lacunes, dilated perivascular spaces, microbleeds, and atrophy. In the present study, we use in vivo magnetic resonance imaging (MRI) to characterize brain morphometry and longitudinal relaxation time (T1) of spontaneously hypertensive rats (SHRs) to study the contribution of chronic hypertension to SVD relevant pathology. Male SHR and Wistar-Kyoto (WKY) rats underwent 3D variable flip angle spoiled gradient echo brain MRI at 9.4 T at early (seven weeks old) and established (19 weeks old) stages of hypertension. The derived proton density weighted and T1 images were utilized for morphometry and to characterize T1 properties in gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF). Custom tissue probability maps were constructed for accurate computerized whole brain tissue segmentations and voxel-wise analyses. Characteristic morphological differences between the two strains included enlarged ventricles, smaller corpus callosum (CC) volumes and general 'thinning' of CC in SHR compared to WKY rats at both age groups. While we did not observe parenchymal T1 differences, the T1 of CSF was elevated in SHR compared to controls. Collectively these findings indicate that SHRs develop WM atrophy which is a clinically robust MRI biomarker associated with WM degeneration.
Collapse
Affiliation(s)
- Sunil Koundal
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States of America
| | - Xiaodan Liu
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States of America
| | - Simon Sanggaard
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States of America
| | - Kristian Mortensen
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joanna Wardlaw
- Center for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute at The University of Edinburgh, The University of Edinburgh, Edinburgh, UK; Row Fogo Centre for Research into Ageing and the Brain, The University of Edinburgh, Edinburgh, UK
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Division of Glia Disease and Therapeutics, Center for Translational Neuromedicine, University of Rochester Medical School, Rochester, NY, USA
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States of America
| | - Hedok Lee
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States of America.
| |
Collapse
|
12
|
Impact of white matter hyperintensities on surrounding white matter tracts. Neuroradiology 2018; 60:933-944. [PMID: 30030550 DOI: 10.1007/s00234-018-2053-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE It is unclear how white matter hyperintensities disrupt surrounding white matter tracts. The aim of this tractography study was to determine the spatial relationship between diffusion characteristics along white matter tracts and the distance from white matter hyperintensities. METHODS Diffusion tensor 3-T MRI scans were acquired in 29 participants with white matter hyperintensities. In each subject, tractography by the fiber assignment by continuous tracking method was used to segment corticospinal tracts. Mean diffusivity, radial diffusivity, axial diffusivity, and fractional anisotropy were measured along corticospinal tracts in relation to white matter hyperintensities. Diffusion characteristics along tracts were correlated with distance from white matter hyperintensities and were also compared between tracts traversing and not traversing white matter hyperintensities. RESULTS In tracts not traversing through white matter hyperintensities, increasing distance from white matter hyperintensities was associated with decreased mean diffusivity (p = 0.002) and increased fractional anisotropy (p = 0.006). In tracts traversing white matter hyperintensities, compared to tracts not traversing white matter hyperintensites, the mean diffusivity was higher at 6-8 voxels, axial diffusivity higher at 4-8 voxels, and radial diffusivity higher at 7 voxels away from white matter hyperintensities (all p < 0.006). CONCLUSION White matter hyperintensities are associated with two patterns of altered diffusion characteristics in the surrounding white matter tract network. Diffusion characteristics along white matter tracts improve further away from white matter hyperintensities suggestive of a local penumbra pattern. Also, altered diffusion extends further along tracts traversing white matter hyperintensities suggestive of a Wallerian-type degenerative pattern.
Collapse
|
13
|
Kimura Y, Sato N, Ota M, Maikusa N, Maekawa T, Sone D, Enokizono M, Sugiyama A, Imabayashi E, Matsuda H, Okamoto T, Yamamura T, Sugimoto H. A structural MRI study of cholinergic pathways and cognition in multiple sclerosis. eNeurologicalSci 2017; 8:11-16. [PMID: 29260029 PMCID: PMC5730909 DOI: 10.1016/j.ensci.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 06/30/2017] [Indexed: 11/17/2022] Open
Abstract
Background White matter hyperintensities (WMH) in the cholinergic pathways are associated with cognitive performance in Alzheimer's disease. This study aimed to evaluate the relationship between the volume reduction of cholinergic pathways and cognitive function in patients with multiple sclerosis (MS). Methods Thirty-two MS patients underwent a brain MRI and cognitive measurements including the Mini-Mental State Examination (MMSE) and the Japanese version of the Montreal Cognitive Assessment (MoCA-J). The extent of WMH within the cholinergic pathways was assessed using the Cholinergic Pathways Hyperintensities Scale (CHIPS). Computerized WMH volumes were also obtained. FreeSurfer was used to measure regional volumes including the cortical and subcortical volumes. The correlations among the CHIPS, the WMH volume, and the clinical data were assessed, in addition to the correlations between the cognitive scores and regional volumes measured by FreeSurfer. Results The CHIPS score and the WMH volume were strongly positively correlated with each other (r = 0.87, P < 0.001). The CHIPS score had significantly negative correlations with the MMSE (r = - 0.49, P = 0.003) and the MoCA-J (r = - 0.47, P = 0.005) results. The WMH volume had significantly negative correlations with the MMSE (r = - 0.54, P = 0.001) and the MoCA-J (r = - 0.57, P < 0.001) results. In the analysis by FreeSurfer, both the MMSE and MoCA-J scores had significant positive correlations only with the volume of the corpus callosum. Conclusions The CHIPS score tended to be less sensitive to the WMH volume in cognitive function evaluation, although the difference did not reach the level of statistical significance. Thus the CHIPS method may not be as effective in MS patients.
Collapse
Affiliation(s)
- Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomoko Maekawa
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Daichi Sone
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Mikako Enokizono
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Atsuhiko Sugiyama
- Department of Radiology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomoko Okamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takashi Yamamura
- Department of Immunology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Hideharu Sugimoto
- Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| |
Collapse
|
14
|
Feng L, Jiang H, Li Y, Teng F, He Y. Effects of citicoline therapy on the network connectivity of the corpus callosum in patients with leukoaraiosis. Medicine (Baltimore) 2017; 96:e5931. [PMID: 28121935 PMCID: PMC5287959 DOI: 10.1097/md.0000000000005931] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aimed to investigate the effects of citicoline therapy on the network connectivity of the corpus callosum in patients with leukoaraiosis (LA) by diffusion tension imaging (DTI).A total of 30 LA patients with Fazekas score of 2 to 3 were voluntarily assigned into citicoline group (n = 14) and control group (n = 16). In citicoline group, citicoline was administered at 0.6 g/d for 1 year. In control group, central nervous system drugs should not be used, except for sleeping pills and antidepressants. Interventions for pre-existing diseases should be conducted in both groups. During the periods of citicoline therapy and post-treatment follow-up, cranial magnetic resonance imaging and DTI were routinely performed in these patients, and the genu, body, and splenium of corpus callosum were selected as the regions of interest (ROIs). The fractional anisotropy (FA) and mean diffusivity (MD) of each ROI were determined with PANDA software.On recruitment, there were no significant differences in the general characteristics, blood biochemical results, cognition function, and the FA and MD of the corpus callosum between 2 groups (P > 0.05). After 1-year treatment, the FA of the corpus callosum reduced gradually, but the MD of the corpus callosum tended to increased in both group, although significant differences were not observed. However, the reductions in FA of genu and splenium of corpus callosum in citicoline group were significantly lower than in control group (P < 0.05); the reductions in MD of genu, body, and splenium of corpus callosum in citicoline group were significantly lower than in control group (P < 0.05).In LA patients, the disruption of the network connectivity of the corpus callosum deteriorates over time. Citicoline treatment may delay the reduction in FA of corpus callosum, which might be beneficial for the improvement of network connectivity of the corpus callosum.
Collapse
Affiliation(s)
- Liang Feng
- Department of Neurology, Tongji Hospital, Tongji University
| | - Hong Jiang
- Department of Radiology, Tongji Hospital, Tongji University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, Tongji University
| | - Fei Teng
- Department of Neurology, Tongji Hospital, Tongji University
| | - Yusheng He
- Department of Neurology, Tongji Hospital, Tongji University
| |
Collapse
|
15
|
Reginold W, Itorralba J, Luedke AC, Fernandez-Ruiz J, Reginold J, Islam O, Garcia A. Tractography at 3T MRI of Corpus Callosum Tracts Crossing White Matter Hyperintensities. AJNR Am J Neuroradiol 2016; 37:1617-22. [PMID: 27127001 DOI: 10.3174/ajnr.a4788] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/16/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The impact of white matter hyperintensities on the diffusion characteristics of crossing tracts is unclear. This study used quantitative tractography at 3T MR imaging to compare, in the same individuals, the diffusion characteristics of corpus callosum tracts that crossed white matter hyperintensities with the diffusion characteristics of corpus callosum tracts that did not pass through white matter hyperintensities. MATERIALS AND METHODS Brain T2 fluid-attenuated inversion recovery-weighted and diffusion tensor 3T MR imaging scans were acquired in 24 individuals with white matter hyperintensities. Tractography data were generated by the Fiber Assignment by Continuous Tracking method. White matter hyperintensities and corpus callosum tracts were manually segmented. In the corpus callosum, the fractional anisotropy, radial diffusivity, and mean diffusivity of tracts crossing white matter hyperintensities were compared with the fractional anisotropy, radial diffusivity, and mean diffusivity of tracts that did not cross white matter hyperintensities. The cingulum, long association fibers, corticospinal/bulbar tracts, and thalamic projection fibers were included for comparison. RESULTS Within the corpus callosum, tracts that crossed white matter hyperintensities had decreased fractional anisotropy compared with tracts that did not pass through white matter hyperintensities (P = .002). Within the cingulum, tracts that crossed white matter hyperintensities had increased radial diffusivity compared with tracts that did not pass through white matter hyperintensities (P = .001). CONCLUSIONS In the corpus callosum and cingulum, tracts had worse diffusion characteristics when they crossed white matter hyperintensities. These results support a role for white matter hyperintensities in the disruption of crossing tracts.
Collapse
Affiliation(s)
- W Reginold
- From the Departments of Medical Imaging (W.R.) Memory Clinics (W.R., A.G.), Division of Geriatric Medicine, Department of Medicine
| | - J Itorralba
- Centre for Neuroscience Studies (J.I., A.G., A.C.L.), Queen's University, Kingston, Ontario, Canada
| | - A C Luedke
- Centre for Neuroscience Studies (J.I., A.G., A.C.L.), Queen's University, Kingston, Ontario, Canada
| | - J Fernandez-Ruiz
- Facultad de Medicina, (J.F.-R.), Universidad Nacional Autonoma de Mexico, Coyoacán, Mexico
| | - J Reginold
- Life Sciences (J.R.), University of Toronto, Toronto, Ontario, Canada
| | - O Islam
- Department of Diagnostic Radiology (O.I.), Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - A Garcia
- Memory Clinics (W.R., A.G.), Division of Geriatric Medicine, Department of Medicine Centre for Neuroscience Studies (J.I., A.G., A.C.L.), Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
16
|
Tokola AM, Åberg LE, Autti TH. Brain MRI findings in aspartylglucosaminuria. J Neuroradiol 2015; 42:345-57. [DOI: 10.1016/j.neurad.2015.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/25/2015] [Accepted: 03/28/2015] [Indexed: 11/25/2022]
|
17
|
Helenius J, Henninger N. Leukoaraiosis Burden Significantly Modulates the Association Between Infarct Volume and National Institutes of Health Stroke Scale in Ischemic Stroke. Stroke 2015; 46:1857-63. [PMID: 25999386 DOI: 10.1161/strokeaha.115.009258] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/27/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The National Institutes of Health Stroke Scale (NIHSS) provides a reliable, quantitative measure of ischemic stroke severity and is predicted by the infarct size. We sought to determine whether leukoaraiosis severity affects the association between infarct size and NIHSS. METHODS NIHSS and diffusion-weighted imaging-defined infarct volumes from 312 prospectively enrolled patients with supratentorial, ischemic strokes were analyzed. Leukoaraiosis severity was graded according to the Fazekas scale and conceptually defined as absent (0; n=44), mild (1-2; n=106), moderate (3-4; n=105), and severe (5-6; n=57). ANCOVA was used to describe the effect of leukoaraiosis on the association between infarct volume and NIHSS. Multivariable linear regression models were constructed to assess whether the association of leukoaraiosis and infarct volume on NIHSS was independent of other clinically relevant covariates. RESULTS Overall, there was a significant correlation between the infarct volume and NIHSS (r=0.591; P<0.001). This correlation significantly attenuated with increasing leukoaraiosis severity from r=0.786 (P<0.001; absent leukoaraiosis) to r=0.498 (P<0.001; severe leukoaraiosis) and as shown by ANCOVA (P<0.001). Leukoaraiosis (coefficient, 0.107; 95% confidence interval, 0.036-0.179; P=0.016) and infarct volume (coefficient, 0.360; 95% confidence interval, 0.305-0.416; P<0.001) were independently associated with a greater NIHSS deficit in the fully adjusted multivariable model. CONCLUSIONS Leukoaraiosis significantly modulates the association between infarct volume and NIHSS. The clinical implications of these findings need further exploration in prospective studies but may be relevant to mitigate outcome differences in patients with stroke by aiding treatment decisions that rely on the NIHSS.
Collapse
Affiliation(s)
- Johanna Helenius
- From the Departments of Neurology (J.H., N.H.) and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester
| | - Nils Henninger
- From the Departments of Neurology (J.H., N.H.) and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester.
| |
Collapse
|
18
|
Barthélemy D, Willerslev-Olsen M, Lundell H, Biering-Sørensen F, Nielsen JB. Assessment of transmission in specific descending pathways in relation to gait and balance following spinal cord injury. PROGRESS IN BRAIN RESEARCH 2015; 218:79-101. [DOI: 10.1016/bs.pbr.2014.12.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
19
|
Bjerke M, Jonsson M, Nordlund A, Eckerström C, Blennow K, Zetterberg H, Pantoni L, Inzitari D, Schmidt R, Wallin A. Cerebrovascular Biomarker Profile Is Related to White Matter Disease and Ventricular Dilation in a LADIS Substudy. Dement Geriatr Cogn Dis Extra 2014; 4:385-94. [PMID: 25493088 PMCID: PMC4255994 DOI: 10.1159/000366119] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Small vessel disease (SVD) represents a common often progressive condition in elderly people contributing to cognitive disability. The relationship between cerebrospinal fluid (CSF) biomarkers and imaging correlates of SVD was investigated, and the findings were hypothesized to be associated with a neuropsychological profile of SVD. METHODS CSF SVD-related biomarkers [neurofilament light (NF-L), myelin basic protein (MBP), soluble amyloid precursor protein-β (sAPPβ), matrix metalloproteinases (MMPs), and tissue inhibitor of metalloproteinase (TIMP)] were analysed in 46 non-demented elderly with imaging findings of SVD. We assessed the relationship between the CSF biomarkers and white matter hyperintensity (WMH) volume, diffusion-weighted imaging and atrophy as well as their association with neuropsychological profiles. RESULTS The WMH volume correlated with ventricular dilation, which was associated with executive function and speed and attention. Increased WMH and ventricular dilation were related to increased CSF levels of TIMP-1, NF-L and MBP and to decreased sAPPβ. A positive correlation was found between the CSF biomarker MMP-9 and WMH progression. CONCLUSIONS The link between progressive WMH and MMP-9 suggests an involvement of the enzyme in white matter degeneration. CSF TIMP-1, NF-L, MBP and sAPPβ may function as biological markers of white matter damage.
Collapse
Affiliation(s)
- Maria Bjerke
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael Jonsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Carl Eckerström
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- UCL Institute of Neurology, London, UK
| | - Leonardo Pantoni
- Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy
| | - Domenico Inzitari
- Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy
| | - Reinhold Schmidt
- Department of Clinical Neurogeriatrics, Medical University of Graz, Graz, Austria
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| |
Collapse
|
20
|
Neurological abnormalities predict disability: the LADIS (Leukoaraiosis And DISability) study. J Neurol 2014; 261:1160-9. [DOI: 10.1007/s00415-014-7332-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 03/25/2014] [Accepted: 03/25/2014] [Indexed: 11/26/2022]
|
21
|
Henninger N, Khan MA, Zhang J, Moonis M, Goddeau RP. Leukoaraiosis predicts cortical infarct volume after distal middle cerebral artery occlusion. Stroke 2014; 45:689-95. [PMID: 24523039 DOI: 10.1161/strokeaha.113.002855] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Leukoaraiosis (LA) predominantly affects the subcortical white matter, but mounting evidence suggests an association with cortical microvascular dysfunction and potentially decreased cortical ischemic tolerance. Thus, we sought to assess whether preexisting LA is predictive of the cortical infarct volume after middle cerebral artery branch occlusion and whether it relates to a worse outcome. METHODS We analyzed data from 117 consecutive patients with middle cerebral artery branch occlusion as documented by admission computed tomography angiography. Baseline clinical, laboratory, and outcome data, as well as final cortical infarct volumes, were retrospectively analyzed from a prospectively collected database. LA severity was assessed on admission computed tomography using the van Swieten scale grading the supratentorial white matter hypoattenuation. Infarct volume predicting a favorable 90-day outcome (modified Rankin Scale score≤2) was determined by receiver operating characteristic curves. Multivariable linear and logistic regression analyses were used to identify independent predictors of the final infarct volume and outcome. RESULTS Receiver operating characteristic curve analyses indicated that a final infarct volume of ≤27 mL best predicted a favorable 90-day outcome. Severe LA (odds ratio, 11.231; 95% confidence interval, 2.526-49.926; P=0.001) was independently associated with infarct volume>27 mL. Severe LA (odds ratio, 3.074; 95% confidence interval, 1.055-8.961; P=0.040) and infarct volume>27 mL (odds ratio, 9.156; 95% confidence interval, 3.191-26.270; P<0.001) were independent predictors of a poor 90-day outcome (modified Rankin Scale, 3-6). CONCLUSIONS The presence of severe, subcortical LA contributes to larger cortical infarct volumes and worse functional outcomes adding to the notion that the brain is negatively affected beyond LA's macroscopic boundaries.
Collapse
Affiliation(s)
- Nils Henninger
- From the Departments of Neurology (N.H., M.A.K., J.Z., M.M., R.P.G.) and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester
| | | | | | | | | |
Collapse
|
22
|
Bauer G, Płonka-Półtorak E, Bauer R, Unterberger I, Kuchukhidze G. Corpus callosum and epilepsies. JOURNAL OF EPILEPTOLOGY 2013. [DOI: 10.1515/joepi-2015-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
SUMMARYIntroduction.Corpus callosum (CC) is the largest forebrain commissure. Structural anomalies and accompanying clinical symptoms are not in the focus of neurologists, epileptologists or neurosurgeons.Aim and method.Anatomy, embryological development, normal functions, structural abnormalities, additional malformations, clinical symptoms and seizure disorders with CC anomalies are reviewed from the literature.Review.The detection of callosal anomalies increased rapidly with widespread use of brain imaging methods. Agenesis or dysgenesis of corpus callosum (AgCC) might be considered an accidental finding. Epileptic seizures occur in up to 89% of patients with AgCC. The causal relationship correctly is questioned. However, additional causative malformations of midline and/or telencephalic structures can be demonstrated in most seizure patients. The interruption of bilateral spread of seizure activities acts as the concept for callosotomy as epilepsy surgery. Indications are drug-resistant generalized, diffuse, or multifocal epilepsies. A resectable seizure onset zone should be excluded. Most treated patients are diagnosed as Lennox-Gastaut or Lennox-like syndrome.Conclusions.In cases with callosal abnormalities and clinical symptoms additional malformations are frequently observed, especially with seizure disorders. Callosotomy is the most effective option against drop attacks. The method probably is underused. After callosotomy a circumscript seizure focus might be unveiled and a second step of resective epilepsy surgery can be successful.
Collapse
|
23
|
Executive dysfunction correlates with caudate nucleus atrophy in patients with white matter changes on MRI: a subset of LADIS. Psychiatry Res 2013; 214:16-23. [PMID: 23916538 DOI: 10.1016/j.pscychresns.2013.05.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 04/19/2013] [Accepted: 05/17/2013] [Indexed: 11/22/2022]
Abstract
White matter changes (WMC) are common magnetic resonance imaging (MRI) findings, particularly in the elderly. Recent studies such as the Leukoaraiosis and Disability Study (LADIS) have found that WMC relate to adverse outcomes including cognitive impairment, depression, disability, unsteadiness and falls in cross-sectional and follow-up studies. Frontostriatal (or frontosubcortical) brain circuits may serve many of these functions, with the caudate nuclei playing a role in convergence of cognitive functions. This study aimed to determine whether reduced caudate volume relates to cognitive functions (executive functions, memory functions and speed of processing) and WMC. We determined caudate nuclei volumes, through manual tracing, on a subgroup of the LADIS study (n=66) from four centres with baseline and 3-year follow-up MRI scans. Regression analysis was used to assess relationships between caudate volume, cognitive function and WMC. Severity of WMC did not relate to caudate volume. Smaller caudate volumes were significantly associated with poorer executive functioning at baseline and at 3 years, but were not associated with scores of memory or speed of processing. Thus, in patients with WMC, a surrogate of small vessel disease, caudate atrophy relates to the dysexecutive syndrome, supporting the role of caudate as an important part of the frontostriatal circuit.
Collapse
|
24
|
Preserved transcallosal inhibition to transcranial magnetic stimulation in nondemented elderly patients with leukoaraiosis. BIOMED RESEARCH INTERNATIONAL 2013. [PMID: 23984349 DOI: 10.1155/2013/351680.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Structural corpus callosum (CC) changes in patients with leukoaraiosis (LA) are significantly associated with cognitive and motor impairment. The aim of this study is to investigate the transcallosal fibers functioning by means of transcranial magnetic stimulation (TMS) in elderly patients with LA. The resting motor threshold (rMT), the motor-evoked potentials (MEPs), and the controlateral (cSP) and ipsilateral silent periods (iSP) were determined using single-pulse TMS in 15 patients and 15 age-matched controls. The neuropsychological profile and the vascular burden at brain magnetic resonance imaging (MRI) were concomitantly explored. Patients reported abnormal scores at tests evaluating executive control functions. No significant difference was found in TMS measures of intra- and intercortical excitability. No CC lesion was evident at MRI. Transcallosal inhibitory mechanisms to TMS seem to be spared in LA patients, a finding which is in line with neuroimaging features and suggests a functional integrity of the CC despite the ischemic interruption of corticosubcortical loops implicated in cognition and behavior. The observed neurophysiological finding differs from that reported in degenerative dementia, even in the preclinical or early stage. In our group of patients, the pure extent of LA is more related to impairment of frontal lobe abilities rather than functional callosal changes.
Collapse
|
25
|
Association between linear measurements of corpus callosum and gait in the elderly. Eur Radiol 2013; 23:2252-7. [PMID: 23512195 DOI: 10.1007/s00330-013-2818-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/03/2013] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Segmentation and diffusion-tensor-imaging of the corpus callosum (CC) have been linked to gait impairment. However, such measurements are impracticable in clinical routine. The purpose of this study was to evaluate the association between simple linear measurements of CC thickness with gait. METHODS Two hundred and seventy-two community-dwelling subjects underwent neurological assessment and brain MRI. Mid-sagittal reformats of T1-weighted images were used to determine CC thickness. The association of measurements with clinical evaluation of gait was assessed by multivariate regression, controlling for numerous clinical and imaging confounders. Differences in CC thickness were, moreover, compared between subgroups with no, moderate or severe impairment of gait. RESULTS In univariate analyses, thickness of the genu and body of CC but not the splenium were associated with postural stability (P < 0.01). Multivariate regression revealed thickness of CC genu as the only imaging variable independently associated with gait (P = 0.01). Genu thickness was significantly different between subjects with high and low (P = 0.0003) or high and moderate (P = 0.001) risk of fall. CONCLUSION Atrophy of the CC genu is an imaging marker of gait impairment in the elderly suggesting higher risk of fall. Simple linear measurements of CC can help in MRI evaluation of patients with gait impairment. KEY POINTS • Regional atrophy of the corpus callosum reflects disruption of gait regulation • Genu thickness on cranial MRI is an independent marker of gait impairment • Findings help in the MRI evaluation of patients with gait impairment.
Collapse
|
26
|
Lanza G, Bella R, Giuffrida S, Cantone M, Pennisi G, Spampinato C, Giordano D, Malaguarnera G, Raggi A, Pennisi M. Preserved transcallosal inhibition to transcranial magnetic stimulation in nondemented elderly patients with leukoaraiosis. BIOMED RESEARCH INTERNATIONAL 2013; 2013:351680. [PMID: 23984349 PMCID: PMC3741902 DOI: 10.1155/2013/351680] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/24/2013] [Accepted: 07/14/2013] [Indexed: 02/07/2023]
Abstract
Structural corpus callosum (CC) changes in patients with leukoaraiosis (LA) are significantly associated with cognitive and motor impairment. The aim of this study is to investigate the transcallosal fibers functioning by means of transcranial magnetic stimulation (TMS) in elderly patients with LA. The resting motor threshold (rMT), the motor-evoked potentials (MEPs), and the controlateral (cSP) and ipsilateral silent periods (iSP) were determined using single-pulse TMS in 15 patients and 15 age-matched controls. The neuropsychological profile and the vascular burden at brain magnetic resonance imaging (MRI) were concomitantly explored. Patients reported abnormal scores at tests evaluating executive control functions. No significant difference was found in TMS measures of intra- and intercortical excitability. No CC lesion was evident at MRI. Transcallosal inhibitory mechanisms to TMS seem to be spared in LA patients, a finding which is in line with neuroimaging features and suggests a functional integrity of the CC despite the ischemic interruption of corticosubcortical loops implicated in cognition and behavior. The observed neurophysiological finding differs from that reported in degenerative dementia, even in the preclinical or early stage. In our group of patients, the pure extent of LA is more related to impairment of frontal lobe abilities rather than functional callosal changes.
Collapse
Affiliation(s)
- Giuseppe Lanza
- 1“G. F. Ingrassia” Department, Section of Neurosciences, University of Catania, 78 Via Santa Sofia, 95123 Catania, Italy
| | - Rita Bella
- 1“G. F. Ingrassia” Department, Section of Neurosciences, University of Catania, 78 Via Santa Sofia, 95123 Catania, Italy
- *Rita Bella:
| | - Salvatore Giuffrida
- 1“G. F. Ingrassia” Department, Section of Neurosciences, University of Catania, 78 Via Santa Sofia, 95123 Catania, Italy
| | - Mariagiovanna Cantone
- 2Department of Neurology I.C., Oasi Institute (IRCCS), 73 Via Conte Ruggiero, 94018 Troina, Italy
| | - Giovanni Pennisi
- 1“G. F. Ingrassia” Department, Section of Neurosciences, University of Catania, 78 Via Santa Sofia, 95123 Catania, Italy
| | - Concetto Spampinato
- 3Department of Electrical, Electronics and Informatics Engineering, University of Catania, 6 Viale Andrea Doria, 95125 Catania, Italy
| | - Daniela Giordano
- 3Department of Electrical, Electronics and Informatics Engineering, University of Catania, 6 Viale Andrea Doria, 95125 Catania, Italy
| | - Giulia Malaguarnera
- 1“G. F. Ingrassia” Department, Section of Neurosciences, University of Catania, 78 Via Santa Sofia, 95123 Catania, Italy
| | - Alberto Raggi
- 4Unit of Neurology, Morgagni-Pierantoni Hospital, 34 Via Carlo Forlanini, 47121 Forlì, Italy
| | - Manuela Pennisi
- 5Department of Chemistry, University of Catania, 6 Viale Andrea Doria, 95125 Catania, Italy
| |
Collapse
|
27
|
Frederiksen KS, Waldemar G. Corpus callosum in aging and neurodegenerative diseases. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
SUMMARY The corpus callosum (CC) is a major white matter bundle that connects primarily homologous areas of the cortex. The structure may be involved in interhemispheric communication and enable the lateralization of certain cerebral functions. Despite its possible role as the main conduit for interhemispheric communication, interest from researchers has, at times, been sparse. Renewed interest has led to research that has shown that the CC may play a role in both cognitive aging and neurodegenerative diseases including Alzheimer´s disease and frontotemporal dementia. Studies employing structural MRI and diffusion-weighted MRI have found distinct subregional patterns of callosal atrophy in aging, Alzheimer´s disease and frontotemporal dementia. Furthermore, imaging studies may help to elucidate the underlying pathological mechanisms of callosal atrophy. The present review aims to provide an overview of the current knowledge of the structure and function of the CC and its role in aging and neurodegenerative disease.
Collapse
Affiliation(s)
- Kristian Steen Frederiksen
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Gunhild Waldemar
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| |
Collapse
|
28
|
Herron TJ, Kang X, Woods DL. Automated measurement of the human corpus callosum using MRI. Front Neuroinform 2012; 6:25. [PMID: 22988433 PMCID: PMC3439830 DOI: 10.3389/fninf.2012.00025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 08/27/2012] [Indexed: 01/16/2023] Open
Abstract
The corpus callosum includes the majority of fibers that connect the two cortical hemispheres. Studies of cross-sectional callosal morphometry and area have revealed developmental, gender, and hemispheric differences in healthy populations and callosal deficits associated with neurodegenerative disease and brain injury. However, accurate quantification of the callosum using magnetic resonance imaging is complicated by intersubject variability in callosal size, shape, and location and often requires manual outlining of the callosum in order to achieve adequate performance. Here we describe an objective, fully automated protocol that utilizes voxel-based images to quantify the area and thickness both of the entire callosum and of different callosal compartments. We verify the method's accuracy, reliability, robustness, and multisite consistency and make comparisons with manual measurements using public brain-image databases. An analysis of age-related changes in the callosum showed increases in length and reductions in thickness and area with age. A comparison of older subjects with and without mild dementia revealed that reductions in anterior callosal area independently predicted poorer cognitive performance after factoring out Mini-Mental Status Examination scores and normalized whole brain volume. Open-source software implementing the algorithm is available at www.nitrc.org/projects/c8c8.
Collapse
Affiliation(s)
- Timothy J Herron
- Human Cognitive Neurophysiology Laboratory, Research Service, US Veterans Affairs, Northern California Health Care System Martinez, CA, USA
| | | | | |
Collapse
|
29
|
Sundal C, Van Gerpen JA, Nicholson AM, Wider C, Shuster EA, Aasly J, Spina S, Ghetti B, Roeber S, Garbern J, Borjesson-Hanson A, Tselis A, Swerdlow RH, Miller BB, Fujioka S, Heckman MG, Uitti RJ, Josephs KA, Baker M, Andersen O, Rademakers R, Dickson DW, Broderick D, Wszolek ZK. MRI characteristics and scoring in HDLS due to CSF1R gene mutations. Neurology 2012; 79:566-74. [PMID: 22843259 DOI: 10.1212/wnl.0b013e318263575a] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To describe the brain MRI characteristics of hereditary diffuse leukoencephalopathy with spheroids (HDLS) with known mutations in the colony-stimulating factor 1 receptor gene (CSF1R) on chromosome 5. METHODS We reviewed 20 brain MRI scans of 15 patients with autopsy- or biopsy-verified HDLS and CSF1R mutations. We assessed sagittal T1-, axial T1-, T2-, proton density-weighted and axial fluid-attenuated inversion recovery images for distribution of white matter lesions (WMLs), gray matter involvement, and atrophy. We calculated a severity score based on a point system (0-57) for each MRI scan. RESULTS Of the patients, 93% (14 of 15) demonstrated localized WMLs with deep and subcortical involvement, whereas one patient revealed generalized WMLs. All WMLs were bilateral but asymmetric and predominantly frontal. Fourteen patients had a rapidly progressive clinical course with an initial MRI mean total severity score of 16.7 points (range 10-33.5). Gray matter pathology and brainstem atrophy were absent, and the corticospinal tracts were involved late in the disease course. There was no enhancement, and there was minimal cerebellar pathology. CONCLUSION Recognition of the typical MRI patterns of HDLS and the use of an MRI severity score might help during the diagnostic evaluation to characterize the natural history and to monitor potential future treatments. Indicators of rapid disease progression were symptomatic disease onset before 45 years, female sex, WMLs extending beyond the frontal regions, a MRI severity score greater than 15 points, and mutation type of deletion.
Collapse
|
30
|
Frederiksen KS, Garde E, Skimminge A, Barkhof F, Scheltens P, van Straaten ECW, Fazekas F, Baezner H, Verdelho A, Ferro JM, Erkinjuntti T, Jokinen H, Wahlund LO, O'Brien JT, Basile AM, Pantoni L, Inzitari D, Waldemar G. Corpus callosum tissue loss and development of motor and global cognitive impairment: the LADIS study. Dement Geriatr Cogn Disord 2012; 32:279-86. [PMID: 22262017 DOI: 10.1159/000334949] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine the impact of corpus callosum (CC) tissue loss on the development of global cognitive and motor impairment in the elderly. METHODS This study was based on the Leukoaraiosis and Disability (LADIS) study. Assessment of cognitive and motor functions and magnetic resonance imaging (MRI) were done at baseline and at a 3-year follow-up in nondemented elderly subjects. RESULTS 328 of 639 LADIS subjects had MRIs at baseline and at the 3-year follow-up, which allowed for assessment of CC. Logistic regression revealed differential tissue loss rates in posterior CC in subjects converting to dementia, compared to nonconverters (p < 0.05). Anterior and posterior CC tissue loss was significantly correlated with self-perceived memory impairment in nonconverters (p < 0.05). CC tissue loss was also significantly associated with impaired single leg stance time (p < 0.01). CONCLUSION The present longitudinal study on CC supports the role of callosal tissue loss in the development of global cognitive as well as motor impairment.
Collapse
Affiliation(s)
- Kristian S Frederiksen
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Copenhagen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Jokinen H, Frederiksen KS, Garde E, Skimminge A, Siebner H, Waldemar G, Ylikoski R, Madureira S, Verdelho A, van Straaten ECW, Barkhof F, Fazekas F, Schmidt R, Pantoni L, Inzitari D, Erkinjuntti T. Callosal tissue loss parallels subtle decline in psychomotor speed. a longitudinal quantitative MRI study. The LADIS Study. Neuropsychologia 2012; 50:1650-5. [PMID: 22497753 DOI: 10.1016/j.neuropsychologia.2012.03.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 03/11/2012] [Accepted: 03/19/2012] [Indexed: 11/30/2022]
Abstract
Cross-sectional studies have suggested that corpus callosum (CC) atrophy is related to impairment in global cognitive function, mental speed, and executive functions in the elderly. Longitudinal studies confirming these findings have been lacking. We investigated whether CC tissue loss is associated with change in cognitive performance over time in subjects with age-related white matter lesions (WML). Two-hundred-fifty-three subjects, aged 65-84 years, were evaluated by using repeated MRI and neuropsychological evaluation at baseline and after 3 years. The effect of overall and regional CC tissue loss on cognitive decline was analyzed with hierarchical linear regression models. After controlling for age, sex, education, and baseline cognitive performance, the rates of tissue loss in the total CC area, and in rostrum/genu and midbody subregions were significantly associated with decline in a compound measure of cognitive speed and motor control, but not in those of executive functions, memory, or global cognitive function. Total CC area and midbody remained significant predictors of speed also after adjusting for baseline WML volume, WML progression, and global brain atrophy. However, the relationship between anterior CC and speed performance was mediated by WML volume. In conclusion, the overall and regional rate of CC tissue loss parallels longitudinal slowing of psychomotor performance. The adverse effect of CC tissue loss on psychomotor function may be driven by altered interhemispheric information transfer between homologous cortical areas.
Collapse
Affiliation(s)
- Hanna Jokinen
- Department of Neurology, Helsinki University Central Hospital Helsinki, Finland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Held V, Szabo K, Bäzner H, Hennerici MG. Chronic small vessel disease affects clinical outcome in patients with acute striatocapsular stroke. Cerebrovasc Dis 2011; 33:86-91. [PMID: 22156561 DOI: 10.1159/000333431] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/06/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recovery from stroke is presumed to be a function of a cerebral network. Chronic small vessel disease (SVD) has been shown to disrupt this network's integrity and has been proposed as a predictor of poor outcome after stroke. We studied this hypothesis in patients with acute ischemic stroke of the striatocapsular region, an area of pronounced cortical and subcortical connectivity. METHODS We identified 62 patients with isolated striatocapsular stroke from our stroke registry. The standardized workup included clinical rating according to the modified Rankin Scale (mRS) and MRI, rated according to the Fazekas scale for the extent of SVD, ranging from grade 0 to III. MRS at admission, at discharge, and a short-term recovery parameter (the difference between mRS at admission and discharge) were correlated with the extent of SVD. Comorbidity was assessed with the Charlson comorbidity index (CCI). RESULTS SVD was graded 0 in 7%, I in 60%, II in 18%, and III in 16% of patients. The median mRS at discharge for the groups was 2, 1, 2 and 4, and the median recovery parameter was 2, 1, 1 and 0.5, respectively. The extent of SVD significantly correlated with both the mRS at discharge and the recovery parameter. While age was also a significant predictor of these outcome parameters, SVD severity was a significant predictor even after correction for age or CCI. CONCLUSIONS SVD is a predictor of poor outcome and recovery in striatocapsular stroke, independent of age or comorbidity. Severe SVD disturbs the integrity of the cerebral network leading to aggravation of and poor recovery from neurological deficits.
Collapse
Affiliation(s)
- V Held
- Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, Germany.
| | | | | | | |
Collapse
|
33
|
Poggesi A, Pantoni L, Inzitari D, Fazekas F, Ferro J, O'Brien J, Hennerici M, Scheltens P, Erkinjuntti T, Visser M, Langhorne P, Chabriat H, Waldemar G, Wallin A, Wahlund A. 2001-2011: A Decade of the LADIS (Leukoaraiosis And DISability) Study: What Have We Learned about White Matter Changes and Small-Vessel Disease? Cerebrovasc Dis 2011; 32:577-88. [PMID: 22277351 DOI: 10.1159/000334498] [Citation(s) in RCA: 208] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/18/2011] [Indexed: 11/19/2022] Open
Abstract
Over the last 20 years, evidence about the clinical correlates of cerebral white matter changes (WMC; also called leukoaraiosis) has been accumulating. WMC are now listed among the neuroimaging expressions of cerebral small-vessel disease and are no longer considered an innocuous finding because they are associated, in cross-sectional surveys, with various disturbances and, in follow-up studies, with poor prognosis. The Leukoaraiosis And DISability (LADIS) study has contributed substantially to this body of knowledge. LADIS is a European multicenter collaboration that was started in 2001 with the aim of assessing the independent role of WMC in predicting disability in subjects aged 65-84. The main results of the LADIS study have been released in 2009 with the demonstration that severe WMC more than double the risk of transition from an autonomous to a dependent status after 3 years of follow-up. The LADIS study has also contributed more focused substudies assessing the possible role of WMC in the decline of cognitive and motor performances, depressive symptoms associated with aging and cerebrovascular diseases, urinary disturbances, and also the role of other brain lesions (lacunar infarcts, cerebral atrophy, and corpus callosum morphology). The LADIS study provides a good example of harmonization of instruments (MRI protocol, clinical, neuropsychological, and functional scales) within an international collaboration. Currently, the LADIS study is providing data about the natural history of WMC. In this paper, we review the background and the main results of the LADIS study. This review puts forward some considerations for future studies in the field.
Collapse
|
34
|
Age related changes in the myelinated fibers of corpus callosum. Neurosci Lett 2011; 499:208-12. [DOI: 10.1016/j.neulet.2011.05.229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 05/22/2011] [Accepted: 05/25/2011] [Indexed: 11/20/2022]
|
35
|
Frederiksen KS, Garde E, Skimminge A, Ryberg C, Rostrup E, Baaré WFC, Siebner HR, Hejl AM, Leffers AM, Waldemar G. Corpus callosum atrophy in patients with mild Alzheimer's disease. NEURODEGENER DIS 2011; 8:476-82. [PMID: 21659724 DOI: 10.1159/000327753] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 03/14/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVES Several studies have found atrophy of the corpus callosum (CC) in patients with Alzheimer's disease (AD). However, it remains unclear whether callosal atrophy is already present in the early stages of AD, and to what extent it may be associated with other structural changes in the brain, such as age-related white matter changes (ARWMC) and progression of the disease. METHODS Twenty-eight patients in the early stages of AD and 50 non-demented elderly subjects with varying degrees of ARWMC were investigated using MRI. The CC was assessed semi-automatically, and ARWMC were rated according to the Fazekas scale. RESULTS A significant difference in posterior CC size could be detected between non-demented elderly subjects and early stage AD patients. The sizes of the total CC, rostral body and splenium at baseline were correlated with change from baseline MMSE score after a 1-year follow-up in AD patients. There was no association between CC size and ARWMC. CONCLUSIONS The present findings indicate that posterior CC atrophy is present in mild AD independently of ARWMC. Furthermore, CC atrophy may be associated with cognitive deterioration.
Collapse
Affiliation(s)
- Kristian Steen Frederiksen
- Department of Neurology, Memory Disorders Research Group, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. kristian.steen.frederiksen @ rh.regionh.dk
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Ryberg C, Rostrup E, Paulson OB, Barkhof F, Scheltens P, van Straaten ECW, van der Flier WM, Fazekas F, Schmidt R, Ferro JM, Baezner H, Erkinjuntti T, Jokinen H, Wahlund LO, Poggesi A, Pantoni L, Inzitari D, Waldemar G. Corpus callosum atrophy as a predictor of age-related cognitive and motor impairment: a 3-year follow-up of the LADIS study cohort. J Neurol Sci 2011; 307:100-5. [PMID: 21621224 DOI: 10.1016/j.jns.2011.05.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 04/28/2011] [Accepted: 05/03/2011] [Indexed: 11/26/2022]
Abstract
The aim of this 3-year follow-up study was to investigate whether corpus callosum (CC) atrophy may predict future motor and cognitive impairment in an elderly population. On baseline MRI from 563 subjects with age-related white matter changes (ARWMC) from the Leukoaraiosis And DISability (LADIS) study, the CC was segmented and subdivided into five anterior-posterior regions (CC1-CC5). Associations between the CC areas and decline in motor performance and cognitive functions over a 3-year period were analyzed. CC atrophy at baseline was significantly associated with impaired cognitive performance (p<0.01 for CC1, p<0.05 for CC5), motor function (p<0.05 for CC2 and CC5), and walking speed (p<0.01 for CC2 and CC5, p<0.05 for CC3 and total CC), and with development of dementia at 3 years (p<0.05 for CC1) after correction for appropriate confounders (ARWMC volume, atrophy, age, gender and handedness). In conclusion, CC atrophy, an indicator of reduced functional connectivity between cortical areas, seems to contribute, independently of ARWMC load, to future cognitive and motor decline in the elderly.
Collapse
Affiliation(s)
- C Ryberg
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Copenhagen, Denmark
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Loss of callosal fibre integrity in healthy elderly with age-related white matter changes. J Neurol 2011; 258:1451-9. [DOI: 10.1007/s00415-011-5956-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 01/18/2011] [Accepted: 02/08/2011] [Indexed: 11/27/2022]
|
38
|
Schmidt R, Ropele S, Ferro J, Madureira S, Verdelho A, Petrovic K, Gouw A, van der Flier WM, Enzinger C, Pantoni L, Inzitari D, Erkinjuntti T, Scheltens P, Wahlund LO, Waldemar G, Rostrup E, Wallin A, Barkhof F, Fazekas F. Diffusion-Weighted Imaging and Cognition in the Leukoariosis and Disability in the Elderly Study. Stroke 2010; 41:e402-8. [DOI: 10.1161/strokeaha.109.576629] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The mechanisms by which leukoariosis impacts on clinical and cognitive functions are not yet fully understood. We hypothesized that ultrastructural abnormalities of the normal-appearing brain tissue (NABT) assessed by diffusion-weighted imaging played a major and independent role.
Methods—
In addition to a comprehensive clinical, neuropsychologic, and imaging work-up, diffusion-weighted imaging was performed in 340 participants of the multicenter leukoariosis and disability study examining the impact of white matter hyperintensities (WMH) on 65- to 85-year old individuals without previous disability. WMH severity was rated according to the Fazekas score. Multivariate regression analysis served to assess correlations of histogram metrics of the apparent diffusion coefficient (ADC) of whole-brain tissue, NABT, and of the mean ADC of WMH with cognitive functions.
Results—
Increasing WMH scores were associated with a higher frequency of hypertension, a greater WMH volume, more brain atrophy, worse overall cognitive performance, and changes in ADC. We found strong associations between the peak height of the ADC histogram of whole-brain tissue and NABT with memory performance, executive dysfunction, and speed, which remained after adjustment for WMH lesion volume and brain atrophy and were consistent among centers. No such association was seen with the mean ADC of WMH.
Conclusions—
Ultrastructural abnormalities of NABT increase with WMH severity and have a strong and independent effect on cognitive functions, whereas diffusion-weighted imaging metrics within WMH have no direct impact. This should be considered when defining outcome measures for trials that attempt to ameliorate the consequences of WMH progression.
Collapse
Affiliation(s)
- Reinhold Schmidt
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Stefan Ropele
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - José Ferro
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Sofia Madureira
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Ana Verdelho
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Katja Petrovic
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Alida Gouw
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Wiesje M. van der Flier
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Christian Enzinger
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Leonardo Pantoni
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Domenico Inzitari
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Timo Erkinjuntti
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Philip Scheltens
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Lars O. Wahlund
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Gunhild Waldemar
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Egill Rostrup
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Anders Wallin
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Frederik Barkhof
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| | - Franz Fazekas
- From Department of Neurology (R.S., S.R., K.P., C.E., F.F.), Medical University of Graz, Graz, Austria; Serviço de Neurologia (J.F., S.M., A.V., F.B.), Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal; Department of Neurology (A.G., W.v.d.F., P.S., F.B.), Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Department of Neurological and Psychiatric Sciences (A.G., L.P., D.I.), University of Florence, Florence, Italy; Memory Research Unit (T.E.), Department of
| |
Collapse
|
39
|
Kalpana R, Muttan S, Agrawala B. Changes in Brain White Matter Assessed Via Textural Features Using a Neural Network. INTERNATIONAL JOURNAL OF HEALTHCARE INFORMATION SYSTEMS AND INFORMATICS 2010. [DOI: 10.4018/jhisi.2010040105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diffusion Tensor Magnetic Resonance Imaging (DTMRI) has proved useful for microstructure characterization of the brain. This technique also helps determining complex connectivity of fiber tracts. The brain white matter (BMW) changes with respect to age and corresponding appearance of white-matter lesions among the brain’s message-carrying axons affects cognitive functions in old age. In this paper, the observed morphology in BWM on ageing is analyzed using statistical parameters extracted from DTMR images of different age groups. The gray level co-occurrence matrix (GLCM) obtained from the segmented images gives 14 textural features, subsets of which are adopted as the input sets in a backpropagation neural network classifier. The network is trained to predict the age based on BMW details used as the inputs. The proposed method helps in understanding the age-related changes in white matter. This is useful for the physician in understanding miscorrelation in motor activities and relevant causes in elderly subjects.
Collapse
|
40
|
Hattingen E, Nichtweiss M, Blasel S, Zanella FE, Weidauer S. [Corpus callosum. Landmark of the origin of cerebral diseases]. Radiologe 2009; 50:152-64. [PMID: 20012004 DOI: 10.1007/s00117-009-1945-5] [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: 11/27/2022]
Abstract
Diseases of the corpus callosum include developmental disorders, immunomodulated CNS diseases, vascular malformations, disturbances of metabolism including the electrolyte homeostasis, secondary degenerations and mechanical injuries. This report provides information on the differential diagnosis of reversible and irreversible pathological changes of the corpus callosum with special focus on the localization, which often allows conclusions on the pathogenesis to be drawn.
Collapse
Affiliation(s)
- E Hattingen
- Institut für Neuroradiologie, Johann-Wolfgang-Goethe-Universität Frankfurt/Main, Schleusenweg 2-16, 60528, Frankfurt.
| | | | | | | | | |
Collapse
|
41
|
Inzitari D, Pracucci G, Poggesi A, Carlucci G, Barkhof F, Chabriat H, Erkinjuntti T, Fazekas F, Ferro JM, Hennerici M, Langhorne P, O'Brien J, Scheltens P, Visser MC, Wahlund LO, Waldemar G, Wallin A, Pantoni L. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ 2009; 339:b2477. [PMID: 19581317 PMCID: PMC2714680 DOI: 10.1136/bmj.b2477] [Citation(s) in RCA: 293] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2009] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the impairment in daily living activities in older people with age related changes in white matter according to the severity of these changes. DESIGN Observational data collection and follow-up of a cohort of older people undergoing brain magnetic resonance imaging after non-disabling complaints. SETTING 11 European centres. PARTICIPANTS 639 non-disabled older patients (mean age 74.1 (SD 5.0), 45.1% men) in whom brain magnetic resonance imaging showed mild, moderate, or severe age related changes in white matter (Fazekas scale). Magnetic resonance imaging assessment also included cerebral infarcts and atrophy. MAIN OUTCOME MEASURE Transition from no disability (defined as a score of 0 or 1 on the instrumental activities of daily living scale) to disability (score >/=2) or death over three year follow-up. Secondary outcomes were incident dementia and stroke. RESULTS Over a mean follow-up period of 2.42 years (SD 0.97, median 2.94 years), information on the main outcome was available for 633 patients. The annual rate of transition or death was 10.5%, 15.1%, and 29.5%, respectively, for patients with mild, moderate, or severe age related changes in white matter (Kaplan-Meier log rank test P<0.001). In a Cox model comparing severe with mild changes and adjusted for clinical factors of functional decline, the risk of transition to disability or death was more than twofold higher (hazard ratio 2.36, 95% confidence interval 1.65 to 3.81). The other predictors were age group, history of atrial fibrillation, and complaint of gait disturbances. The effect of severe changes remained significant independently of baseline degree of atrophy and number of infarcts. Incident stroke and dementia only slightly modified this effect. CONCLUSION The three year results of the LADIS study suggest that in older adults who seek medical attention for non-disabling complaints, severe age related changes in white matter independently and strongly predict rapid global functional decline.
Collapse
Affiliation(s)
- Domenico Inzitari
- Department of Neurological and Psychiatric Sciences, University of Florence, Viale Morgagni 85, 50134 Firenze, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Lou X, Jiang W, Ma L, Ma N, Cai Y, Huang D, Wong EH. Lower fractional anisotropy at the anterior body of the normal-appearing corpus callosum in multiple sclerosis versus symptomatic carotid occlusion. Neuroradiology 2009. [PMID: 19504090 DOI: 10.1007/s00234-009-0535–6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Not uncommonly, differentiating multiple sclerosis (MS) from ischemic cerebral vascular disease is difficult based on conventional magnetic resonance imaging (MRI). We aim to determine whether preferential occult injury in the normal-appearing corpus callosum (NACC) is more severe in patients with MS than symptomatic carotid occlusion by comparing fractional anisotropy (FA) from diffusion tensor imaging (DTI). METHODS Eighteen patients (eight men, ten women; mean age, 38.6 years) with MS and 32 patients (24 men, eight women; mean age, 64.0 years) with symptomatic unilateral internal carotid occlusion were included. DTI (1.5 T) were performed at corpus callosum which were normal-appearing on fluid-attenuated inversion recovery MRI. Mean FA was obtained from the genu, anterior body, posterior body, and splenium of NACC. Independent-sample t test statistical analysis was performed. RESULTS The FA values in various regions of NACC were lower in the MS patients than symptomatic carotid occlusion patients, which was statistically different at the anterior body (0.67 +/- 0.12 vs 0.74 +/- 0.06, P = 0.009), but not at genu, posterior body, and splenium (0.63 +/- 0.09 vs 0.67 +/- 0.07, P = 0.13; 0.68 +/- 0.09 vs 0.73 +/- 0.05, P = 0.07; 0.72 +/- 0.09 vs 0.76 +/- 0.05, P = 0.13). CONCLUSION MS patients have lower FA in the anterior body of NACC compared to patients with symptomatic carotid occlusion. It suggests that DTI has potential ability to differentiate these two conditions due to the more severe preferential occult injury at the anterior body of NACC in MS.
Collapse
Affiliation(s)
- Xin Lou
- Department of Radiology, The PLA General Hospital, No. 28 Fuxing road, Beijing, People's Republic of China
| | | | | | | | | | | | | |
Collapse
|
43
|
Lower fractional anisotropy at the anterior body of the normal-appearing corpus callosum in multiple sclerosis versus symptomatic carotid occlusion. Neuroradiology 2009; 51:557-61. [PMID: 19504090 DOI: 10.1007/s00234-009-0535-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Accepted: 05/07/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Not uncommonly, differentiating multiple sclerosis (MS) from ischemic cerebral vascular disease is difficult based on conventional magnetic resonance imaging (MRI). We aim to determine whether preferential occult injury in the normal-appearing corpus callosum (NACC) is more severe in patients with MS than symptomatic carotid occlusion by comparing fractional anisotropy (FA) from diffusion tensor imaging (DTI). METHODS Eighteen patients (eight men, ten women; mean age, 38.6 years) with MS and 32 patients (24 men, eight women; mean age, 64.0 years) with symptomatic unilateral internal carotid occlusion were included. DTI (1.5 T) were performed at corpus callosum which were normal-appearing on fluid-attenuated inversion recovery MRI. Mean FA was obtained from the genu, anterior body, posterior body, and splenium of NACC. Independent-sample t test statistical analysis was performed. RESULTS The FA values in various regions of NACC were lower in the MS patients than symptomatic carotid occlusion patients, which was statistically different at the anterior body (0.67 +/- 0.12 vs 0.74 +/- 0.06, P = 0.009), but not at genu, posterior body, and splenium (0.63 +/- 0.09 vs 0.67 +/- 0.07, P = 0.13; 0.68 +/- 0.09 vs 0.73 +/- 0.05, P = 0.07; 0.72 +/- 0.09 vs 0.76 +/- 0.05, P = 0.13). CONCLUSION MS patients have lower FA in the anterior body of NACC compared to patients with symptomatic carotid occlusion. It suggests that DTI has potential ability to differentiate these two conditions due to the more severe preferential occult injury at the anterior body of NACC in MS.
Collapse
|