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Anderson ME, Wind EJ, Robison LS. Exploring the neuroprotective role of physical activity in cerebral small vessel disease. Brain Res 2024; 1833:148884. [PMID: 38527712 DOI: 10.1016/j.brainres.2024.148884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
Cerebral small vessel disease (cSVD) is a common neurological finding characterized by abnormalities of the small blood vessels in the brain. Previous research has established a strong connection between cSVD and stroke, as well as neurodegenerative disorders, notably Alzheimer's disease (AD) and other dementias. As the search for effective interventions continues, physical activity (PA) has emerged as a potential preventative and therapeutic avenue. This review synthesizes the human and animal literature on the influence of PA on cSVD, highlighting the importance of determining optimal exercise protocols, considering aspects such as intensity, duration, timing, and exercise type. Furthermore, the necessity of widening the age bracket in research samples is discussed, ensuring a holistic understanding of the interventions across varying pathological stages of the disease. The review also suggests the potential of exploring diverse biomarkers and risk profiles associated with clinically significant outcomes. Moreover, we review findings demonstrating the beneficial effects of PA in various rodent models of cSVD, which have uncovered numerous mechanisms of neuroprotection, including increases in neuroplasticity and integrity of the vasculature and white matter; decreases in inflammation, oxidative stress, and mitochondrial dysfunction; and alterations in amyloid processing and neurotransmitter signaling. In conclusion, this review highlights the potential of physical activity as a preventive strategy for addressing cSVD, offering insights into the need for refining exercise parameters, diversifying research populations, and exploring novel biomarkers, while shedding light on the intricate mechanisms through which exercise confers neuroprotection in both humans and animal models.
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Affiliation(s)
- Maria E Anderson
- Department of Psychology, Family, and Justice Studies, University of Saint Joseph, 1678 Asylum Ave, West Hartford, CT 06117, USA
| | - Eleanor J Wind
- Department of Psychology and Neuroscience, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL 33328, USA
| | - Lisa S Robison
- Department of Psychology and Neuroscience, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL 33328, USA.
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2
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Borrelli S, Guisset F, Vanden Bulcke C, Stölting A, Bugli C, Lolli V, Du Pasquier R, van Pesch V, Absinta M, Pasi M, Maggi P. Enlarged perivascular spaces are associated with brain microangiopathy and aging in multiple sclerosis. Mult Scler 2024:13524585241256881. [PMID: 38850029 DOI: 10.1177/13524585241256881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
BACKGROUND Growing evidence links brain-MRI enlarged perivascular spaces (EPVS) and multiple sclerosis (MS), but their role remains unclear. OBJECTIVE This study aimed to investigate the cross-sectional associations of EPVS with several neuroinflammatory and neurodegenerative features in a large multicentric-MS cohort. METHODS In total, 207 patients underwent 3T axial-T2-weighted brain-MRI for EPVS assessment (EPVS dichotomized into high/low according to ⩾ 2/< 2 rating categories). MRI biomarkers included brain-predicted age and brain-predicted age difference (brain-PAD), central vein sign (CVS)-positive lesion percentage (CVS%), paramagnetic rim and cortical lesions, T2-lesion load, and brain volumetry. The variable relative importance for EPVS-category prediction was explored using a classification random forest approach. RESULTS High EPVS patients were older (49 vs 44 years, p = 0.003), had ⩾ 1 vascular risk factors (VRFs; p = 0.005), lower CVS% (67% vs 78%, p < 0.001), reduced brain volumes (whole brain: 0.63 vs 0.73, p = 0.01; gray matter: 0.36 vs 0.40; p = 0.002), and older brain-predicted age (58 vs 50 years, p < 0.001). No differences were found for neuroinflammatory markers. After adjusting for age and VFRs (multivariate analyses), the high EPVS category correlated with lower CVS% (odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.96-0.99; p = 0.02), lower whole brain (OR = 0.01, 95% CI = 0.0003-0.5; p = 0.02), gray matter (OR = 0.0004, 95% CI = 0.0000004-0.4; p = 0.03) volumes, and higher brain-PAD (OR = 1.05, 95% CI = 1.01-1.09; p = 0.02). Random forest identified brain-PAD as the most important predictor of high EPVS. CONCLUSION EPVS in MS likely reflect microangiopathic disease rather than neuroinflammation, potentially contributing to accelerated neurodegeneration.
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Affiliation(s)
- Serena Borrelli
- Neuroinflammation Imaging Lab (NIL), Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium/Department of Neurology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Brussels, Brussels, Belgium
| | - François Guisset
- Neuroinflammation Imaging Lab (NIL), Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium
| | - Colin Vanden Bulcke
- Neuroinflammation Imaging Lab (NIL), Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium/ICTEAM Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Anna Stölting
- Neuroinflammation Imaging Lab (NIL), Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium
| | - Céline Bugli
- Plateforme technologique de Support en Méthodologie et Calcul Statistique, Université catholique de Louvain, Brussels, Belgium
| | - Valentina Lolli
- Department of Radiology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Brussels, Brussels, Belgium
| | - Renaud Du Pasquier
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Vincent van Pesch
- Department of Neurology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Martina Absinta
- Vita-Salute San Raffaele University, Milan, Italy/Translational Neuropathology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marco Pasi
- Stroke Unit, Department of Neurology, CIC-IT 1415, CHRU de Tours, INSERM 1253 iBrain, Tours, France
| | - Pietro Maggi
- Neuroinflammation Imaging Lab (NIL), Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium/Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland/Department of Neurology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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3
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Pei YF, Li XD, Liu QY, Zhang CW, Wang YH, Chen MR, Chen HS. A nomogram for predicting cerebral white matter lesions in elderly men. Front Neurol 2024; 15:1343654. [PMID: 38751887 PMCID: PMC11094237 DOI: 10.3389/fneur.2024.1343654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study aimed to develop a nomogram tool to predict cerebral white matter lesions (WMLs) in elderly men. Methods Based on a retrospective cohort from January 2017 to December 2019, a multivariate logistic analysis was performed to construct a nomogram for predicting WMLs. The nomogram was further validated using a follow-up cohort between January 2020 and December 2022. The calibration curve, receiver operating characteristics (ROC) curves, and the decision curves analysis (DCA) were used to evaluate discrimination and calibration of this nomogram. Result A total of 436 male patients were enrolled in this study, and all 436 patients were used as the training cohort and 163 follow-up patients as the validation cohort. A multivariate logistic analysis showed that age, cystatin C, uric acid, total cholesterol, platelet, and the use of antiplatelet drugs were independently associated with WMLs. Based on these variables, a nomogram was developed. The nomogram displayed excellent predictive power with the area under the ROC curve of 0.951 [95% confidence interval (CI), 0.929-0.972] in the training cohort and 0.915 (95% CI, 0.864-0.966) in the validation cohort. The calibration of the nomogram was also good, as indicated by the Hosmer-Lemeshow test with p-value of 0.594 in the training cohort and 0.178 in the validation cohort. The DCA showed that the nomogram holds good clinical application value. Conclusion We have developed and validated a novel nomogram tool for identifying elderly men at high risk of WMLs, which exhibits excellent predictive power, discrimination, and calibration.
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Affiliation(s)
| | | | | | | | | | | | - Hui-Sheng Chen
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
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4
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Xie X, Zhai J, Zhou X, Guo Z, Lo PC, Zhu G, Chan KWY, Yang M. Magnetic Particle Imaging: From Tracer Design to Biomedical Applications in Vasculature Abnormality. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2306450. [PMID: 37812831 DOI: 10.1002/adma.202306450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/14/2023] [Indexed: 10/11/2023]
Abstract
Magnetic particle imaging (MPI) is an emerging non-invasive tomographic technique based on the response of magnetic nanoparticles (MNPs) to oscillating drive fields at the center of a static magnetic gradient. In contrast to magnetic resonance imaging (MRI), which is driven by uniform magnetic fields and projects the anatomic information of the subjects, MPI directly tracks and quantifies MNPs in vivo without background signals. Moreover, it does not require radioactive tracers and has no limitations on imaging depth. This article first introduces the basic principles of MPI and important features of MNPs for imaging sensitivity, spatial resolution, and targeted biodistribution. The latest research aiming to optimize the performance of MPI tracers is reviewed based on their material composition, physical properties, and surface modifications. While the unique advantages of MPI have led to a series of promising biomedical applications, recent development of MPI in investigating vascular abnormalities in cardiovascular and cerebrovascular systems, and cancer are also discussed. Finally, recent progress and challenges in the clinical translation of MPI are discussed to provide possible directions for future research and development.
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Affiliation(s)
- Xulin Xie
- Department of Precision Diagnostic and Therapeutic Technology, City University of Hong Kong Shenzhen Futian Research Institute, Shenzhen, 518057, China
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Jiao Zhai
- Department of Precision Diagnostic and Therapeutic Technology, City University of Hong Kong Shenzhen Futian Research Institute, Shenzhen, 518057, China
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Xiaoyu Zhou
- Department of Precision Diagnostic and Therapeutic Technology, City University of Hong Kong Shenzhen Futian Research Institute, Shenzhen, 518057, China
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Zhengjun Guo
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
- Department of Oncology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Pui-Chi Lo
- Department of Precision Diagnostic and Therapeutic Technology, City University of Hong Kong Shenzhen Futian Research Institute, Shenzhen, 518057, China
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Guangyu Zhu
- Department of Chemistry, City University of Hong Kong, Hong Kong SAR, 999077, China
| | - Kannie W Y Chan
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, 999077, China
| | - Mengsu Yang
- Department of Precision Diagnostic and Therapeutic Technology, City University of Hong Kong Shenzhen Futian Research Institute, Shenzhen, 518057, China
- Department of Biomedical Sciences, and Tung Biomedical Sciences Centre, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
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Dhabalia R, Kashikar SV, Parihar PS, Mishra GV. Unveiling the Intricacies: A Comprehensive Review of Magnetic Resonance Imaging (MRI) Assessment of T2-Weighted Hyperintensities in the Neuroimaging Landscape. Cureus 2024; 16:e54808. [PMID: 38529430 PMCID: PMC10961652 DOI: 10.7759/cureus.54808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/24/2024] [Indexed: 03/27/2024] Open
Abstract
T2-weighted hyperintensities in neuroimaging represent areas of heightened signal intensity on magnetic resonance imaging (MRI) scans, holding crucial importance in neuroimaging. This comprehensive review explores the T2-weighted hyperintensities, providing insights into their definition, characteristics, clinical relevance, and underlying causes. It highlights the significance of these hyperintensities as sensitive markers for neurological disorders, including multiple sclerosis, vascular dementia, and brain tumors. The review also delves into advanced neuroimaging techniques, such as susceptibility-weighted and diffusion tensor imaging, and the application of artificial intelligence and machine learning in hyperintensities analysis. Furthermore, it outlines the challenges and pitfalls associated with their assessment and emphasizes the importance of standardized protocols and a multidisciplinary approach. The review discusses future directions for research and clinical practice, including the development of biomarkers, personalized medicine, and enhanced imaging techniques. Ultimately, the review underscores the profound impact of T2-weighted hyperintensities in shaping the landscape of neurological diagnosis, prognosis, and treatment, contributing to a deeper understanding of complex neurological conditions and guiding more informed and effective patient care.
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Affiliation(s)
- Rishabh Dhabalia
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Shivali V Kashikar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Pratap S Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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6
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Oi Y, Hirose M, Togo H, Yoshinaga K, Akasaka T, Okada T, Aso T, Takahashi R, Glasser MF, Hayashi T, Hanakawa T. Identifying and reverting the adverse effects of white matter hyperintensities on cortical surface analyses. Neuroimage 2023; 281:120377. [PMID: 37714391 DOI: 10.1016/j.neuroimage.2023.120377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 08/22/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
The Human Connectome Project (HCP)-style surface-based brain MRI analysis is a powerful technique that allows precise mapping of the cerebral cortex. However, the strength of its surface-based analysis has not yet been tested in the older population that often presents with white matter hyperintensities (WMHs) on T2-weighted (T2w) MRI (hypointensities on T1w MRI). We investigated T1-weighted (T1w) and T2w structural MRI in 43 healthy middle-aged to old participants. Juxtacortical WMHs were often misclassified by the default HCP pipeline as parts of the gray matter in T1w MRI, leading to incorrect estimation of the cortical surfaces and cortical metrics. To revert the adverse effects of juxtacortical WMHs, we incorporated the Brain Intensity AbNormality Classification Algorithm into the HCP pipeline (proposed pipeline). Blinded radiologists performed stereological quality control (QC) and found a decrease in the estimation errors in the proposed pipeline. The superior performance of the proposed pipeline was confirmed using an originally-developed automated surface QC based on a large database. Here we showed the detrimental effects of juxtacortical WMHs for estimating cortical surfaces and related metrics and proposed a possible solution for this problem. The present knowledge and methodology should help researchers identify adequate cortical surface biomarkers for aging and age-related neuropsychiatric disorders.
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Affiliation(s)
- Yuki Oi
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Laboratory for Brain Connectomics Imaging, Center for Biosystems Dynamics Research, RIKEN, Kobe, Japan
| | - Masakazu Hirose
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Togo
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan; Laboratory for Brain Connectomics Imaging, Center for Biosystems Dynamics Research, RIKEN, Kobe, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Kenji Yoshinaga
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Thai Akasaka
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, Center for Biosystems Dynamics Research, RIKEN, Kobe, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Matthew F Glasser
- Departments of Radiology and Neuroscience, Washington University School of Medicine, St. Louis, MO, United States
| | - Takuya Hayashi
- Laboratory for Brain Connectomics Imaging, Center for Biosystems Dynamics Research, RIKEN, Kobe, Japan; Department of Brain Connectomics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Hanakawa
- Department of Integrated Neuroanatomy and Neuroimaging, Kyoto University Graduate School of Medicine, Kyoto, Japan; Laboratory for Brain Connectomics Imaging, Center for Biosystems Dynamics Research, RIKEN, Kobe, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Japan; Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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7
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Fongang B, Satizabal C, Kautz TF, Wadop YN, Muhammad JAS, Vasquez E, Mathews J, Gireud-Goss M, Saklad AR, Himali J, Beiser A, Cavazos JE, Mahaney MC, Maestre G, DeCarli C, Shipp EL, Vasan RS, Seshadri S. Cerebral small vessel disease burden is associated with decreased abundance of gut Barnesiella intestinihominis bacterium in the Framingham Heart Study. Sci Rep 2023; 13:13622. [PMID: 37604954 PMCID: PMC10442369 DOI: 10.1038/s41598-023-40872-5] [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: 02/13/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023] Open
Abstract
A bidirectional communication exists between the brain and the gut, in which the gut microbiota influences cognitive function and vice-versa. Gut dysbiosis has been linked to several diseases, including Alzheimer's disease and related dementias (ADRD). However, the relationship between gut dysbiosis and markers of cerebral small vessel disease (cSVD), a major contributor to ADRD, is unknown. In this cross-sectional study, we examined the connection between the gut microbiome, cognitive, and neuroimaging markers of cSVD in the Framingham Heart Study (FHS). Markers of cSVD included white matter hyperintensities (WMH), peak width of skeletonized mean diffusivity (PSMD), and executive function (EF), estimated as the difference between the trail-making tests B and A. We included 972 FHS participants with MRI scans, neurocognitive measures, and stool samples and quantified the gut microbiota composition using 16S rRNA sequencing. We used multivariable association and differential abundance analyses adjusting for age, sex, BMI, and education level to estimate the association between gut microbiota and WMH, PSMD, and EF measures. Our results suggest an increased abundance of Pseudobutyrivibrio and Ruminococcus genera was associated with lower WMH and PSMD (p values < 0.001), as well as better executive function (p values < 0.01). In addition, in both differential and multivariable analyses, we found that the gram-negative bacterium Barnesiella intestinihominis was strongly associated with markers indicating a higher cSVD burden. Finally, functional analyses using PICRUSt implicated various KEGG pathways, including microbial quorum sensing, AMP/GMP-activated protein kinase, phenylpyruvate, and β-hydroxybutyrate production previously associated with cognitive performance and dementia. Our study provides important insights into the association between the gut microbiome and cSVD, but further studies are needed to replicate the findings.
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Affiliation(s)
- Bernard Fongang
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Claudia Satizabal
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Tiffany F Kautz
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yannick N Wadop
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jazmyn A S Muhammad
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Erin Vasquez
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Julia Mathews
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Monica Gireud-Goss
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Amy R Saklad
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jayandra Himali
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Alexa Beiser
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Jose E Cavazos
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Michael C Mahaney
- Department of Human Genetics, South Texas Diabetes and Obesity Institute, The University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Gladys Maestre
- Department of Neurosciences and Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Charles DeCarli
- Department of Neurology, Alzheimer's Disease Center, University of California, Davis, Sacramento, CA, USA
| | - Eric L Shipp
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ramachandran S Vasan
- Framingham Heart Study, Framingham, MA, USA
- Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
- Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Boston University's Center for Computing and Data Sciences, Boston, MA, USA
- The University of Texas School of Public Health in San Antonio, San Antonio, TX, USA
- The Long School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Framingham Heart Study, Framingham, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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8
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Powell E, Ohene Y, Battiston M, Dickie BR, Parkes LM, Parker GJM. Blood-brain barrier water exchange measurements using FEXI: Impact of modeling paradigm and relaxation time effects. Magn Reson Med 2023; 90:34-50. [PMID: 36892973 PMCID: PMC10962589 DOI: 10.1002/mrm.29616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE To evaluate potential modeling paradigms and the impact of relaxation time effects on human blood-brain barrier (BBB) water exchange measurements using FEXI (BBB-FEXI), and to quantify the accuracy, precision, and repeatability of BBB-FEXI exchange rate estimates at 3 T $$ \mathrm{T} $$ . METHODS Three modeling paradigms were evaluated: (i) the apparent exchange rate (AXR) model; (ii) a two-compartment model (2 CM $$ 2\mathrm{CM} $$ ) explicitly representing intra- and extravascular signal components, and (iii) a two-compartment model additionally accounting for finite compartmentalT 1 $$ {\mathrm{T}}_1 $$ andT 2 $$ {\mathrm{T}}_2 $$ relaxation times (2 CM r $$ 2{\mathrm{CM}}_r $$ ). Each model had three free parameters. Simulations quantified biases introduced by the assumption of infinite relaxation times in the AXR and2 CM $$ 2\mathrm{CM} $$ models, as well as the accuracy and precision of all three models. The scan-rescan repeatability of all paradigms was quantified for the first time in vivo in 10 healthy volunteers (age range 23-52 years; five female). RESULTS The assumption of infinite relaxation times yielded exchange rate errors in simulations up to 42%/14% in the AXR/2 CM $$ 2\mathrm{CM} $$ models, respectively. Accuracy was highest in the compartmental models; precision was best in the AXR model. Scan-rescan repeatability in vivo was good for all models, with negligible bias and repeatability coefficients in grey matter ofRC AXR = 0 . 43 $$ {\mathrm{RC}}_{\mathrm{AXR}}=0.43 $$ s - 1 $$ {\mathrm{s}}^{-1} $$ ,RC 2 CM = 0 . 51 $$ {\mathrm{RC}}_{2\mathrm{CM}}=0.51 $$ s - 1 $$ {\mathrm{s}}^{-1} $$ , andRC 2 CM r = 0 . 61 $$ {\mathrm{RC}}_{2{\mathrm{CM}}_r}=0.61 $$ s - 1 $$ {\mathrm{s}}^{-1} $$ . CONCLUSION Compartmental modelling of BBB-FEXI signals can provide accurate and repeatable measurements of BBB water exchange; however, relaxation time and partial volume effects may cause model-dependent biases.
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Affiliation(s)
- Elizabeth Powell
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Yolanda Ohene
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Marco Battiston
- Queen Square MS CentreUCL Institute of Neurology, University College LondonLondonUK
| | - Ben R. Dickie
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
- Division of Informatics, Imaging and Data SciencesSchool of Health Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchesterUK
| | - Laura M. Parkes
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - Geoff J. M. Parker
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
- Queen Square MS CentreUCL Institute of Neurology, University College LondonLondonUK
- Bioxydyn LimitedManchesterUK
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Zhao J, Wang X, Yu M, Zhang S, Li Q, Liu H, Zhang J, Cai R, Lu C, Li S. The Relevance of Serum Macrophage Migration Inhibitory Factor Level and Executive Function in Patients with White Matter Hyperintensity in Cerebral Small Vessel Disease. Brain Sci 2023; 13:brainsci13040616. [PMID: 37190581 DOI: 10.3390/brainsci13040616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
(1) Objective: To investigate the relationship between serum macrophage migration inhibitory factor (MIF) level and white matter hyperintensity (WMH) and executive function (EF) in cerebral small vascular disease (CSVD), and assess the impact and predictive value of MIF level and Fazekas scores in CSVD-related cognitive impairment (CI) (CSVD-CI); (2) Methods: A total of 117 patients with WMH admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2022 were enrolled. According to the Montreal cognitive assessment (MoCA) scale, subjects were divided into a normal cognitive group and an impaired group. All subjects required serum MIF level, 3.0 T MRI, and neuropsychological evaluation to investigate the risk factors for CDVD-CI, analyze the correlation between MIF level, WMH, and EF, and to analyze the diagnostic value of MIF and WMH degree in predicting CSVD-CI; (3) Results: 1. Fazekas score and MIF level were the risk factors of CSVD-CI. 2. The Fazekas score was negatively correlated with MoCA score, positively correlated with Stroop C-Time, Stroop C-Mistake, Stroop interference effects (SIE)-Time, SIE-Mistake, and color trails test (CTT) interference effects (CIE) (B-A). 3. The MIF level was positively correlated with Fazekas score, Stroop C-Time, SIE-Time, CTT B-Time, and CIE (B-A), and negatively correlated with MoCA score. 4. Fazekas score and MIF level were significant factors for diagnosing CSVD-CI; (4) Conclusion: The Fazekas score and MIF level may be the risk factors of CSVD-CI, and they are closely correlated to CI, especially the EF, and they have diagnostic value for CSVD-CI.
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Affiliation(s)
- Jianhua Zhao
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Xiaoting Wang
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Miao Yu
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Shiyun Zhang
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Qiong Li
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Hao Liu
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Jian Zhang
- Imaging Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Ruiyan Cai
- Henan Joint International Research Laboratory of Neurorestoratology for Senile Dementia, Henan Key Laboratory of Neurorestoratology, Neurology Department, First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Chengbiao Lu
- Sino-UK Joint Laboratory of Brain Function and Injury of Henan Province, Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang 453003, China
| | - Shaomin Li
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Lapucci C, Tazza F, Rebella S, Boffa G, Sbragia E, Bruschi N, Mancuso E, Mavilio N, Signori A, Roccatagliata L, Cellerino M, Schiavi S, Inglese M. Central vein sign and diffusion MRI differentiate microstructural features within white matter lesions of multiple sclerosis patients with comorbidities. Front Neurol 2023; 14:1084661. [PMID: 36970546 PMCID: PMC10030505 DOI: 10.3389/fneur.2023.1084661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction The Central Vein Sign (CVS) has been suggested as a potential biomarker to improve diagnostic specificity in multiple sclerosis (MS). Nevertheless, the impact of comorbidities on CVS performance has been poorly investigated so far. Despite the similar features shared by MS, migraine and Small Vessel Disease (SVD) at T2-weighted conventional MRI sequences, ex-vivo studies demonstrated their heterogeneous histopathological substrates. If in MS, inflammation, primitive demyelination and axonal loss coexist, in SVD demyelination is secondary to ischemic microangiopathy, while the contemporary presence of inflammatory and ischemic processes has been suggested in migraine. The aims of this study were to investigate the impact of comorbidities (risk factors for SVD and migraine) on the global and subregional assessment of the CVS in a large cohort of MS patients and to apply the Spherical Mean Technique (SMT) diffusion model to evaluate whether perivenular and non-perivenular lesions show distinctive microstructural features. Methods 120 MS patients stratified into 4 Age Groups performed 3T brain MRI. WM lesions were classified in "perivenular" and "non-perivenular" by visual inspection of FLAIR* images; mean values of SMT metrics, indirect estimators of inflammation, demyelination and fiber disruption (EXTRAMD: extraneurite mean diffusivity, EXTRATRANS: extraneurite transverse diffusivity and INTRA: intraneurite signal fraction, respectively) were extracted. Results Of the 5303 lesions selected for the CVS assessment, 68.7% were perivenular. Significant differences were found between perivenular and non-perivenular lesion volume in the whole brain (p < 0.001) and between perivenular and non-perivenular lesion volume and number in all the four subregions (p < 0.001 for all). The percentage of perivenular lesions decreased from youngest to oldest patients (79.7%-57.7%), with the deep/subcortical WM of oldest patients as the only subregion where the number of non-perivenular was higher than the number of perivenular lesions. Older age and migraine were independent predictors of a higher percentage of non-perivenular lesions (p < 0.001 and p = 0.013 respectively). Whole brain perivenular lesions showed higher inflammation, demyelination and fiber disruption than non perivenular lesions (p = 0.001, p = 0.001 and p = 0.02 for EXTRAMD, EXTRATRANS and INTRA respectively). Similar findings were found in the deep/subcortical WM (p = 0.001 for all). Compared to non-perivenular lesions, (i) perivenular lesions located in periventricular areas showed a more severe fiber disruption (p = 0.001), (ii) perivenular lesions located in juxtacortical and infratentorial regions exhibited a higher degree of inflammation (p = 0.01 and p = 0.05 respectively) and (iii) perivenular lesions located in infratentorial areas showed a higher degree of demyelination (p = 0.04). Discussion Age and migraine have a relevant impact in reducing the percentage of perivenular lesions, particularly in the deep/subcortical WM. SMT may differentiate perivenular lesions, characterized by higher inflammation, demyelination and fiber disruption, from non perivenular lesions, where these pathological processes seemed to be less pronounced. The development of new non-perivenular lesions, especially in the deep/subcortical WM of older patients, should be considered a "red flag" for a different -other than MS- pathophysiology.
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Affiliation(s)
- Caterina Lapucci
- HNSR, IRRCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Francesco Tazza
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | | | - Giacomo Boffa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Elvira Sbragia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Nicolò Bruschi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Elisabetta Mancuso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Nicola Mavilio
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alessio Signori
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Luca Roccatagliata
- Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Maria Cellerino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Simona Schiavi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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11
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Hauser KF, Ohene-Nyako M, Knapp PE. Accelerated brain aging with opioid misuse and HIV: New insights on the role of glially derived pro-inflammation mediators and neuronal chloride homeostasis. Curr Opin Neurobiol 2023; 78:102653. [PMID: 36584655 PMCID: PMC9933139 DOI: 10.1016/j.conb.2022.102653] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/26/2022] [Accepted: 11/10/2022] [Indexed: 12/29/2022]
Abstract
Opioid use disorder (OUD) has become a national crisis and contributes to the spread of human immunodeficiency virus (HIV) infection. Emerging evidence and advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal that opioids per se can directly exacerbate the pathophysiology of neuroHIV. Despite substantial inroads, the impact of OUD on the severity, development, and prognosis of neuroHIV and HIV-associated neurocognitive disorders is not fully understood. In this review, we explore current evidence that OUD and neuroHIV interact to accelerate cognitive deficits and enhance the neurodegenerative changes typically seen with aging, through their effects on neuroinflammation. We suggest new thoughts on the processes that may underlie accelerated brain aging, including dysregulation of neuronal inhibition, and highlight findings suggesting that opioids, through actions at the μ-opioid receptor, interact with HIV in the central nervous system to promote unique structural and functional comorbid deficits not seen in either OUD or neuroHIV alone.
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Affiliation(s)
- Kurt F Hauser
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA; Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0709, USA; Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, Virginia 23298-0059, USA
| | - Michael Ohene-Nyako
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA
| | - Pamela E Knapp
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0613, USA; Department of Anatomy and Neurobiology, School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-0709, USA; Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, Virginia 23298-0059, USA.
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12
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Zhou D, Lu C, Su C, Liu Y, Chen J, Zhang F, Bai H, Li Q. Relationship between heart rate variability and cognitive function in patients with enlarged perivascular space. Front Aging Neurosci 2022; 14:1031031. [DOI: 10.3389/fnagi.2022.1031031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
ObjectiveTo explore the relationship between heart rate variability (HRV), the brain distribution of enlarged perivascular space (EPVS), and cognitive impairment in patients with EPVS.Materials and methodsThe clinical and imaging data of 199 patients with EPVS were retrospectively analyzed. EPVS load in the basal ganglia (BG) and centrum semiovale (CS) regions were assessed using the Potter’s method. Cognitive function was evaluated using the Montreal Cognitive Assessment Scale. A logistic regression model was used to analyze the relationship between HRV, the brain distribution of EPVS and cognitive function in patients with EPVS. A receiver operating characteristic curve was used to assess the predictive value of HRV for cognitive function in patients with EPVS.ResultsOf the 199 patients, 27 and 42 presented with severe BG-EPVS and cognitive impairment, respectively. Significant differences were observed in the root mean square of successive differences of normal-normal (NN) intervals for period of interest (rMSSD), the percentage of adjacent NN intervals greater than 50 ms (PNN50), and the ratio of low-frequency power (LF) to high-frequency power (HF) between the mild and severe BG-EPVS groups (P < 0.05). Patients who presented with and without cognitive impairment differed significantly in the standard deviation of NN intervals (SDNN), rMSSD, PNN50, total power, LF, and LF/HF (P < 0.05). rMSSD (odds ratio [OR] 0.871, 95% confidence interval [CI] 0.768–0.988) and LF/HF (OR 3.854, 95% CI 1.196–12.419) were independent influencing factors of BG-EPVS, and rMSSD (OR 0.936, 95% CI 0.898–0.976) was an independent influencing factor of cognitive impairment in patients with EPVS. The optimal cut-off point was 0.312, with an area under the curve of 0.795 (95% CI 0.719–0.872) for predicting cognitive impairment in patients with EPVS by rMSSD.ConclusionReduced HRV is involved in the pathophysiological mechanisms of the formation and development of BG-EPVS and is associated with cognitive impairment in patients with EPVS, independent of CS-EPVS. For patients with HRV changes but without autonomic nervous system symptoms, positive intervention may slow the occurrence or progression of EPVS and cognitive impairment in patients with EPVS.
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Low A, Prats-Sedano MA, McKiernan E, Carter SF, Stefaniak JD, Nannoni S, Su L, Dounavi ME, Muniz-Terrera G, Ritchie K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie CW, Markus HS, O’Brien JT. Modifiable and non-modifiable risk factors of dementia on midlife cerebral small vessel disease in cognitively healthy middle-aged adults: the PREVENT-Dementia study. Alzheimers Res Ther 2022; 14:154. [PMID: 36224605 PMCID: PMC9554984 DOI: 10.1186/s13195-022-01095-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Background Considerable overlap exists between the risk factors of dementia and cerebral small vessel disease (SVD). However, studies remain limited to older cohorts wherein pathologies of both dementia (e.g. amyloid) and SVD (e.g. white matter hyperintensities) already co-exist. In younger asymptomatic adults, we investigated differential associations and interactions of modifiable and non-modifiable inherited risk factors of (future) late-life dementia to (present-day) mid-life SVD. Methods Cognitively healthy middle-aged adults (aged 40–59; mean 51.2 years) underwent 3T MRI (n = 630) as part of the PREVENT-Dementia study. To assess SVD, we quantified white matter hyperintensities, enlarged perivascular spaces, microbleeds, lacunes, and computed composite scores of SVD burden and subtypes of hypertensive arteriopathy and cerebral amyloid angiopathy (CAA). Non-modifiable (inherited) risk factors were APOE4 status and parental family history of dementia. Modifiable risk factors were derived from the 2020 Lancet Commission on dementia prevention (early/midlife: education, hypertension, obesity, alcohol, hearing impairment, head injuries). Confirmatory factor analysis (CFA) was used to evaluate the latent variables of SVD and risk factors. Structural equation modelling (SEM) of the full structural assessed associations of SVD with risk factors and APOE4*risk interaction. Results In SEM, the latent variable of global SVD related to the latent variable of modifiable midlife risk SVD (β = 0.80, p = .009) but not non-modifiable inherited risk factors of APOE4 or family history of dementia. Interaction analysis demonstrated that the effect of modifiable risk on SVD was amplified in APOE4 non-carriers (β = − 0.31, p = .009), rather than carriers. These associations and interaction effects were observed in relation to the SVD subtype of hypertensive arteriopathy, rather than CAA. Sensitivity analyses using separate general linear models validated SEM results. Conclusions Established modifiable risk factors of future (late-life) dementia related to present-day (mid-life) SVD, suggesting that early lifestyle modifications could potentially reduce rates of vascular cognitive impairment attributed to SVD, a major ‘silent’ contributor to global dementia cases. This association was amplified in APOE4 non-carriers, suggesting that lifestyle modifications could be effective even in those with genetic predisposition to dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01095-4.
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Affiliation(s)
- Audrey Low
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Maria A. Prats-Sedano
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Elizabeth McKiernan
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Stephen F. Carter
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - James D. Stefaniak
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Stefania Nannoni
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Li Su
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.11835.3e0000 0004 1936 9262Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Maria-Eleni Dounavi
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Graciela Muniz-Terrera
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Karen Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK ,grid.457377.5INSERM, Montpellier, France
| | - Brian Lawlor
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- grid.417895.60000 0001 0693 2181Division of Brain Science, Imperial College Healthcare NHS Trust, London, UK
| | - Clare Mackay
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Ivan Koychev
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Craig W. Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Hugh S. Markus
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T. O’Brien
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Safri AA, Nassir CMNCM, Iman IN, Mohd Taib NH, Achuthan A, Mustapha M. Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects. World J Clin Cases 2022; 10:8450-8462. [PMID: 36157806 PMCID: PMC9453345 DOI: 10.12998/wjcc.v10.i24.8450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/20/2022] [Accepted: 07/17/2022] [Indexed: 02/05/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of age-related microvascular cognitive decline, resulting in significant morbidity and decreased quality of life. Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging (MRI), key questions on CSVD remain elusive. Enhanced relationships and reliable lesion studies, such as white matter tractography using diffusion-based MRI (dMRI) are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD. Diffusion tensor imaging (DTI) and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage. However, due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting, interpreting the findings remain contentious, especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use. In this minireview, we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD, even for subclinical CSVD in at-risk individuals.
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Affiliation(s)
- Amanina Ahmad Safri
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Nurul Iman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nur Hartini Mohd Taib
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Anusha Achuthan
- School of Computer Sciences, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Incontri-Abraham D, Esparza-Salazar FJ, Ibarra A. Copolymer-1 as a potential therapy for mild cognitive impairment. Brain Cogn 2022; 162:105892. [PMID: 35841771 DOI: 10.1016/j.bandc.2022.105892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
Mild cognitive impairment (MCI) is a prodromal stage of memory impairment that may precede dementia. MCI is classified by the presence or absence of memory impairment into amnestic or non-amnestic MCI, respectively. More than 90% of patients with amnestic MCI who progress towards dementia meet criteria for Alzheimer's disease (AD). A combination of mechanisms promotes MCI, including intracellular neurofibrillary tangle formation, extracellular amyloid deposition, oxidative stress, neuronal loss, synaptodegeneration, cholinergic dysfunction, cerebrovascular disease, and neuroinflammation. However, emerging evidence indicates that neuroinflammation plays an important role in the pathogenesis of cognitive impairment. Unfortunately, there are currently no Food and Drug Administration (FDA)-approved drugs for MCI. Copolymer-1 (Cop-1), also known as glatiramer acetate, is a synthetic polypeptide of four amino acids approved by the FDA for the treatment of relapsing-remitting multiple sclerosis. Cop-1 therapeutic effect is attributed to immunomodulation, promoting a switch from proinflammatory to anti-inflammatory phenotype. In addition to its anti-inflammatory properties, it stimulates brain-derived neurotrophic factor (BDNF) secretion, a neurotrophin involved in neurogenesis and the generation of hippocampal long-term potentials. Moreover, BDNF levels are significantly decreased in patients with cognitive impairment. Therefore, Cop-1 immunization might promote synaptic plasticity and memory consolidation by increasing BDNF production in patients with MCI.
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Affiliation(s)
- Diego Incontri-Abraham
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Av. Universidad Anáhuac No. 46, Col. Lomas Anáhuac, Huixquilucan, CP 52786, Edo. de México, Mexico
| | - Felipe J Esparza-Salazar
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Av. Universidad Anáhuac No. 46, Col. Lomas Anáhuac, Huixquilucan, CP 52786, Edo. de México, Mexico
| | - Antonio Ibarra
- Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Av. Universidad Anáhuac No. 46, Col. Lomas Anáhuac, Huixquilucan, CP 52786, Edo. de México, Mexico.
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Chung CP, Lee WJ, Chou KH, Lee PL, Peng LN, Wang PN, Lin CP, Chen LK. Frailty and dementia risks in asymptomatic cerebral small vessel disease: A longitudinal cohort study. Arch Gerontol Geriatr 2022; 102:104754. [PMID: 35728329 DOI: 10.1016/j.archger.2022.104754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Frailty has been shown to predict adverse outcomes in several diseases. We aimed to evaluate the associations between frailty profiles, both severity and subtype, and dementia risk in a community-based population with asymptomatic (without stroke and dementia) cerebral small vessel disease (CSVD). METHODS Individuals with asymptomatic CSVD were recruited from the community-based I-Lan Longitudinal Aging Study between 2011 and 2014 (baseline) and were followed up between 2018 and 2019. All participants underwent CSVD assessment by 3T brain MRI, as well as physical and cognitive assessments at baseline. Univariate and multivariate logistic regression analyses were performed to evaluate the associations between each factor and dementia conversion at follow-up. RESULTS Among 261 participants with asymptomatic CSVD (64.8 [50.0-89.1, 8.4] years; 136 [52.1%] men), 13 (5.0%) developed dementia during a mean follow-up of 5.7 (0.7) years. Dementia converters were less likely to be robust (30.8% vs. 61.5%) and more likely to be pre-frail/frail (69.2% vs. 38.5%) than non-converters (p = 0.040). Meanwhile, there was significantly more frequent mobility frailty (53.8% vs. 19.8%, p = 0.009), but a similar prevalence of non-mobility frailty in dementia converters compared with non-converters. Univariate analyses showed that neither frailty severity nor CSVD burden was associated with a higher risk of dementia; it was the frailty subtype, the mobility frailty, which was significantly associated with dementia conversion in participants with asymptomatic CSVD, with an odds-ratio of 4.8 (95% CI = 1.5-14.8, p = 0.007). The significance remained after adjusting for age, sex, education and baseline cognitive function, respectively. CONCLUSION Mobility frailty was associated with a higher risk of incident dementia in individuals with subclinical CSVD. Mobility frailty might be involved in the pathology of cognitive decline in CSVD and potentially serve as a marker to identify people at risk of cognitive impairment at an early stage of CSVD.
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Affiliation(s)
- Chih-Ping Chung
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei City 112, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Pei-Lin Lee
- Institute of Neuroscience, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Center for Geriatric and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Ning Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei City 112, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (managed by Taipei Veterans General Hospital), Taipei, Taiwan
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17
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Wu CY, Shapiro L, Ouk M, MacIntosh BJ, Black SE, Shah BR, Swardfager W. Glucose-lowering drugs, cognition, and dementia: The clinical evidence. Neurosci Biobehav Rev 2022; 137:104654. [PMID: 35398114 DOI: 10.1016/j.neubiorev.2022.104654] [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: 02/01/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is an important risk factor for dementia. The possibility to mitigate this risk by controlling T2DM is compelling; however, different glucose-lowering drugs have different effects on the brain by virtue of their different mechanisms of action. The clinical and epidemiological data appear mixed, warranting careful critical evaluation of the human studies. Here we examine the evidence in the context of dementia prevention and treatment, both for people with and without T2DM. We discuss the evidence on this scaffold of research directions, identifying methodological complexities in the extant literature (e.g. comparator discrepancies, changes in the therapeutic landscape), and the implications of different outcome measures (e.g. neuropsychological). We consider possible implications of cerebrovascular protection vs. effects on progression of neurodegenerative proteinopathy, and we present a research roadmap for glucose-lowering drugs in cognitive neurology, including neuroimaging, and fluid biomarkers. We conclude that there is great potential to advance personalized strategies to prevent and treat dementia with glucose-lowering drugs.
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Affiliation(s)
- Che-Yuan Wu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Lila Shapiro
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Michael Ouk
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sandra E Black
- Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Toronto Dementia Research Alliance, Toronto, Ontario, Canada
| | - Baiju R Shah
- ICES, Toronto, Ontario, Canada; Divisions of Endocrinology and Obstetric Medicine, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada; Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, Ontario, Canada; KITE UHN Toronto Rehabilitation Institute, Toronto, Ontario, Canada
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18
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Cerebral small vessel disease alters neurovascular unit regulation of microcirculation integrity involved in vascular cognitive impairment. Neurobiol Dis 2022; 170:105750. [DOI: 10.1016/j.nbd.2022.105750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/09/2022] [Accepted: 05/08/2022] [Indexed: 12/25/2022] Open
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19
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Mahammedi A, Wang LL, Williamson BJ, Khatri P, Kissela B, Sawyer RP, Shatz R, Khandwala V, Vagal A. Small Vessel Disease, a Marker of Brain Health: What the Radiologist Needs to Know. AJNR Am J Neuroradiol 2022; 43:650-660. [PMID: 34620594 PMCID: PMC9089248 DOI: 10.3174/ajnr.a7302] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/05/2021] [Indexed: 11/07/2022]
Abstract
Small vessel disease, a disorder of cerebral microvessels, is an expanding epidemic and a common cause of stroke and dementia. Despite being almost ubiquitous in brain imaging, the clinicoradiologic association of small vessel disease is weak, and the underlying pathogenesis is poorly understood. The STandards for ReportIng Vascular changes on nEuroimaging (STRIVE) criteria have standardized the nomenclature. These include white matter hyperintensities of presumed vascular origin, recent small subcortical infarcts, lacunes of presumed vascular origin, prominent perivascular spaces, cerebral microbleeds, superficial siderosis, cortical microinfarcts, and brain atrophy. Recently, the rigid categories among cognitive impairment, vascular dementia, stroke, and small vessel disease have become outdated, with a greater emphasis on brain health. Conventional and advanced small vessel disease imaging markers allow a comprehensive assessment of global brain heath. In this review, we discuss the pathophysiology of small vessel disease neuroimaging nomenclature by means of the STRIVE criteria, clinical implications, the role of advanced imaging, and future directions.
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Affiliation(s)
- A Mahammedi
- From the Departments of Neuroradiology (A.M., L.L.W., B.J.W., V.K., A.V.)
| | - L L Wang
- From the Departments of Neuroradiology (A.M., L.L.W., B.J.W., V.K., A.V.)
| | - B J Williamson
- From the Departments of Neuroradiology (A.M., L.L.W., B.J.W., V.K., A.V.)
| | - P Khatri
- Neurology (P.K., B.K., R.P.S., R.S.) University of Cincinnati Medical Center, Cincinnati, Ohio
| | - B Kissela
- Neurology (P.K., B.K., R.P.S., R.S.) University of Cincinnati Medical Center, Cincinnati, Ohio
| | - R P Sawyer
- Neurology (P.K., B.K., R.P.S., R.S.) University of Cincinnati Medical Center, Cincinnati, Ohio
| | - R Shatz
- Neurology (P.K., B.K., R.P.S., R.S.) University of Cincinnati Medical Center, Cincinnati, Ohio
| | - V Khandwala
- From the Departments of Neuroradiology (A.M., L.L.W., B.J.W., V.K., A.V.)
| | - A Vagal
- From the Departments of Neuroradiology (A.M., L.L.W., B.J.W., V.K., A.V.)
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20
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Perosa V, Arts T, Assmann A, Mattern H, Speck O, Oltmer J, Heinze HJ, Düzel E, Schreiber S, Zwanenburg JJM. Pulsatility Index in the Basal Ganglia Arteries Increases with Age in Elderly with and without Cerebral Small Vessel Disease. AJNR Am J Neuroradiol 2022; 43:540-546. [PMID: 35332021 PMCID: PMC8993201 DOI: 10.3174/ajnr.a7450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral small vessel disease contributes to stroke and cognitive impairment and interacts with Alzheimer disease pathology. Because of the small dimensions of the affected vessels, in vivo characterization of blood flow properties is challenging but important to unravel the underlying mechanisms of the disease. MATERIALS AND METHODS A 2D phase-contrast sequence at 7T MR imaging was used to assess blood flow velocity and the pulsatility index of the perforating basal ganglia arteries. We included patients with cerebral amyloid angiopathy (n = 8; identified through the modified Boston criteria), hypertensive arteriopathy (n = 12; identified through the presence of strictly deep or mixed cerebral microbleeds), and age- and sex-matched controls (n = 28; no cerebral microbleeds). RESULTS Older age was related to a greater pulsatility index, irrespective of cerebral small vessel disease. In hypertensive arteriopathy, there was an association between lower blood flow velocity of the basal ganglia and the presence of peri-basal ganglia WM hyperintensities. CONCLUSIONS Our results suggest that age might be the driving factor for altered cerebral small vessel hemodynamics. Furthermore, this study puts cerebral small vessel disease downstream pathologies in the basal ganglia region in relation to blood flow characteristics of the basal ganglia microvasculature.
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Affiliation(s)
- V Perosa
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- J. Philip Kistler Stroke Research Center (V.P.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - T Arts
- Department of Radiology (T.A., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - A Assmann
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
| | | | - O Speck
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Leibniz-Institute for Neurobiology (O.S., H.-J.H.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
| | - J Oltmer
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
| | - H-J Heinze
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Leibniz-Institute for Neurobiology (O.S., H.-J.H.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
| | - E Düzel
- Institute of Cognitive Neurology and Dementia Research (E.D.), Ottovon-Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
- Center for Behavioral Brain Sciences (O.S., H.-J.H., E.D.), Magdeburg, Germany
- Institute of Cognitive Neuroscience (E.D.), University College London, London, UK
| | - S Schreiber
- From the Department of Neurology (V.P., A.A., J.O., H.-J.H., S.S.)
- German Center for Neurodegenerative Diseases (V.P., O.S., H.-J.H., E.D., S.S.), Magdeburg, Germany
| | - J J M Zwanenburg
- Department of Radiology (T.A., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands
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21
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Ouyang F, Wang M, Liao M, Lan L, Liu X, Li H, Mo R, Shi L, Fan Y. Association between periodic limb movements during sleep and neuroimaging features of cerebral small vessel disease: A preliminary cross‐sectional study. J Sleep Res 2022; 31:e13573. [DOI: 10.1111/jsr.13573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Fubing Ouyang
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Meng Wang
- Department of Radiology The First Affiliated Hospital Sun Yat‐sen University Guangzhou China
| | - Mengshi Liao
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Linfan Lan
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Xiaolu Liu
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Hao Li
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Rong Mo
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
| | - Lin Shi
- Department of Imaging and Interventional Radiology The Chinese University of Hong Kong Hong Kong China
| | - Yuhua Fan
- Department of Neurology National Key Clinical Department and Key Discipline of Neurology The First Affiliated Hospital Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases Sun Yat‐sen University Guangzhou China
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22
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Zhukovsky P, Anderson JAE, Coughlan G, Mulsant BH, Cipriani A, Voineskos AN. Coordinate-Based Network Mapping of Brain Structure in Major Depressive Disorder in Younger and Older Adults: A Systematic Review and Meta-Analysis. Am J Psychiatry 2021; 178:1119-1128. [PMID: 34645274 DOI: 10.1176/appi.ajp.2021.21010088] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Structural neuroimaging findings in younger and older adults with major depressive disorder (MDD) are highly heterogeneous, possibly as a result of methodological limitations, lack of distinction between MDD and late-life depression (LLD), or clinical moderators. Using a novel meta-analytic network mapping approach, the authors sought to identify the circuits affected in different clinical subtypes of MDD. METHODS The authors identified all voxel-based and surface-based morphometry studies published through October 2020 that compared younger adults with MDD or older adults with LLD to nonpsychiatric control participants. An activation likelihood estimation (ALE) analysis and a novel coordinate-based network mapping approach were used to identify brain circuits affected in MDD and LLD. Meta-regressions examined the impact of age at onset in older patients with LLD and treatment with antidepressants in younger patients with MDD. RESULTS The authors analyzed 145 comparisons from 143 articles, including a total of 14,318 participants (MDD: N=6,362; LLD: N=535; control subjects: N=7,421). Significant ALE results confirmed previous findings implicating the left and right parahippocampus and anterior cingulate in MDD and the anterior cingulate in LLD. In contrast, coordinate-based network mapping showed differences in the frontoparietal, dorsal attention, and visual networks both in MDD and LLD. Meta-regressions showed that late onset was significantly associated with widespread structural abnormalities in LLD, and treatment with antidepressants showed a significant association with abnormalities in the anterior cingulate (Brodmann's area 32) and dorsolateral prefrontal cortex (Brodmann's area 9) in MDD. CONCLUSIONS These findings help to clarify the shared circuitry of depression across the adult lifespan and highlight some unique circuitry relevant to late-onset depression, which may explain some of the risk for cognitive decline and dementia.
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Affiliation(s)
- Peter Zhukovsky
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - John A E Anderson
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Gillian Coughlan
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Andrea Cipriani
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
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Hotz I, Deschwanden PF, Mérillat S, Liem F, Kollias S, Jäncke L. Associations of subclinical cerebral small vessel disease and processing speed in non-demented subjects: A 7-year study. Neuroimage Clin 2021; 32:102884. [PMID: 34911190 PMCID: PMC8633374 DOI: 10.1016/j.nicl.2021.102884] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/16/2021] [Indexed: 12/22/2022]
Abstract
Markers of cerebral small vessel disease (CSVD) have previously been associated with age-related cognitive decline. Using longitudinal data of cognitively healthy, older adults (N = 216, mean age at baseline = 70.9 years), we investigated baseline status and change in white matter hyperintensities (WMH) (total, periventricular, deep), normal appearing white matter (NAWM), brain parenchyma volume (BPV) and processing speed over seven years as well as the impact of different covariates by applying latent growth curve (LGC) models. Generally, we revealed a complex pattern of associations between the different CSVD markers. More specifically, we observed that changes of deep WMH (dWMH), as compared to periventricular WMH (pWMH), were more strongly related to the changes of other CSVD markers and also to baseline processing speed performance. Further, the number of lacunes rather than their volume reflected the severity of CSVD. With respect to the studied covariates, we revealed that higher education had a protective effect on subsequent total WMH, pWMH, lacunar number, NAWM volume, and processing speed performance. The indication of antihypertensive drugs was associated with lower lacunar number and volume at baseline and the indication of antihypercholesterolemic drugs came along with higher processing speed performance at baseline. In summary, our results confirm previous findings, and extend them by providing information on true within-person changes, relationships between the different CSVD markers and brain-behavior associations. The moderate to strong associations between changes of the different CSVD markers indicate a common pathological relationship and, thus, support multidimensional treatment strategies.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
| | - Pascal Frédéric Deschwanden
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Spyridon Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland; University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
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24
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Fiford CM, Sudre CH, Young AL, Macdougall A, Nicholas J, Manning EN, Malone IB, Walsh P, Goodkin O, Pemberton HG, Barkhof F, Alexander DC, Cardoso MJ, Biessels GJ, Barnes J. Presumed small vessel disease, imaging and cognition markers in the Alzheimer's Disease Neuroimaging Initiative. Brain Commun 2021; 3:fcab226. [PMID: 34661106 PMCID: PMC8514859 DOI: 10.1093/braincomms/fcab226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 01/18/2023] Open
Abstract
MRI-derived features of presumed cerebral small vessel disease are frequently found in Alzheimer's disease. Influences of such markers on disease-progression measures are poorly understood. We measured markers of presumed small vessel disease (white matter hyperintensity volumes; cerebral microbleeds) on baseline images of newly enrolled individuals in the Alzheimer's Disease Neuroimaging Initiative cohort (GO and 2) and used linear mixed models to relate these to subsequent atrophy and neuropsychological score change. We also assessed heterogeneity in white matter hyperintensity positioning within biomarker abnormality sequences, driven by the data, using the Subtype and Stage Inference algorithm. This study recruited both sexes and included: controls: [n = 159, mean(SD) age = 74(6) years]; early and late mild cognitive impairment [ns = 265 and 139, respectively, mean(SD) ages =71(7) and 72(8) years, respectively]; Alzheimer's disease [n = 103, mean(SD) age = 75(8)] and significant memory concern [n = 72, mean(SD) age = 72(6) years]. Baseline demographic and vascular risk-factor data, and longitudinal cognitive scores (Mini-Mental State Examination; logical memory; and Trails A and B) were collected. Whole-brain and hippocampal volume change metrics were calculated. White matter hyperintensity volumes were associated with greater whole-brain and hippocampal volume changes independently of cerebral microbleeds (a doubling of baseline white matter hyperintensity was associated with an increase in atrophy rate of 0.3 ml/year for brain and 0.013 ml/year for hippocampus). Cerebral microbleeds were found in 15% of individuals and the presence of a microbleed, as opposed to none, was associated with increases in atrophy rate of 1.4 ml/year for whole brain and 0.021 ml/year for hippocampus. White matter hyperintensities were predictive of greater decline in all neuropsychological scores, while cerebral microbleeds were predictive of decline in logical memory (immediate recall) and Mini-Mental State Examination scores. We identified distinct groups with specific sequences of biomarker abnormality using continuous baseline measures and brain volume change. Four clusters were found; Group 1 showed early Alzheimer's pathology; Group 2 showed early neurodegeneration; Group 3 had early mixed Alzheimer's and cerebrovascular pathology; Group 4 had early neuropsychological score abnormalities. White matter hyperintensity volumes becoming abnormal was a late event for Groups 1 and 4 and an early event for 2 and 3. In summary, white matter hyperintensities and microbleeds were independently associated with progressive neurodegeneration (brain atrophy rates) and cognitive decline (change in neuropsychological scores). Mechanisms involving white matter hyperintensities and progression and microbleeds and progression may be partially separate. Distinct sequences of biomarker progression were found. White matter hyperintensity development was an early event in two sequences.
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Affiliation(s)
- Cassidy M Fiford
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Carole H Sudre
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
- Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Health Sciences, University College London, London WC1E 3HB, UK
| | - Alexandra L Young
- Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 3AF, UK
| | - Amy Macdougall
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Jennifer Nicholas
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Emily N Manning
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Ian B Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Phoebe Walsh
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Olivia Goodkin
- Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
| | - Hugh G Pemberton
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
- Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam Neuroscience, 1081 HV Amsterdam, The Netherlands
- UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
- UCL Institute of Healthcare Engineering, London WC1E 6DH, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, University College London, London WC1V 6LJ, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Josephine Barnes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, UK
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Hayley S, Hakim AM, Albert PR. Depression, dementia and immune dysregulation. Brain 2021; 144:746-760. [PMID: 33279966 DOI: 10.1093/brain/awaa405] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/26/2020] [Accepted: 09/20/2020] [Indexed: 12/17/2022] Open
Abstract
Major depression is a prevalent illness that increases the risk of several neurological conditions. These include stroke, cardiovascular disease, and dementia including Alzheimer's disease. In this review we ask whether certain types of depression and associated loneliness may be a harbinger of cognitive decline and possibly even dementia. We propose that chronic stress and inflammation combine to compromise vascular and brain function. The resulting increases in proinflammatory cytokines and microglial activation drive brain pathology leading to depression and mild cognitive impairment, which may progress to dementia. We present evidence that by treating the inflammatory changes, depression can be reversed in many cases. Importantly, there is evidence that anti-inflammatory and antidepressant treatments may reduce or prevent dementia in people with depression. Thus, we propose a model in which chronic stress and inflammation combine to increase brain permeability and cytokine production. This leads to microglial activation, white matter damage, neuronal and glial cell loss. This is first manifest as depression and mild cognitive impairment, but can eventually evolve into dementia. Further research may identify clinical subgroups with inflammatory depression at risk for dementia. It would then be possible to address in clinical trials whether effective treatment of the depression can delay the onset of dementia.
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Affiliation(s)
- Shawn Hayley
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Antoine M Hakim
- Ottawa Hospital Research Institute (Neuroscience), uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Paul R Albert
- Ottawa Hospital Research Institute (Neuroscience), uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada
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26
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Role of Purinergic Signalling in Endothelial Dysfunction and Thrombo-Inflammation in Ischaemic Stroke and Cerebral Small Vessel Disease. Biomolecules 2021; 11:biom11070994. [PMID: 34356618 PMCID: PMC8301873 DOI: 10.3390/biom11070994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 12/20/2022] Open
Abstract
The cerebral endothelium is an active interface between blood and the central nervous system. In addition to being a physical barrier between the blood and the brain, the endothelium also actively regulates metabolic homeostasis, vascular tone and permeability, coagulation, and movement of immune cells. Being part of the blood–brain barrier, endothelial cells of the brain have specialized morphology, physiology, and phenotypes due to their unique microenvironment. Known cardiovascular risk factors facilitate cerebral endothelial dysfunction, leading to impaired vasodilation, an aggravated inflammatory response, as well as increased oxidative stress and vascular proliferation. This culminates in the thrombo-inflammatory response, an underlying cause of ischemic stroke and cerebral small vessel disease (CSVD). These events are further exacerbated when blood flow is returned to the brain after a period of ischemia, a phenomenon termed ischemia-reperfusion injury. Purinergic signaling is an endogenous molecular pathway in which the enzymes CD39 and CD73 catabolize extracellular adenosine triphosphate (eATP) to adenosine. After ischemia and CSVD, eATP is released from dying neurons as a damage molecule, triggering thrombosis and inflammation. In contrast, adenosine is anti-thrombotic, protects against oxidative stress, and suppresses the immune response. Evidently, therapies that promote adenosine generation or boost CD39 activity at the site of endothelial injury have promising benefits in the context of atherothrombotic stroke and can be extended to current CSVD known pathomechanisms. Here, we have reviewed the rationale and benefits of CD39 and CD39 therapies to treat endothelial dysfunction in the brain.
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Vergoossen LWM, Jansen JFA, van Sloten TT, Stehouwer CDA, Schaper NC, Wesselius A, Dagnelie PC, Köhler S, van Boxtel MPJ, Kroon AA, de Jong JJA, Schram MT, Backes WH. Interplay of White Matter Hyperintensities, Cerebral Networks, and Cognitive Function in an Adult Population: Diffusion-Tensor Imaging in the Maastricht Study. Radiology 2020; 298:384-392. [PMID: 33350892 DOI: 10.1148/radiol.2021202634] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Lesions of cerebral small vessel disease, such as white matter hyperintensities (WMHs) in individuals with cardiometabolic risk factors, interfere with the trajectories of the white matter and eventually contribute to cognitive decline. However, there is no consensus yet about the precise underlying topological mechanism. Purpose To examine whether WMH and cognitive function are associated and whether any such association is mediated or explained by structural connectivity measures in an adult population. In addition, to investigate underlying local abnormalities in white matter by assessing the tract-specific WMH volumes and their tract-specific association with cognitive function. Materials and Methods In the prospective type 2 diabetes-enriched population-based Maastricht Study, structural and diffusion-tensor MRI was performed (December 2013 to February 2017). Total and tract-specific WMH volumes; network measures; cognition scores; and demographic, cardiovascular, and lifestyle characteristics were determined. Multivariable linear regression and mediation analyses were used to investigate the association of WMH volume, tract-specific WMH volumes, and network measures with cognitive function. Associations were adjusted for age, sex, education, diabetes status, and cardiovascular risk factors. Results A total of 5083 participants (mean age, 59 years ± 9 [standard deviation]; 2592 men; 1027 with diabetes) were evaluated. Larger WMH volumes were associated with stronger local (standardized β coefficient, 0.065; P < .001), but not global, network efficiency and lower information processing speed (standardized β coefficient, -0.073; P < .001). Moreover, lower local efficiency (standardized β coefficient, -0.084; P < .001) was associated with lower information processing speed. In particular, the relationship between WMHs and information processing speed was mediated (percentage mediated, 7.2% [95% CI: 3.5, 10.9]; P < .05) by the local network efficiency. Finally, WMH load was larger in the white matter tracts important for information processing speed. Conclusion White matter hyperintensity volume, local network efficiency, and information processing speed scores are interrelated, and local network properties explain lower cognitive performance due to white matter network alterations. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Laura W M Vergoossen
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Jacobus F A Jansen
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Thomas T van Sloten
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Coen D A Stehouwer
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Nicolaas C Schaper
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Anke Wesselius
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Pieter C Dagnelie
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Sebastiaan Köhler
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Martin P J van Boxtel
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Abraham A Kroon
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Joost J A de Jong
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Miranda T Schram
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Walter H Backes
- From the Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6229 HX Maastricht, the Netherlands (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., W.H.B.); MHeNs School for Mental Health and Neuroscience (L.W.M.V., J.F.A.J., S.K., M.P.J.v.B., J.J.A.d.J., M.T.S., W.H.B.), Department of Internal Medicine (T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S.), School for Cardiovascular Disease (CARIM) (L.W.M.V., T.T.v.S., C.D.A.S., N.C.S., P.C.D., A.A.K., M.T.S., W.H.B.), Care and Public Health Institute (CAPHRI) (N.C.S.), School of Nutrition and Translational Research in Metabolism (NUTRIM) (A.W., M.T.S.), and Department of Complex Genetics & Epidemiology (A.W.), Maastricht University, Maastricht, the Netherlands; and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
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28
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Gogoleva AG, Zakharov VV. The etiology, manifestations, and therapy of chronic cerebrovascular diseases. ACTA ACUST UNITED AC 2020. [DOI: 10.14412/2074-2711-2020-5-84-91] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The paper presents the current etiopathogenetic classification of chronic cerebrovascular diseases (CVD) and discusses the role of hypertension, cerebral amyloid angiopathy, and genetically determined syndromes in the development of this pathological condition. It gives recommendations for the neuroradiological diagnosis of chronic CVD in accordance with the international standards. The paper discusses the clinical manifestations of chronic CVD, primarily vascular cognitive impairment. It discusses international guidelines for the examination and treatment of patients with chronic CVD, as well as the rules for stroke prevention in this patient cohort. The possibilities of pathogenetically based therapy in decreasing the severity of vascular cognitive impairment in the presence of chronic CVD are also highlighted.
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Affiliation(s)
- A. G. Gogoleva
- N.V. Sklifosovsky Institute of Clinical Medicine I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - V. V. Zakharov
- N.V. Sklifosovsky Institute of Clinical Medicine I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
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29
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Zhang X, Liu X, Xia R, Li N, Liao X, Chen Z. Chinese herbal medicine for vascular cognitive impairment in cerebral small vessel disease: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e22455. [PMID: 33019432 PMCID: PMC7535689 DOI: 10.1097/md.0000000000022455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cerebral small vessel disease (CSVD) is the most common etiology of vascular cognitive impairment (VCI). VCI in CSVD (CSVD-VCI) shows a progressive course with multiple stages and is also associated with dysfunctions such as gait, emotional and behavioral, and urinary disturbances, which seriously affect the life quality of elderly people. In mainland China, Chinese herbal medicine (CHM) is clinically used for CSVD-VCI and presenting positive efficacy, but the evidence revealed in relevant clinical trials has not been systematically evaluated. The purpose of this study is to assess the current evidence available for the clinical efficacy and safety of CHM for CSVD-VCI. METHODS A literature search of published RCTs up to April 30, 2020, has been conducted in the following 7 electronic databases: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technology Journals Database (VIP), Wanfang Database, and Chinese Biomedical Literature Service System (SinoMed). For unpublished studies, 2 clinical trial online registration websites will be searched: ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR). Only randomized controlled trials (RCTs) using CHM in the treatment of patients with CSVD-VCI, which compares CHM with no treatment, placebo, or other conventional treatments, will be included in this systematic review. Primary outcomes will be set as acknowledged scales measuring cognitive function. Secondary outcomes will involve activities of daily living, behavioral, and psychological symptoms, global performance of dementia, neurological function, biological markers of endothelial dysfunction, the clinical effective rate, and adverse events. After screening studies and extracting data, the Cochrane Collaborations tool for assessing risk of bias will be applied to assess the methodological quality of included RCTs. Review Manager Version 5.3 software will be used for data synthesis and statistical analysis. Subgroup analyses, sensitivity analyses, and meta-regression will be conducted to detect potential sources of heterogeneity. The funnel plot and Eggers test will be developed to evaluate publication bias, if available. We will perform the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to appraise the quality of evidence. RESULTS Evidence exhibited in this systematic review will provide practical references in the field of CHM treating CSVD-VCI. Moreover, our detailed appraisals of methodological deficiencies of relevant RCTs will offer helpful advice for researchers who are designing trials of CHMs in the treatment of CSVD-VCI. CONCLUSION The conclusion about the clinical efficacy and safety of CHM for CSVD-VCI will be provided for clinical plans, decisions, and policy developments in the full version of this systematic review. SYSTEMATIC REVIEW REGISTRATION INPLASY202080120.
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Affiliation(s)
| | | | - Ruyu Xia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine
| | | | - Xing Liao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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30
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Simões-Pires EN, Ferreira ST, Linden R. Roles of glutamate receptors in a novel in vitro model of early, comorbid cerebrovascular, and Alzheimer's diseases. J Neurochem 2020; 156:539-552. [PMID: 32683713 DOI: 10.1111/jnc.15129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 11/28/2022]
Abstract
Systemic multimorbidity is highly prevalent in the elderly and, remarkably, coexisting neuropathological markers of Alzheimer's (AD) and cerebrovascular (CVD) diseases are found at autopsy in most brains of patients clinically diagnosed as AD. Little is known on neurodegeneration peculiar to comorbidities, especially at early stages when pathogenesis may propagate at subclinical levels. We developed a novel in vitro model of comorbid CVD/AD in organotypic hippocampal cultures, by combining oxygen-glucose deprivation (OGD) and exposure to amyloid-Aβ oligomers (AβOs), both applied at levels subtoxic to neurons when used in isolation. We focused on synaptic proteins and the roles of glutamate receptors, which have been implicated in many basic and clinical approaches to either CVD or AD. Subtoxic insults by OGD and AβOs synergized to reduce levels of synaptophysin (SYP) and PSD-95 without cell death, while effects of antagonists of either metabotropic or ionotropic glutamate receptors were distinct from reports in models of isolated CVD or AD. In particular, modulation of glutamate receptors differentially impacted SYP and PSD-95, and antagonists of a single receptor subtype had distinct effects when either isolated or combined. Our findings highlight the complexity of CVD/AD comorbidity, help understand variable responses to glutamate receptor antagonists in patients diagnosed with AD and may contribute to future development of therapeutics based on investigation of the pattern of progressive comorbidity.
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Affiliation(s)
| | - Sergio T Ferreira
- Instituto de Biofísica Carlos Chagas Filho, UFRJ, Rio de Janeiro, Brazil.,Instituto de Bioquímica Médica Leopoldo de Meis, UFRJ, Rio de Janeiro, Brazil
| | - Rafael Linden
- Instituto de Biofísica Carlos Chagas Filho, UFRJ, Rio de Janeiro, Brazil
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31
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Guisset F, Lolli V, Bugli C, Perrotta G, Absil J, Dachy B, Pot C, Théaudin M, Pasi M, van Pesch V, Maggi P. The central vein sign in multiple sclerosis patients with vascular comorbidities. Mult Scler 2020; 27:1057-1065. [DOI: 10.1177/1352458520943785] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The central vein sign (CVS) is an imaging biomarker able to differentiate multiple sclerosis (MS) from other conditions causing similar appearance lesions on magnetic resonance imaging (MRI), including cerebral small vessel disease (CSVD). However, the impact of vascular risk factors (VRFs) for CSVD on the percentage of CVS positive (CVS+) lesions in MS has never been evaluated. Objective: To investigate the association between different VRFs and the percentage of CVS+ lesions in MS. Methods: In 50 MS patients, 3T brain MRIs (including high-resolution 3-dimensional T2*-weighted images) were analyzed for the presence of the CVS and MRI markers of CSVD. A backward stepwise regression model was used to predict the combined predictive effect of VRF (i.e. age, hypertension, diabetes, obesity, ever-smoking, and hypercholesterolemia) and MRI markers of CSVD on the CVS. Results: The median frequency of CVS+ lesions was 71% (range: 35%–100%). In univariate analysis, age ( p < 0.0001), hypertension ( p < 0.001), diabetes ( p < 0.01), obesity ( p < 0.01), smoking ( p < 0.05), and the presence of enlarged-perivascular-spaces on MRI ( p < 0.005) were all associated with a lower percentage of CVS+ lesions. The stepwise regression model showed that age and arterial hypertension were both associated with the percentage of CVS+ lesions in MS (adjusted R2 = 0.46; p < 0.0001 and p = 0.01, respectively). Conclusion: The proportion of CVS+ lesions significantly decreases in older and hypertensive MS patients. Although this study was conducted in patients with an already established MS diagnosis, the diagnostic yield of the previously proposed 35% CVS proportion-based diagnostic threshold appears to be not affected. Overall these results suggest that the presence of VRF for CSVD should be taken into account during the CVS assessment.
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Affiliation(s)
- François Guisset
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium/Department of Neurology, Hôpital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Valentina Lolli
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Céline Bugli
- Plateforme technologique de Support en Méthodologie et Calcul Statistique, Université Catholique de Louvain, Brussels, Belgium
| | - Gaetano Perrotta
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Bernard Dachy
- Department of Neurology, Hôpital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Caroline Pot
- Department of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Théaudin
- Department of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marco Pasi
- University of Lille, Inserm, CHU Lille, U1172—LilNCog—Lille Neuroscience & Cognition, Lille, France
| | - Vincent van Pesch
- Department of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pietro Maggi
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium/Department of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland/Department of Neurology, Cliniques universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
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32
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Thomas MA, Hazany S, Ellingson BM, Hu P, Nguyen KL. Pathophysiology, classification, and MRI parallels in microvascular disease of the heart and brain. Microcirculation 2020; 27:e12648. [PMID: 32640064 DOI: 10.1111/micc.12648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/12/2020] [Accepted: 07/02/2020] [Indexed: 12/13/2022]
Abstract
Diagnostic imaging technology in vascular disease has long focused on large vessels and the pathologic processes that impact them. With improved diagnostic techniques, investigators are now able to uncover many underlying mechanisms and prognostic factors for microvascular disease. In the heart and brain, these pathologic entities include coronary microvascular disease and cerebral small vessel disease, both of which have significant impact on patients, causing angina, myocardial infarction, heart failure, stroke, and dementia. In the current paper, we will discuss parallels in pathophysiology, classification, and diagnostic modalities, with a focus on the role of magnetic resonance imaging in microvascular disease of the heart and brain. Novel approaches for streamlined imaging of the cardiac and central nervous systems including the use of intravascular contrast agents such as ferumoxytol are presented, and unmet research gaps in diagnostics are summarized.
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Affiliation(s)
- Michael A Thomas
- Division of Cardiology, David Geffen School of Medicine at, UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Radiology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Saman Hazany
- Department of Radiology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Benjamin M Ellingson
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Peng Hu
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kim-Lien Nguyen
- Division of Cardiology, David Geffen School of Medicine at, UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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