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Zavriyev AI, Kaya K, Wu KC, Pierce ET, Franceschini MA, Robinson MB. Measuring pulsatile cortical blood flow and volume during carotid endarterectomy. BIOMEDICAL OPTICS EXPRESS 2024; 15:1355-1369. [PMID: 38495722 PMCID: PMC10942688 DOI: 10.1364/boe.507730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 03/19/2024]
Abstract
Carotid endarterectomy (CEA) involves removal of plaque in the carotid artery to reduce the risk of stroke and improve cerebral perfusion. This study aimed to investigate the utility of assessing pulsatile blood volume and flow during CEA. Using a combined near-infrared spectroscopy/diffuse correlation spectroscopy instrument, pulsatile hemodynamics were assessed in 12 patients undergoing CEA. Alterations to pulsatile amplitude, pulse transit time, and beat morphology were observed in measurements ipsilateral to the surgical side. The additional information provided through analysis of pulsatile hemodynamic signals has the potential to enable the discovery of non-invasive biomarkers related to cortical perfusion.
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Affiliation(s)
- Alexander I. Zavriyev
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kutlu Kaya
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kuan Cheng Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Eric T. Pierce
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maria Angela Franceschini
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mitchell B. Robinson
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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2
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Lv YJ, Zhang QX, Li JW, Yun WW, Zhang M. Correlation between Carotid Blood Flow Velocity and Total Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease in Patients with Recent Small Subcortical Infarcts. Curr Neurovasc Res 2024; 20:528-534. [PMID: 38099528 DOI: 10.2174/0115672026285373231120054627] [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: 09/28/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 07/16/2024]
Abstract
BACKGROUND The common and internal carotid arteries are the upstream vessels of the small cerebral vessels. The relationship between hemodynamic changes in the significant cervical vessels and cerebral small vessel disease (CSVD) remains uncertain. This research sought to analyze the correlation between carotid blood flow velocity and the total magnetic resonance imaging (MRI) burden of CSVD in patients with recent small subcortical infarcts (RSSIs). METHODS Data were gathered from individuals diagnosed with RSSIs admitted to Changzhou Second People's Hospital between January 2022 and June 2023. Brain MRI was performed on every patient to determine the overall MRI burden of CSVD, along with carotid duplex ultrasound to evaluate carotid blood flow velocity and pulsatility index (PI) of the common carotid (CCA) and internal carotid (ICA) arteries. The association between carotid blood flow velocity and the total MRI load of CSVD was examined using univariate and multivariate analyses. RESULTS For our investigation, 272 individuals with RSSIs were screened. 82 individuals had a moderate to severe load of CSVD, while 190 participants showed a mild burden. Patients with moderate to severe burden of CSVD had lower end-diastolic velocity (EDV) and higher PI in CCA and ICA than those with mild load (P < 0.001). After adjusting for variables like age, hypertension, systolic blood pressure, and blood homocysteine levels, multivariate logistic regression analysis showed that EDV in CCA (OR, 0.894; P = 0.011), PI in CCA (OR, 5.869; P = 0.017), EDV in ICA (OR, 0.909; P = 0.008), and PI in ICA (OR, 5.324; P = 0.041) were independently related to moderate to severe CSVD burden. Spearman correlation analysis showed that EDV in CCA and ICA was negatively related to the total MRI load of CSVD in patients with RSSIs (P < 0.001). PI in CCA and ICA was positively associated with the whole MRI load of CSVD (P < 0.001). CONCLUSION Low carotid blood flow velocity and high carotid pulsatility index are independently associated with moderate to severe burden of CSVD.
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Affiliation(s)
- Yi-Jun Lv
- Department of Neurology, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Qing-Xiu Zhang
- Department of Neurology, Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Jing-Wei Li
- Department of Neurology, Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Wen-Wei Yun
- Department of Neurology, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Min Zhang
- Department of Neurology, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, China
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3
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Montes-Garrido R, Riesco MF, Anel-Lopez L, Neila-Montero M, Palacin-Martinez C, Boixo JC, de Paz P, Ortega-Ferrusola C, Hassan MAA, Anel L, Alvarez M. Application of ultrasound technique to evaluate the testicular function and its correlation to the sperm quality after different collection frequency in rams. Front Vet Sci 2022; 9:1035036. [PMID: 36504850 PMCID: PMC9732105 DOI: 10.3389/fvets.2022.1035036] [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: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
The frequency of semen collection is a crucial factor to consider in the rams performance inside breeding centers workout. To evaluate this factor, ram Breeding Soundness Evaluation could include sperm quality evaluation and new predictive and non-invasive tools such as ultrasound technique. In this work, an advanced ultrasonography technology, analyzing the testicular volume, echotexture, and vascular function, was used in three different frequencies of semen collection (abstinence frequency, AF; standard frequency, SF; and intensive frequency, IF). Semen samples were cooled (15°C, 6 h) and evaluated in terms of production, motility, viability, apoptosis, and content of reactive oxygen species. Correlation coefficients were calculated between ultrasonography measurements of echotexture and blood flow and sperm quality parameters. Our results showed an increase in the testicular echotexture when the frequency of semen collection was intensified. Doppler parameters (PSV, RI, PI, TABF) increased (P ≤ 0.05) when the frequency of semen collection was intensified. The sperm motility and functionality decreased in the samples of IF (P ≤ 0.05), evidencing the frequency of semen collection's influence. Moreover, moderate positive correlations were established among echotexture and different Doppler parameters with motility parameters in SF. Furthermore, the influence of abstinence days on AI success was analyzed in a field assay. The highest fertility rates were obtained when males had two to five abstinence days. To conclude, frequency of semen collection could be influenced in terms of semen quantity and sperm quality, showing changes in parenchyma echotexture and testicular vascularization. The standard semen collection frequency was the most adequate option. In addition, ultrasonography may be a predictive tool for estimating variations in the sperm quality of donor rams subjected to different frequencies of semen collection in reproduction centers.
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Affiliation(s)
- Rafael Montes-Garrido
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
| | - Marta F. Riesco
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Celular Biology, Department of Molecular Biology, University of León, León, Spain
| | - Luis Anel-Lopez
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Anatomy, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain,*Correspondence: Luis Anel-Lopez
| | - Marta Neila-Montero
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
| | - Cristina Palacin-Martinez
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
| | - Juan Carlos Boixo
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
| | - Paulino de Paz
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Celular Biology, Department of Molecular Biology, University of León, León, Spain
| | - Cristina Ortega-Ferrusola
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - Mohamed A. A. Hassan
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag, Egypt
| | - Luis Anel
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
| | - Mercedes Alvarez
- Investigación en Técnicas de Reproducción Asistida – Universidad de León, Instituto de Desarrollo Ganadero y Sanidad Animal, University of León, León, Spain,Animal Reproduction and Obstetrics, Department of Veterinary Medicine, Surgery and Anatomy, University of León, León, Spain
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Fabiani M, Asnakew BA, Bowie DC, Chism SM, Clements GM, Gardner JC, Islam SS, Rubenstein SL, Gratton G. A healthy mind in a healthy body: Effects of arteriosclerosis and other risk factors on cognitive aging and dementia. THE PSYCHOLOGY OF LEARNING AND MOTIVATION 2022; 77:69-123. [PMID: 37139101 PMCID: PMC10153623 DOI: 10.1016/bs.plm.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this review we start from the assumption that, to fully understand cognitive aging, it is important to embrace a holistic view, integrating changes in bodily, brain, and cognitive functions. This broad view can help explain individual differences in aging trajectories and could ultimately enable prevention and remediation strategies. As the title of this review suggests, we claim that there are not only indirect but also direct effects of various organ systems on the brain, creating cascades of phenomena that strongly contribute to age-related cognitive decline. Here we focus primarily on the cerebrovascular system, because of its direct effects on brain health and close connections with the development and progression of Alzheimer's Disease and other types of dementia. We start by reviewing the main cognitive changes that are often observed in normally aging older adults, as well as the brain systems that support them. Second, we provide a brief overview of the cerebrovascular system and its known effects on brain anatomy and function, with a focus on aging. Third, we review genetic and lifestyle risk factors that may affect the cerebrovascular system and ultimately contribute to cognitive decline. Lastly, we discuss this evidence, review limitations, and point out avenues for additional research and clinical intervention.
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Affiliation(s)
- Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Bethlehem A. Asnakew
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Daniel C. Bowie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sydney M. Chism
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Grace M. Clements
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jennie C. Gardner
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samia S. Islam
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samantha L. Rubenstein
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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5
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Hsieh S, Yang MH. Potential Diffusion Tensor Imaging Biomarkers for Elucidating Intra-Individual Age-Related Changes in Cognitive Control and Processing Speed. Front Aging Neurosci 2022; 14:850655. [PMID: 35557836 PMCID: PMC9087335 DOI: 10.3389/fnagi.2022.850655] [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: 01/08/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
Cognitive aging, especially cognitive control, and processing speed aging have been well-documented in the literature. Most of the evidence was reported based on cross-sectional data, in which inter-individual age effects were shown. However, there have been some studies pointing out the possibility of overlooking intra-individual changes in cognitive aging. To systematically examine whether age-related differences and age-related changes might yield distinctive patterns, this study directly compared cognitive control function and processing speed between different cohorts versus follow-up changes across the adult lifespan. Moreover, considering that cognitive aging has been attributed to brain disconnection in white matter (WM) integrity, this study focused on WM integrity via acquiring diffusion-weighted imaging data with an MRI instrument that are further fitted to a diffusion tensor model (i.e., DTI) to detect water diffusion directionality (i.e., fractional anisotropy, FA; mean diffusivity, MD; radial diffusivity, RD; axial diffusivity, AxD). Following data preprocessing, 114 participants remained for further analyses in which they completed the two follow-up sessions (with a range of 1-2 years) containing a series of neuropsychology instruments and computerized cognitive control tasks. The results show that many significant correlations between age and cognitive control functions originally shown on cross-sectional data no longer exist on the longitudinal data. The current longitudinal data show that MD, RD, and AxD (especially in the association fibers of anterior thalamic radiation) are more strongly correlated to follow-up aging processes, suggesting that axonal/myelin damage is a more robust phenomenon for observing intra-individual aging processes. Moreover, processing speed appears to be the most prominent cognitive function to reflect DTI-related age (cross-sectional) and aging (longitudinal) effects. Finally, converging the results from regression analyses and mediation models, MD, RD, and AxD appear to be the representative DTI measures to reveal age-related changes in processing speed. To conclude, the current results provide new insights to which indicator of WM integrity and which type of cognitive changes are most representative (i.e., potentially to be neuroimaging biomarkers) to reflect intra-individual cognitive aging processes.
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Affiliation(s)
- Shulan Hsieh
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion, Department of Psychology, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Heng Yang
- Cognitive Electrophysiology Laboratory: Control, Aging, Sleep, and Emotion, Department of Psychology, National Cheng Kung University, Tainan, Taiwan
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6
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Zhao Y, Dang L, Tian X, Yang M, Lv M, Sun Q, Du Y. Association Between Intracranial Pulsatility and White Matter Hyperintensities in Asymptomatic Intracranial Arterial Stenosis: A Population-Based Study in Shandong, China. J Stroke Cerebrovasc Dis 2022; 31:106406. [PMID: 35248835 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The effects of increased intracranial pulsatility on the severity of white matter hyperintensities (WMH) in participants with asymptomatic intracranial arterial stenosis (aICAS) remain uncertain. We aimed to investigate whether an increased pulsatility index (PI) is associated with WMH volume (WMHV) in individuals with aICAS. MATERIALS AND METHODS All participants were recruited from the Kongcun Town aICAS Study, including a total of 103 participants with aICAS and 98 healthy controls (age- and sex-matched). PI was assessed using transcranial Doppler ultrasound. The WMHV was calculated through the lesion segmentation tool system for the Statistical Parametric Mapping package based on magnetic resonance imaging. The association between PI and lnWMHV was analyzed by linear regression models adjusting for demographics, lifestyle, and vascular risk factors. RESULTS The lnWMHV and PI between the aICAS and control groups showed no significant differences (P = 0.171 and 0.287, respectively). In a multivariable model, age ≥ 60 years and male sex (P = 0.000 and 0.006, respectively) were significant predictors of lnWMHV in the aICAS group. In sex-stratified analyses, there was a significant association between PI and lnWMHV in males with aICAS (P = 0.038). CONCLUSIONS This study suggest there might be a likely association between increased intracranial pulsatility and WMH burden in males with aICAS.
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Affiliation(s)
- Yuanyuan Zhao
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Liang Dang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xue Tian
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Meilan Yang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ming Lv
- Department of Clinical Epidemiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qinjian Sun
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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7
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Abstract
Arterial stiffness, a leading marker of risk in hypertension, can be measured at material or structural levels, with the latter combining effects of the geometry and composition of the wall, including intramural organization. Numerous studies have shown that structural stiffness predicts outcomes in models that adjust for conventional risk factors. Elastic arteries, nearer to the heart, are most sensitive to effects of blood pressure and age, major determinants of stiffness. Stiffness is usually considered as an index of vascular aging, wherein individuals excessively affected by risk factor exposure represent early vascular aging, whereas those resistant to risk factors represent supernormal vascular aging. Stiffness affects the function of the brain and kidneys by increasing pulsatile loads within their microvascular beds, and the heart by increasing left ventricular systolic load; excessive pressure pulsatility also decreases diastolic pressure, necessary for coronary perfusion. Stiffness promotes inward remodeling of small arteries, which increases resistance, blood pressure, and in turn, central artery stiffness, thus creating an insidious feedback loop. Chronic antihypertensive treatments can reduce stiffness beyond passive reductions due to decreased blood pressure. Preventive drugs, such as lipid-lowering drugs and antidiabetic drugs, have additional effects on stiffness, independent of pressure. Newer anti-inflammatory drugs also have blood pressure independent effects. Reduction of stiffness is expected to confer benefit beyond the lowering of pressure, although this hypothesis is not yet proven. We summarize different steps for making arterial stiffness measurement a keystone in hypertension management and cardiovascular prevention as a whole.
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Affiliation(s)
- Pierre Boutouyrie
- Faculté de Médecine, Université de Paris, INSERM U970, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, France (P.B.)
| | - Phil Chowienczyk
- King's College London British Heart Foundation Centre, Department of Clinical Pharmacology, St Thomas' Hospital, London, United Kingdom (P.C.)
| | - Jay D Humphrey
- Department of Biomedical Engineering and Vascular Biology and Therapeutics Program, Yale University, New Haven, CT (J.D.H.)
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8
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Pahlavian SH, Wang X, Ma S, Zheng H, Casey M, D’Orazio LM, Shao X, Ringman JM, Chui H, Wang DJJ, Yan L. Cerebroarterial pulsatility and resistivity indices are associated with cognitive impairment and white matter hyperintensity in elderly subjects: A phase-contrast MRI study. J Cereb Blood Flow Metab 2021; 41:670-683. [PMID: 32501154 PMCID: PMC7922759 DOI: 10.1177/0271678x20927101] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Increased cerebroarterial pulsations are thought to be contributing factors in microvascular damage and cognitive impairment. In this study, we assessed the utility of two-dimensional (2D) phase-contrast MRI (PC-MRI) in quantifying cerebroarterial pulsations and evaluated the associations of pulsatile and non-pulsatile hemodynamic measures with cognitive performance and white matter hyperintensities (WMH). Neurocognitive assessments on 50 elderly subjects were performed using clinical dementia rating (CDR) and Montreal cognitive assessment (MoCA). An electrocardiogram-gated 2D PC-MRI sequence was used to calculate mean flow rate, pulsatility index (PI), and resistivity index (RI) of the internal carotid artery. For each subject, whole brain global cerebral blood flow (gCBF) and relative WMH volume were also quantified. Elevated RI was significantly associated with reduced cognitive performance quantified using MoCA (p = 0.04) and global CDR (p = 0.02). PI and RI were both significantly associated with relative WMH volume (p = 0.01, p < 0.01, respectively). However, non-pulsatile hemodynamic measures were not associated with cognitive impairment or relative WMH volume. This study showed that the cerebroarterial pulsatile measures obtained using PC-MRI have stronger association with the measures of cognitive impairment compared to global blood flow measurement and as such, might be useful as potential biomarkers of cerebrovascular dysfunction in preclinical populations.
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Affiliation(s)
- Soroush H Pahlavian
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Xinhui Wang
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Samantha Ma
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Hong Zheng
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
| | - Marlena Casey
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Lina M D’Orazio
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Xingfeng Shao
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - John M Ringman
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Helena Chui
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Danny JJ Wang
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
| | - Lirong Yan
- USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, Los Angeles, CA, USA
- Department of Neurology, University
of Southern California, Los Angeles, CA, USA
- Lirong Yan, USC Stevens Neuroimaging and
Informatics Institute, Keck School of Medicine, University of Southern
California, 2025 Zonal Ave, Los Angeles, CA 90033, USA.
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9
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Heidari Pahlavian S, Cen SY, Bi X, Wang DJJ, Chui HC, Yan L. Assessment of carotid stiffness by measuring carotid pulse wave velocity using a single-slice oblique-sagittal phase-contrast MRI. Magn Reson Med 2021; 86:442-455. [PMID: 33543788 DOI: 10.1002/mrm.28677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 11/06/2022]
Abstract
PURPOSE Increased arterial stiffness has been shown to be one of the earliest markers of cerebrovascular dysfunction. As a surrogate marker of arterial stiffness, pulse wave velocity (PWV) quantifications are generally carried out on central and peripheral arteries. The purpose of this study was to develop and evaluate an MRI approach to assess carotid stiffness by measuring carotid PWV (cPWV) using a fast oblique-sagittal phase-contrast MRI sequence. METHODS In 29 volunteers, a single-slice oblique-sagittal phase-contrast MRI sequence with retrospective cardiac gating was used to quantify blood velocity waveforms along a vessel segment covering the common carotid artery (CCA) and the internal carotid artery (ICA). The CCA-ICA segment length was measured from a region of interest selected on the magnitude image. Phase-contrast MRI-measured velocities were also used to quantify the ICA pulsatility index along with cPWV quantification. RESULTS The mean value of cPWV calculated using the middle upslope area algorithm was 2.86 ± 0.71 and 3.97 ± 1.14 m/s in young and elderly subjects, respectively. Oblique-sagittal phase-contrast MRI-derived cPWV measurements showed excellent intrascan and interscan repeatability. cPWV and ICA pulsatility index were significantly greater in older subjects compared to those in the young subjects (P < .01 and P = .01, respectively). Also, increased cPWV values were associated with elevated systolic blood pressure (β = 0.05, P = .03). CONCLUSION This study demonstrated that oblique-sagittal phase-contrast MRI is a feasible technique for the quantification of both cPWV and ICA pulsatility index and showed their potential utility in evaluating cerebroarterial aging and age-related neurovascular disorders.
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Affiliation(s)
- Soroush Heidari Pahlavian
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Steven Yong Cen
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Danny J J Wang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Helena Chang Chui
- Department of Neurology, University of Southern California, Los Angeles, California, USA
| | - Lirong Yan
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Neurology, University of Southern California, Los Angeles, California, USA
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10
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Karayanidis F, McKewen M. More than “just a test”—Task-switching paradigms offer an early warning system for cognitive decline. PSYCHOLOGY OF LEARNING AND MOTIVATION 2021. [DOI: 10.1016/bs.plm.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Kneihsl M, Hofer E, Enzinger C, Niederkorn K, Horner S, Pinter D, Fandler-Höfler S, Eppinger S, Haidegger M, Schmidt R, Gattringer T. Intracranial Pulsatility in Relation to Severity and Progression of Cerebral White Matter Hyperintensities. Stroke 2020; 51:3302-3309. [DOI: 10.1161/strokeaha.120.030478] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose:
Previous studies suggested an association between increased intracranial arterial pulsatility and the severity of microangiopathic white matter hyperintensities (WMH). However, possible confounders such as age and hypertension were seldomly considered and longitudinal data are lacking. We here aimed to explore whether increased middle cerebral artery pulsatility is associated with baseline severity and progression of cerebral small vessel disease–related WMH in elderly individuals.
Methods:
The study population consisted of elderly participants from the community-based ASPS (Austrian Stroke Prevention Study). Baseline and follow-up assessment comprised transcranial Doppler sonography, brain magnetic resonance imaging, and clinical/laboratory examination of vascular risk factors. Pulsatility index on transcranial Doppler sonography was averaged from baseline indices of both middle cerebral arteries and was correlated with baseline WMH severity and WMH progression over a median follow-up period of 5 years in uni- and multivariable analyses. WMH severity was graded according to the Fazekas scale, and WMH load was quantified by semiautomated volumetric assessment.
Results:
The study cohort comprised 491 participants (mean age: 60.7±6.9 years; female: 48.5%). Pulsatility index was increased in participants with more severe WMH at baseline (
P
<0.001) but was not associated with WMH progression during follow-up (r
s
: 0.097,
P
=0.099). In multivariable analyses, only arterial hypertension remained significantly associated with baseline severity (
P
=0.04) and progression (
P
=0.008) of WMH, although transcranial Doppler sonography pulsatility index was not predictive (
P
>0.1, respectively).
Conclusions:
This community-based cohort study of elderly individuals does not support the pulsatility index of the middle cerebral artery on transcranial Doppler sonography as an independent marker of microangiopathic WMH severity and progression over time.
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Affiliation(s)
- Markus Kneihsl
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Edith Hofer
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation (E.H.), Medical University of Graz, Austria
| | - Christian Enzinger
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology (C.E., T.G.), Medical University of Graz, Austria
| | - Kurt Niederkorn
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Susanna Horner
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Daniela Pinter
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Simon Fandler-Höfler
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Sebastian Eppinger
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Melanie Haidegger
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Reinhold Schmidt
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
| | - Thomas Gattringer
- Department of Neurology (M.K., E.H., C.E., K.N., S.H., D.P., S.F.-H., S.E., M.H., R.S., T.G.), Medical University of Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology (C.E., T.G.), Medical University of Graz, Austria
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12
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The Incidence of Transverse Sinus Stenosis in Multiple Sclerosis: Further Evidence of Pulse Wave Encephalopathy. Mult Scler Relat Disord 2020; 46:102524. [DOI: 10.1016/j.msard.2020.102524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
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13
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Conley AC, Karayanidis F, Jolly TAD, Yang MH, Hsieh S. Cerebral Arterial Pulsatility and Global White Matter Microstructure Impact Spatial Working Memory in Older Adults With and Without Cardiovascular Risk Factors. Front Aging Neurosci 2020; 12:245. [PMID: 32848715 PMCID: PMC7427001 DOI: 10.3389/fnagi.2020.00245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/16/2020] [Indexed: 12/27/2022] Open
Abstract
Aging is associated with an increased prevalence of vascular health conditions that are linked to a disruption in the cerebral vasculature and white matter microstructural organization. In people with cardiovascular risk factors, increased cerebral arterial pulsatility is associated with poorer white matter microstructural organization and cognitive functioning. This study examines the relationship among arterial pulsatility, white matter microstructural organization, and cognitive ability in a healthy adult lifespan sample. One hundred and eighty-nine adults were divided into a younger adult (<50 years, n = 97) and older adult (>50 years, n = 92). The latter were further subdivided into two subgroups with (CV+, n = 25) and without (CV−, n = 67) cardiovascular risk factors. Arterial pulsatility was measured using cardiac-gated phase-contrast flow quantification sequence and three indexes of whole-brain white matter microstructural organization [i.e., fractional anisotropy (FA), radial diffusivity (RaD), mean diffusivity (MD)] were derived from diffusion-weighted imaging (DWI). Cognitive ability was assessed using global cognitive functioning (MoCA) and a measure of working memory [sensitivity (d′) from a 2-back task]. Neither the whole group analysis nor the younger adult group showed an association between measures of arterial pulsatility, global white matter microstructural organization, and cognition. In older adults, higher MD and RaD were associated with increased arterial pulsatility and poorer working memory performance. The indirect pathway from arterial pulsatility to working memory performance via both MD and RaD measures was significant in this group. Interestingly, a comparison of CV+ and CV− subgroups showed that this mediating relationship was only evident in older adults with at least one CV risk factor. These findings are consistent with cardiovascular risk factors as underlying arterial, white matter, and cognitive decline in cognitively normal older adults.
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Affiliation(s)
- Alexander C Conley
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science, University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Todd A D Jolly
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science, University of Newcastle, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Meng-Heng Yang
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.,Department and Institute of Public health, National Cheng Kung University, Tainan, Taiwan
| | - Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan.,Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.,Department and Institute of Public health, National Cheng Kung University, Tainan, Taiwan
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14
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Nam KW, Kwon HM, Lee YS. Distinct association between cerebral arterial pulsatility and subtypes of cerebral small vessel disease. PLoS One 2020; 15:e0236049. [PMID: 32673353 PMCID: PMC7365409 DOI: 10.1371/journal.pone.0236049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/27/2020] [Indexed: 01/08/2023] Open
Abstract
Background Increased arterial resistance is a potential pathological mechanism of cerebral small vessel disease (cSVD). Aim In this study, we aimed to investigate the association between pulsatility index (PI) representing cerebral arterial resistance and subtypes of cSVD in patients with lacunar stroke. Methods We included consecutive lacunar stroke patients between 2010 and 2013. White matter hyperintensity (WMH) volume was rated using semi-automated quantitative methods. Additionally, the presence of old lacunar infarct (OLI), cerebral microbleed (CMB), or enlarged perivascular space (EPVS) was also evaluated. The relationship between PI, measured in each middle cerebral artery, and the subtype/burden of cSVD was analyzed in the relevant hemisphere. Results A total of 206 lacunar patients were included and 412 hemispheres were analyzed (mean age: 64 years, male: 68.4%). In multivariable analysis, PI was positively associated with the WMH volume [beta = 1.372, 95% confidence interval (CI) = 0.624 to 2.120, P < 0.001] after adjusting for confounders. PI was also related to the presence of OLI (adjusted odds ratio = 11.37, 95% CI = 2.55–48.56, P = 0.001); however, this relationship was not significant in CMB or EPVS. Regarding the cSVD burden, PI increased according to the WMH tertiles (P for trend < 0.001), the burden of OLI (P for trend < 0.001), and EPVS tertiles (P for trend < 0.001), showing a quantitative relationship. Conclusions Ipsilateral PI is closely associated with cSVD in patients with lacunar stroke. Furthermore, this association is different between subtypes of cSVD, which is suggestive of underlying pathophysiological differences.
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Affiliation(s)
- Ki-Woong Nam
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Seok Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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15
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Nicolas K, Levi C, Evans TJ, Michie PT, Magin P, Quain D, Bivard A, Karayanidis F. Cognition in the First Year After a Minor Stroke, Transient Ischemic Attack, or Mimic Event and the Role of Vascular Risk Factors. Front Neurol 2020; 11:216. [PMID: 32373041 PMCID: PMC7186464 DOI: 10.3389/fneur.2020.00216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/09/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Cognitive impairment following a minor stroke or transient ischemic attack (TIA) is common; however, due to diagnostic difficulties, the prevalence and underlying cause of impairment remain poorly defined. We compared cognition in patients after a minor stroke, TIA, or mimic event at three time points in the first year following the event. We examine whether cognitive impairment occurs following these events and whether this impairment differs based on the event type. Further, we measure whether these findings persist after controlling for age, education, and the presence of vascular risk factors and whether the presence of vascular risk factors, independent of event etiology, is associated with cognitive impairment. Lastly, we investigate whether increased stroke risk, as assessed by the ABCD2, is associated with reduced cognition. Methods: Medical information, a cognitive screening test, and a measure of executive functioning were collected from 613 patients (123 minor stroke, 175 TIA, and 315 mimics) using phone interviews at three time points in the first year following the event. Linear mixed models were used to determine the effect of event type, vascular risk factors, and predicted stroke risk on cognitive performance while controlling for confounders. Results: There was no relationship between event type and performance on either cognitive measure. When all confounders are controlled for, performance on the cognitive screening test was uniquely accounted for by the presence of heart failure, myocardial infarction, angina, and hypertension (all p < 0.047), whereas the measure of executive functioning was uniquely accounted for by the presence of hypertension and angina (all p < 0.032). Increased stroke risk also predicted performance on the cognitive screening test and the measure of executive functioning (all p < 0.002). Conclusions: Our findings indicate that cognitive impairment following a minor stroke or TIA may be attributed to the high prevalence of chronic vascular risk factors in these patients. This highlights the importance of long-term management of vascular risk factors beyond event recovery to reduce the risk of cognitive impairment. Increased stroke risk (i.e., ABCD2 score) was also associated with reduced cognition, suggesting that it may be helpful in signaling the need for further cognitive evaluation and intervention post-event.
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Affiliation(s)
- Korinne Nicolas
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
| | - Christopher Levi
- Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia.,Sydney Partnership for Health, Education, Research and Enterprise, Sydney, NSW, Australia
| | - Tiffany-Jane Evans
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia
| | - Patricia T Michie
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Parker Magin
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
| | - Debbie Quain
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Andrew Bivard
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.,Melbourne Brain Center, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, University of Newcastle, Newcastle, NSW, Australia.,Brain and Mental Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
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16
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Shi Y, Thrippleton MJ, Blair GW, Dickie DA, Marshall I, Hamilton I, Doubal FN, Chappell F, Wardlaw JM. Small vessel disease is associated with altered cerebrovascular pulsatility but not resting cerebral blood flow. J Cereb Blood Flow Metab 2020; 40:85-99. [PMID: 30295558 PMCID: PMC6928551 DOI: 10.1177/0271678x18803956] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cerebral small vessel disease (SVD) contributes to 25% of ischemic strokes and 45% of dementias. We aimed to investigate the role of cerebral blood flow (CBF) and intracranial pulsatility in SVD. We scanned 60 patients with minor ischemic stroke, representing a range of white matter hyperintensities (WMH). We rated WMH and perivascular spaces (PVS) using semi-quantitative scales and measured WMH volume. We measured flow and pulsatility in the main cerebral vessels and cerebrospinal fluid (CSF) using phase-contrast MRI. We investigated the association between flow, pulsatility and SVD features. In 56/60 patients (40 male, 67.8±8.3 years) with complete data, median WMH volume was 10.7 mL (range 1.4-75.0 mL), representing median 0.77% (0.11-5.17%) of intracranial volume. Greater pulsatility index (PI) in venous sinuses was associated with larger WMH volume (e.g. superior sagittal sinus, β = 1.29, P < 0.01) and more basal ganglia PVS (e.g. odds ratio = 1.38, 95% confidence interval 1.06, 1.79, per 0.1 increase in superior sagittal sinus PI) independently of age, sex and blood pressure. CSF pulsatility and CBF were not associated with SVD features. Our results support a close association of SVD features with increased intracranial pulsatility rather than with low global CBF, and provide potential targets for mechanistic research, treatment and prevention of SVD.
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Affiliation(s)
- Yulu Shi
- Department of Neurology, Zhongnan Hospital, Wuhan University, Wuhan, China.,Department of Neurology, Tiantan Hospital, Beijing, China.,Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Michael J Thrippleton
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute at The University of Edinburgh, Edinburgh Medical School, Edinburgh, UK
| | - Gordon W Blair
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute at The University of Edinburgh, Edinburgh Medical School, Edinburgh, UK
| | - David A Dickie
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Ian Marshall
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute at The University of Edinburgh, Edinburgh Medical School, Edinburgh, UK
| | - Iona Hamilton
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Fergus N Doubal
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Francesca Chappell
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Brain Research Imaging Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,UK Dementia Research Institute at The University of Edinburgh, Edinburgh Medical School, Edinburgh, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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17
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Birnefeld J, Wåhlin A, Eklund A, Malm J. Cerebral arterial pulsatility is associated with features of small vessel disease in patients with acute stroke and TIA: a 4D flow MRI study. J Neurol 2019; 267:721-730. [PMID: 31728712 PMCID: PMC7035303 DOI: 10.1007/s00415-019-09620-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/30/2019] [Accepted: 11/02/2019] [Indexed: 11/16/2022]
Abstract
Cerebral small vessel disease (SVD) is a major cause of stroke and cognitive impairment. However, the underlying mechanisms behind SVD are still poorly understood. High cerebral arterial pulsatility has been suggested as a possible cause of SVD. In population studies, arterial pulsatility has been linked to white matter hyperintensities (WMH), cerebral atrophy, and cognitive impairment, all features of SVD. In stroke, pulsatility data are scarce and contradictory. The aim of this study was to investigate the relationship between arterial pulsatility and SVD in stroke patients. With a cross-sectional design, 89 patients with acute ischemic stroke or TIA were examined with MRI. A neuropsychological assessment was performed 1 year later. Using 4D flow MRI, pulsatile indices (PI) were calculated for the internal carotid artery (ICA) and middle cerebral artery (M1, M3). Flow volume pulsatility (FVP), a measure corresponding to the cyclic expansion of the arterial tree, was calculated for the same locations. These parameters were assessed for associations with WMH volume, brain volume and cognitive function. ICA-FVP was associated with WMH volume (β = 1.67, 95% CI: [0.1, 3.24], p = 0.037). M1-PI and M1-FVP were associated with decreasing cognitive function (β = − 4.4, 95% CI: [− 7.7, − 1.1], p = 0.009 and β = − 13.15, 95% CI: [− 24.26, − 2.04], p = 0.02 respectively). In summary, this supports an association between arterial pulsatility and SVD in stroke patients, and provides a potential target for further research and preventative treatment. FVP may become a useful biomarker for assessing pulsatile stress with PCMRI and 4D flow MRI.
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Affiliation(s)
- Johan Birnefeld
- Department of Pharmacology and Clinical Neuroscience, Umeå University, 90187, Umeå, Sweden.
| | - Anders Wåhlin
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Umeå Centre for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Centre for Biomedical Engineering and Physics, Umeå University, Umeå, Sweden
| | - Jan Malm
- Department of Pharmacology and Clinical Neuroscience, Umeå University, 90187, Umeå, Sweden
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18
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Atwi S, Robertson AD, Theyers AE, Ramirez J, Swartz RH, Marzolini S, MacIntosh BJ. Cardiac-Related Pulsatility in the Insula Is Directly Associated With Middle Cerebral Artery Pulsatility Index. J Magn Reson Imaging 2019; 51:1454-1462. [PMID: 31667941 DOI: 10.1002/jmri.26950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Arterial stiffness in large arteries is a risk factor for cerebral small vessel disease and neurodegeneration. The challenge of accessing intracranial pulsatility noninvasively is one reason few studies provide empirical insight on the relationship between large artery and tissue pulsatility in the human brain. PURPOSE To investigate the association between the functional magnetic resonance imaging (fMRI)-derived cardiac-related pulsatility in the insular cortex and the ultrasound-derived pulsatility index in the middle cerebral artery (MCA-PI). STUDY TYPE Cross-sectional. POPULATION Younger adults (11; 25 ± 4 years) and older adults with and without cardiovascular risk factors (44; 70 ± 6 years). FIELD STRENGTH/SEQUENCE T1 -weighted, fluid attenuated inversion recovery, and T2 *-weighted blood oxygenation level-dependent (BOLD) sequences at 3T. ASSESSMENT MCA-PI and cardiac-related pulsatility were assessed at rest by transcranial Doppler ultrasound and BOLD fMRI, respectively. STATISTICAL TESTS Multivariate analyses of covariance between MCA-PI and cardiac-related pulsatility. Analysis of variance was used to assess regional differences. RESULTS MCA-PI was associated with cardiac-related insular pulsatility (P = 0.037), but not whole-brain pulsatility (P = 0.81). Left insular pulsatility was higher than right insular pulsatility (P < 0.01) and was associated with diastolic blood pressure (P = 0.028). DATA CONCLUSION We show a correlation between ultrasound and fMRI measures of cerebrovascular pulsatility. This association provides insight into the transmission of pulsatile energy from large basal arteries at the Circle of Willis to downstream cerebrovascular beds and has implications for the utility of cardiac-related pulsatility as a potential marker for cerebral small vessel disease. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:1454-1462.
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Affiliation(s)
- Sarah Atwi
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Andrew D Robertson
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Athena E Theyers
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Richard H Swartz
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Susan Marzolini
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehab, University Health Network, Toronto, ON, Canada
| | - Bradley J MacIntosh
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
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19
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Winklewski PJ, Wolf J, Gruszecki M, Wszedybyl-Winklewska M, Narkiewicz K. Current understanding of the effects of inspiratory resistance on the interactions between systemic blood pressure, cerebral perfusion, intracranial pressure, and cerebrospinal fluid dynamics. J Appl Physiol (1985) 2019; 127:1206-1214. [DOI: 10.1152/japplphysiol.00058.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Negative intrathoracic pressure (nITP) is generated by the respiratory muscles during inspiration to overcome inspiratory resistance, thus enabling lung ventilation. Recently developed noninvasive techniques have made it possible to assess the effects of nITP in real time in several physiological aspects such as systemic blood pressure (BP), intracranial pressure (ICP), and cerebral blood flow (CBF). It has been shown that nITP from 0 to −20 cmH2O elevates BP and diminishes ICP, which facilitates brain perfusion. The effects of nITP from −20 to −40 cmH2O on BP, ICP, and CBF remain largely unrecognized, yet even nITP at −40 cmH2O may facilitate CBF by diminishing ICP. Importantly, nITP from −20 to −40 cmH2O has been documented in adults in commonly encountered obstructive sleep apnea, which justifies research in this area. Recent revelations about interactions between ICP and BP have opened up new fields of research in physiological regulation and the pathophysiology of common diseases, such as hypertension, brain injury, and respiratory disorders. A better understanding of these interactions may translate directly into new therapies in various fields of clinical medicine.
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Affiliation(s)
- Pawel J. Winklewski
- Department of Human Physiology, Medical University of Gdansk, Gdansk, Poland
- Department of Clinical Anatomy and Physiology, Pomeranian University of Slupsk, Slupsk, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Medical University of Gdansk, Gdansk, Poland
| | | | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
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20
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Effects of acute aerobic exercise on arterial stiffness and cerebrovascular pulsatility in adults with and without hypertension. J Hypertens 2019; 36:1743-1752. [PMID: 29677054 DOI: 10.1097/hjh.0000000000001752] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Stiffer central arteries, as seen in hypertension (HTN), foster transmission of pulsatile hemodynamics into fragile cerebral vessels. Aerobic exercise is recommended for adults with HTN, but its effects on arterial stiffness and pulsatility in this group are unclear. This study sought to investigate the effect of acute aerobic exercise on arterial stiffness and cerebrovascular pulsatility in 30 adults with treated HTN and 30 age, sex, and BMI-matched adults without HTN (56 ± 6 years, BMI 28.2 ± 2.9 kg/m; 28 women). METHODS Patients underwent hemodynamic measures before/after 30-min cycling (≈55% peak oxygen consumption). Aortic stiffness was measured using carotid-femoral pulse wave velocity, and carotid artery stiffness was assessed with β-stiffness via ultrasound. Aortic/carotid pulse pressure (aortic via radial generalized transfer function) was measured by tonometry and calibrated to brachial mean pressure and diastolic pressure. Carotid/middle cerebral artery (MCA) blood velocity pulsatility indices were measured using Doppler. Carotid wave intensity analysis was used to derive forward wave intensity (W1). RESULTS Exercise impacted hemodynamics similarly in HTN compared to no-HTN. Carotid-femoral pulse wave velocity, MCA pulsatility index, carotid pulsatility index, and W1 increased similarly after exercise in both groups (P < 0.05). Carotid pulse pressure and β-stiffness were unaltered after exercise. Postexercise changes in W1 were positively associated with carotid pulsatility index, which was further associated with MCA pulsatility index. CONCLUSIONS These data suggest adults with treated HTN experience similar increases in aortic stiffness and cerebrovascular hemodynamic pulsatility during early recovery from acute aerobic exercise as their counterparts without HTN.
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Predicting the Aqueductal Cerebrospinal Fluid Pulse: A Statistical Approach. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9102131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The cerebrospinal fluid (CSF) pulse in the Aqueduct of Sylvius (aCSF pulse) is often used to evaluate structural changes in the brain. Here we present a novel application of the general linear model (GLM) to predict the motion of the aCSF pulse. MR venography was performed on 13 healthy adults (9 female and 4 males—mean age = 33.2 years). Flow data was acquired from the arterial, venous and CSF vessels in the neck (C2/C3 level) and from the AoS. Regression analysis was undertaken to predict the motion of the aCSF pulse using the cervical flow rates as predictor variables. The relative contribution of these variables to predicting aCSF flow rate was assessed using a relative weights method, coupled with an ANOVA. Analysis revealed that the aCSF pulse could be accurately predicted (mean (SD) adjusted r2 = 0.794 (0.184)) using the GLM (p < 0.01). Venous flow rate in the neck was the strongest predictor of aCSF pulse (p = 0.001). In healthy individuals, the motion of the aCSF pulse can be predicted using the GLM. This indicates that the intracranial fluidic system has broadly linear characteristics. Venous flow in the neck is the strongest predictor of the aCSF pulse.
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22
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Tarumi T, Thomas BP, Wang C, Zhang L, Liu J, Turner M, Riley J, Tangella N, Womack KB, Kerwin DR, Cullum CM, Lu H, Vongpatanasin W, Zhu DC, Zhang R. Ambulatory pulse pressure, brain neuronal fiber integrity, and cerebral blood flow in older adults. J Cereb Blood Flow Metab 2019; 39:926-936. [PMID: 29219028 PMCID: PMC6501504 DOI: 10.1177/0271678x17745027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Ambulatory blood pressure (ABP) reflects the end-organ vascular stress in daily life; however, its influence on brain neuronal fiber integrity and cerebral blood flow (CBF) remains unclear. The objective of this study was to determine the associations among ABP, white matter (WM) neuronal fiber integrity, and CBF in older adults. We tested 144 participants via ABP monitoring and diffusion tensor imaging. The total level and pulsatile indices of CBF were measured by phase-contrast MRI and transcranial Doppler, respectively. Neuropsychological assessment was conducted in 72 participants. Among ambulatory and office BP measures, elevated 24-h pulse pressure (PP) was associated with the greatest number of WM skeleton voxels with decreased fractional anisotropy (FA) and increased mean diffusivity (MD). Furthermore, these associations remained significant after adjusting for age, antihypertensive use, aortic stiffness, WM lesion volume, and office PP. Radial diffusivity (RD) was elevated in the regions with decreased FA, while axial diffusivity was unaltered. The reduction in diastolic index explained a significant proportion of the individual variability in FA, MD, and RD. Executive function performance was correlated with WM fiber integrity. These findings suggest that elevated ambulatory PP may deteriorate brain neuronal fiber integrity via reduction in diastolic index.
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Affiliation(s)
- Takashi Tarumi
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Binu P Thomas
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ciwen Wang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Li Zhang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,4 Department of Ultrasound Diagnostics, Fourth Military Medical University, Xi'an, China
| | - Jie Liu
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,4 Department of Ultrasound Diagnostics, Fourth Military Medical University, Xi'an, China
| | - Marcel Turner
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Jonathan Riley
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Nikita Tangella
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - Kyle B Womack
- 2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,5 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Diana R Kerwin
- 6 Texas Alzheimer's and Memory Disorders, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - C Munro Cullum
- 2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,5 Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hanzhang Lu
- 3 Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Wanpen Vongpatanasin
- 7 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David C Zhu
- 8 Department of Radiology, Cognitive Imaging Research Center, Michigan State University, Lansing, MI, USA.,9 Department of Psychology, Cognitive Imaging Research Center, Michigan State University, Lansing, MI, USA
| | - Rong Zhang
- 1 Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA.,2 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,7 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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23
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Nuckowska MK, Gruszecki M, Kot J, Wolf J, Guminski W, Frydrychowski AF, Wtorek J, Narkiewicz K, Winklewski PJ. Impact of slow breathing on the blood pressure and subarachnoid space width oscillations in humans. Sci Rep 2019; 9:6232. [PMID: 30996273 PMCID: PMC6470142 DOI: 10.1038/s41598-019-42552-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/29/2019] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to assess cardiac and respiratory blood pressure (BP) and subarachnoid space (SAS) width oscillations during the resting state for slow and fast breathing and breathing against inspiratory resistance. Experiments were performed on a group of 20 healthy volunteers (8 males and 12 females; age 25.3 ± 7.9 years; BMI = 22.1 ± 3.2 kg/m2). BP and heart rate (HR) were measured using continuous finger-pulse photoplethysmography. SAS signals were recorded using an SAS monitor. Oxyhaemoglobin saturation (SaO2) and end-tidal CO2 (EtCO2) were measured using a medical monitoring system. Procedure 1 consisted of breathing spontaneously and at controlled rates of 6 breaths/minute and 6 breaths/minute with inspiratory resistance for 10 minutes. Procedure 2 consisted of breathing spontaneously and at controlled rates of 6, 12 and 18 breaths/minute for 5 minutes. Wavelet analysis with the Morlet mother wavelet was applied for delineation of BP and SAS signals cardiac and respiratory components. Slow breathing diminishes amplitude of cardiac BP and SAS oscillations. The overall increase in BP and SAS oscillations during slow breathing is driven by the respiratory component. Drop in cardiac component of BP amplitude evoked by slow-breathing may be perceived as a cardiovascular protective mechanism to avoid target organ damage. Further studies are warranted to assess long-term effects of slow breathing.
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Affiliation(s)
- Magdalena K Nuckowska
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Kot
- National Centre for Hyperbaric Medicine, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdynia, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Guminski
- Department of Computer Communications, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | | | - Jerzy Wtorek
- Department of Biomedical Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Pawel J Winklewski
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.
- Department of Clinical Anatomy and Physiology, Faculty of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland.
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Tremblay P, Perron M, Deschamps I, Kennedy‐Higgins D, Houde J, Dick AS, Descoteaux M. The role of the arcuate and middle longitudinal fasciculi in speech perception in noise in adulthood. Hum Brain Mapp 2019; 40:226-241. [PMID: 30277622 PMCID: PMC6865648 DOI: 10.1002/hbm.24367] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/13/2022] Open
Abstract
In this article, we used High Angular Resolution Diffusion Imaging (HARDI) with advanced anatomically constrained particle filtering tractography to investigate the role of the arcuate fasciculus (AF) and the middle longitudinal fasciculus (MdLF) in speech perception in noise in younger and older adults. Fourteen young and 15 elderly adults completed a syllable discrimination task in the presence of broadband masking noise. Mediation analyses revealed few effects of age on white matter (WM) in these fascicles but broad effects of WM on speech perception, independently of age, especially in terms of sensitivity and criterion (response bias), after controlling for individual differences in hearing sensitivity and head size. Indirect (mediated) effects of age on speech perception through WM microstructure were also found, after controlling for individual differences in hearing sensitivity and head size, with AF microstructure related to sensitivity, response bias and phonological priming, and MdLF microstructure more strongly related to response bias. These findings suggest that pathways of the perisylvian region contribute to speech processing abilities, with relatively distinct contributions for the AF (sensitivity) and MdLF (response bias), indicative of a complex contribution of both phonological and cognitive processes to age-related speech perception decline. These results provide new and important insights into the roles of these pathways as well as the factors that may contribute to elderly speech perception deficits. They also highlight the need for a greater focus to be placed on studying the role of WM microstructure to understand cognitive aging.
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Affiliation(s)
- Pascale Tremblay
- CERVO Brain Research CenterQuebec CityCanada
- Département de Réadaptation, Faculté de MédecineUniversité LavalQuebec CityCanada
| | | | - Isabelle Deschamps
- CERVO Brain Research CenterQuebec CityCanada
- Département de Réadaptation, Faculté de MédecineUniversité LavalQuebec CityCanada
| | - Dan Kennedy‐Higgins
- CERVO Brain Research CenterQuebec CityCanada
- Department of Speech, Hearing and Phonetic SciencesUniversity College LondonUnited Kingdom
| | - Jean‐Christophe Houde
- Département d'informatique, Faculté des Sciences, Sherbrooke Connectivity Imaging LabUniversité de SherbrookeSherbrookeCanada
| | | | - Maxime Descoteaux
- Département d'informatique, Faculté des Sciences, Sherbrooke Connectivity Imaging LabUniversité de SherbrookeSherbrookeCanada
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Talai AS, Sedlacik J, Boelmans K, Forkert ND. Widespread diffusion changes differentiate Parkinson's disease and progressive supranuclear palsy. NEUROIMAGE-CLINICAL 2018; 20:1037-1043. [PMID: 30342392 PMCID: PMC6197764 DOI: 10.1016/j.nicl.2018.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/17/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parkinson's disease (PD) and progressive supranuclear palsy - Richardson's syndrome (PSP-RS) are often represented by similar clinical symptoms, which may challenge diagnostic accuracy. The objective of this study was to investigate and compare regional cerebral diffusion properties in PD and PSP-RS subjects and evaluate the use of these metrics for an automatic classification framework. MATERIAL AND METHODS Diffusion-tensor MRI datasets from 52 PD and 21 PSP-RS subjects were employed for this study. Using an atlas-based approach, regional median values of mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were measured and employed for feature selection using RELIEFF and subsequent classification using a support vector machine. RESULTS According to RELIEFF, the top 17 diffusion values consisting of deep gray matter structures, the brainstem, and frontal cortex were found to be especially informative for an automatic classification. A MANCOVA analysis performed on these diffusion values as dependent variables revealed that PSP-RS and PD subjects differ significantly (p < .001). Generally, PSP-RS subjects exhibit reduced FA, and increased MD, RD, and AD values in nearly all brain structures analyzed compared to PD subjects. The leave-one-out cross-validation of the support vector machine classifier revealed that the classifier can differentiate PD and PSP-RS subjects with an accuracy of 87.7%. More precisely, six PD subjects were wrongly classified as PSP-RS and three PSP-RS subjects were wrongly classified as PD. CONCLUSION The results of this study demonstrate that PSP-RS subjects exhibit widespread and more severe diffusion alterations compared to PD patients, which appears valuable for an automatic computer-aided diagnosis approach.
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Affiliation(s)
- Aron S Talai
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada
| | - Jan Sedlacik
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Kai Boelmans
- Department of Neurology, University Hospital Würzburg, Germany
| | - Nils D Forkert
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada.
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26
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de la Cruz-Cosme C, Dawid-Milner MS, Ojeda-Burgos G, Gallardo-Tur A, Segura T. Doppler Resistivity and Cerebral Small Vessel Disease: Hemodynamic Structural Correlation and Usefulness for the Etiological Classification of Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2018; 27:3425-3435. [PMID: 30185397 DOI: 10.1016/j.jstrokecerebrovasdis.2018.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/15/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION AND GOAL Lacunar stroke is defined as an <1.5 cm diameter infarct located in the territory of a perforating artery, that is not accessible for direct study using conventional imaging techniques. Diagnosis requires exclusion of other causes. It usually occurs in the context of chronic cerebral small vessel disease, which can be suspected during the neurosonography study in the form of high pulsatility [PI] or resistance index [RI]. Clinical research was performed to confirm that PI and RI correlate with cerebral small vessel lesion burden and to determine whether these parameters are useful for supporting a lacunar origin (LO) in acute stroke. MATERIAL AND METHODS We prospectively recorded internal carotid artery resistivity and the Fazekas score for all patients with acute ischemic stroke who met inclusion but not exclusion criteria over a 6-month period. RESULTS The study population comprised 74 patients. A correlation was observed between the Fazekas score and resistivity. Both parameters predicted a LO, with an area under the curve of .78 and .696, respectively. The optimal cut-offs were PI = .96/RI = .58 for screening (sensitivity, 96%) and PI = 1.46/RI = .83 for confirmation (specificity, 89%). CONCLUSIONS Doppler ultrasound is a useful technique for determining the LO of acute stroke.
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Affiliation(s)
| | - Marc Stefan Dawid-Milner
- Neurophysiology of the Autonomic Nervous System Unit, CIMES, Universidad de Málaga, Málaga, Spain
| | - Guillermo Ojeda-Burgos
- Internal Medicine Service, Hospital Universitario Virgen de la Victoria (Málaga), Málaga, Spain
| | - Alejandro Gallardo-Tur
- Neurology Service, Hospital Universitario Virgen de la Victoria (Málaga), Málaga, Spain; FIMABIS (Fundación Pública Andaluza para la Investigación de Málaga en Biomedicina y Salud [Andalusian Public Research Foundation]), Málaga, Spain
| | - Tomás Segura
- Neurology Department, Hospital Universitario de Albacete (Albacete), Albacete, Spain
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27
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Dawe RJ, Yu L, Schneider JA, Arfanakis K, Bennett DA, Boyle PA. Postmortem brain MRI is related to cognitive decline, independent of cerebral vessel disease in older adults. Neurobiol Aging 2018; 69:177-184. [PMID: 29908416 PMCID: PMC6424332 DOI: 10.1016/j.neurobiolaging.2018.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/13/2018] [Accepted: 05/16/2018] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to determine whether metrics of brain tissue integrity derived from postmortem magnetic resonance imaging (MRI) are associated with late-life cognitive decline, independent of cerebral vessel disease. Using data from 554 older adults, we used voxelwise regression to identify regions where the postmortem MRI transverse relaxation rate constant R2 was associated with the rate of decline in global cognition. We then used linear mixed models to investigate the association between a composite R2 measure and cognitive decline, controlling for neuropathology including 3 indices of vessel disease: atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy. This composite R2 measure was associated with the rate of decline (0.049 unit annually per R2 unit, p < 0.0001) and accounted for 6.1% of its variance, beyond contributions from vessel disease indices and other prominent age-related neuropathologies. Thus, postmortem brain R2 reflects disease processes underlying cognitive decline that are not captured by vessel disease indices or other standard neuropathologic indices and may provide a measure of brain tissue integrity that is complementary to histopathologic evaluation.
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Affiliation(s)
- Robert J Dawe
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Shirzadi Z, Robertson AD, Metcalfe AW, Duff-Canning S, Marras C, Lang AE, Masellis M, MacIntosh BJ. Brain tissue pulsatility is related to clinical features of Parkinson's disease. NEUROIMAGE-CLINICAL 2018; 20:222-227. [PMID: 30090696 PMCID: PMC6079564 DOI: 10.1016/j.nicl.2018.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/05/2018] [Accepted: 07/21/2018] [Indexed: 12/21/2022]
Abstract
Introduction This study investigated whether brain tissue pulsatility is associated with features of disease severity in Parkinson's disease (PD). Methods Data were extracted from the Parkinson's Progression Markers Initiative among 81 adults with PD (confirmed with DATSCAN™). Brain tissue pulsatility was computed using resting state blood oxygenation level dependent (BOLD) MRI in white matter (WM), referred to as BOLDTP. Motor impairment was assessed using the Movement Disorders Society unified Parkinson's disease rating scale. Factor analysis generated composite scores for cognition and vascular risk burden. A linear regression model examined the association of BOLDTP with age, sex, motor impairment, cognition, vascular risk burden and PD duration. In addition, we investigated whether BOLDTP relates to WM hyperintensity (WMH) volume, WM fractional anisotropy (WM-FA) and striatal binding ratio (SBR) of dopamine transporter. Results Motor impairment (t = 2.3, p = .02), vascular burden (t = 2.4, p = .02) and male sex (t = 3.0, p = .003) were independently associated with BOLDTP (r2 = 0.40, p < .001). BOLDTP was correlated with WMH volume (r = 0.22, p = .05) but not WM-FA nor SBR (p > .1). In addition, BOLDTP (t = 2.76, p = .008) and SBR (t = -2.04, p = .04) were independently related to motor impairment (r2 = 0.18, p = .006). Conclusion Our findings show that brain tissue pulsatility from BOLD images in WM is related to neurological and vascular features in PD. BOLDTP may be useful in PD to study small vessel alterations that appear distinct from WM structural changes.
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Affiliation(s)
- Zahra Shirzadi
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.
| | - Andrew D Robertson
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Arron W Metcalfe
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Duff-Canning
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's disease, Toronto western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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Impact of Aging on Endurance and Neuromuscular Physical Performance: The Role of Vascular Senescence. Sports Med 2018; 47:583-598. [PMID: 27459861 DOI: 10.1007/s40279-016-0596-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The portion of society aged ≥60 years is the fastest growing population in the Western hemisphere. Aging is associated with numerous changes to systemic physiology that affect physical function and performance. We present a narrative review of the literature aimed at discussing the age-related changes in various metrics of physical performance (exercise economy, anaerobic threshold, peak oxygen uptake, muscle strength, and power). It also explores aging exercise physiology as it relates to global physical performance. Finally, this review examines the vascular contributions to aging exercise physiology. Numerous studies have shown that older adults exhibit substantial reductions in physical performance. The process of decline in endurance capacity is particularly insidious over the age of 60 years and varies considerably as a function of sex, task specificity, and individual training status. Starting at the age of 50 years, aging also implicates an impressive deterioration of neuromuscular function, affecting muscle strength and power. Muscle atrophy, together with minor deficits in the structure and function of the nervous system and/or impairments in intrinsic muscle quality, plays an important role in the development of neuromotor senescence. Large artery stiffness increases as a function of age, thus triggering subsequent changes in pulsatile hemodynamics and systemic endothelial dysfunction. For this reason, we propose that vascular senescence has a negative impact on cerebral, cardiac, and neuromuscular structure and function, detrimentally affecting physical performance.
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Wszedybyl-Winklewska M, Wolf J, Szarmach A, Winklewski PJ, Szurowska E, Narkiewicz K. Central sympathetic nervous system reinforcement in obstructive sleep apnoea. Sleep Med Rev 2018; 39:143-154. [DOI: 10.1016/j.smrv.2017.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/29/2017] [Accepted: 08/31/2017] [Indexed: 01/30/2023]
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Fleysher R, Lipton ML, Noskin O, Rundek T, Lipton R, Derby CA. White matter structural integrity and transcranial Doppler blood flow pulsatility in normal aging. Magn Reson Imaging 2018; 47:97-102. [PMID: 29158187 PMCID: PMC5828865 DOI: 10.1016/j.mri.2017.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/13/2017] [Indexed: 12/15/2022]
Abstract
Cerebrovascular diseases underlie many forms of age-related cognitive impairment and the mechanism linking the two is hypothesized to involve adverse changes in white matter (WM) integrity. Despite being systemic, small vessel disease does not uniformly affect WM. We performed voxel-wise analysis of MRI images to examine the association between fractional anisotropy (FA) - a diffusion tensor measure of WM structural integrity - and pulsatility index (PI) - a transcranial Doppler ultrasound measure of abnormal arterial flow - in adults over the age of 70years who were free of stroke and dementia. We demonstrate that the relation of PI to microstructural changes in WM is artery specific and regional. We identified spatial clusters of significant correlations between elevated PI and reduced FA which cannot be explained by aging, supporting a vascular hypothesis of WM injury. These areas are not limited to the vascular territories of the vessels where PI is assessed, suggesting that the linkage between PI and FA is not likely a function of perfusion per se, but is consistent with injury caused by mechanical wave emanating from pulsating vessel walls.
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Affiliation(s)
- Roman Fleysher
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
| | - Michael L Lipton
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
| | - Olga Noskin
- Neurology Group of Bergen County, P. A., Ridgewood, NJ, United States.
| | - Tatjana Rundek
- Departments of Neurology and Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.
| | - Richard Lipton
- Saul R Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
| | - Carol A Derby
- Saul R Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States; Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
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Intracranial pulsatility in patients with cerebral small vessel disease: a systematic review. Clin Sci (Lond) 2018; 132:157-171. [DOI: 10.1042/cs20171280] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/20/2017] [Accepted: 12/07/2017] [Indexed: 01/30/2023]
Abstract
Growing evidence suggests that increased intracranial pulsatility is associated with cerebral small vessel disease (SVD). We systematically reviewed papers that assessed intracranial pulsatility in subjects with SVD. We included 27 cross-sectional studies (n=3356): 20 used Doppler ultrasound and 7 used phase-contrast MRI. Most studies measured pulsatility in the internal carotid or middle cerebral arteries (ICA, MCA), whereas few assessed veins or cerebrospinal fluid (CSF). Methods to reduce bias and risk factor adjustment were poorly reported. Substantial variation between studies in assessment of SVD and of pulsatility indices precluded a formal meta-analysis. Eight studies compared pulsatility by SVD severity (n=26–159, median = 74.5): arterial pulsatility index was generally higher in more severe SVD (e.g. MCA: standardized mean difference = 3.24, 95% confidence interval [2.40, 4.07]), although most did not match for age. Seventeen studies (n=9–700; median = 110) performed regression or correlation analysis, of which most showed that increased pulsatility was associated with SVD after adjustment for age. In conclusion, most studies support a cross-sectional association between higher pulsatility in large intracranial arteries and SVD. Future studies should minimize bias, adjust for potential confounders, include pulsatility in veins and CSF, and examine longitudinal relationship between pulsatility and SVD. Agreement on reliable measures of intracranial pulsatility would be helpful.
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Gruszecki M, Nuckowska MK, Szarmach A, Radkowski M, Szalewska D, Waskow M, Szurowska E, Frydrychowski AF, Demkow U, Winklewski PJ. Oscillations of Subarachnoid Space Width as a Potential Marker of Cerebrospinal Fluid Pulsatility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1070:37-47. [PMID: 29435957 DOI: 10.1007/5584_2018_155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In the cerebrospinal fluid (CSF) circulation, two components can be distinguished: bulk flow (circulation) and pulsatile flow (back and forth motion). CSF pulsatile flow is generated by both cardiac and respiratory cycles. Recent years have seen increased interest in cardiac- and respiratory-driven CSF pulsatility as an important component of cerebral homeostasis. CSF pulsatility is affected by cerebral arterial inflow and jugular outflow and potentially linked to white matter abnormalities in various diseases, such as multiple sclerosis or hypertension. In this review, we discuss the physiological mechanisms associated with CSF pulsation and its clinical significance. Finally, we explain the concept of using the oscillations of subarachnoid space width as a surrogate for CSF pulsatility.
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Affiliation(s)
- Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Medical University of Gdansk, Gdansk, Poland
| | | | - Arkadiusz Szarmach
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland
| | - Dominika Szalewska
- Chair of Rehabilitation Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Monika Waskow
- Faculty of Health Sciences, Slupsk Pomeranian University, Slupsk, Poland
| | - Edyta Szurowska
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | | | - Urszula Demkow
- Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Warsaw Medical University, Warsaw, Poland
| | - Pawel J Winklewski
- Department of Human Physiology, Medical University of Gdansk, Gdansk, Poland.
- Second Department of Radiology, Medical University of Gdansk, Gdansk, Poland.
- Faculty of Health Sciences, Slupsk Pomeranian University, Slupsk, Poland.
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Heffernan KS, Augustine JA, Lefferts WK, Spartano NL, Hughes WE, Jorgensen RS, Gump BB. Arterial stiffness and cerebral hemodynamic pulsatility during cognitive engagement in younger and older adults. Exp Gerontol 2018; 101:54-62. [DOI: 10.1016/j.exger.2017.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/07/2017] [Indexed: 11/17/2022]
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Kalicka R, Mazur K, Wolf J, Frydrychowski AF, Narkiewicz K, Winklewski PJ. Modelling of subarachnoid space width changes in apnoea resulting as a function of blood flow parameters. Microvasc Res 2017; 113:16-21. [DOI: 10.1016/j.mvr.2017.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 03/14/2017] [Accepted: 03/19/2017] [Indexed: 11/30/2022]
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Wszedybyl-Winklewska M, Wolf J, Swierblewska E, Kunicka K, Mazur K, Gruszecki M, Winklewski PJ, Frydrychowski AF, Bieniaszewski L, Narkiewicz K. Increased inspiratory resistance affects the dynamic relationship between blood pressure changes and subarachnoid space width oscillations. PLoS One 2017; 12:e0179503. [PMID: 28654638 PMCID: PMC5487010 DOI: 10.1371/journal.pone.0179503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 05/31/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Respiration is known to affect cerebrospinal fluid (CSF) movement. We hypothesised that increased inspiratory resistance would affect the dynamic relationship between blood pressure (BP) changes and subarachnoid space width (SAS) oscillations. METHODS Experiments were performed in a group of 20 healthy volunteers undergoing controlled intermittent Mueller Manoeuvres (the key characteristic of the procedure is that a studied person is subjected to a controlled, increased inspiratory resistance which results in marked potentiation of the intrathoracic negative pressure). BP and heart rate (HR) were measured using continuous finger-pulse photoplethysmography; oxyhaemoglobin saturation with an ear-clip sensor; end-tidal CO2 with a gas analyser; cerebral blood flow velocity (CBFV), pulsatility and resistive indices with Doppler ultrasound. Changes in SAS were recorded with a new method i.e. near-infrared transillumination/backscattering sounding. Wavelet transform analysis was used to assess the BP and SAS oscillations coupling. RESULTS Initiating Mueller manoeuvres evoked cardiac SAS component decline (-17.8%, P<0.001), systolic BP, diastolic BP and HR increase (+6.3%, P<0.001; 6.7%, P<0.001 and +2.3%, P<0.05, respectively). By the end of Mueller manoeuvres, cardiac SAS component and HR did not change (+2.3% and 0.0%, respectively; both not statistically significant), but systolic and diastolic BP was elevated (+12.6% and +8.9%, respectively; both P<0.001). With reference to baseline values there was an evident decrease in wavelet coherence between BP and SAS oscillations at cardiac frequency in the first half of the Mueller manoeuvres (-32.3%, P<0.05 for left hemisphere and -46.0%, P<0.01 for right hemisphere) which was followed by subsequent normalization at end of the procedure (+3.1% for left hemisphere and +23.1% for right hemisphere; both not statistically significant). CONCLUSIONS Increased inspiratory resistance is associated with swings in the cardiac contribution to the dynamic relationship between BP and SAS oscillations. Impaired cardiac performance reported in Mueller manoeuvres may influence the pattern of cerebrospinal fluid pulsatility.
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Affiliation(s)
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne’s University Hospital in Brno (FNUSA), Brno, Czech Republic
| | - Ewa Swierblewska
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Kunicka
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Kamila Mazur
- Department of Biomedical Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Medical University of Gdansk, Gdansk, Poland
| | - Pawel J. Winklewski
- Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland
- Institute of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland
| | | | | | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne’s University Hospital in Brno (FNUSA), Brno, Czech Republic
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Jolly TA, Cooper PS, Rennie JL, Levi CR, Lenroot R, Parsons MW, Michie PT, Karayanidis F. Age-related decline in task switching is linked to both global and tract-specific changes in white matter microstructure. Hum Brain Mapp 2017; 38:1588-1603. [PMID: 27879030 PMCID: PMC6866847 DOI: 10.1002/hbm.23473] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/08/2016] [Accepted: 11/08/2016] [Indexed: 11/11/2022] Open
Abstract
Task-switching performance relies on a broadly distributed frontoparietal network and declines in older adults. In this study, they investigated whether this age-related decline in task switching performance was mediated by variability in global or regional white matter microstructural health. Seventy cognitively intact adults (43-87 years) completed a cued-trials task switching paradigm. Microstructural white matter measures were derived using diffusion tensor imaging (DTI) analyses on the diffusion-weighted imaging (DWI) sequence. Task switching performance decreased with increasing age and radial diffusivity (RaD), a measure of white matter microstructure that is sensitive to myelin structure. RaD mediated the relationship between age and task switching performance. However, the relationship between RaD and task switching performance remained significant when controlling for age and was stronger in the presence of cardiovascular risk factors. Variability in error and RT mixing cost were associated with RaD in global white matter and in frontoparietal white matter tracts, respectively. These findings suggest that age-related increase in mixing cost may result from both global and tract-specific disruption of cerebral white matter linked to the increased incidence of cardiovascular risks in older adults. Hum Brain Mapp 38:1588-1603, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Todd A.D. Jolly
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Patrick S. Cooper
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Jaime L. Rennie
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Christopher R. Levi
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
| | - Rhoshel Lenroot
- Neuroscience Research Australia, University of New South WalesSydneyAustralia
| | - Mark W. Parsons
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleAustralia
| | - Patricia T. Michie
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Brain and Mental Health Research, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of PsychologyUniversity of NewcastleNewcastleAustralia
- Priority Research Centre for Stroke and Brain Injury, University of NewcastleNewcastleAustralia
- Hunter Medical Research InstituteNewcastleAustralia
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Wszedybyl-Winklewska M, Wolf J, Swierblewska E, Kunicka K, Gruszecka A, Gruszecki M, Kucharska W, Winklewski PJ, Zabulewicz J, Guminski W, Pietrewicz M, Frydrychowski AF, Bieniaszewski L, Narkiewicz K. Acute hypoxia diminishes the relationship between blood pressure and subarachnoid space width oscillations at the human cardiac frequency. PLoS One 2017; 12:e0172842. [PMID: 28241026 PMCID: PMC5328277 DOI: 10.1371/journal.pone.0172842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/10/2017] [Indexed: 12/20/2022] Open
Abstract
Background Acute hypoxia exerts strong effects on the cardiovascular system. Heart-generated pulsatile cerebrospinal fluid motion is recognised as a key factor ensuring brain homeostasis. We aimed to assess changes in heart-generated coupling between blood pressure (BP) and subarachnoid space width (SAS) oscillations during hypoxic exposure. Methods Twenty participants were subjected to a controlled decrease in oxygen saturation (SaO2 = 80%) for five minutes. BP and heart rate (HR) were measured using continuous finger-pulse photoplethysmography, oxyhaemoglobin saturation with an ear-clip sensor, end-tidal CO2 with a gas analyser, and cerebral blood flow velocity (CBFV), pulsatility and resistive indices with Doppler ultrasound. Changes in SAS were recorded with a recently-developed method called near-infrared transillumination/backscattering sounding. Wavelet transform analysis was used to assess the relationship between BP and SAS oscillations. Results Gradual increases in systolic, diastolic BP and HR were observed immediately after the initiation of hypoxic challenge (at fifth minute +20.1%, +10.2%, +16.5% vs. baseline, respectively; all P<0.01), whereas SAS remained intact (P = NS). Concurrently, the CBFV was stable throughout the procedure, with the only increase observed in the last two minutes of deoxygenation (at the fifth minute +6.8% vs. baseline, P<0.05). The cardiac contribution to the relationship between BP and SAS oscillations diminished immediately after exposure to hypoxia (at the fifth minute, right hemisphere -27.7% and left hemisphere -26.3% vs. baseline; both P<0.05). Wavelet phase coherence did not change throughout the experiment (P = NS). Conclusions Cerebral haemodynamics seem to be relatively stable during short exposure to normobaric hypoxia. Hypoxia attenuates heart-generated BP SAS coupling.
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Affiliation(s)
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Ewa Swierblewska
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Katarzyna Kunicka
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Agnieszka Gruszecka
- Department of Radiology Informatics and Statistics, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Medical University of Gdansk, Gdansk, Poland
| | - Wieslawa Kucharska
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Pawel J. Winklewski
- Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland
- Institute of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland
| | - Joanna Zabulewicz
- Institute of Human Physiology, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Guminski
- Department of Computer Communications, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Michal Pietrewicz
- Department of Biomedical Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | | | | | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
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Carotid artery stiffness and cognitive function in adults with and without type 2 diabetes: Extracranial contribution to an intracranial problem? Atherosclerosis 2016; 253:268-269. [DOI: 10.1016/j.atherosclerosis.2016.08.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 08/18/2016] [Accepted: 08/25/2016] [Indexed: 12/26/2022]
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Jolly TAD, Cooper PS, Wan Ahmadul Badwi SA, Phillips NA, Rennie JL, Levi CR, Drysdale KA, Parsons MW, Michie PT, Karayanidis F. Microstructural white matter changes mediate age-related cognitive decline on the Montreal Cognitive Assessment (MoCA). Psychophysiology 2015; 53:258-67. [DOI: 10.1111/psyp.12565] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 09/10/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Todd A. D. Jolly
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Patrick S. Cooper
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Syarifah Azizah Wan Ahmadul Badwi
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Department of Psychology, Kulliyyah of IRKHS; International Islamic University Malaysia; Kuala Lumpur Malaysia
| | - Natalie A. Phillips
- Centre for Research in Human Development, Department of Psychology; Concordia University; Montreal Quebec Canada
- Lady Davis Institute for Medical Research; Jewish General Hospital; Montreal Quebec Canada
| | - Jaime L. Rennie
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Christopher R. Levi
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Newcastle Australia
| | - Karen A. Drysdale
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Mark W. Parsons
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
- School of Medicine and Public Health, Faculty of Health and Medicine; University of Newcastle; Newcastle Australia
| | - Patricia T. Michie
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Frini Karayanidis
- Functional Neuroimaging Laboratory, School of Psychology, Faculty of Science & IT; University of Newcastle; Newcastle Australia
- Centre for Brain and Mental Health Research; University of Newcastle; Newcastle Australia
- Hunter Medical Research Institute; Newcastle Australia
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Heffernan KS, Spartano NL, Augustine JA, Lefferts WK, Hughes WE, Mitchell GF, Jorgensen RS, Gump BB. Carotid artery stiffness and hemodynamic pulsatility during cognitive engagement in healthy adults: a pilot investigation. Am J Hypertens 2015; 28:615-22. [PMID: 25384407 DOI: 10.1093/ajh/hpu198] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 09/10/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The matching of vascular supply to neuronal metabolic demand during cognitive engagement is known as neurovascular coupling (NVC). Arterial stiffness is a prominent determinant of pulsatility in the systemic circulation and may thus indirectly impact NVC. In this pilot investigation, we explored changes in carotid artery stiffness and cerebrovascular hemodynamic pulsatiltiy during cognitive engagement in healthy adults. METHODS Twenty-seven adults (age 39 ± 3 years, BMI 24 ± 1 kg/m(2)) underwent Doppler ultrasonography of the common carotid artery (CCA) combined with applanation tonometry to derive (i) CCA elastic modulus (Ep) and β-stiffness index; (ii) CCA flow pulsatility index (PI); (iii) CCA pulse pressure, (iv) CCA augmentation index (AIx). Cerebral PI was assessed using transcranial Doppler at the middle cerebral artery (MCA). All measures were made at rest and during an incongruent Stroop task. RESULTS CCA PI was reduced (1.75 ± 0.06 to 1.57 ± 0.06, P < 0.05) while MCA PI was unchanged (0.75 ± 0.02 to 0.75 ± 0.02, P > 0.05) during Stroop. Brachial pulse pressure increased during Stroop (43 ± 1 to 46 ± 1 mm Hg, P < 0.05) while CCA pulse pressure was unchanged (36 ± 1 to 35 ± 1 mm Hg, P > 0.05). Similarly, CCA Ep (54.5 ± 5.5 to 53.8 ± 4.9 kPa, P > 0.05) and β-stiffness index (4.4 ± 0.4 to 4.2 ± 0.3 aU, P > 0.05) were unchanged. CCA AIx increased (1 ± 4 to 13 ± 4%, P < 0.05). CONCLUSION Carotid pressure pulsatility is unaltered while carotid flow pulsatility is reduced during cognitive engagement. Carotid artery stiffness does not change suggesting that factors other than the dynamic elastic properties of the CCA buffer cerebrovascular hemodynamic pulsatility during cognitive engagement.
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Affiliation(s)
- Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA;
| | - Nicole L Spartano
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
| | | | - Wesley K Lefferts
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
| | - William E Hughes
- Department of Exercise Science, Syracuse University, Syracuse, New York, USA
| | - Gary F Mitchell
- Cardiovascular Engineering, Inc., Norwood, Massachusetts, USA
| | | | - Brooks B Gump
- Department of Public Health, Syracuse University, Syracuse, New York, USA
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Beggs CB, Magnano C, Shepherd SJ, Belov P, Ramasamy DP, Hagemeier J, Zivadinov R. Dirty-Appearing White Matter in the Brain is Associated with Altered Cerebrospinal Fluid Pulsatility and Hypertension in Individuals without Neurologic Disease. J Neuroimaging 2015; 26:136-43. [DOI: 10.1111/jon.12249] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/04/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Clive B. Beggs
- Centre for Infection Control and Biophysics; University of Bradford; Bradford UK
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Christopher Magnano
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Simon J. Shepherd
- Centre for Infection Control and Biophysics; University of Bradford; Bradford UK
| | - Pavel Belov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Deepa P. Ramasamy
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Jesper Hagemeier
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
| | - Robert Zivadinov
- Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo; Buffalo NY
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Lefferts WK, Hughes WE, Heffernan KS. Effect of acute high-intensity resistance exercise on optic nerve sheath diameter and ophthalmic artery blood flow pulsatility. J Hum Hypertens 2015; 29:744-8. [PMID: 25739332 DOI: 10.1038/jhh.2015.12] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 01/02/2015] [Accepted: 01/19/2015] [Indexed: 11/09/2022]
Abstract
Exertional hypertension associated with acute high-intensity resistance exercise (RE) increases both intravascular and intracranial pressure (ICP), maintaining cerebrovascular transmural pressure. Carotid intravascular pressure pulsatility remains elevated after RE. Whether ICP also remains elevated after acute RE in an attempt to maintain the vessel wall transmural pressure is unknown. Optic nerve sheath diameter (ONSD), a valid proxy of ICP, was measured in 20 participants (6 female; 24 ± 4 yr, 24.2 ± 3.9 kg m(-)(2)) at rest (baseline), following a time-control condition, and following RE (5 sets, 5 repetition maximum bench press, 5 sets 10 repetition maximum biceps curls) using ultrasound. Additionally, intracranial hemodynamic pulsatility index (PI) was assessed in the ophthalmic artery (OA) by using Doppler. Aortic pulse wave velocity (PWV) was obtained from synthesized aortic pressure waveforms obtained via a brachial oscillometric cuff and carotid pulse pressure was measured by using applanation tonometry. Aortic PWV (5.2 ± 0.5-6.0 ± 0.7 m s(-1), P < 0.05) and carotid pulse pressure (45 ± 17-59 ± 19 mm Hg, P < 0.05) were significantly elevated post RE compared with baseline. There were no significant changes in ONSD (5.09 ± 0.7-5.09 ± 0.7 mm, P > 0.05) or OA flow PI (1.35 ± 0.2-1.38 ± 0.3, P > 0.05) following acute RE. In conclusion, during recovery from acute high-intensity RE, there are increases in aortic stiffness and extracranial pressure pulsatility in the absence of changes in ICP and flow pulsatility. These findings may have implications for alterations in cerebral transmural pressure and cerebral aneurysmal wall stress following RE.
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Affiliation(s)
- W K Lefferts
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - W E Hughes
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
| | - K S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, USA
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44
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Lefferts WK, Augustine JA, Heffernan KS. Effect of acute resistance exercise on carotid artery stiffness and cerebral blood flow pulsatility. Front Physiol 2014; 5:101. [PMID: 24678301 PMCID: PMC3958641 DOI: 10.3389/fphys.2014.00101] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/28/2014] [Indexed: 01/27/2023] Open
Abstract
Arterial stiffness is associated with cerebral flow pulsatility. Arterial stiffness increases following acute resistance exercise (RE). Whether this acute RE-induced vascular stiffening affects cerebral pulsatility remains unknown. Purpose: To investigate the effects of acute RE on common carotid artery (CCA) stiffness and cerebral blood flow velocity (CBFv) pulsatility. Methods: Eighteen healthy men (22 ± 1 yr; 23.7 ± 0.5 kg·m−2) underwent acute RE (5 sets, 5-RM bench press, 5 sets 10-RM bicep curls with 90 s rest intervals) or a time control condition (seated rest) in a randomized order. CCA stiffness (β-stiffness, Elastic Modulus (Ep)) and hemodynamics (pulsatility index, forward wave intensity, and reflected wave intensity) were assessed using a combination of Doppler ultrasound, wave intensity analysis and applanation tonometry at baseline and 3 times post-RE. CBFv pulsatility index was measured with transcranial Doppler at the middle cerebral artery (MCA). Results: CCA β-stiffness, Ep and CCA pulse pressure significantly increased post-RE and remained elevated throughout post-testing (p < 0.05). No changes in MCA or CCA pulsatility index were observed (p > 0.05). There were significant increases in forward wave intensity post-RE (p < 0.05) but not reflected wave intensity (p > 0.05). Conclusion: Although acute RE increases CCA stiffness and pressure pulsatility, it does not affect CCA or MCA flow pulsatility. Increases in pressure pulsatility may be due to increased forward wave intensity and not pressure from wave reflections.
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Affiliation(s)
- Wesley K Lefferts
- Department of Exercise Science, Syracuse University Syracuse, NY, USA
| | | | - Kevin S Heffernan
- Department of Exercise Science, Syracuse University Syracuse, NY, USA
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