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Desrosiers J, Caron-Desrochers L, René A, Gaudet I, Pincivy A, Paquette N, Gallagher A. Functional connectivity development in the prenatal and neonatal stages measured by functional magnetic resonance imaging: A systematic review. Neurosci Biobehav Rev 2024; 163:105778. [PMID: 38936564 DOI: 10.1016/j.neubiorev.2024.105778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/28/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
The prenatal and neonatal periods are two of the most important developmental stages of the human brain. It is therefore crucial to understand normal brain development and how early connections are established during these periods, in order to advance the state of knowledge on altered brain development and eventually identify early brain markers of neurodevelopmental disorders and diseases. In this systematic review (Prospero ID: CRD42024511365), we compiled resting state functional magnetic resonance imaging (fMRI) studies in healthy fetuses and neonates, in order to outline the main characteristics of typical development of the functional brain connectivity during the prenatal and neonatal periods. A systematic search of five databases identified a total of 12 573 articles. Of those, 28 articles met pre-established selection criteria based determined by the authors after surveying and compiling the major limitations reported within the literature. Inclusion criteria were: (1) resting state studies; (2) presentation of original results; (3) use of fMRI with minimum one Tesla; (4) a population ranging from 20 weeks of GA to term birth (around 37-42 weeks of PMA); (5) singleton pregnancy with normal development (absence of any complications known to alter brain development). Exclusion criteria were: (1) preterm studies; (2) post-mortem studies; (3) clinical or pathological studies; (4) twin studies; (5) papers with a sole focus on methodology (i.e. focused on tool and analysis development); (6) volumetric studies; (7) activation map studies; (8) cortical analysis studies; (9) conference papers. A risk of bias assessment was also done to evaluate each article's methodological rigor. 1877 participants were included across all the reviewed articles. Results consistently revealed a developmental gradient of increasing functional brain connectivity from posterior to anterior regions and from proximal-to-distal regions. A decrease in local small-world organization shortly after birth was also observed; small-world characteristics were present in fetuses and newborns, but appeared weaker in the latter group. Also, the posterior-to-anterior gradient could be associated with earlier development of the sensorimotor networks in the posterior regions while more complex higher-order networks (e.g. attention-related) mature later in the anterior regions. The main limitations of this systematic review stem from the inherent limitations of functional imaging in fetuses, mainly: unevenly distributed populations and limited sample sizes; fetal movements in the womb and other imaging obstacles; and a large voxel resolution when imaging a small brain. Another limitation specific to this review is the relatively small number of included articles compared to very a large search result, which may have led to relevant articles having been overlooked.
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Affiliation(s)
- Jérémi Desrosiers
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; School of Psychoeducation, University of Montreal, QC, Canada
| | - Laura Caron-Desrochers
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; Department of Psychology, University of Montreal, QC, Canada
| | - Andréanne René
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; Department of Psychology, University of Montreal, QC, Canada
| | - Isabelle Gaudet
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; Department of Health Sciences, Université du Québec à Chicoutimi, QC, Canada
| | - Alix Pincivy
- Sainte-Justine University Health Center and Research Center Libraries, Montreal, QC, Canada
| | - Natacha Paquette
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; Department of Psychology, University of Montreal, QC, Canada
| | - Anne Gallagher
- Neurodevelopmental Optical Imaging Laboratory (LIONLAB), Sainte-Justine University Hospital Research Center, Montreal, QC, Canada; Department of Psychology, University of Montreal, QC, Canada.
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Zhao Y, Zhang J, Yu H, Hou X, Zhang J. Noninvasive microvascular imaging in newborn rats using high-frequency ultrafast ultrasound. Neuroimage 2024; 297:120738. [PMID: 39009248 DOI: 10.1016/j.neuroimage.2024.120738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024] Open
Abstract
Ultrasound imaging stands as the predominant modality for neonatal health assessment, with recent advancements in ultrafast Doppler (μDoppler) technology offering significant promise in fields such as neonatal brain imaging. Combining μDoppler with high-frequency ultrasound (HF-μDoppler) presents a potential efficient avenue to enhance in vivo microvascular imaging in small animals, notably newborn rats, a crucial preclinical animal model for neonatal disease and development research. It is necessary to verify the imaging performance of HF-μDoppler in preclinical trials. This study investigates the microvascular imaging capabilities of HF-μDoppler using a 30 MHz high-frequency linear array probe in newborn rats. Results demonstrate the clarity of cerebral microvascular imaging in rats aged 1 to 7 postnatal days, extending to whole-body microvascular imaging, encompassing the central nervous system, including the brain and spinal cord. In conclusion, HF-μDoppler technology emerges as a reliable imaging tool, offering a new perspective for preclinical investigations into neonatal diseases and development.
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Affiliation(s)
- Yunlong Zhao
- Department of Pediatrics, Peking University First Hospital, Beijing, China; Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Jiabin Zhang
- College of Future Technology, Peking University, Beijing, China.
| | - Hao Yu
- College of Engineering, Peking University, Beijing, China
| | - Xinlin Hou
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; College of Engineering, Peking University, Beijing, China
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Ladthavorlaphatt K, Surti FBS, Beishon LC, Robinson TG, Panerai RB. Depression of dynamic cerebral autoregulation during neural activation: The role of responders and non-responders. J Cereb Blood Flow Metab 2024; 44:1231-1245. [PMID: 38301726 PMCID: PMC11179612 DOI: 10.1177/0271678x241229908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 02/03/2024]
Abstract
Neurovascular coupling (NVC) interaction with dynamic cerebral autoregulation (dCA) remains unclear. We investigated the effect of task complexity and duration on the interaction with dCA. Sixteen healthy participants (31.6 ± 11.6 years) performed verbal fluency (naming-words (NW)) and serial subtraction (SS) paradigms, of varying complexity, at durations of 05, 30 and 60 s. The autoregulation index (ARI), was estimated from the bilateral middle cerebral artery blood velocity (MCAv) step response, calculated by transfer function analysis (TFA), for each paradigm during unstimulated (2 min) and neuroactivated (1 min) segments. Intraclass correlation (ICC) and coefficient of variation (CV) determined reproducibility for two visits and objective criteria were applied to classify responders (R) and non-responders (NoR) to task-induced MCAv increase. ICC values demonstrated fair reproducibility in all tasks. ARI decreased in right (RH) and left (LH) hemispheres, irrespective of paradigm complexity and duration (p < 0.0001). Bilateral ARI estimates were significantly decreased during NW for the R group only (p < 0.0001) but were reduced in both R (p < 0.0001) and NoR (p = 0.03) groups for SS tasks compared with baseline. The reproducible attenuation of dCA efficiency due to paradigm-induced NVC response, its interaction, and different behaviour in R and NoR, warrant further research in different physiological and clinical conditions.
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Affiliation(s)
- Kannaphob Ladthavorlaphatt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- Medical Diagnostics Unit, Thammasat University Hospital, Thammasat University, Pathum Thani, Thailand
- Thammasat University Centre of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Pathum Thani, Thailand
| | - Farhaana BS Surti
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Lucy C Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
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Chock VY, Vesoulis ZA, El-Dib M, Austin T, van Bel F. The Future of Neonatal Cerebral Oxygenation Monitoring: Directions After the SafeBoosC-III Trial. J Pediatr 2024; 270:114016. [PMID: 38492916 DOI: 10.1016/j.jpeds.2024.114016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/18/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Affiliation(s)
- Valerie Y Chock
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, CA.
| | | | - Mohamed El-Dib
- Division of Newborn Medicine, Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Topun Austin
- Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Frank van Bel
- Department of Neonatology, University Medical Center Utrecht, Utrecht, The Netherlands
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Deery HA, Liang E, Di Paolo R, Voigt K, Murray G, Siddiqui MN, Egan GF, Moran C, Jamadar SD. The association of regional cerebral blood flow and glucose metabolism in normative ageing and insulin resistance. Sci Rep 2024; 14:14574. [PMID: 38914735 PMCID: PMC11196590 DOI: 10.1038/s41598-024-65396-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
Rising rates of insulin resistance and an ageing population are set to exact an increasing toll on individuals and society. Here we examine the contribution of age and insulin resistance to the association of cerebral blood flow and glucose metabolism; both critical process in the supply of energy for the brain. Thirty-four younger (20-42 years) and 41 older (66-86 years) healthy adults underwent a simultaneous resting state MR/PET scan, including arterial spin labelling. Rates of cerebral blood flow and glucose metabolism were derived using a functional atlas of 100 brain regions. Older adults had lower cerebral blood flow than younger adults in 95 regions, reducing to 36 regions after controlling for cortical atrophy and blood pressure. Lower cerebral blood flow was also associated with worse working memory and slower reaction time in tasks requiring cognitive flexibility and response inhibition. Younger and older insulin sensitive adults showed small, negative correlations between relatively high rates of regional cerebral blood flow and glucose metabolism. This pattern was inverted in insulin resistant older adults, who showed hypoperfusion and hypometabolism across the cortex, and a positive correlation. In insulin resistant younger adults, the association showed inversion to positive correlations, although not to the extent seen in older adults. Our findings suggest that the normal course of ageing and insulin resistance alter the rates of and associations between cerebral blood flow and glucose metabolism. They underscore the criticality of insulin sensitivity to brain health across the adult lifespan.
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Affiliation(s)
- Hamish A Deery
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia.
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia.
| | - Emma Liang
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - Robert Di Paolo
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - Katharina Voigt
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - Gerard Murray
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - M Navyaan Siddiqui
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - Gary F Egan
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia
| | - Chris Moran
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Sharna D Jamadar
- School of Psychological Sciences, Monash University, Wellington Rd, Melbourne, 3800, Australia.
- Monash Biomedical Imaging, Monash University, 770 Blackburn Rd, Melbourne, 3800, Australia.
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Iorga RE, Costin D, Munteanu-Dănulescu RS, Rezuș E, Moraru AD. Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease. J Pers Med 2024; 14:501. [PMID: 38793083 PMCID: PMC11122007 DOI: 10.3390/jpm14050501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular changes in a non-invasive way, fundus images can be taken and analysed. The central retinal arteriolar (CRAE), the venular (CRVE) diameter and the arteriolar-to-venular diameter ratio (AVR) can be used as biomarkers to predict the cardiovascular mortality. A narrower CRAE, wider CRVE and a lower AVR have been associated with increased cardiovascular events. Dynamic retinal vessel analysis (DRVA) allows the quantification of retinal changes using digital image sequences in response to visual stimulation with flicker light. This article is not just a review of the current literature, it also aims to discuss the methodological benefits and to identify research gaps. It highlights the potential use of microvascular biomarkers for screening and treatment monitoring of cardiovascular disease. Artificial intelligence (AI), such as Quantitative Analysis of Retinal vessel Topology and size (QUARTZ), and SIVA-deep learning system (SIVA-DLS), seems efficient in extracting information from fundus photographs and has the advantage of increasing diagnosis accuracy and improving patient care by complementing the role of physicians. Retinal vascular imaging using AI may help identify the cardiovascular risk, and is an important tool in primary cardiovascular disease prevention. Further research should explore the potential clinical application of retinal microvascular biomarkers, in order to assess systemic vascular health status, and to predict cardiovascular events.
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Affiliation(s)
- Raluca Eugenia Iorga
- Department of Surgery II, Discipline of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, Strada Universitatii No. 16, 700115 Iași, Romania; (R.E.I.); (A.D.M.)
| | - Damiana Costin
- Doctoral School, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | | | - Elena Rezuș
- Department of Internal Medicine II, Discipline of Reumathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Andreea Dana Moraru
- Department of Surgery II, Discipline of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, Strada Universitatii No. 16, 700115 Iași, Romania; (R.E.I.); (A.D.M.)
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Shahdadian S, Wang X, Liu H. Directed physiological networks in the human prefrontal cortex at rest and post transcranial photobiomodulation. Sci Rep 2024; 14:10242. [PMID: 38702415 PMCID: PMC11068774 DOI: 10.1038/s41598-024-59879-7] [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] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
Cerebral infra-slow oscillation (ISO) is a source of vasomotion in endogenic (E; 0.005-0.02 Hz), neurogenic (N; 0.02-0.04 Hz), and myogenic (M; 0.04-0.2 Hz) frequency bands. In this study, we quantified changes in prefrontal concentrations of oxygenated hemoglobin (Δ[HbO]) and redox-state cytochrome c oxidase (Δ[CCO]) as hemodynamic and metabolic activity metrics, and electroencephalogram (EEG) powers as electrophysiological activity, using concurrent measurements of 2-channel broadband near-infrared spectroscopy and EEG on the forehead of 22 healthy participants at rest. After preprocessing, the multi-modality signals were analyzed using generalized partial directed coherence to construct unilateral neurophysiological networks among the three neurophysiological metrics (with simplified symbols of HbO, CCO, and EEG) in each E/N/M frequency band. The links in these networks represent neurovascular, neurometabolic, and metabolicvascular coupling (NVC, NMC, and MVC). The results illustrate that the demand for oxygen by neuronal activity and metabolism (EEG and CCO) drives the hemodynamic supply (HbO) in all E/N/M bands in the resting prefrontal cortex. Furthermore, to investigate the effect of transcranial photobiomodulation (tPBM), we performed a sham-controlled study by delivering an 800-nm laser beam to the left and right prefrontal cortex of the same participants. After performing the same data processing and statistical analysis, we obtained novel and important findings: tPBM delivered on either side of the prefrontal cortex triggered the alteration or reversal of directed network couplings among the three neurophysiological entities (i.e., HbO, CCO, and EEG frequency-specific powers) in the physiological network in the E and N bands, demonstrating that during the post-tPBM period, both metabolism and hemodynamic supply drive electrophysiological activity in directed network coupling of the prefrontal cortex (PFC). Overall, this study revealed that tPBM facilitates significant modulation of the directionality of neurophysiological networks in electrophysiological, metabolic, and hemodynamic activities.
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Affiliation(s)
- Sadra Shahdadian
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Xinlong Wang
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Hanli Liu
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA.
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Notte C, Alionte C, Strubakos CD. The efficacy and methodology of using near-infrared spectroscopy to determine resting-state brain networks. J Neurophysiol 2024; 131:668-677. [PMID: 38416714 DOI: 10.1152/jn.00357.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024] Open
Abstract
Functional connectivity is a critical aspect of brain function and is essential for understanding, diagnosing, and treating neurological and psychiatric disorders. It refers to the synchronous activity between different regions of the brain, which gives rise to communication and information processing. Resting-state functional connectivity is a subarea of study that allows researchers to examine brain activity in the absence of a task or stimulus. This can provide insight into the brain's intrinsic functional architecture and help identify neural networks that are active during rest. Thus, determining functional connectivity topography is valuable both clinically and in research. Traditional methods using functional magnetic resonance imaging have proven to be effective, however, they have their limitations. In this review, we investigate the feasibility of using functional near-infrared spectroscopy (fNIRS) as a low-cost, portable alternative for measuring functional connectivity. We first establish fNIRS' ability to detect localized brain activity during task-based experiments. Next, we verify its use in resting-state studies with results showing a high degree of correspondence with resting-state functional magnetic resonance imaging (rs-fMRI). Also discussed are various data-processing methods and the validity of filtering the global signal, which is the current standard for analysis. We consider the possible origins of the global signal, if it contains pertinent neuronal information that could be of importance in better understanding neuronal networks, and what we believe is the best method of approaching signal analysis and regression.
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Affiliation(s)
- Christian Notte
- Department of Physics, University of Windsor, Windsor, Ontario, Canada
| | - Caroline Alionte
- Department of Physics, University of Windsor, Windsor, Ontario, Canada
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Dourandeesh M, Akbari M, Pourramzani A, Alizadeh Y, Leili EK, Shemshadi AH, Mohammadi-Manesh G. The association between the severity of diabetic retinopathy and cognitive impairment: a cross-sectional study. Int Ophthalmol 2024; 44:30. [PMID: 38329590 DOI: 10.1007/s10792-024-03022-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To assess the correlation among cognitive impairment (CI) and the degree of diabetic retinopathy (DR). METHODS The current analytic cross-sectional study has been carried out on two hundred ten individuals having diabetes mellitus type 2. Individuals were split into 7 groups in order of severity of DR in the worse eye with 30 cases in each group. Cognition function has been determined utilizing mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) tests. RESULTS Comparing the severity of CI using both MMSE and MoCA tests, statistically substantial differences have been discovered among individuals without DR, those having non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) (p < 0.001). The greatest percentage of severe and moderate CI was seen in the PDR group. Regarding the severity of CI, there has been a statistically substantial difference among NPDR and PDR groups, as well as among no-DR and PDR groups (p < 0.001). Moreover, the severity of CI in the MMSE and MoCA tests had a negative connection with the grades of DR (r = - 0.522, P < 0.001 and r = - 0.540, P < 0.001, respectively). CONCLUSION We discovered a negative connection between the grades of DR and the severity of CI that persisted as a significant finding, showing that patients with more severe DR tended to have higher levels of CI. These results might offer retinal examination or retinal photography as a promising strategy for mass screening of CI in diabetic patients, especially if it is combined with artificial intelligence and telemedicine.
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Affiliation(s)
- Maryam Dourandeesh
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Mitra Akbari
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran.
| | - Ali Pourramzani
- Department of Psychiatry, Kavosh Cognitive Behavior Sciences and Addiction Research Center, School of Medicine, Guilan University of Medical Science, Rasht, Iran
| | - Yousef Alizadeh
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Ehsan Kazemnezhad Leili
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Amir Hossein Shemshadi
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran
| | - Ghazaleh Mohammadi-Manesh
- Department of Eye, Eye Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Science, Rasht, Iran
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Danielescu C, Dabija MG, Nedelcu AH, Lupu VV, Lupu A, Ioniuc I, Gîlcă-Blanariu GE, Donica VC, Anton ML, Musat O. Automated Retinal Vessel Analysis Based on Fundus Photographs as a Predictor for Non-Ophthalmic Diseases-Evolution and Perspectives. J Pers Med 2023; 14:45. [PMID: 38248746 PMCID: PMC10817503 DOI: 10.3390/jpm14010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
The study of retinal vessels in relation to cardiovascular risk has a long history. The advent of a dedicated tool based on digital imaging, i.e., the retinal vessel analyzer, and also other software such as Integrative Vessel Analysis (IVAN), Singapore I Vessel Assessment (SIVA), and Vascular Assessment and Measurement Platform for Images of the Retina (VAMPIRE), has led to the accumulation of a formidable body of evidence regarding the prognostic value of retinal vessel analysis (RVA) for cardiovascular and cerebrovascular disease (including arterial hypertension in children). There is also the potential to monitor the response of retinal vessels to therapies such as physical activity or bariatric surgery. The dynamic vessel analyzer (DVA) remains a unique way of studying neurovascular coupling, helping to understand the pathogenesis of cerebrovascular and neurodegenerative conditions and also being complementary to techniques that measure macrovascular dysfunction. Beyond cardiovascular disease, retinal vessel analysis has shown associations with and prognostic value for neurological conditions, inflammation, kidney function, and respiratory disease. Artificial intelligence (AI) (represented by algorithms such as QUantitative Analysis of Retinal vessel Topology and siZe (QUARTZ), SIVA-DLS (SIVA-deep learning system), and many others) seems efficient in extracting information from fundus photographs, providing prognoses of various general conditions with unprecedented predictive value. The future challenges will be integrating RVA and other qualitative and quantitative risk factors in a unique, comprehensive prediction tool, certainly powered by AI, while building the much-needed acceptance for such an approach inside the medical community and reducing the "black box" effect, possibly by means of saliency maps.
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Affiliation(s)
- Ciprian Danielescu
- Department of Ophthalmology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Marius Gabriel Dabija
- Department of Surgery II, Discipline of Neurosurgery, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Alin Horatiu Nedelcu
- Department of Morpho-Functional Sciences I, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Vasile Valeriu Lupu
- Department of Pediatrics, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (V.V.L.); (I.I.)
| | - Ancuta Lupu
- Department of Pediatrics, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (V.V.L.); (I.I.)
| | - Ileana Ioniuc
- Department of Pediatrics, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (V.V.L.); (I.I.)
| | | | - Vlad-Constantin Donica
- Doctoral School, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (V.-C.D.); (M.-L.A.)
| | - Maria-Luciana Anton
- Doctoral School, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (V.-C.D.); (M.-L.A.)
| | - Ovidiu Musat
- Department of Ophthalmology, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucuresti, Romania;
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Chen Y, Fei X, Liu G, Li X, Huang L, Yang LZ, Li Y, Xu B, Fang W. P-Glycoprotein Exacerbates Brain Injury Following Experimental Cerebral Ischemia by Promoting Proinflammatory Microglia Activation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:6916819. [PMID: 38144707 PMCID: PMC10748718 DOI: 10.1155/2023/6916819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/02/2023] [Accepted: 11/24/2023] [Indexed: 12/26/2023]
Abstract
Microglia are activated following cerebral ischemic insult. P-glycoprotein (P-gp) is an efflux transporter on microvascular endothelial cells and upregulated after cerebral ischemia. This study evaluated the effects and possible mechanisms of P-gp on microglial polarization/activation in mice after ischemic stroke. P-gp-specific siRNA and adeno-associated virus (p-AAV) were used to silence and overexpress P-gp, respectively. Middle cerebral artery occlusion/reperfusion (MCAO/R) and oxygen-glucose deprivation/reoxygenation (OGD/R) were performed in mice and cerebral microvascular endothelial cells (bEnd.3) in vitro, respectively. OGD/R-injured bEnd.3 cells were cocultured with mouse microglial cells (BV2) in Transwell. Influences on acute ischemic stroke outcome, the expression of inflammatory cytokines, and chemokines and chemokines receptors, microglial polarization, glucocorticoid receptor (GR) nuclear translocation, and GR-mediated mRNA decay (GMD) activation were evaluated via reverse transcription real-time polymerase chain reaction, western blot, or immunofluorescence. Silencing P-gp markedly alleviated experimental ischemia injury as indicated by reduced cerebral infarct size, improved neurological deficits, and reduced the expression of interleukin-6 (IL-6) and IL-12 expression. Silencing P-gp also mitigated proinflammatory microglial polarization and the expression of C-C motif chemokine ligand 2 (CCL2) and its receptor CCR2 expression, whereas promoted anti-inflammatory microglia polarization. Additionally, P-gp silencing promoted GR nuclear translocation and the expression of GMD relative proteins in endothelial cells. Conversely, overexpressing P-gp via p-AAV transfection offset all these effects. Furthermore, silencing endothelial GR counteracted all effects mediated by silencing or overexpressing P-gp. Elevated P-gp expression aggravated inflammatory response and brain damage after ischemic stroke by augmenting proinflammatory microglial polarization in association with increased endothelial CCL2 release due to GMD inhibition by P-gp.
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Affiliation(s)
- Yan Chen
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Xuan Fei
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Ge Liu
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Xiang Li
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Liangliang Huang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Lele Zixin Yang
- Penn State University, University Park, State College, PA 16802, USA
| | - Yunman Li
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
| | - Baohui Xu
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Weirong Fang
- State Key Laboratory of Natural Medicines, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
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Xie H, Li X, Xu G, Huo C, Fan Y, Li Z, Dou Z. Effects of transcranial magnetic stimulation on dynamic functional networks in stroke patients as assessed by functional near-infrared spectroscopy: a randomized controlled clinical trial. Cereb Cortex 2023; 33:11668-11678. [PMID: 37885140 DOI: 10.1093/cercor/bhad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Studies have shown that there is heterogeneity in the efficacy bewteen the low-frequency (LF) and high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS), but the neural mechanisms underlying the differences in efficacy remain unclear. This study aimed to investigate the specific effects of LF- and HF-rTMS on cortial functional network and the process of neural regulation. A total of sixty-eight patients with hemiplegic motor impairment after stroke were randomly allocated to one of three groups: the LF-rTMS, HF-rTMS, and sham groups. Tissue concentrations of oxyhaemoglobin and deoxyhaemoglobin oscillations in cerebral cortex regions were measured by functional near-infrared spectroscopy (fNIRS) in the resting and rTMS states. Four specific time-windows were divided from the trial duration to observe dynamic changes in cortical haemodynamic responses. Compared with sham, LF-rTMS significantly induced the activation of the contralesional superior frontal cortex and premotor cortex, and continuously regulated ipsilesional hemisphere functional networks in stroke patients. However, HF-rTMS did not induce a significant neurovascular coupling response. Our study provided evidence that LF- and HF-rTMS interventions induced different neurovascular coupling responses and demonstrated the cortical functional network change process of rTMS in specific time-windows. These findings may help to understand the differences in the efficacy of rTMS modalities.
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Affiliation(s)
- Hui Xie
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100086, China
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
| | - Xin Li
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Gongcheng Xu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100086, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
| | - Congcong Huo
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100086, China
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100086, China
| | - Zengyong Li
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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Ando S, Tsukamoto H, Stacey BS, Washio T, Owens TS, Calverley TA, Fall L, Marley CJ, Iannetelli A, Hashimoto T, Ogoh S, Bailey DM. Acute hypoxia impairs posterior cerebral bioenergetics and memory in man. Exp Physiol 2023; 108:1516-1530. [PMID: 37898979 PMCID: PMC10988469 DOI: 10.1113/ep091245] [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: 04/06/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
Hypoxia has the potential to impair cognitive function; however, it is still uncertain which cognitive domains are adversely affected. We examined the effects of acute hypoxia (∼7 h) on central executive (Go/No-Go) and non-executive (memory) tasks and the extent to which impairment was potentially related to regional cerebral blood flow and oxygen delivery (CDO2 ). Twelve male participants performed cognitive tasks following 0, 2, 4 and 6 h of passive exposure to both normoxia and hypoxia (12% O2 ), in a randomized block cross-over single-blinded design. Middle cerebral artery (MCA) and posterior cerebral artery (PCA) blood velocities and corresponding CDO2 were determined using bilateral transcranial Doppler ultrasound. In hypoxia, MCA DO2 was reduced during the Go/No-Go task (P = 0.010 vs. normoxia, main effect), and PCA DO2 was attenuated during memorization (P = 0.005 vs. normoxia) and recall components (P = 0.002 vs. normoxia) in the memory task. The accuracy of the memory task was also impaired in hypoxia (P = 0.049 vs. normoxia). In contrast, hypoxia failed to alter reaction time (P = 0.19 vs. normoxia) or accuracy (P = 0.20 vs. normoxia) during the Go/No-Go task, indicating that selective attention and response inhibition were preserved. Hypoxia did not affect cerebral blood flow or corresponding CDO2 responses to cognitive activity (P > 0.05 vs. normoxia). Collectively, these findings highlight the differential sensitivity of cognitive domains, with memory being selectively vulnerable in hypoxia. NEW FINDINGS: What is the central question of this study? We sought to examine the effects of acute hypoxia on central executive (selective attention and response inhibition) and non-executive (memory) performance and the extent to which impairments are potentially related to reductions in regional cerebral blood flow and oxygen delivery. What is the main finding and its importance? Memory was impaired in acute hypoxia, and this was accompanied by a selective reduction in posterior cerebral artery oxygen delivery. In contrast, selective attention and response inhibition remained well preserved. These findings suggest that memory is selectively vulnerable to hypoxia.
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Affiliation(s)
- Soichi Ando
- Graduate School of Informatics and EngineeringThe University of Electro‐CommunicationsTokyoJapan
| | - Hayato Tsukamoto
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
- Faculty of Sports ScienceWaseda UniversitySaitamaJapan
| | - Benjamin S. Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Takuro Washio
- Department of Biomedical EngineeringToyo UniversityKawagoeSaitamaJapan
| | - Thomas S. Owens
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Thomas A. Calverley
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Lewis Fall
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Christopher J. Marley
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | - Angelo Iannetelli
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
| | | | - Shigehiko Ogoh
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
- Department of Biomedical EngineeringToyo UniversityKawagoeSaitamaJapan
| | - Damian M. Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
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Yang CM, Shin J, Kim JI, Lim YB, Park SH, Kim BN. Classifying Children with ADHD Based on Prefrontal Functional Near-infrared Spectroscopy Using Machine Learning. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:693-700. [PMID: 37859442 PMCID: PMC10591175 DOI: 10.9758/cpn.22.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 10/21/2023]
Abstract
Objective : Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adults characterized by cognitive and emotional self-control deficiencies. Previous functional near-infrared spectroscopy (fNIRS) studies found significant group differences between ADHD children and healthy controls during cognitive flexibility tasks in several brain regions. This study aims to apply a machine learning approach to identify medication-naive ADHD patients and healthy control (HC) groups using task-based fNIRS data. Methods : fNIRS signals from 33 ADHD children and 39 HC during the Stroop task were analyzed. In addition, regularized linear discriminant analysis (RLDA) was used to identify ADHD individuals from healthy controls, and classification performance was evaluated. Results : We found that participants can be correctly classified in RLDA leave-one-out cross validation, with a sensitivity of 0.67, specificity of 0.93, and accuracy of 0.82. Conclusion : RLDA using only fNIRS data can effectively discriminate children with ADHD from HC. This study suggests the potential utility of the fNIRS signal as a diagnostic biomarker for ADHD children.
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Affiliation(s)
- Chan-Mo Yang
- Department of Psychiatry, Wonkwang University School of Medicine, Iksan, Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jaeyoung Shin
- Department of Electronic Engineering, Wonkwang University, Iksan, Korea
| | | | - You Bin Lim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - So Hyun Park
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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15
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Shahdadian S, Wang X, Liu H. Directed physiological networks in the human prefrontal cortex at rest and post transcranial photobiomodulation. RESEARCH SQUARE 2023:rs.3.rs-3393702. [PMID: 37886539 PMCID: PMC10602070 DOI: 10.21203/rs.3.rs-3393702/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Cerebral infra-slow oscillation (ISO) is a source of vasomotion in endogenic (E; 0.005-0.02 Hz), neurogenic (N; 0.02-0.04 Hz), and myogenic (M; 0.04-0.2 Hz) frequency bands. In this study, we quantified changes in prefrontal concentrations of oxygenated hemoglobin ( Δ [ H b O ] ) and redox-state cytochrome c oxidase ( Δ [ C C O ] ) as hemodynamic and metabolic activity metrics, and electroencephalogram (EEG) powers as electrophysiological activity, using concurrent measurements of 2-channel broadband near-infrared spectroscopy and EEG on the forehead of 22 healthy participants at rest. After preprocessing, the multi-modality signals were analyzed using generalized partial directed coherence to construct unilateral neurophysiological networks among the three neurophysiological metrics (with simplified symbols of HbO, CCO, and EEG) in each E/N/M frequency band. The links in these networks represent neurovascular, neurometabolic, and metabolicvascular coupling (NVC, NMC, and MVC). The results illustrate that the demand for oxygen by neuronal activity and metabolism (EEG and CCO) drives the hemodynamic supply (HbO) in all E/N/M bands in the resting prefrontal cortex. Furthermore, to investigate the effect of transcranial photobiomodulation (tPBM), we performed a sham-controlled study by delivering an 800-nm laser beam to the left and right prefrontal cortex of the same participants. After performing the same data processing and statistical analysis, we obtained novel and important findings: tPBM delivered on either side of the prefrontal cortex triggered the alteration or reversal of directed network couplings among the three neurophysiological entities (i.e., HbO, CCO, and EEG frequency-specific powers) in the physiological network in the E and N bands, demonstrating that during the post-tPBM period, both metabolism and hemodynamic supply drive electrophysiological activity in directed network coupling of the PFC. Overall, this study revealed that tPBM facilitates significant modulation of the directionality of neurophysiological networks in electrophysiological, metabolic, and hemodynamic activities.
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16
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Sanicola HW, Stewart CE, Luther P, Yabut K, Guthikonda B, Jordan JD, Alexander JS. Pathophysiology, Management, and Therapeutics in Subarachnoid Hemorrhage and Delayed Cerebral Ischemia: An Overview. PATHOPHYSIOLOGY 2023; 30:420-442. [PMID: 37755398 PMCID: PMC10536590 DOI: 10.3390/pathophysiology30030032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/21/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
Subarachnoid hemorrhage (SAH) is a type of hemorrhagic stroke resulting from the rupture of an arterial vessel within the brain. Unlike other stroke types, SAH affects both young adults (mid-40s) and the geriatric population. Patients with SAH often experience significant neurological deficits, leading to a substantial societal burden in terms of lost potential years of life. This review provides a comprehensive overview of SAH, examining its development across different stages (early, intermediate, and late) and highlighting the pathophysiological and pathohistological processes specific to each phase. The clinical management of SAH is also explored, focusing on tailored treatments and interventions to address the unique pathological changes that occur during each stage. Additionally, the paper reviews current treatment modalities and pharmacological interventions based on the evolving guidelines provided by the American Heart Association (AHA). Recent advances in our understanding of SAH will facilitate clinicians' improved management of SAH to reduce the incidence of delayed cerebral ischemia in patients.
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Affiliation(s)
- Henry W. Sanicola
- Department of Neurology, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA;
| | - Caleb E. Stewart
- Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA;
| | - Patrick Luther
- School of Medicine, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA; (P.L.); (K.Y.)
| | - Kevin Yabut
- School of Medicine, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA; (P.L.); (K.Y.)
| | - Bharat Guthikonda
- Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA;
| | - J. Dedrick Jordan
- Department of Neurology, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA;
| | - J. Steven Alexander
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center in Shreveport, Shreveport, LA 71103, USA
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Scheinost D, Pollatou A, Dufford AJ, Jiang R, Farruggia MC, Rosenblatt M, Peterson H, Rodriguez RX, Dadashkarimi J, Liang Q, Dai W, Foster ML, Camp CC, Tejavibulya L, Adkinson BD, Sun H, Ye J, Cheng Q, Spann MN, Rolison M, Noble S, Westwater ML. Machine Learning and Prediction in Fetal, Infant, and Toddler Neuroimaging: A Review and Primer. Biol Psychiatry 2023; 93:893-904. [PMID: 36759257 PMCID: PMC10259670 DOI: 10.1016/j.biopsych.2022.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/10/2022] [Accepted: 10/07/2022] [Indexed: 12/01/2022]
Abstract
Predictive models in neuroimaging are increasingly designed with the intent to improve risk stratification and support interventional efforts in psychiatry. Many of these models have been developed in samples of children school-aged or older. Nevertheless, despite growing evidence that altered brain maturation during the fetal, infant, and toddler (FIT) period modulates risk for poor mental health outcomes in childhood, these models are rarely implemented in FIT samples. Applications of predictive modeling in children of these ages provide an opportunity to develop powerful tools for improved characterization of the neural mechanisms underlying development. To facilitate the broader use of predictive models in FIT neuroimaging, we present a brief primer and systematic review on the methods used in current predictive modeling FIT studies. Reflecting on current practices in more than 100 studies conducted over the past decade, we provide an overview of topics, modalities, and methods commonly used in the field and under-researched areas. We then outline ethical and future considerations for neuroimaging researchers interested in predicting health outcomes in early life, including researchers who may be relatively new to either advanced machine learning methods or using FIT data. Altogether, the last decade of FIT research in machine learning has provided a foundation for accelerating the prediction of early-life trajectories across the full spectrum of illness and health.
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Affiliation(s)
- Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut; Department of Biomedical Engineering, Yale University, New Haven, Connecticut; Department of Statistics and Data Science, Yale University, New Haven, Connecticut; Child Study Center, Yale School of Medicine, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut.
| | - Angeliki Pollatou
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Alexander J Dufford
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Rongtao Jiang
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Michael C Farruggia
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Matthew Rosenblatt
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Hannah Peterson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | | | | | - Qinghao Liang
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Wei Dai
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Maya L Foster
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Chris C Camp
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Link Tejavibulya
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Brendan D Adkinson
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Huili Sun
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Jean Ye
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut
| | - Qi Cheng
- Departments of Neuroscience and Psychology, Smith College, Northampton, Massachusetts
| | - Marisa N Spann
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Max Rolison
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Stephanie Noble
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Margaret L Westwater
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
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Martini S, Thewissen L, Austin T, da Costa CS, de Boode WP, Dempsey E, Kooi E, Pellicer A, Rhee CJ, Riera J, Wolf M, Wong F. Near-infrared spectroscopy monitoring of neonatal cerebrovascular reactivity: where are we now? Pediatr Res 2023:10.1038/s41390-023-02574-6. [PMID: 36997690 DOI: 10.1038/s41390-023-02574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 06/19/2023]
Abstract
Cerebrovascular reactivity defines the ability of the cerebral vasculature to regulate its resistance in response to both local and systemic factors to ensure an adequate cerebral blood flow to meet the metabolic demands of the brain. The increasing adoption of near-infrared spectroscopy (NIRS) for non-invasive monitoring of cerebral oxygenation and perfusion allowed investigation of the mechanisms underlying cerebrovascular reactivity in the neonatal population, confirming important associations with pathological conditions including the development of brain injury and adverse neurodevelopmental outcomes. However, the current literature on neonatal cerebrovascular reactivity is mainly still based on small, observational studies and is characterised by methodological heterogeneity; this has hindered the routine application of NIRS-based monitoring of cerebrovascular reactivity to identify infants most at risk of brain injury. This review aims (1) to provide an updated review on neonatal cerebrovascular reactivity, assessed using NIRS; (2) to identify critical points that need to be addressed with targeted research; and (3) to propose feasibility trials in order to fill the current knowledge gaps and to possibly develop a preventive or curative approach for preterm brain injury. IMPACT: NIRS monitoring has been largely applied in neonatal research to assess cerebrovascular reactivity in response to blood pressure, PaCO2 and other biochemical or metabolic factors, providing novel insights into the pathophysiological mechanisms underlying cerebral blood flow regulation. Despite these insights, the current literature shows important pitfalls that would benefit to be addressed in a series of targeted trials, proposed in the present review, in order to translate the assessment of cerebrovascular reactivity into routine monitoring in neonatal clinical practice.
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Affiliation(s)
- Silvia Martini
- Neonatal Intensive Care Unit, IRCCS AOU S. Orsola, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | | | - Topun Austin
- Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Willem P de Boode
- Department of Neonatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Eugene Dempsey
- Department of Paediatrics and Child Health, INFANT Centre, University College Cork, Cork, Ireland
| | - Elisabeth Kooi
- Division of Neonatology, Beatrix Children's Hospital, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Adelina Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Christopher J Rhee
- Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Joan Riera
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
- Center for Biomedical Technology, Technical University, Madrid, Spain
| | - Martin Wolf
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Flora Wong
- Monash Newborn, Monash Children's Hospital, Hudson Institute of Medical Research, Department of Paediatrics, Monash University, Melbourne, VIC, Australia
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Chan RNF, Tang Z, Chan VTT, Chan RNC, Cheng ETW, Ng NCY, Cheung CY. The cross-sectional and longitudinal relationship of diabetic retinopathy to cognitive impairment: a systematic review and meta-analysis. Eye (Lond) 2023; 37:220-227. [PMID: 35501601 PMCID: PMC9873601 DOI: 10.1038/s41433-022-02033-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/07/2022] [Accepted: 03/14/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To establish a potential relationship between diabetic retinopathy (DR) and different stages of cognitive impairment METHODS: Literature searches were conducted on PubMed and EMBASE, with keywords "diabetic retinopathy" and "cognitive impairment". Inclusion criteria were original human studies, and English language. Quality of studies was assessed by the Newcastle-Ottawa Quality Assessment (NOSGEN). The register number of this study on the International Prospective Register of Systematic Reviews (PROSPERO) is CRD42021236747. The main outcome measures were odds ratios (OR) and risk ratios (RR) for cross-sectional and longitudinal studies, respectively. Meta-regression was performed to evaluate the effects of potential moderator variables, including, age, onset age of diabetes mellitus (DM), duration of DM, and HbA1c. RESULTS Twenty-five studies (17 cross-sectional and 8 longitudinal studies) with a total of 1,963,914 subjects, were included. Among the cross-sectional studies, the pooled ORs of any cognitive impairment, early stage of cognitive impairment and dementia in subjects with DR (95% confidence interval) were 1.48 (1.08-2.02), 1.59 (1.01-2.51), and 1.13 (0.86-1.50), respectively. Among the longitudinal studies, the pooled RRs of any cognitive impairment, early stage of cognitive impairment, and dementia in subjects with DR (95% confidence interval) were 1.35 (1.12-1.65), 1.50 (1.06-2.12), and 1.31 (1.03-1.66), respectively. Meta-regression showed age, onset age of DM, duration of DM, and glycated hemoglobin (HbA1c) were not statistically associated with the outcomes. CONCLUSIONS The presence of DR in DM patients indicates both higher odds of prevalent cognitive impairment and escalated risks of developing cognitive impairment in the future.
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Affiliation(s)
- Robert N F Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Ziqi Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Victor T T Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, Hong Kong, China
| | - Raymond N C Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Esther T W Cheng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Natalie C Y Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
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Inocencio IM, Kaur N, Tran NT, Wong FY. Cerebral haemodynamic response to somatosensory stimulation in preterm lambs is enhanced following sildenafil and inhaled nitric oxide administration. Front Physiol 2023; 14:1101647. [PMID: 36760535 PMCID: PMC9905131 DOI: 10.3389/fphys.2023.1101647] [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: 11/18/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Neurovascular coupling (NVC) leads to an increase in local cerebral blood flow and oxygenation in response to increased neural activity and metabolic demand. Impaired or immature NVC reported in the preterm brain, potentially reduces cerebral oxygenation following increased neural activity, predisposing to cerebral tissue hypoxia. Endogenous nitric oxide (NO) is a potent vasodilator and a major mediator of NVC and the cerebral haemodynamic response. NO modulators, such as inhaled nitric oxide (iNO) and sildenafil, induce vasodilation and are used clinically to treat pulmonary hypertension in preterm neonates. However, their impact on NVC in the preterm brain are unknown. We aimed to characterise the cerebral functional haemodynamic response in the preterm brain exposed to NO modulators. We hypothesized that iNO and sildenafil in clinical dosages would increase the baseline cerebral perfusion and the cerebral haemodynamic response to neural activation. Methods: Preterm lambs (126-7 days' gestation) were delivered and mechanically ventilated. The cerebral functional haemodynamic response was measured using near infrared spectroscopy as changes in cerebral oxy- and deoxyhaemoglobin (ΔoxyHb, ΔdeoxyHb), following left median nerve stimulations of 1.8, 4.8, and 7.8 s durations in control preterm lambs (n = 11), and following 4.8 and 7.8 s stimulations in preterm lambs receiving either sildenafil citrate (n = 6, 1.33 mcg/kg/hr) or iNO (n = 8, 20 ppm). Results: Following 1.8, 4.8, and 7.8 s stimulations, ∆oxyHb in the contralateral cortex increased (positive functional response) in 7/11 (64%), 7/11 (64%), and 4/11 (36%) control lambs respectively (p < 0.05). Remaining lambs showed decreased ΔoxyHb (negative functional response). Following 4.8 s stimulations, more lambs receiving sildenafil or iNO (83% and 100% respectively) showed positive functional response compared to the controls (p < 0.05). No significant difference between the three groups was observed at 7.8 s stimulations. Conclusion: In the preterm brain, prolonged somatosensory stimulations increased the incidence of negative functional responses with decreased cerebral oxygenation, suggesting that cerebral oxygen delivery may not match the oxygen demand. Sildenafil and iNO increased the incidence of positive functional responses, potentially enhancing NVC, and cerebral oxygenation.
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Affiliation(s)
- Ishmael Miguel Inocencio
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Navneet Kaur
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Nhi T. Tran
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Flora Y. Wong
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia,Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia,*Correspondence: Flora Y. Wong,
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21
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Bickel MA, Csik B, Gulej R, Ungvari A, Nyul-Toth A, Conley SM. Cell non-autonomous regulation of cerebrovascular aging processes by the somatotropic axis. Front Endocrinol (Lausanne) 2023; 14:1087053. [PMID: 36755922 PMCID: PMC9900125 DOI: 10.3389/fendo.2023.1087053] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
Age-related cerebrovascular pathologies, ranging from cerebromicrovascular functional and structural alterations to large vessel atherosclerosis, promote the genesis of vascular cognitive impairment and dementia (VCID) and exacerbate Alzheimer's disease. Recent advances in geroscience, including results from studies on heterochronic parabiosis models, reinforce the hypothesis that cell non-autonomous mechanisms play a key role in regulating cerebrovascular aging processes. Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) exert multifaceted vasoprotective effects and production of both hormones is significantly reduced in aging. This brief overview focuses on the role of age-related GH/IGF-1 deficiency in the development of cerebrovascular pathologies and VCID. It explores the mechanistic links among alterations in the somatotropic axis, specific macrovascular and microvascular pathologies (including capillary rarefaction, microhemorrhages, impaired endothelial regulation of cerebral blood flow, disruption of the blood brain barrier, decreased neurovascular coupling, and atherogenesis) and cognitive impairment. Improved understanding of cell non-autonomous mechanisms of vascular aging is crucial to identify targets for intervention to promote cerebrovascular and brain health in older adults.
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Affiliation(s)
- Marisa A. Bickel
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Boglarka Csik
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Rafal Gulej
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Anna Ungvari
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- International Training Program in Geroscience, Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Adam Nyul-Toth
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- International Training Program in Geroscience, Department of Public Health, Semmelweis University, Budapest, Hungary
- Institute of Biophysics, Biological Research Centre, Eötvös Lorand Research Network (ELKH), Szeged, Hungary
| | - Shannon M. Conley
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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22
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Hermans T, Carkeek K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy. Sci Rep 2023; 13:457. [PMID: 36627381 PMCID: PMC9832127 DOI: 10.1038/s41598-022-27275-8] [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: 04/06/2022] [Accepted: 12/29/2022] [Indexed: 01/12/2023] Open
Abstract
In neonates with hypoxic ischemic encephalopathy, the computation of wavelet coherence between electroencephalogram (EEG) power and regional cerebral oxygen saturation (rSO2) is a promising method for the assessment of neurovascular coupling (NVC), which in turn is a promising marker for brain injury. However, instabilities in arterial oxygen saturation (SpO2) limit the robustness of previously proposed methods. Therefore, we propose the use of partial wavelet coherence, which can eliminate the influence of SpO2. Furthermore, we study the added value of the novel NVC biomarkers for identification of brain injury compared to traditional EEG and NIRS biomarkers. 18 neonates with HIE were monitored for 72 h and classified into three groups based on short-term MRI outcome. Partial wavelet coherence was used to quantify the coupling between C3-C4 EEG bandpower (2-16 Hz) and rSO2, eliminating confounding effects of SpO2. NVC was defined as the amount of significant coherence in a frequency range of 0.25-1 mHz. Partial wavelet coherence successfully removed confounding influences of SpO2 when studying the coupling between EEG and rSO2. Decreased NVC was related to worse MRI outcome. Furthermore, the combination of NVC and EEG spectral edge frequency (SEF) improved the identification of neonates with mild vs moderate and severe MRI outcome compared to using EEG SEF alone. Partial wavelet coherence is an effective method for removing confounding effects of SpO2, improving the robustness of automated assessment of NVC in long-term EEG-NIRS recordings. The obtained NVC biomarkers are more sensitive to MRI outcome than traditional rSO2 biomarkers and provide complementary information to EEG biomarkers.
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Affiliation(s)
- Tim Hermans
- Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium.
| | - Katherine Carkeek
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium ,grid.48769.340000 0004 0461 6320Neonatal Intensive Care Unit, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Anneleen Dereymaeker
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Katrien Jansen
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Child Neurology, UZ Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium
| | - Maarten De Vos
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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23
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Jadhav P, Karande M, Sarkar A, Sahu S, Sarmah D, Datta A, Chaudhary A, Kalia K, Sharma A, Wang X, Bhattacharya P. Glial Cells Response in Stroke. Cell Mol Neurobiol 2023; 43:99-113. [PMID: 35066715 DOI: 10.1007/s10571-021-01183-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/15/2021] [Indexed: 01/07/2023]
Abstract
As the second-leading cause of death, stroke faces several challenges in terms of treatment because of the limited therapeutic interventions available. Previous studies primarily focused on metabolic and blood flow properties as a target for treating stroke, including recombinant tissue plasminogen activator and mechanical thrombectomy, which are the only USFDA approved therapies. These interventions have the limitation of a narrow therapeutic time window, the possibility of hemorrhagic complications, and the expertise required for performing these interventions. Thus, it is important to identify the contributing factors that exacerbate the ischemic outcome and to develop therapies targeting them for regulating cellular homeostasis, mainly neuronal survival and regeneration. Glial cells, primarily microglia, astrocytes, and oligodendrocytes, have been shown to have a crucial role in the prognosis of ischemic brain injury, contributing to inflammatory responses. They play a dual role in both the onset as well as resolution of the inflammatory responses. Understanding the different mechanisms driving these effects can aid in the development of therapeutic targets and further mitigate the damage caused. In this review, we summarize the functions of various glial cells and their contribution to stroke pathology. The review highlights the therapeutic options currently being explored and developed that primarily target glial cells and can be used as neuroprotective agents for the treatment of ischemic stroke.
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Affiliation(s)
- Poonam Jadhav
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Mayuri Karande
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Abhishek Sarkar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Shubhrakanta Sahu
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Deepaneeta Sarmah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Aishika Datta
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Antra Chaudhary
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Kiran Kalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India
| | - Arvind Sharma
- Department of Neurology, Zydus Hospital, Ahmedabad, 380054, Gujarat, India
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, 382355, India.
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24
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Ladthavorlaphatt K, Surti FBS, Beishon LC, Panerai RB, Robinson TG. Challenging neurovascular coupling through complex and variable duration cognitive paradigms: A subcomponent analysis. Med Eng Phys 2022; 110:103921. [PMID: 36564144 DOI: 10.1016/j.medengphy.2022.103921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/04/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
A similar pattern of cerebral blood velocity (CBv) response has been observed for neurovascular coupling (NVC) assessment with cognitive tasks of varying complexity and duration. This lack of specificity could result from parallel changes in arterial blood pressure (BP) and PaCO2, which could confound the estimates of NVC integrity. Healthy participants (n = 16) underwent recordings at rest (5 min sitting) and during randomized paradigms of different complexity (naming words (NW) beginning with P-, R-, V- words and serial subtractions (SS) of 100-2, 100-7, 1000-17, with durations of 5, 30 and 60 s). Bilateral CBv (middle cerebral arteries, transcranial Doppler), end-tidal CO2 (EtCO2, capnography), blood pressure (BP, Finapres) and heart rate (HR, ECG) were recorded continuously. The bilateral CBv response to all paradigms was classified under objective criteria to select only responders, then the repeated data were averaged between visits. Bilateral CBv change to tasks was decomposed into the relative contributions (subcomponents) of arterial BP (VBP; neurogenic), critical closing pressure (VCrCP; metabolic) and resistance area product (VRAP; myogenic). A temporal effect was demonstrated in bilateral VBP and VRAP during all tasks (p<0.002), increased VBP early (between 0 and 10 s) and followed by decreases of VRAP late (25-35 s) in the response. VCrCP varied by complexity and duration (p<0.046). The main contributions to CBv responses to cognitive tasks of different complexity and duration were VBP and VRAP, whilst a smaller contribution from VCrCP would suggest sensitivity to metabolic demands. Further studies are needed to assess the influence of different paradigms, ageing and cerebrovascular conditions.
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Affiliation(s)
- Kannaphob Ladthavorlaphatt
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; Medical Diagnostics Unit, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand.
| | - Farhaana B S Surti
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom
| | - Lucy C Beishon
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, College of Life Sciences, Leicester Royal Infirmary, University of Leicester, Level 4, Robert Kilpatrick Clinical Sciences Building, Leicester LE2 7LX, United Kingdom; NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
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25
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Wang D, Wu Q, Hong D. Extracting default mode network based on graph neural network for resting state fMRI study. FRONTIERS IN NEUROIMAGING 2022; 1:963125. [PMID: 37555154 PMCID: PMC10406295 DOI: 10.3389/fnimg.2022.963125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/08/2022] [Indexed: 08/10/2023]
Abstract
Functional magnetic resonance imaging (fMRI)-based study of functional connections in the brain has been highlighted by numerous human and animal studies recently, which have provided significant information to explain a wide range of pathological conditions and behavioral characteristics. In this paper, we propose the use of a graph neural network, a deep learning technique called graphSAGE, to investigate resting state fMRI (rs-fMRI) and extract the default mode network (DMN). Comparing typical methods such as seed-based correlation, independent component analysis, and dictionary learning, real data experiment results showed that the graphSAGE is more robust, reliable, and defines a clearer region of interests. In addition, graphSAGE requires fewer and more relaxed assumptions, and considers the single subject analysis and group subjects analysis simultaneously.
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Affiliation(s)
| | | | - Don Hong
- Program of Computational and Data Science, Department of Mathematical Sciences, Middle Tennessee State University, Murfreesboro, TN, United States
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26
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Hendrikx D, Costerus SA, Zahn K, Perez-Ortiz A, Dorado AC, Van Huffel S, de Graaff J, Wijnen R, Wessel L, Tibboel D, Naulaers G. Neurocardiovascular coupling in congenital diaphragmatic hernia patients undergoing different types of surgical treatment. Eur J Anaesthesiol 2022; 39:662-672. [PMID: 34860716 PMCID: PMC9451916 DOI: 10.1097/eja.0000000000001642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The effect of peri-operative management on the neonatal brain is largely unknown. Triggers for perioperative brain injury might be revealed by studying changes in neonatal physiology peri-operatively. OBJECTIVE To study neonatal pathophysiology and cerebral blood flow regulation peri-operatively using the neuro-cardiovascular graph. DESIGN Observational, prospective cohort study on perioperative neuromonitoring. Neonates were included between July 2018 and April 2020. SETTING Multicentre study in two high-volume tertiary university hospitals. PATIENTS Neonates with congenital diaphragmatic hernia were eligible if they received surgical treatment within the first 28 days of life. Exclusion criteria were major cardiac or chromosomal anomalies, or syndromes associated with altered cerebral perfusion or major neurodevelopmental impairment. The neonates were stratified into different groups by type of peri-operative management. INTERVENTION Each patient was monitored using near-infrared spectroscopy and EEG in addition to the routine peri-operative monitoring. Neurocardiovascular graphs were computed off-line. MAIN OUTCOME MEASURES The primary endpoint was the difference in neurocardiovascular graph connectivity in the groups over time. RESULTS Thirty-six patients were included. The intraoperative graph connectivity decreased in all patients operated upon in the operation room (OR) with sevoflurane-based anaesthesia ( P < 0.001) but remained stable in all patients operated upon in the neonatal intensive care unit (NICU) with midazolam-based anaesthesia. Thoracoscopic surgery in the OR was associated with the largest median connectivity reduction (0.33 to 0.12, P < 0.001) and a loss of baroreflex and neurovascular coupling. During open surgery in the OR, all regulation mechanisms remained intact. Open surgery in the NICU was associated with the highest neurovascular coupling values. CONCLUSION Neurocardiovascular graphs provided more insight into the effect of the peri-operative management on the pathophysiology of neonates undergoing surgery. The neonate's clinical condition as well as the surgical and the anaesthesiological approach affected the neonatal physiology and CBF regulation mechanisms at different levels. TRIAL REGISTRATION NL6972, URL: https://www.trialre-gister.nl/trial/6972 .
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27
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Gao T, Zou C, Li J, Han C, Zhang H, Li Y, Tang X, Fan Y. Identification of moyamoya disease based on cerebral oxygen saturation signals using machine learning methods. JOURNAL OF BIOPHOTONICS 2022; 15:e202100388. [PMID: 35102703 DOI: 10.1002/jbio.202100388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
Moyamoya is a cerebrovascular disease with a high mortality rate. Early detection and mechanistic studies are necessary. Near-infrared spectroscopy (NIRS) was used to study the signals of the cerebral tissue oxygen saturation index (TOI) and the changes in oxygenated and deoxygenated hemoglobin concentrations (HbO and Hb) in 64 patients with moyamoya disease and 64 healthy volunteers. The wavelet transforms (WT) of TOI, HbO and Hb signals, as well as the wavelet phase coherence (WPCO) of these signals from the left and right frontal lobes of the same subject, were calculated. Features were extracted from the spontaneous oscillations of TOI, HbO and Hb in five physiological activity-related frequency segments. Machine learning models based on support vector machine (SVM), random forest (RF) and extreme gradient boosting (XGBoost) have been built to classify the two groups. For 20-min signals, the 10-fold cross-validation accuracies of SVM, RF and XGBoost were 87%, 85% and 85%, respectively. For 5-min signals, the accuracies of the three methods were 88%, 88% and 84%, respectively. The method proposed in this article has potential for detecting and screening moyamoya with high proficiency. Evaluating the cerebral oxygenation with NIRS shows great potential in screening moyamoya diseases.
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Affiliation(s)
- Tianxin Gao
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Chuyue Zou
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Jinyu Li
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Cong Han
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Houdi Zhang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Yue Li
- School of Medicine, Tsinghua University, Beijing, China
| | - Xiaoying Tang
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Yingwei Fan
- School of Medical Technology, Beijing Institute of Technology, Beijing, China
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28
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Hanssen H, Streese L, Vilser W. Retinal vessel diameters and function in cardiovascular risk and disease. Prog Retin Eye Res 2022; 91:101095. [PMID: 35760749 DOI: 10.1016/j.preteyeres.2022.101095] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022]
Abstract
In the last two decades evidence has gradually accumulated suggesting that the eye may be a unique window for cardiovascular risk stratification based on the assessment of subclinical damage of retinal microvascular structure and function. This can be facilitated by non-invasive analysis of static retinal vessel diameters and dynamic recording of flicker light-induced and endothelial function-related dilation of both retinal arterioles and venules. Recent new findings have made retinal microvascular biomarkers strong candidates for clinical implementation as reliable risk predictors. Beyond a review of the current evidence and state of research, the article aims to discuss the methodological benefits and pitfalls and to identify research gaps and future directions. Above all, the potential use for screening and treatment monitoring of cardiovascular disease risk are highlighted. The article provides fundamental comprehension of retinal vessel imaging by explaining anatomical and physiological essentials of the retinal microcirculation leading to a detailed description of the methodological approach. This allows for better understanding of the underlying retinal microvascular pathology associated with the prevalence and development of cardiovascular disease. A body of new evidence is presented on the clinical validity and predictive value of retinal vessel diameters and function for incidence cardiovascular disease and outcome. Findings in children indicate the potential for utility in childhood cardiovascular disease prevention, and the efficacy of exercise interventions highlight the treatment sensitivity of retinal microvascular biomarkers. Finally, coming from the availability of normative data, solutions for diagnostic challenges are discussed and conceptual steps towards clinical implementation are put into perspective.
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Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland.
| | - Lukas Streese
- Department of Sport, Exercise and Health, Preventive Sports Medicine and Systems Physiology, Medical Faculty, University of Basel, Switzerland
| | - Walthard Vilser
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany; Neonatology and Pediatric Intensive Care Unit, Department of Pediatrics, Jena University Hospital, Jena, Germany
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29
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Luhmann HJ, Kanold PO, Molnár Z, Vanhatalo S. Early brain activity: Translations between bedside and laboratory. Prog Neurobiol 2022; 213:102268. [PMID: 35364141 PMCID: PMC9923767 DOI: 10.1016/j.pneurobio.2022.102268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 01/29/2023]
Abstract
Neural activity is both a driver of brain development and a readout of developmental processes. Changes in neuronal activity are therefore both the cause and consequence of neurodevelopmental compromises. Here, we review the assessment of neuronal activities in both preclinical models and clinical situations. We focus on issues that require urgent translational research, the challenges and bottlenecks preventing translation of biomedical research into new clinical diagnostics or treatments, and possibilities to overcome these barriers. The key questions are (i) what can be measured in clinical settings versus animal experiments, (ii) how do measurements relate to particular stages of development, and (iii) how can we balance practical and ethical realities with methodological compromises in measurements and treatments.
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Affiliation(s)
- Heiko J. Luhmann
- Institute of Physiology, University Medical Center of the Johannes Gutenberg University Mainz, Duesbergweg 6, Mainz, Germany.,Correspondence:, , ,
| | - Patrick O. Kanold
- Department of Biomedical Engineering and Kavli Neuroscience Discovery Institute, Johns Hopkins University, School of Medicine, 720 Rutland Avenue / Miller 379, Baltimore, MD 21205, USA.,Correspondence:, , ,
| | - Zoltán Molnár
- Department of Physiology, Anatomy and Genetics, Sherrington Building, University of Oxford, Parks Road, Oxford OX1 3PT, UK.
| | - Sampsa Vanhatalo
- BABA Center, Departments of Physiology and Clinical Neurophysiology, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
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30
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Blood-brain barrier leakage in Alzheimer's disease: From discovery to clinical relevance. Pharmacol Ther 2022; 234:108119. [PMID: 35108575 PMCID: PMC9107516 DOI: 10.1016/j.pharmthera.2022.108119] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 12/16/2022]
Abstract
Alzheimer's disease (AD) is the most common form of dementia. AD brain pathology starts decades before the onset of clinical symptoms. One early pathological hallmark is blood-brain barrier dysfunction characterized by barrier leakage and associated with cognitive decline. In this review, we summarize the existing literature on the extent and clinical relevance of barrier leakage in AD. First, we focus on AD animal models and their susceptibility to barrier leakage based on age and genetic background. Second, we re-examine barrier dysfunction in clinical and postmortem studies, summarize changes that lead to barrier leakage in patients and highlight the clinical relevance of barrier leakage in AD. Third, we summarize signaling mechanisms that link barrier leakage to neurodegeneration and cognitive decline in AD. Finally, we discuss clinical relevance and potential therapeutic strategies and provide future perspectives on investigating barrier leakage in AD. Identifying mechanistic steps underlying barrier leakage has the potential to unravel new targets that can be used to develop novel therapeutic strategies to repair barrier leakage and slow cognitive decline in AD and AD-related dementias.
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Ando K, Tong L, Peng D, Vázquez-Liébanas E, Chiyoda H, He L, Liu J, Kawakami K, Mochizuki N, Fukuhara S, Grutzendler J, Betsholtz C. KCNJ8/ABCC9-containing K-ATP channel modulates brain vascular smooth muscle development and neurovascular coupling. Dev Cell 2022; 57:1383-1399.e7. [PMID: 35588738 DOI: 10.1016/j.devcel.2022.04.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 12/22/2021] [Accepted: 04/26/2022] [Indexed: 12/30/2022]
Abstract
Loss- or gain-of-function mutations in ATP-sensitive potassium channel (K-ATP)-encoding genes, KCNJ8 and ABCC9, cause human central nervous system disorders with unknown pathogenesis. Here, using mice, zebrafish, and cell culture models, we investigated cellular and molecular causes of brain dysfunctions derived from altered K-ATP channel function. We show that genetic/chemical inhibition or activation of KCNJ8/ABCC9-containing K-ATP channel function leads to brain-selective suppression or promotion of arterial/arteriolar vascular smooth muscle cell (VSMC) differentiation, respectively. We further show that brain VSMCs develop from KCNJ8/ABCC9-containing K-ATP channel-expressing mural cell progenitor and that K-ATP channel cell autonomously regulates VSMC differentiation through modulation of intracellular Ca2+ oscillation via voltage-dependent calcium channels. Consistent with defective VSMC development, Kcnj8 knockout mice showed deficiency in vasoconstrictive capacity and neuronal-evoked vasodilation leading to local hyperemia. Our results demonstrate a role for KCNJ8/ABCC9-containing K-ATP channels in the differentiation of brain VSMC, which in turn is necessary for fine-tuning of cerebral blood flow.
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Affiliation(s)
- Koji Ando
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Dag Hammarskjölds väg 20, 751 85 Uppsala, Sweden; Department of Molecular Pathophysiology, Institute of Advanced Medical Science, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8602, Japan; Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shinmachi, Suita, Osaka 564-8565, Japan.
| | - Lei Tong
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Di Peng
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Dag Hammarskjölds väg 20, 751 85 Uppsala, Sweden
| | - Elisa Vázquez-Liébanas
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Dag Hammarskjölds väg 20, 751 85 Uppsala, Sweden
| | - Hirohisa Chiyoda
- Department of Molecular Pathophysiology, Institute of Advanced Medical Science, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8602, Japan; Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shinmachi, Suita, Osaka 564-8565, Japan
| | - Liqun He
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Dag Hammarskjölds väg 20, 751 85 Uppsala, Sweden
| | - Jianping Liu
- Department of Medicine Huddinge (MedH), Karolinska Institute, Campus Flemingsburg, Neo, Blickagången 16, 141 57 Huddinge, Sweden
| | - Koichi Kawakami
- Laboratory of Molecular and Developmental Biology, National Institute of Genetics, 1111 Yata, Mishima, Shizuoka 411-8540, Japan; Department of Genetics, SOKENDAI (The Graduate University for Advanced Studies), 1111 Yata, Mishima, Shizuoka 411-8540, Japan
| | - Naoki Mochizuki
- Department of Cell Biology, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shinmachi, Suita, Osaka 564-8565, Japan
| | - Shigetomo Fukuhara
- Department of Molecular Pathophysiology, Institute of Advanced Medical Science, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8602, Japan
| | - Jaime Grutzendler
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Christer Betsholtz
- Department of Immunology, Genetics and Pathology, Rudbeck Laboratory, Uppsala University, Dag Hammarskjölds väg 20, 751 85 Uppsala, Sweden; Department of Medicine Huddinge (MedH), Karolinska Institute, Campus Flemingsburg, Neo, Blickagången 16, 141 57 Huddinge, Sweden.
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Common Shared Pathogenic Aspects of Small Vessels in Heart and Brain Disease. Biomedicines 2022; 10:biomedicines10051009. [PMID: 35625746 PMCID: PMC9138783 DOI: 10.3390/biomedicines10051009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
Small-vessel disease (SVD), also known as microvascular endothelial dysfunction, is a disorder with negative consequences for various organs such as the heart and brain. Impaired dilatation and constriction of small vessels in the heart lead to reduced blood flow and ischemia independently of coronary artery disease (CAD) and are associated with major cardiac events. SVD is usually a silent form of subcortical vascular burden in the brain with various clinical manifestations, such as silent-lacunar-ischemic events and confluent white-matter hyperintensities. Imaging techniques are the main help for clinicians to diagnose cardiac and brain SVD correctly. Markers of inflammation, such as C-reactive protein, tumor-necrosis-factor α, and interleukin 6, provide insight into the disease and markers that negatively influence nitric-oxide bioavailability and promote oxidative stress. Unfortunately, the therapeutic approach against SVD is still not well-defined. In the last decades, various antioxidants, oxidative stress inhibitors, and superoxide scavengers have been the target of extensive investigations due to their potential therapeutic effect, but with unsatisfactory results. In clinical practice, traditional anti-ischemic and risk-reduction therapies for CAD are currently in use for SVD treatment.
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Small Vessel Disease: Ancient Description, Novel Biomarkers. Int J Mol Sci 2022; 23:ijms23073508. [PMID: 35408867 PMCID: PMC8998274 DOI: 10.3390/ijms23073508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 12/22/2022] Open
Abstract
Small vessel disease (SVD) is one of the most frequent pathological conditions which lead to dementia. Biochemical and neuroimaging might help correctly identify the clinical diagnosis of this relevant brain disease. The microvascular alterations which underlie SVD have common origins, similar cognitive outcomes, and common vascular risk factors. Nevertheless, the arteriolosclerosis process, which underlines SVD development, is based on different mechanisms, not all completely understood, which start from a chronic hypoperfusion state and pass through a chronic brain inflammatory condition, inducing a significant endothelium activation and a consequent tissue remodeling action. In a recent review, we focused on the pathophysiology of SVD, which is complex, involving genetic conditions and different co-morbidities (i.e., diabetes, chronic hypoxia condition, and obesity). Currently, many points still remain unclear and discordant. In this paper, we wanted to focus on new biomarkers, which can be the expression of the endothelial dysfunction, or of the oxidative damage, which could be employed as markers of disease progression or for future targets of therapies. Therefore, we described the altered response to the endothelium-derived nitric oxide-vasodilators (ENOV), prostacyclin, C-reactive proteins, and endothelium-derived hyperpolarizing factors (EDHF). At the same time, due to the concomitant endothelial activation and chronic neuroinflammatory status, we described hypoxia-endothelial-related markers, such as HIF 1 alpha, VEGFR2, and neuroglobin, and MMPs. We also described blood–brain barrier disruption biomarkers and imaging techniques, which can also describe perivascular spaces enlargement and dysfunction. More studies should be necessary, in order to implement these results and give them a clinical benefit.
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Stanisavljevic A, Schrader JM, Zhu X, Mattar JM, Hanks A, Xu F, Majchrzak M, Robinson JK, Van Nostrand WE. Impact of Non-pharmacological Chronic Hypertension on a Transgenic Rat Model of Cerebral Amyloid Angiopathy. Front Neurosci 2022; 16:811371. [PMID: 35368255 PMCID: PMC8964963 DOI: 10.3389/fnins.2022.811371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Cerebral amyloid angiopathy (CAA), a common comorbidity of Alzheimer’s disease (AD), is a cerebral small vessel disease (CSVD) characterized by deposition of fibrillar amyloid β (Aβ) in blood vessels of the brain and promotes neuroinflammation and vascular cognitive impairment and dementia (VCID). Hypertension, a prominent non-amyloidal CSVD, has been found to increase risk of dementia, but clinical data regarding its effects in CAA patients is controversial. To understand the effects of hypertension on CAA, we bred rTg-DI transgenic rats, a model of CAA, with spontaneously hypertensive, stroke prone (SHR-SP) rats producing bigenic rTg-DI/SHR-SP and non-transgenic SHR-SP littermates. At 7 months (M) of age, cohorts of both rTg-DI/SHR-SP and SHR-SP littermates exhibit elevated systolic blood pressures. However, transgene human amyloid β-protein (Aβ) precursor and Aβ peptide levels, as well as behavioral testing showed no changes between bigenic rTg-DI/SHR-SP and rTg-DI rats. Subsequent cohorts of rats were aged further to 10 M where bigenic rTg-DI/SHR-SP and SHR-SP littermates exhibit elevated systolic and diastolic blood pressures. Vascular amyloid load in hippocampus and thalamus was significantly decreased, whereas pial surface vessel amyloid increased, in bigenic rTg-DI/SHR-SP rats compared to rTg-DI rats suggesting a redistribution of vascular amyloid in bigenic animals. There was activation of both astrocytes and microglia in rTg-DI rats and bigenic rTg-DI/SHR-SP rats not observed in SHR-SP rats indicating that glial activation was likely in response to the presence of vascular amyloid. Thalamic microbleeds were present in both rTg-DI rats and bigenic rTg-DI/SHR-SP rats. Although the number of thalamic small vessel occlusions were not different between rTg-DI and bigenic rTg-DI/SHR-SP rats, a significant difference in occlusion size and distribution in the thalamus was found. Proteomic analysis of cortical tissue indicated that bigenic rTg-DI/SHR-SP rats largely adopt features of the rTg-DI rats with enhancement of certain changes. Our findings indicate that at 10 M of age non-pharmacological hypertension in rTg-DI rats causes a redistribution of vascular amyloid and significantly alters the size and distribution of thalamic occluded vessels. In addition, our findings indicate that bigenic rTg-DI/SHR-SP rats provide a non-pharmacological model to further study hypertension and CAA as co-morbidities for CSVD and VCID.
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Affiliation(s)
- Aleksandra Stanisavljevic
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Joseph M. Schrader
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Xiaoyue Zhu
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Jennifer M. Mattar
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Ashley Hanks
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Feng Xu
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - Mark Majchrzak
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
| | - John K. Robinson
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | - William E. Van Nostrand
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, United States
- *Correspondence: William E. Van Nostrand,
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The cerebral haemodynamic response to somatosensory stimulation in preterm newborn lambs is reduced following intrauterine inflammation and dopamine infusion. Exp Neurol 2022; 352:114049. [DOI: 10.1016/j.expneurol.2022.114049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/01/2022] [Accepted: 03/13/2022] [Indexed: 11/18/2022]
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Investigating the association between depression and cerebral haemodynamics-A systematic review and meta-analysis. J Affect Disord 2022; 299:144-158. [PMID: 34800572 DOI: 10.1016/j.jad.2021.11.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/25/2021] [Accepted: 11/14/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Vascular mechanisms may play a role in depression. The aim of this review is to summarise the evidence on alterations in cerebral haemodynamics in depression. METHODS MEDLINE (1946- present), Embase (1947-present), Web of Science (1970-present), PsycINFO (1984-present), CINAHL (1976-present) and CENTRAL were searched using a predefined search strategy. A meta-analysis was conducted in four groups: 1) global cerebral blood flow (CBF) in ml/min/100 g, 2) CBF velocity (CBFv) in cm/s (maximum flow of left middle cerebral artery, 3) combined CBF and CBFv, 4) Ratio of uptake of Tc 99 m HMPAO (region of interest compared to whole brain). Data are presented as mean difference or standardised mean difference and 95% confidence interval (95% CI). A narrative synthesis of the remaining studies was performed. RESULTS 87 studies were included. CBF was significantly reduced in depressed patients compared to HC [15 studies, 538 patients, 416 HC, MD: -2.24 (95% CI -4.12, -0.36), p = 0.02, I2 = 64%]. There were no statistically significant differences in other parameters. The narrative synthesis revealed variable changes in CBF in depressed patients, particularly affecting the anterior cingulate and prefrontal cortices. LIMITATIONS There were various sources of heterogeneity including the severity of depression, use of antidepressant medication, imaging modality used and reporting of outcomes. All of these factors made direct comparisons between studies difficult. CONCLUSIONS The reduction in CBF in depressed patients compared to HCs may indicate a role for assessment and CBF altering interventions in high-risk groups. However, results were inconsistent across studies, warranting further work to investigate specific subgroups.
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Hermans T, Carkeek K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Assessing Neurovascular Coupling Using Wavelet Coherence in Neonates with Asphyxia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1395:183-187. [PMID: 36527635 DOI: 10.1007/978-3-031-14190-4_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Brain monitoring is important in neonates with asphyxia in order to assess the severity of hypoxic ischaemic encephalopathy (HIE) and identify neonates at risk of adverse neurodevelopmental outcome. Previous studies suggest that neurovascular coupling (NVC), quantified as the interaction between electroencephalography (EEG) and near-infrared spectroscopy (NIRS)-derived regional cerebral oxygen saturation (rSO2) is a promising biomarker for HIE severity and outcome. In this study, we explore how wavelet coherence can be used to assess NVC. Wavelet coherence was computed in 18 neonates undergoing therapeutic hypothermia in the first 3 days of life, with varying HIE severities (mild, moderate, severe). We compared two pre-processing methods of the EEG prior to wavelet computation: amplitude integrated EEG (aEEG) and EEG bandpower. Furthermore, we proposed average real coherence as a biomarker for NVC. Our results indicate that NVC as assessed by wavelet coherence between EEG bandpower and rSO2 can be a valuable biomarker for HIE severity in neonates with peripartal asphyxia. More specifically, average real coherence in a very low frequency range (0.21-0.83 mHz) tends to be high (positive) in neonates with mild HIE, low (positive) in neonates with moderate HIE, and negative in neonates with severe HIE. Further investigation in a larger patient cohort is needed to validate our findings.
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Vedrenne-Cloquet M, Chareyre J, Léger PL, Genuini M, Renolleau S, Oualha M. Low Dosing Norepinephrine Effects on Cerebral Oxygenation and Perfusion During Pediatric Shock. Front Pediatr 2022; 10:898444. [PMID: 35874564 PMCID: PMC9298794 DOI: 10.3389/fped.2022.898444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cerebral hypoperfusion and impaired oxygen delivery during pediatric critical illness may result in acute neurologic injury with subsequent long-term effects on neurodevelopmental outcome. Yet, the impact of norepinephrine on cerebral hemodynamics is unknown in children with shock. We aimed to describe the norepinephrine effects on cerebral perfusion and oxygenation during pediatric shock. PATIENTS AND METHODS We conducted an observational multicentre prospective study in 3 French pediatric intensive care units. Children <18 years of age excluding traumatic brain injury were included in the study if they need norepinephrine for shock. Systemic and cerebral hemodynamics were compared between the time of initiation of norepinephrine (T0), and the steady-state (Tss). Cardiac output (CO) was measured using ultrasound. Cerebral perfusion was assessed on middle cerebral arteries (MCA) using transcranial doppler ultrasound. Cerebral tissue oxygen saturation (rScO2) was recorded using near infrared spectroscopy, and we calculated cerebral fractional tissue oxygen extraction (cFTOE = SpO2-rScO2/SpO2). MAIN RESULTS Fourteen children (median [IQR] age of 3.5[1; 13.5] years) were included. Norepinephrine at 0.2[0.1; 0.32] μg/kg/min significantly increased mean arterial blood pressure (61[56; 73] mmHg at Tss vs. 49[42;54] mmHg at T0, p=10-3) without change of CO. MCA velocities, pulsatility index, rScO2, and cFTOE did not significantly change between T0 and Tss. Some individuals observed variations in estimated CBF, which slightly improved in 7 patients, remained unchanged in 5, and was impaired in 2. No patient experienced significant variations of rScO2. CONCLUSIONS Low-dosing norepinephrine, despite a homogeneous and significant increase in arterial blood pressure, had little effects on cerebral perfusion and oxygenation during pediatric shock. This reinforces the need for personalized tailored therapies in this population. TRIAL REGISTRATION Clinicaltrials.gov, NCT03731104. Registered 6 November, 2018. https://clinicaltrials.gov/ct2/show/NCT03731104.
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Affiliation(s)
| | - Judith Chareyre
- Pediatric Intensive Care Unit, AP-HP CHU Necker-Enfants Malades, Paris, France
| | - Pierre-Louis Léger
- Pediatric Intensive Care Unit, AP-HP CHU Trousseau-La Roche Guyon, Paris, France
| | - Mathieu Genuini
- Pediatric Intensive Care Unit, AP-HP CHU Robert Debré, Paris, France.,Pediatric Intensive Care Transport Unit, AP-HP CHU Robert Debré, Paris, France
| | - Sylvain Renolleau
- Pediatric Intensive Care Unit, AP-HP CHU Necker-Enfants Malades, Paris, France
| | - Mehdi Oualha
- Pediatric Intensive Care Unit, AP-HP CHU Necker-Enfants Malades, Paris, France
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Elorza Ridaura I, Sorrentino S, Moroni L. Parallels between the Developing Vascular and Neural Systems: Signaling Pathways and Future Perspectives for Regenerative Medicine. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2101837. [PMID: 34693660 PMCID: PMC8655224 DOI: 10.1002/advs.202101837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Indexed: 05/10/2023]
Abstract
Neurovascular disorders, which involve the vascular and nervous systems, are common. Research on such disorders usually focuses on either vascular or nervous components, without looking at how they interact. Adopting a neurovascular perspective is essential to improve current treatments. Therefore, comparing molecular processes known to be involved in both systems separately can provide insight into promising areas of future research. Since development and regeneration share many mechanisms, comparing signaling molecules involved in both the developing vascular and nervous systems and shedding light to those that they have in common can reveal processes, which have not yet been studied from a regenerative perspective, yet hold great potential. Hence, this review discusses and compares processes involved in the development of the vascular and nervous systems, in order to provide an overview of the molecular mechanisms, which are most promising with regards to treatment for neurovascular disorders. Vascular endothelial growth factor, semaphorins, and ephrins are found to hold the most potential, while fibroblast growth factor, bone morphogenic protein, slits, and sonic hedgehog are shown to participate in both the developing vascular and nervous systems, yet have not been studied at the neurovascular level, therefore being of special interest for future research.
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Affiliation(s)
- Idoia Elorza Ridaura
- Complex Tissue Regeneration DepartmentMERLN Institute for Technology‐Inspired Regenerative MedicineMaastricht UniversityUniversiteitssingel 40Maastricht6229ERThe Netherlands
| | - Stefano Sorrentino
- CNR Nanotec – Institute of NanotechnologyCampus Ecotekne, via MonteroniLecce73100Italy
| | - Lorenzo Moroni
- Complex Tissue Regeneration DepartmentMERLN Institute for Technology‐Inspired Regenerative MedicineMaastricht UniversityUniversiteitssingel 40Maastricht6229ERThe Netherlands
- CNR Nanotec – Institute of NanotechnologyCampus Ecotekne, via MonteroniLecce73100Italy
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Classification of Individual Finger Movements from Right Hand Using fNIRS Signals. SENSORS 2021; 21:s21237943. [PMID: 34883949 PMCID: PMC8659988 DOI: 10.3390/s21237943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
Functional near-infrared spectroscopy (fNIRS) is a comparatively new noninvasive, portable, and easy-to-use brain imaging modality. However, complicated dexterous tasks such as individual finger-tapping, particularly using one hand, have been not investigated using fNIRS technology. Twenty-four healthy volunteers participated in the individual finger-tapping experiment. Data were acquired from the motor cortex using sixteen sources and sixteen detectors. In this preliminary study, we applied standard fNIRS data processing pipeline, i.e., optical densities conversation, signal processing, feature extraction, and classification algorithm implementation. Physiological and non-physiological noise is removed using 4th order band-pass Butter-worth and 3rd order Savitzky–Golay filters. Eight spatial statistical features were selected: signal-mean, peak, minimum, Skewness, Kurtosis, variance, median, and peak-to-peak form data of oxygenated haemoglobin changes. Sophisticated machine learning algorithms were applied, such as support vector machine (SVM), random forests (RF), decision trees (DT), AdaBoost, quadratic discriminant analysis (QDA), Artificial neural networks (ANN), k-nearest neighbors (kNN), and extreme gradient boosting (XGBoost). The average classification accuracies achieved were 0.75±0.04, 0.75±0.05, and 0.77±0.06 using k-nearest neighbors (kNN), Random forest (RF) and XGBoost, respectively. KNN, RF and XGBoost classifiers performed exceptionally well on such a high-class problem. The results need to be further investigated. In the future, a more in-depth analysis of the signal in both temporal and spatial domains will be conducted to investigate the underlying facts. The accuracies achieved are promising results and could open up a new research direction leading to enrichment of control commands generation for fNIRS-based brain-computer interface applications.
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Herrera EA, González-Candia A. Gestational Hypoxia and Blood-Brain Barrier Permeability: Early Origins of Cerebrovascular Dysfunction Induced by Epigenetic Mechanisms. Front Physiol 2021; 12:717550. [PMID: 34489733 PMCID: PMC8418233 DOI: 10.3389/fphys.2021.717550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/19/2021] [Indexed: 01/25/2023] Open
Abstract
Fetal chronic hypoxia leads to intrauterine growth restriction (IUGR), which is likely to reduce oxygen delivery to the brain and induce long-term neurological impairments. These indicate a modulatory role for oxygen in cerebrovascular development. During intrauterine hypoxia, the fetal circulation suffers marked adaptations in the fetal cardiac output to maintain oxygen and nutrient delivery to vital organs, known as the "brain-sparing phenotype." This is a well-characterized response; however, little is known about the postnatal course and outcomes of this fetal cerebrovascular adaptation. In addition, several neurodevelopmental disorders have their origins during gestation. Still, few studies have focused on how intrauterine fetal hypoxia modulates the normal brain development of the blood-brain barrier (BBB) in the IUGR neonate. The BBB is a cellular structure formed by the neurovascular unit (NVU) and is organized by a monolayer of endothelial and mural cells. The BBB regulates the entry of plasma cells and molecules from the systemic circulation to the brain. A highly selective permeability system achieves this through integral membrane proteins in brain endothelial cells. BBB breakdown and dysfunction in cerebrovascular diseases lead to leakage of blood components into the brain parenchyma, contributing to neurological deficits. The fetal brain circulation is particularly susceptible in IUGR and is proposed to be one of the main pathological processes deriving BBB disruption. In the last decade, several epigenetic mechanisms activated by IU hypoxia have been proposed to regulate the postnatal BBB permeability. However, few mechanistic studies about this topic are available, and little evidence shows controversy. Therefore, in this mini-review, we analyze the BBB permeability-associated epigenetic mechanisms in the brain exposed to chronic intrauterine hypoxia.
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Affiliation(s)
- Emilio A Herrera
- Laboratory of Vascular Function and Reactivity, Pathophysiology Program, ICBM, Faculty of Medicine, University of Chile, Santiago, Chile
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Beishon L, Panerai RB, Robinson TG, Haunton VJ. Cerebral blood flow response rate to task-activation using a novel method can discriminate cognitive impairment from healthy aging. Physiol Meas 2021; 42. [PMID: 34229305 DOI: 10.1088/1361-6579/ac1185] [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: 01/13/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
Objective.A new method to classify individuals as 'responders' to task-activated cerebral blood flow velocity (CBFv) has recently been developed. This study investigated whether CBFv response rate to task-activation is affected by Alzheimer's disease (AD) and mild cognitive impairment (MCI).Approach.The 95th thresholds for cross correlation function peak and variance ratio were derived from 270 unstimulated, healthy hemispheres, and were used to classify the presence of a response to task-activation. Thresholds were applied to five cognitive tasks (attention, verbal fluency, language, visuospatial, memory) in CBFv data from 30 healthy older adults (HC), 35 AD and 22 MCI participants. Cumulative response rate (CRR) was calculated from the sum of responses across five tasks, for both hemispheres. Area under the curve (AUC) was derived from receiver operating characteristic (ROC) curve analysis.Main results. The number of responders differed significantly between tasks (p < 0.005) and diagnostic groups (p = 0.011). On post hoc tests there were more responders in the visuospatial (79%-90%) compared to fluency (45%-80%), language (50%-77%), and memory (44%-70%) tasks bilaterally, and responders were greater in the HC (70%) compared to AD (41%) and MCI (23%) groups to at least eight out of ten tasks. At an optimal threshold of 7.5 out of 10 responses, the AUC-ROC distinguished HC from AD and MCI with a; sensitivity 66% and specificity 70% (AUC = 0.72).Significance. Using a novel method to classify responders to cognitive task-activation, HC demonstrated a higher CRR than those with MCI or AD, and a threshold of <8 responses distinguished healthy ageing from dementia.
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Affiliation(s)
- Lucy Beishon
- University of Leicester, Department of Cardiovascular Sciences, Leicester, United Kingdom
| | - Ronney B Panerai
- University of Leicester, Department of Cardiovascular Sciences, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Thompson G Robinson
- University of Leicester, Department of Cardiovascular Sciences, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Victoria J Haunton
- University of Leicester, Department of Cardiovascular Sciences, Leicester, United Kingdom.,NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, United Kingdom
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Tataranno ML, Vijlbrief DC, Dudink J, Benders MJNL. Precision Medicine in Neonates: A Tailored Approach to Neonatal Brain Injury. Front Pediatr 2021; 9:634092. [PMID: 34095022 PMCID: PMC8171663 DOI: 10.3389/fped.2021.634092] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/14/2021] [Indexed: 11/27/2022] Open
Abstract
Despite advances in neonatal care to prevent neonatal brain injury and neurodevelopmental impairment, predicting long-term outcome in neonates at risk for brain injury remains difficult. Early prognosis is currently based on cranial ultrasound (CUS), MRI, EEG, NIRS, and/or general movements assessed at specific ages, and predicting outcome in an individual (precision medicine) is not yet possible. New algorithms based on large databases and machine learning applied to clinical, neuromonitoring, and neuroimaging data and genetic analysis and assays measuring multiple biomarkers (omics) can fulfill the needs of modern neonatology. A synergy of all these techniques and the use of automatic quantitative analysis might give clinicians the possibility to provide patient-targeted decision-making for individualized diagnosis, therapy, and outcome prediction. This review will first focus on common neonatal neurological diseases, associated risk factors, and most common treatments. After that, we will discuss how precision medicine and machine learning (ML) approaches could change the future of prediction and prognosis in this field.
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Affiliation(s)
| | | | | | - Manon J. N. L. Benders
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Cao Y, Song X, Wang L, Qi Y, Chen Y, Xing Y. Transcranial Doppler Combined With Quantitative Electroencephalography Brain Function Monitoring for Estimating the Prognosis of Patients With Posterior Circulation Cerebral Infarction. Front Neurol 2021; 12:600985. [PMID: 34079507 PMCID: PMC8165540 DOI: 10.3389/fneur.2021.600985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/21/2021] [Indexed: 11/30/2022] Open
Abstract
Posterior circulation cerebral infarction (PCCI) can lead to deceased infratentorial cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional cerebral blood flow both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) is a technique that evaluates neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate the efficacy of TCD-QEEG for predicting the prognosis of patients with PCCI. We used a TCD-QEEG recording system to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta + theta)/(alpha + beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Forty patients (aged 63.7 ± 9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD [hazard ratio (HR) 0.168, confidence interval (CI) 0.047-0.597, p = 0.006] and QEEG indicators of DTABR (HR 12.527, CI 1.637-95.846, p = 0.015) were the independent predictors of the clinical outcomes. The AUROC after combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p < 0.05). TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.
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Affiliation(s)
- Yanting Cao
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
- Department of Neurology, Linyi People’s Hospital, Linyi, China
| | - Xiaonan Song
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Lijuan Wang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yajie Qi
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Ying Chen
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yingqi Xing
- Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China
- Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
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Dubois J, Alison M, Counsell SJ, Hertz‐Pannier L, Hüppi PS, Benders MJ. MRI of the Neonatal Brain: A Review of Methodological Challenges and Neuroscientific Advances. J Magn Reson Imaging 2021; 53:1318-1343. [PMID: 32420684 PMCID: PMC8247362 DOI: 10.1002/jmri.27192] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 01/04/2023] Open
Abstract
In recent years, exploration of the developing brain has become a major focus for researchers and clinicians in an attempt to understand what allows children to acquire amazing and unique abilities, as well as the impact of early disruptions (eg, prematurity, neonatal insults) that can lead to a wide range of neurodevelopmental disorders. Noninvasive neuroimaging methods such as MRI are essential to establish links between the brain and behavioral changes in newborns and infants. In this review article, we aim to highlight recent and representative studies using the various techniques available: anatomical MRI, quantitative MRI (relaxometry, diffusion MRI), multiparametric approaches, and functional MRI. Today, protocols use 1.5 or 3T MRI scanners, and specialized methodologies have been put in place for data acquisition and processing to address the methodological challenges specific to this population, such as sensitivity to motion. MR sequences must be adapted to the brains of newborns and infants to obtain relevant good soft-tissue contrast, given the small size of the cerebral structures and the incomplete maturation of tissues. The use of age-specific image postprocessing tools is also essential, as signal and contrast differ from the adult brain. Appropriate methodologies then make it possible to explore multiple neurodevelopmental mechanisms in a precise way, and assess changes with age or differences between groups of subjects, particularly through large-scale projects. Although MRI measurements only indirectly reflect the complex series of dynamic processes observed throughout development at the molecular and cellular levels, this technique can provide information on brain morphology, structural connectivity, microstructural properties of gray and white matter, and on the functional architecture. Finally, MRI measures related to clinical, behavioral, and electrophysiological markers have a key role to play from a diagnostic and prognostic perspective in the implementation of early interventions to avoid long-term disabilities in children. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Jessica Dubois
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Marianne Alison
- University of ParisNeuroDiderot, INSERM,ParisFrance
- Department of Pediatric RadiologyAPHP, Robert‐Debré HospitalParisFrance
| | - Serena J. Counsell
- Centre for the Developing BrainSchool of Biomedical Engineering & Imaging Sciences, King's College LondonLondonUK
| | - Lucie Hertz‐Pannier
- University of ParisNeuroDiderot, INSERM,ParisFrance
- UNIACT, NeuroSpin, CEA; Paris‐Saclay UniversityGif‐sur‐YvetteFrance
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Woman, Child and AdolescentUniversity Hospitals of GenevaGenevaSwitzerland
| | - Manon J.N.L. Benders
- Department of NeonatologyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtthe Netherlands
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Abstract
BACKGROUND The altered neurodevelopment of children operated on during the neonatal period might be due to peri-operative changes in the homeostasis of brain perfusion. Monitoring of vital signs is a standard of care, but it does not usually include monitoring of the brain. OBJECTIVES To evaluate methods of monitoring the brain that might be of value. We also wanted to clarify if there are specific risk factors that result in peri-operative changes and how this might be evaluated. DESIGN Systematic review. DATA SOURCES A structured literature search was performed in MEDLINE in Ovid, Embase, Cochrane CENTRAL, Web of Science and Google Scholar. ELIGIBILITY CRITERIA Studies in neonates who received peri-operative neuromonitoring were eligible for inclusion; studies on neurosurgical procedures or cardiac surgery with cardiopulmonary bypass and/or deep hypothermia cardiac arrest were excluded. RESULTS Nineteen of the 24 included studies, totalling 374 infants, reported the use of near-infrared spectroscopy. Baseline values of cerebral oxygenation greatly varied (mean 53 to 91%) and consequently, no coherent results were found. Two studies found a correlation between cerebral oxygenation and mean arterial blood pressure. Five studies, with in total 388 infants, used (amplitude-integrated) electro-encephalography to study peri-operative brain activity. Overall, the brain activity decreased during anaesthesia and epileptic activity was more frequent in the peri-operative phase. The association between intra-operative cerebral saturation or activity and neuro-imaging abnormalities and/or neurodevelopmental outcome was investigated in six studies, but no association was found. CONCLUSION Neuromonitoring with the techniques currently used will neither help our understanding of the altered neonatal pathophysiology, nor enable early detection of deviation from the norm. The modalities lack specificity and are not related to clinical (long-term) outcome or prognosis. Accordingly, we were unable to draw up a monitoring guideline.
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Chiarelli AM, Perpetuini D, Croce P, Filippini C, Cardone D, Rotunno L, Anzoletti N, Zito M, Zappasodi F, Merla A. Evidence of Neurovascular Un-Coupling in Mild Alzheimer's Disease through Multimodal EEG-fNIRS and Multivariate Analysis of Resting-State Data. Biomedicines 2021; 9:biomedicines9040337. [PMID: 33810484 PMCID: PMC8066873 DOI: 10.3390/biomedicines9040337] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 12/18/2022] Open
Abstract
Alzheimer’s disease (AD) is associated with modifications in cerebral blood perfusion and autoregulation. Hence, neurovascular coupling (NC) alteration could become a biomarker of the disease. NC might be assessed in clinical settings through multimodal electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). Multimodal EEG-fNIRS was recorded at rest in an ambulatory setting to assess NC and to evaluate the sensitivity and specificity of the methodology to AD. Global NC was evaluated with a general linear model (GLM) framework by regressing whole-head EEG power envelopes in three frequency bands (theta, alpha and beta) with average fNIRS oxy- and deoxy-hemoglobin concentration changes in the frontal and prefrontal cortices. NC was lower in AD compared to healthy controls (HC) with significant differences in the linkage of theta and alpha bands with oxy- and deoxy-hemoglobin, respectively (p = 0.028 and p = 0.020). Importantly, standalone EEG and fNIRS metrics did not highlight differences between AD and HC. Furthermore, a multivariate data-driven analysis of NC between the three frequency bands and the two hemoglobin species delivered a cross-validated classification performance of AD and HC with an Area Under the Curve, AUC = 0.905 (p = 2.17 × 10−5). The findings demonstrate that EEG-fNIRS may indeed represent a powerful ecological tool for clinical evaluation of NC and early identification of AD.
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Affiliation(s)
- Antonio M. Chiarelli
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
- Correspondence: ; Tel.: +39-087-1355-6954
| | - David Perpetuini
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
| | - Pierpaolo Croce
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
| | - Chiara Filippini
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
| | - Daniela Cardone
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
| | - Ludovica Rotunno
- Department of Medicine and Science of Ageing, Faculty of Medicine, University G. d’Annunzio of Chieti-Pescara, Via Dei Vestini 31, 66100 Chieti, Italy; (L.R.); (N.A.); (M.Z.)
| | - Nelson Anzoletti
- Department of Medicine and Science of Ageing, Faculty of Medicine, University G. d’Annunzio of Chieti-Pescara, Via Dei Vestini 31, 66100 Chieti, Italy; (L.R.); (N.A.); (M.Z.)
| | - Michele Zito
- Department of Medicine and Science of Ageing, Faculty of Medicine, University G. d’Annunzio of Chieti-Pescara, Via Dei Vestini 31, 66100 Chieti, Italy; (L.R.); (N.A.); (M.Z.)
| | - Filippo Zappasodi
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
| | - Arcangelo Merla
- Department of Neuroscience, Imaging and Clinical Sciences, Institute for Advanced Biomedical Technologies, Faculty of Medicine, University G. D’Annunzio of Chieti-Pescara, Via Luigi Polacchi 13, 66100 Chieti, Italy; (D.P.); (P.C.); (C.F.); (D.C.); (F.Z.); (A.M.)
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Inocencio IM, Tran NT, Khor SJ, Wiersma M, Nakamura S, Walker DW, Wong FY. The cerebral haemodynamic response to somatosensory stimulation in preterm newborn lambs is reduced with dopamine or dobutamine infusion. Exp Neurol 2021; 341:113687. [PMID: 33713656 DOI: 10.1016/j.expneurol.2021.113687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND In the adult brain, increases in neural activity lead to increases in local blood flow. However, in the preterm neonate, studies of cerebral functional haemodynamics have yielded inconsistent results, including negative responses suggesting decreased perfusion and localised tissue hypoxia, probably due to immature neurovascular coupling. Furthermore, the impact of vasoactive medications, such as dopamine and dobutamine used as inotropic therapies in preterm neonates, on cerebrovascular responses to somatosensory input is unknown. We aimed to characterise the cerebral haemodynamic functional response after somatosensory stimulation in the preterm newborn brain, with and without dopamine or dobutamine treatment. METHODS We studied the cerebral haemodynamic functional response in 13 anaesthetised preterm lambs, using near infrared spectroscopy to measure changes in cerebral oxy- and deoxyhaemoglobin (ΔoxyHb, ΔdeoxyHb) following left median nerve stimulation using stimulus trains of 1.8, 4.8 and 7.8 s. The 4.8 and 7.8 s stimulations were repeated during dopamine or dobutamine infusion. RESULTS Stimulation always produced a somatosensory evoked response. Majority of preterm lambs demonstrated positive functional responses (i.e. increased ΔoxyHb) in the contralateral cortex following stimulus trains of all durations. Dopamine increased baseline oxyHb and total Hb, whereas dobutamine increased baseline deoxyHb. Both dopamine and dobutamine reduced the evoked ΔoxyHb responses to 4.8 and 7.8 s stimulations. CONCLUSIONS Somatosensory stimulation increases cerebral oxygenation in the preterm brain, consistent with increased cerebral blood flow due to neurovascular coupling. Notably, our results show that dopamine/dobutamine reduces oxygen delivery relative to consumption in the preterm brain during somatosensory stimulations, suggesting there may be a risk of intermittent localised tissue hypoxia which has clear implications for clinical practice and warrants further investigation.
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Affiliation(s)
- Ishmael M Inocencio
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | - Nhi T Tran
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Song J Khor
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | - Manon Wiersma
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | - Shinji Nakamura
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - David W Walker
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Flora Y Wong
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia; Monash Newborn, Monash Medical Centre, Melbourne, Australia.
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49
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Tian F, Sepulveda P, Kota S, Liu Y, Das Y, Liu H, Zhang R, Chalak L. Regional heterogeneity of cerebral hemodynamics in mild neonatal encephalopathy measured with multichannel near-infrared spectroscopy. Pediatr Res 2021; 89:882-888. [PMID: 32492696 DOI: 10.1038/s41390-020-0992-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Neuromonitoring at the bedside is the key to understand the pathophysiological mechanisms of brain injury associated with neonatal encephalopathy. The current practice is to monitor the forehead using a noninvasive cerebral oximetry-it remains unknown to what extent cerebral hemodynamics in other brain regions is different to the frontal region. METHOD A multichannel near-infrared spectroscopy (NIRS) system was used to monitor neonates (n = 14) with fetal acidosis and mild neonatal encephalopathy at four brain regions (the frontal, posterior, left temporal, and right temporal lobes). The data were compared to delineate the regional difference in (1) cerebral hemodynamics and (2) pressure autoregulation. For both analyses, wavelet transform coherence was applied. RESULTS We observed frontal-posterior heterogeneity as indicated by significantly lower coherence between these two regions (p = 0.02). Furthermore, areas with regional magnetic resonance imaging (MRI)-detected lesions showed greater hemodynamic variations compared to non-affected areas (p = 0.03), while cerebral autoregulation was not affected and showed no difference. CONCLUSION Cerebral hemodynamics in mild neonatal encephalopathy is heterogeneous across different brain regions, while cerebral autoregulation remains intact. These findings indicate the robustness of the wavelet measure of cerebral autoregulation in this population, but need to be further investigated in the presence of severe injury. IMPACT This proof-of-concept study is the first to investigate the regional difference of cerebral hemodynamics and autoregulation in mild neonatal encephalopathy. Study findings confirm that brain functions are complex in the developing neonatal brain and that cerebral hemodynamics are region specific in newborns with frontal-posterior heterogeneity among brain regions probed by multichannel NIRS. Regional MRI lesions were associated with differences across NIRS regional channels among the affected side. Cerebral autoregulation with multichannel NIRS is not affected by regional MRI abnormalities.
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Affiliation(s)
- Fenghua Tian
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Pollieanna Sepulveda
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Srinivas Kota
- Departments of Internal Medicine and Neurosciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - Yulun Liu
- Departments of Internal Medicine and Neurosciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - Yudhajit Das
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Hanli Liu
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA
| | - Rong Zhang
- Departments of Internal Medicine and Neurosciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Institute for Exercise and Environmental Medicine, Dallas, TX, USA
| | - Lina Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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50
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Olung NF, Aluko OM, Jeje SO, Adeagbo AS, Ijomone OM. Vascular Dysfunction in the Brain; Implications for Heavy Metal Exposures. Curr Hypertens Rev 2021; 17:5-13. [PMID: 33632106 DOI: 10.2174/1573402117666210225085528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/24/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022]
Abstract
Normal or diseased conditions that alter the brain's requirement for oxygen and nutrients via alterations to neurovascular coupling have an impact on the level of the neurovascular unit; comprising neuronal, glial and vascular components. The communications between the components of the neurovascular unit are precise and accurate for its functions; hence a minute disturbance can result in neurovascular dysfunction. Heavy metals such as cadmium, mercury, and lead have been identified to increase the vulnerability of the neurovascular unit to damage. This review examines the role of heavy metals in neurovascular dysfunctions and the possible mechanisms by which these metals act. Risk factors ranging from lifestyle, environment, genetics, infections, and physiologic ageing involved in neurological dysfunctions were highlighted, while stroke was discussed as the prevalent consequence of neurovascular dysfunctions. Furthermore, the role of these heavy metals in the pathogenesis of stroke consequently pinpoints the importance of understanding the mechanisms of neurovascular damage in a bid to curb the occurrence of neurovascular dysfunctions.
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Affiliation(s)
- Nzube F Olung
- The Neuro-Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Oritoke M Aluko
- The Neuro-Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Sikirullai O Jeje
- Department of Physiology, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Ayotunde S Adeagbo
- Department of Physiology, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
| | - Omamuyovwi M Ijomone
- The Neuro-Lab, School of Health and Health Technology, Federal University of Technology, Akure, Nigeria
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