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Plasma and cerebrospinal fluid neurofilament light concentrations reflect neuronal damage in systemic lupus Erythematosus. BMC Neurol 2022; 22:467. [PMID: 36494778 PMCID: PMC9733256 DOI: 10.1186/s12883-022-02998-3] [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: 05/04/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neuronal damage in systemic lupus erythematosus (SLE) is common, but the extent and mechanisms are unclear. Neurofilament light (NfL) concentrations rise in plasma and cerebrospinal fluid (CSF) during neuronal damage in various neurological disorders. In this cross-sectional study, plasma and CSF concentrations of NfL were explored as a marker of neuronal damage in SLE. METHODS Seventy-two consecutive SLE out-patients and 26 healthy controls, all female, aged < 55 years, underwent magnetic resonance imaging (MRI) and neurocognitive testing. NfL concentrations in plasma from all individuals and in CSF from 32 patients were measured with single-molecule array technology. Patients were assessed by a rheumatologist and neurologist to define neuropsychiatric involvement (NPSLE) according to three attribution models: SLICC A, SLICC B and ACR. RESULTS Plasma and CSF NfL concentrations correlated strongly (r = 0.72, p < 0.001). Both NPSLE and non-NPSLE patients in all attribution models had higher plasma NfL concentrations compared with healthy controls (log-NfL, pg/ml, mean (SD); healthy controls (0.71 (0.17)); SLICC A model: NPSLE (0.87 (0.13), p = 0.003), non-NPSLE (0.83 (0.18), p = 0.005); SLICC B model: NPSLE (0.87 (0.14), p = 0.001), non-NPSLE (0.83 (0.18), p = 0.008); ACR model: NPSLE (0.86 (0.16), p < 0.001), non-NPSLE (0.81 (0.17), p = 0.044)). Plasma and CSF NfL concentrations did not differ between NPSLE and non-NPSLE patients. Higher plasma NfL concentrations correlated with larger CSF volumes on MRI (r = 0.34, p = 0.005), and was associated with poorer cognitive performance in the domains of simple attention, psychomotor speed and verbal memory. SLICC/ACR-Damage Index ≥1 was independently associated with higher plasma NfL concentrations (β = 0.074, p = 0.038). Higher plasma creatinine concentrations, anti-dsDNA-positivity, low complement C3 levels, or a history of renal involvement were associated with higher plasma NfL concentrations (β = 0.003, p = 0.009; β = 0.072, p = 0.031; β = 0.077, p = 0.027; β = 0.069, p = 0.047, respectively). CONCLUSIONS Higher plasma NfL concentrations in NPSLE and non-NPSLE patients may indicate a higher degree of neuronal damage in SLE in general, corresponding to cognitive impairment and organ damage development. Furthermore, our results may indicate a higher degree of neuronal breakdown in patients with active SLE, also without overt clinical symptoms. NfL may serve as an indicator of neuronal damage in SLE in further studies.
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Nooraei A, Khazaeel K, Darvishi M, Ghotbeddin Z, Basir Z. Dimorphic evaluation of hippocampal changes in rat model of demyelination: A comparative functional, morphometric, and histological study. Brain Behav 2022; 12:e32723. [PMID: 35861689 PMCID: PMC9392515 DOI: 10.1002/brb3.2723] [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: 08/27/2021] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is the most common autoimmune disease. Progressive depletion of the brain and spinal cord tissue appears at the onset of the disease. Several studies have shown the increased size of the ventricles of the brain and decreases in the area of the corpus callosum and the width of the brain. Other important symptoms of this disease are cognitive, learning, and memory disorders. AIM The aim of this study was to compare morphometric, histological, and functional changes in the demyelination model in both sexes. MATERIALS AND METHODS In this experimental study, male and female Wistar rats were studied in four experimental groups. Demyelination was induced by the injection of ethidium bromide in the ventricular region. The chronic effect of demyelination on spatial memory, movement, and coordination was investigated using the Morris Water Maze (MWM), and clinical and balance beam tests, respectively. Myelin degradation, cell death and neurogenesis were estimated using Luxol Fast Blue staining and immunohistochemistry (Caspase-3 and Nestin markers). In addition, morphometric findings were recorded for the brain and hippocampus (weight, volume, length, width). RESULT Demyelination increased the time and distance index and decreased the residence time in the target quarter in the water maze test (p < .001). It also increases the neuromuscular and modified neurological severity score (p < .01). Demyelination increases caspase-3 (p < .05) expression and decreases Nestin expression (p < .001), which are directly related to the extent of damage. CONCLUSION This study showed an interaction between hippocampal structural and functional networks in explaining spatial learning and memory in the early stages of MS.
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Affiliation(s)
- Aref Nooraei
- Faculty of Veterinary Medicine, Department of Basic Sciences, Shahid Chamran University of Ahvaz, Iran
| | - Kaveh Khazaeel
- Faculty of Veterinary Medicine, Department of Basic Sciences, Shahid Chamran University of Ahvaz, Iran.,Stem Cell and Transgenic Technology Research Center, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Marzieh Darvishi
- Faculty of Medicine, Department of Anatomy, Ilam University of Medical Sciences, Ilam, Iran.,Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Zohreh Ghotbeddin
- Faculty of Veterinary Medicine, Department of Basic Sciences, Shahid Chamran University of Ahvaz, Iran.,Stem Cell and Transgenic Technology Research Center, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Zahra Basir
- Faculty of Veterinary Medicine, Department of Basic Sciences, Shahid Chamran University of Ahvaz, Iran
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da Silva PHR, Paschoal AM, Secchinatto KF, Zotin MCZ, Dos Santos AC, Viswanathan A, Pontes-Neto OM, Leoni RF. Contrast agent-free state-of-the-art magnetic resonance imaging on cerebral small vessel disease - Part 2: Diffusion tensor imaging and functional magnetic resonance imaging. NMR IN BIOMEDICINE 2022; 35:e4743. [PMID: 35429070 DOI: 10.1002/nbm.4743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Cerebral small vessel disease (cSVD) has been widely studied using conventional magnetic resonance imaging (MRI) methods, although the association between MRI findings and clinical features of cSVD is not always concordant. We assessed the additional contribution of contrast agent-free, state-of-the-art MRI techniques, particularly diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), to understand brain damage and structural and functional connectivity impairment related to cSVD. We performed a review following the PICOS worksheet and Search Strategy, including 152 original papers in English, published from 2000 to 2022. For each MRI method, we extracted information about their contributions regarding the origins, pathology, markers, and clinical outcomes in cSVD. In general, DTI studies have shown that changes in mean, radial, and axial diffusivity measures are related to the presence of cSVD. In addition to the classical deficit in executive functions and processing speed, fMRI studies indicate connectivity dysfunctions in other domains, such as sensorimotor, memory, and attention. Neuroimaging metrics have been correlated with the diagnosis, prognosis, and rehabilitation of patients with cSVD. In short, the application of contrast agent-free, state-of-the-art MRI techniques has provided a complete picture of cSVD markers and tools to explore questions that have not yet been clarified about this clinical condition. Longitudinal studies are desirable to look for causal relationships between image biomarkers and clinical outcomes.
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Affiliation(s)
| | - André Monteiro Paschoal
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Maria Clara Zanon Zotin
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Antônio Carlos Dos Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Anand Viswanathan
- J Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Octavio M Pontes-Neto
- Department of Neurosciences and Behavioral Science, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Ferranti Leoni
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Rroji M, Figurek A, Viggiano D, Capasso G, Spasovski G. Phosphate in the Context of Cognitive Impairment and Other Neurological Disorders Occurrence in Chronic Kidney Disease. Int J Mol Sci 2022; 23:ijms23137362. [PMID: 35806367 PMCID: PMC9266940 DOI: 10.3390/ijms23137362] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023] Open
Abstract
The nervous system and the kidneys are linked under physiological states to maintain normal body homeostasis. In chronic kidney disease (CKD), damaged kidneys can impair the central nervous system, including cerebrovascular disease and cognitive impairment (CI). Recently, kidney disease has been proposed as a new modifiable risk factor for dementia. It is reported that uremic toxins may have direct neurotoxic (astrocyte activation and neuronal death) and/or indirect action through vascular effects (cerebral endothelial dysfunction, calcification, and inflammation). This review summarizes the evidence from research investigating the pathophysiological effects of phosphate toxicity in the nervous system, raising the question of whether the control of hyperphosphatemia in CKD would lower patients’ risk of developing cognitive impairment and dementia.
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Affiliation(s)
- Merita Rroji
- Department of Nephrology, Faculty of Medicine, University of Medicine Tirana, 1001 Tirana, Albania
- Correspondence:
| | - Andreja Figurek
- Department of Internal Medicine, Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
- Institute of Anatomy, University of Zurich, 8057 Zurich, Switzerland
| | - Davide Viggiano
- Department of Translational Medical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (D.V.); (G.C.)
- BioGeM, Institute of Molecular Biology and Genetics, 83031 Ariano Irpino, Italy
| | - Giovambattista Capasso
- Department of Translational Medical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (D.V.); (G.C.)
- BioGeM, Institute of Molecular Biology and Genetics, 83031 Ariano Irpino, Italy
| | - Goce Spasovski
- University Clinic for Nephrology, Medical Faculty, University St. Cyril and Methodius, 1000 Skopje, North Macedonia;
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Guo Z, Meng Z, Mu R, Qin X, Zhuang Z, Zheng W, Liu F, Zhu X. Amide Proton Transfer MRI Could Be Used to Evaluate the Pathophysiological Status of White Matter Hyperintensities. J Magn Reson Imaging 2021; 56:301-309. [PMID: 34854519 DOI: 10.1002/jmri.28013] [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: 10/12/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The pathophysiology of white matter hyperintensities (WMH) remains unclear, investigations of amide proton transfer (APT) signals in WMH disease may provide relevant pathophysiological information. PURPOSE To evaluate the APT signals differences and heterogeneity of WMH and adjacent normal-appearing white matter (NAWM) at different Fazekas grades and different locations. STUDY TYPE Prospective. POPULATION In all, 180 WMH patients (age, 40-76; male/female, 77/103) and 59 healthy controls (age, 42-70; male/female, 23/36). FIELD STRENGTH/SEQUENCE A 3 T; 3D fluid-attenuated inversion recovery (FLAIR), 3D APT-weighted (APTw). ASSESSMENT The mean APTw values (APTwmean ) and the APTw signals heterogeneity (APTwmax-min ) among different grades WMH and NAWM and the APTwmean of the same grade deep WMH (DWMH) and paraventricular WMH (PWMH) were calculated and compared. Regions of interests were delineated on WMH lesions, NAWM and healthy white matter. STATISTICAL TESTS One-way analysis of variance (ANOVA); independent sample t test; Chi-square test. Significance level: P < 0.05. RESULTS APTwmean among different grade WMH (from grade 0 to 3, 0.58 ± 0.14% vs. 0.29 ± 0.23% vs. 0.37 ± 0.24% vs. 0.61 ± 0.22%, respectively) were significantly different except between grade 1 and 2 (P = 0.27) and between grade 0 and 3 (P = 0.97). The differences in APTwmean between WMH and NAWM were significant (WMH vs. NAWM from grade 1 to 3, 0.29% ± 0.23% vs. 0.55% ± 0.27%; 0.37% ± 0.24% vs. 0.59% ± 0.22%; 0.61% ± 0.22% vs. 0.42% ± 0.24%, respectively). Lower APTwmean values were found only in grade 3 NAWM than other grades NAWM and controls. The APTwmax-min values of grade 1-3 WMH (0.38% ± 0.27% vs. 0.51% ± 0.31% vs. 0.67% ± 0.34%, respectively) were significantly different. Higher APTmean values were found only in grade 2 PWMH (0.47% ± 0.22% vs. 0.32% ± 0.24%). DATA CONCLUSION Significant differences of APT signals were found in WMH of different Fazekas grades and different locations. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Zixuan Guo
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zhuoni Meng
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Ronghua Mu
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiaoyan Qin
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Zeyu Zhuang
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Wei Zheng
- Department of Medical Imaging, Guilin Medical University, Guilin, China.,Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Fuzhen Liu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Xiqi Zhu
- Department of Medical Imaging, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
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Jacków-Nowicka J, Podgórski P, Bladowska J, Szcześniak D, Rymaszewska J, Zatońska K, Połtyn-Zaradna K, Szuba A, Sa Siadek M, Zimny A. The Impact of Common Epidemiological Factors on Gray and White Matter Volumes in Magnetic Resonance Imaging-Is Prevention of Brain Degeneration Possible? Front Neurol 2021; 12:633619. [PMID: 34326804 PMCID: PMC8315783 DOI: 10.3389/fneur.2021.633619] [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: 11/25/2020] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The aim of the study was to evaluate the impact of multiple risk factors (age, diabetes, hypertension, hyperlipidemia, BMI, smoking, alcohol) on the gray and white matter volumes as well as on the burden of white matter hyperintensities (WMH). Material and Methods: The study group consisted of 554 subjects (age range: 50–69 yrs, F/M: 367/187) recruited from the larger cohort of the Polish fraction of the Prospective Urban Rural Epidemiological (PURE) study. The participants answered questionnaires about their lifestyle, underwent physical and psychological examination (MoCA test), laboratory blood tests followed by brain MRI. Volumetric measurements of the total gray matter (GMvol), total white matter (WMvol) and WHM (WMHvol) normalized to the total intracranial volume were performed using the Computational Anatomy Toolbox 12 (CAT12) and Statistical Parametric Maps 12 (SPM12) based on 3D T1-weighted sequence. The influence of risk factors was assessed using multiple regression analysis before and after correction for multiple comparisons. Results: Older age was associated with lower GMvol and WMvol, and higher WMHvol (p < 0.001). Smaller GMvol volume was associated with higher WMHvol (p < 0.001). Higher WMHvol was associated with hypertension (p = 0.01) and less significantly with hyperlipidemia (only before correction p = 0.03). Diabetes, abnormal BMI, smoking and alcohol intake did not have any significant impact on GMvol, WMvol or WMHvol (p > 0.05). MoCA score was not influenced by any of the factors. Conclusions: Gray matter loss is strongly associated with the accumulation of WMH which seems to be potentially preventable by maintaining normal blood pressure and cholesterol levels.
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Affiliation(s)
- Jagoda Jacków-Nowicka
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Przemysław Podgórski
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Katarzyna Zatońska
- Department of Social Medicine, Wroclaw Medical University, Wrocław, Poland
| | | | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Wrocław, Poland
| | - Marek Sa Siadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Anna Zimny
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
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