Association of Intracranial Atherosclerotic Disease With Brain β-Amyloid Deposition

Alzheimer’s disease (AD) is the most prevalent and severe neurodegenerative disease affecting more than 0.024 billion people globally, more common in women as compared to men. Senile plaques and amyloid deposition are among the main causes of AD. Amyloid deposition is considered as a central event which induces the link between the production of β amyloid and vascular changes. Presence of numerous biomarkers such as cerebral amyloid angiopathy, microvascular changes, senile plaques, changes in white matter, granulovascular degeneration specifies the manifestation of AD while an aggregation of tau protein is considered as a primary marker of AD. Likewise, microvascular changes, activation of microglia (immune defense system of CNS), amyloid-beta aggregation, senile plaque and many more biomarkers are nearly found in all Alzheimer’s patients. It was seen that 70% of Alzheimer’s cases occur due to genetic factors. It has been reported in various studies that apolipoprotein E(APOE) mainly APOE4 is one of the major risk factors for the later onset of AD. Several pathological changes also occur in the white matter which include dilation of the perivascular space, loss of axons, reactive astrocytosis, oligodendrocytes and failure to drain interstitial fluid. In this review, we aim to highlight the various biological signatures associated with the AD which may further help in discovering multitargeting drug therapy.

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A Comparison of β-Amyloid Deposition in the Medial Temporal Lobe in Sporadic Alzheimer's Disease, Down's Syndrome and Normal Elderly Brains

Neurodegeneration ◽

10.1006/neur.1996.0005 ◽

1996 ◽

Vol 5 (1) ◽

pp. 35-41 ◽

Cited By ~ 14

Author(s):

R.A. Armstrong ◽

N.J. Cairns ◽

D. Myers ◽

C.U.M. Smith ◽

P.L. Lantos ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Temporal Lobe ◽

Medial Temporal Lobe ◽

Down's Syndrome ◽

Down’S Syndrome ◽

Amyloid Deposition ◽

Sporadic Alzheimer’S Disease ◽

Β Amyloid

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Striatal β-Amyloid Deposition in Parkinson Disease With Dementia

Journal of Neuropathology & Experimental Neurology ◽

10.1097/nen.0b013e31816362aa ◽

2008 ◽

Vol 67 (2) ◽

pp. 155-161 ◽

Cited By ~ 86

Author(s):

Michail E. Kalaitzakis ◽

Manuel B. Graeber ◽

Stephen M. Gentleman ◽

Ronald K. B. Pearce

Keyword(s):

Parkinson Disease ◽

Amyloid Deposition ◽

Β Amyloid

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Intraplaque Hemorrhage in Symptomatic Intracranial Atherosclerotic Disease

Journal of Neuroimaging ◽

10.1111/j.1552-6569.2009.00442.x ◽

2011 ◽

Vol 21 (2) ◽

pp. e159-e161 ◽

Cited By ~ 48

Author(s):

Tanya N. Turan ◽

Leonardo Bonilha ◽

Paul S. Morgan ◽

Robert J. Adams ◽

Marc I. Chimowitz

Keyword(s):

Atherosclerotic Disease ◽

Intraplaque Hemorrhage ◽

Intracranial Atherosclerotic Disease

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Abstract P476: Safety and Efficacy of Balloon Mounted Drug-Eluting Stent in the Treatment of Symptomatic Intracranial Atherosclerotic Disease Multicenter International Experience

Stroke ◽

10.1161/str.52.suppl_1.p476 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mahmoud Mohammaden ◽

Raul G Nogueira ◽

WONDWOSSEN TEKLE ◽

farhan siddiq ◽

Diogo C Haussen ◽

...

Keyword(s):

Clinical Trials ◽

Endovascular Treatment ◽

Medical Management ◽

Randomized Clinical Trials ◽

Atherosclerotic Disease ◽

Drug Eluting Stent ◽

Safety And Efficacy ◽

Intracranial Atherosclerotic Disease ◽

Drug Eluting

Introduction: Intracranial atherosclerotic disease (ICAD) is a common cause of refractory stroke. Randomized clinical trials failed to prove the safety and efficacy of the endovascular treatment options of symptomatic ICAD (sICAD). However, there are many concerns regarding inclusion criteria in these trials which made them less effective than standard medical management. Herein, we aim to study the safety and efficacy of drug-eluting balloon mounted stents (DES) in the treatment of sICAD. Methods: A retrospective review of endovascular database from 10 comprehensive stroke centers inside and outside the USA from January 2017 to January 2020 was reviewed. Patients were included if they had symptomatic intracranial stenosis ≥70% in the target vessel, failed best medical management, and underwent intracranial stenting with DES. The primary outcome was the occurrence of ischemic stroke, hemorrhage, or mortality within 72 hours of the procedure. Secondary outcomes included rates of symptomatic and angiographic recurrence within 6 months of the procedure. Results: There was a total of 129 patients, the median age was 65 [58-72] years, 40 (31%) were females. The intracranial stenotic lesions were located in anterior circulation in 74 (57.4%) of cases [24 (18.6%) supraclinoid ICA, 5 (3.9%) cavernous ICA, 17 (13.2%) petrous ICA, 5 (19.4%) MCA-M1, and 3 (2.3%) M2] and in posterior circulation in 55 (42.6%) of cases [36 (27.9) vertebral artery V4 segment, 18 (14%) basilar and 1 (0.7%) PCA]. Recurrent stroke was the qualifying event in 101 (78.3%) while transient ischemic attacks (TIA) were identified in 28 (21.7%) of cases. The median time from the qualifying event to stenting was 6 [2-24] days. Strokes were reported within 72 hours of the procedure; 2 (1.6%) ischemic, 2 (1.6%) hemorrhagic strokes and 2 (1.6%) patients suffered inpatient mortality. The median follow-up time was 6 [3-6.75] months. Among 99 patients who had clinical follow up 2 (2%) had TIA and 6 (6.1%) had strokes. Fifty-one patients had follow-up imaging of whom symptomatic ISR was reported in 8 (15.7%). Conclusion: Our study has shown that in appropriately selected patients with sICAD, endovascular treatment using DES is safe and effective. Prospective randomized clinical trials are warranted.

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