The neuropsychological evaluation including word fluency test in the patients with cerebral white matter ischemia

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.

Download Full-text

Tractography Alterations in the Arcuate and Uncinate Fasciculi in Post-Stroke Aphasia

Brain Sciences ◽

10.3390/brainsci11010053 ◽

2021 ◽

Vol 11 (1) ◽

pp. 53

Author(s):

Sara Kierońska ◽

Milena Świtońska ◽

Grzegorz Meder ◽

Magdalena Piotrowska ◽

Paweł Sokal

Keyword(s):

White Matter ◽

Brain Connectivity ◽

Three Dimensional ◽

Cerebral White Matter ◽

Neural Pathways ◽

Uncinate Fasciculus ◽

Arcuate Fasciculus ◽

Fiber Tractography ◽

Post Stroke

Fiber tractography based on diffuse tensor imaging (DTI) can reveal three-dimensional white matter connectivity of the human brain. Tractography is a non-invasive method of visualizing cerebral white matter structures in vivo, including neural pathways surrounding the ischemic area. DTI may be useful for elucidating alterations in brain connectivity resulting from neuroplasticity after stroke. We present a case of a male patient who developed significant mixed aphasia following ischemic stroke. The patient had been treated by mechanical thrombectomy followed by an early rehabilitation, in conjunction with transcranial direct current stimulation (tDCS). DTI was used to examine the arcuate fasciculus and uncinate fasciculus upon admission and again at three months post-stroke. Results showed an improvement in the patient’s symptoms of aphasia, which was associated with changes in the volume and numbers of tracts in the uncinate fasciculus and the arcuate fasciculus.

Download Full-text

Significant higher‐level C‐C motif chemokine ligand 2/3 and chemotactic power in cerebral white matter than grey matter in rat and human.

European Journal of Neuroscience ◽

10.1111/ejn.15187 ◽

2021 ◽

Author(s):

Jingdong Zhang ◽

Xinrui Gong ◽

Huangui Xiong

Keyword(s):

White Matter ◽

Grey Matter ◽

Cerebral White Matter ◽

Chemokine Ligand ◽

Chemokine Ligand 2

Download Full-text

Impaired Cerebrovascular Hemodynamics are Associated with Cerebral White Matter Damage

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2013.180 ◽

2013 ◽

Vol 34 (2) ◽

pp. 228-234 ◽

Cited By ~ 70

Author(s):

Sushmita Purkayastha ◽

Otite Fadar ◽

Aujan Mehregan ◽

David H Salat ◽

Nicola Moscufo ◽

...

Keyword(s):

White Matter ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Cerebral Autoregulation ◽

Structural Integrity ◽

Cerebral White Matter ◽

Elderly Individuals ◽

Transfer Function Analysis ◽

Dynamic Cerebral Autoregulation ◽

Cerebrovascular Hemodynamics

White matter hyperintensities (WMH) in elderly individuals with vascular diseases are presumed to be due to ischemic small vessel diseases; however, their etiology is unknown. We examined the cross-sectional relationship between cerebrovascular hemodynamics and white matter structural integrity in elderly individuals with vascular risk factors. White matter hyperintensity volumes, fractional anisotropy (FA), and mean diffusivity (MD) were obtained from MRI in 48 subjects (75±7years). Pulsatility index (PI) and dynamic cerebral autoregulation (dCA) was assessed using transcranial Doppler ultrasound of the middle cerebral artery. Dynamic cerebral autoregulation was calculated from transfer function analysis (phase and gain) of spontaneous blood pressure and flow velocity oscillations in the low (LF, 0.03 to 0.15 Hz) and high (HF, 0.16 to 0.5 Hz) frequency ranges. Higher PI was associated with greater WMH ( P<0.005). Higher phase across all frequency ranges was associated with greater FA and lower MD ( P<0.005). Lower gain was associated with higher FA in the LF range ( P=0.001). These relationships between phase and FA were significant in the territories limited to the middle cerebral artery as well as across the entire brain. Our results show a strong relationship between impaired cerebrovascular hemodynamics (PI and dCA) and loss of cerebral white matter structural integrity (WMH and DTI metrics) in elderly individuals.

Download Full-text

Arterial stiffness and progression of cerebral white matter hyperintensities in patients with type 2 diabetes and matched controls: a 5-year cohort study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00691-y ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Kristian L. Funck ◽

Esben Laugesen ◽

Pernille Høyem ◽

Brian Stausbøl-Grøn ◽

Won Y. Kim ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

White Matter ◽

Arterial Stiffness ◽

White Matter Hyperintensities ◽

Cerebrovascular Diseases ◽

Study Data ◽

Cerebral White Matter ◽

Intracranial Volume

Abstract Background Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. Methods In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (0.8–3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). Results Patients with T2DM had a higher PWV than controls (8.8 ± 2.2 vs. 7.9 ± 1.4 m/s, p < 0.01). WMH progression were similar in the two groups (p = 0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1–32%], p < 0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p < 0.05). We found no interaction between diabetes and PWV on cWMH progression. Conclusions PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.

Download Full-text