scholarly journals DIFFUSION TENSOR MAGNETIC RESONANCE IMAGING IN EARLY DIAGNOSIS OF STRUCTURAL CHANGES IN BRAIN WHITE MATTER IN SMALL VESSEL DISEASE ASSOCIATED WITH ARTERIAL HYPERTENSION AND IONIZING RADIATION

2020 ◽  
Vol 25 ◽  
pp. 558-568
Author(s):  
I. Dykan ◽  
◽  
Y. Golovchenko ◽  
K. Loganovsky ◽  
O. Semonova ◽  
...  
Keyword(s):  
White Matter ◽  
Ionizing Radiation ◽  
Arterial Hypertension ◽  
Structural Changes ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Brain White Matter ◽  
Commissural Pathways ◽  
The Brain

Objective. to determine the early signs of structural changes in brain white matter in small vessel disease associated with arterial hypertension and exposure to ionizing radiation using DTI-MRI. Materials and methods. 45 patients (mean age (57.56 ± 6.34) years) with small vessel disease (SVD) associated with arterial hypertension (AH) were examined: group I – 20 patients, participants of liquidation of the accident at the Chornobyl nuclear power plant (Chornobyl clean-up workers); group II – 25 patients not exposed to ionizing radiation. MRI was performed on an Ingenia 3T tomograph («Philips»). The fractional anisotropy (FA) was determined in the main associative and commissural pathways, periventricular prefrontal areas (fasciculus fronto-occipitalis superior / anterior – f. FO ant., corona radiata anterior – CR ant.) and semioval centers (SC). Results. No signs of cerebral cortex or brain white matter (WM) atrophy, intracerebral microhemorrhages, and widespread areas of leukoaraiosis consolidation were observed in the examined patients. In the Chornobyl clean-up workers a larger number of foci of subcortical leukoaraiosis was visualized (80 %) on MRI images including multiple – 8 (40 %), > 0.5 cm – 10 (50 %), with signs of consolidation – 5 (25 %). The results of the FA analysis in semioval centers showed its significant decrease in the patients of groups I and II (p < 0,007), regardless of the presence or absence of visual signs of subcortical leukoaraiosis (ScLA) (III gr.: 253–317, p < 0.00001; IV gr.: 287– 375, p < 0.001). FA indicators in f. FO ant. and CR ant. in the patients of groups I and II differed insignificantly but were substantially lower than controls (p < 0.05). FA was significantly lower, compared to reference levels, in visually unchanged f. FO ant. (0.389–0.425; p = 0.015) and CR ant. (0.335–0.403; p = 0.05). In patients with AH-associated SVD of middle age, regardless of the effects of ionizing radiation, no significant changes in FA in the main WM associative and commissural pathways were found (p > 0.05). Conclusions. DTI-MRI allows to detect early signs of structural changes in the white matter of the brain – a significant decrease in fractional anisotropy indicators in visually unchanged periventricular and subcortical areas. The main associative and commissural pathways of the brain remain intact in the absence of widespread consolidated foci of leukoaraiosis and lacunar infarctions. The negative impact of ionizing radiation on the course of SVD associated with arterial hypertension is manifested by more active processes of WM disorganization: the prevalence and tendency to the consolidation of periventricular and subcortical leukoaraiosis foci, a significant FA decrease in semioval centers. Key words: DTI, MRI, fractional anisotropy, arterial hypertension, small vessel disease, white matter of the brain, ionizing radiation. Key words: cirrhosis, hepatobiliary system, clean-up workers of Chornobyl NPP accident, retrospective study.

scholarly journals Evaluation of Cerebral Blood Flow Measured by 3D PCASL as Biomarker of Vascular Cognitive Impairment and Dementia (VCID) in a Cohort of Elderly Latinx Subjects at Risk of Small Vessel Disease

2021 ◽  
Vol 15 ◽  
Author(s):  
Kay Jann ◽  
Xingfeng Shao ◽  
Samantha J. Ma ◽  
Steven Y. Cen ◽  
Lina D’Orazio ◽  
...  
Keyword(s):  
At Risk ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cognitive Impairment ◽  
White Matter ◽  
Small Vessel Disease ◽  
Vascular Cognitive Impairment ◽  
Small Vessel ◽  
Vessel Disease ◽  
Brain White Matter

Cerebral small vessel disease (cSVD) affects arterioles, capillaries, and venules and can lead to cognitive impairments and clinical symptomatology of vascular cognitive impairment and dementia (VCID). VCID symptoms are similar to Alzheimer’s disease (AD) but the neurophysiologic alterations are less well studied, resulting in no established biomarkers. The purpose of this study was to evaluate cerebral blood flow (CBF) measured by 3D pseudo-continuous arterial spin labeling (pCASL) as a potential biomarker of VCID in a cohort of elderly Latinx subjects at risk of cSVD. Forty-five elderly Latinx subjects (12 males, 69 ± 7 years) underwent repeated MRI scans ∼6 weeks apart. CBF was measured using 3D pCASL in the whole brain, white matter and 4 main vascular territories (leptomeningeal anterior, middle, and posterior cerebral artery (leptoACA, leptoMCA, leptoPCA), as well as MCA perforator). The test-retest repeatability of CBF was assessed by intra-class correlation coefficient (ICC) and within-subject coefficient of variation (wsCV). Absolute and relative CBF was correlated with gross cognitive measures and domain specific assessment of executive and memory function, vascular risks, and Fazekas scores and volumes of white matter hyperintensity (WMH). Neurocognitive evaluations were performed using Montreal Cognitive Assessment (MoCA) and neuropsychological test battery in the Uniform Data Set v3 (UDS3). Good to excellent test-retest repeatability was achieved (ICC = 0.77–0.85, wsCV 3–9%) for CBF measurements in the whole brain, white matter, and 4 vascular territories. Relative CBF normalized by global mean CBF in the leptoMCA territory was positively correlated with the executive function composite score, while relative CBF in the leptoMCA and MCA perforator territory was positively correlated with MoCA scores, controlling for age, gender, years of education, and testing language. Relative CBF in WM was negatively correlated with WMH volume and MoCA scores, while relative leptoMCA CBF was positively correlated with WMH volume. Reliable 3D pCASL CBF measurements were achieved in the cohort of elderly Latinx subjects. Relative CBF in the leptomeningeal and perforator MCA territories were the most likely candidate biomarker of VCID. These findings need to be replicated in larger cohorts with greater variability of stages of cSVD.

Rich-Club Analysis of the Structural Brain Network in Cases with Cerebral Small Vessel Disease and Depression Symptoms

2021 ◽  
pp. 1-10
Author(s):  
Yanjing Lu ◽  
Yifan Li ◽  
Qian Feng ◽  
Rong Shen ◽  
Hao Zhu ◽  
...  
Keyword(s):  
White Matter ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Depression Symptoms ◽  
Rich Club ◽  
Symptoms Of Depression ◽  
Vessel Disease ◽  
Severity Of Depression ◽  
The Brain

<b><i>Background:</i></b> Altered white matter brain networks have been extensively studied in cerebral small vessel disease (SVD). However, there exists currently a deficiency of comprehending the performance of changes within the structural networks of the brain in cases with cerebral SVD and depression symptoms. The main aim of the present research is to study the network topology behaviors and features of rich-club organization in SVD patients using graph theory and diffusion tensor imaging (DTI) to characterize changes in the microstructure of the brain. <b><i>Methods:</i></b> DTI datasets were acquired from 26 SVD patients with symptoms of depression (SVD + D) and 26 SVD patients without symptoms of depression (SVD − D), and a series of neuropsychological assessments were completed. A structural network was created using a deterministic fiber tracking method. The analysis of rich-club was performed in company with analysis of the global network features of the network to characterize the topological properties of all subjects. <b><i>Results:</i></b> DTI data were obtained from SVD patients who manifested symptoms of depression (SVD + D) and from control SVD patients (SVD − D). In comparison with SVD − D patients, SVD + D cases demonstrated a diminished coefficient of clustering along with lower global efficiencies and longer path length characteristics. Rich-club analysis showed SVD + D patients had decreased feeder connectivity and local connectivity strengths compared to SVD − D patients. Our data also showed that the feeder connections in the brain correlated significantly with the severity of depression in SVD + D patients. <b><i>Conclusions:</i></b> Our study revealed that SVD patients with depressive symptoms have disrupted white matter networks that characteristically have reduced network efficiency compared to the networks in other SVD patients. Disrupted information interactions among the regions of nonrich-club and rich-club in SVD cases are related to the severity of depression. Our data suggest that DTI may be utilized as an appropriate biomarker for the diagnosis of depression in comorbid SVD patients.

scholarly journals Validation and comparison of two automated methods for quantifying brain white matter hyperintensities of presumed vascular origin

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051988005
Author(s):  
Jennifer M.J. Waymont ◽  
Chariklia Petsa ◽  
Chris J. McNeil ◽  
Alison D. Murray ◽  
Gordon D. Waiter
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Manual Segmentation ◽  
Lesion Segmentation ◽  
Vessel Disease ◽  
Brain White Matter ◽  
Automated Methods

Objectives White matter hyperintensities (WMH) are a common imaging finding indicative of cerebral small vessel disease. Lesion segmentation algorithms have been developed to overcome issues arising from visual rating scales. In this study, we evaluated two automated methods and compared them to visual and manual segmentation to determine the most robust algorithm provided by the open-source Lesion Segmentation Toolbox (LST). Methods We compared WMH data from visual ratings (Scheltens’ scale) with those derived from algorithms provided within LST. We then compared spatial and volumetric WMH data derived from manually-delineated lesion maps with WMH data and lesion maps provided by the LST algorithms. Results We identified optimal initial thresholds for algorithms provided by LST compared with visual ratings (Lesion Growth Algorithm (LGA): initial κ and lesion probability thresholds, 0.5; Lesion Probability Algorithm (LPA) lesion probability threshold, 0.65). LGA was found to perform better then LPA compared with manual segmentation. Conclusion LGA appeared to be the most suitable algorithm for quantifying WMH in relation to cerebral small vessel disease, compared with Scheltens’ score and manual segmentation. LGA offers a user-friendly, effective WMH segmentation method in the research environment.

scholarly journals An intrinsic endothelial dysfunction causes cerebral small vessel disease

2021 ◽  
Author(s):  
Sophie Quick ◽  
Tessa V. Procter ◽  
Jonathan Moss ◽  
Angus Lawson ◽  
Serena Baker ◽  
...  
Keyword(s):  
White Matter ◽  
Endothelial Dysfunction ◽  
Blood Brain Barrier ◽  
Small Vessel Disease ◽  
Brain Barrier ◽  
Small Vessel ◽  
Extrinsic Factors ◽  
Vessel Disease ◽  
Brain White Matter ◽  
Blood Brain

Small Vessel Disease (SVD) is the leading cause of vascular dementia, causes a quarter of strokes, and worsens stroke outcomes(1, 2). The disease is characterised by cerebral small vessel and white matter pathology, but the underlying mechanisms are poorly understood. Classically, the microvascular and tissue damage has been considered secondary to extrinsic factors, such as hypertension, consisting of microvessel stiffening, impaired vasoreactivity and blood-brain barrier dysfunction identified in human sporadic SVDs. However, increasing evidence points to an underlying vulnerability to SVD-related brain damage, not just extrinsic factors. Here, in a novel normotensive transgenic rat model where the phospholipase flippase Atp11b is deleted, we show pathological, imaging and behavioural changes typical of those in human sporadic SVD, but that occur without hypertension. These changes are due to an intrinsic endothelial cell dysfunction, identified in vessels of the brain white matter and the retina, with pathological evidence of vasoreactivity and blood-brain barrier deficits, which precipitate a secondary maturation block in oligodendroglia and myelin disruption around the small vessels. This highlights that an intrinsic endothelial dysfunction may underlie vulnerability to human sporadic SVD, providing alternative therapeutic targets to prevent a major cause of stroke and dementia.

scholarly journals Brain White Matter: A Substrate for Resilience and a Substance for Subcortical Small Vessel Disease

2019 ◽  
Vol 9 (8) ◽  
pp. 193 ◽  
Author(s):  
Farzaneh A. Sorond ◽  
Philip B. Gorelick
Keyword(s):  
White Matter ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
White Matter Disease ◽  
Perivascular Spaces ◽  
Vessel Disease ◽  
Brain White Matter ◽  
Age Related ◽  
Vascular Origin ◽  
White Matter Development

Age-related brain white matter disease is a form of small vessel disease (SVD) that may be associated with lacunar and other small subcortical infarcts, cerebral microbleeds, and perivascular spaces. This common form of cerebrovascular disease may manifest clinically as cognitive impairment of varying degrees and difficulty with mobility. Whereas some persons show cognitive decline and mobility failure when there are brain white matter hyperintensities (WMH) and acute stroke, others recover, and not everyone with brain white matter disease is disabled. Thus, repair or compensation of brain white matter may be possible, and furthermore, certain vascular risks, such as raised blood pressure, are targets for prevention of white matter disease or are administered to reduce the burden of such disease. Vascular risk modification may be useful, but alone may not be sufficient to prevent white matter disease progression. In this chapter, we specifically focus on WMH of vascular origin and explore white matter development, plasticity, and enduring processes of myelination across the health span in the context of experimental and human data, and compare and contrast resilient brain white matter propensity to a diseased white matter state. We conclude with thoughts on novel ways one might study white matter resilience, and predict future healthy cognitive and functional outcomes.

scholarly journals Clinically Silent Small Vessel Disease of the Brain in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1673
Author(s):  
Dimitrios G. Raptis ◽  
Olga Sinani ◽  
Georgia G. Rapti ◽  
Aikaterini Papanikolaou ◽  
Katerina Dadouli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
White Matter ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Hypopnea Syndrome ◽  
The Brain

Obstructive sleep apnea hypopnea syndrome (OSAHS) is associated with increased risk of cerebrovascular disease. The aim of the present study was to investigate the association between the presence of the small vessel disease (SVD) of the brain in patients with OSAHS. The study included 24 patients with moderate to severe OSAHS and 34 healthy volunteers. All the subjects underwent magnetic resonance imaging (MRI) of the brain, in order to sought periventricular white matter (PVWM), deep white matter (DWM) and brainstem SVD. Among patients with OSAHS, 79.1% had SVD (grade 1–3, Fazekas score) in DWM and 91.7% in PVWM while 22.4% had brainstem—white matter hyperintensities (B-WMH). Patients with OSAHS had a much higher degree of SVD in the DWM and PVWM compared to the control group (p < 0.001). The multivariate analysis showed an independent significant association of OSAHS with SVD (DWM and PVWM) (p = 0.033, OR 95% CI: 8.66 (1.19–63.08) and: p = 0.002, OR 95% CI: 104.98 (5.15–2141)). The same analysis showed a moderate association of OSAHS with B-WMH (p = 0.050, OR 15.07 (0.97–234.65)). Our study demonstrated an independent significant association of OSAHS with SVD and a moderate association of OSAHS with B-WMH.

scholarly journals Small Vessel Disease/White Matter Disease of the Brain and Its Association With Osteoporosis

2015 ◽  
Vol 7 (5) ◽  
pp. 297-302 ◽  
Author(s):  
Kannayiram Alagiakrishnan ◽  
Jenny Hsueh ◽  
Edwin Zhang ◽  
Khurshid Khan ◽  
Ambikaipakan Senthilselvan
Keyword(s):  
White Matter ◽  
Small Vessel Disease ◽  
Small Vessel ◽  
White Matter Disease ◽  
Vessel Disease ◽  
The Brain

Higher Cerebral Small Vessel Disease Burden in Patients with White Matter Recent Small Subcortical Infarcts

2021 ◽  
Vol 30 (7) ◽  
pp. 105824
Author(s):  
Salvatore Rudilosso ◽  
Luis Mena ◽  
Diana Esteller ◽  
Marta Olivera ◽  
Juan José Mengual ◽  
...  
Keyword(s):  
White Matter ◽  
Disease Burden ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Vessel Disease

scholarly journals Role of Purinergic Signalling in Endothelial Dysfunction and Thrombo-Inflammation in Ischaemic Stroke and Cerebral Small Vessel Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 994
Author(s):  
Natasha Ting Lee ◽  
Lin Kooi Ong ◽  
Prajwal Gyawali ◽  
Che Mohd Nasril Che Mohd Nassir ◽  
Muzaimi Mustapha ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Endothelial Dysfunction ◽  
Inflammatory Response ◽  
Small Vessel Disease ◽  
Ischemia Reperfusion ◽  
Cerebral Small Vessel Disease ◽  
Small Vessel ◽  
Purinergic Signalling ◽  
Vessel Disease ◽  
The Brain

The cerebral endothelium is an active interface between blood and the central nervous system. In addition to being a physical barrier between the blood and the brain, the endothelium also actively regulates metabolic homeostasis, vascular tone and permeability, coagulation, and movement of immune cells. Being part of the blood–brain barrier, endothelial cells of the brain have specialized morphology, physiology, and phenotypes due to their unique microenvironment. Known cardiovascular risk factors facilitate cerebral endothelial dysfunction, leading to impaired vasodilation, an aggravated inflammatory response, as well as increased oxidative stress and vascular proliferation. This culminates in the thrombo-inflammatory response, an underlying cause of ischemic stroke and cerebral small vessel disease (CSVD). These events are further exacerbated when blood flow is returned to the brain after a period of ischemia, a phenomenon termed ischemia-reperfusion injury. Purinergic signaling is an endogenous molecular pathway in which the enzymes CD39 and CD73 catabolize extracellular adenosine triphosphate (eATP) to adenosine. After ischemia and CSVD, eATP is released from dying neurons as a damage molecule, triggering thrombosis and inflammation. In contrast, adenosine is anti-thrombotic, protects against oxidative stress, and suppresses the immune response. Evidently, therapies that promote adenosine generation or boost CD39 activity at the site of endothelial injury have promising benefits in the context of atherothrombotic stroke and can be extended to current CSVD known pathomechanisms. Here, we have reviewed the rationale and benefits of CD39 and CD39 therapies to treat endothelial dysfunction in the brain.

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