WorldWideScience

Sample records for cerebral disease response

  1. Cerebral imaging revealing Alzheimer's disease

    International Nuclear Information System (INIS)

    2011-01-01

    Cerebral imaging is the only non-invasive means of examining the brain and is essential in studying Alzheimer's disease. As a tool for early diagnosis, evaluation and treatment monitoring, this technology is at the heart of the research being done to further improve its reliability and sensitivity. (authors)

  2. What is cerebral small vessel disease?

    International Nuclear Information System (INIS)

    Onodera, Osamu

    2011-01-01

    An accumulating amount of evidence suggests that the white matter hyperintensities on T 2 weighted brain magnetic resonance imaging predict an increased risk of dementia and gait disturbance. This state has been proposed as cerebral small vessel disease, including leukoaraiosis, Binswanger's disease, lacunar stroke and cerebral microbleeds. However, the concept of cerebral small vessel disease is still obscure. To understand the cerebral small vessel disease, the precise structure and function of cerebral small vessels must be clarified. Cerebral small vessels include several different arteries which have different anatomical structures and functions. Important functions of the cerebral small vessels are blood-brain barrier and perivasucular drainage of interstitial fluid from the brain parenchyma. Cerebral capillaries and glial endfeet, take an important role for these functions. However, the previous pathological investigations on cerebral small vessels have focused on larger arteries than capillaries. Therefore little is known about the pathology of capillaries in small vessel disease. The recent discoveries of genes which cause the cerebral small vessel disease indicate that the cerebral small vessel diseases are caused by a distinct molecular mechanism. One of the pathological findings in hereditary cerebral small vessel disease is the loss of smooth muscle cells, which is an also well-recognized finding in sporadic cerebral small vessel disease. Since pericytes have similar character with the smooth muscle cells, the pericytes should be investigated in these disorders. In addition, the loss of smooth muscle cells may result in dysfunction of drainage of interstitial fluid from capillaries. The precise correlation between the loss of smooth muscle cells and white matter disease is still unknown. However, the function that is specific to cerebral small vessel may be associated with the pathogenesis of cerebral small vessel disease. (author)

  3. Behcet's disease with cerebral vasculitis

    International Nuclear Information System (INIS)

    Scardamaglia, L.; Desmond, P.M.; Gonzales, M.F.; Bendrups, A.; Brodtmann, A.

    2001-01-01

    The case presented illustrates the diagnostic dilemma off neurological involvement in Behcet's disease and other inflammatory diseases. 'Psychiatric' symptoms were present for 2 years without abnormalities on SPECT or MRI and without CSF pleocytosis. Even at the time of fitting, no CSF abnormalities were observed. The preceding psychiatric presentations may have been due to cerebral vasculitis that was exacerbated by withdrawal of steroids. Magnetic resonance imaging is currently the most sensitive imaging modality. Lesions are usually in the brainstem, cerebellum, basal ganglia region or periventricular white matter, and the pons and the mesencephalon are commonly affected. In our patient there was no diencephalic or brainstem involvement. The inflammatory process can appear as a very large lesion, with gadolinium enhancement and significant mass effect, as in our patient. Brain magnetic resonance imaging. Postgadolinium-diethylenetriamine pentaacetic acid, axial image shows two large lesions in the right frontal lobe, with the larger, posterior lesion demonstrating vivid ring enhancement. A central nodule is isodense, with the cerebral white matter within the larger lesion. Surrounding low T 1 signal involves the hemispheric white matter without cortical extension and is consistent with vasogenic oedema. Minor mass effect is demonstrated with bowing of the anterior falx cerebri to the left. Biopsy shows prominent fibrinoid necrosis in small calibre postcapillary venules and cerebral white matter. There are surrounding acute and chronic inflammatory cells and nuclear debris, consistent with vasculitis

  4. Cerebral hemodynamics in adult ischemic-type patients with moyamoya disease compared with those of atherothrombotic middle cerebral artery occlusion

    International Nuclear Information System (INIS)

    Idei, Masaru; Yamane, Kanji; Nishida, Masahiro; Manabe, Kazufumi; Yokota, Akira

    2005-01-01

    We measured regional cerebral blood flow (rCBF) in adult ischemic-type patients with moyamoya disease and in patients with atherothrombotic middle cerebral artery occlusion (MCAO) to investigate cerebral hemodynamics in adult ischemic-type of moyamoya disease. In this study we measured rCBF and regional cerebro-vascular response (rCVR) using acetazolamide by Xe-non-enhanced CT. Our subjects consisted of 15 adult ischemic-type patients with moyamoya disease and 27 atherothrombotic stroke patients with proximal occlusion of the middle cerebral artery. The region of inter est was conducted in the anterior cerebral artery, middle cerebral artery and posterior cerebral artery territories as well as basal ganglia regions. rGBF was preserved in all regions of patients with moyamoya disease. However, rCVR severely decreased in the anterior circulation territory in patients with moyamoya disease compared with those of MCAO. These results suggest that rCBF in the anterior circulation territory of adult ischemic-type patients with moyamoya disease is preserved by vasodilation of the cerebral arteries, while cerebral hemodynamic reserve capacity is severely reduced. The results indicated that basal moyamoya vessels are dilated. These findings may be one of the reasons why stroke occurs more frequently in adult than child patients with moyamoya disease. (author)

  5. Cerebral small vessel disease and chronic kidney disease.

    Science.gov (United States)

    Toyoda, Kazunori

    2015-01-01

    Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients.

  6. Hereditary cerebral small vessel disease and stroke

    DEFF Research Database (Denmark)

    Søndergaard, Christian Baastrup; Nielsen, Jørgen Erik; Hansen, Christine Krarup

    2017-01-01

    disturbances. Some also present with extra-cerebral manifestations such as microangiopathy of the eyes and kidneys. Many present with clinically recognizable syndromes. Investigations include a thorough family medical history, medical history, neurological examination, neuroimaging, often supplemented...... by specific examinations e.g of the of vision, retinal changes, as well as kidney and heart function. However molecular genetic analysis is the final gold standard of diagnosis. There are increasing numbers of reports on new monogenic syndromes causing cerebral small vessel disease. Genetic counseling...

  7. Pediatric neuroradiology: Cerebral and cranial diseases

    International Nuclear Information System (INIS)

    Diebler, C.; Dulac, O.

    1987-01-01

    In this book, a neuroradiologist and a neuropediatrician have combined forces to provide the widest possible knowledge in investigating cranial and cerebral disorders in infancy and childhood. Based on more than 20,000 pediatric CT examinations, with a follow-up time often exceeding ten years, the book aims to bridge interdisciplinary gaps and help radiologists, pediatricians and neurosurgeons solve the various problems of pediatric neuroradiology that frequently confront them. For each disease, the etiology, clinical manifestation, pathological lesions and radiological presentations are discussed, supported by extensive illustrations. Malformative, vascular, traumatic, tumoral, infectious and metabolic diseases are reviewed. Miscellaneous conditions presenting particular symptoms or syndromes are also studied, such as hydrocephalus and neurological complications of leukemia. Contents: Cerebral and cranial malformations; neurocutaneous syndromes; inherited metabolic diseases; infectious diseases - vascular disorders; intracranial tumors; cranial trauma - miscellaneous and subject index

  8. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Kino, Masao; Anno, Izumi; Yano, Yuhiko; Anno, Yasuro.

    1980-01-01

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  9. Cerebral blood flow response to functional activation

    DEFF Research Database (Denmark)

    Paulson, Olaf B; Hasselbalch, Steen G; Rostrup, Egill

    2010-01-01

    Cerebral blood flow (CBF) and cerebral metabolic rate are normally coupled, that is an increase in metabolic demand will lead to an increase in flow. However, during functional activation, CBF and glucose metabolism remain coupled as they increase in proportion, whereas oxygen metabolism only...... most distant from the capillaries, whereas other studies point to a shift toward a higher degree of non-oxidative glucose consumption during activation. In this review, we argue that the key mechanism responsible for the regional CBF (rCBF) increase during functional activation is a tight coupling...... between rCBF and glucose metabolism. We assert that uncoupling of rCBF and oxidative metabolism is a consequence of a less pronounced increase in oxygen consumption. On the basis of earlier studies, we take into consideration the functional recruitment of capillaries and attempt to accommodate...

  10. Cerebral glucose metabolism in Parkinson's disease

    International Nuclear Information System (INIS)

    Martin, W.R.W.; Beckman, J.H.; Calne, D.B.; Adam, M.J.; Harrop, R.; Rogers, J.G.; Ruth, T.J.; Sayre, C.I.; Pate, B.D.

    1984-01-01

    Local cerebral glucose utilization was measured in patients with predominantly unilateral Parkinson's disease using sup(18)F-2-fluoro-deoxyglucose and positron emission tomography. Preliminary results indicate the presence of asymmetric metabolic rates in the inferior basal ganglia. The structure comprising the largest portion of basal ganglia at this level is globus pallidus. These findings are consistent with metabolic studies on animals with unilateral nigrostriatal lesions in which pallidal hypermetabolism on the lesioned side has been demonstrated. Increased pallidal activity is likely secondary to a loss of inhibitory dopaminergic input to the striatum from substantia nigra

  11. Epilepsy: unusual presentation of cerebral hydatid disease in children

    African Journals Online (AJOL)

    Cerebral hydatid disease is very rare, representing only 2% of all cerebral space occupying lesions even in the countries where the disease is endemic. Intracranial hydatid cysts are more common in children and occur more frequently in the supratentorial space. The aim of this paper is to describe the characteristic features ...

  12. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Kitamura, Shin

    1983-01-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways. (J.P.N.)

  13. Hypercholesterolemia induced cerebral small vessel disease.

    Science.gov (United States)

    Kraft, Peter; Schuhmann, Michael K; Garz, Cornelia; Jandke, Solveig; Urlaub, Daniela; Mencl, Stine; Zernecke, Alma; Heinze, Hans-Jochen; Carare, Roxana O; Kleinschnitz, Christoph; Schreiber, Stefanie

    2017-01-01

    While hypercholesterolemia plays a causative role for the development of ischemic stroke in large vessels, its significance for cerebral small vessel disease (CSVD) remains unclear. We thus aimed to understand the detailed relationship between hypercholesterolemia and CSVD using the well described Ldlr-/- mouse model. We used Ldlr-/- mice (n = 16) and wild-type (WT) mice (n = 15) at the age of 6 and 12 months. Ldlr-/- mice develop high plasma cholesterol levels following a high fat diet. We analyzed cerebral capillaries and arterioles for intravascular erythrocyte accumulations, thrombotic vessel occlusions, blood-brain barrier (BBB) dysfunction and microbleeds. We found a significant increase in the number of erythrocyte stases in 6 months old Ldlr-/- mice compared to all other groups (P hypercholesterolemia is related to a thrombotic CSVD phenotype, which is different from hypertension-related CSVD that associates with a hemorrhagic CSVD phenotype. Our data demonstrate a relationship between hypercholesterolemia and the development of CSVD. Ldlr-/- mice appear to be an adequate animal model for research into CSVD.

  14. Response of the cerebral vasculature following traumatic brain injury.

    Science.gov (United States)

    Salehi, Arjang; Zhang, John H; Obenaus, Andre

    2017-07-01

    The critical role of the vasculature and its repair in neurological disease states is beginning to emerge particularly for stroke, dementia, epilepsy, Parkinson's disease, tumors and others. However, little attention has been focused on how the cerebral vasculature responds following traumatic brain injury (TBI). TBI often results in significant injury to the vasculature in the brain with subsequent cerebral hypoperfusion, ischemia, hypoxia, hemorrhage, blood-brain barrier disruption and edema. The sequalae that follow TBI result in neurological dysfunction across a host of physiological and psychological domains. Given the importance of restoring vascular function after injury, emerging research has focused on understanding the vascular response after TBI and the key cellular and molecular components of vascular repair. A more complete understanding of vascular repair mechanisms are needed and could lead to development of new vasculogenic therapies, not only for TBI but potentially vascular-related brain injuries. In this review, we delineate the vascular effects of TBI, its temporal response to injury and putative biomarkers for arterial and venous repair in TBI. We highlight several molecular pathways that may play a significant role in vascular repair after brain injury.

  15. Research progress of cerebral venous system diseases and cerebral small vessel disease: Chinese scholars' reports published abroad

    Directory of Open Access Journals (Sweden)

    Tian CAO

    2016-11-01

    Full Text Available In recent years, Chinese scholars have published several high-quality articles on cerebral venous system diseases and cerebral small vessel disease (cSVD in foreign professional journals, covering new imaging techniques for diagnosis and differential diagnosis of cerebral venous thrombosis (CVT, combination therapy in severe CVT, influencing factors of cSVD, detection methods and treatment exploration, etc. In this review, we briefly outline the data on their studies. DOI: 10.3969/j.issn.1672-6731.2016.11.005

  16. l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease

    DEFF Research Database (Denmark)

    Karlsson, William K; Sørensen, Caspar G; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and NG -monomethyl-l-arginine (l......-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible...... according to inclusion and exclusion criteria. Studies investigated the effect of age (n=2), type 2 diabetes mellitus (DM) (n=1), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (n=1), leukoaraiosis (n=1), and prior ischaemic stroke or transient ischaemic...

  17. Subclinical cerebral abnormalities in chronic kidney disease.

    Science.gov (United States)

    Yao, Hiroshi; Takashima, Yuki; Hashimoto, Manabu; Uchino, Akira; Yuzuriha, Takefumi

    2013-01-01

    Impaired kidney function or chronic kidney disease (CKD), as measured by estimated glomerular filtration rate (eGFR), is associated with incident stroke risk. However, few studies have examined the relationship between CKD and subclinical cerebral abnormalities. We examined 675 elderly subjects (mean age 69.9 years), who were living independently at home without apparent dementia, using magnetic resonance imaging. Serum creatinine values, measured by the enzymatic method, were used for the Japanese equation of eGFR. Subclinical lacunar infarction, deep white matter lesions, and periventricular hyperintensities were detected in 88 (13.0%), 240 (35.6%) and 158 (23.4%) of the 675 participants, respectively. In the forward stepwise method of logistic analysis, age (OR 2.081/10, 95% CI 1.541-2.810), hypertension (OR 3.656, 95% CI 2.184-6.119), diabetes mellitus (OR 1.961, 95% CI 1.007-3.820), alcohol intake (OR 2.130, 95% CI 1.283-3.535), and eGFR <45 ml/min/1.73 m(2) were significant factors concerning subclinical lacunar infarction. CKD defined as eGFR <60 ml/min/1.73 m(2) was not significantly associated with subclinical lacunar infarction. Decreased eGFR was not a significant factor associated with white matter lesions (WMLs). Age (OR 2.781/10, 95% CI 2.252-3.435), hypertension (OR 1.746, 95% CI 1.231-2.477), diabetes mellitus (OR 1.854, 95% CI 1.070-3.213), but not eGFR were significant factors concerning WMLs. The present study showed that community-dwelling elderly subjects with late stage 3 CKD were at high risk for prevalent subclinical lacunar infarction. The identification of CKD-specific modifiable risk factors for SBI and WMLs is of increased importance for prevention of subclinical brain ischemic lesions. Copyright © 2013 S. Karger AG, Basel.

  18. Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease.

    Science.gov (United States)

    Blanco, Pablo J; Müller, Lucas O; Spence, J David

    2017-09-01

    The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the 'vascular centrencephalon'), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called 'lacunes', probably have different aetiologies. We studied pressure gradients from proximal to distal regions of the cerebral vasculature by mathematical modelling. Blood flow/pressure equations were solved in an Anatomically Detailed Arterial Network (ADAN) model, considering a normotensive and a hypertensive case. Model parameters were suitably modified to account for structural changes in arterial vessels in the hypertensive scenario. Computations predict a marked drop in blood pressure from large and medium-sized cerebral vessels to cerebral peripheral beds. When blood pressure in the brachial artery is 192/113 mm Hg, the pressure in the small arterioles of the posterior parietal artery bed would be only 117/68 mm Hg. In the normotensive case, with blood pressure in the brachial artery of 117/75 mm Hg, the pressure in small parietal arterioles would be only 59/38 mm Hg. These findings have important implications for understanding small vessel disease. The marked pressure gradient across cerebral arteries should be taken into account when evaluating the pathogenesis of small WMIs on MRI. Hypertensive small vessel disease, affecting the arterioles at the base of the brain should be distinguished from small vessel disease in subcortical regions of the convexity and venous disease in the periventricular white matter.

  19. Determinants of resting cerebral blood flow in sickle cell disease

    NARCIS (Netherlands)

    Bush, Adam M.; Borzage, Matthew T.; Choi, Soyoung; Václavů, Lena; Tamrazi, Benita; Nederveen, Aart J.; Coates, Thomas D.; Wood, John C.

    2016-01-01

    Stroke is common in children with sickle cell disease and results from an imbalance in oxygen supply and demand. Cerebral blood flow (CBF) is increased in patients with sickle cell disease to compensate for their anemia, but adequacy of their oxygen delivery has not been systematically demonstrated.

  20. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  1. Cerebral blood flow in Binswanger's disease

    International Nuclear Information System (INIS)

    Kawabata, Keita; Tachibana, Hisao; Sugita, Minoru

    1991-01-01

    Eight patients with a clinical diagnosis of Binswanger's disease (BD) were evaluated with I-123 IMP SPECT. The SPECT findings were compared with those in 7 other patients with Alzheimer's disease (AD) and 9 normal subjects. The ratios of I-123 IMP in the temporal cortex, thalamus, and basal ganglia to that in the cerebellum were lower in the BD group than the normal group. The BD group had a higher ratio of the occipital cortex/the cerebellum than the control group, suggesting a decreased blood flow in the cerebellum. When I-123 IMP ratio in various areas to that in the occipital cortex was examined, both the BD and AD groups seemed to have a decreased blood flow over the whole cerebrum. The BD group had a lower I-123 IMP uptake in the thalamus and basal ganglia, and the AD group had it in the parietal cortex, relative to the occipital cortex. Blood flow patterns for BD were found to be different from those for AD. This suggests the difference in areas responsible for etiology between BD and AD. (N.K.)

  2. Visualized Characterization for Cerebral Response of Acupuncture Deqi: Paradox Underway

    Directory of Open Access Journals (Sweden)

    Jie Yang

    2013-01-01

    Full Text Available Acupuncture as an oriental natural healing therapy with prolonged history has been extensively utilized in the management of great numbers of disorders. Deqi, a renowned acupuncture needling sensation, is profoundly regarded as the predictor and also the prerequisite of a preferable acupuncture treatment efficacy. Till now, there is still no consistency being reached towards the mechanism of acupuncture Deqi as a result of the discrepancy for publicly acknowledged evidence. Recent visualized research on Deqi using modern technologies has demonstrated possible central mechanism towards it. However, there is a conspicuous paradox underway in the research of cerebral response to acupuncture Deqi. This paper provided a view of up-to-date studies using visualized tools to characterize the brain response to acupuncture Deqi, such as functional magnetic resonance imaging (fMRI and positron emission tomography/computed tomography (PET/CT. The paradox was extruded to highlight certain reasons from a TCM view. It is hypothesized that acupoints located at different dermal sites, state of participant, and needling manipulation can all contribute to the current paradox. Hence, further studies on acupuncture Deqi should pay more attention to the strategy of experiment design with generalized measurement, valid sham control methods, and more to subjects in diseased condition.

  3. Genomic responses in rat cerebral cortex after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Mathiesen Tiit

    2005-11-01

    Full Text Available Abstract Background Traumatic brain injury (TBI initiates a complex sequence of destructive and neuroprotective cellular responses. The initial mechanical injury is followed by an extended time period of secondary brain damage. Due to the complicated pathological picture a better understanding of the molecular events occurring during this secondary phase of injury is needed. This study was aimed at analysing gene expression patterns following cerebral cortical contusion in rat using high throughput microarray technology with the goal of identifying genes involved in an early and in a more delayed phase of trauma, as genomic responses behind secondary mechanisms likely are time-dependent. Results Among the upregulated genes 1 day post injury, were transcription factors and genes involved in metabolism, e.g. STAT-3, C/EBP-δ and cytochrome p450. At 4 days post injury we observed increased gene expression of inflammatory factors, proteases and their inhibitors, like cathepsins, α-2-macroglobulin and C1q. Notably, genes with biological function clustered to immune response were significantly upregulated 4 days after injury, which was not found following 1 day. Osteopontin and one of its receptors, CD-44, were both upregulated showing a local mRNA- and immunoreactivity pattern in and around the injury site. Fewer genes had decreased expression both 1 and 4 days post injury and included genes implicated in transport, metabolism, signalling, and extra cellular matrix formation, e.g. vitronectin, neuroserpin and angiotensinogen. Conclusion The different patterns of gene expression, with little overlap in genes, 1 and 4 days post injury showed time dependence in genomic responses to trauma. An early induction of factors involved in transcription could lead to the later inflammatory response with strongly upregulated CD-44 and osteopontin expression. An increased knowledge of genes regulating the pathological mechanisms in trauma will help to find future

  4. The cerebral circulation and cerebrovascular disease I: Anatomy

    Directory of Open Access Journals (Sweden)

    Ankush Chandra

    2017-01-01

    Full Text Available In this paper, which is the first in a three-part series that reviews cerebrovascular anatomy, pathogenesis, and stroke, we lay the anatomical foundation for the rest of the series. Beginning with its origin in the branches of the aorta, we start by describing the arterial system. This system is partitioned into two major divisions (anterior and posterior circulations that differ significantly in features and pathogenic potential. The systems, and the major branches that comprise them, are described. Description of the arterial system proceeds to the point of the fulfillment of its function. This function, the exchange of gases and nutrients with the cerebral parenchyma, is the subject of a subsequent section on the microcirculation and blood–brain barrier. Finally, the cerebral venous system, which is composed of cerebral veins and dural venous sinuses, is described. Thus, an anatomical context is supplied for the discussion of cerebrovascular disease pathogenesis provided by our second paper.

  5. Differential Effects of Acetylcholinesterase Inhibitors on Clinical Responses and Cerebral Blood Flow Changes in Patients with Alzheimer's Disease: A 12-Month, Randomized, and Open-Label Trial

    Directory of Open Access Journals (Sweden)

    Soichiro Shimizu

    2015-04-01

    Full Text Available Background/Aims: The present study evaluated the differences in treatment outcomes and brain perfusion changes among 3 types of acetylcholinesterase inhibitors (AchEIs, i.e. donepezil, rivastigmine, and galantamine. Methods: This was a prospective, longitudinal, randomized, open-label, 3-arm (donepezil, rivastigmine, or galantamine, parallel-group, 12-month clinical trial carried out in 55 patients with AD. Results: At 6 months, the results of the Mini-Mental State Examination (MMSE and the Trail Making Test (TMT-Part A showed an improvement versus baseline in the donepezil treatment group. All groups showed a significant increase in regional cerebral blood flow (rCBF, mainly in the frontal lobe. Significant rCBF reduction was observed in the temporal lobe and cingulate gyrus in all 3 groups. Conclusion: AchEI treatment prevents the progression of cognitive impairment and increases the relative rCBF in the frontal lobe.

  6. L-arginine and L-NMMA for Assessing Cerebral Endothelial Dysfunction in Ischemic Cerebrovascular Disease: A Systematic Review

    DEFF Research Database (Denmark)

    Karlsson, William Kristian; Sørensen, Caspar Godthaab; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and NG -monomethyl-l-arginine (l......-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible...... cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease....

  7. Elevated arteriolar cerebral blood volume in prodromal Huntington's disease.

    Science.gov (United States)

    Hua, Jun; Unschuld, Paul G; Margolis, Russell L; van Zijl, Peter C M; Ross, Christopher A

    2014-03-01

    Neurovascular alterations have been implicated in the pathophysiology of Huntington's disease (HD). Because arterioles are most responsive to metabolic alterations, arteriolar cerebral blood volume (CBVa) is an important indicator of cerebrovascular regulation. The objective of this pilot study was to investigate potential neurovascular (CBVa ) abnormality in prodromal-HD patients and compare it with the widely used imaging marker: brain atrophy. CBVa and brain volumes were measured with ultra-high-field (7.0-Telsa) magnetic resonance imaging in seven prodromal-HD patients and nine age-matched controls. Cortical CBVa was elevated significantly in prodromal-HD patients compared with controls (relative difference, 38.5%; effect size, 1.48). Significant correlations were found between CBVa in the frontal cortex and genetic measures. By contrast, no significant brain atrophy was detected in the prodromal-HD patients. CBVa may be abnormal in prodromal-HD, even before substantial brain atrophy occurs. Further investigation with a larger cohort and longitudinal follow-up is merited to determine whether CBVa could be used as a potential biomarker for clinical trials. © 2013 International Parkinson and Movement Disorder Society.

  8. Gait in elderly with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Bloem, Bastiaan R; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2010-08-01

    Gait disorders are common in the elderly and are related to loss of functional independence and death. White matter lesions (WMLs) may be related, but only a minority of individuals with WMLs has gait disorders. Probably other factors are involved, including location and the independent effect of frequently coinciding lacunar infarcts, the other aspect of cerebral small vessel disease. The aim of our study was to investigate the effect of both the severity and location of both WMLs and lacunar infarcts on gait. Four hundred thirty-one independently living, nondemented elderly aged between 50 and 85 years with cerebral small vessel disease were included in this analysis and underwent MRI scanning. The number and location of lacunar infarcts were rated and WML volume was assessed by manual segmentation with automated delineating of different regions. Gait was assessed quantitatively with an electronic walkway as well as the semiquantitatively Tinetti and Timed-Up-and-Go test. WMLs and lacunar infarcts were both independently associated with most gait parameters with stride length as the most sensitive parameter related to WMLs. WMLs in the sublobar (basal ganglia/internal capsule) and limbic areas and lacunar infarcts in the frontal lobe and thalamus were related to a lower velocity. Cerebral small vessel disease is related to gait disturbances. Because small vessel disease may, in part, be preventable, it should be regarded as a potentially important target for postponing gait impairment.

  9. Cerebral blood flow mapping in children with sickle cell disease

    International Nuclear Information System (INIS)

    Numaguchi, Y.; Humbert, J.R.; Robinson, A.E.; Lindstrom, W.W.; Gruenauer, L.M.

    1988-01-01

    A cerebral blood flow mapping system was applied to the evaluation of cerebral blood flow (CBF) in 21 patients with sickle cell cerebrovascular disease, by means of a Picker xenon computed tomographic (CT) scanner. Results indicate that (1) xenon CT is a safe and reliable procedure in children with cerebrovascular diseases; (2) CBF in the gray matter of children seems to be higher than in previously reported data obtained with use of isotopes; and (3) regional CBF can be altered significantly by changing the size of the region of interest (ROI). The term regional CBF probably has to be carefully defined in xenon CT flow mapping. Correlation with anatomy by means of CT or magnetic resonance imaging and comparison with the ROI of the contralateral side and/or adjacent sections is important

  10. Changes in Cardiorespiratory Responses and Kinematics with Hippotherapy in Youth with and without Cerebral Palsy

    Science.gov (United States)

    Rigby, Brandon Rhett; Gloeckner, Adam Robert; Sessums, Suzanne; Lanning, Beth Anne; Grandjean, Peter Walter

    2017-01-01

    Purpose: The purpose of this study was to characterize pelvic displacement and cardiorespiratory responses to simulated horseback riding and walking in youth with cerebral palsy and to compare responses to youth without cerebral palsy before and after 8 weeks of hippotherapy. Method: Eight youth with cerebral palsy (M[subscript age] = 10 ± 4…

  11. Cerebral oxygen metabolism in patients with early Parkinson's disease

    DEFF Research Database (Denmark)

    Borghammer, Per; Cumming, Paul; Østergaard, Karen

    2012-01-01

    AIM: Decreased activity of the mitochondrial electron transport chain (ETC) has been implicated in the pathogenesis of Parkinson's disease (PD). This model would most likely predict a decrease in the rate of cerebral oxygen consumption (CMRO(2)). To test this hypothesis, we compared CMRO(2...... in spatially contiguous cortical regions in early PD, and support the hypothesis that ETC dysfunction could be a primary pathogenic mechanism in early PD....

  12. Population Imaging of Cerebral Small Vessel Disease

    NARCIS (Netherlands)

    M.M.F. Poels (Mariëlle)

    2012-01-01

    textabstractAs we grow older, our brain tends to shrink. We become increasingly vul nerable to dementia and stroke, two common disorders in the elderly that have great impact on brain functioning and the way people live their lives. The burden of these diseases will rapidly grow over the coming

  13. Cigarette smoking impairs nitric oxide-mediated cerebral blood flow increase: Implications for Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Noboru Toda

    2016-08-01

    Full Text Available Cerebral blood flow is mainly regulated by nitrergic (parasympathetic, postganglionic nerves and nitric oxide (NO liberated from endothelial cells in response to shear stress and stretch of vasculature, whereas sympathetic vasoconstrictor control is quite weak. On the other hand, peripheral vascular resistance and blood flow are mainly controlled by adrenergic vasoconstrictor nerves; endothelium-derived NO and nitrergic nerves play some roles as vasodilator factors. Cigarette smoking impairs NO synthesis in cerebral vascular endothelial cells and nitrergic nerves leading to interference with cerebral blood flow and glucose metabolism in the brain. Smoking-induced cerebral hypoperfusion is induced by impairment of synthesis and actions of NO via endothelial nitric oxide synthase (eNOS/neuronal NOS (nNOS inhibition and by increased production of oxygen radicals, resulting in decreased actions of NO on vascular smooth muscle. Nicotine acutely and chronically impairs the action of endothelial NO and also inhibits nitrergic nerve function in chronic use. Impaired cerebral blood supply promotes the synthesis of amyloid β that accelerates blood flow decrease. This vicious cycle is thought to be one of the important factors involving in Alzheimer's disease (AD. Quitting smoking is undoubtedly one of the important ways to prevent and delay the genesis or slow the progress of impaired cognitive function and AD.

  14. l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review.

    Science.gov (United States)

    Karlsson, William K; Sørensen, Caspar G; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and N G -monomethyl-l-arginine (l-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible according to inclusion and exclusion criteria. Studies investigated the effect of age (n=2), type 2 diabetes mellitus (DM) (n=1), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (n=1), leukoaraiosis (n=1), and prior ischaemic stroke or transient ischaemic attack (TIA) (n=2) on cerebral ED. Most studies applied transcranial Doppler to quantify cerebral ED. Endothelium-dependent vasodilatation (EDV) induced by l-arginine was impaired in elderly and subjects with leukoaraiosis, but enhanced in CADASIL patients. Studies including subjects with prior ischaemic stroke or TIA reported both enhanced and impaired EDV to l-arginine. Responses to l-NMMA deviated between subjects with type 2 DM and the elderly. We found only few studies investigating cerebral endothelial responses to l-arginine and l-NMMA in subjects with vascular risk factors or ischaemic cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease. © 2016 John Wiley & Sons Australia, Ltd.

  15. Cerebral blood flow in sickle cell cerebrovascular disease

    International Nuclear Information System (INIS)

    Huttenlocher, P.R.; Moohr, J.W.; Johns, L.; Brown, F.D.

    1984-01-01

    Cerebral blood flow (CBF) has been studied by the xenon-133 ( 133 Xe) inhalation method in 16 children with suspected sickle cell cerebrovascular disease. Abnormalities consisting of decreases in total, hemispheral, or regional CBF were found in 17 of 26 studies. Eleven studies performed immediately after stroke, transient ischemic attack, or depression of state of alertness showed abnormalities. In addition to confirming regional cerebrovascular insufficiency in children with stroke due to major cerebral artery occlusion, the method detected diffuse decrease in CBF in children with stupor, coma, and seizures who had normal angiographic findings. In contrast, six of seven studies obtained after exchange transfusion or during maintenance on hypertransfusion therapy showed normal findings. The difference between results in patients with acute neurologic disturbances and those receiving transfusion therapy was statistically significant (P less than .005). The data indicate that the 133 Xe method reliably demonstrates cerebrovascular impairment in sickle cell disease. They also suggest that CBF changes in patients with sickle cell disease can be reversed by exchange transfusion and by hypertransfusion therapy. The 133 Xe CBF method may be useful for following up children with sickle cell disease who are at high risk for recurrent stroke

  16. [EEG in Parkinson's disease and cerebral hypoxia (author's transl)].

    Science.gov (United States)

    Girke, W; Löwe, H P; Xenakis, C

    1978-03-01

    EEG-findings of a group of 95 patients suffering from Parkinson's disease were related to accompanying diseases inducing cerebral hypoxic hypoxidosis. The EEG in 59 to 74 per cent of our patients was abnormal but the changes were not specific. There was a correlation between age and EEG-abnormalities. On the other hand no association could be seen between EEG-changes and duration of the Parkinson's disease. At least 74 per cent of the patients suffered from concomitant cardiovascular complications and 36 of them had a severe pathologic EEG as well as a pathologic ECG. The results lead to the conclusion that in treatment of parkinsonian patients attention is to be paid to accompanying diseases as heart failure, angiopathy or anemia.

  17. A case with post-irradiation cerebral vascular disease accompanied by Cushing's disease

    International Nuclear Information System (INIS)

    Shinoda, Keiichi; Kuriyama, Takanobu; Kimura, Fumiharu; Kawamura, Hiroshi; Takamatsu, Junta; Mozai, Toshiji

    1986-01-01

    A 37-year-old man with Cushing's disease developed cerebral infarction 13 years after Co-60 irradiation of a total dose of 60 Gy for pituitary adenoma. Cerebral angiography showed stenosis or occlusion of the bilateral carotid arteries and basilar artery which were in the radiation fields. A basophilic adenoma was resected, and symptoms of Cushing's disease have resolved. The vascular lesions are likely to be not only radiation-induced, but also stimulated by hyperlipemia and hypertension associated with Cushing's disease. It is recommended to eliminate factors, such as hyperlipemia and hypertension, stimulatig vascular damage in the management of patients treated with radiation therapy. The relevant literature is reviewed. (Namekawa, K.)

  18. Cerebral blood flow is an earlier indicator of perfusion abnormalities than cerebral blood volume in Alzheimer's disease

    OpenAIRE

    Lacalle-Aurioles, María; Mateos-Pérez, José M; Guzmán-De-Villoria, Juan A; Olazarán, Javier; Cruz-Orduña, Isabel; Alemán-Gómez, Yasser; Martino, María-Elena; Desco, Manuel

    2014-01-01

    The purpose of this study was to elucidate whether cerebral blood flow (CBF) can better characterize perfusion abnormalities in predementia stages of Alzheimer's disease (AD) than cerebral blood volume (CBV) and whether cortical atrophy is more associated with decreased CBV or with decreased CBF. We compared measurements of CBV, CBF, and mean cortical thickness obtained from magnetic resonance images in a group of healthy controls, patients with mild cognitive impairment (MCI) who converted t...

  19. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin (Nippon Medical School, Tokyo)

    1983-04-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways.

  20. Cerebral blood flow changes in Parkinson's disease associated with dementia

    International Nuclear Information System (INIS)

    Derejko, M.; Lass, P.; Slawek, J.; Nyka, W.M.

    2001-01-01

    Dementia is one of the main non-motor symptoms of Parkinson's disease (PD) and it is diagnosed in about 30% of cases. Its aetiology remains unclear and contributing factors are controversial. Dementia may be more common in old patients with severe motor symptoms and mild cognitive impairment. Clinico-pathological studies show the association between dementia in PD and the age-related group of dementias, such as AD and VaD. A valuable aid in the assessment of dementia in PD is cerebral blood flow (CBF) brain SPECT scanning. It shows three different patterns of rCBF reduction, including frontal lobe hypoperfusion, iu Alzheimer-likel type of hypoperfusion and multiple, vascular defects. The heterogeneity of rCBF reduction may reflect the multifactorial pathophysiology of dementia in PD. It may result from concomitant AD pathology, cerebrovascular disease, destruction of nigro-striato-frontal projection or may be a distinct disease of different aetiology. (author)

  1. Cerebral Microbleeds in Patients with Dementia with Lewy Bodies and Parkinson Disease Dementia.

    Science.gov (United States)

    Kim, S W; Chung, S J; Oh, Y-S; Yoon, J H; Sunwoo, M K; Hong, J Y; Kim, J-S; Lee, P H

    2015-09-01

    The burden of amyloid β is greater in patients with dementia with Lewy bodies than in those with Parkinson disease dementia, and an increased amyloid β load is closely related to a higher incidence of cerebral microbleeds. Here, we investigated the prevalence and topography of cerebral microbleeds in patients with dementia with Lewy bodies and those with Parkinson disease dementia to examine whether cerebral microbleeds are more prevalent in patients with dementia with Lewy bodies than in those with Parkinson disease dementia. The study population consisted of 42 patients with dementia with Lewy bodies, 88 patients with Parkinson disease dementia, and 35 controls who underwent brain MR imaging with gradient recalled-echo. Cerebral microbleeds were classified as deep, lobar, or infratentorial. The frequency of cerebral microbleeds was significantly greater in patients with dementia with Lewy bodies (45.2%) than in those with Parkinson disease dementia (26.1%) or in healthy controls (17.1%; P = .017). Lobar cerebral microbleeds were observed more frequently in the dementia with Lewy bodies group (40.5%) than in the Parkinson disease dementia (17%; P = .004) or healthy control (8.6%; P = .001) group, whereas the frequencies of deep and infratentorial cerebral microbleeds did not differ among the 3 groups. Logistic regression analyses revealed that, compared with the healthy control group, the dementia with Lewy bodies group was significantly associated with the presence of lobar cerebral microbleeds after adjusting for age, sex, nonlobar cerebral microbleeds, white matter hyperintensities, and other vascular risk factors (odds ratio, 4.39 [95% CI, 1.27-15.25]). However, compared with the healthy control group, the Parkinson disease dementia group was not significantly associated with lobar cerebral microbleeds. This study showed that patients with dementia with Lewy bodies had a greater burden of cerebral microbleeds and exhibited a lobar predominance of cerebral

  2. Cerebral Small Vessel Disease and Chronic Kidney Disease

    OpenAIRE

    Toyoda, Kazunori

    2015-01-01

    Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small arter...

  3. Regional cerebral glucose consumption measured by positron emission tomography in patients with Wilson's disease

    International Nuclear Information System (INIS)

    Kuwert, T.; Scholz, D.; Milz, M.; Herzog, H.; Feinendegen, L.E.; Hefter, H.; Weiss, P.; Arendt, G.; Loken, M.; Minnesota Univ., Minneapolis, MN; Hennerici, M.

    1992-01-01

    Using positron emission tomography (PET), the regional cerebral metabolic rate of glucose consumption (rCMRGlc) was measured in 14 patients with Wilson's disease (WD) and 23 normal subjects. In WD patients, cerebellar, striatal and - to a lesser extent - cortical and thalamic rCMRGlc were significantly decreased compared with controls. Striatal rCMRGlc was significantly reduced in those 4 patients who had recently started decoppering therapy as compared with striatal rCMRGlc measured in those 10 patients with longer duration of medication. Caudate rCMRGlc correlated significantly with various signs of extrapyramidal dysfunction. Cerebellar, thalamic and cortical rCMRGlc correlated significantly with the severity of pyramidal signs. These data indicate that the PET measurement of rCMRGlc may be a useful tool to evaluate cerebral involvement in WD and to monitor the response to treatment. (orig.)

  4. Cerebral imaging for Wilson disease; Zerebrale Bildgebung bei Morbus Wilson

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, K.; Saleh, A. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Diagnostische Radiologie; Suedmeyer, M. [Universitaetsklinikum Duesseldorf (Germany). Klinik fuer Neurologie

    2007-03-15

    Wilson disease is an autosomal recessive inherited copper metabolic disorder that is characterized by diminished biliary excretion of copper and a raised serum level of free copper. This leads to a toxic copper accumulation, particularly in the liver and the brain. Therefore, clinical symptoms are dominated by hepatic and extrapyramidal symptoms. Untreated Wilson disease has an unfavorable outcome. Cerebral changes are depicted most sensitively by magnetic resonance tomography. Pathological findings mainly focus on the basal ganglia, the midbrain and the brainstem. Depending on the therapy and the severity of the neurological symptoms, signal increase as well as signal decrease may be observed in T1-weighted (T1w) and T2-weighted (T2w) images and can be reversible when using an appropriate therapy. Hyperintense areas in T2-weighted images are induced by edema, gliosis, demyelinisation or cystic degeneration. Signal increase in T1-weighted images are found in patients with hepatic insufficiency and are probably due to manganese deposits. Signal decrease in T2-weighted images is probably caused by the paramagnetic effect of the copper accumulation. Furthermore, recent studies show a correlation between the clinical severity and changes in diffusion-weighted sequences. Although cross-section imaging plays a rather subordinate role in the primary diagnostics of Wilson disease, the described cerebral changes in patients with extrapyramidal disturbances should include Wilson disease in the differential. Persistent or progressive hyperintense lesions in T2-weighted images reflect therapy failure, and clinical recovery correlates to an improvement in MR images. Therefore, repeat MR imaging can be used to monitor medical therapy.

  5. Cerebral hemodynamics in patients with moyamoya disease, (2)

    International Nuclear Information System (INIS)

    Takeuchi, Shigekazu

    1983-01-01

    Regional cerebral blood flow (rCBF) was measured by the 133 Xe inhalation method in 19 patients with moyamoya disease aged 5 to 46 and compared with that in 17 healthy volunteers aged 7 to 67. In healthy volunteers, mean hemispheric flow values (mCBF) in the steady state decreased and cerebrovascular resistance (CVR) increased with advancing age. Most young patients showed low values of mCBF in both hemispheres in comparison with healthy volunteers. About half of the young patients showed higher values of CVR than young healthy volunteers. The distribution of rCBF showed a hyperfrontal pattern in healthy volunteers. However, in the patients, regional distribution of hemispheric flow showed a different pattern with low flow in the upper frontal region and mean flow in the posterotemporal and occipital regions. rCBF measurements were carried out during hyperventilation in five healthy volunteers and in one patient, and during 5% CO 2 inhalation in one healthy volunteer and two patients. CO 2 reactivity was uniformly present in the hemispheres of healthy volunteers. rCBF in both hemispheres was reduced by hyperventilation, more markedly in the patient than in healthy volunteers. On the other hand, in two patients, the flow was increased in the temporo-occipital regions and was decreased in the frontal region by 5% CO 2 inhalation, and mCBF was slightly increased. Postoperative rCBF measurements in 21 sides of 12 young patients indicated a gradual increase of mCBF in 14 sides of nine patients from 3 months after surgery. These results indicate that rCBF measurements by the 133 Xe inhalation method are useful in determining cerebral hemodynamics in patients with moyamoya disease, especially in children. (J.P.N.)

  6. Cerebral blood flow and metabolic abnormalities in Alzheimer's disease

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi

    2001-01-01

    In this review I summarize observations of PET and SPECT studies about cerebral blood flow and metabolic abnormalities in Alzheimer's disease (AD). In very early AD flow or metabolism reduces first in the posterior cingulate gyrus and precuneus. This reduction may arise from functional deafferentation caused by primary neural degeneration in the remote area of the entorhinal cortex that is the first to be pathologically affected in AD. Then medial temporal structures and parietotemporal association cortex show flow or metabolic reduction as disease processes. The reason why flow or metabolism in medial temporal structures shows delay in starting to reduce in spite of the earliest pathological affection remains to be elucidated. It is likely that anterior cingulate gyrus is functionally involved, since attention is the first non-memory domain to be affected, before deficits in language and visuospatial functions. However few reports have described involvement in the anterior cingulate gyrus. Relationship between cerebral blood flow or metabolism and apolipoprotein E (APOE) genotype has been investigated. Especially, the APOEε4 allele has been reported to increase risk and to lower onset age as a function of the inherited dose of the ε4 allele. Reduction of flow or metabolism in the posterior cingulate gyrus and precuneus has been reported even in presymptomatic nondemented subjects who were cognitively normal and had at least a single ε4 allele. On the contrary the relation of ε4 allele to the progression rate of AD has been controversial from neuroimaging approaches. PET and SPECT imaging has become to be quite useful for assessing therapeutical effects of newly introduced treatment for AD. Recent investigations observed significant regional flow increase after donepezil hydrochloride treatment. Most of these observations have been made by applying computer assisted analysis of three-dimensional stereotactic surface projection or statistical parametric mapping

  7. Cerebral Blood Flow Responses to Aquatic Treadmill Exercise.

    Science.gov (United States)

    Parfitt, Rhodri; Hensman, Marianne Y; Lucas, Samuel J E

    2017-07-01

    Aquatic treadmills are used as a rehabilitation method for conditions such as spinal cord injury, osteoarthritis, and stroke, and can facilitate an earlier return to exercise training for athletes. However, their effect on cerebral blood flow (CBF) responses has not been examined. We tested the hypothesis that aquatic treadmill exercise would augment CBF and lower HR compared with land-based treadmill exercise. Eleven participants completed incremental exercise (crossover design) starting from walking pace (4 km·h, immersed to iliac crest [aquatic], 6 km·h [land]) and increasing 1 km·h every 2 min up to 10 km·h for aquatic (maximum belt speed) or 12 km·h for land. After this, participants completed two 2-min bouts of exercise immersed to midthigh and midchest at constant submaximal speed (aquatic), or were ramped to exhaustion (land; increased gradient 2° every min). Middle cerebral artery blood flow velocity (MCAv) and HR were measured throughout, and the initial 10 min of each protocol and responses at each immersion level were compared. Compared with land-based treadmill, MCAvmean increased more from baseline for aquatic exercise (21% vs 12%, P aquatic walking compared with land-based moderate intensity running (~10 cm·s, P = 0.56). Greater water immersion lowered HR (139 vs 178 bpm for midchest vs midthigh), whereas MCAvmean remained constant (P = 0.37). Findings illustrate the potential for aquatic treadmill exercise to enhance exercise-induced elevations in CBF and thus optimize shear stress-mediated adaptation of the cerebrovasculature.

  8. Cerebral small vessel disease is related to disturbed 24-h activity rhythms: a population-based study

    NARCIS (Netherlands)

    Zuurbier, L.A.; Ikram, M.A.; Luik, A.I.; Hofman, A.; van Someren, E.J.W.; Vernooij, M.W.; Tiemeier, H.

    2015-01-01

    Background and purpose: Cerebral small vessel disease is common in elderly persons. Patients with dementia or stroke frequently have cerebral small vessel disease and often experience disturbances in the sleep-wake rhythm. It is unknown whether cerebral small vessel disease is related to

  9. Relationship Between Cerebral Oxygenation and Hemodynamic and Oxygen Transport Parameters in Surgery for Acquired Heart Diseases

    Directory of Open Access Journals (Sweden)

    A. I. Lenkin

    2012-01-01

    Full Text Available Objective: to evaluate the relationship between cerebral oxygenation and hemodynamic and oxygen transport parameters in surgical correction of concomitant acquired heart diseases. Subjects and methods. Informed consent was received from 40 patients who required surgery because of concomitant (two or more acquired heart defects. During procedure, perioperative monitoring of oxygen transport and cerebral oxygenation was performed with the aid of PiCCO2 monitor (Pulsion Medical Systems, Germany and a Fore-Sight cerebral oximeter (CASMED, USA. Anesthesia was maintained with propofol and fen-tanyl, by monitoring the depth of anesthesia. Early postoperative intensive therapy was based on the protocol for early targeted correction of hemodynamic disorders. Oxygen transport and cerebral oxygenation parameters were estimated intraopera-tively and within 24 postoperative hours. A statistical analysis including evaluation of Spearman correlations was performed with the aid of SPSS 15.0. Results. During perfusion, there was a relationship between cerebral oximetry values and hemat-ocrit levels, and oxygen partial pressure in the venous blood. Furthermore, a negative correlation between cerebral oximetry values and blood lactate levels was found 30 minutes after initiation of extracorporeal circulation (EC. During the study, there was a positive correlation between cerebral oxygenation and values of cardiac index, central venous saturation, and oxygen delivery index. There was a negative relationship between cerebral oxygenation and extravascular lung water at the beginning of surgery and a correlation between cerebral oximetry values and oxygenation index by the end of the first 24 postoperative hours. Conclusion. The cerebral oxygenation values correlate -with the main determinants of oxygen transport during EC and after cardiac surgical procedures. Cerebral oximetry may be used in early targeted therapy for the surgical correction of acquired combined

  10. Stress test with adenosine in cerebral perfusion imaging for the diagnosis of ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Yuan Gengbiao; Kuang Anren; Chen Xuehong; Li Xihuan; Feng Jianzhong

    2004-01-01

    Objective: This study purpose is to evaluate cerebrovascular response and reserve capacity (CVR, CVRC) by stress test with adenosine in cerebral perfusion imaging for the diagnosis of ischemic cerebrovascular diseases. Methods There were 25 patients suffered from transient ischemia attack and 16 patients suffered from occlusive cerebral artery in this study. The rest cerebral perfusion imaging was obtained 30 minutes post-injection of 99mTC-ethylene cysteinate dimmer. After 2-5 days, adenosine stress tests were performed. Adenosine (0.14 mg/kg min) was administered intravenously 3 minutes pre-injection of 99mTC-ECD.Under same condition, the rest and stress tests of cerebral perfusion imaging were performed. By visual and semiquantitative analysis, the results of the rest/stress imaging were divided into the following four patterns: A: The stress imaging showed an expand areas of hypoperfusion, asymmetry index (AI) was decreased; B: Rest imaging was normal but new hypoperfused areas appeared with AI index declining in stress test; C: The hypoperfused areas were decreased or disappeared in size with AI index increasing in stress test; D: No changes showed in cerebral perfusion imaging patterns and Al index between rest and stress tests. AI index was ratio of radio account of interest regions than average radio account of cerebella. Results It was found that A, B, C and D type were 24%,12%,56% and 8% respectively in the group of transient ischemia attack patients, and 31%,44%, 19% and 6% respectively in the group of occlusive cerebrovascular patients. In rest test, of 41 patients of cerebrovascular disease, there were 28 cases decreased of radio uptake, moreover in stress test, there were 38 case decreased of radio uptake, positive rate were 68.29% and 92.68% respectively. Compared to X±SD of AI index of rest/stress test, it is found to increasing and being significant statistics (p<0.01, Spass 8.0 statistics software). Conclusion: Adenosinal-induced vasodilatation

  11. Moyamoya disease and its effect on cerebral perfusion

    International Nuclear Information System (INIS)

    Turner, James K.

    2009-01-01

    Full text: Objective: Moyamoya disease is a rare progressive occlusive disorder which affects the vasculature of the brain. It results in stroke like systems and can cause death due to haemorrhage. This poster follows the clinical case of a 12 year old South Korean Female diagnosed with Moyamoya disease in January 2004 and the role nuclear medicine played in her management. Methods: The clinical history of the patient was examined closely, with all previous medical imaging reports and nursing entries collated. An extensive literature review of Moyamoya disease was then performed using a range of resources. Results: The patient's clinical work-up involved a range of medical imaging procedures the results of which did not provide a clear pathway for clinical management. A Nuclear Medicine Cerebral Perfusion Diamox Challenge study was subsequently performed providing a critical result. The results of this study were indicative of no change in vascular reserve both pre and post Diamox infusion. Ultimately the patient's physicians then delayed the need for anastmosis surgery, with alternate methods of treatment required. Conclusion: Overall this case highlights the need for functional imaging and the importance of drug therapies including Diamox in nuclear medicine procedures. This study ensured the patients quality of life was maintained and eliminated any risk involved in performing further surgery.

  12. [A prospective study for systemic inflammatory response syndrome (SIRS) after cerebral infarction].

    Science.gov (United States)

    Xue, Yuan-yuan; Xu, Xiao-yun; Li, Gang; Wang, Yue

    2008-12-01

    To investigate whether systemic inflammatory response syndrome (SIRS) after cerebral infarction is associated with poor outcome and its associated clinical factors. We prospectively studied 500 patients with cerebral infarction, recorded the associated clinical factors on presentation and calculated the mortality at 21st day. There are 85 SIRS patients in 500 patients with cerebral infarction, 31 with total anterior cerebral infarction (TACI), 34 with partial anterior cerebral infarction (PACI), 15 with posterior cerebral infarction (POCI) and 5 with lacunar cerebral infarction (LACI). The frequency of SIRS was positively correlated with mortality rate according to Oxfordshire Community Stroke Project (OCSP) subtypes in cerebral infarction patients with fever (Spearman correlation coefficient = 1.0; P SIRS and mortality of cerebral infarction were as follows: age, infection, 48 h Chinese Stroke Scale score, 48 h Glasgow score, OCSP subtypes and dysphagia. Diabetes was the risk factor for SIRS, but had no effect on mortality. On Cox regression, 48 h Glasgow score was the sole independent risk factor of outcome. However, if SIRS was included in the formula, P > 0.05. SIRS is the predictor of poor outcome after acute cerebral infarction. It is important to prevent SIRS especially in TACI and POCI. Diabetes is the risk factor for SIRS, but has no effect on mortality.

  13. Cerebral blood flow in small vessel disease : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Shi, Yulu; Thrippleton, Michael J; Makin, Stephen D; Marshall, Ian; Geerlings, Mirjam I; de Craen, Anton Jm; van Buchem, Mark A; Wardlaw, Joanna M

    2016-01-01

    White matter hyperintensities are frequent on neuroimaging of older people and are a key feature of cerebral small vessel disease. They are commonly attributed to chronic hypoperfusion, although whether low cerebral blood flow is cause or effect is unclear. We systematically reviewed studies that

  14. Acetazolamide as a vasodilatory stimulus in cerebrovascular diseases and in conditions affecting the cerebral vasculature

    NARCIS (Netherlands)

    Settakis, G.; Molnár, C.; Kerényi, L.; Kollár, J.; Legemate, D.; Csiba, L.; Fülesdi, B.

    2003-01-01

    Pathologic processes affecting the brain vessels may damage cerebral vasodilatory capacity. Early detection of cerebral dysfunction plays an important role in the prevention of cerebrovascular diseases. In recent decades acetazolamide (AZ) has frequently been used for this purpose. In the present

  15. Comparison of the cerebral SPECT and biological markers in the Alzheimer disease

    International Nuclear Information System (INIS)

    Ravasi, L.; Semah, F.; Steinling, M.; Bombois, S.; Pasquier, F.; Schraen, S.; Buee, L.

    2009-01-01

    This study aim was to compare the contribution of SPECT of cerebral perfusion and bio markers of the cerebrospinal liquid in the diagnosis of Alzheimer disease. Our preliminary conclusions show that the concordance of the SPECT and cerebrospinal liquid is good in the possible Alzheimer disease. the interest of the cerebral SPECT and bio markers of the cerebrospinal liquid, used alone or conjointly, for a more reliable diagnosis of Alzheimer disease must be evaluated of prospective way. (N.C.)

  16. Cerebral small vessel disease, cognitive reserve and cognitive dysfunction.

    Science.gov (United States)

    Pinter, Daniela; Enzinger, Christian; Fazekas, Franz

    2015-11-01

    The concept of cognitive reserve describes differences between individuals in the ability to compensate age-related brain changes or pathology as a result of greater intellectual enrichment. Cerebral small vessel disease (CSVD) is a common age-related vascular disease of the brain associated with slowly accumulating tissue damage and represents a leading cause of functional loss, disability and cognitive decline in the elderly. The promotion of cognitive reserve might be a valuable possibility to moderate the negative impact of accumulating brain changes associated with CSVD on cognitive function and thus limit the functional consequences of CSVD. We here review existing studies investigating this topic in CSVD and provide conceptual considerations why future research is needed. Relevant studies were identified using the electronic databases PubMed and MEDLINE. Six studies including 7893 subjects were found that all focused on a single feature of CSVD only, i.e., white matter hyperintensities (WMH). We also included one study investigating 247 CADASIL patients. In general, they confirm that higher cognitive reserve (i.e., educational attainment) attenuates the negative impact of WMH on cognition. Further studies should attempt to replicate this association for all features of CSVD and to expand the concept to other areas of functional loss like disordered gait. Finally intervention studies will be needed to define when and how we can still increase our cognitive reserve and what kind and magnitude of protective effects this may offer.

  17. Cerebral haemodynamic response to somatosensory stimulation in near-term fetal sheep.

    Science.gov (United States)

    Nakamura, S; Walker, D W; Wong, F Y

    2017-02-15

    Cerebral haemodynamic response to neural stimulation has been extensively investigated in animal and clinical studies, in both adult and paediatric populations, but little is known about cerebral haemodynamic functional response in the fetal brain. The present study describes the cerebral haemodynamic response measured by near-infrared spectroscopy to somatosensory stimulation in fetal sheep. The cerebral haemodynamic response in the fetal sheep brain changes from a positive (increase in oxyhaemoglobin (oxyHb)) response pattern to a negative or biphasic response pattern when the duration of somatosensory stimulation is increased, probably due to cerebral vasoconstriction with prolonged stimulations. In contrast to adult studies, we have found that changes in fetal cerebral blood flow and oxyHb are positively increased in response to somatosensory stimulation during hypercapnia. We propose this is related to reduced vascular resistance and recruitment of cerebral vasculature in the fetal brain during hypercapnia. Functional hyperaemia induced by a localised increase in neuronal activity has been suggested to occur in the fetal brain owing to a positive blood oxygen level-dependent (BOLD) signal recorded by functional magnetic resonance imaging following acoustic stimulation. To study the effect of somatosensory input on local cerebral perfusion we used near-infrared spectroscopy (NIRS) in anaesthetised, partially exteriorised fetal sheep where the median nerve was stimulated with trains of pulses (2 ms, 3.3 Hz) for durations of 1.8, 4.8 and 7.8 s. Signal averaging of cerebral NIRS responses to 20 stimulus trains repeated every 60 s revealed that a short duration of stimulation (1.8 s) increased oxyhaemoglobin in the contralateral cortex consistent with a positive functional response, whereas longer durations of stimulation (4.8, 7.8 s) produced more variable oxyhaemoglobin responses including positive, negative and biphasic patterns of change. Mean arterial

  18. Cerebral haemodynamic response to somatosensory stimulation in near‐term fetal sheep

    Science.gov (United States)

    Nakamura, S.; Walker, D. W.

    2016-01-01

    Key points Cerebral haemodynamic response to neural stimulation has been extensively investigated in animal and clinical studies, in both adult and paediatric populations, but little is known about cerebral haemodynamic functional response in the fetal brain.The present study describes the cerebral haemodynamic response measured by near‐infrared spectroscopy to somatosensory stimulation in fetal sheep.The cerebral haemodynamic response in the fetal sheep brain changes from a positive (increase in oxyhaemoglobin (oxyHb)) response pattern to a negative or biphasic response pattern when the duration of somatosensory stimulation is increased, probably due to cerebral vasoconstriction with prolonged stimulations.In contrast to adult studies, we have found that changes in fetal cerebral blood flow and oxyHb are positively increased in response to somatosensory stimulation during hypercapnia. We propose this is related to reduced vascular resistance and recruitment of cerebral vasculature in the fetal brain during hypercapnia. Abstract Functional hyperaemia induced by a localised increase in neuronal activity has been suggested to occur in the fetal brain owing to a positive blood oxygen level‐dependent (BOLD) signal recorded by functional magnetic resonance imaging following acoustic stimulation. To study the effect of somatosensory input on local cerebral perfusion we used near‐infrared spectroscopy (NIRS) in anaesthetised, partially exteriorised fetal sheep where the median nerve was stimulated with trains of pulses (2 ms, 3.3 Hz) for durations of 1.8, 4.8 and 7.8 s. Signal averaging of cerebral NIRS responses to 20 stimulus trains repeated every 60 s revealed that a short duration of stimulation (1.8 s) increased oxyhaemoglobin in the contralateral cortex consistent with a positive functional response, whereas longer durations of stimulation (4.8, 7.8 s) produced more variable oxyhaemoglobin responses including positive, negative and biphasic patterns of

  19. Tanshinone inhibits neuronal cell apoptosis and inflammatory response in cerebral infarction rat model.

    Science.gov (United States)

    Zhou, Liang; Zhang, Jie; Wang, Chao; Sun, Qiangsan

    2017-06-01

    We aimed to investigate the effect and mechanisms of tanshinone (TSN) IIA in cerebral infarction. The cerebral infarction rat model was established by middle cerebral artery occlusion (MCAO). After pretreatment with TSN, cerebral infarct volume, cerebral edema, and neurological deficits score were evaluated, as well as cell apoptosis in hippocampus and cortex of the brain was examined with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were determined by Enzyme-Linked Immunosorbent Assay (ELISA). In addition, rat primary neuronal cells were isolated and cultured in oxygen-glucose deprivation (OGD) conditions. After pretreatment with TSN, cell viability and apoptosis were observed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and flow cytometry analysis, respectively. The expressions of Bax and B-cell lymphoma 2 (Bcl-2) were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blotting. Compared with untreated cerebral infarction rat, TSN treatment significantly reduced cerebral infarct volume, cerebral edema, and neurological deficits score ( P TSN ( P TSN remarkably increased cell viability and inhibited cell apoptosis ratio ( P TSN significantly downregulated the expression of Bax and upregulated Bcl-2 ( P TSN IIA has a preventive effect on cerebral infarction by inhibiting neuronal cell apoptosis and inflammatory response in vitro and in vivo.

  20. Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, K.F. de; Tuladhar, A.M.; Norden, A.G.W. van; Norris, D.G.; Zwiers, M.P.; Leeuw, F.E. de

    2011-01-01

    Gait disturbances are common in the elderly. Cerebral small vessel disease, including white matter lesions and lacunars infarcts, is thought to disrupt white matter tracts that connect important motor regions, hence resulting in gait disturbances. Pathological studies have demonstrated abnormalities

  1. Albendazole treatment of cerebral hydatid disease: evaluation of results with CT and MRI.

    Science.gov (United States)

    Kalaitzoglou, I; Drevelengas, A; Petridis, A; Palladas, P

    1998-01-01

    We report a case of cerebral hydatid disease demonstrated by CT and MRI, treated with albendazole. Follow-up showed complete disappearance of the cysts with residual focal calcification on CT and presumed gliosis on MRI.

  2. NADPH Oxidase Activity in Cerebral Arterioles Is a Key Mediator of Cerebral Small Vessel Disease-Implications for Prevention.

    Science.gov (United States)

    McCarty, Mark F

    2015-04-15

    Cerebral small vessel disease (SVD), a common feature of brain aging, is characterized by lacunar infarcts, microbleeds, leukoaraiosis, and a leaky blood-brain barrier. Functionally, it is associated with cognitive decline, dementia, depression, gait abnormalities, and increased risk for stroke. Cerebral arterioles in this syndrome tend to hypertrophy and lose their capacity for adaptive vasodilation. Rodent studies strongly suggest that activation of Nox2-dependent NADPH oxidase activity is a crucial driver of these structural and functional derangements of cerebral arterioles, in part owing to impairment of endothelial nitric oxide synthase (eNOS) activity. This oxidative stress may also contribute to the breakdown of the blood-brain barrier seen in SVD. Hypertension, aging, metabolic syndrome, smoking, hyperglycemia, and elevated homocysteine may promote activation of NADPH oxidase in cerebral arterioles. Inhibition of NADPH oxidase with phycocyanobilin from spirulina, as well as high-dose statin therapy, may have potential for prevention and control of SVD, and high-potassium diets merit study in this regard. Measures which support effective eNOS activity in other ways-exercise training, supplemental citrulline, certain dietary flavonoids (as in cocoa and green tea), and capsaicin, may also improve the function of cerebral arterioles. Asian epidemiology suggests that increased protein intakes may decrease risk for SVD; conceivably, arginine and/or cysteine-which boosts tissue glutathione synthesis, and can be administered as N-acetylcysteine-mediate this benefit. Ameliorating the risk factors for SVD-including hypertension, metabolic syndrome, hyperglycemia, smoking, and elevated homocysteine-also may help to prevent and control this syndrome, although few clinical trials have addressed this issue to date.

  3. Knee jerk responses in infants at high risk for cerebral palsy: an observational EMG study

    NARCIS (Netherlands)

    Hamer, E.G.; Dijkstra, L.J.; Hooijsma, S.J.; Zijdewind, I.; Hadders-Algra, M.

    2016-01-01

    BACKGROUND: Following our clinical observation of tonic responses in response to the knee jerk in infants at very high risk for cerebral palsy (VHR infants), we systematically studied tonic responses, clonus, and reflex irradiation. We questioned (i) whether these responses occurred more often in

  4. Hypoxia Inducible Factor 1α Promotes Endogenous Adaptive Response in Rat Model of Chronic Cerebral Hypoperfusion

    Directory of Open Access Journals (Sweden)

    Ying Yang

    2017-01-01

    Full Text Available Hypoxia inducible factor 1α (HIF-1α, a pivotal regulator of gene expression in response to hypoxia and ischemia, is now considered to regulate both pro-survival and pro-death responses depending on the duration and severity of the stress. We previously showed that chronic global cerebral hypoperfusion (CCH triggered long-lasting accumulation of HIF-1α protein in the hippocampus of rats. However, the role of the stabilized HIF-1α in CCH is obscure. Here, we knock down endogenous HIF-1α to determine whether and how HIF-1α affects the disease processes and phenotypes of CCH. Lentivirus expressing HIF-1α small hairpin RNA was injected into the bilateral hippocampus and bilateral ventricles to knock down HIF-1α gene expression in the hippocampus and other brain areas. Permanent bilateral common carotid artery occlusions, known as 2-vessel occlusions (2VOs, were used to induce CCH in rats. Angiogenesis, oxidative stress, histopathological changes of the brain, and cognitive function were tested. Knockdown of HIF-1α prior to 2VO significantly exacerbates the impairment of learning and memory after four weeks of CCH. Mechanically, reduced cerebral angiogenesis, increased oxidative damage, and increased density of astrocytes and microglia in the cortex and some subregions of hippocampus are also shown after four weeks of CCH. Furthermore, HIF-1α knockdown also disrupts upregulation of regulated downstream genes. Our findings suggest that HIF-1α-protects the brain from oxidative stress and inflammation response in the disease process of CCH. Accumulated HIF-1α during CCH mediates endogenous adaptive processes to defend against more severe hypoperfusion injury of the brain, which may provide a therapeutic benefit.

  5. Cerebral venous thrombosis in Behçet's disease.

    Science.gov (United States)

    Saadoun, D; Wechsler, B; Resche-Rigon, M; Trad, S; Le Thi Huong, D; Sbai, A; Dormont, D; Amoura, Z; Cacoub, P; Piette, J C

    2009-04-15

    To analyze the clinical findings, treatment, outcome, and prevalence of cerebral venous thrombosis (CVT) in a large cohort of patients with Behçet's disease (BD) from a single center. We reported a series of 64 consecutive patients with CVT who fulfilled the international criteria for BD. Multivariate analysis was performed to define factors that affect prognosis. Among a cohort of 820 patients with BD, CVT was present in 64 (7.8%). Compared with BD patients without CVT, those with CVT had lower parenchymal central nervous system involvement (4.7% versus 28.7%; P = 0.0001) and higher extraneurologic vascular lesions (62.5% versus 38.8%; P = 0.03). Up to 90% of patients responded to anticoagulation therapy without severe hemorrhagic complications. Neither steroid nor immunosuppressant use provided better outcome. Severe visual loss due to optic atrophy was the main complication of CVT, being found in 15% of patients. In multivariate analysis, papilledema (odds ratio [OR] 7.1, 95% confidence interval [95% CI] 1.6-31.9) and concurrent prothrombotic risk factors (OR 4.6, 95% CI 1.1-20.2) were independently associated with the occurrence of sequelae. Factors associated with relapse of thrombosis were concurrent prothrombotic risk factors (hazard ratio [HR] 4.9, 95% CI 1.5-15.4) and a peripheral venous thrombosis (HR 2.8, 95% CI 0.7-10.5). After a mean +/- SD followup of 8.2 +/- 6.9 years, 4 deaths unrelated to CVT were noted. CVT in patients with BD may result in serious neurologic outcomes. Anticoagulation represents a safe and effective therapy. Extensive investigation of prothrombotic disorders should be considered.

  6. SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Momose, Toshimitsu; Machida, Kikuo; Honda, Norinari; Nishikawa, Junichi; Sasaki, Yasuhito.

    1994-01-01

    Cerebral blood volume before and after acetazolamide was measured by SPECT to evaluate cerebral vasodilatory capacity in eight patients with cerebrovascular disease and five control subjects. Two SPECT measurements were performed serially, and acetazolamide was administered between them. The ratio of increase in hemispheric blood volume was calculated, and it was compared with the results of cerebral blood flow and cerebral blood volume measurements. A cerebral vasodilatory capacity map, the image after acetazolamide minus the baseline image, was also produced. Acetazolamide increased hemispheric blood volume in all subjects. The ratio of increase was lower in the involved hemispheres of the patients with unilateral carotid disease than in the uninvolved hemispheres of the patients and control subjects. The ratio of concordance with blood flow and blood volume measurements was approximated at 80%. Cerebral vasodilatory capacity mapping revealed three defects compatible with the clinical data. SPECT measurements of cerebral blood volume after acetazolamide can be performed following baseline SPECT with no additional radiotracer, and may be helpful to assess hemodynamic status. (author)

  7. Sex, aging, and preexisting cerebral ischemic disease in patients with aortic stenosis.

    Science.gov (United States)

    Wang, Ping; Acker, Michael A; Bilello, Michel; Melhem, Elias R; Stambrook, Elizabeth; Ratcliffe, Sarah J; Floyd, Thomas F

    2010-10-01

    Patients undergoing cardiac surgery have a high frequency of preexisting cerebral ischemic lesions, the presence of which appears to predict cognitive sequelae. Patients undergoing aortic valve replacement for aortic stenosis (AS) incur an exceptionally high risk for perioperative cerebral ischemia. The extreme risk in this subgroup may arise from the preexisting burden of cerebral ischemic disease. We tested the hypotheses that increasing age, female sex, coronary artery disease, and the severity of AS are predictive of the severity of preexisting cerebral ischemic lesions. A total of 95 subjects were included in this study. Subjects were imaged on 1.5 Tesla magnetic resonance imaging scanners to obtain multimodal image sets which were used for the automatic segmentation of cerebral lesion volume. The dependence of lesion volume upon age, sex, coronary artery disease, and the severity of AS were tested. The results demonstrate a strong correlation between aging, female sex, and white matter and ischemia-like lesion volume in patients with aortic stenosis. Women and those of advanced age presenting for aortic valve replacement for AS may incur a particularly high risk for postoperative neurologic sequelae due to an exceptional preexisting burden of cerebral ischemic disease. Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

    International Nuclear Information System (INIS)

    Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

    1987-01-01

    The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

  9. Cerebral vasodilatory capacity mapping using technetium-99m-DTPA-HSA SPECT and acetazolamide in moyamoya disease.

    Science.gov (United States)

    Inoue, Y; Momose, T; Machida, K; Honda, N; Tsutsumi, K

    1993-11-01

    A cerebral vasodilatory capacity map, consisting of a 99mTc-DTPA-HSA SPECT image obtained after acetazolamide injection minus the baseline image, was produced in a patient with moyamoya disease. The map demonstrated diminished capacity in the posterior region of the right cerebral hemisphere. Subsequently, cerebral infarction occurred in the corresponding area. This observation suggests that regions of low vasodilatory capacity identified by cerebral vasodilatory capacity mapping may be at high risk of ischemic stroke.

  10. Associations Between Cerebral Small-Vessel Disease and Alzheimer Disease Pathology as Measured by Cerebrospinal Fluid Biomarkers

    NARCIS (Netherlands)

    Kester, M.I.; Goos, J.D.C.; Teunissen, C.E.; Benedictus, M.R.; Bouwman, F.H.; Wattjes, M.P.; Barkhof, F.; Scheltens, P.; van der Flier, W.M.

    2014-01-01

    IMPORTANCE: It remains unclear if and how associations between cerebral small-vessel disease and Alzheimer disease (AD) pathology lead to cognitive decline and dementia. OBJECTIVE: To determine associations between small-vessel disease and AD pathology. DESIGN, SETTING, AND PARTICIPANTS:

  11. Cerebral haemodynamic response or excitability is not affected by sildenafil

    DEFF Research Database (Denmark)

    Kruuse, Christina; Hansen, Adam E; Larsson, Henrik B W

    2009-01-01

    Sildenafil (Viagra), a cyclic guanosine monophosphate-degrading phosphodiesterase 5 inhibitor, induces headache and migraine. Such headache induction may be caused by an increased neuronal excitability, as no concurrent effect on cerebral arteries is found. In 13 healthy females (23+/-3 years, 70...

  12. Electroencephalographic Response to Sodium Nitrite May Predict Delayed Cerebral Ischemia After Severe Subarachnoid Hemorrhage.

    Science.gov (United States)

    Garry, Payashi S; Rowland, Matthew J; Ezra, Martyn; Herigstad, Mari; Hayen, Anja; Sleigh, Jamie W; Westbrook, Jon; Warnaby, Catherine E; Pattinson, Kyle T S

    2016-11-01

    Aneurysmal subarachnoid hemorrhage often leads to death and poor clinical outcome. Injury occurring during the first 72 hours is termed "early brain injury," with disruption of the nitric oxide pathway playing an important pathophysiologic role in its development. Quantitative electroencephalographic variables, such as α/δ frequency ratio, are surrogate markers of cerebral ischemia. This study assessed the quantitative electroencephalographic response to a cerebral nitric oxide donor (intravenous sodium nitrite) to explore whether this correlates with the eventual development of delayed cerebral ischemia. Unblinded pilot study testing response to drug intervention. Neuroscience ICU, John Radcliffe Hospital, Oxford, United Kingdom. Fourteen World Federation of Neurosurgeons grades 3, 4, and 5 patients (mean age, 52.8 yr [range, 41-69 yr]; 11 women). IV sodium nitrite (10 μg/kg/min) for 1 hour. Continuous electroencephalographic recording for 2 hours. The alpha/delta frequency ratio was measured before and during IV sodium nitrite infusion. Seven of 14 patients developed delayed cerebral ischemia. There was a +30% to +118% (range) increase in the alpha/delta frequency ratio in patients who did not develop delayed cerebral ischemia (p accounting for major confounds). Administration of sodium nitrite after severe subarachnoid hemorrhage differentially influences quantitative electroencephalographic variables depending on the patient's susceptibility to development of delayed cerebral ischemia. With further validation in a larger sample size, this response may be developed as a tool for risk stratification after aneurysmal subarachnoid hemorrhage.

  13. A study of the cerebral blood flow pattern and cognitive deficit in Parkinson's disease

    International Nuclear Information System (INIS)

    Tamaru, Fuyuhiko

    1997-01-01

    Cerebral blood flow pattern in Parkinson's disease was examined by 123 I-IMP SPECT to determine whether the deficit in cognitive function is reflected in it. The patient group with Parkinson's disease showed deterioration in intelligence (Minimental state examination, Raven's Colored Progressive Matrices) and frontal lobe test (the Wisconsin Card Sorting Test). Though the uptake ratio of prefrontal area/occipital area in 123 I-IMP SPECT study varied widely in the Parkinson's disease group compared to the normal control group, there was no significant difference in the mean. Selective depletion of frontal lobe blood flow was not confirmed in this study. There was no correlation between cerebral blood flow pattern and cognitive functions including frontal lobe function and intelligence. We concluded that the deficit in cognitive function was not reflected in the cerebral blood flow pattern in Parkinson's disease. (author)

  14. Dipyridamole cerebral flow stress test evaluating ischemic cerebrovascular diseases

    International Nuclear Information System (INIS)

    Xiu, Y.; Chen, S.; Sun, X.; Liu, S.; Li, W.; Fan, W.; Wang, X.

    2000-01-01

    To detect the clinical value of dipyridamole cerebral blood flow stress test in cerebrovascular diseases (CVD). Nineteen patients (9 male, 10 female, mean age=65) who were diagnosed as CVD were included. One suffered from infarct, two suffered from thrombosis, one feel dizziness. All 4 performed rest and stress test. The other 15 were VBI, 9 of them performed stress test. Rest and stress test were done two-day method using Elscint Apex SP-6 SPECT equipped with low energy all purpose collimator. Rest perfusion imaging was started 30 min after injecting 1.11 GBq 99m Tc-ECD. Dipyridamole stress test was done within one week. 0.56 mg/Kg dipyridamole was injected intravenously during 4 min the same dose of ECD was injected 2 min later. The acquisition started 30 min later with the same parameter. Heart rate, ECG and the patient's complaint were monitored 2 min before and after dipyridamole. After correction for attenuation, transverse, coronal and sagittal slices were reconstructed. Eighteen ROIs were drawn symmetrically on cingulate, frontal, temporal-parietal, temporal, occipital, vision cortex, basal ganglia, superior frontal and parietal on the 3 rd , 6 th , 9 th transverse slices, selecting the contralateral as the reference region. The counts per pixel in each ROI were divided by the counts of the mirror region to obtain the relative uptake ratio. We think it abnormality when the ratio is above 1,1 or below 0.9. The sensitivity for rest and stress rCBF test was compared. rCBF was decreased at 10 of 19 patients (sensitivity 52.6%). 14 had low rCBF after dipyridamole (sensitivity 72.3%), Among the patients who studied stress test, 6 had normal rCBF at rest and low rCBF after stress. The abnormal area was enlarged after dipyridamole for 1 patients, 2 improved and 2 unchanged. 8 of 15 VBI had normal rCBF at rest (sensitivity 53.3%). 9 of 15 VBI performed stress test. rCBF was normal at rest for 5 patients, rCBF was decreased after stress, it was improved for one

  15. Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Kitamura, Shin; Ujike, Takashi; Kuroki, Soemu; Sakamoto, Shizuki; Soeda, Toshiyuki; Terashi, Akiro; Iio, Masaaki.

    1988-01-01

    The purpose of this study was to determine functional changes in the cerebral cortex and basal ganglia in Parkinson's disease (PD). Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO 2 ) were determined using 0-15 positron emission tomography in 10 PD patients and five age-matched healthy volunteers. There was a tendency among PD patients towards a decreased CBF and CMRO 2 in the cerebral cortex and basal ganglia. These values were significantly lower in the frontal cortex in the PD group than the control group. There was no difference in OEF between the groups. A more decreased cerebral oxygen metabolism was observed in patients staged as severer on the scale of Hoehn and Yahr. There was no correlation between cerebral oxygen metabolism and tremor, rigidity, or bradykinesis. A decreased cerebral oxygen metabolism was associated with mental disorders, such as depression, hallucination, and dementia. These results may provide an important clue for the understanding of mesocortical dopaminergic pathway and the relationship between PD and dementia. (N.K.)

  16. Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin; Ujike, Takashi; Kuroki, Soemu; Sakamoto, Shizuki; Soeda, Toshiyuki; Terashi, Akiro; Iio, Masaaki.

    1988-10-01

    The purpose of this study was to determine functional changes in the cerebral cortex and basal ganglia in Parkinson's disease (PD). Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO/sub 2/) were determined using 0-15 positron emission tomography in 10 PD patients and five age-matched healthy volunteers. There was a tendency among PD patients towards a decreased CBF and CMRO/sub 2/ in the cerebral cortex and basal ganglia. These values were significantly lower in the frontal cortex in the PD group than the control group. There was no difference in OEF between the groups. A more decreased cerebral oxygen metabolism was observed in patients staged as severer on the scale of Hoehn and Yahr. There was no correlation between cerebral oxygen metabolism and tremor, rigidity, or bradykinesis. A decreased cerebral oxygen metabolism was associated with mental disorders, such as depression, hallucination, and dementia. These results may provide an important clue for the understanding of mesocortical dopaminergic pathway and the relationship between PD and dementia. (N.K.).

  17. Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease

    NARCIS (Netherlands)

    Laat, Karlijn de; Norden, Anouk van; Gons, R.A.R.; Oudheusden, L.J.B. van; Uden, I.W.M. van; Norris, D.G.; Zwiers, M.P.; Leeuw, F.E. de

    2011-01-01

    BACKGROUND AND PURPOSE: Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of

  18. Clinical aspects and characteristics of the course of Parkinson’s disease with chronic cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Voskresenskaya O.N.

    2012-06-01

    Full Text Available

    The article is devoted characteristics current of Parkinson’s disease with chronic cerebral ischemia. Objective: to study the clinical presentation and features of PD against cerebral ischemia. Methods. A total of 44 patients with a diagnosis of “Parkinson’s disease”, 20 of which were determined by accurate clinical and instrumental signs of chronic cerebral ischemia. Comparative characteristics of the neurological status, cognitive functions, some laboratory and instrumental data in the two groups of patients: Parkinson’s disease with a background of chronic ischemia of the brain and without it. Results. Statistically signifcant differences between groups are observed on the following variables: duration of illness, severity of depression, the concentration of glucose in the blood. Formed groups of signifcant difference in the severity of atherosclerosis of cerebral vessels. Conclusion. The data of the acceleration of the progression of Parkinson’s disease with chronic cerebral ischemia, as well as the more frequent occurrence of depression in this patient group.

  19. Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is related to Alzheimer disease

    International Nuclear Information System (INIS)

    van Duinen, S.G.; Castano, E.M.; Prelli, F.; Bots, G.T.A.B.; Luyendijk, W.; Frangione, B.

    1987-01-01

    Hereditary cerebral hemorrhage with amyloidosis in Dutch patients is an autosomal dominant form of vascular amyloidosis restricted to the leptomeninges and cerebral cortex. Clinically the disease is characterized by cerebral hemorrhages leading to an early death. Immunohistochemical studies of five patients revealed that the vascular amyloid deposits reacted intensely with an antiserum raised against a synthetic peptide homologous to the Alzheimer disease-related β-protein. Silver stain-positive, senile plaque-like structures were also labeled by the antiserum, yet these lesions lacked the dense amyloid cores present in typical plaques of Alzheimer disease. No neurofibrillary tangles were present. Amyloid fibrils were purified from the leptomeningeal vessels of one patient who clinically had no signs of dementia. The protein had a molecular weight of ∼ 4000 and its partial amino acid sequence to position 21 showed homology to the β-protein of Alzheimer disease and Down syndrome. These results suggest that hereditary cerebral hemorrhage with amyloidosis of Dutch origin is pathogenetically related to Alzheimer disease and support the concept that the initial amyloid deposition in this disorder occurs in the vessel walls before damaging the brain parenchyma. Thus, deposition of β-protein in brain tissue seems to be related to a spectrum of diseases involving vascular syndromes, progressive dementia, or both

  20. The relation between chronic kidney disease and cerebral microbleeds: difference between patients with and without diabetes.

    Science.gov (United States)

    Ryu, Wi-Sun; Lee, Seung-Hoon; Kim, Chi Kyung; Kim, Beom Joon; Yoon, Byung-Woo

    2012-10-01

    Cerebral microbleeds are an important radiologic marker of bleeding-prone brain and have been reported to be associated with the increased risk of intracerebral haemorrhage. We sought to examine the association of chronic kidney disease with cerebral microbleeds, and determine whether the association differs between patients with and without diabetes. A total of 909 patients with ischemic stroke who were consecutively admitted to our hospital were included in this study. We collected demographic, clinical, and laboratory data (including serum creatinine levels) and documented the presence and numbers of microbleeds. Kidney function was estimated by using the Modification of Diet in Renal Disease formula. We categorized estimated glomerular filtration rates into moderate to severe, mild, and normal (90 ml/min/1·73 m(2), respectively). Cerebral microbleeds is most frequent in the moderate-to-severe chronic kidney disease group (45·6%). In patients without diabetes, mild and moderate-to-severe chronic kidney disease was found to be independently associated with the presence of cerebral microbleeds (adjusted odds ratio, 1·68; 95% confidence interval, 1·04-2·71 and adjusted odds ratio, 3·74; 95% confidence interval, 1·87-7·47) compared with normal kidney function. In patients with diabetes, however, this relationship was not found. Furthermore, ordinal logistic regression analysis revealed that an increased serum creatinine level and a reduced kidney function were associated with the number of cerebral microbleeds. We found that chronic kidney disease is independently associated with cerebral microbleeds in patients without diabetes but not in patients with diabetes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  1. Cerebral Palsy and Intellectual Disability in the Children of Women With Chronic Kidney Disease.

    Science.gov (United States)

    Tsuchiyama, Fumika; Makino, Yasuo; Hirasawa, Kyoko; Nagata, Satoru; Matsui, Hideo

    2017-08-01

    This study examined the risk of adverse maternal and neonatal outcomes, especially cerebral palsy and intellectual disability, in pregnant women with and without chronic kidney disease and their children. In total, 156 pregnancies involving 139 women with chronic kidney disease who were treated at our center between 2001 and 2010 were identified. We also selected 3067 women without chronic kidney disease who delivered their infants without suffering any medical complications during the same period as control groups. Long-term neonatal prognosis was assessed based on the frequencies of cerebral palsy and/or intellectual disability. The pregnant women had the following types of chronic kidney disease: immunoglobulin A nephropathy (n = 54), glomerulonephritis (n = 17), chronic renal failure (n = 16), nephrotic syndrome (n = 12), nephritis (n = 11), diabetic nephropathy (n = 10), congenital malformations and deformations (n = 10), purpura nephritis (n = 7), and others (n = 19). Of the children who were born to mothers with chronic kidney disease, one developed cerebral palsy, and another developed cerebral palsy with intellectual disability. Seven of the children who were born to mothers without chronic kidney disease developed cerebral palsy. The posterior probability of these conditions was 0.01900 and 0.002610 in the children born to mothers with and without chronic kidney disease, respectively. A primiparous mother (odds ratio [OR]: 4.07, 95% confidence interval [CI]): 2.78 to 5.95), preeclampsia (OR: 6.44, 95% CI: 3.92 to 10.59), grade 1 to 4 intraventricular hemorrhaging (OR: 7.71, 95% CI: 2.05 to 28.92), and an Apgar score of less than 7 at five minutes (OR: 0.51, 95% CI: 0.27 to 0.96) were found to influence the risk of cerebral palsy and/or intellectual disability in children born to women with chronic kidney disease. We found that the incidence of cerebral palsy and/or intellectual disability is 7.2-fold higher in children born to women

  2. Oxidative stress in cerebral small vessel disease. Role of reactive species.

    Science.gov (United States)

    Grochowski, Cezary; Litak, Jakub; Kamieniak, Piotr; Maciejewski, Ryszard

    2018-01-01

    Cerebral small vessel disease (CSVD) is a wide term describing the condition affecting perforating arterial branches as well as arterioles, venules, and capillaries. Cerebral vascular net is one of the main targets of localised oxidative stress processes causing damage to vasculature, changes in the blood flow and blood-brain barrier and, in consequence, promoting neurodegenerative alterations in the brain tissue. Numerous studies report the fact of oxidation to proteins, sugars, lipids and nucleic acids, occurring in most neurodegenerative diseases mainly in the earliest stages and correlations with the development of cognitive and motor disturbances. The dysfunction of endothelium can be caused by oxidative stress and inflammatory mechanisms as a result of reactions and processes generating extensive reactive oxygen species (ROS) production such as high blood pressure, oxidised low density lipoproteins (oxLDL), very low density lipoproteins (vLDL), diabetes, homocysteinaemia, smoking, and infections. Several animal studies show positive aspects of ROS, especially within cerebral vasculature.

  3. The renin-angiotensin-aldosterone system in cerebral small vessel disease

    NARCIS (Netherlands)

    Brenner, D.; Labreuche, J.; Pico, F.; Scheltens, P.; Poirier, O.; Cambien, F.; Amarenco, P.

    2008-01-01

    Introduction: Cerebral small vessel disease (SVD) appears on magnetic resonance imaging (MRI) as leukoaraiosis (LA), état criblé (EC), and multiple lacunar infarctions (MLI). Although the pathophysiology of SVD is poorly understood, there is evidence of a genetic contribution. We sought to analyze

  4. Cerebral manifestations of Erdheim-Chester disease. Zerebrale Manifestationen der Erdheim-Chester-Krankheit

    Energy Technology Data Exchange (ETDEWEB)

    Kujat, C.; Junk, B. (Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Abt. fuer Neuroradiologie); Hermes, M. (Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Radiologische Klinik); Martin, J. (Universitaet des Saarlandes, Homburg/Saar (Germany, F.R.). Nervenklinik); Dewes, W.

    1991-06-01

    Cerebral manifestations of Erdheim-Chester disease are variable, giving a picture like that of multiple sclerosis. White matter lesions are located mainly in cerebellum and pons and lipid granulomas in the meninges. An asymptomatic lesion in the choroid plexus, with prolonged uptake of Gd-DTPA is described for the first time. (orig.).

  5. Baseline Cerebral Small Vessel Disease Is Not Associated with Gait Decline After Five Years

    NARCIS (Netherlands)

    Van Der Holst, Helena M.; Van Uden, Ingeborg W.M.; de Laat, Karlijn F.; Van Leijsen, Esther M.C.; van Norden, Anouk G.W.; Norris, David G.; Van DIjk, Ewoud J.; Tuladhar, Anil M.; de Leeuw, Frank-Erik

    2017-01-01

    Background Cerebral small vessel disease (SVD) is cross-sectionally associated with gait disturbances, however, the relation between baseline SVD and gait decline over time is uncertain. Furthermore, diffusion tensor imaging (DTI) studies on gait decline are currently lacking. Objective To

  6. Mutation of FOXC1 and PITX2 induces cerebral small-vessel disease

    NARCIS (Netherlands)

    French, Curtis R.; Seshadri, Sudha; Destefano, Anita L.; Fornage, Myriam; Arnold, Corey R.; Gage, Philip J.; Skarie, Jonathan M.; Dobyns, William B.; Millen, Kathleen J.; Liu, Ting; Dietz, William; Kume, Tsutomu; Hofker, Marten; Emery, Dere; Childs, Sarah J.; Waskiewicz, Andrew J.; Lehmann, Orden J.

    2014-01-01

    Patients with cerebral small-vessel disease (CSVD) exhibit perturbed end-artery function and have an increased risk for stroke and age-related cognitive decline. Here, we used targeted genome-wide association (GWA) analysis and defined a CSVD locus adjacent to the forkhead transcription factor

  7. Albendazole treatment of cerebral hydatid disease: evaluation of results with CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kalaitzoglou, I.; Drevelengas, A.; Petridis, A.; Palladas, P. [Department of Radiology, ``G. Papanikolaou`` General Hospital, Thessaloniki (Greece)

    1998-01-01

    We report a case of cerebral hydatid disease demonstrated by CT and MRI, treated with albendazole. Follow-up showed complete dissapearance of the cysts with residual focal calcification on CT and presumed gliosis on MRI. (orig.) With 3 figs., 17 refs.

  8. Personal Responsibility and Lifestyle Diseases

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman; Nielsen, Morten Ebbe Juul

    2016-01-01

    What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them......, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal...

  9. microRNA in Cerebral Spinal Fluid as Biomarkers of Alzheimer’s Disease Risk After Brain Injury

    Science.gov (United States)

    2017-08-01

    AWARD NUMBER: W81XWH-15-1-0318 TITLE: microRNA in Cerebral Spinal Fluid as Biomarkers of Alzheimer’s Disease Risk After Brain Injury...After Brain Injury 5b. GRANT NUMBER AZ14046 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) J 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER...responses to brain injury that precede, and likely drive, changes in protein expression that lead to the development of AD. We have additional preliminary

  10. Nasal administration of amyloid-beta peptide decreases cerebral amyloid burden in a mouse model of Alzheimer's disease

    DEFF Research Database (Denmark)

    Weiner, H L; Lemere, C A; Maron, R

    2000-01-01

    Progressive cerebral deposition of amyloid-beta (Abeta) peptide, an early and essential feature of Alzheimer's disease (AD), is accompanied by an inflammatory reaction marked by microgliosis, astrocytosis, and the release of proinflammatory cytokines. Mucosal administration of disease-implicated ......Progressive cerebral deposition of amyloid-beta (Abeta) peptide, an early and essential feature of Alzheimer's disease (AD), is accompanied by an inflammatory reaction marked by microgliosis, astrocytosis, and the release of proinflammatory cytokines. Mucosal administration of disease...

  11. Cerebral blood flow response to flavanol-rich cocoa in healthy elderly humans

    Directory of Open Access Journals (Sweden)

    Farzaneh A Sorond

    2008-04-01

    Full Text Available Farzaneh A Sorond1,2, Lewis A Lipsitz2,4, Norman K Hollenberg3,5, Naomi DL Fisher31Department of Neurology, Stroke Division; 2Institute for Aging Research, Hebrew SeniorLife, Boston, MA; 3Department of Medicine, Endocrine-Hypertension Division; 4Department of Medicine, Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA; 5Department of Radiology, Brigham and Women’s Hospital, Boston, MABackground and Purpose: Cerebral ischemia is a common, morbid condition accompanied by cognitive decline. Recent reports on the vascular health benefits of flavanol-containing foods signify a promising approach to the treatment of cerebral ischemia. Our study was designed to investigate the effects of flavanol-rich cocoa (FRC consumption on cerebral blood flow in older healthy volunteers.Methods: We used transcranial Doppler (TCD ultrasound to measure mean blood flow velocity (MFV in the middle cerebral artery (MCA in thirty-four healthy elderly volunteers (72 ± 6 years in response to the regular intake of FRC or flavanol-poor cocoa (FPC.Results: In response to two weeks of FRC intake, MFV increased by 8% ± 4% at one week (p = 0.01 and 10% ± 4% (p = 0.04 at two weeks. In response to one week of cocoa, significantly more subjects in the FRC as compared with the FPC group had an increase in their MFV (p < 0.05.Conclusions: In summary, we show that dietary intake of FRC is associated with a significant increase in cerebral blood flow velocity in the MCA as measured by TCD. Our data suggest a promising role for regular cocoa flavanol’s consumption in the treatment of cerebrovascular ischemic syndromes, including dementias and stroke.Keywords: cerebral blood flow, flavanol, cocoa, transcranial Doppler ultrasound

  12. Cerebral blood flow and vascular response to hypercapnia in hypertensive patients with leukoaraiosis

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Ibayashi, Setsuro; Fujishima, Masatoshi

    1996-01-01

    Both arteriosclerosis and leukoaraiosis have a close relationship with hypertension, but the relationship between cerebral hemodynamics and leukoaraiosis in hypertensive patients has not been fully examined. To clarify this issue, we measured the regional cerebral blood flow (rCBF) and cerebrovascular response to hypercapnia in hypertensive patients with various degrees of leukoaraiosis. The subjects consisted of 7 normotensive normal controls and 17 hypertensive patients. The hypertensive patients were divided into three groups according to the severity of white matter lesions (leukoaraiosis) on MRI and the presence of dementia, namely, negative or mild leukoaraiosis without dementia, moderate to severe leukoaraiosis without dementia and severe leukoaraiosis with dementia. Both the rCBF and the cerebrovascular response to hypercapnia were measured by the O-15 H 2 O bolus-injection method and positron emission tomography. The rCBF in hypertensive patients without dementia did not decrease when compared with the normotensive controls, but the rCBF in hypertensive patients with dementia markedly decreased in the cerebral cortices and white matter. On the other hand, the cerebrovascular response to hypercapnia declined with the severity of leukoaraiosis, and it decreased most severely in patients with severe leukoaraiosis and dementia. Our results indicate that the reduction in the cerebral hemodynamic reserve capacity has a close relationship with the severity of leukoaraiosis in hypertensive patients, although the rCBF is maintained in hypertensive patients without dementia, and suggest that arteriosclerotic change reduces cerebrovascular CO 2 response and causes a leukoaraiosis in hypertensive patients. (author)

  13. Maximal aerobic and anaerobic exercise responses in children with cerebral palsy.

    NARCIS (Netherlands)

    Balemans, A.C.J.; van Wely, L.; de Heer, S.J.; van den Brink, J.; de Koning, J.J.; Becher, J.G.; Dallmeijer, A.J.

    2013-01-01

    PURPOSE: The objective of this study is to compare the maximal aerobic and anaerobic exercise responses of children with cerebral palsy (CP) by level of motor impairment and in comparison with those of typically developing children (TD). METHODS: Seventy children with CP, with varying levels of

  14. Capillary pericytes regulate cerebral blood flow in health and disease

    DEFF Research Database (Denmark)

    Hall, Catherine N; Reynell, Clare; Gesslein, Bodil

    2014-01-01

    Increases in brain blood flow, evoked by neuronal activity, power neural computation and form the basis of BOLD (blood-oxygen-level-dependent) functional imaging. Whether blood flow is controlled solely by arteriole smooth muscle, or also by capillary pericytes, is controversial. We demonstrate...... blood flow, capillaries dilate before arterioles and are estimated to produce 84% of the blood flow increase. In pathology, ischaemia evokes capillary constriction by pericytes. We show that this is followed by pericyte death in rigor, which may irreversibly constrict capillaries and damage the blood......-brain barrier. Thus, pericytes are major regulators of cerebral blood flow and initiators of functional imaging signals. Prevention of pericyte constriction and death may reduce the long-lasting blood flow decrease that damages neurons after stroke....

  15. Increased Arterial Diameters in the Posterior Cerebral Circulation in Men with Fabry Disease

    Science.gov (United States)

    Üçeyler, Nurcan; Homola, György A.; Guerrero González, Hans; Kramer, Daniela; Wanner, Christoph; Weidemann, Frank; Solymosi, László; Sommer, Claudia

    2014-01-01

    A high load of white matter lesions and enlarged basilar arteries have been shown in selected patients with Fabry disease, a disorder associated with an increased stroke risk. We studied a large cohort of patients with Fabry disease to differentially investigate white matter lesion load and cerebral artery diameters. We retrospectively analyzed cranial magnetic resonance imaging scans of 87 consecutive Fabry patients, 20 patients with ischemic stroke, and 36 controls. We determined the white matter lesion load applying the Fazekas score on fluid-attenuated inversion recovery sequences and measured the diameters of cerebral arteries on 3D-reconstructions of the time-of-flight-MR-angiography scans. Data of different Fabry patient subgroups (males – females; normal – impaired renal function) were compared with data of patients with stroke and controls. A history of stroke or transient ischemic attacks was present in 4/30 males (13%) and 5/57 (9%) females with Fabry disease, all in the anterior circulation. Only one man with Fabry disease showed confluent cerebral white matter lesions in the Fazekas score assessment (1%). Male Fabry patients had a larger basilar artery (p3.2 mm distinguished between men with Fabry disease and controls (sensitivity: 87%, specificity: 86%, pFabry disease independent of disease severity. PMID:24475221

  16. Regional cerebral glucose metabolism after pridopidine (ACR16) treatment in patients with Huntington disease.

    Science.gov (United States)

    Esmaeilzadeh, Mouna; Kullingsjö, Johan; Ullman, Henrik; Varrone, Andrea; Tedroff, Joakim

    2011-01-01

    Huntington disease is a hereditary neurodegenerative disorder resulting in loss of motor, cognitive, and behavioral functions and is characterized by a distinctive pattern of cerebral metabolic abnormalities. Pridopidine (ACR16) belongs to a novel class of central nervous system compounds in development for the treatment of Huntington disease. The objective of the study was to investigate the metabolic changes in patients with Huntington disease before and after pridopidine treatment. [(18)F]Fluorodeoxyglucose positron emission tomographic imaging was used to measure the regional cerebral metabolic rate of glucose at baseline and after 14 days of open-label pridopidine treatment in 8 patients with Huntington disease. Clinical assessments were performed using the Unified Huntington's Disease Rating Scale. Statistical parametric mapping analysis showed increased metabolic activity in several brain regions such as the precuneus and the mediodorsal thalamic nucleus after treatment. In addition, after pridopidine treatment, the correlation between the clinical status and the cerebral metabolic activity was strengthened. Our findings suggest that pridopidine induces metabolic changes in brain regions implicated as important for mediating compensatory mechanisms in Huntington disease. In addition, the finding of a strong relationship between clinical severity and metabolic activity after treatment also suggests that pridopidine treatment targets a Huntington disease-related metabolic activity pattern.

  17. Conantokin probes of NMDA receptors in normal and Alzheimer disease human cerebral cortex

    International Nuclear Information System (INIS)

    Ragnarsson, L.; Dodd, P.R.; Lewis, R.J.

    2002-01-01

    Full text: The pharmacology of the N-methyl-D-aspartate (NMDA) receptor site was examined in pathologically affected and relatively spared regions of cerebral cortex tissue obtained at autopsy from Alzheimer disease cases and matched controls. The affinity and density of the [ 3 H]MK-801 binding site were delineated along with the enhancement of [ 3 H]MK-801 binding by glutamate and spermine. Sites with distinct pharmacologies were distributed regionally through the cortex. The differences could not be explained by variations in the parameters of [ 3 H]MK-801 binding; rather, the data suggest that the subunit composition of NMDA receptors may be locally variable. Selective differences were also found between controls and Alzheimer disease cases in certain brain regions. The interactions of human NMDA sites with the Ala(7) and Lys(7) derivatives of conantokin-G (Con-G) were also characterized. Ala(7)-con-G showed the higher affinity of the two peptides, and also defined two distinct binding sites in controls. In distinction to the Ala(7) peptide, Lys(7)- con-G showed preferential binding to receptor sites in Alzheimer disease cf. control brain. Modified conantokins are useful for identifying differences in subunit composition of the NMDA receptors between brain areas. They may also have potential as protective agents against over-excitation mediated by specific NMDA receptors, which might contribute to localized brain damage in Alzheimer disease. For further characterization of the pharmacology of different NMDA receptor subunits, a mammalian expression system has been developed for the analysis of their responses to selected ligands, including conantokins. Copyright (2002) Australian Neuroscience Society

  18. Male-female differences in upregulation of vasoconstrictor responses in human cerebral arteries.

    Directory of Open Access Journals (Sweden)

    Hilda Ahnstedt

    Full Text Available BACKGROUND AND PURPOSE: Male-female differences may significantly impact stroke prevention and treatment in men and women, however underlying mechanisms for sexual dimorphism in stroke are not understood. We previously found in males that cerebral ischemia upregulates contractile receptors in cerebral arteries, which is associated with lower blood flow. The present study investigates if cerebral arteries from men and women differ in cerebrovascular receptor upregulation. EXPERIMENTAL APPROACH: Freshly obtained human cerebral arteries were placed in organ culture, an established model for studying receptor upregulation. 5-hydroxtryptamine type 1B (5-HT1B, angiotensin II type 1 (AT1 and endothelin-1 type A and B (ETA and ETB receptors were evaluated using wire myograph for contractile responses, real-time PCR for mRNA and immunohistochemistry for receptor expression. KEY RESULTS: Vascular sensitivity to angiotensin II and endothelin-1 was markedly lower in cultured cerebral arteries from women as compared to men. ETB receptor-mediated contraction occurred in male but not female arteries. Interestingly, there were similar upregulation in mRNA and expression of 5-HT1B, AT1, and ETB receptors and in local expression of Ang II after organ culture. CONCLUSIONS AND IMPLICATIONS: In spite of receptor upregulation after organ culture in both sexes, cerebral arteries from women were significantly less responsive to vasoconstrictors angiotensin II and endothelin-1 as compared to arteries from men. This suggests receptor coupling and/or signal transduction mechanisms involved in cerebrovascular contractility may be suppressed in females. This is the first study to demonstrate sex differences in the vascular function of human brain arteries.

  19. Nasal administration of amyloid-beta peptide decreases cerebral amyloid burden in a mouse model of Alzheimer's disease

    DEFF Research Database (Denmark)

    Weiner, H L; Lemere, C A; Maron, R

    2000-01-01

    Progressive cerebral deposition of amyloid-beta (Abeta) peptide, an early and essential feature of Alzheimer's disease (AD), is accompanied by an inflammatory reaction marked by microgliosis, astrocytosis, and the release of proinflammatory cytokines. Mucosal administration of disease-implicated ......Progressive cerebral deposition of amyloid-beta (Abeta) peptide, an early and essential feature of Alzheimer's disease (AD), is accompanied by an inflammatory reaction marked by microgliosis, astrocytosis, and the release of proinflammatory cytokines. Mucosal administration of disease......-implicated proteins can induce antigen-specific anti-inflammatory immune responses in mucosal lymphoid tissue which then act systemically. We hypothesized that chronic mucosal administration of Abeta peptide might induce an anti-inflammatory process in AD brain tissue that could beneficially affect...... Abeta plaque burden and Abeta42 levels in mice treated intranasally with Abeta peptide versus controls treated with myelin basic protein or left untreated. This lower Abeta burden was associated with decreased local microglial and astrocytic activation, decreased neuritic dystrophy, serum anti...

  20. Autonomic cerebral vascular response to sildenafil in diabetic patient

    Directory of Open Access Journals (Sweden)

    Al-Amran Fadhil G

    2012-01-01

    Full Text Available Abstract Background Erectile dysfunction is a common problem in type 2 diabetic patients who are at higher risk of cerebrovascular events, and it's recorded with sildenafil, a drug which is primarily used for erectile dysfunction. Objectives We tested the hypothesis whether or not sildenafil modulates cerebrovascular reactivity (CVR in patients with type 2 diabetes mellitus. Methods A total of 35 male participants were enrolled; eighteen with type 2 diabetes mellitus matched with seventeen normal individuals. Transcranial Doppler Ultrasonographic examination (TCD was performed for all participants to insonate the middle cerebral artery (MCA through a trans-temporal window. CVR was assessed by using breath holding (BH-hyperventilation (HV test, before and after oral 50 mg sildenafil; recordings were analyzed by using SPSS program version 12. Results In normal individuals, sildenafil did not result in statistically significant change in breath holding index (BHI from 0.91 ± 0.11 to 0.81 ± 0.09 and full range of vasodilatation (FVD from (59.4% ± 6.3% to (53.7% ± 4.9%. In diabetic patients, giving sildenafil resulted in significant increase in BHI (from 0.74 ± 0.14 to 1.03 ± 0.14 and FVD (from 60.2% ± 4.96% to 74% ± 4.8%, (p Conclusion Sildenafil significantly improves CVR in type 2 diabetic patients but not in normal subjects.

  1. Cerebral small vessel disease in middle age and genetic predisposition to late-onset Alzheimer's disease.

    Science.gov (United States)

    Stefaniak, James D; Su, Li; Mak, Elijah; Sheikh-Bahaei, Nasim; Wells, Katie; Ritchie, Karen; Waldman, Adam; Ritchie, Craig W; O'Brien, John T

    2018-02-01

    Cerebral small vessel disease (CSVD) is associated with late-onset Alzheimer's disease (LOAD) and might contribute to the relationship between apolipoprotein E ε4 (APOE ε4) and LOAD, in older people. However, it is unclear whether CSVD begins in middle age in individuals genetically predisposed to LOAD. We assessed the relationship between radiological markers of CSVD, white matter hyperintensities and microbleeds, and genetic predisposition to LOAD in a cross-sectional analysis of cognitively normal subjects aged 40-59 years recruited from the PREVENT Dementia study. Microbleed prevalence was 14.5%, and mean ± standard deviation white matter hyperintensity percentage of total brain volume was 0.41 ± 0.28%. There was no significant association between APOE ε4 carrier status or history of parental dementia and white matter hyperintensity volume (P = .713, .912 respectively) or microbleeds (P = .082, .562 respectively) on multiple regression. Genetic predisposition to LOAD, through APOE genotype or AD family history, is not associated with CSVD in middle age. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  2. Effectiveness of treatment with donepezil hydrochloride and changes in regional cerebral blood flow in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Yoshida, Tsunetaka; Ha-Kawa, S.; Yoshimura, Masafumi; Nobuhara, Kenji; Kinoshita, Toshihiko; Sawada, Satoshi

    2007-01-01

    The objective of this study was to elucidate the relationship between the effects of donepezil hydrochloride (donepezil) and cerebral blood flow, and to evaluate the usefulness of cerebral blood flow imaging in assessing and predicting treatment effectiveness. The subjects were 29 outpatients (12 men and 17 women; age 50-82 years; mean age 69.2 years), who had received a diagnosis of Alzheimer's disease (AD). Efficacy was evaluated before donepezil administration; after 1 month, 3 months, and 6 months of drug administration; and at 1 year after completion of administration using the Japanese version of the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog), as a measure of cognitive function. The ADAS-cog has been frequently used to evaluate cognitive function in AD patients. Patients whose ADAS-cog scores improved by 3 or more points during the observation period were classified as responders, and those with no improvement were classified as nonresponders. 123 I-iofetamine (IMP) was used for single photon emission computed tomography cerebral blood flow scintigraphy. On the basis of ADAS-cog score improvement, 22 of the 29 patients were responders (7 men and 15 women; age 50-82 years; mean age 69.0 years) and seven were nonresponders (5 men and 2 women; age 61-80 years; mean age 70.0 years). The results indicate that a difference in cerebral blood flow responsiveness after 1 month of treatment distinguishes responders from nonresponders. After 1 month, blood flow was significantly decreased in all regions of nonresponders, whereas significant increases in blood flow were seen in the anterior frontal lobe and parietal lobe of responders. At that time point, blood flow in the basal ganglion differed significantly between the two groups, indicating that this difference in responsiveness after 1 month of treatment may distinguish responders from nonresponders. In cognitive function testing, the group that exhibited a complete response showed

  3. Effective surgical revascularization improves cerebral hemodynamics and resolves headache in pediatric Moyamoya disease.

    Science.gov (United States)

    Kawabori, Masahito; Kuroda, Satoshi; Nakayama, Naoki; Hirata, Kenji; Shiga, Toru; Houkin, Kiyohiro; Tamaki, Nagara

    2013-11-01

    Headache is one of the major clinical presentations in pediatric Moyamoya disease. However, the clinical features and underlying mechanisms are not fully understood. This study aimed to clarify the clinical feature of headache in pediatric Moyamoya disease and the effect of surgical revascularization. This study included 29 pediatric patients who underwent superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis and indirect bypass for Moyamoya disease. Their medical records were precisely evaluated to identify the clinical features of their headache. The findings on magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography also were analyzed. Preoperative headache was documented in 11 (38%) of 29 patients. The majority of them complained of severe headache in the frontal or temporal region in the morning. Headache was significantly related to more advanced disease stage and to the decreases in cerebral blood flow and its reactivity to acetazolamide. Surgical revascularization completely resolved headache in all 11 patients. These findings strongly suggest that disturbed cerebral hemodynamics may play key roles in developing severe headache in pediatric Moyamoya disease. STA-MCA anastomosis and encephalo-duro-myo-arterio-pericranial synangiosis may be effective procedures to rapidly resolve headache by widely supplying collateral blood flow to the operated hemispheres. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Evaluation of regional cerebral circulation and metabolism in moyamoya disease using positron emission computed tomography

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo

    1986-01-01

    Regional cerebral blood flow, oxygen extraction fraction, metabolic rate of oxygen, blood volume and transit time were evaluated in 11 patients with moyamoya disease and 3 with suspected moyamoya disease using positron emission computed tomography. Eight of them were examined before and after EC-IC bypass surgery. Moyamoya patients were classified into four groups, namely, pediatric bilateral chronic type (over 5 years from onset), pediatric bilateral early type (within 5 years from onset), pediatric unilateral early type and adult type, according to age, duration of disease from onset and angiographic findings. These four groups showed different patterns on PET images; diffusely decreased CBF and CMRO2 in pediatric bilateral chronic type, decreased CBF and increased OEF in the frontal or temporoparietal region in pediatric bilateral early type, diffusely decreased CBF and increased OEF in the unilateral cerebral hemisphere in pediatric unilateral cerebral hemisphere in pediatric unilateral early type, and decreased CBF and CMRO2 in adult type. An increase of rCBV was demonstrated in frontal regions or basal ganglia in all groups, more prominently in pediatric patients. This was thought to be a common finding in moyamoya disease, corresponding to moyamoya vessels. Staging of moyamoya disease by PET was presented and compared to the angiographic staging. They were significantly correlated, and the stage 3 on PET image with decreased CMRO2 corresponded to the stage 3 or 4 on angiography, the most active stage of moyamoya disease. PET revealed increased CBF in the cortical area around EC-IC bypass but no remarkable changes in mean values of rCBF, OEF, CMRO2 and CBV in cerebral hemisphere. Some patients showed decreased rCBV in the basal ganglia. (J.P.N.)

  5. Corpus callosum. Landmark of the origin of cerebral diseases

    International Nuclear Information System (INIS)

    Hattingen, E.; Blasel, S.; Zanella, F.E.; Nichtweiss, M.; Weidauer, S.

    2010-01-01

    Diseases of the corpus callosum include developmental disorders, immunomodulated CNS diseases, vascular malformations, disturbances of metabolism including the electrolyte homeostasis, secondary degenerations and mechanical injuries. This report provides information on the differential diagnosis of reversible and irreversible pathological changes of the corpus callosum with special focus on the localization, which often allows conclusions on the pathogenesis to be drawn. (orig.) [de

  6. Role of thalamic diffusion for disease differentiation between multiple sclerosis and ischemic cerebral small vessel disease

    Energy Technology Data Exchange (ETDEWEB)

    Oeztoprak, Bilge; Oeztoprak, Ibrahim; Salk, Ismail [Cumhuriyet University School of Medicine, Department of Radiology, Sivas (Turkey); Topalkara, Kamil [Bayindir Hospital, Department of Neurology, Ankara (Turkey); Erkoc, Mustafa F. [Bozok University School of Medicine, Department of Radiology, Yozgat (Turkey)

    2015-04-01

    Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases. DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm{sup 2}. ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm{sup 2} which were oriented parallel to the long axis of the thalamus were used for this purpose. The mean ADC value of the thalamus was (0.99 ± 0.16) x 10{sup -3} mm{sup 2}/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) x 10{sup -3} mm{sup 2}/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) x 10{sup -3} mm{sup 2}/s in MS patients, and (0.75 ± 0.08) x 10{sup -3} mm{sup 2}/s in the control group, which are not significantly different (p > 0.05). Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation. (orig.)

  7. A sonographic quantitative cutoff value of cerebral venous outflow in neurologic diseases: a blinded study of 115 subjects.

    Science.gov (United States)

    Monti, L; Menci, E; Piu, P; Leonini, S; Arrigucci, U; Bellini, M; Zandonella, A; Galluzzi, P; Casasco, A

    2014-07-01

    The autonomic nervous system maintains constant cerebral venous blood outflow in changing positions. Alterations in cerebral autoregulation can be revealed by postural changes at quantitative color Doppler sonography. The aim of this study was to reach an optimal cutoff value of the difference between the cerebral venous blood outflow in the supine and seated positions that can discriminate healthy controls from patients with multiple sclerosis and those with other neurologic diseases and to evaluate its specificity, sensitivity, and diagnostic accuracy. One hundred fifteen subjects (54 with MS, 31 healthy controls, 30 with other neurologic diseases) underwent a blinded quantitative color Doppler sonography evaluation of cerebral venous blood outflow in the supine and sitting positions. An optimal difference value between the supine and sitting positions of the cerebral venous blood outflow cutoff value was sought. The difference value between supine and sitting positions of the cerebral venous blood outflow was ≤ 503.24 in 38/54 (70.37%) patients with MS, 9/31 (29.03%) healthy controls, and 13/30 (43.33%) subjects with other neurological diseases. A difference value between supine and sitting positions of the cerebral venous blood outflow at a 503.24 cutoff reached a sensitivity at 70.37%, a 70.96% specificity, a 80.85% positive predictive value, and a 57.89% negative predictive value; the quantitative color Doppler sonography parameters yielded significant differences. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 assessed the significant difference between MS versus other neurological diseases. Alteration of cerebral venous blood outflow discriminated MS versus other neurologic diseases and MS versus healthy controls. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 was statistically associated with MS. © 2014 by American Journal of Neuroradiology.

  8. The cerebral lesions of Wilson's disease on computer tomography

    International Nuclear Information System (INIS)

    Rodiek, S.

    1983-01-01

    M. Wilson is often being mistaken as such for several years and kept for psychosis or another extrapyramidal disease. When the disease causes neuro-psychiatric symptoms a certain part of cases shows typical lesions in CT mainly affecting the Nucleus lentiformis and frontal cortex. From our own material two cases of M. Wilson are shown and compared with two other cases with identical patterns of lesions following toxic and hypoxic brain damage. (orig.) [de

  9. Characteristics of cerebral hemodynamics assessed by CT perfusion in moyamoya disease.

    Science.gov (United States)

    Sasagawa, Ayaka; Mikami, Takeshi; Hirano, Toru; Akiyama, Yukinori; Mikuni, Nobuhiro

    2018-01-01

    Due to the recent development of multidetector row computed tomography (CT), hemodynamic parameters can now be conveniently obtained with CT perfusion. The purpose of this study is to characterize the hemodynamic parameters of CT perfusion in moyamoya disease, and to discuss the differences in collateral circulation between moyamoya disease and atherosclerotic disease. A total of 16 hemispheric sides of 15 patients with moyamoya disease and 10 hemispheric sides of 9 patients with atherosclerotic disease who underwent bypass surgery were included. CT perfusion was performed with 123 I-IMP SPECT. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) values obtained by CT perfusion using standard singular value decomposition as the deconvolution algorithm in moyamoya disease were calculated. Preoperative values of these parameters were compared with those of atherosclerotic disease. Then, the postoperative changes of these parameters were analyzed. In the impaired side, CBF as measured by CT perfusion was correlated with that measured by 123 I-IMP SPECT. In moyamoya disease, CBV as measured by CT perfusion was significantly increased compared to in atherosclerotic disease, yet CBF was significantly decreased in atherosclerotic disease. Postoperatively, the asymmetry ratios of MTT were significantly improved, especially in atherosclerotic disease compared with moyamoya disease. On CT perfusion, the parameters included transit time and arrival time. CBV increase in moyamoya disease and postoperative improvement of MTT, especially in atherosclerotic disease, were unique characteristics in each. This might be due to the difference of collateral circulation and compensatory mechanisms between moyamoya disease and atherosclerotic disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Evoked Electrical and Cerebral Vascular Responses Following Sleep Deprivation

    Science.gov (United States)

    Schei, Jennifer L.; Rector, David M.

    2011-01-01

    Neuronal activity elicits vascular dilation, delivering additional blood and metabolites to the activated region. With increasing neural activity, vessels stretch and may become less compliant. Most functional imaging studies assume that limits to vascular expansion are not normally reached except under pathological conditions, with the possibility that metabolism could outpace supply. However, we previously demonstrated that evoked hemodynamic responses were larger during quiet sleep when compared to both waking and REM sleep, suggesting that high basal activity during wake may elicit blunted evoked hemodynamic responses due to vascular expansion limits. We hypothesized that extended brain activity through sleep deprivation will further dilate blood vessels, and exacerbate the blunted evoked hemodynamic responses observed during wake, and dampen responses in subsequent sleep. We measured evoked electrical and hemodynamic responses from rats using auditory clicks (0.5 s, 10 Hz, 2–13 s random ISIs) for one hour following 2, 4, or 6 hours of sleep deprivation. Time-of-day matched controls were recorded continuously for 7 hours. Within quiet sleep periods following deprivation, ERP amplitude did not differ; however, the evoked vascular response was smaller with longer sleep deprivation periods. These results suggest that prolonged neural activity periods through sleep deprivation may diminish vascular compliance as indicated by the blunted vascular response. Subsequent sleep may allow vessels to relax, restoring their ability to deliver blood. These results also suggest that severe sleep deprivation or chronic sleep disturbances could push the vasculature to critical limits, leading to metabolic deficit and the potential for tissue trauma. PMID:21854966

  11. Effect of preceding exercise on cerebral and splanchnic vascular responses to mental task

    Directory of Open Access Journals (Sweden)

    Someya Nami

    2012-06-01

    Full Text Available Abstract Background To investigate the effect of preceding acute exercise on the peripheral vascular response to a mental task, we measured splanchnic and cerebral blood flow responses to performing a mental task after exercise and resting. Methods In the exercise trial, 11 males exercised for 30 min on a cycle ergometer with a workload set at 70% of the age-predicted maximal heart rate for each individual. After a 15-min recovery period, the subjects rested for 5 min for pre-task baseline measurement and then performed mental arithmetic for 5 min followed by 5 min of post-task measurement. In the resting trial, they rested for 45 min and pre-task baseline data was obtained for 5 min. Then mental arithmetic was performed for 5 min followed by post-task measurement. We measured the mean blood velocity in the middle cerebral artery and superior mesenteric artery and the mean arterial pressure. Results Mean arterial pressure and mean blood velocity in the middle cerebral artery were significantly higher than the baseline during mental arithmetic in both exercise and resting trials. Mean blood velocity in the middle cerebral artery during mental arithmetic was greater in the control trial than the exercise trial. Mean blood velocity in the superior mesenteric artery showed no significant change during mental arithmetic from baseline in both trials. Conclusion These results suggest that acute exercise can moderate the increase in cerebral blood flow induced by a mental task.

  12. Measurement of cerebral perfusion and haemodynamic reserve by SPECT: application to cerebrovascular disease

    International Nuclear Information System (INIS)

    Steinling, M.

    1990-01-01

    The isolated measurement of cerebral blood flow can lead to gross errors in vascular disease, particularly ischaemic disease, because of disruption of the relations between blood flow and metabolism. In contrast, the measurement of cerebral blood flow combined with measurement of the haemodynamic reserve overcomes these difficulties, regardless of the method of evaluation: reactivity to CO 2 or to acetazolamide; measurement of the flow volume ratio. The author demonstrates that these measurements are even more valuable in situations in which morphological examinations (MRI or computed tomography) are of little value: transient ischaemic attacks, asymptomatic carotid artery stenosis, etc. However, these measurements are useful in constituted infarctions or in vasospasm to assess the distant effects or to guide the therapeutic adjustment or even to provide prognostic elements. Combined measurement of perfusion and haemodynamic reserve, although it does not constitute a formal proof, is now largely accessible by means of non-specialized gamma cameras with determination of the flow/volume ratio [fr

  13. Measurement of cerebral perfusion and haemodynamic reserve by SPECT: application to cerebrovascular disease

    International Nuclear Information System (INIS)

    Steinling, M.

    1990-01-01

    The isolated measurement of cerebral blood flow can lead to gross errors in vascular disease, particularly ischaemic disease, because of disruption of the relations between blood flow and metabolism. In contrast, the measurement of cerebral blood flow combined with measurement of the haemodynamic reserve overcomes these difficulties, regardless of the method of evaluation: reactivity to CO 2 or to acetazolamide; measurement of the flow/volume ratio. The author demonstrates that these measurements are even more valuable in situations in which morphological examinations (MRI or computed tomography) are of little value: transient ischaemic attacks, asymptomatic carotid artery stenosis, etc. However, these measurements are useful in constituted infarctions or in vasospasm to assess the distant effects or to guide the therapeutic adjustment or even to provide prognostic elements. Combined measurement of perfusion and haemodynamic reserve, although it does not constitute a formal proof, is now largely accessible by means of non-specialized gamma cameras with determination of the flow/volume ratio [fr

  14. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

    Guo, Song; Barringer, Filippa; Zois, Nora Elisabeth

    2014-01-01

    in decompensated disease. In contrast, their biological effects on the cerebral hemodynamics are poorly understood. In this mini-review, we summarize the hemodynamic effects of the natriuretic peptides with a focus on the cerebral hemodynamics. In addition, we will discuss its potential implications in diseases...... where alteration of the cerebral hemodynamics plays a role such as migraine and acute brain injury including stroke. We conclude that a possible role of the peptides is feasible as evaluated from animal and in vitro studies, but more research is needed in humans to determine the precise response...

  15. Cerebral atrophy in Parkinson's disease - represented in CT

    International Nuclear Information System (INIS)

    Becker, H.; Schneider, E.; Hacker, H.; Fischer, P.A.; Frankfurt Univ.

    1979-01-01

    To clarify the importance of brain atrophy in relation to the symptoms of Parkinson's disease, 173 patients were examined by computed tomography (CT). In 51.4% of the CT findings, brain atrophy was considered to be pathological. Statistically significant relations of age and sex were found with regard to the extent and localization of brain atrophy. Cortical atrophy also showed a significant dependence on duration of disease. Linear measurements at the lateral ventricles and the third ventricle lead us to assume that brain atrophy in Parkinson's patients is more prevalent than in normal patients within the scope of age involution. (orig.)

  16. Cerebral involvement in a patient with Goodpasture's disease due to shortened induction therapy: a case report

    Directory of Open Access Journals (Sweden)

    Preul Christoph

    2009-11-01

    Full Text Available Abstract Introduction Goodpasture's disease is a rare immunological disease with formation of pathognomonic antibodies against renal and pulmonary basement membranes. Cerebral involvement has been reported in several cases in the literature, yet the pathogenetic mechanism is not entirely clear. Case presentation A 21-year-old Caucasian man with Goodpasture's disease and end-stage renal disease presented with two generalized seizures after a period of mild cognitive disturbance. Blood pressure and routine laboratory tests did not exceed the patient's usual values, and examination of cerebrospinal fluid was unremarkable. Cerebral magnetic resonance imaging (MRI revealed multiple cortical and subcortical lesions on fluid-attenuated inversion recovery sequences. Since antiglomerular basement membrane antibodies were found to be positive with high titers, plasmapheresis was started. In addition, cyclophosphamide pulse therapy was given on day 13. Encephalopathy and MRI lesions disappeared during this therapy, and antiglomerular basement membrane antibodies were significantly reduced. Previous immunosuppressive therapy was performed without corticosteroids and terminated early after 3 months. The differential diagnostic considerations were cerebral vasculitis and posterior reversible encephalopathy syndrome. Vasculitis could be seen as an extrarenal manifestation of the underlying disease. Posterior reversible encephalopathy syndrome, on the other hand, can be triggered by immunosuppressive therapy and may appear without a hypertensive crisis. Conclusion A combination of central nervous system symptoms with a positive antiglomerular basement membrane test in a patient with Goodpasture's disease should immediately be treated as an acute exacerbation of the disease with likely cross-reactivity of antibodies with the choroid plexus. In our patient, a discontinuous strategy of immunosuppressive therapy may have favored recurrence of Goodpasture's disease.

  17. LXW7 ameliorates focal cerebral ischemia injury and attenuates inflammatory responses in activated microglia in rats

    Energy Technology Data Exchange (ETDEWEB)

    Fang, T.; Zhou, D.; Lu, L.; Tong, X.; Wu, J.; Yi, L. [Department of Neurology, Shenzhen Hospital, Peking University, Shenzhen (China)

    2016-08-01

    Inflammation plays a pivotal role in ischemic stroke, when activated microglia release excessive pro-inflammatory mediators. The inhibition of integrin αvβ3 improves outcomes in rat focal cerebral ischemia models. However, the mechanisms by which microglia are neuroprotective remain unclear. This study evaluated whether post-ischemic treatment with another integrin αvβ3 inhibitor, the cyclic arginine-glycine-aspartic acid (RGD) peptide-cGRGDdvc (LXW7), alleviates cerebral ischemic injury. The anti-inflammatory effect of LXW7 in activated microglia within rat focal cerebral ischemia models was examined. A total of 108 Sprague-Dawley rats (250–280 g) were subjected to middle cerebral artery occlusion (MCAO). After 2 h, the rats were given an intravenous injection of LXW7 (100 μg/kg) or phosphate-buffered saline (PBS). Neurological scores, infarct volumes, brain water content (BWC) and histology alterations were determined. The expressions of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], and Iba1-positive activated microglia, within peri-ischemic brain tissue, were assessed with ELISA, western blot and immunofluorescence staining. Infarct volumes and BWC were significantly lower in LXW7-treated rats compared to those in the MCAO + PBS (control) group. The LXW7 treatment lowered the expression of pro-inflammatory cytokines. There was a reduction of Iba1-positive activated microglia, and the TNF-α and IL-1β expressions were attenuated. However, there was no difference in the Zea Longa scores between the ischemia and LXW7 groups. The results suggest that LXW7 protected against focal cerebral ischemia and attenuated inflammation in activated microglia. LXW7 may be neuroprotective during acute MCAO-induced brain damage and microglia-related neurodegenerative diseases.

  18. LXW7 ameliorates focal cerebral ischemia injury and attenuates inflammatory responses in activated microglia in rats

    International Nuclear Information System (INIS)

    Fang, T.; Zhou, D.; Lu, L.; Tong, X.; Wu, J.; Yi, L.

    2016-01-01

    Inflammation plays a pivotal role in ischemic stroke, when activated microglia release excessive pro-inflammatory mediators. The inhibition of integrin αvβ3 improves outcomes in rat focal cerebral ischemia models. However, the mechanisms by which microglia are neuroprotective remain unclear. This study evaluated whether post-ischemic treatment with another integrin αvβ3 inhibitor, the cyclic arginine-glycine-aspartic acid (RGD) peptide-cGRGDdvc (LXW7), alleviates cerebral ischemic injury. The anti-inflammatory effect of LXW7 in activated microglia within rat focal cerebral ischemia models was examined. A total of 108 Sprague-Dawley rats (250–280 g) were subjected to middle cerebral artery occlusion (MCAO). After 2 h, the rats were given an intravenous injection of LXW7 (100 μg/kg) or phosphate-buffered saline (PBS). Neurological scores, infarct volumes, brain water content (BWC) and histology alterations were determined. The expressions of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], and Iba1-positive activated microglia, within peri-ischemic brain tissue, were assessed with ELISA, western blot and immunofluorescence staining. Infarct volumes and BWC were significantly lower in LXW7-treated rats compared to those in the MCAO + PBS (control) group. The LXW7 treatment lowered the expression of pro-inflammatory cytokines. There was a reduction of Iba1-positive activated microglia, and the TNF-α and IL-1β expressions were attenuated. However, there was no difference in the Zea Longa scores between the ischemia and LXW7 groups. The results suggest that LXW7 protected against focal cerebral ischemia and attenuated inflammation in activated microglia. LXW7 may be neuroprotective during acute MCAO-induced brain damage and microglia-related neurodegenerative diseases

  19. Cerebral organoids derived from Sandhoff disease-induced pluripotent stem cells exhibit impaired neurodifferentiation.

    Science.gov (United States)

    Allende, Maria L; Cook, Emily K; Larman, Bridget C; Nugent, Adrienne; Brady, Jacqueline M; Golebiowski, Diane; Sena-Esteves, Miguel; Tifft, Cynthia J; Proia, Richard L

    2018-03-01

    Sandhoff disease, one of the GM2 gangliosidoses, is a lysosomal storage disorder characterized by the absence of β-hexosaminidase A and B activity and the concomitant lysosomal accumulation of its substrate, GM2 ganglioside. It features catastrophic neurodegeneration and death in early childhood. How the lysosomal accumulation of ganglioside might affect the early development of the nervous system is not understood. Recently, cerebral organoids derived from induced pluripotent stem (iPS) cells have illuminated early developmental events altered by disease processes. To develop an early neurodevelopmental model of Sandhoff disease, we first generated iPS cells from the fibroblasts of an infantile Sandhoff disease patient, then corrected one of the mutant HEXB alleles in those iPS cells using CRISPR/Cas9 genome-editing technology, thereby creating isogenic controls. Next, we used the parental Sandhoff disease iPS cells and isogenic HEXB -corrected iPS cell clones to generate cerebral organoids that modeled the first trimester of neurodevelopment. The Sandhoff disease organoids, but not the HEXB -corrected organoids, accumulated GM2 ganglioside and exhibited increased size and cellular proliferation compared with the HEXB -corrected organoids. Whole-transcriptome analysis demonstrated that development was impaired in the Sandhoff disease organoids, suggesting that alterations in neuronal differentiation may occur during early development in the GM2 gangliosidoses.

  20. Cerebral hydatid disease: Is it primary or secondary?

    Directory of Open Access Journals (Sweden)

    Onteddu Joji Reddy

    2014-01-01

    Full Text Available Hydatid disease is a serious medical problem in Mediterranean and particularly among sheep farming countries, caused by larval stages of dog tapeworms belonging to the genus Echinococcus. Hydatid cysts may affect every organ in the human body; however, multiple organ involvement (spleen, adrenal gland, heart, pericardium, intravascular growth of hydatids and brain without affecting the two major filters in the body liver and the lung was very rare. In this case, myocardial hydatid cyst is considered as primary and involvement of other organs such as brain, spleen, adrenal glands, and vascular involvement are considered as secondary involvement due to the rupture of hydatid in heart. Rarity of this atypical presentation of hydatid disease leads to this case report.

  1. Post-mortem assessment of hypoperfusion of cerebral cortex in Alzheimer's disease and vascular dementia.

    Science.gov (United States)

    Thomas, Taya; Miners, Scott; Love, Seth

    2015-04-01

    Perfusion is reduced in the cerebral neocortex in Alzheimer's disease. We have explored some of the mechanisms, by measurement of perfusion-sensitive and disease-related proteins in post-mortem tissue from Alzheimer's disease, vascular dementia and age-matched control brains. To distinguish physiological from pathological reduction in perfusion (i.e. reduction exceeding the decline in metabolic demand), we measured the concentration of vascular endothelial growth factor (VEGF), a protein induced under conditions of tissue hypoxia through the actions of hypoxia-inducible factors, and the myelin associated glycoprotein to proteolipid protein 1 (MAG:PLP1) ratio, which declines in chronically hypoperfused brain tissue. To evaluate possible mechanisms of hypoperfusion, we also measured the levels of amyloid-β40, amyloid-β42, von Willebrand factor (VWF; a measure of microvascular density) and the potent vasoconstrictor endothelin 1 (EDN1); we assayed the activity of angiotensin I converting enzyme (ACE), which catalyses the production of another potent vasoconstrictor, angiotensin II; and we scored the severity of arteriolosclerotic small vessel disease and cerebral amyloid angiopathy, and determined the Braak tangle stage. VEGF was markedly increased in frontal and parahippocampal cortex in Alzheimer's disease but only slightly and not significantly in vascular dementia. In frontal cortex the MAG:PLP1 ratio was significantly reduced in Alzheimer's disease and even more so in vascular dementia. VEGF but not MAG:PLP1 increased with Alzheimer's disease severity, as measured by Braak tangle stage, and correlated with amyloid-β42 and amyloid-β42: amyloid-β40 but not amyloid-β40. Although MAG:PLP1 tended to be lowest in cortex from patients with severe small vessel disease or cerebral amyloid angiopathy, neither VEGF nor MAG:PLP1 correlated significantly with the severity of structural vascular pathology (small vessel disease, cerebral amyloid angiopathy or VWF

  2. Cerebral vasculitis

    International Nuclear Information System (INIS)

    Greenan, T.J.; Grossman, R.I.

    1990-01-01

    This paper reviews retrospectively MR, CT, and angiographic findings in patients with cerebral vasculitis in order to understand the strengths and weaknesses of the various imaging modalities, as well as the spectrum of imaging abnormalities in this disease entity. Studies were retrospectively reviewed in 12 patients with cerebral vasculitis proved by means of angiography and/or brain biopsy

  3. Chronic kidney disease and poor outcomes in ischemic stroke: is impaired cerebral autoregulation the missing link?

    Science.gov (United States)

    Castro, Pedro; Azevedo, Elsa; Rocha, Isabel; Sorond, Farzaneh; Serrador, Jorge M

    2018-03-02

    Chronic kidney disease increases stroke incidence and severity but the mechanisms behind this cerebro-renal interaction are mostly unexplored. Since both vascular beds share similar features, microvascular dysfunction could be the possible missing link. Therefore, we examined the relationship between renal function and cerebral autoregulation in the early hours post ischemia and its impact on outcome. We enrolled 46 ischemic strokes (middle cerebral artery). Dynamic cerebral autoregulation was assessed by transfer function (coherence, phase and gain) of spontaneous blood pressure oscillations to blood flow velocity within 6 h from symptom-onset. Estimated glomerular filtration rate (eGFR) was calculated. Hemorrhagic transformation (HT) and white matter lesions (WML) were collected from computed tomography performed at presentation and 24 h. Outcome was evaluated with modified Rankin Scale at 3 months. High gain (less effective autoregulation) was correlated with lower eGFR irrespective of infarct side (p functional outcome [ipsilateral OR = 4.39 (CI95% 3.15-25.6), p = 0.019; contralateral OR = 8.15 (CI95% 4.15-15.6), p = 0.002] and increased risk of HT [ipsilateral OR = 3.48 (CI95% 0.60-24.0), p = 0.132; contralateral OR = 6.43 (CI95% 1.40-32.1), p = 0.034]. Lower renal function correlates with less effective dynamic cerebral autoregulation in acute ischemic stroke, both predicting a bad outcome. The evaluation of serum biomarkers of renal dysfunction could have interest in the future for assessing cerebral microvascular risk and relationship with stroke complications.

  4. Cerebral amyloidosis associated with cognitive decline in autosomal dominant Alzheimer disease.

    Science.gov (United States)

    Wang, Fen; Gordon, Brian A; Ryman, Davis C; Ma, Shengmei; Xiong, Chengjie; Hassenstab, Jason; Goate, Alison; Fagan, Anne M; Cairns, Nigel J; Marcus, Daniel S; McDade, Eric; Ringman, John M; Graff-Radford, Neill R; Ghetti, Bernardino; Farlow, Martin R; Sperling, Reisa; Salloway, Steve; Schofield, Peter R; Masters, Colin L; Martins, Ralph N; Rossor, Martin N; Jucker, Mathias; Danek, Adrian; Förster, Stefan; Lane, Christopher A S; Morris, John C; Benzinger, Tammie L S; Bateman, Randall J

    2015-09-01

    To investigate the associations of cerebral amyloidosis with concurrent cognitive performance and with longitudinal cognitive decline in asymptomatic and symptomatic stages of autosomal dominant Alzheimer disease (ADAD). Two hundred sixty-three participants enrolled in the Dominantly Inherited Alzheimer Network observational study underwent neuropsychological evaluation as well as PET scans with Pittsburgh compound B. One hundred twenty-one participants completed at least 1 follow-up neuropsychological evaluation. Four composite cognitive measures representing global cognition, episodic memory, language, and working memory were generated using z scores from a battery of 13 standard neuropsychological tests. General linear mixed-effects models were used to investigate the relationship between baseline cerebral amyloidosis and baseline cognitive performance and whether baseline cerebral amyloidosis predicts cognitive change over time (mean follow-up 2.32 years ± 0.92, range 0.89-4.19) after controlling for estimated years from expected symptom onset, APOE ε4 allelic status, and education. In asymptomatic mutation carriers, amyloid burden was not associated with baseline cognitive functioning but was significantly predictive of longitudinal decline in episodic memory. In symptomatic mutation carriers, cerebral amyloidosis was correlated with worse baseline performance in multiple cognitive composites and predicted greater decline over time in global cognition, working memory, and Mini-Mental State Examination. Cerebral amyloidosis predicts longitudinal episodic memory decline in presymptomatic ADAD and multidomain cognitive decline in symptomatic ADAD. These findings imply that amyloidosis in the brain is an indicator of early cognitive decline and provides a useful outcome measure for early assessment and prevention treatment trials. © 2015 American Academy of Neurology.

  5. Impaired cerebral vasoreactivity to CO2 in Alzheimer's disease using BOLD fMRI.

    Science.gov (United States)

    Cantin, S; Villien, M; Moreaud, O; Tropres, I; Keignart, S; Chipon, E; Le Bas, J-F; Warnking, J; Krainik, A

    2011-09-15

    To evaluate the cerebral vasoreactivity using blood oxygenation level dependent functional MRI during carbogen inhalation with 7% CO(2) in Alzheimer's disease and amnestic mild cognitive impairment. Thirty nine subjects were included to be investigated using blood oxygenation level dependent (BOLD) functional MRI at 1.5T during a block-design carbogen inhalation paradigm, with a high concentration face-mask under physiological monitoring. Basal cerebral perfusion was measured using pulsed arterial spin labeling. Image analyses were conducted using Matlab® and SPM5 with physiological regressors and corrected for partial volume effect. Among selected participants, 12 subjects were excluded because of incomplete protocol, leaving for analysis 27 subjects without significant microangiopathy diagnosed for Alzheimer's disease (n=9), amnestic mild cognitive impairment (n=7), and matched controls (n=11). No adverse reaction related to the CO(2) challenge was reported. Carbogen inhalation induced a whole-brain signal increase, predominant in the gray matter. In patients, signal changes corrected for gray matter partial volume were decreased (0.36±0.13% BOLD/mmHg in Alzheimer's disease, 0.36±0.12 in patients with mild cognitive impairment, 0.62±0.20 in controls). Cerebral vasoreactivity impairments were diffuse but seemed predominant in posterior areas. The basal hypoperfusion in Alzheimer's disease was not significantly different from patients with mild cognitive impairment and controls. Among clinical and biological parameters, no effect of apoE4 genotype was detected. Cerebral vasoreactivity values were correlated with cognitive performances and hippocampal volumes. Among age and hippocampal atrophy, mean CVR was the best predictor of the mini-mental status examination. This BOLD functional MRI study on CO(2) challenge shows impaired cerebral vasoreactivity in patients with Alzheimer's disease and amnestic mild cognitive impairment at the individual level. These

  6. Luminance contrast of a visual stimulus modulates the BOLD response more than the cerebral blood flow response in the human brain

    OpenAIRE

    Liang, Christine L.; Ances, Beau M.; Perthen, Joanna E.; Moradi, Farshad; Liau, Joy; Buracas, Giedrius T.; Hopkins, Susan R.; Buxton, Richard B.

    2012-01-01

    The blood oxygenation level dependent (BOLD) response measured with functional magnetic resonance imaging (fMRI) depends on the evoked changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) in response to changes in neural activity. This response is strongly modulated by the CBF/CMRO2 coupling relationship with activation, defined as n, the ratio of the fractional changes. The reliability of the BOLD signal as a quantitative reflection of underlying physiological c...

  7. Sickle cell disease complicated by post-streptococcal glomerulonephritis, cerebral hemorrhage and reversible posterior leucoencephalopathy syndrome.

    Science.gov (United States)

    Pashankar, Farzana D; Ment, Laura R; Pearson, Howard A

    2008-04-01

    A patient with homozygous hemoglobin SS disease presented with an intracerebral hemorrhage complicating reversible posterior leucoencephalopathy syndrome (RPLS), secondary to hypertension associated with acute post-streptococcal glomerulonephritis (APSGN). Distinguishing potentially reversible causes of central nervous system events from primary cerebral infarction or hemorrhage in patients with sickle cell disease is important because the management and prognosis of these complications is very different. Similarly, because of the difference in prognosis between APSGN and other forms of sickle cell nephropathy, it is also important to differentiate these conditions. (c) 2008 Wiley-Liss, Inc.

  8. Adult cerebral adrenoleukodystrophy and Addison's disease in a female carrier.

    Science.gov (United States)

    Chen, Xiaoyan; Chen, Zhiye; Huang, Dehui; Liu, Xiaofeng; Gui, Qiuping; Yu, Shengyuan

    2014-07-10

    We described a 38-year-old woman of rapidly progressive dementia with white matter encephalopathy and death. She had Addison's disease but the adrenal glands were hyperplastic. Brain magnetic resonance imaging revealed diffuse white matter lesion predominantly in the frontal lobe with band-like contrast enhancement. l-Methyl-11C-methionine positron emission tomography revealed accumulation of tracer in bilateral frontal lobes. Stereotactic biopsy demonstrated demyelination changes. A number of urinary organic acids were elevated. Adrenoleukodystrophy was diagnosed by elevated plasma very long chain fatty acid and ABCD1 gene mutation (C1544C/T). Adrenoleukodystrophy should be considered as a differential diagnosis in women with rapidly progressive white matter encephalopathy. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    International Nuclear Information System (INIS)

    Perani, D.; Di Piero, V.; Vallar, G.

    1988-01-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([/sup 99m/Tc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data

  10. Changes of cerebral hemodynamics following the administration of surfactant in the hyaline membrane disease of prematurity

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jeong Hyun; Kim, Kyung Hee [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2000-09-15

    To evaluate the changes of cerebral blood flow velocity according to the time, before and after surfactant administration in hyaline membrane disease using Doppler ultrasonography. The patients were 15 premature babies who were clinically and radiologically diagnosed HMD. The ratio of male : female was 11:4, the mean gestational age was 30.1 {+-} 2.5 wks, mean body weight was 1.4 {+-} 0.6 kg,mean Apgar score at 5 min was 6.28, and type of delivery was C-section : vaginal delivery 9.6. Before and after, 10 mm, 30 min, 1 hr, 6 hr, 12 hr, 1 day, 3 day, 5 day and 7 day after surfactant administration, peak systolic and end-diastolic cerebral blood flow velocity (PSFV, EDFV) and resistive index (RI) were estimated by Doppler ultrasonography measuring MCA flow velocity using temporal window. The averages of all data according to the time were obtained and analyzed statistical significance. For the evaluation of the clinical status systemic BP, FiO2, pH, and respiratory rate were also checked according to the same time. The clinical status of FiO2, metabolic acidosis, and tachypnea was significantly improved after surfactant administration. There was no significant change of cerebral blood flow velocity (PSFV, EDFV) after the surfactant administration. The change of RI was nor statistically significant. The changes of the systemic BP had no significant changes. In spite of clinical improvement, there were no significant increases of cerebral blood flow velocity and changes of RI after surfactant administration in hyaline membrane disease.

  11. Congenital heart disease affects cerebral size but not brain growth.

    Science.gov (United States)

    Ortinau, Cynthia; Inder, Terrie; Lambeth, Jennifer; Wallendorf, Michael; Finucane, Kirsten; Beca, John

    2012-10-01

    Infants with congenital heart disease (CHD) have delayed brain maturation and alterations in brain volume. Brain metrics is a simple measurement technique that can be used to evaluate brain growth. This study used brain metrics to test the hypothesis that alterations in brain size persist at 3 months of age and that infants with CHD have slower rates of brain growth than control infants. Fifty-seven infants with CHD underwent serial brain magnetic resonance imaging (MRI). To evaluate brain growth across the first 3 months of life, brain metrics were undertaken using 19 tissue and fluid spaces shown on MRIs performed before surgery and again at 3 months of age. Before surgery, infants with CHD have smaller frontal, parietal, cerebellar, and brain stem measures (p < 0.001). At 3 months of age, alterations persisted in all measures except the cerebellum. There was no difference between control and CHD infants in brain growth. However, the cerebellum trended toward greater growth in infants with CHD. Somatic growth was the primary factor that related to brain growth. Presence of focal white matter lesions before and after surgery did not relate to alterations in brain size or growth. Although infants with CHD have persistent alterations in brain size at 3 months of age, rates of brain growth are similar to that of healthy term infants. Somatic growth was the primary predictor of brain growth, emphasizing the importance of optimal weight gain in this population.

  12. Cerebral ischemia and asymptomatic coronary artery disease: a prospective study of 83 patients

    International Nuclear Information System (INIS)

    Di Pasquale, G.; Andreoli, A.; Pinelli, G.; Grazi, P.; Manini, G.; Tognetti, F.; Testa, C.

    1986-01-01

    A prospective cardiologic evaluation was performed in 83 consecutive patients with transient cerebral ischemia or mild stroke and without symptoms or electrocardiographic signs of ischemic heart disease. Patients were studied with an electrocardiographic exercise test; a positive test was followed by exercise Thallium-201 myocardial scintigraphy. Results were compared to those obtained in a group of 83 age and sex-matched healthy subjects submitted to the same study protocol. Asymptomatic coronary artery disease was detected in 28% of cerebrovascular patients with adequate electrocardiographic exercise test. A scintigraphic perfusion defect of variable extension was found in 19 of them. In the control group the electrocardiographic exercise test was positive in only 6% (p less than 0.01). Our results support the concept that: asymptomatic ischemic heart disease is often associated with cerebrovascular disease; therefore cerebral ischemic attacks may be a marker of coronary artery disease, an active investigation of the heart should be considered in cerebrovascular patients in order to plan optimal, comprehensive management

  13. Quantitative Analysis of Regional Cerebral Blood Flow using 99mTc-HMPAO SPECT in Parkinson's Disease

    International Nuclear Information System (INIS)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin; Lee, Myung Hae

    1992-01-01

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using 99m Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 ± 0.033 and 0.108 ± 0.062, respectively and PIA were -0.4 ± 0.7% and -0.7 ± 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  14. Cerebral blood flow response to hypoglycemia is altered in patients with type 1 diabetes and impaired awareness of hypoglycemia.

    Science.gov (United States)

    Wiegers, Evita C; Becker, Kirsten M; Rooijackers, Hanne M; von Samson-Himmelstjerna, Federico C; Tack, Cees J; Heerschap, Arend; de Galan, Bastiaan E; van der Graaf, Marinette

    2017-06-01

    It is unclear whether cerebral blood flow responses to hypoglycemia are altered in people with type 1 diabetes and impaired awareness of hypoglycemia. The aim of this study was to investigate the effect of hypoglycemia on both global and regional cerebral blood flow in type 1 diabetes patients with impaired awareness of hypoglycemia, type 1 diabetes patients with normal awareness of hypoglycemia and healthy controls ( n = 7 per group). The subjects underwent a hyperinsulinemic euglycemic-hypoglycemic glucose clamp in a 3 T MR system. Global and regional changes in cerebral blood flow were determined by arterial spin labeling magnetic resonance imaging, at the end of both glycemic phases. Hypoglycemia generated typical symptoms in patients with type 1 diabetes and normal awareness of hypoglycemia and healthy controls, but not in patients with impaired awareness of hypoglycemia. Conversely, hypoglycemia increased global cerebral blood flow in patients with impaired awareness of hypoglycemia, which was not observed in the other two groups. Regionally, hypoglycemia caused a redistribution of cerebral blood flow towards the thalamus of both patients with normal awareness of hypoglycemia and healthy controls, consistent with activation of brain regions associated with the autonomic response to hypoglycemia. No such redistribution was found in the patients with impaired awareness of hypoglycemia. An increase in global cerebral blood flow may enhance nutrient supply to the brain, hence suppressing symptomatic awareness of hypoglycemia. Altogether these results suggest that changes in cerebral blood flow during hypoglycemia contribute to impaired awareness of hypoglycemia.

  15. Novel assessment of cortical response to somatosensory stimuli in children with hemiparetic cerebral palsy.

    Science.gov (United States)

    Maitre, Nathalie L; Barnett, Zachary P; Key, Alexandra P F

    2012-10-01

    The brain's response to somatosensory stimuli is essential to experience-driven learning in children. It was hypothesized that advances in event-related potential technology could quantify the response to touch in somatosensory cortices and characterize the responses of hemiparetic children. In this prospective study of 8 children (5-8 years old) with hemiparetic cerebral palsy, both event-related potential responses to sham or air puff trials and standard functional assessments were used. Event-related potential technology consistently measured signals reflecting activity in the primary and secondary somatosensory cortices as well as complex cognitive processing of touch. Participants showed typical early responses but less efficient perceptual processes. Significant differences between affected and unaffected extremities correlated with sensorimotor testing, stereognosis, and 2-point discrimination (r > 0.800 and P = .001 for all). For the first time, a novel event-related potential paradigm shows that hemiparetic children have slower and less efficient tactile cortical perception in their affected extremities.

  16. Selective accumulation of aluminum in cerebral arteries in Alzheimer's disease (AD).

    Science.gov (United States)

    Bhattacharjee, Surjyadipta; Zhao, Yuhai; Hill, James M; Culicchia, Frank; Kruck, Theodore P A; Percy, Maire E; Pogue, Aileen I; Walton, J R; Lukiw, Walter J

    2013-09-01

    Once biologically available aluminum bypasses gastrointestinal and blood-brain barriers, this environmentally-abundant neurotoxin has an exceedingly high affinity for the large pyramidal neurons of the human brain hippocampus. This same anatomical region of the brain is also targeted by the earliest evidence of Alzheimer's disease (AD) neuropathology. The mechanism for the selective targeting and transport of aluminum into the hippocampus of the human brain is not well understood. In an effort to improve our understanding of a pathological aluminum entry system into the brain, this study examined the aluminum content of 8 arteries that supply blood to the hippocampus, including the aorta and several cerebral arteries. In contrast to age-matched controls, in AD patients we found a gradient of increasing aluminum concentration from the aorta to the posterior cerebral artery that supplies blood to the hippocampus. Primary cultures of human brain endothelial cells were found to have an extremely high affinity for aluminum when compared to other types of brain cells. Together, these results suggest for the first time that endothelial cells that line the cerebral vasculature may have biochemical attributes conducive to binding and targeting aluminum to selective anatomical regions of the brain, such as the hippocampus, with potential downstream pro-inflammatory and pathogenic consequences. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Effects of pectin liquid on gastroesophageal reflux disease in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Shimizu Nobuzo

    2008-04-01

    Full Text Available Abstract Background The use of thickeners is a standard therapy for decreasing episodes of regurgitation or vomiting in infants. However, it remains to be investigated whether thickener is effective for vomiting and/or chronic respiratory symptoms in children with cerebral palsy. Methods We enrolled 18 neurologically impaired children caused by cerebral palsy, with gastroesophageal reflux disease. In the first part of this study (pH monitoring, subjects were randomly allocated to two groups: fed with a high-pectin diet [enteral formula: pectin liquid = 2:1 (v/v], or a low-pectin diet [enteral formula: pectin liquid = 3:1 (v/v]. Two-channel esophageal pH monitoring was performed over 48 h. In the second part (clinical trial, subjects were fed a high- or low-pectin diet and non-pectin diet for 4 weeks in a crossover manner. Nurses recorded the feeding volume, number of episodes of vomiting, volume of gastric residue, episodes of cough and wheeze, frequency of using oxygen for dyspnea, and the day when the child could return to school. Cough and wheeze were recorded as a cough-score. Results The median value for the % time pH Conclusion Pectin liquid partially decreased gastroesophageal reflux as measured by eshophageal pH monitoring, and might improve vomiting and respiratory symptoms in children with cerebral palsy. Trial registration ISRCTN19787793

  18. Simvastatin attenuates the cerebral vascular endothelial inflammatory response in a rat traumatic brain injury.

    Science.gov (United States)

    Wang, Kuo-Wei; Chen, Han-Jung; Lu, Kang; Liliang, Po-Chou; Liang, Cheng-Loong; Tsai, Yu-Duan; Cho, Chung-Lung

    2014-01-01

    Traumatic brain injury (TBI) leads to important and deleterious inflammation, as evidenced by edema, cytokine production, induction of nitric oxide synthase, and leukocyte infiltration. After TBI, the activation of cerebral vascular endothelial cells plays a crucial role in the pathogenesis of inflammation. In this study, we hypothesized that the activation of cerebral vascular endothelial cells plays a crucial role in the pathogenesis of inflammation and outcome after TBI. It may represent a key cellular target for statin therapy. In our study, cortical contusions were induced, and the effect of continuous treatment of simvastatin on behavior and inflammation in adult rats following experimental TBI was evaluated. The treatment group received 15 mg/kg of simvastatin daily for 3 days. Neurological function was assessed with the grip test. The results showed that the non-treatment control group had a significantly greater increase in ICAM-1 expression from pre-injury to the post-injury 72 h time point as compared to the expression in treatment group. The treatment group had better neurological function as evidenced in a grip test performed from baseline to 72 h. The analysis of a western blot test and pathology also demonstrated reduced ICAM-1 expression and a smaller area of damage and tissue loss. Our findings suggest that simvastatin could attenuate the activation of cerebral vascular endothelial inflammatory response and decrease the loss of neurological function and brain tissue.

  19. Inhibition of P2X7 receptor ameliorates transient global cerebral ischemia/reperfusion injury via modulating inflammatory responses in the rat hippocampus

    Directory of Open Access Journals (Sweden)

    Chu Ketan

    2012-04-01

    Full Text Available Abstract Background Neuroinflammation plays an important role in cerebral ischemia/reperfusion (I/R injury. The P2X7 receptor (P2X7R has been reported to be involved in the inflammatory response of many central nervous system diseases. However, the role of P2X7Rs in transient global cerebral I/R injury remains unclear. The purpose of this study is to determine the effects of inhibiting the P2X7R in a rat model of transient global cerebral I/R injury, and then to explore the association between the P2X7R and neuroinflammation after transient global cerebral I/R injury. Methods Immediately after infusion with the P2X7R antagonists Brilliant blue G (BBG, adenosine 5′-triphosphate-2′,3′-dialdehyde (OxATP or A-438079, 20 minutes of transient global cerebral I/R was induced using the four-vessel occlusion (4-VO method in rats. Survival rate was calculated, neuronal death in the hippocampal CA1 region was observed using H & E staining, and DNA cleavage was observed by deoxynucleotidyl transferase-mediated UTP nick end labeling TUNEL. In addition, behavioral deficits were measured using the Morris water maze, and RT-PCR and immunohistochemical staining were performed to measure the expression of IL-1β, TNF-α and IL-6, and to identify activated microglia and astrocytes. Results The P2X7R antagonists protected against transient global cerebral I/R injury in a dosage-dependent manner. A high dosage of BBG (10 μg and A-0438079 (3 μg, and a low dosage of OxATP (1 μg significantly increased survival rates, reduced I/R-induced learning memory deficit, and reduced I/R-induced neuronal death, DNA cleavage, and glial activation and inflammatory cytokine overexpression in the hippocampus. Conclusions Our study indicates that inhibiting P2X7Rs protects against transient global cerebral I/R injury by reducing the I/R-induced inflammatory response, which suggests inhibition of P2X7Rs may be a promising therapeutic strategy for clinical treatment of

  20. Widespread heterogeneous neuronal loss across the cerebral cortex in Huntington's disease.

    Science.gov (United States)

    Nana, Alissa L; Kim, Eric H; Thu, Doris C V; Oorschot, Dorothy E; Tippett, Lynette J; Hogg, Virginia M; Synek, Beth J; Roxburgh, Richard; Waldvogel, Henry J; Faull, Richard L M

    2014-01-01

    Huntington's disease is an autosomal dominant neurodegenerative disease characterized by neuronal degeneration in the basal ganglia and cerebral cortex, and a variable symptom profile. Although progressive striatal degeneration is known to occur and is related to symptom profile, little is known about the cellular basis of symptom heterogeneity across the entire cerebral cortex. To investigate this, we have undertaken a double blind study using unbiased stereological cell counting techniques to determine the pattern of cell loss in six representative cortical regions from the frontal, parietal, temporal, and occipital lobes in the brains of 14 Huntington's disease cases and 15 controls. The results clearly demonstrate a widespread loss of total neurons and pyramidal cells across all cortical regions studied, except for the primary visual cortex. Importantly, the results show that cell loss is remarkably variable both within and between Huntington's disease cases. The results also show that neuronal loss in the primary sensory and secondary visual cortices relate to Huntington's disease motor symptom profiles, and neuronal loss across the associational cortices in the frontal, parietal and temporal lobes is related to both Huntington's disease motor and to mood symptom profiles. This finding considerably extends a previous study (Thu et al., Brain, 2010; 133:1094-1110) which showed that neuronal loss in the primary motor cortex was related specifically to the motor symptom profiles while neuronal loss in the anterior cingulate cortex was related specifically to mood symptom profiles. The extent of cortical cell loss in the current study was generally related to the striatal neuropathological grade, but not to CAG repeat length on the HTT gene. Overall our findings show that Huntington's disease is characterized by a heterogeneous pattern of neuronal cell loss across the entire cerebrum which varies with symptom profile.

  1. Diffusion tensor imaging and gait in elderly persons with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Norris, David G; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2011-02-01

    Although cerebral small vessel disease, including white matter lesions (WML) and lacunar infarcts, is associated with gait disturbances, not all individuals with small vessel disease have these disturbances. Identical-appearing WML on MRI could reflect different degrees of microstructural integrity. Moreover, conventional MRI does not assess the integrity of normal-appearing white matter (NAWM). We therefore investigated the relation between white matter integrity assessed by diffusion tensor imaging in WML, NAWM, several regions of interest, and gait. A total of 484 nondemented elderly persons between 50 and 85 years old with cerebral small vessel disease were included in this analysis and underwent MRI and diffusion tensor imaging scanning. Mean diffusivity and fractional anisotropy within WML, NAWM, and regions of interest were related to quantitative and semiquantitative gait parameters. Mean diffusivity in the WML was inversely related with gait (velocity β=-0.15; P=0.002). For the fractional anisotropy, this relation was less evident. The same was found in the NAWM (velocity β=-0.21; Pgait disturbances.

  2. Three dimensional cerebral blood flow in patients with idiopathic Parkinson's disease

    International Nuclear Information System (INIS)

    Hata, Takashi

    1987-01-01

    Three dimensional local cerebral blood flow values were measured in 28 patients with idiopathic Parkinson's disease without dementia and 17 control subjects, by means of xenon enhanced CT method using low concentration cold xenon and autoradiographic strategy. The results demonstrated that local cerebral perfusion in the patients with Parkinson's disease decreased with close correlations with aging and severity of the clinical symptoms and signs. Stepwise multiregression analysis revealed that mean CBF values and 1-CBF values through thalamus and white matter decreased primarily depending on aging and degree of brain atrophy, whereas 1-CBF values through basal ganglia decreased depending on severity of disease. The spatial distributions of 1-CBF were maintained normally and symmetrically even in the severely affected cases or in those with hemiparkinsonism, therefore hyperfrontalities were well preserved in all of the patients. Acute intravenous administration of L-DOPA gave rise to a diffuse increase in 1-CBF only in the patients and the increment was more prominent in patients severely affected than in those mildly affected. It was concluded that reduction of 1-CBF in the basal ganglia and cortex may be attributed to hypometabolism in the mesostriatal and mesocortical dopaminergic system. (author)

  3. The Rendu-Osler-Weber Disease Revealed by a Refractory Hypoxemia and Severe Cerebral Fat Embolism

    Directory of Open Access Journals (Sweden)

    Leonel Barreto

    2013-01-01

    Full Text Available The Rendu-Osler-Weber disease is a genetic disease which may lead to severe hemorrhage and less frequently to severe organ dysfunction. We report the case of a 22-year-old patient with no personal medical history who was involved in a motorcycle accident and exhibited severe complications related to large arteriovenous pulmonary shunts during his ICU stay. The patient developed an unexplained severe hypoxemia which was attributed to several arteriovenous shunts of the pulmonary vasculature by a contrast study during a transesophageal echocardiographic examination. The course was subsequently complicated by a prolonged coma associated with hemiplegia which was attributed to a massive paradoxical fat embolism in the setting of an untreated femoral fracture. In addition to hemorrhagic complications which may lead to intractable shock, arteriovenous malformations associated with the Rendu-Osler-Weber disease may involve the pulmonary vasculature and result in unexpected complications, such as hypoxemia or severe cerebral fat embolism in high-risk patients.

  4. Examining the regional and cerebral depth-dependent BOLD cerebrovascular reactivity response at 7T.

    Science.gov (United States)

    Bhogal, Alex A; Philippens, Marielle E P; Siero, Jeroen C W; Fisher, Joseph A; Petersen, Esben Thade; Luijten, Peter R; Hoogduin, Hans

    2015-07-01

    Changes in cerebral blood flow (CBF) in response to hypercapnia induced changes in vascular tone, known as cerebrovascular reactivity (CVR), can be measured using the Blood Oxygenation Level Dependent (BOLD) MR contrast. We examine regional differences in the BOLD-CVR response to a progressively increasing hypercapnic stimulus as well as regional BOLD characteristics for the return to baseline normocapnia. CVR across 9 subjects was highest in the cerebral lobes and deep gray matter. Peak CVR in these regions was measured at 3.6±1.6mmHg above baseline end-tidal CO2. White matter CVR was generally reduced compared to that of the gray matter (peak white matter CVR was ~48% lower). A positive relationship between the end-tidal CO2 value at which peak CVR was measured and white matter depth is observed. Furthermore, the time required for the BOLD signal to return to baseline after cessation of the hypercapnic stimulus, was also related to white matter depth; the return, expressed as a time constant, was ~25% longer in white matter. To explain the observed differences in regional CVR response, a model is proposed that takes into account the local architecture of the cerebrovascular, which can result in changes in regional blood flow distribution as a function of end-tidal CO2. Copyright © 2015. Published by Elsevier Inc.

  5. MR imaging response of cerebral metastases and peritumoral edema after Gamma Knife surgery

    International Nuclear Information System (INIS)

    Guo Qi; Wang Congyin; Zhang Xuening; Zheng Jingjing; Xu Desheng; Zhang Yipei

    2012-01-01

    Objective: To evaluation the treatment response of Gamma Knife surgery (GKS) for the control of cerebral metastases and peritumoral edema using standard MRI. Method: 42 consecutive patients with 75 metastatic lesions were recruited in this study (28 men, 14 women; mean age 60±12 years). Gadolinium enhancement T 1 WI scans were performed on one day before and three months after GKS. Treatment response was evaluated by calculating the changes of tumor volume and edema index before and after GKS. Results: Mean tumor volumes on the baseline and post treatment were 7.0 cm 3 and 3.3 cm 3 respectively. Mean peritumoral edema indexes were 9.9 and 4.3 respectively. Tumor growth control rate and peritumoral edema control rate were 91% and 85% respectively. Conclusion: GKS is effective for both brain metastasis and peritumoral edema, and the tumor volume influences GKS efficacy. Conventional MRI provides useful information to predict treatment response of GKS for cerebral metastasis. (authors)

  6. Structural cerebral abnormalities and neurodevelopmental status in single ventricle congenital heart disease before Fontan procedure.

    Science.gov (United States)

    Knirsch, Walter; Mayer, Kristina Nadine; Scheer, Ianina; Tuura, Ruth; Schranz, Dietmar; Hahn, Andreas; Wetterling, Kristina; Beck, Ingrid; Latal, Beatrice; Reich, Bettina

    2017-04-01

    Neonates with single ventricle congenital heart disease are at risk for structural cerebral abnormalities. Little is known about the further evolution of cerebral abnormalities until Fontan procedure. Between August 2012 and July 2015, we conducted a prospective cross-sectional two centre study using cerebral magnetic resonance imaging (MRI) and neuro-developmental outcome assessed by the Bayley-III. Forty-seven children (31 male) were evaluated at a mean age of 25.9 ± 3.4 months with hypoplastic left heart syndrome (25) or other single ventricle (22). Cerebral MRI was abnormal in 17 patients (36.2%) including liquor space enlargements (10), small grey (9) and minimal white (5) matter injuries. Eight of 17 individuals had combined lesions. Median (range) cognitive composite score (CCS) (100, 65-120) and motor composite score (MCS) (97, 55-124) were comparable to the reference data, while language composite score (LCS) (97, 68-124) was significantly lower ( P  = 0.040). Liquor space enlargement was associated with poorer performance on all Bayley-III subscores (CCS: P  = 0.02; LCS: P  = 0.002; MCS: P  = 0.013). The number of re-operations [odds ratio (OR) 2.2, 95% confidence interval (CI) 1.1-4.3] ( P  = 0.03) and re-interventions (OR 2.1, 95% CI 1.1-3.8) ( P  = 0.03) was associated with a higher rate of overall MRI abnormalities. Cerebral MRI abnormalities occur in more than one third of children with single ventricle, while the neuro-developmental status is less severely affected before Fontan procedure. Liquor space enlargement is the predominant MRI finding associated with poorer neuro-developmental status, warranting further studies to determine aetiology and further evolution until school-age. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. Usefulness of time-resolved projection MRA on evaluation of hemodynamics in cerebral occlusive diseases

    International Nuclear Information System (INIS)

    Oka, Yoshihisa; Kusunoki, Katsusuke; Nochide, Ichiro; Igase, Keiji; Harada, Hironobu; Sadamoto, Kazuhiko; Nagasawa, Kiyoshi

    2001-01-01

    The usefulness for evaluation of cerebral hemodynamics using time-resolved projection MRA was studied in normal volunteers and patients of cerebrovascular diseases. Six normal volunteers and ten patients with cerebrovascular occlusive diseases including 6 of IC occlusion and 4 of post EC/IC bypass surgery underwent time-resolved projection MRA on a 1.5 T clinical MRI system. Projection angiograms are acquired with 2D-fast SPGR sequence with a time resolution of approximately one image per second, 40 images being acquired consecutively before and after bolus injection Gd-DTPA. And all images were calculated by complex subtraction from the background mask in a work station. In normal volunteers, the quality of images of time-resolved projection MRA was satisfactory. The arteries from internal carotid artery through M2 segment of middle cerebral artery and all major venous systems were well portrayed. In 4 cases of IC occlusion who were assessed the collateral flow through the anterior communicating artery and posterior communicating artery, there were delayed to demonstrate the ipsilateral MCA. However, in 2 cases of IC occlusion that were assessed the collateral flow through leptomeningeal anastomosis, ipsilateral MCA and collateral circulation were not demonstrated. In all patients of post EC/IC bypass surgery, the patency of EC/IC bypass could be evaluated as properly with time-resolved projection MRA as 3D-TOF MRA. Although the temporal and spatial resolutions are insufficient, time-resolved projection MRA was power-full non-invasive method to evaluate the cerebral hemodynamics vis the basal communicating arteries in IC occlusion and identify the patency of EC/IC bypass. (author)

  8. Cerebral radioprotection by pentobarbital: Dose-response characteristics and association with GABA agonist activity

    Energy Technology Data Exchange (ETDEWEB)

    Olson, J.J.; Friedman, R.; Orr, K.; Delaney, T.; Oldfield, E.H. (National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (USA))

    1990-05-01

    Pentobarbital reduces cerebral radiation toxicity; however, the mechanism of this phenomenon remains unknown. As an anesthetic and depressant of cerebral metabolism, pentobarbital induces its effects on the central nervous system by stimulating the binding of gamma-aminobutyric acid (GABA) to its receptor and by inhibiting postsynaptic excitatory amino acid activity. The purpose of this study is to investigate the role of these actions as well as other aspects of the radioprotective activity of pentobarbital. Fischer 344 rats were separated into multiple groups and underwent two dose-response evaluations. In one set of experiments to examine the relationship of radioprotection to pentobarbital dose, a range of pentobarbital doses (0 to 75 mg/kg) were given intraperitoneally prior to a constant-level radiation dose (70 Gy). In a second series of experiments to determine the dose-response relationship of radiation protection to radiation dose, a range of radiation doses (10 to 90 Gy) were given with a single pentobarbital dose. Further groups of animals were used to evaluate the importance of the timing of pentobarbital administration, the function of the (+) and (-) isomers of pentobarbital, and the role of an alternative GABA agonist (diazepam). In addition, the potential protective effects of alternative methods of anesthesia (ketamine) and induction of cerebral hypometabolism (hypothermia) were examined. Enhancement of survival time from acute radiation injury due to high-dose single-fraction whole-brain irradiation was maximal with 60 mg/kg of pentobarbital, and occurred over the range of all doses examined between 30 to 90 Gy. Protection was seen only in animals that received the pentobarbital before irradiation. Administration of other compounds that enhance GABA binding (Saffan and diazepam) also significantly enhanced survival time.

  9. Comparison between cerebral ischemia disease and multiple sclerosis by using MR diffusion tensor imaging

    International Nuclear Information System (INIS)

    Lou Xin; Cai Youquan; Ma Lin; Cai Jianming

    2007-01-01

    Objective: To assess the value of MR diffusion tensor imaging (DTI) in the differentiation between the patients with cerebral ischemia disease and multiple sclerosis. Methods: MR diffusion tensor imaging was performed in thirty-two patients with internal carotid artery stenosis ≥70% and eighteen patients with clinical diagnosed multiple sclerosis. Fractional anisotropy (FA) value of the germ, splenium, body of the corpus callosum, and the white matter of the frontal and occipital lobe were measured respectively, and independent-sample t-test statistical analysis was performed. Results: The FA value was decreased obviously in the anterior and posterior body and splenium of the corpus callosumin the MS patients compared with the ICA severe stenosis patients (0.67 ± 0.12 vs. 0.75 ± 0.05, t=3.443, P 0.05; 0.34 ± 0.08 vs. 0.34 ± 0.05, t=0.137, P> 0.05; 0.29 ± 0.06 vs. 0.40 ± 0.06, t=5.449, P>0.05). Conclusion: DTI can noninvasive detect the potential disorder of corpus callosum in vivo, thus providing useful information to differentiate the cerebral ischemia disease from multiple sclerosis. (authors)

  10. Oxygen, a key factor regulating cell behaviour during neurogenesis and cerebral diseases

    Directory of Open Access Journals (Sweden)

    Kuan eZhang

    2011-04-01

    Full Text Available Oxygen is vital to maintain the normal functions of alomost all the organs, especially for brain which is one of the heaviest oxygen consumers in the body. The important roles of oxygen on the brain are not only reflected in the development, but also showed in the pathological processes of many cerebral diseases. In the current review, we summarized the oxygen levels in brain tissues tested by real-time measurements during the embryonic and adult neurogenesis, the cerebral diseases or in the hyperbaric/hypobaric oxygen environment. Oxygen concentration is low in fetal brain (0.01%- 1% and in adult brain (1.5%-7%, decreased during stroke, and increased in hyperbaric oxygen environment. In addition, we reviewed the effects of oxygen tensions on the behaviors of neural stem cells (NSCs in vitro cultures at different oxygen concentration (2%-20% and in vivo niche during different pathological states and in hyperbaric/hypobaric oxygen environment. Moderate hypoxia (3%-10% is known can promote the proliferation of NSCs and enhance the differentiation of NSCs into the TH-positive neurons. Next, we briefly presented the oxygen-sensitive molecular mechanisms regulating NSCs proliferation and differentiation recently found including the Notch, BMP and Wnt pathways. Finally, the future perspectives about the roles of oxygen on brain and NSCs were given.

  11. Misery perfusion, blood pressure control, and 5-year stroke risk in symptomatic major cerebral artery disease.

    Science.gov (United States)

    Yamauchi, Hiroshi; Kagawa, Shinya; Kishibe, Yoshihiko; Takahashi, Masaaki; Higashi, Tatsuya

    2015-01-01

    The benefit of strict blood pressure (BP) control in high-risk patients with symptomatic major cerebral artery disease and misery perfusion (MP) is controversial. Our purposes were (1) to determine whether MP is a predictor of a 5-year risk of subsequent stroke and (2) to investigate the relationships among BP during follow-up, MP, and the stroke risk. We studied 130 nondisabled patients with symptomatic major cerebral artery disease. Baseline hemodynamic measurements were obtained from (15)O-gas positron emission tomography, and patients received medical treatment and they were followed for 5 years or until stroke recurrence or death. During 5 years, strokes occurred in 6 of 16 patients with MP and in 15 of 114 without MP (log-rank test; Pstrokes in patients with MP and 4 in those without MP (Pstroke declined markedly after 2 years, and there was only 1 ipsilateral ischemic stroke in a patient without MP. Normal systolic BP (strokes in patients with impaired perfusion (including MP), whereas systolic BP outside the 130 to 149 mm Hg range was associated with an increased risk of all strokes in patients without MP. Patients with MP showed a high-5-year stroke recurrence, but a large part of the 5-year stroke risk disappeared after 2 years. Aggressive BP control may be hazardous in patients with impaired perfusion, including MP. © 2014 American Heart Association, Inc.

  12. [Management of cerebral small vessel disease for the diagnosis and treatment of dementia].

    Science.gov (United States)

    Ihara, Masafumi

    2013-07-01

    With the demographic shift in life expectancy inexorably increasing in developed countries, dementia is set to become one of the most important health problems worldwide. In recent years, cerebral small vessel disease (SVD) has received much attention as an important cause of dementia. The reason for this is twofold: firstly, arteriosclerosis (type 1 SVD) is the leading cause of vascular cognitive impairment, and secondly, cerebral amyloid angiopathy (CAA; type 2 SVD) is an almost invariable accompaniment of Alzheimer's disease. SVD is known to induce a variety of pathological changes; for example, type 1 SVD results in lacunar infarction, deep microbleeds, and white matter damage, while type 2 SVD leads to cortical microinfarcts, lobar microbleeds, and white matter damage. SVD is considered a spectrum of abnormalities, with the majority of patients experiencing symptoms from both type 1 and type 2 SVD as the disease progresses. The discouraging results of immunotherapy clinical trials for Alzheimer's disease have shifted the scientific attention from the classical neuron-centric approach towards a novel neurovascular approach. As arteries stiffen with age or with other co-morbid factors such as life-related diseases, amyloid β (Aβ) synthesis becomes upregulated, resulting in the deposition of insoluble Aβ not only in the parenchyma as senile plaques but also in the perivascular drainage pathways as CAA. Therefore, therapeutic strategies such as vasoactive drugs that enhance the patency of this Aβ drainage pathway may facilitate Aβ removal and help prevent cognitive decline in the elderly. Based on this emerging paradigm, clinical trials are warranted to investigate whether a neurovascular therapeutic approach can effectively halt cognitive decline and act as a preemptive medicine for patients at risk of dementia.

  13. Visual dependence affects postural sway responses to continuous visual field motion in individuals with cerebral palsy.

    Science.gov (United States)

    Yu, Yawen; Lauer, Richard T; Tucker, Carole A; Thompson, Elizabeth D; Keshner, Emily A

    2018-01-17

    The current study aimed to explore the impact of visual dependence on sensorimotor coupling of postural sway and visual motion in adults and teens with spastic cerebral palsy (CP). We hypothesized that individuals with CP would exhibit greater magnitudes of sway than healthy individuals, and the presence of visual dependence (VD) would produce instability in the direction of visual motion. Participants stood in a virtual environment in which the visual scene remained static or continuously rotated 30 degree/second in pitch-up or pitch-down. Increased center of pressure and center of mass responses were observed in the direction of visual scene motion in those with CP. Those with VD exhibited reduced frequency responses in anterior-posterior direction than those who were visually independent. VD suggests deficient sensorimotor integration that could contribute to postural instability and reduced motor function. Individuals with CP who are visually dependent may benefit from more sensory focused rehabilitation strategies. AP, anterior-posterior; CP, cerebral palsy; COM, center of mass; COP, center of pressure; MDF, median frequency; ML, mediolateral; PD, pitch down (nose down) rotation; PU, pitch up (nose up) rotation; RFT, rod and frame test; RMS, root mean square; SLP, slope of the fitted line; TD, typical development; VD, visual dependence; VI, visual independence; VOR, vestibulo-ocular reflex; VPI, visual perceptual impairment.

  14. Reduced Numbers of Somatostatin Receptors in the Cerebral Cortex in Alzheimer's Disease

    Science.gov (United States)

    Flint Beal, M.; Mazurek, Michael F.; Tran, Vinh T.; Chattha, Geetinder; Bird, Edward D.; Martin, Joseph B.

    1985-07-01

    Somatostatin receptor concentrations were measured in patients with Alzheimer's disease and controls. In the frontal cortex (Brodmann areas 6, 9, and 10) and temporal cortex (Brodmann area 21), the concentrations of somatostatin in receptors in the patients were reduced to approximately 50 percent of control values. A 40 percent reduction was seen in the hippocampus, while no significant changes were found in the cingulate cortex, postcentral gyrus, temporal pole, and superior temporal gyrus. Scatchard analysis showed a reduction in receptor number rather than a change in affinity. Somatostatin-like immunoreactivity was significantly reduced in both the frontal and temporal cortex. Somatostatin-like immunoreactivity was linearly related to somatostatin-receptor binding in the cortices of Alzheimer's patients. These findings may reflect degeneration of postsynaptic neurons or cortical afferents in the patients' cerebral cortices. Alternatively, decreased somatostatinlike immunoreactivity in Alzheimer's disease might indicate increased release of somatostatin and down regulation of postsynaptic receptors.

  15. [Emergency Bypass Surgery for Progressive Cerebral Infarction Following Hemorrhagic Onset of Moyamoya Disease:A Case Report].

    Science.gov (United States)

    Hatakeyama, Junya; Yanagisawa, Toshiharu; Kudo, Erina; Togashi, Shuntaro; Shimizu, Hiroaki

    2016-10-01

    Progressive cerebral infarction in patients with hemorrhagic onset of moyamoya disease is rare, and a treatment strategy is not well established. Here, we report a case that was successfully treated with emergency bypass surgery. A 58-year-old woman presented with a sudden disturbance of consciousness and right-sided hemiparesis. Computed tomography(CT)showed intraventricular hemorrhage involving the head of the left caudate nucleus. Ventricular drainage was immediately performed, and the patient was treated conservatively. Magnetic resonance(MR)angiography revealed bilateral stenosis of the supraclinoid internal carotid artery(ICA), and arterial spin labeling(ASL)showed low signal intensity in the left cerebral hemisphere. The patient was diagnosed with hemorrhagic onset of moyamoya disease with cerebral infarction. Her neurological symptoms worsened on the 7th day after ictus despite medical treatment. MR imaging showed a new infarction in the left insular cortex. Based on the diagnosis of progressive stroke, emergency anastomoses between the superficial temporal artery and the middle and anterior cerebral arteries, along with encephalo-duro-myo-synangiosis, were performed. Her symptoms gradually improved following surgery, and 1 month later, she was able to regain independent function. Emergency bypass surgery may be the treatment of choice for patients with hemorrhagic onset of moyamoya disease presenting with progressive cerebral infarction, despite conservative treatments.

  16. Silent microemboli related to diagnostic cerebral angiography: a matter of operator's experience and patient's disease

    International Nuclear Information System (INIS)

    Krings, T.; Willmes, K.; Meister, I.G.; Becker, R.; Mull, M.; Thron, A.; Hans, F.J.; Reinges, M.H.T.

    2006-01-01

    The aim of the present investigation was to elucidate in a large consecutive patient cohort whether the level of training has an effect on the number of microemboli detected by diffusion-weighted imaging (DWI) and which additional risk factors can be identified. A total of 107 consecutive patients in whom a diagnostic cerebral angiography had been performed were prospectively investigated with DWI; 51 angiographies were performed by experienced neuroradiologists, 56 by neuroradiologists in training. In 12 patients (11.1%), a total of 17 new lesions without any clinically overt neurological symptoms were identified. Of these, 12 patients, 11 (91.7%) with 16 lesions were investigated by junior neuroradiologists. In 11 of 12 patients with DWI abnormalities (91.7%), risk factors could be identified (atherosclerotic vessel wall disease, vasculitis, hypercoagulable states). Experienced neuroradiologists performed 21 of 48 angiographies (43.8%) on patients with the above-mentioned risk factors, whereas junior neuroradiologists performed 27 angiographies in this subgroup (46.2%). The rate of diffusion abnormalities in patients with risk factors was 11/48 (22.9%) - considerably higher than in patients without risk factors (1/59; 1.7%). The level of experience and the nature of the underlying disease are predictors of the occurrence of cerebral ischemic events following neuroangiography. Alternative diagnostic modalities should be employed in patients who are investigated for diseases with the highest risk of angiographic complications (i.e., vasculitis, and arteriosclerotic vessel wall disease). If diagnostic angiography remains necessary in these patients, the highest level of practitioner training is necessary to ensure good patient outcome. (orig.)

  17. Arterial spin labeling in patients with chic cerebral artery steno-occlusive disease - Correlation with 15O-PET

    International Nuclear Information System (INIS)

    Kamano, Hironori; Yoshiura, Takashi; Hiwatashi, Akio; Abe, Koichiro; Yamashita, Koji; Honda, Hiroshi; Togao, Osamu

    2013-01-01

    Background: Heterogeneity of arterial transit time due to cerebral artery steno-occlusive lesions hampers accurate regional cerebral blood flow measurement by arterial spin labeling (ASL). Purpose: To assess the feasibility of regional cerebral blood flow measurement by ASL with multiple-delay time sampling in patients with steno-occlusive diseases by comparing with positron emission tomography (PET), and to determine whether regional arterial transit time measured by this ASL technique is correlated with regional mean transit time, a PET index of perfusion pressure. Material and Methods: Sixteen patients with steno-occlusive diseases received both ASL and 15 O-PET. The mean regional cerebral blood flow measured by ASL and PET, regional arterial transit time by ASL, and regional mean transit time by PET were obtained by a region-of-interest analysis. Correlation between regional cerebral blood flow by ASL and that by PET, and correlation between regional arterial transit time by ASL and regional mean transit time by PET were tested using Pearson's correlation coefficient for both absolute and relative values. A multivariate regression analysis was performed to test whether regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling the effect of regional cerebral blood flow by ASL. Results: A significant positive correlation was found between regional cerebral blood flow by ASL and that by PET for both absolute (r = 0.520, P < 0.0001) and relative (r = 0.691, P < 0.0001) values. A significant positive correlation was found between regional arterial transit time by ASL and regional mean transit time by PET both for absolute (r = 0.369, P = 0.0002) and relative (r = 0.443, P < 0.0001) values. The regression analysis revealed that regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling regional cerebral blood flow by ASL

  18. Peptidergic and non-peptidergic innervation and vasomotor responses of human lenticulostriate and posterior cerebral arteries

    DEFF Research Database (Denmark)

    Jansen-Olesen, Inger; Gulbenkian, Sergio; Engel, Ulla

    2004-01-01

    ) between the two vessels. However, the general pattern indicates stronger vasomotor responses (Emax and Imax) in the PCA branches as compared to the lenticulostriate arteries which may lend support for the clinical observation of a difference in stroke expression between the two vascular areas.......The aim of the present study was to compare in man the innervation pattern and the functional responses to neuronal messengers in medium sized lenticulostriate and branches of the posterior cerebral arteries (PCA). The majority of the nerve fibers found were sympathetic and displayed specific...... immunoreactivity for tyrosine hydroxylase (TH) and neuropeptide Y (NPY). Only few nerve fibers displayed vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP) and substance P (SP) immunoreactivity. In both arteries, the contractions induced by noradrenaline (NA), NPY and 5...

  19. Male-female differences in upregulation of vasoconstrictor responses in human cerebral arteries

    DEFF Research Database (Denmark)

    Ahnstedt, Hilda; Cao, Lei; Krause, Diana N

    2013-01-01

    Male-female differences may significantly impact stroke prevention and treatment in men and women, however underlying mechanisms for sexual dimorphism in stroke are not understood. We previously found in males that cerebral ischemia upregulates contractile receptors in cerebral arteries, which...... is associated with lower blood flow. The present study investigates if cerebral arteries from men and women differ in cerebrovascular receptor upregulation....

  20. Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses.

    Directory of Open Access Journals (Sweden)

    Mathieu Gayda

    Full Text Available Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and [Formula: see text] peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC, 20 age-matched old healthy controls (OHC and 25 patients with stable CHD were recruited. Cognitive function assessment included short term-working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis, cardiac hemodynamic (impedance cardiography and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher [Formula: see text] peak, maximal cardiac index (CI max, cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery and cognitive function (for all items (P<0.05. Compared to OHC, CHD patients had lower [Formula: see text] peak, CI max, cerebral oxygenation-perfusion (during recovery and short term-working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05. [Formula: see text] peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005. Cerebral oxygenation-perfusion (exercise was related to cognitive function (P<0.005. Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with [Formula: see text] peak, CI max and cerebral oxygenation-perfusion.

  1. Regional cerebral blood flow in schizophrenic patients; In relation to the subtypes of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Sagawa, Katsuo; Sibuya, Isoo; Oiji, Arata; Kawakatsu, Sinobu; Morinobu, Shigeru; Totsuka, Shiro (Yamagata Univ. (Japan). School of Medicine); Kinoshita, Osami; Yazaki, Mitsuyasu

    1990-03-01

    Seventy-six schizophrenic patients were examined by a Xe-133 inhalation method to determine regional cerebral blood flow. A decreased blood flow was observed in the frontal lobe, especially in the right inferior part. In a study on the relationship between disease subtypes and regional cerebral blood flow, negative symptoms were found more predominantly associated with dissolution type than delusion type. In the group of dissolution type, a decreased blood flow was observed in both the right inferior frontal lobe and the right upper hemisphere, in comparison to the group of delution type. Patients presenting with auditory hallucination had a significantly higher incidence of both negative and positive symptoms, as compared with those not presenting with it. In such patients, a significantly decreased blood flow was also seen in the left upper frontal lobe and the bilateral parietal lobe. Xe-133 inhalation method should assist in evaluating brain function in schizophrenic patients, thus leading to the likelihood of developing a new treatment modality. (N.K.).

  2. Prevalence of coronary artery disease in Japanese patients with cerebral infarction. Impact of metabolic syndrome and intracranial large artery atherosclerosis

    International Nuclear Information System (INIS)

    Hoshino, Atsushi; Enomoto, Satoko; Kawahito, Hiroyuki; Nakamura, Takashi; Kurata, Hiroyuki; Nakahara, Yoshifumi; Ijichi, Toshiharu

    2008-01-01

    Patients with cerebral infarction have a high prevalence of asymptomatic coronary artery disease (CAD) and other vascular diseases, but there is a lack of such data for Japanese patients, so the present study investigated the prevalence of cardiovascular disease (CVD) in Japanese patients and determined the predictors of CAD. The study group comprised 104 patients with cerebral infarction who had no history of CVD. All patients underwent coronary computed tomographic angiography, and systematic evaluation was done on the basis of the presence of other vascular diseases, CVD risk markers, and the degree of atherosclerosis. Of the total, 39 patients (37.5%) had CAD, 9 (8.7%) had carotid artery stenosis, 9 (8.7%) had peripheral artery disease of the lower limbs, and 3 (2.9%) had atherosclerotic renal artery stenosis. Multiple regression analysis showed that the presence of CAD was independently associated with metabolic syndrome (odds ratio (OR) 5.008, 95% confidence interval (CI) 1.538-16.309; p<0.01) and intracranial large artery atherosclerosis (OR 4.979, 95% CI 1.633-15.183; p<0.01). Japanese patients with cerebral infarction have a high prevalence of CVD, especially asymptomatic CAD. Both metabolic syndrome and intracranial large artery atherosclerosis may be potential predictors for identifying patients with cerebral infarction who are at the highest risk of asymptomatic CAD. (author)

  3. Cerebral artery alpha-1 AR subtypes: high altitude long-term acclimatization responses.

    Directory of Open Access Journals (Sweden)

    Ravi Goyal

    Full Text Available In response to hypoxia and other stress, the sympathetic (adrenergic nervous system regulates arterial contractility and blood flow, partly through differential activities of the alpha1 (α1 - adrenergic receptor (AR subtypes (α1A-, α1B-, and α1D-AR. Thus, we tested the hypothesis that with acclimatization to long-term hypoxia (LTH, contractility of middle cerebral arteries (MCA is regulated by changes in expression and activation of the specific α1-AR subtypes. We conducted experiments in MCA from adult normoxic sheep maintained near sea level (300 m and those exposed to LTH (110 days at 3801 m. Following acclimatization to LTH, ovine MCA showed a 20% reduction (n = 5; P<0.05 in the maximum tension achieved by 10-5 M phenylephrine (PHE. LTH-acclimatized cerebral arteries also demonstrated a statistically significant (P<0.05 inhibition of PHE-induced contractility in the presence of specific α1-AR subtype antagonists. Importantly, compared to normoxic vessels, there was significantly greater (P<0.05 α1B-AR subtype mRNA and protein levels in LTH acclimatized MCA. Also, our results demonstrate that extracellular regulated kinase 1 and 2 (ERK1/2-mediated negative feedback regulation of PHE-induced contractility is modulated by α1B-AR subtype. Overall, in ovine MCA, LTH produces profound effects on α1-AR subtype expression and function.

  4. White matter reorganization and functional response after focal cerebral ischemia in the rat.

    Directory of Open Access Journals (Sweden)

    Chrystelle Po

    Full Text Available After stroke, the brain has shown to be able to achieve spontaneous functional recovery despite severe cerebral damage. This phenomenon is poorly understood. To address this issue, focal transient ischemia was induced by 60 min middle cerebral artery occlusion in Wistar rats. The evolution of stroke was followed using two magnetic resonance imaging modalities: diffusion spectrum imaging (acquired before, one and four weeks after stroke and functional magnetic resonance imaging (acquired before and five weeks after stroke. To confirm the imaging observations, immunohistochemical staining for myelin, astrocytes and macrophages/microglia was added. At four weeks after stroke, a focal alteration of the diffusion anisotropy was observed between the ipsilesional ventricle and the lesion area. Using tractography this perturbation was identified as reorganization of the ipsilesional internal capsule. Functional imaging at five weeks after ischemia demonstrated activation of the primary sensorimotor cortex in both hemispheres in all rats except one animal lacking a functional response in the ipsilesional cortex. Furthermore, fiber tracking showed a transhemispheric fiber connection through the corpus callosum, which-in the rat without functional recovery-was lost. Our study shows the influence of the internal capsule reorganization, combined with inter-hemispheric connections though the corpus callosum, on the functional activation of the brain from stroke. In conclusion, tractography opens a new door to non-invasively investigate the structural correlates of lack of functional recovery after stroke.

  5. Control of the cerebral circulation and metabolism by the rostral ventrolateral medulla: Possible role in the cerebrovascular response to hypoxia

    Energy Technology Data Exchange (ETDEWEB)

    Underwood, M.D.

    1988-01-01

    Neurons within the rostral ventrolateral medulla (RVL) corresponding to the location of adrenaline neurons of the C1 group (C1 area) maintain resting levels of arterial pressure (AP) and mediate the reflex cardiovascular responses to baro- and chemoreceptor activation and cerebral ischemia. The author therefore sought to determine whether neurons in the C1 area: (a) modulate regional cerebral blood flow (rCBF) and/or cerebral glucose utilization (rCGU), (b) participate in the maintenance of resting levels of CBF and CGU, and (c) mediate the CBF response to hypoxia. Rats were anesthetized, paralyzed and ventilated. The RVL was stimulated electrically or chemically, with kainic acid; lesions were placed electrolytically. rCBF was measured using 14-C-iodoantipyrine and rCGU with {sup 14}C-2-deoxyglucose in 11 dissected brain regions.

  6. Error detection and response adjustment in youth with mild spastic cerebral palsy: an event-related brain potential study.

    Science.gov (United States)

    Hakkarainen, Elina; Pirilä, Silja; Kaartinen, Jukka; van der Meere, Jaap J

    2013-06-01

    This study evaluated the brain activation state during error making in youth with mild spastic cerebral palsy and a peer control group while carrying out a stimulus recognition task. The key question was whether patients were detecting their own errors and subsequently improving their performance in a future trial. Findings indicated that error responses of the group with cerebral palsy were associated with weak motor preparation, as indexed by the amplitude of the late contingent negative variation. However, patients were detecting their errors as indexed by the amplitude of the response-locked negativity and thus improved their performance in a future trial. Findings suggest that the consequence of error making on future performance is intact in a sample of youth with mild spastic cerebral palsy. Because the study group is small, the present findings need replication using a larger sample.

  7. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  8. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    International Nuclear Information System (INIS)

    Herold, S.

    1985-01-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack. (orig.) [de

  9. Functional response of cerebral blood flow induced by somatosensory stimulation in rats with subarachnoid hemorrhage

    Science.gov (United States)

    Li, Zhiguo; Huang, Qin; Liu, Peng; Li, Pengcheng; Ma, Lianting; Lu, Jinling

    2015-09-01

    Subarachnoid hemorrhage (SAH) is often accompanied by cerebral vasospasm (CVS), which is the phenomenon of narrowing of large cerebral arteries, and then can produce delayed ischemic neurological deficit (DIND) such as lateralized sensory dysfunction. CVS was regarded as a major contributor to DIND in patients with SAH. However, therapy for preventing vasospasm after SAH to improve the outcomes may not work all the time. It is important to find answers to the relationship between CVS and DIND after SAH. How local cerebral blood flow (CBF) is regulated during functional activation after SAH still remains poorly understood, whereas, the regulation of CBF may play an important role in weakening the impact of CVS on cortex function. Therefore, it is worthwhile to evaluate the functional response of CBF in the activated cortex in an SAH animal model. Most evaluation of the effect of SAH is presently carried out by neurological behavioral scales. The functional imaging of cortical activation during sensory stimulation may help to reflect the function of the somatosensory cortex more locally than the behavioral scales do. We investigated the functional response of CBF in the somatosensory cortex induced by an electrical stimulation to contralateral forepaw via laser speckle imaging in a rat SAH model. Nineteen Sprague-Dawley rats from two groups (control group, n=10 and SAH group, n=9) were studied. SAH was induced in rats by double injection of autologous blood into the cisterna magna after CSF aspiration. The same surgical procedure was applied in the control group without CSF aspiration or blood injection. Significant CVS was found in the SAH group. Meanwhile, we observed a delayed peak of CBF response in rats with SAH compared with those in the control group, whereas no significant difference was found in magnitude, duration, and areas under curve of relative CBF changes between the two groups. The results suggest that the regulation function of local CBF during

  10. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  11. Social Functioning and Communication in Children with Cerebral Palsy: Association with Disease Characteristics and Personal and Environmental Factors

    Science.gov (United States)

    Voorman, Jeanine M.; Dallmeijer, Annet J.; van Eck, Mirjam; Schuengel, Carlo; Becher, Jules G.

    2010-01-01

    Aim: The objective of this longitudinal study was to describe the course of social functioning and communication in children with cerebral palsy (CP) over a 3-year period, its difference with the normative course, and its relationship with disease characteristics and personal and environmental factors. Method: Participants in this study were 110…

  12. Hemoglobin, hematocrit, and changes in cerebral blood flow : The Second Manifestations of ARTerial disease-Magnetic Resonance study

    NARCIS (Netherlands)

    van der Veen, Pieternella H.; Muller, Majon; Vincken, Koen L.; Westerink, Jan; Mali, Willem P. T. M.; van der Graaf, Yolanda; Geerlings, Mirjam I.; Doevendans, PAFM

    Hemoglobin and hematocrit are important determinants of blood viscosity and arterial oxygen content and may therefore influence cerebral blood flow (CBF). We examined cross-sectional and prospective associations of hemoglobin and hematocrit with CBF in 569 patients with manifest arterial disease

  13. Report of diffusion-weighted MRI in two cases with different cerebral hydatid disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitis, O.; Calli, C.; Yunten, N. [Ege Univ., Izmir (Turkey). Dept. of Radiology

    2004-02-01

    To present MRI findings in two cases of cerebral hydatid disease with an emphasis on diffusion-weighted imaging (DWI) findings of Echinococcus granulosus (EG) versus Echinococcus alveolaris (EA). EG lesions were isointense with cerebrospinal fluid in all sequences including DWI. On DWI, EA lesions remained hypointense on b = 1000 s/mm2 diffusion-weighted images. Apparent diffusion coefficient (ADC) values of EG and EA lesions were completely different from each other, 2.88 {+-} 0.24 x 10{sup -3} s/mm{sup 2} and 1.33 {+-} 0.15 x 10{sup -3} s/mm{sup 2}, respectively. The ADC values could not be used to discriminate from other differential diagnoses.

  14. Cerebral blood flow reduction in Alzheimer's disease: impact of capillary occlusions on mice and humans

    Science.gov (United States)

    Berg, Maxime; Merlo, Adlan; Peyrounette, Myriam; Doyeux, Vincent; Smith, Amy; Cruz-Hernandez, Jean; Bracko, Oliver; Haft-Javaherian, Mohammad; Nishimura, Nozomi; Schaffer, Chris B.; Davit, Yohan; Quintard, Michel; Lorthois, Sylvie

    2017-11-01

    Alzheimer's disease may be the most common form of dementia, yet a satisfactory diagnosis procedure has still to be found. Recent studies suggest that a significant decrease of cerebral blood flow, probably caused by white blood cells stalling small vessels, may be among the earliest biological markers. To assess this hypothesis we derive a blood flow model, validate it against in vitro controlled experiments and in vivo measurements made on mice. We then investigate the influence of capillary occlusions on regional perfusion (sum of all arteriole flowrates feeding the network) of large mice and humans anatomical networks. Consistent with experiments, we observe no threshold effect, so that even a small percentage of occlusions (2-4%) leads to significant blood flow decrease (5-12%). We show that both species share the same linear dependance, suggesting possible translation from mice to human. ERC BrainMicroFlow GA61510, CALMIP HPC (Grant 2017-1541).

  15. Posterior cerebral artery involvement in moyamoya disease: initial infarction and angle between PCA and basilar artery.

    Science.gov (United States)

    Lee, Ji Yeoun; Kim, Seung-Ki; Cheon, Jung-Eun; Choi, Jung Won; Phi, Ji Hoon; Kim, In-One; Cho, Byung-Kyu; Wang, Kyu-Chang

    2013-12-01

    Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease, and progressive involvement of the posterior cerebral artery (PCA) has been reported. However, majority of MMD articles are presenting classic anterior circulation related issues. This study investigates the preoperative factors related to the long-term outcome of posterior circulation in MMD. Retrospective review of 88 MMD patients (166 PCAs in either hemisphere) without symptomatic disease involvement of PCA at initial diagnosis was done. Data at initial diagnosis regarding age, presence of infarction, status of the PCA, type of posterior communicating artery, and the angle between PCA and basilar artery were reviewed. Progressive stenosis of PCA was evaluated by symptom or radiological imaging during follow up. During an average follow up of 8.3 years, 29 out of 166 (18 %) evaluated PCAs showed progressive disease involvement. The average time of progression from the initial operation was 4.9 years, with the latest onset at 10.8 years. The patients who showed progressive stenosis of the PCA tended to be younger, present with infarction, have smaller angle between PCA and basilar artery, and have asymptomatic stenosis of the PCA at initial presentation. However, multivariate analysis confirmed only the presence of initial infarction and a smaller angle between PCA and basilar artery to be significantly associated with progressive stenosis of PCA. Involvement of PCA in MMD may occur in a delayed fashion, years after the completion of revascularization of anterior circulation. Persistent long-term follow-up regarding the posterior circulation is recommended.

  16. Cerebral glucose metabolic patterns in Alzheimer's disease. Effect of gender and age at dementia onset

    International Nuclear Information System (INIS)

    Small, G.W.; Kuhl, D.E.; Riege, W.H.; Fujikawa, D.G.; Ashford, J.W.; Metter, E.J.; Mazziotta, J.C.

    1989-01-01

    No previous study of Alzheimer's disease has, to our knowledge, assessed the effect of both age at dementia onset and gender on cerebral glucose metabolic patterns. To this end, we used positron emission tomography (fludeoxyglucose F 18 method) to study 24 patients with clinical diagnoses of probable Alzheimer's disease. Comparisons of the 13 patients with early-onset dementia (less than 65 years of age) with the 11 patients with late-onset dementia (greater than 65 years of age) revealed significantly lower left parietal metabolic ratios (left posterior parietal region divided by the hemispheric average) in the early-onset group. The metabolic ratio of posterior parietal cortex divided by the relatively disease-stable average of caudate and thalamus also separated patients with early-onset dementia from those with late-onset dementia, but not men from women. Further comparisons between sexes showed that, in all brain regions studied, the 9 postmenopausal women had higher nonweighted mean metabolic rates than the 15 men from the same age group, with hemispheric sex differences of 9% on the right and 7% on the left. These results demonstrate decreased parietal ratios in early-onset dementia of Alzheimer's disease, independent of a gender effect

  17. The Dynamic cerebral autoregulatory adaptive response to noradrenaline is attenuated during systemic inflammation in humans

    DEFF Research Database (Denmark)

    Berg, Ronan M. G.; Plovsing, Ronni R.; Bailey, Damian M.

    2015-01-01

    and repeated after a 4-h intravenous LPS infusion. The assessments of dCA were based on transfer function analysis of spontaneous oscillations between MAP and middle cerebral artery blood flow velocity measured by transcranial Doppler ultrasound in the low frequency range (0.07-0.20 Hz). Prior to LPS.......81-0.97) cm/mmHg per s; P = 0.46) nor phase (1.10 (1.04-1.30) vs 1.37 (1.23-1.51) radians; P = 0.64). The improvement of dCA to a steady state increase in MAP is attenuated during an LPS-induced systemic inflammatory response. This may suggest that vasopressor treatment with noradrenaline offers no additional...

  18. Cerebral Asymmetry of fMRI-BOLD Responses to Visual Stimulation

    DEFF Research Database (Denmark)

    Hougaard, Anders; Jensen, Bettina Hagström; Amin, Faisal Mohammad

    2015-01-01

    was correlated with subject age, suggesting a shift towards the left hemisphere with increasing age. Our findings suggest a right-hemispheric dominance of these areas, which could lend support to the generally observed leftward visual attentional bias and to the left hemifield advantage for some visual......Hemispheric asymmetry of a wide range of functions is a hallmark of the human brain. The visual system has traditionally been thought of as symmetrically distributed in the brain, but a growing body of evidence has challenged this view. Some highly specific visual tasks have been shown to depend...... on hemispheric specialization. However, the possible lateralization of cerebral responses to a simple checkerboard visual stimulation has not been a focus of previous studies. To investigate this, we performed two sessions of blood-oxygenation level dependent (BOLD) functional magnetic resonance imaging (f...

  19. Cerebral blood flow and metabolic abnormalities in Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi [National Center of Neurology and Psychiatry, Kodaira, Tokyo (Japan). National Center Hospital for Mental, Nervous, and Muscular Disorders

    2001-04-01

    In this review I summarize observations of PET and SPECT studies about cerebral blood flow and metabolic abnormalities in Alzheimer's disease (AD). In very early AD flow or metabolism reduces first in the posterior cingulate gyrus and precuneus. This reduction may arise from functional deafferentation caused by primary neural degeneration in the remote area of the entorhinal cortex that is the first to be pathologically affected in AD. Then medial temporal structures and parietotemporal association cortex show flow or metabolic reduction as disease processes. The reason why flow or metabolism in medial temporal structures shows delay in starting to reduce in spite of the earliest pathological affection remains to be elucidated. It is likely that anterior cingulate gyrus is functionally involved, since attention is the first non-memory domain to be affected, before deficits in language and visuospatial functions. However few reports have described involvement in the anterior cingulate gyrus. Relationship between cerebral blood flow or metabolism and apolipoprotein E (APOE) genotype has been investigated. Especially, the APOE{epsilon}4 allele has been reported to increase risk and to lower onset age as a function of the inherited dose of the {epsilon}4 allele. Reduction of flow or metabolism in the posterior cingulate gyrus and precuneus has been reported even in presymptomatic nondemented subjects who were cognitively normal and had at least a single {epsilon}4 allele. On the contrary the relation of {epsilon}4 allele to the progression rate of AD has been controversial from neuroimaging approaches. PET and SPECT imaging has become to be quite useful for assessing therapeutical effects of newly introduced treatment for AD. Recent investigations observed significant regional flow increase after donepezil hydrochloride treatment. Most of these observations have been made by applying computer assisted analysis of three-dimensional stereotactic surface projection

  20. Differential effects of gaseous versus injectable anesthetics on changes in regional cerebral blood flow and metabolism induced by l-DOPA in a rat model of Parkinson's disease.

    Science.gov (United States)

    Bimpisidis, Zisis; Öberg, Carl M; Maslava, Natallia; Cenci, M Angela; Lundblad, Cornelia

    2017-06-01

    Preclinical imaging of brain activity requires the use of anesthesia. In this study, we have compared the effects of two widely used anesthetics, inhaled isoflurane and ketamine/xylazine cocktail, on cerebral blood flow and metabolism in a rat model of Parkinson's disease and l-DOPA-induced dyskinesia. Specific tracers were used to estimate regional cerebral blood flow (rCBF - [ 14 C]-iodoantipyrine) and regional cerebral metabolic rate (rCMR - [ 14 C]-2-deoxyglucose) with a highly sensitive autoradiographic method. The two types of anesthetics had quite distinct effects on l-DOPA-induced changes in rCBF and rCMR. Isoflurane did not affect either the absolute rCBF values or the increases in rCBF in the basal ganglia after l-DOPA administration. On the contrary, rats anesthetized with ketamine/xylazine showed lower absolute rCBF values, and the rCBF increases induced by l-DOPA were masked. We developed a novel improved model to calculate rCMR, and found lower metabolic activities in rats anesthetized with isoflurane compared to animals anesthetized with ketamine/xylazine. Both anesthetics prevented changes in rCMR upon l-DOPA administration. Pharmacological challenges in isoflurane-anesthetized rats indicated that drugs mimicking the actions of ketamine/xylazine on adrenergic or glutamate receptors reproduced distinct effects of the injectable anesthetics on rCBF and rCMR. Our results highlight the importance of anesthesia in studies of cerebral flow and metabolism, and provide novel insights into mechanisms mediating abnormal neurovascular responses to l-DOPA in Parkinson's disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Slow pupillary light responses in infants at high risk of cerebral palsy were associated with periventricular leukomalacia and neurological outcome

    NARCIS (Netherlands)

    Hamer, Elisa G.; Vermeulen, R. Jeroen; Dijkstra, Linze J.; Hielkema, Tjitske; Kos, Claire; Bos, Arend F.; Hadders-Algra, Mijna

    2016-01-01

    Aim: Having observed slow pupillary light responses (PLRs) in infants at high risk of cerebral palsy, we retrospectively evaluated whether these were associated with specific brain lesions or unfavourable outcomes. Methods: We carried out neurological examinations on 30 infants at very high risk of

  2. Maximal aerobic and anaerobic exercise responses in children with cerebral palsy.

    Science.gov (United States)

    Balemans, Astrid C J; Van Wely, Leontien; De Heer, Susan J A; Van den Brink, Janneke; De Koning, Jos J; Becher, Jules G; Dallmeijer, Annet J

    2013-03-01

    The objective of this study is to compare the maximal aerobic and anaerobic exercise responses of children with cerebral palsy (CP) by level of motor impairment and in comparison with those of typically developing children (TD). Seventy children with CP, with varying levels of motor impairment (Gross Motor Function Classification System (GMFCS) I-III), and 31 TD performed an incremental continuous maximal aerobic exercise test and a 20-s anaerobic Wingate test on a cycle ergometer. Peak oxygen uptake (V˙O2peak), anaerobic threshold (AT), peak ventilation (V˙Epeak), peak oxygen pulse (peak O2 pulse), peak ventilatory equivalent of oxygen (peak V˙E/V˙O2) and carbon dioxide (peak V˙E/V˙CO2), peak aerobic power output (POpeak), and mean anaerobic power (P20mean) were measured. Isometric leg muscle strength was determined as a secondary outcome. Analysis revealed a lower V˙O2peak for CP (I: 35.5 ± 1.2 (SE); II: 33.9 ± 1.6; III: 29.3 ± 2.5 mL·kg-1·min-1) compared with TD (41.0 ± 1.3, P exercise responses, but decreases in respiratory and aerobic exercise responses were not as severe as predicted by motor impairment. Future research should reveal the role of inactivity on the exercise responses of children with CP and possibilities for improvement through training interventions.

  3. Crohns disease with central nervous system vasculitis causing subarachnoid hemorrhage due to aneurysm and cerebral ischemic stroke.

    Science.gov (United States)

    Garge, Shaileshkumar S; Vyas, Pooja D; Modi, Pranav D; Ghatge, Sharad

    2014-10-01

    Cerebral vasculitis secondary to Crohn's disease (CD) seems to be a very rare phenomenon. We report a 39-year-old male who presented with headache, vomiting, and left-sided weakness in the known case of CD. Cross-sectional imaging (computed tomography and magnetic resonance imaging,) showed right gangliocapsular acute infarct with supraclinoid cistern subarachnoid hemorrhage (SAH). Cerebral digital substraction angiography (DSA) showed dilatation and narrowing of right distal internal carotid artery (ICA). Left ICA was chronically occluded. His inflammatory markers were significantly raised. Imaging features are suggestive of cerebral vasculitis. Arterial and venous infarcts due to thrombosis are known in CD. Our case presented with acute subarachnoid hemorrhage in supraclinoid cistern due to rupture of tiny aneurysm of perforator arteries causing SAH and infarction in right basal ganglia. Patient was treated conservatively with immunosuppression along with medical management of SAH.

  4. Crohns disease with central nervous system vasculitis causing subarachnoid hemorrhage due to aneurysm and cerebral ischemic stroke

    Directory of Open Access Journals (Sweden)

    Shaileshkumar S Garge

    2014-01-01

    Full Text Available Cerebral vasculitis secondary to Crohn′s disease (CD seems to be a very rare phenomenon. We report a 39-year-old male who presented with headache, vomiting, and left-sided weakness in the known case of CD. Cross-sectional imaging (computed tomography and magnetic resonance imaging, showed right gangliocapsular acute infarct with supraclinoid cistern subarachnoid hemorrhage (SAH. Cerebral digital substraction angiography (DSA showed dilatation and narrowing of right distal internal carotid artery (ICA. Left ICA was chronically occluded. His inflammatory markers were significantly raised. Imaging features are suggestive of cerebral vasculitis. Arterial and venous infarcts due to thrombosis are known in CD. Our case presented with acute subarachnoid hemorrhage in supraclinoid cistern due to rupture of tiny aneurysm of perforator arteries causing SAH and infarction in right basal ganglia. Patient was treated conservatively with immunosuppression along with medical management of SAH.

  5. The Immune Response to Acute Focal Cerebral Ischemia and Associated Post-stroke Immunodepression: A Focused Review.

    Science.gov (United States)

    Famakin, Bolanle M

    2014-10-01

    It is currently well established that the immune system is activated in response to transient or focal cerebral ischemia. This acute immune activation occurs in response to damage, and injury, to components of the neurovascular unit and is mediated by the innate and adaptive arms of the immune response. The initial immune activation is rapid, occurs via the innate immune response and leads to inflammation. The inflammatory mediators produced during the innate immune response in turn lead to recruitment of inflammatory cells and the production of more inflammatory mediators that result in activation of the adaptive immune response. Under ideal conditions, this inflammation gives way to tissue repair and attempts at regeneration. However, for reasons that are just being understood, immunosuppression occurs following acute stroke leading to post-stroke immunodepression. This review focuses on the current state of knowledge regarding innate and adaptive immune activation in response to focal cerebral ischemia as well as the immunodepression that can occur following stroke. A better understanding of the intricate and complex events that take place following immune response activation, to acute cerebral ischemia, is imperative for the development of effective novel immunomodulatory therapies for the treatment of acute stroke.

  6. Doppler ultrasound evaluation of cerebral blood flow pattern in neonates with congenital heart disease

    International Nuclear Information System (INIS)

    Kim, Tae Hoon; Kim, Mi Young; Kim, Yang Min; Lee, Soo Hyun; Kim, Soo Jin; Kim, Woong Han

    2003-01-01

    To evaluate intracerebral resistive index (RI) values in neonates with congenital heart disease and to investigate their changes after the corrective surgery of the congenital heart disease. Sixty nine neonates with congenital heart disease who underwent brain ultrasonography were included. Resistive index values were obtained at the genu portion of the anterior cerebral arteries through the anterior fontanelles. The patients were divided into 4 groups according to the presence of associated patent ductus arteriosus (PDA) and intracranial RI values. We evaluated the types of congenital heart disease that could influence RI values. Resistive index values were statistically higher in patients with PDA than in patients without PDA (p<0.05). RI values were higher in cases of large PDA with left-to-right shunt, but within the normal range in cases of small or nearly closing PDA or large PDA with bidirectional blood flow or with right-to-left shunt. For those patients without PDA, RI values were higher when patients had pulmonary atresia with multiple collateral vessels into the lung or when truncus arteriosus was present. RI values were also high in patients with hypoplastic left heart syndrome. RI values were normalized after the ligation of PDA, but patients with hypoplastic left heart syndrome showed persistently high RI values even after the Norwood's operation with Blalock-Taussig shunt. RI values are influenced by various congenital heart diseases except PDA. Therefore, the presences of the congenital heart disease and its hemodynamic changes should be taken into consideration in the evaluation of the intracranial RI values using Doppler ultrasonography.

  7. Local cerebral metabolic rate of glucose (lCMRGlc) in treated and untreated patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Rougemont, D.; Baron, J.C.; Collard, P.; Bustany, P.; Comar, D.; Agid, Y.

    1983-06-01

    Local cerebral metabolic rate of glucose (lCMRGlc) was measured twice, using positron emission tomography and 18 F-Fluoro-2-deoxy-D-glucose ( 18 FDG), in 4 patients with Parkinson disease, first unmedicated and then treated with L-DOPA. Despite a dramatic clinical improvement, no significant changes in lCMRGlc could be detected. Moreover, no reproducible differences of lCMRGlc were found between patients with Parkinson disease and with normal brain

  8. Novel COL4A1 mutations cause cerebral small vessel disease by haploinsufficiency.

    Science.gov (United States)

    Lemmens, Robin; Maugeri, Alessandra; Niessen, Hans W M; Goris, An; Tousseyn, Thomas; Demaerel, Philippe; Corveleyn, Anniek; Robberecht, Wim; van der Knaap, Marjo S; Thijs, Vincent N; Zwijnenburg, Petra J G

    2013-01-15

    Mutations in COL4A1 have been identified in families with hereditary small vessel disease of the brain presumably due to a dominant-negative mechanism. Here, we report on two novel mutations in COL4A1 in two families with porencephaly, intracerebral hemorrhage and severe white matter disease caused by haploinsufficiency. Two families with various clinical presentations of cerebral microangiopathy and autosomal dominant inheritance were examined. Clinical, neuroradiological and genetic investigations were performed. Electron microscopy of the skin was also performed. In one of the families, sequence analysis revealed a one base deletion, c.2085del, leading to a frameshift and a premature stopcodon, p.(Gly696fs). In the other family, a splice site mutation was identified, c.2194-1G>A, which most likely leads to skipping of an exon with a frameshift and premature termination as a result. In fibroblasts of affected individuals from both the families, nonsense-mediated decay (NMD) of the mutant COL4A1 messenger RNAs (mRNAs) and a clear reduction of COL4A1 protein expression were demonstrated, indicating haploinsufficiency of COL4A1. Moreover, thickening of the capillary basement membrane in the skin was documented, similar to reports in patients with COL4A1 missense mutations. These findings suggest haploinsufficiency, a different mechanism from the commonly assumed dominant-negative effect, for COL4A1 mutations as a cause of (antenatal) intracerebral hemorrhage and white matter disease.

  9. Unusual Case of Cerebral Venous Thrombosis in Patient with Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Inha Kim

    2015-05-01

    Full Text Available The development of cerebral venous thrombosis (CVT as a secondary complication of Crohn's disease (CD seems to be rare, but it is generally accepted that the disease activity of CD contributes to the establishment of a hypercoagulable state. Here, we describe a case of CVT that developed outside the active phase of CD. A 17-year-old male visited the emergency room because of a sudden onset of right-sided weakness and right-sided hypesthesia. He had been diagnosed with CD 1 year before and was on a maintenance regimen of mesalazine and azathioprine. He did not exhibit any symptoms indicating a CD flare-up (bloody stools, abdominal pain, complications, or weight loss. A brain MRI scan revealed an acute infarction of the left frontal cortex and a cortical subarachnoid hemorrhage. Additionally, a magnetic resonance venography revealed a segmental filling defect in the superior sagittal sinus and also the non-visualizability of some bilateral cortical veins. The characteristics of the present case suggest that the risk of CVT is most likely related to CD per se rather than disease activity associated with CD.

  10. Receiver operating characteristic analysis of regional cerebral blood flow in Alzheimer's disease

    International Nuclear Information System (INIS)

    Zemcov, A.; Barclay, L.L.; Sansone, J.; Metz, C.E.

    1985-01-01

    Receiver operating characteristic (ROC) curves were used to quantitatively assess the ability of individual detectors in a 32-detector 133 Xe inhalation system to discriminate between two populations over the range of regional cerebral blood flow (rCBF) values. These populations were clinically evaluated as normal (age 63.1 +/- 13.1, n = 23) and presumed Alzheimer's disease (age 72.7 +/- 7.0, n = 82). Summary statistics showed that for homologous detectors the average value of blood flow in the normal group was greater than the flow value in the group of subjects with Alzheimer's disease. Conclusions drawn from single values of flow or mean hemispheric flow can lead to erroneous conclusions about hemisphere asymmetries. However, the dynamic relationship between the correct identifications (true positives) compared with incorrect identifications (false positives) of Alzheimer's disease at each detector varies over the range of blood flow values, and quantitative characterization of this relationship in terms of an ROC curve provides more insight into the structure of the data. Detectors approximating the speech, auditory and association cortex were most effective in discriminating between groups. Frontal detectors were marginally useful diagnostically

  11. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease

    DEFF Research Database (Denmark)

    Lidegaard, O

    1995-01-01

    -matched, randomly selected controls. RESPONSE: Of the 692 case and 1584 control questionnaires sent out, 590 (85.1%) and 1396 (88.1%), respectively, were returned. Of the 590 cases, nine had had cerebral thrombosis before 1980, 15 refused to participate, 44 had a revised diagnosis (primarily multiple sclerosis......) and 25 had an unreliable diagnosis, leaving 497 with a reliable cerebral thromboembolic diagnosis. Among the 1396 controls, 26 either refused to participate, were mentally handicapped, lived abroad or returned an uncompleted questionnaire, leaving 1370 controls included in the study. RESULTS: After...

  12. Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease

    DEFF Research Database (Denmark)

    Lidegaard, O

    1995-01-01

    -matched, randomly selected controls. RESPONSE: Of the 692 case and 1584 control questionnaires sent out, 590 (85.1%) and 1396 (88.1%), respectively, were returned. Of the 590 cases, nine had had cerebral thrombosis before 1980, 15 refused to participate, 44 had a revised diagnosis (primarily multiple sclerosis......) and 25 had an unreliable diagnosis, leaving 497 with a reliable cerebral thromboembolic diagnosis. Among the 1396 controls, 26 either refused to participate, were mentally handicapped, lived abroad or returned an uncompleted questionnaire, leaving 1370 controls included in the study. RESULTS: After...... thromboembolism whereas diabetes, hypertension, migraine and past thromboembolic events increased the risk of cerebral thromboembolism significantly. Women with these increased thrombotic risks should use oestrogen-containing oral contraceptives only after careful considerations of the risks, if at all....

  13. Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome

    International Nuclear Information System (INIS)

    Kajtazi, Naim I; Arulneyam, Jayanthi C; AlSenani, Fahmi M; Zimmerman, Valerie A; AlShami, Sadiq Y

    2009-01-01

    To investigate cerebral venous thrombosis (CVTR) clinical presentations, risk factors, and response to treatment in Saudi Arabia. Retrospective analysis of the King Farad Medical City, Riyadh, acute stroke database from April 2005 through February 2008 revealed 22 patients with CVTR. Hyper coagulable work-up and neuroimaging were performed. Sixteen patients were female (72.7%), and the median age was 35 years. Clinical presentations included: headache (77.3%), seizures (54.5%), focal neurological signs (54.5%), and decreased level of consciousness (50%). Over two-thirds (n=11; 69%) of female patients had a history of oral contraceptive use, which was the most common risk factor. Protein S deficiency (n=3), anti phospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n=1), rhinocerebral mucormycosis (n=1), leukemia (n=1), non-Hodgkin's lymphoma (n=1), sepsis (n=1), and unknown (n=6) were causes. Affected areas included superior sagittal (n=13), transverse (n=16), sigmoid (n=14), straight (n=6), and cavernous sinus (n=1); internal cerebral vein (n=2); vein of Galen (n=3); cortical veins (n=10); and internal jugular vein (n=12). Two patients had quadriparesis, and 2 patients died. The remainder (n=18, 81.8%) improved. Bilateral hemorrhagic presentation or venous infarction, deep venous system thrombosis, and underlying malignancy had less favorable results. Presentations in our series were similar to those in other reports, although altered consciousness and seizures were more common. Cortical vein involvement was also higher than commonly reported. Oral contraceptive use was a primary risk factor in female patients. Outcomes were favorable in 81.8% of patients. (author)

  14. Role of CO2 in the cerebral hyperemic response to incremental normoxic and hyperoxic exercise

    Science.gov (United States)

    Wildfong, K. W.; Hoiland, R. L.; Harper, M.; Lewis, N. C.; Pool, A.; Smith, S. L.; Kuca, T.; Ainslie, P. N.

    2016-01-01

    Cerebral blood flow (CBF) is temporally related to exercise-induced changes in partial pressure of end-tidal carbon dioxide (PetCO2); hyperoxia is known to enhance this relationship. We examined the hypothesis that preventing PetCO2 from rising (isocapnia) during submaximal exercise with and without hyperoxia [end-tidal Po2 (PetO2) = 300 mmHg] would attenuate the increases in CBF. Additionally, we aimed to identify the magnitude that breathing, per se, influences the CBF response to normoxic and hyperoxic exercise. In 14 participants, CBF (intra- and extracranial) measurements were measured during exercise [20, 40, 60, and 80% of maximum workload (Wmax)] and during rest while ventilation (V̇e) was volitionally increased to mimic volumes achieved during exercise (isocapnic hyperpnea). While V̇e was uncontrolled during poikilocapnic exercise, during isocapnic exercise and isocapnic hyperpnea, V̇e was increased to prevent PetCO2 from rising above resting values (∼40 mmHg). Although PetCO2 differed by 2 ± 3 mmHg during normoxic poikilocapnic and isocapnic exercise, except for a greater poikilocapnic compared with isocapnic increase in blood velocity in the posterior cerebral artery at 60% Wmax, the between condition increases in intracranial (∼12-15%) and extracranial (15–20%) blood flow were similar at each workload. The poikilocapnic hyperoxic increases in both intra- and extracranial blood-flow (∼17–29%) were greater compared with poikilocapnic normoxia (∼8–20%) at intensities >40% Wmax (P exercise influenced by the prevailing PetO2. PMID:26769951

  15. Chronic overexpression of cerebral Epo improves the ventilatory response to acute hypoxia during the postnatal development.

    Science.gov (United States)

    Caravagna, Céline; Schneider Gasser, Edith M; Ballot, Orlane; Joseph, Vincent; Soliz, Jorge

    2015-08-01

    Clinicians observed that the treatment of premature human newborns for anemia with erythropoietin (Epo) also improved their respiratory autonomy. This observation is in line with our previous in vitro studies showing that acute and chronic Epo stimulation enhances fictive breathing of brainstem-spinal cord preparations of postnatal day 3-4 mice during hypoxia. Furthermore, we recently reported that the antagonization of the cerebral Epo (by using the soluble Epo receptor; sEpoR) significantly reduced the basal ventilation and the hypoxic ventilatory response of 10 days old mice. In this study, we used transgenic (Tg21) mice to investigate the effect of the chronic cerebral Epo overexpression on the modulation of the normoxic and hypoxic ventilatory drive during the post-natal development. Ventilation was evaluated by whole body plethysmography at postnatal ages 3 (P3), 7 (P7), 15 (P15) and 21 (P21). In addition Epo quantification was performed by RIA and mRNA EpoR was evaluated by qRT-PCR. Our results showed that compared to control animals the chronic Epo overexpression stimulates the hypoxic (but not the normoxic) ventilation assessed as VE/VO2 at the ages of P3 and P21. More interestingly, we observed that at P7 and P15 the chronic Epo stimulation of ventilation was attenuated by the down regulation of the Epo receptor in brainstem areas. We conclude that Epo, by stimulating ventilation in brainstem areas crucially helps tolerating physiological (e.g., high altitude) and/or pathological (e.g., respiratory disorders, prematurity, etc.) oxygen deprivation at postnatal ages. Copyright © 2015 ISDN. Published by Elsevier Ltd. All rights reserved.

  16. Cerebral haemodynamic response to acute intracranial hypertension induced by head-down tilt.

    Science.gov (United States)

    Bosone, Daniele; Ozturk, Vesile; Roatta, Silvestro; Cavallini, Anna; Tosi, Piera; Micieli, Giuseppe

    2004-01-01

    The aim of this study was to evaluate, in a context of general inhibition of the sympathetic nervous system, the cerebral haemodynamic response to -30 degrees head-down tilt (HDT), a manoeuvre that produces an increase in intracranial arterial pressure. Nineteen healthy subjects were studied according to the following protocol: 10 min lying in supine position, 10 min HDT, 10 min recovery. Inhibition of the sympathetic system was confirmed by the decrease in heart rate (-3.6 bpm) and arterial blood pressure (-5.9 mmHg, p<0.05) in the late phase of the test. Blood velocity and blood pusatility index initially increased (+3.2 cm s(-1) and +9% respectively, p<0.01) then returned towards baseline before the end of HDT, while the cerebrovascular resistance index (=arterial blood pressure/blood velocity) dropped significantly and remained below control level (-7%, p<0.01) throughout the test. The changes in both these indices were opposite to those reported in several sympathetic activation tests, such as the handgrip and cold pressor tests. Conversely, arterial pressure at cranial level increased during HDT (as it also does during sympathetic activation tests), due to the development of a hydrostatic pressure gradient between heart and brain levels. Therefore, the effects observed on the pulsatility and resistance indices are not secondary to the increase in intracranial arterial pressure. It is suggested that the changes in these cerebrovascular indices are mediated by a reduction of sympathetic tone that presumably involves the cerebral as well as the peripheral vascular bed.

  17. Chronic cerebral hypoperfusion independently exacerbates cognitive impairment within the pathopoiesis of Parkinson's disease via microvascular pathologys.

    Science.gov (United States)

    Tang, Hongmei; Gao, Yuyuan; Zhang, Qingxi; Nie, Kun; Zhu, Ruiming; Gao, Liang; Feng, Shujun; Wang, Limin; Zhao, Jiehao; Huang, Zhiheng; Zhang, Yuhu; Wang, Lijuan

    2017-08-30

    To date, the role of microvascular pathology and chronic cerebral hypoperfusion (CHH) in the development of mild cognitive impairment in Parkinson's disease (PD-MCI) is unclear. Here, we investigated how the combined injury through interaction of CHH and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity act as an exacerbating element to damagae cognitive fuction in a mouse model. In the present study, C57BL/6 mice underwent MPTP injection. Subjects were classified into a PD with normal cognitive performance (PDCN) group or a PD-MCI group using the Morris Water Maze test. Further, CHH was induced by stenosis of the bilateral common carotid arteries (BCCAs). Consequently, the animals were divided into 7 groups: they are control, sham, BCCAs, PDCN, PD-MCI, PDCN+BCCAs and PD-MCI+BCCAs. The Morris Water Maze test, open field test, histological investigation and western blotting were performed to analyze cerebral microvascular impairment in each group. The results showed that CHH and MPTP injection caused spatial memory and behavioral impairment, accompanied by microvascular impairment and down-regulation of ZO-1 and Occludin at the protein level compared to the control group. The above injuries were synergistically exacerbated in the PDCN+BCCAs group and the PD-MCI+BCCAs group, which paralleled the elevated expression of p-MAPK and p-Akt. In short, our data demonstrate that CHH and MPTP caused cognitive and microvascular impairment separately. Moreover, CHH may exacerbate cognitive impairment in a mouse model of PD. The study provides a new opportunity for understanding the pathogenesis of PD-MCI. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Longitudinal relationship between chronic kidney disease and distribution of cerebral microbleeds in patients with ischemic stroke.

    Science.gov (United States)

    Peng, Qing; Sun, Wei; Liu, Wenhong; Liu, Ran; Huang, Yining

    2016-03-15

    Chronic kidney disease (CKD) has been reported to be independently associated with cerebral microbleeds (CMB). Since both glomerular afferent arterioles and cerebral perforating arteries are strain vessels, CKD and CMB may share similar dynamic changes. To clarify whether CKD and CKD progression are related to the distribution and evolution of CMB in patients with ischemic stroke. We retrospectively examined the data from the CASISP study. 500 patients with ischemic stroke were analyzed. The number and distribution of CMB were assessed using Microbleed Anatomical Rating Scale. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) and proteinuria. 51 (10.2%) and 158 (31.6%) had decreased eGFR (<60ml/min/1.73m(2)) and CMB at baseline, respectively; 31 (6.6%) and 84 (16.8%) had CKD and CMB progression. Decreased eGFR at baseline (OR=1.533, 95% CI: 1.111-2.114; p=0.009), proteinuria (OR=1.778, 95% CI: 1.026-3.083; p=0.040), CKD progression (OR=2.004, 95% CI: 1.191-3.370; p=0.009) and history of hypertension (OR=2.084, 95% CI: 1.241-3.49; p=0.005) were independently associated with the presence of deep or infratentorial CMB at follow-up. CMB progression in deep or infratentorial area was more frequent in patients with CKD progression than those without (29.0% versus 13.1%, p=0.028). Logistic regression analyses showed that CKD progression (OR=2.577, 95% CI: 1.393-4.769; p=0.003) was independently associated with the progression of deep or infratentorial CMB. CKD and CKD progression are independently associated with presence and evolution of deep or infratentorial CMB, but not lobar CMB. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

    International Nuclear Information System (INIS)

    Saito, Yuko

    1982-01-01

    CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the teritorry of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appeares inside of the teritorry of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area. (J.P.N.)

  20. Cerebral Small Vessel Disease Burden Is Associated With Poststroke Depressive Symptoms: A 15-Month Prospective Study

    Directory of Open Access Journals (Sweden)

    Yan Liang

    2018-02-01

    Full Text Available Objective: All types of cerebral small vessel disease (SVD markers including lacune, white matter hyperintensities (WMH, cerebral microbleeds, and perivascular spaces were found to be associated with poststroke depressive symptoms (PDS. This study explored whether the combination of the four markers constituting an overall SVD burden was associated with PDS.Methods: A cohort of 563 patients with acute ischemic stroke were followed over a 15-month period after the index stroke. A score of ≥7 on the 15-item Geriatric Depression Scale was defined as clinically significant PDS. Scores of the four SVD markers ascertained on magnetic resonance imaging were summed up to represent total SVD burden. The association between SVD burden and PDS was assessed with generalized estimating equation models.Results: The study sample had a mean age of 67.0 ± 10.2 years and mild-moderate stroke [National Institutes of Health Stroke Scale score: 3, interquartile, 1–5]. PDS were found in 18.3%, 11.6%, and 12.3% of the sample at 3, 9, and 15 months after stroke, respectively. After adjusting for demographic characteristics, vascular risk factors, social support, stroke severity, physical and cognitive functions, and size and locations of stroke, the SVD burden was associated with an increased risk of PDS [odds ratio = 1.30; 95% confidence interval = 1.07–1.58; p = 0.010]. Other significant predictors of PDS were time of assessment, female sex, smoking, number of acute infarcts, functional independence, and social support.Conclusion: SVD burden was associated with PDS examined over a 15-month follow-up in patients with mild to moderate acute ischemic stroke.

  1. BH4 treatment in BH4-responsive PKU patients: preliminary data on blood prolactin concentrations suggest increased cerebral dopamine concentrations.

    Science.gov (United States)

    van Vliet, Danique; Anjema, Karen; Jahja, Rianne; de Groot, Martijn J; Liemburg, Geertje B; Heiner-Fokkema, M Rebecca; van der Zee, Eddy A; Derks, Terry G J; Kema, Ido P; van Spronsen, Francjan J

    2015-01-01

    In phenylketonuria (PKU), cerebral neurotransmitter deficiencies have been suggested to contribute to brain dysfunction. Present treatment aims to reduce blood phenylalanine concentrations by a phenylalanine-restricted diet, while in some patients blood phenylalanine concentrations also respond to cofactor treatment with tetrahydrobiopterin (BH4). Recently, a repurposing approach of BH4 was suggested to increase cerebral neurotransmitter synthesis. To investigate whether BH4 may improve cerebral dopamine concentrations in PKU patients beyond its effect through lowering blood phenylalanine concentrations, we investigated blood prolactin concentrations-as a parameter of brain dopamine availability. We retrospectively compared blood prolactin in relation to blood phenylalanine concentrations of nine (male) BH4-responsive PKU patients, when being treated without and with BH4. Blood prolactin concentrations positively correlated to blood phenylalanine concentrations (p=0.002), being significantly lower with than without BH4 treatment (p=0.047). In addition, even in this small number of male patients, blood prolactin concentrations tended to be lower at increasing BH4 dose (p=0.054), while taking blood phenylalanine concentrations into account (p=0.002). In individual BH4-responsive patients, median blood prolactin concentrations were significantly lower while using BH4 than before using BH4 treatment (p=0.024), whereas median blood phenylalanine concentrations tended to be lower, but this did not reach statistical significance (p=0.107). Therefore, these data show that high blood phenylalanine in BH4-responsive PKU male patients seems to be associated with increased blood prolactin concentrations, suggesting reduced cerebral dopamine availability. Moreover, these data suggest that BH4 treatment in itself could decrease blood prolactin concentrations in a dose-responsive way, independent of blood phenylalanine concentrations. We conclude that these preliminary data

  2. Comparing Cerebral White Matter Lesion Burdens between Parkinson’s Disease with and without Dementia

    Directory of Open Access Journals (Sweden)

    Sun-Ah Choi

    2010-05-01

    Full Text Available Cerebral white matter lesions (CWMLs have been suggested to be associated with an increased risk of dementia, disability, and death. CWMLs are more common in individuals with Alzheimer’s disease (AD than in normal elderly individuals of comparable age. Only a few studies have been done to determine whether CWMLs may influence cognitive decline in Parkinson’s disease (PD. Fully developed PD with concurrent AD was reported to likely cause impaired cognition in spite of accumulating evidence suggesting that PD with dementia (PDD is more closely associated with Lewy body (LB pathology. Currently, contradictory data on the neuropathology of dementia in PD require further prospective clinicopathological studies in larger cohorts to elucidate the impact of AD and α-synuclein (SCNA pathologies on the cognitive status in these disorders. Previous reports did not suggest CWMLs to be associated with an increased risk of PDD. After adjusting for age at death, age at onset of PD, and duration of PD, our recent study investigating CWMLs in PDD via autopsy has shown a positive correlation between the burden of CWMLs and PDD. The frequent co-existence of both LB and AD lesions suggests that both pathologies independently or synergistically contribute to both movement disorders and cognitive impairment. The individual and cumulative burden of CWMLs, LB lesions, and AD lesions may synergistically contribute to cognitive decline in LB disorders such as PDD.

  3. Cerebral perfusion in the predementia stages of Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Binnewijzend, Maja A.A.; Wattjes, Mike P.; Berckel, Bart N.M. van; Barkhof, Frederik [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, Alzheimercenter Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Benedictus, Marije R.; Prins, Niels D.; Scheltens, Philip [VU University Medical Center, Department of Neurology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Center, Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Center, Department of Neurology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Epidemiology and Biostatistics Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Teunissen, Charlotte E. [VU University Medical Center, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands)

    2016-02-15

    To investigate arterial spin-labelling (ASL) cerebral blood flow (CBF) changes in predementia stages of Alzheimer's disease (AD). Data were obtained from 177 patients with subjective complaints, mild cognitive impairment and AD from the Amsterdam Dementia Cohort. AD stages were based on diagnosis and cerebrospinal fluid biomarkers amyloid-β (Aβ) and total-tau (tau). General-linear-models were used to assess relationships between AD stages and total and regional CBF, correcting for age and sex. Decreasing CBF was related to more advanced AD stages in all supratentorial regions (p for trend < 0.05). Post-hoc testing revealed that CBF was lower in AD compared to controls and stage-1 predementia patients (i.e. abnormal Aβ and normal tau) in temporal and parietal regions, and compared to stage-2 predementia patients (i.e. abnormal Aβ and tau) in temporal regions. CBF values of stage-2 predementia patients were numerically in between those of stage-1 predementia patients and AD. The continuing decrease of CBF along the continuum of AD indicates the potential of ASL-CBF as a measure for disease progression. (orig.)

  4. Strategic lacunes and their relationship to cognitive impairment in cerebral small vessel disease.

    Science.gov (United States)

    Benjamin, Philip; Lawrence, Andrew J; Lambert, Christian; Patel, Bhavini; Chung, Ai Wern; MacKinnon, Andrew D; Morris, Robin G; Barrick, Thomas R; Markus, Hugh S

    2014-01-01

    Lacunes are an important disease feature of cerebral small vessel disease (SVD) but their relationship to cognitive impairment is not fully understood. To investigate this we determined (1) the relationship between lacune count and total lacune volume with cognition, (2) the spatial distribution of lacunes and the cognitive impact of lacune location, and (3) the whole brain anatomical covariance associated with these strategically located regions of lacune damage. One hundred and twenty one patients with symptomatic lacunar stroke and radiological leukoaraiosis were recruited and multimodal MRI and neuropsychological data acquired. Lacunes were mapped semi-automatically and their volume calculated. Lacune location was automatically determined by projection onto atlases, including an atlas which segments the thalamus based on its connectivity to the cortex. Lacune locations were correlated with neuropsychological results. Voxel based morphometry was used to create anatomical covariance maps for these 'strategic' regions. Lacune number and lacune volume were positively associated with worse executive function (number p speed (number p speed (Bonferroni corrected p = 0.016). Regions of associated anatomical covariance included the medial prefrontal, orbitofrontal, anterior insular cortex and the striatum. Lacunes are important predictors of cognitive impairment in SVD. We highlight the importance of spatial distribution, particularly of anteromedial thalamic lacunes which are associated with impaired information processing speed and may mediate cognitive impairment via disruption of connectivity to the prefrontal cortex.

  5. Cerebral perfusion in the predementia stages of Alzheimer's disease

    International Nuclear Information System (INIS)

    Binnewijzend, Maja A.A.; Wattjes, Mike P.; Berckel, Bart N.M. van; Barkhof, Frederik; Benedictus, Marije R.; Prins, Niels D.; Scheltens, Philip; Kuijer, Joost P.A.; Flier, Wiesje M. van der; Teunissen, Charlotte E.

    2016-01-01

    To investigate arterial spin-labelling (ASL) cerebral blood flow (CBF) changes in predementia stages of Alzheimer's disease (AD). Data were obtained from 177 patients with subjective complaints, mild cognitive impairment and AD from the Amsterdam Dementia Cohort. AD stages were based on diagnosis and cerebrospinal fluid biomarkers amyloid-β (Aβ) and total-tau (tau). General-linear-models were used to assess relationships between AD stages and total and regional CBF, correcting for age and sex. Decreasing CBF was related to more advanced AD stages in all supratentorial regions (p for trend < 0.05). Post-hoc testing revealed that CBF was lower in AD compared to controls and stage-1 predementia patients (i.e. abnormal Aβ and normal tau) in temporal and parietal regions, and compared to stage-2 predementia patients (i.e. abnormal Aβ and tau) in temporal regions. CBF values of stage-2 predementia patients were numerically in between those of stage-1 predementia patients and AD. The continuing decrease of CBF along the continuum of AD indicates the potential of ASL-CBF as a measure for disease progression. (orig.)

  6. Study of cerebral vascular diseases with radioisotopes in cerebral atherosclerotical subjects and/for subjects with sequelae of cerebral stroke, before and after use of the association piracetam-dihydroergotoxine

    International Nuclear Information System (INIS)

    Lara, P.F.; Ferreira, A.; Paulillo, L.F.; Cukierman, M.

    1985-01-01

    Twently subjects with cerebral sclerosis and/or sequelas of cerebral stroke were studied, before and after use of piracetam-dihydroergotoxine. We performed the complete hemispheric cerebral blood flow and cerebral scintigraphy, beyond clinical and neurological examination. Scintigraphies were unchanged. Cerebral circulation times, or both hemispheres, diminished. This occurred, probably, in relation with metabolic effects of both pharmaceutical drugs. The alpha sympatolytic and modulatory effects of dihydroergotoxine should be considered. (author) [pt

  7. Caregiver Response to Alzheimer's Disease.

    Science.gov (United States)

    Novak, Mark; Guest, Carol

    1989-01-01

    Examined correlates of caregiver burden among 30 caregivers of Alzheimer's disease patients. Results revealed no significant correlation between length of time a caregiver had given care to a particular patient and the caregiver's subjective feelings of caregiver burden. Found significant, moderate correlation between caregiver burden and patient…

  8. Temporal dynamics of cortical and subcortical responses to apomorphine in Parkinson disease: an H2(15)O PET study

    NARCIS (Netherlands)

    Hosey, Lara A.; Thompson, Jennifer L. W.; Metman, Leonard Verhagen; van den Munckhof, Pepyn; Braun, Allen R.

    2005-01-01

    H2(15)O positron emission tomography (PET) was used to study the temporal course of central nervous system (CNS) responses to apomorphine in patients with idiopathic Parkinson disease (PD). Agonist-induced changes in regional cerebral blood flow (rCBF) were evaluated within

  9. In vivo quantification of cerebral r2*-response to graded hyperoxia at 3 tesla.

    Science.gov (United States)

    Gotzamanis, Grigorios; Kocian, Roman; Özbay, Pinar S; Redle, Manuel; Kollias, Spyridon; Eberhardt, Christian; Boss, Andreas; Nanz, Daniel; Rossi, Cristina

    2015-01-01

    This study aims to quantify the response of the transverse relaxation rate of the magnetic resonance (MR) signal of the cerebral tissue in healthy volunteers to the administration of air with step-wise increasing percentage of oxygen. The transverse relaxation rate (R2*) of the MR signal was quantified in seven volunteers under respiratory intake of normobaric gas mixtures containing 21, 50, 75, and 100% oxygen, respectively. End-tidal breath composition, arterial blood saturation (SaO2), and heart pulse rate were monitored during the challenge. R2* maps were computed from multi-echo, gradient-echo magnetic resonance imaging (MRI) data, acquired at 3.0T. The average values in the segmented white matter (WM) and gray matter (GM) were tested by the analysis of variance (ANOVA), with Bonferroni post-hoc correction. The GM R2*-reactivity to hyperoxia was modeled using the Hill's equation. Graded hyperoxia resulted in a progressive and significant (P s(-1). At 75% O2 supply, the R2* had reached a saturation level, with 16.4 ± 0.7 s(-1) (P = 0.02), without a significant further decrease for 100% O2. The R2*-response of GM correlated positively with CO2 partial pressure (R = 0.69 ± 0.19) and negatively with SaO2 (R = -0.74 ± 0.17). The WM showed a similar progressive, but non-significant, decrease in the relaxation rates, with an increase in oxygen intake (P = 0.055). The Hill's model predicted a maximum R2* response of the GM, of 3.5%, with half the maximum at 68% oxygen concentration. The GM-R2* responds to hyperoxia in a concentration-dependent manner, suggesting that monitoring and modeling of the R2*-response may provide new oxygenation biomarkers for tumor therapy or assessment of cerebrovascular reactivity in patients.

  10. Cerebral Blood Flow Response to Hypercapnia in Children with Obstructive Sleep Apnea Syndrome.

    Science.gov (United States)

    Busch, David R; Lynch, Jennifer M; Winters, Madeline E; McCarthy, Ann L; Newland, John J; Ko, Tiffany; Cornaglia, Mary Anne; Radcliffe, Jerilynn; McDonough, Joseph M; Samuel, John; Matthews, Edward; Xiao, Rui; Yodh, Arjun G; Marcus, Carole L; Licht, Daniel J; Tapia, Ignacio E

    2016-01-01

    Children with obstructive sleep apnea syndrome (OSAS) often experience periods of hypercapnia during sleep, a potent stimulator of cerebral blood flow (CBF). Considering this hypercapnia exposure during sleep, it is possible that children with OSAS have abnormal CBF responses to hypercapnia even during wakefulness. Therefore, we hypothesized that children with OSAS have blunted CBF response to hypercapnia during wakefulness, compared to snorers and controls. CBF changes during hypercapnic ventilatory response (HCVR) were tested in children with OSAS, snorers, and healthy controls using diffuse correlation spectroscopy (DCS). Peak CBF changes with respect to pre-hypercapnic baseline were measured for each group. The study was conducted at an academic pediatric sleep center. Twelve children with OSAS (aged 10.1 ± 2.5 [mean ± standard deviation] y, obstructive apnea hypopnea index [AHI] = 9.4 [5.1-15.4] [median, interquartile range] events/hour), eight snorers (11 ± 3 y, 0.5 [0-1.3] events/hour), and 10 controls (11.4 ± 2.6 y, 0.3 [0.2-0.4] events/hour) were studied. The fractional CBF change during hypercapnia, normalized to the change in end-tidal carbon dioxide, was significantly higher in controls (9 ± 1.8 %/mmHg) compared to OSAS (7.1 ± 1.5, P = 0.023) and snorers (6.7 ± 1.9, P = 0.025). Children with OSAS and snorers have blunted CBF response to hypercapnia during wakefulness compared to controls. Noninvasive DCS blood flow measurements of hypercapnic reactivity offer insights into physiopathology of OSAS in children, which could lead to further understanding about the central nervous system complications of OSAS. © 2016 Associated Professional Sleep Societies, LLC.

  11. Alterations of the cerebral cortex in sporadic small vessel disease: A systematic review of in vivo MRI data.

    Science.gov (United States)

    Peres, Roxane; De Guio, François; Chabriat, Hugues; Jouvent, Eric

    2016-04-01

    Cerebral small vessel diseases of the brain are a major determinant of cognitive impairment in the elderly. In small vessel diseases, the most easily identifiable lesions, both at post-mortem evaluation and magnetic resonance imaging, lie in subcortical areas. However, recent results obtained post-mortem, particularly in severe cases, have highlighted the burden of cortex lesions such as microinfarcts and diffuse neuronal loss. The recent development of image post-processing methods allows now assessing in vivo multiple aspects of the cerebral cortex. This systematic review aimed to analyze in vivo magnetic resonance imaging studies evaluating cortex alterations at different stages of small vessel diseases. Studies assessing the relationships between small vessel disease magnetic resonance imaging markers obtained at the subcortical level and cortex estimates were reviewed both in community-dwelling elderly and in patients with symptomatic small vessel diseases. Thereafter, studies analyzing cortex estimates in small vessel disease patients compared with healthy subjects were evaluated. The results support that important cortex alterations develop along the course of small vessel diseases independently of concomitant neurodegenerative processes. Easy detection and quantification of cortex changes in small vessel diseases as well as understanding their underlying mechanisms are challenging tasks for better understanding cognitive decline in small vessel diseases. © The Author(s) 2016.

  12. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Toshitaka Umemura

    2013-07-01

    Full Text Available Background/Aims: In recent years, the relationship between chronic kidney disease (CKD and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods: Seventy-nine type 2 diabetic patients (mean age, 76.0 years were enrolled in the present study. CKD was defined as the presence of albuminuria and/or a low estimated glomerular filtration rate (eGFR 2. SVD was evaluated by the presence and severity of silent brain infarcts (SBIs and white matter lesions (WMLs on brain magnetic resonance imaging. Neuropsychological tests were assessed using four validated cognitive instruments. Results: In multiple linear regression analyses, albuminuria was associated with worse modified Stroop Color Word scores (β = 0.284, p = 0.017 and low eGFR was associated with reduced Digit Symbol Substitution scores (β = -0.224, p = 0.026 after adjustment for age, sex, education years, diabetes duration, hypertension, multiple SBIs, and advanced WMLs. In contrast, there were no significant associations between CKD markers and Mini-Mental State Examination or Word Recall scores. Conclusion: Our findings suggest that albuminuria and low eGFR are associated with frontal lobe dysfunction independently of SVD in elderly type 2 diabetic patients.

  13. Regional Cerebral Disease Progression in Friedreich's Ataxia: A Longitudinal Diffusion Tensor Imaging Study.

    Science.gov (United States)

    Mascalchi, Mario; Toschi, Nicola; Giannelli, Marco; Ginestroni, Andrea; Della Nave, Riccardo; Tessa, Carlo; Piacentini, Silvia; Dotti, Maria Teresa; Aiello, Marco; Nicolai, Emanuele; Soricelli, Andrea; Salvi, Fabrizio; Diciotti, Stefano

    2016-01-01

    Imaging biomarkers of disease progression are desirable in inherited ataxias. MRI has demonstrated brain damage in Friedreich ataxia (FRDA) in form of regional atrophy of the medulla, peridentate cerebellar white matter (WM) and superior cerebellar peduncles (visible in T1-weighted images) and of change of microstructural characteristics of WM tracts of the brainstem, cerebellar peduncles, cerebellum, and supratentorial structures (visible through diffusion-weighted imaging). We explored the potential of brain MR morphometry and diffusion tensor imaging (DTI) to track the progression of neurodegeneration in FRDA. Eight patients (5F, 3M; age 13.4-41.2 years) and 8 healthy controls (2F, 6M; age 26.2-48.3 years) underwent 2 MRI examinations (mean 3.9 and 4.1 years apart, respectively) on the same 1.5T scanner. The protocol included 3D T1-weighted images and axial diffusion-weighted images (b-value 1,000 s/mm(2)) for calculating maps of fractional anisotropy, mean, axial and radial diffusivity, and mode of anisotropy. Tensor-based morphometry was used to investigate regional volume changes and tract-based spatial statistics was used to investigate microstructural changes in WM tracts. Longitudinal analyses showed no differences in regional volume changes but a significant difference in axial diffusivity changes in cerebral and corpus callosum WM of patients as compared to controls (mean longitudinal rate of change for axial diffusivity: -.02 × 10(-3) mm(2)/s/year in patients vs. .01 × 10(-3) mm(2)/s/year in controls). No correlation with number of triplets, disease duration, and worsening of the clinical deficit was observed. DTI can track brain microstructural changes in FRDA and can be considered a potential biomarker of disease progression. Copyright © 2015 by the American Society of Neuroimaging.

  14. Effect of PAS triple therapy on nerve injury, oxidative stress and inflammatory response in patients with cerebral infarction

    Directory of Open Access Journals (Sweden)

    Li-Jun Deng

    2017-10-01

    Full Text Available Objective: To study the effect of probucol + aspirin + atorvastatin (PAS triple therapy on nerve injury, oxidative stress and inflammatory response in patients with cerebral infarction. Methods: Patients with acute cerebral infarction who were treated in Affiliated Hospital of Jianghan University between February 2015 and January 2015 were selected and randomly divided into the PAS group who received probucol + aspirin + atorvastatin triple therapy and the control group who received aspirin + atorvastatin double therapy. The markers of nerve injury, oxidative stress and inflammatory response were determined before treatment and 15 d after treatment. Results: 15 d after treatment, peripheral blood Keap-1 expression and serum GPX1 contents of both groups of patients were significantly higher than those before treatment while peripheral blood Nrf-2 and ARE expression as well as serum S100B, NSE, sTRAIL, FKN, HMGB-1, sICAM-1, Chemerin and 8-iso-PGF2α contents were significantly lower than those before treatment, and peripheral blood Keap-1 expression and serum GPX1 content of PAS group were significantly higher than those of control group while peripheral blood Nrf-2 and ARE expression as well as serum S100B, NSE, sTRAIL, FKN, HMGB-1, sICAM-1, Chemerin and 8-iso-PGF2α contents were significantly lower than those of control group. Conclusion: PAS triple therapy can reduce the nerve injury as well as oxidative stress response and inflammatory response in patients with cerebral infarction.

  15. Low intensity areas observed T2-weighted magnetic resonance imaging of the cerebral cortex in various neurological diseases

    Energy Technology Data Exchange (ETDEWEB)

    Imon, Yukari [Hiroshima Univ. (Japan). School of Medicine

    1996-02-01

    We retrospectively studied magnetic resonance images of the brain in 158 patients (8 cases of amyotrophic lateral sclerosis, 16 cases of Alzheimer`s disease, 8 cases of Parkinson`s disease, 53 cases of multiple cerebral infarct, 20 cases of other central nervous system (CNS) diseases, and 53 cases without any CNS disease) to examine the appearance of T2-weighted low signal intensity areas (LIA) in the cerebral cortex. The age of subjects ranged from 36 to 85 years with the mean 65.0 and SD 9.9 years. LIA in the motor and sensory cortices, and brain atrophy were evaluated visually on axial images of the spin-echo sequence obtained with a 1.5 tesla system. The incidence of LIA in the motor cortex was significantly higher in all CNS diseases than in cases without any CNS disease, but not significantly different among CNS diseases. LIA in the motor cortex showed a correlation with age, temporal and parietal atrophy. The appearance of LIA in the sensory cortex correlated with that of LIA in the motor cortex, and parietal atrophy. These results suggest that LIA may appear according to age and be associated with the accumulation of nonheme iron in the cortex, especially in patients with CNS diseases. (author)

  16. Cerebral Oedema, Blood-Brain Barrier Breakdown and the Decrease in Na(+),K(+)-ATPase Activity in the Cerebral Cortex and Hippocampus are Prevented by Dexamethasone in an Animal Model of Maple Syrup Urine Disease.

    Science.gov (United States)

    Rosa, Luciana; Galant, Leticia S; Dall'Igna, Dhébora M; Kolling, Janaina; Siebert, Cassiana; Schuck, Patrícia F; Ferreira, Gustavo C; Wyse, Angela T S; Dal-Pizzol, Felipe; Scaini, Giselli; Streck, Emilio L

    2016-08-01

    Maple syrup urine disease (MSUD) is a rare metabolic disorder associated with acute and chronic brain dysfunction. This condition has been shown to lead to macroscopic cerebral alterations that are visible on imaging studies. Cerebral oedema is widely considered to be detrimental for MSUD patients; however, the mechanisms involved are still poorly understood. Therefore, we investigated whether acute administration of branched-chain amino acids (BCAA) causes cerebral oedema, modifies the Na(+),K(+)-ATPase activity, affects the permeability of the blood-brain barrier (BBB) and alters the levels of cytokines in the hippocampus and cerebral cortex of 10-day-old rats. Additionally, we investigated the influence of concomitant administration of dexamethasone on the alterations caused by BCAA. Our results showed that the animals submitted to the model of MSUD exhibited an increase in the brain water content, both in the cerebral cortex and in the hippocampus. By investigating the mechanism of cerebral oedema, we discovered an association between H-BCAA and the Na(+),K(+)-ATPase activity and the permeability of the BBB to small molecules. Moreover, the H-BCAA administration increases Il-1β, IL-6 and TNF-α levels in the hippocampus and cerebral cortex, whereas IL-10 levels were decreased in the hippocampus. Interestingly, we showed that the administration of dexamethasone successfully reduced cerebral oedema, preventing the inhibition of Na(+),K(+)-ATPase activity, BBB breakdown and the increase in the cytokines levels. In conclusion, these findings suggest that dexamethasone can improve the acute cerebral oedema and brain injury associated with high levels of BCAA, either through a direct effect on brain capillary Na(+),K(+)-ATPase or through a generalized effect on the permeability of the BBB to all compounds.

  17. Associative memory and its cerebral correlates in Alzheimer's disease: Evidence for distinct deficits of relational and conjunctive memory

    OpenAIRE

    Bastin, Christine; Bahri, Mohamed Ali; Miévis, Frédéric; Lemaire, Christian; Collette, Fabienne; Genon, Sarah; Simon, Jessica; Guillaume, Bénédicte; Diana, Rachel A.; Yonelinas, Andrew P.; Salmon, Eric

    2014-01-01

    This study investigated the impact of Alzheimer's disease (AD) on conjunctive and relational binding in episodic memory. Mild AD patients and controls had to remember item-color associations by imagining color either as a contextual association (relational memory) or as a feature of the item to be encoded (conjunctive memory). Patients' performance in each condition was correlated with cerebral metabolism measured by FDG-PET. The results showed that AD patients had an impaired capacity to rem...

  18. A Report of Accelerated Coronary Artery Disease Associated with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

    OpenAIRE

    Rubin, Courtney B.; Hahn, Virginia; Kobayashi, Taisei; Litwack, Andrew

    2015-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common heritable form of vascular dementia and it is caused by mutations in the NOTCH3 gene. The neurologic manifestations of CADASIL syndrome have been well characterized; however, here we report one of the first de novo cases of CADASIL-associated coronary artery disease. A 45-year-old woman with a history of CADASIL and remote tobacco use presented with unstable angina. She was ...

  19. Cerebral microhemorrhage in Marchiafava-Bignami disease detected by susceptibility-weighted imaging.

    Science.gov (United States)

    Kinno, Ryuta; Yamamoto, Masahiro; Yamazaki, Takahiro; Owan, Yoshiyuki; Fukui, Toshiya; Kinugasa, Eriko

    2013-04-01

    Marchiafava-Bignami disease (MBD) is a rare alcohol-associated disorder. Clinical features include not only disturbed consciousness, dysarthria, tetraparesis, astasia-abasia, and symptoms of interhemispheric disconnection as initial symptoms but also cognitive deficits as clinical outcomes. The clinical significance of cerebral microhemorrhage (CMH) has been recognized in patients with cognitive deficits; however, the presence of CMH in patients with MBD has not been emphasized. The aim of the present study was to clarify the relationship between CMH and MBD. For this purpose, we report four patients with MBD, who showed asymmetrical hypointense areas in multiple cortico-subcortical regions on susceptibility-weighted imaging (SWI). All cases had a history of chronic alcohol abuse and symmetrical lesions in the entire corpus callosum. These patients' clinical symptoms included not only coma, dysarthria, and astasia-abasia as initial symptoms but also dementia as a clinical outcome. SWI showed asymmetrical hypointense areas in the multiple cortico-subcortical regions, indicating the presence of CMH. Compared with patients with normal cognitive function, demented patients showed higher severity of CMH. Our report would indicate that CMH is an important factor indicating the severity of dementia in patients with MBD.

  20. Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease.

    Directory of Open Access Journals (Sweden)

    Valerie Lohner

    Full Text Available To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD, and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed.196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation. Path analysis and binary logistic regression were used to assess the relation between apathy, depression and cognitive impairment.31 participants with SVD (15.8% met criteria for apathy only, 23 (11.8% for both apathy and depression, and 2 (1.0% for depression only. In the SVD group the presence of apathy was related to global cognition, and specifically to impaired executive functioning/processing speed, but not memory/orientation. The presence of depression was not related to global cognition, impaired executive functioning/processing speed or memory/orientation.Apathy is a common feature of SVD and is associated with impaired executive functioning/processing speed suggesting the two may share biological mechanisms. Screening for apathy should be considered in SVD, and further work is required to develop and evaluate effective apathy treatment or management in SVD.

  1. Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease.

    Science.gov (United States)

    Lohner, Valerie; Brookes, Rebecca L; Hollocks, Matthew J; Morris, Robin G; Markus, Hugh S

    2017-01-01

    To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation. Path analysis and binary logistic regression were used to assess the relation between apathy, depression and cognitive impairment. 31 participants with SVD (15.8%) met criteria for apathy only, 23 (11.8%) for both apathy and depression, and 2 (1.0%) for depression only. In the SVD group the presence of apathy was related to global cognition, and specifically to impaired executive functioning/processing speed, but not memory/orientation. The presence of depression was not related to global cognition, impaired executive functioning/processing speed or memory/orientation. Apathy is a common feature of SVD and is associated with impaired executive functioning/processing speed suggesting the two may share biological mechanisms. Screening for apathy should be considered in SVD, and further work is required to develop and evaluate effective apathy treatment or management in SVD.

  2. Verbal or Visual Memory Score and Regional Cerebral Blood Flow in Alzheimer Disease

    Directory of Open Access Journals (Sweden)

    Satoshi Hayashi

    2018-01-01

    Full Text Available Objective: Among many cognitive function deficits, memory impairment is an initial and cardinal symptom in Alzheimer disease (AD. In most cases, verbal and visual memory scores correlate highly, but in some cases the deficit of verbal or visual memory is very different from that of the other memory. In this study, we examined the neural substrates of verbal and visual memory in patients with AD. Methods: One hundred eighty-eight consecutive patients with AD were recruited from outpatient units. Verbal and visual memory scores were evaluated using the Wechsler Memory Scale – revised. The patients underwent brain SPECT with 99mTc-ethylcysteinate dimer. Results: After removing the effects of age, sex, education, and Mini-Mental State Examination scores, correlation analysis showed a significant correlation of verbal memory scores to regional cerebral blood flow (rCBF in the bilateral cingulate gyrus and left precuneus. Similarly, a significant correlation of visual memory scores to rCBF was found in the right precuneus and right cingulate gyrus. Conclusion: The posterior medial cortices (PMC are very important areas in episodic memory among patients with mild AD. Verbal memory is more closely related to the both sides of the PMC, while visual memory is more closely related to the right PMC.

  3. Progression of MRI markers in cerebral small vessel disease: Sample size considerations for clinical trials

    Science.gov (United States)

    Zeestraten, Eva; Lambert, Christian; Chis Ster, Irina; Williams, Owen A; Lawrence, Andrew J; Patel, Bhavini; MacKinnon, Andrew D; Barrick, Thomas R; Markus, Hugh S

    2016-01-01

    Detecting treatment efficacy using cognitive change in trials of cerebral small vessel disease (SVD) has been challenging, making the use of surrogate markers such as magnetic resonance imaging (MRI) attractive. We determined the sensitivity of MRI to change in SVD and used this information to calculate sample size estimates for a clinical trial. Data from the prospective SCANS (St George’s Cognition and Neuroimaging in Stroke) study of patients with symptomatic lacunar stroke and confluent leukoaraiosis was used (n = 121). Ninety-nine subjects returned at one or more time points. Multimodal MRI and neuropsychologic testing was performed annually over 3 years. We evaluated the change in brain volume, T2 white matter hyperintensity (WMH) volume, lacunes, and white matter damage on diffusion tensor imaging (DTI). Over 3 years, change was detectable in all MRI markers but not in cognitive measures. WMH volume and DTI parameters were most sensitive to change and therefore had the smallest sample size estimates. MRI markers, particularly WMH volume and DTI parameters, are more sensitive to SVD progression over short time periods than cognition. These markers could significantly reduce the size of trials to screen treatments for efficacy in SVD, although further validation from longitudinal and intervention studies is required. PMID:26036939

  4. Verbal or Visual Memory Score and Regional Cerebral Blood Flow in Alzheimer Disease.

    Science.gov (United States)

    Hayashi, Satoshi; Terada, Seishi; Oshima, Etsuko; Sato, Shuhei; Kurisu, Kairi; Takenoshita, Shintaro; Yokota, Osamu; Yamada, Norihito

    2018-01-01

    Among many cognitive function deficits, memory impairment is an initial and cardinal symptom in Alzheimer disease (AD). In most cases, verbal and visual memory scores correlate highly, but in some cases the deficit of verbal or visual memory is very different from that of the other memory. In this study, we examined the neural substrates of verbal and visual memory in patients with AD. One hundred eighty-eight consecutive patients with AD were recruited from outpatient units. Verbal and visual memory scores were evaluated using the Wechsler Memory Scale - revised. The patients underwent brain SPECT with 99m Tc-ethylcysteinate dimer. After removing the effects of age, sex, education, and Mini-Mental State Examination scores, correlation analysis showed a significant correlation of verbal memory scores to regional cerebral blood flow (rCBF) in the bilateral cingulate gyrus and left precuneus. Similarly, a significant correlation of visual memory scores to rCBF was found in the right precuneus and right cingulate gyrus. The posterior medial cortices (PMC) are very important areas in episodic memory among patients with mild AD. Verbal memory is more closely related to the both sides of the PMC, while visual memory is more closely related to the right PMC.

  5. Does disease cause vaccination? Disease outbreaks and vaccination response.

    Science.gov (United States)

    Oster, Emily

    2017-11-02

    Parental fear of vaccines has limited vaccination rates in the United States. I test whether disease outbreaks increase vaccination using a new dataset of county-level disease and vaccination data. I find that pertussis (whooping cough) outbreaks in a county decrease the share of unvaccinated children entering kindergarten. These responses do not reflect changes in the future disease risk. I argue that these facts are best fit by a model in which individuals are both myopic and irrational. This suggests that better promotion of information about outbreaks could enhance the response. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Pattern and Rate of Cognitive Decline in Cerebral Small Vessel Disease: A Prospective Study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cognitive impairment, predominantly affecting processing speed and executive function, is an important consequence of cerebral small vessel disease (SVD. To date, few longitudinal studies of cognition in SVD have been conducted. We determined the pattern and rate of cognitive decline in SVD and used the results to determine sample size calculations for clinical trials of interventions reducing cognitive decline.121 patients with MRI confirmed lacunar stroke and leukoaraiosis were enrolled into the prospective St George's Cognition And Neuroimaging in Stroke (SCANS study. Patients attended one baseline and three annual cognitive assessments providing 36 month follow-up data. Neuropsychological assessment comprised a battery of tests assessing working memory, long-term (episodic memory, processing speed and executive function. We calculated annualized change in cognition for the 98 patients who completed at least two time-points.Task performance was heterogeneous, but significant cognitive decline was found for the executive function index (p<0.007. Working memory and processing speed decreased numerically, but not significantly. The executive function composite score would require the smallest samples sizes for a treatment trial with an aim of halting decline, but this would still require over 2,000 patients per arm to detect a 30% difference with power of 0.8 over a three year follow-up.The pattern of cognitive decline seen in SVD over three years is consistent with the pattern of impairments at baseline. Rates of decline were slow and sample sizes would need to be large for clinical trials aimed at halting decline beyond initial diagnosis using cognitive scores as an outcome measure. This emphasizes the importance of more sensitive surrogate markers in this disease.

  7. Prevalence, risk factors and consequences of cerebral small vessel diseases: data from three Asian countries.

    Science.gov (United States)

    Hilal, Saima; Mok, Vincent; Youn, Young Chul; Wong, Adrian; Ikram, Mohammad Kamran; Chen, Christopher Li-Hsian

    2017-08-01

    Cerebral small vessel disease (SVD) has been suggested to be more common in Asians compared with Caucasians. However, data from population-based studies in Asia are lacking. We report on the prevalence, risk factors and consequences of SVD from contemporary studies in three Asian countries using 3-Tesla MRI for the evaluation of SVD. Clinical, cognitive and 3-Tesla brain MRI assessments were performed among participants of three studies from Singapore, Hong Kong and Korea. SVD markers include white matter hyperintensities (WMHs) using the modified Fazekas scale, lacunes and microbleeds. Cognition was assessed using the Mini Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Adjustments were made for age, sex and cardiovascular risk factors. A total of 1797 subjects were available for analysis (mean age: 70.1±6.3 years and 57% women). The prevalence of confluent WMH was 36.6%, lacunes, 24.6% and microbleeds, 26.9%. Presence of all three SVD markers showed a steeper increase with increasing age rising from 1.9% in the lowest to 46.2% in the highest 5-year age strata. The major risk factors for the increased severity of SVD markers were advancing age and hypertension. Moreover, increasing severity of SVD markers was independently associated with worse performance on MMSE and MoCA. Elderly Asians have a high burden of SVD which was associated with cognitive dysfunction. This suggests that SVD markers should be a potential target for treatment in clinical trials so as to delay progression of cerebrovascular disease and potentially cognitive decline. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Pattern and Rate of Cognitive Decline in Cerebral Small Vessel Disease: A Prospective Study

    Science.gov (United States)

    Lawrence, Andrew J.; Brookes, Rebecca L.; Zeestraten, Eva A.; Barrick, Thomas R.; Morris, Robin G.; Markus, Hugh S.

    2015-01-01

    Objectives Cognitive impairment, predominantly affecting processing speed and executive function, is an important consequence of cerebral small vessel disease (SVD). To date, few longitudinal studies of cognition in SVD have been conducted. We determined the pattern and rate of cognitive decline in SVD and used the results to determine sample size calculations for clinical trials of interventions reducing cognitive decline. Methods 121 patients with MRI confirmed lacunar stroke and leukoaraiosis were enrolled into the prospective St George’s Cognition And Neuroimaging in Stroke (SCANS) study. Patients attended one baseline and three annual cognitive assessments providing 36 month follow-up data. Neuropsychological assessment comprised a battery of tests assessing working memory, long-term (episodic) memory, processing speed and executive function. We calculated annualized change in cognition for the 98 patients who completed at least two time-points. Results Task performance was heterogeneous, but significant cognitive decline was found for the executive function index (p<0.007). Working memory and processing speed decreased numerically, but not significantly. The executive function composite score would require the smallest samples sizes for a treatment trial with an aim of halting decline, but this would still require over 2,000 patients per arm to detect a 30% difference with power of 0.8 over a three year follow-up. Conclusions The pattern of cognitive decline seen in SVD over three years is consistent with the pattern of impairments at baseline. Rates of decline were slow and sample sizes would need to be large for clinical trials aimed at halting decline beyond initial diagnosis using cognitive scores as an outcome measure. This emphasizes the importance of more sensitive surrogate markers in this disease. PMID:26273828

  9. Responsiveness of cerebral and hepatic cytochrome P450s in rat offspring prenatally exposed to lindane

    International Nuclear Information System (INIS)

    Johri, Ashu; Yadav, Sanjay; Dhawan, Alok; Parmar, Devendra

    2008-01-01

    ABSTRACT: Prenatal exposure to low doses of lindane has been shown to affect the ontogeny of xenobiotic metabolizing cytochrome P450s (CYPs), involved in the metabolism and neurobehavioral toxicity of lindane. Attempts were made in the present study to investigate the responsiveness of CYPs in offspring prenatally exposed to lindane (0.25 mg/kg b. wt.; 1/350th of LD 50 ; p. o. to mother) when challenged with 3-methylcholanthrene (MC) or phenobarbital (PB), inducers of CYP1A and 2B families or a sub-convulsant dose of lindane (30 mg/kg b. wt., p. o.) later in life. Prenatal exposure to lindane was found to produce an increase in the mRNA and protein expression of CYP1A1, 1A2, 2B1, 2B2 isoforms in brain and liver of the offspring at postnatal day 50. The increased expression of the CYPs in the offspring suggests the sensitivity of the CYPs during postnatal development, possibly, to low levels of lindane, which may partition into mother's milk. A higher increase in expression of CYP1A and 2B isoenzymes and their catalytic activity was observed in animals pretreated prenatally with lindane and challenged with MC (30 mg/kg, i. p. x 5 days) or PB (80 mg/kg, i. p. x 5 days) when young at age (approx. 7 weeks) compared to animals exposed to MC or PB alone. Further, challenge of the control and prenatally exposed offspring with a single sub-convulsant dose of lindane resulted in an earlier onset and increased incidence of convulsions in the offspring prenatally exposed to lindane have demonstrated sensitivity of the CYPs in the prenatally exposed offspring. Our data assume significance as the subtle changes in the expression profiles of hepatic and cerebral CYPs in rat offspring during postnatal development could modify the adult response to a later exposure to xenobiotics

  10. Novelty Seeking, Harm Avoidance, and Cerebral Responses to Conflict Anticipation: An Exploratory Study

    Science.gov (United States)

    Hu, Jianping; Hu, Sien; Maisano, Julianna R.; Chao, Herta H.; Zhang, Sheng; Li, Chiang-Shan R.

    2016-01-01

    Proactive control allows us to maneuver a changing environment and individuals are distinct in how they anticipate and approach such changes. Here, we examined how individual differences in personality traits influence cerebral responses to conflict anticipation, a critical process of proactive control. We explored this issue in an fMRI study of the stop signal task, in which the probability of stop signal – p(Stop) – was computed trial by trial with a Bayesian model. Higher p(Stop) is associated with prolonged go trial reaction time, indicating conflict anticipation and proactive control of motor response. Regional brain activations to conflict anticipation were correlated to novelty seeking (NS), harm avoidance (HA), reward dependence, as assessed by the Tridimensional Personality Questionnaire, with age and gender as covariates, in a whole-brain linear regression. Results showed that increased anticipation of the stop signal is associated with activations in the bilateral inferior parietal lobules (IPL), right lateral orbitofrontal cortex (lOFC), middle frontal gyrus (MFG), anterior pre-supplementary motor area (pre-SMA), and bilateral thalamus, with men showing greater activation in the IPL than women. NS correlated negatively to activity in the anterior pre-SMA, right IPL, and MFG/lOFC, and HA correlated negatively to activity in the thalamus during conflict anticipation. In addition, the negative association between NS and MFG/lOFC activity was significant in men but not in women. Thus, NS and HA traits are associated with reduced mobilization of cognitive control circuits when enhanced behavioral control is necessary. The findings from this exploratory study characterize the influence of NS and HA on proactive control and provide preliminary evidence for gender differences in these associations. PMID:27857686

  11. In Vivo Quantification of Cerebral R2FNx01-Response to Graded Hyperoxia at 3 Tesla

    Directory of Open Access Journals (Sweden)

    Grigorios Gotzamanis

    2015-01-01

    Full Text Available Objectives: This study aims to quantify the response of the transverse relaxation rate of the magnetic resonance (MR signal of the cerebral tissue in healthy volunteers to the administration of air with step-wise increasing percentage of oxygen. Materials and Methods: The transverse relaxation rate (R2FNx01 of the MR signal was quantified in seven volunteers under respiratory intake of normobaric gas mixtures containing 21, 50, 75, and 100% oxygen, respectively. End-tidal breath composition, arterial blood saturation (SaO 2 , and heart pulse rate were monitored during the challenge. R2FNx01 maps were computed from multi-echo, gradient-echo magnetic resonance imaging (MRI data, acquired at 3.0T. The average values in the segmented white matter (WM and gray matter (GM were tested by the analysis of variance (ANOVA, with Bonferroni post-hoc correction. The GM R2FNx01-reactivity to hyperoxia was modeled using the Hill′s equation. Results: Graded hyperoxia resulted in a progressive and significant (P < 0.05 decrease of the R2FNx01 in GM. Under normoxia the GM-R2FNx01 was 17.2 ± 1.1 s -1 . At 75% O 2 supply, the R2FNx01 had reached a saturation level, with 16.4 ± 0.7 s -1 (P = 0.02, without a significant further decrease for 100% O 2 . The R2FNx01-response of GM correlated positively with CO 2 partial pressure (R = 0.69 ± 0.19 and negatively with SaO 2 (R = -0.74 ± 0.17. The WM showed a similar progressive, but non-significant, decrease in the relaxation rates, with an increase in oxygen intake (P = 0.055. The Hill′s model predicted a maximum R2FNx01 response of the GM, of 3.5%, with half the maximum at 68% oxygen concentration. Conclusions: The GM-R2FNx01 responds to hyperoxia in a concentration-dependent manner, suggesting that monitoring and modeling of the R2FNx01-response may provide new oxygenation biomarkers for tumor therapy or assessment of cerebrovascular reactivity in patients.

  12. Strong Impact of Chronic Cerebral Hypoperfusion on Neurovascular Unit, Cerebrovascular Remodeling, and Neurovascular Trophic Coupling in Alzheimer's Disease Model Mouse.

    Science.gov (United States)

    Shang, Jingwei; Yamashita, Toru; Zhai, Yun; Nakano, Yumiko; Morihara, Ryuta; Fukui, Yusuke; Hishikawa, Nozomi; Ohta, Yasuyuki; Abe, Koji

    2016-03-05

    Although chronic cerebral hypoperfusion (CCH) may affect Alzheimer's disease (AD) pathogenesis, the mechanism remains elusive. In the present study, we investigated the role of CCH on an AD mouse model in neurovascular unit, cerebrovascular remodeling, and neurovascular trophic coupling. Moreover, examined protective effect of galantamine. Alzheimer's disease transgenic mice (APP23) were subjected to bilateral common carotid arteries stenosis with ameroid constrictors for slowly progressive cerebral hypoperfusion. CCH exacerbated neuronal loss and decrease of α7 subunit of nicotinic acetylcholine receptors (α7-nAChRs) expression in hippocampus and thalamus at 12 months. Meanwhile, CCH greatly induced advanced glycation end products expression, and blood-brain barrier leakage through observing IgG and MMP9 expressions. Furthermore, a significant number of dramatic enlarged cerebral vessels with remodeling, BDNF/TrkB decreased in neurovascular trophic coupling. The present study demonstrated that CCH strongly enhanced primary AD pathology including neurodegeneration, neurovascular unit disruption, cerebrovascular remodeling and neurovascular trophic coupling damage in AD mice, and that galantamine treatment greatly ameliorated such neuropathologic abnormalities.

  13. A Highly Similar Mathematical Model for Cerebral Blood Flow Velocity in Geriatric Patients with Suspected Cerebrovascular Disease

    Science.gov (United States)

    Liu, Bo; Li, Qi; Wang, Jisheng; Xiang, Hu; Ge, Hong; Wang, Hui; Xie, Peng

    2015-10-01

    Cerebral blood flow velocity(CBFV) is an important parameter for study of cerebral hemodynamics. However, a simple and highly similar mathematical model has not yet been established for analyzing CBFV. To alleviate this issue, through TCD examination in 100 geriatric patients with suspected cerebrovascular disease (46 males and 54 females), we established a representative eighth-order Fourier function Vx(t) that simulates the CBFV. The measured TCD waveforms were compared to those derived from Vx(t), an illustrative Kolmogorov-Smirnov test was employed to determine the validity. The results showed that the TCD waves could been reconstructed for patients with different CBFVs by implementing their variable heart rates and the formulated maximum/minimum of Vx(t). Comparisons between derived and measured TCD waveforms suggest that the two waveforms are very similar. The results confirm that CBFV can be well-modeled through an eighth-order Fourier function. This function Vx(t) can be used extensively for a prospective study of cerebral hemodynamics in geriatric patients with suspected cerebrovascular disease.

  14. Studies on asymptomatic cerebral ischemia in coronary heart disease with special reference to evaluation of postural changes in cerebral blood flow with {sup 99m}Tc-ECD brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinozaki, Hideko [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

    2001-03-01

    Postural changes in cerebral blood flow in patients with coronary heart disease (CHD) were evaluated with SPECT to detect asymptomaic cerebral ischemia (ACI). {sup 99m}Tc-ECD was used as a tracer. We developed a new analysis system for the processing of multiple images, making it possible to avoid the spatial shift in ROIs in different positions. The severity of ACI was classified into 3 groups based on SPECT findings in the supine position: group 1 without any abnormalities in cerebral perfusion, group 2 with a single perfusion defect, and group 3 with a number of perfusion defects. No cerebral siteobserved in any group showed a significant difference between the supine and upright positions in cerebral perfusion. Each group in each position, however, revealed a consistent perfusion pattern characterized by a significant decrease in perfusion in the occipital, temporal and frontal lobes. Moreover, the decrease in the latter two sites was significantly greater than in the former site. Concerning clinical profiles, hypertension and the thickness of the intima and media complex (TIMC) of the common carotid artery significantly correlated with the severity of ACI. Furthermore, in multiple regression analysis, only TIMC was identified as a significant determinant of ACI. In conclusion, cerebral blood flow determined with {sup 99m}Tc-ECD SPECT could accurately detect ACI in patients with CHD. (author)

  15. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Perani, D.; Di Piero, V.; Vallar, G.; Cappa, S.; Messa, C.; Bottini, G.; Berti, A.; Passafiume, D.; Scarlato, G.; Gerundini, P.

    1988-09-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ((/sup 99m/Tc)HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data.

  16. Large deep infarcts found in proximal middle cerebral artery steno-occlusive disease: MRI and angiographic findings

    International Nuclear Information System (INIS)

    Yi, Bum Ha; Kim, Eui Jong; Choi, Woo Suk; Jang, Dae Il; Chung, Kyung Cheon; Oh, Joo Hyung; Yoon, Yup; Hong, Hoon Pyo

    1998-01-01

    To determine the nature of large deep-seated infarcts without cortical infarct in patients with steno-occlusive disease of the proximal middle cerebral artery (MCA) using magnetic resonance images (MRI) and angiography. By means of MRI and MR angiography (MRA), we examined 24 patients with large deep cerebral infarctions (>3cm in size) involving the basal ganglia, corona radiata and/or centrum semiovale, as well as steno-occlusive lesion of the proximal MCA. According to location, infarctions were classified into five groups, as follows:Group 1:basal ganlgia and corona radiata; 2:basal ganglia, corona radiata and centrum semiovale;3:corona radiata and centrum semiovale;4:corona radiata;5:basal ganglia only. We evaluated the topography of the lesions and correlated the results with the findings of angiography (all 24 MRA;the 13:conventional angiography). Involvement of the head of the caudate nucleus and the internal capsule were also evaluated. Fifteen of 24 cases (63%) were assigned to group 1 (4 proximal MCA(M1) occlusion and 11 stenosis), and five of 24 (21%) with M1 occlusions to group 2. Group 3 comprised only one case with M1 occlusion. Two cases with both occlusion and stenosis were included in group 4, and only one case-with M1 stenosis-in group 5. Infarctions at the caudate nucleus were seen in five cases, and at the internal capsule in two. On conventional angiography (13 cases) cortical branches of the MCA were delineated through the leptomeningeal collaterals of anterior or posterior cerebral arteries. Most large deep cerebral infarctions found in proximal MCA diseases are thought to extend cephalad to the corona radiata. When large deep-seated infarctions with proximal MCA occlusion is observed more frequently than stenosis.=20

  17. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr {approx} 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1{approx}9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI.

  18. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    International Nuclear Information System (INIS)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui

    2007-01-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr ∼ 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1∼9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI

  19. Occupancy of pramipexole (Sifrol at cerebral dopamine D2/3 receptors in Parkinson's disease patients

    Directory of Open Access Journals (Sweden)

    Angela Deutschländer

    2016-01-01

    Full Text Available Whereas positron emission tomography (PET with the antagonist ligand [18F]fallypride reveals the composite of dopamine D2 and D3 receptors in brain, treatment of Parkinson's disease (PD patients with the D3-prefering agonist pramipexole should result in preferential occupancy in the nucleus accumbens, where the D3-subtype is most abundant. To test this prediction we obtained pairs of [18F]fallypride PET recordings in a group of nine PD patients, first in a condition of treatment as usual with pramipexole (ON-Sifrol; 3 × 0.7 mg p.d., and again at a later date, after withholding pramipexole 48–72 h (OFF-Sifrol; in that condition the serum pramipexole concentration had declined by 90% and prolactin levels had increased four-fold, in conjunction with a small but significant worsening of PD motor symptoms. Exploratory comparison with historical control material showed 14% higher dopamine D2/3 availability in the more-affected putamen of patients OFF medication. On-Sifrol there was significant (p ˂ 0.01 occupancy at [18F]fallypride binding sites in globus pallidus (8% thalamus (9% and substantia nigra (19%, as well as marginally significant occupancy in frontal and temporal cortex of patients. Contrary to expectation, comparison of ON- and OFF-Sifrol results did not reveal any discernible occupancy in nucleus accumbens, or elsewhere in the extended striatum; present methods should be sensitive to a 10% change in dopamine D2/3 receptor availability in striatum; the significant findings elsewhere in the basal ganglia and in cerebral cortex are consistent with a predominance of D3 receptors in those structures, especially in substantia nigra, and imply that therapeutic effects of pramipexole may be obtained at sites outside the extended striatum.

  20. Laboratory and Genetic Biomarkers Associated with Cerebral Blood Flow Velocity in Hemoglobin SC Disease

    Directory of Open Access Journals (Sweden)

    Rayra Pereira Santiago

    2017-01-01

    Full Text Available Reference values for cerebral blood flow velocity (CBFV in hemoglobin SC disease (HbSC have not been established. We aimed to investigate associations between laboratory and genetic biomarkers associated with CBFV in HbSC children. Sixty-eight HbSC children were included; CBFV was analyzed by transcranial Doppler, and the time-averaged maximum mean velocity (TAMMV was estimated. Hematological, biochemical, immunological, and genetic analyses were performed. TAMMV was negatively correlated with red blood cell count (RBC count, hemoglobin, hematocrit, and direct bilirubin (DB, yet positively correlated with monocytes and ferritin. We found that children with TAMMV ≥ 128 cm/s had decreased red blood cell distribution width (RDW and nitric oxide metabolite (NOx concentration. Children with TAMMV ≥ 143.50 cm/s had decreased hemoglobin and hematocrit, as well as increased ferritin levels. Decreased hemoglobin, hematocrit, RDW, and NOx and increased ferritin were detected in children with TAMMV ≥ 125.75 cm/s. The CAR haplotype was associated with higher TAMMV. In association analyses, RBC, hemoglobin, hematocrit, RDW, monocyte, DB, NOx, and ferritin, as well as the CAR haplotype, were found to be associated with higher TAMMV in HbSC children. Multivariate analysis suggested that high TAMMV was independently associated with hematocrit, RDW, and NOx. Additional studies are warranted to validate the establishment of a cutoff value of 125.75 cm/s associated with elevated TAMMV in HbSC children.

  1. Effect of dialysis on cerebral blood flow in depressive end-stage renal disease patients

    International Nuclear Information System (INIS)

    Nam, Hyun-Yeol; Kim, Seong-Jang; Song, Sang-Heon

    2011-01-01

    The aim of this study was to investigate regional cerebral blood flow (rCBF) changes of end-stage renal disease (ESRD) patients with depressive symptoms during dialysis. Fourteen patients with ESRD underwent Tc-99m ethylcysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) and were evaluated the severity of depressive mood at pre-dialytic period and at least 6 months after dialysis initiation. rCBF was analyzed using statistical parametric mapping (SPM) in brain SPECT image. The responder was defined as a decrease of ≥25% in Hamilton Depression Rating Scale (HDRS) score from baseline HDRS score. Pre-dialysis brain SPECT did not show any rCBF differences between responders and non-responders. The follow-up brain SPECT revealed a significant higher perfusion in left middle temporal gyrus of responder group when compared with non-responder (hemisphere coordinate X, Y, Z; -58, -2, -16, peak Z=3.36, p=0.046). In responder, a significant increase in rCBF was found in right parahippocampal gyrus (hemisphere coordinate X, Y, Z; 30, -40, -14, peak Z=3.51, p=0.043). In non-responder, there were significant decreases in rCBF in left superior frontal gyrus (hemisphere coordinate X, Y, Z; -22, 30, 42, peak Z=3.86, p=0.032) and right orbitofrontal cortex (hemisphere coordinate X, Y, Z; 10, 58, -6, peak Z=3.81, p=0.046). The present findings showed the characteristic patterns of rCBF changes in depressive ESRD patients having maintenance dialysis. Further investigations in brain blood flow and glucose metabolism are needed to elucidate the effect of dialysis itself and the difference of according to dialysis modality in patients having depression and ESRD. (author)

  2. Monoclonal antibody identification of subpopulations of cerebral cortical neurons affected in Alzheimer's disease

    International Nuclear Information System (INIS)

    Miller, C.A.; Rudnicka, M.; Hinton, D.R.; Blanks, J.C.; Kozlowski, M.

    1987-01-01

    Neuronal degeneration is one of the hallmarks of Alzheimer's disease (AD). Given the paucity of molecular markers available for the identification of neuronal subtypes, the specificity of neuronal loss within the cerebral cortex has been difficult to evaluate. With a panel of four monoclonal antibodies (mAbs) applied to central nervous system tissues from AD patients, the authors have immunocytochemically identified a population of vulnerable cortical neurons; a subpopulation of pyramidal neurons is recognized by mAbs 3F12 and 44.1 in the hippocampus and neocortex, and clusters of multipolar neurons in the entorhinal cortex reactive with mAb 44.1 show selective degeneration. Closely adjacent stellate-like neurons in these regions, identified by mAb 6A2, show striking preservation in AD. The neurons recognized by mAbs 3F12 and 44.1 do not comprise a single known neurotransmitter system. mAb 3A4 identifies a phosphorylated antigen that is undetectable in normal brain but accumulates early in the course of AD in somas of vulnerable neurons. Antigen 3A4 is distinct from material reactive with thioflavin S or antibody generated against paired helical filaments. Initially, antigen 3A4 is localized to neurons in the entorhinal cortex and subiculum, later in the association neocortex, and, ultimately in cases of long duration, in primary sensory cortical regions. mAb 3F12 recognizes multiple bands of immunoblots of homogenates of normal and AD cortical tissues, whereas mAb 3A4 does not bind to immunoblots containing neurofilament proteins or brain homogenates from AD patients. Ultrastructurally, antigen 3A4 is localized to paired-helical filaments. Using these mAbs, further molecular characterization of the affected cortical neurons is now possible

  3. Involvement of the reward network is associated with apathy in cerebral small vessel disease.

    Science.gov (United States)

    Lisiecka-Ford, Danuta M; Tozer, Daniel J; Morris, Robin G; Lawrence, Andrew J; Barrick, Thomas R; Markus, Hugh S

    2018-05-01

    Apathy is a common yet under-recognised feature of cerebral small vessel disease (SVD), but its underlying neurobiological basis is not yet understood. We hypothesized that damage to the reward network is associated with an increase of apathy in patients with SVD. In 114 participants with symptomatic SVD, defined as a magnetic resonance imaging confirmed lacunar stroke and confluent white matter hyperintensities, we used diffusion tensor imaging tractography to derive structural brain networks and graph theory to determine network efficiency. We determined which parts of the network correlated with apathy symptoms. We tested whether apathy was selectively associated with involvement of the reward network, compared with two "control networks" (visual and motor). Apathy symptoms negatively correlated with connectivity in network clusters encompassing numerous areas of the brain. Network efficiencies within the reward network correlated negatively with apathy scores; (r = - 0.344, p < 0.001), and remained significantly correlated after co-varying for the two control networks. Of the three networks tested, only variability in the reward network independently explained variance in apathetic symptoms, whereas this was not observed for the motor or visual networks. The analysis refers only to cerebrum and not cerebellum. The apathy measure is derivative of depression measure. Our results suggest that reduced neural efficiency, particularly in the reward network, is associated with increased apathy in patients with SVD. Treatments which improve connectivity in this network may improve apathy in SVD, which in turn may improve psychiatric outcome after stroke. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Relation between clinical findings and progression of cerebral cortical pathology in MM1-type sporadic Creutzfeldt-Jakob disease: proposed staging of cerebral cortical pathology.

    Science.gov (United States)

    Iwasaki, Yasushi; Tatsumi, Shinsui; Mimuro, Maya; Kitamoto, Tetsuyuki; Hashizume, Yoshio; Yoshida, Mari

    2014-06-15

    In our pathologic observation of the cerebral cortex including the neocortex, hippocampus, and limbic cortex in 43 Japanese patients with MM1-type sporadic Creutzfeldt-Jakob disease, the earliest pathologic finding was spongiform change and next was gliosis. Subsequently, neuropil rarefaction appeared, followed by neuron loss. On the basis of these observations, we propose the following cortical pathologic staging: Stage I, spongiform change; Stage II, hypertrophic astrocytosis; Stage III, neuropil rarefaction; Stage IV, neuron loss; Stage V, status spongiosus; and Stage VI, large cavity formation. We also suggest a more simple staging classification: Stages I and II, mild; Stages III and IV, moderate; and Stages V and VI, severe involvement. Based on statistical analysis of the cases, strong correlation coefficients were obtained between the neocortical and limbic pathologic stage and both total disease duration and brain weight. We estimated that the first observation times of cortical hyperintensity on diffusion-weighted images of magnetic resonance imaging, myoclonus, and periodic sharp wave complexes on the electroencephalogram approximately correspond to the early phase of Stage II of the neocortex. The time to reach the akinetic mutism state approximately corresponds to the middle phase of Stage II of the neocortex. Therefore, we think that approximate clinical manifestations at death, total disease duration, and brain weight can be estimated according to the pathologic stage of the neocortex or limbic cortex. Panencephalopathic-type pathology appeared approximately 12 months after disease onset, and this time approximately corresponds to the middle phase of Stage III of the neocortex. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Demonstration of cerebral vessels by multiplane computed cerebral angiotomography

    International Nuclear Information System (INIS)

    Asari, Syoji; Satoh, Toru; Sakurai, Masaru; Yamamoto, Yuji; Sadamoto, Kazuhiko.

    1981-01-01

    1. Cerebral arteries and veins were demonstrated by multiplane computed cerebral angiotomography [combination of axial, modified coronal, half axial (Towne), and semisagittal planes]. The vessels which were demonstrated by various planes were as follows: Axial plane: Willis ring, middle cerebral arteries (horizontal and insular portions), anterior cerebral arteries (Horizontal and ascending portions), posterior cerebral arteries, basal vein of Rosenthal, internal cerebral veins (and the subependymal veins which join the ICV), and vein of Galen. Coronal plane: intermal carotid arteries (supraclinoid portion), anterior cerebral arteries (horizontal portion), middle cerebral arteries (horizontal and insular portions), lenticulostriate arteries, basal vein of Rosenthal (and the subependymal veins which join this vessel), internal cerebral veins, and vein of Galen. Half axial plane (Towne projection): basilar artery, vertebral arteries, posterior cerebral arteries, superior cerebellar arteries, middle cerebral arteries (horizontal portion), and anterior cerebral arteries (horizontal and ascending portions). Semisagittal plane: internal carotid artery (supraclinoid portion), posterior communicating artery, posterior carebral artery, superior cerebellar artery, internal cerebral vein, basal vein of Rosenthal, vein of Galen, and straight shinus. 2. A detailed knowledge of normal cerebrovascular structures acquired by computed tomography (CT) is essential in detecting and more precisely localizing lesions such as cerebrovascular disease, neoplasm or abscess, in differentiating these lesions from the normal contrast-enhanced structures, and in understanding the spatial relationship between the mass lesion and the neighboring vessels. In addition, it will be possible to discover such asymptomatic cerebrovascular diseases as non-ruptured aneurysms, arteriovenous malformations, and Moyamoya disease by means of computed cerebral angiotomography. (author)

  6. Cerebral Small Vessel Disease and Risk of Death, Ischemic Stroke, and Cardiac Complications in Patients With Atherosclerotic Disease The Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) Study

    NARCIS (Netherlands)

    Conijn, Mandy M. A.; Kloppenborg, Raoul P.; Algra, Ale; Mali, Willem P. Th M.; Kappelle, L. Jaap; Vincken, Koen L.; van der Graaf, Yolanda; Geerlings, Mirjam I.

    2011-01-01

    Background and Purpose-Cerebral small vessel disease may be related to vascular and nonvascular pathology. We assessed whether lacunar infarcts and white matter lesions on MRI increased the risk of vascular and nonvascular death and future vascular events in patients with atherosclerotic disease.

  7. Luminance contrast of a visual stimulus modulates the BOLD response more than the cerebral blood flow response in the human brain.

    Science.gov (United States)

    Liang, Christine L; Ances, Beau M; Perthen, Joanna E; Moradi, Farshad; Liau, Joy; Buracas, Giedrius T; Hopkins, Susan R; Buxton, Richard B

    2013-01-01

    The blood oxygenation level dependent (BOLD) response measured with functional magnetic resonance imaging (fMRI) depends on the evoked changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO(2)) in response to changes in neural activity. This response is strongly modulated by the CBF/CMRO(2) coupling relationship with activation, defined as n, the ratio of the fractional changes. The reliability of the BOLD signal as a quantitative reflection of underlying physiological changes depends on the stability of n in response to different stimuli. The effect of visual stimulus contrast on this coupling ratio was tested in 9 healthy human subjects, measuring CBF and BOLD responses to a flickering checkerboard at four visual contrast levels. The theory of the BOLD effect makes a robust prediction-independent of details of the model-that if the CBF/CMRO(2) coupling ratio n remains constant, then the response ratio between the lowest and highest contrast levels should be higher for the BOLD response than the CBF response because of the ceiling effect on the BOLD response. Instead, this response ratio was significantly lower for the BOLD response (BOLD response: 0.23 ± 0.13, mean ± SD; CBF response: 0.42 ± 0.18; p=0.0054). This data is consistent with a reduced dynamic range (strongest/weakest response ratio) of the CMRO(2) response (~1.7-fold) compared to that of the CBF response (~2.4-fold) as luminance contrast increases, corresponding to an increase of n from 1.7 at the lowest contrast level to 2.3 at the highest contrast level. The implication of these results for fMRI studies is that the magnitude of the BOLD response does not accurately reflect the magnitude of underlying physiological processes. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Efficacy of superficial temporal artery-middle cerebral artery bypass in cerebrovascular steno-occlusive diseases: Hemodynamics assessed by perfusion computed tomography.

    Science.gov (United States)

    Kwon, Woo-Keun; Kwon, Taek-Hyun; Park, Dong-Hyuk; Kim, Joo-Han; Ha, Sung-Kon

    2017-01-01

    Our purpose of this study was to assess the cerebral hemodynamic improvement with perfusion computed tomography (CT), before and after superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery in patients with cerebrovascular steno-occlusive diseases including both moyamoya disease and nonmoyamoya steno-occlusions. Twenty-four STA-MCA bypasses were performed to 22 patients with symptomatic cerebrovascular steno-occlusive diseases, including both moyamoya disease and nonmoyamoya steno-occlusive diseases. Brain perfusion CT images were obtained before and after the bypass surgery. The relative parameters such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) derived from the perfusion CT were collected and analyzed to assess the efficacy of STA-MCA bypass. The CBF increased, and MTT decreased after the bypass surgery in both moyamoya group and nonmoyamoya group. The increase of CBF in nonmoyamoya group and the decrease of MTT delay in moyamoya group, overall group were statistically significant ( P cerebrovascular steno-occlusive diseases, such as moyamoya disease and internal carotid artery/MCA steno-occlusion. And perfusion CT can be used as an effective quantitative modality to assess the cerebral perfusion before and after the STA-MCA bypass surgery.

  9. Cerebral responses and role of the prefrontal cortex in conditioned pain modulation: an fMRI study in healthy subjects

    Science.gov (United States)

    Bogdanov, Volodymyr B.; Viganò, Alessandro; Noirhomme, Quentin; Bogdanova, Olena V.; Guy, Nathalie; Laureys, Steven; Renshaw, Perry F.; Dallel, Radhouane; Phillips, Christophe; Schoenen, Jean

    2017-01-01

    The mechanisms underlying conditioned pain modulation (CPM) are multifaceted. We searched for a link between individual differences in prefrontal cortex activity during multi-trial heterotopic noxious cold conditioning and modulation of the cerebral response to phasic heat pain. In 24 healthy female subjects, we conditioned laser heat stimuli to the left hand by applying alternatively ice-cold or lukewarm compresses to the right foot. We compared pain ratings with cerebral fMRI BOLD responses. We also analyzed the relation between CPM and BOLD changes produced by the heterotopic cold conditioning itself, as well as the impact of anxiety and habituation of cold-pain ratings. Specific cerebral activation was identified in precuneus and left posterior insula/SII, respectively, during early and sustained phases of cold application. During cold conditioning, laser pain decreased (n = 7), increased (n = 10) or stayed unchanged (n = 7). At the individual level, the psychophysical effect was directly proportional to the cold-induced modulation of the laser-induced BOLD response in left posterior insula/SII. The latter correlated with the BOLD response recorded 80 s earlier during the initial 10-s phase of cold application in anterior cingulate, orbitofrontal and lateral prefrontal cortices. High anxiety and habituation of cold pain were associated with greater laser heat-induced pain during heterotopic cold stimulation. The habituation was also linked to the early cold-induced orbitofrontal responses. We conclude that individual differences in conditioned pain modulation are related to different levels of prefrontal cortical activation by the early part of the conditioning stimulus, possibly due to different levels in trait anxiety. PMID:25461267

  10. Significance of visual hallucinations and cerebral hypometabolism in the risk of dementia in Parkinson's disease patients with mild cognitive impairment.

    Science.gov (United States)

    Gasca-Salas, Carmen; Clavero, Pedro; García-García, David; Obeso, José A; Rodríguez-Oroz, María C

    2016-03-01

    Mild cognitive impairment (MCI) and visual hallucinations (VH) are common co-morbidities and risk factors for dementia in Parkinson's disease (PD). The relative value of each of them in the progression to dementia is unknown. We investigated cognitive impairment and cerebral hypometabolism in PD-MCI patients with VH (VH-positive) and without (VH-negative). Twenty-one PD-MCI patients (12 VH-negative, nine VH-positive) and 19 controls were studied using a comprehensive neuropsychological battery and [18F]-Fluorodeoxyglucose positron emission tomography (FDG-PET). The neuropsychological assessment was repeated after 30 months. Regional FDG uptake was analyzed using statistical parametric mapping. VH-positive patients had lower FDG uptake bilaterally in the occipital, and parietal cortex, right temporal lobe and in the left cingulum compared with VH-negative patients. The two groups showed no significant differences in clinical characteristics and cognitive status at baseline. After 30 months of follow-up, three (25%) and four (50%) of the VH-negative and VH-positive patients, respectively, had progressed to dementia. Even in the absence of significant cognitive differences, PD-MCI patients with VH exhibit more severe cerebral hypometabolism and had a higher rate of progression to dementia than VH-negative patients, supporting the importance of VH and cerebral hypometabolism in establishing the risk of dementia in PD-MCI. © 2015 Wiley Periodicals, Inc.

  11. MDCTA diagnosis of cerebral vessel disease among patients with arterial hypertension

    International Nuclear Information System (INIS)

    Romanko-Hrushchak, Nataliya

    2013-01-01

    to study changes involving cerebral vessels in patients with hypertension and various levels of total cardiovascular risk. One hundred and thirty-four patients underwent CT-angiography of intracranial vessels. Ninety-eight of them were diagnosed with hypertension. Taking into consideration high blood pressure, presence of risk factors and target organ damage subjects were divided into 4 groups: with low, medium, high and very high total cardiovascular risk. Control group included 36 patients. They were not diagnosed with hypertension at the time of examination. One hundred and five patients were examined using a 4-slice CT scanner (Toshiba Asteion 4, Toshiba Medical System, Japan), and 29 patients were examined using a 128-slice scanner (Siemens Definition AS+, Siemens Healthcare, Germany) with an injection system. We used iodine-containing contrast agents such as iodixanol and iopromide for angiography. Anatomical and topographic changes of cerebral vessels were most frequently found in hypertensive patients with high and very high total cardiovascular risk. Narrowing of vertebral vessels was the most common change (27 patients (27.55%), 21 patients (21.43%) had narrowing of the right artery, and 6 (6.12%) subjects – of the left one). Tortuous course of internal carotid arteries at the neck level was visualized in 11 patients (11.22%). Narrowing of A1 segment of anterior cerebral artery was noted in 9 patients (9.18%), of the right one – in 8 patients (8.16%), of the left one – in 1 patient (1.02%). Aneurysmal dilation of intracranial vessels was visualized in 6 patients (6.12%). Saccular aneurysm of left internal carotid artery was diagnosed in 2 patients (2.04%), one patient (1.02%) had right internal carotid artery aneurysm and one patient (1.02%) had an aneurysm of the basilar artery. the most common changes of cerebral vessels diagnosed in MDCTA among patients with hypertension included various degrees of narrowing of vertebral vessels, anterior

  12. Non-invasive near-infrared fluorescence imaging of the neutrophil response in a mouse model of transient cerebral ischaemia.

    Science.gov (United States)

    Vaas, Markus; Enzmann, Gaby; Perinat, Therese; Siler, Ulrich; Reichenbach, Janine; Licha, Kai; Kipar, Anja; Rudin, Markus; Engelhardt, Britta; Klohs, Jan

    2017-08-01

    Near-infrared fluorescence (NIRF) imaging enables non-invasive monitoring of molecular and cellular processes in live animals. Here we demonstrate the suitability of NIRF imaging to investigate the neutrophil response in the brain after transient middle cerebral artery occlusion (tMCAO). We established procedures for ex vivo fluorescent labelling of neutrophils without affecting their activation status. Adoptive transfer of labelled neutrophils in C57BL/6 mice before surgery resulted in higher fluorescence intensities over the ischaemic hemisphere in tMCAO mice with NIRF imaging when compared with controls, corroborated by ex vivo detection of labelled neutrophils using fluorescence microscopy. NIRF imaging showed that neutrophils started to accumulate immediately after tMCAO, peaking at 18 h, and were still visible until 48 h after reperfusion. Our data revealed accumulation of neutrophils also in extracranial tissue, indicating damage in the external carotid artery territory in the tMCAO model. Antibody-mediated inhibition of α4-integrins did reduce fluorescence signals at 18 and 24, but not at 48 h after reperfusion, compared with control treatment animals. Antibody treatment reduced cerebral lesion volumes by 19%. In conclusion, the non-invasive nature of NIRF imaging allows studying the dynamics of neutrophil recruitment and its modulation by targeted interventions in the mouse brain after transient experimental cerebral ischaemia.

  13. Visualization of posture-dependent cerebral blood flow in a patient with Takayasu's disease by means of 99mTc-HMPAO brain single photon emission tomography

    International Nuclear Information System (INIS)

    Hayashida, Kohei; Hirose, Yoshiaki; Kaminaga, Tatsurou; Imakita, Satoshi; Uehara, Toshiisa; Nishimura, Tsunehiko; Osaka Univ.

    1992-01-01

    A case of Takayasu's disease in a 22-year-old woman who complained of severe fainting attacks is presented. Bilateral obstruction of the cervical arteries was confirmed by digital subtraction angiography. Preoperative technetium-99m hexamethylpropylene amine oxime brain SPET in the sitting position showed bilateral hypoactivity in the temporoparietal areas. Subtraction brain SPET showed slightly increased activity in the lying position. The patient has had no fainting attacks since bypass surgery. Postoperative 99m Tc-HMPAO brain SPET in the sitting position showed normal activity except in the right temporoparietal area. This area was filled in the lying position. 99m Tc-HMPAO brain SPET is the only technique that can visualize the cerebral blood flow in any position, this capability deriving on the fact that the distribution, of 99m Tc-HMPAO in the brain is fixed in the first 2-3 min following injection. The use of both sitting and lying 99m Tc-HMPAO brain SPET is very useful for detecting an abnormality (i.e. an inhomogeneous response due to the fall in perfusion pressure) that could not be seen if the cerebral blood flow were to be assessed only in the lying position. (orig.)

  14. Electromyographic, cerebral and muscle hemodynamic responses during intermittent, isometric contractions of the biceps brachii at three submaximal intensities

    Directory of Open Access Journals (Sweden)

    Yagesh eBhambhani

    2014-06-01

    Full Text Available This study examined the electromyographic, cerebral and muscle hemodynamic responses during intermittent isometric contractions of biceps brachii at 20%, 40% and 60% of maximal voluntary contraction (MVC. Eleven volunteers completed two minutes of intermittent isometric contractions (12/min at an elbow angle of 90° interspersed with three minutes rest between intensities in systematic order. Surface electromyography (EMG was recorded from the right biceps brachii and near infrared spectroscopy (NIRS was used to simultaneously measure left prefrontal and right biceps brachii oxyhemoglobin (HbO2, deoxyhemoglobin (HHb and total hemoglobin (Hbtot. Transcranial Doppler ultrasound was used to measure middle cerebral artery velocity (MCAv bilaterally. Finger photoplethysmography was used to record beat-to-beat blood pressure and heart rate. EMG increased with force output from 20% to 60% MVC (P0.05. MCAv increased from rest to exercise but was not different among intensities (P>0.05. Force output correlated with the root mean square EMG and changes in muscle HbO2 (P0.05 at all three intensities. Force output declined by 8% from the 1st to the 24th contraction only at 60% MVC and was accompanied by systematic increases in RMS, cerebral HbO2 and Hbtot with a levelling off in muscle HbO2 and Hbtot. These changes were independent of alterations in mean arterial pressure. Since cerebral blood flow and oxygenation were elevated at 60% MVC, we attribute the development of fatigue to reduced muscle oxygen availability rather than impaired central n

  15. The endoplasmic reticulum stress response in disease ...

    African Journals Online (AJOL)

    These proteins are essential for cell survival, and intuitively the ER must activate stress responses to evade immediate cell dysfunction as the cell processes lag behind. This review will discuss mainly the ER and its role in the pathogenesis and pathophysiology of epidemiologically-relevant diseases, as well as updates on ...

  16. Integrated Disease Surveillance and Response Reporting

    African Journals Online (AJOL)

    stage sampling technique was used to select a sample of 216 primary healthcare workers in. Mangu and Jos South Local ... The intervention group received the training throughout the study and the control at the end. ... Key Words: Training, Integrated Disease Surveillance Response Reporting. Correspondence: Dr Lar, LA ...

  17. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo

    1998-01-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ) were measured using the steady-state 15 O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson's disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean±SD, 51.8±3.7) and the duration of the illness ranged from 10 to 48 months (mean±SD, 28.8±15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson's Disease Rating Scale decreased from 35.1 (SD±11.3) to 25.7 (SD±11.6). The cognitive function assessed by Hasegawa's dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO 2 decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO 2 significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson's disease. (author)

  18. Cerebral blood velocity and other cardiovascular responses to 2 days of head-down tilt

    Science.gov (United States)

    Frey, Mary A. B.; Mader, Thomas H.; Bagian, James P.; Charles, John B.; Meehan, Richard T.

    1993-01-01

    Spaceflight induces a cephalad redistribution of fluid volume and blood flow within the human body, and space motion sickness, which is a problem during the first few days of space flight, could be related to these changes in fluid status and in blood flow of the cerebrum and vestibular system. To evaluate possible changes in cerebral blood flow during simulated weightlessness, we measured blood velocity in the middle cerebral artery (MCA) along with retinal vascular diameters, intraocular pressure, impedance cardiography, and sphygmomanometry on nine men (26.2 +/- 6.6 yr) morning and evening for 2 days during continuous 10 deg head-down tilt (HDT). When subjects went from seated to head-down bed rest, their heart rate and retinal diameters decreased, and intraocular pressures increased. After 48 h of HDT, blood flow velocity in the MCA was decreased and thoracic impedance was increased, indicating less fluid in the thorax. Percent changes in blood flow velocities in the MCA after 48 h of HDT were inversely correlated with percent changes in retinal vascular diameters. Blood flow velocities in the MCA were inversely correlated (intersubject) with arterial pressures and retinal vascular diameters. Heart rate, stroke volume, cardiac output, systolic arterial pressure, and at times pulse pressure and blood flow velocities in the MCA were greater in the evening. Total peripheral resistance was higher in the morning. Although cerebral blood velocity is reduced after subjects are head down for 2 days, the inverse relationship with retinal vessel diameters, which have control analogous to that of cerebral vessels, indicates cerebral blood flow is not reduced.

  19. Cellular and substrate adhesion molecules (integrins) and their ligands in cerebral amyloid plaques in Alzheimer's disease

    NARCIS (Netherlands)

    Eikelenboom, P.; Zhan, S. S.; Kamphorst, W.; van der Valk, P.; Rozemuller, J. M.

    1994-01-01

    Integrins belonging to different subfamilies can be identified immunohistochemically in cerebral amyloid plaques. Monoclonal antibodies against the VLA family beta 1-integrins show staining of the corona of classical amyloid plaques for beta 1, alpha 3 and alpha 6. Immunostaining reveal also the

  20. Reversibility of cerebral ischaemia. Dynamic and xenon computed tomography study on ischaemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Ujiie, H.; Oikawa, A.; Satoh, K.; Onda, H.; Kagawa, M.; Takakura, K.; Kakinoki, Y.; Ono, Y.; Kobayashi, N.

    1994-01-01

    Flow studies using dynamic CT and xenon (Xe) CT were carried out in 25 patients with ischaemic stroke in the territory of the middle cerebral artery to define the clinical characteristics of cerebral ischaemia at a chronic stage. The parameter of peak height/mean transit time (PH/MTT) obtained from dynamic CT can provide an accurate index for blood circulation in the cerebral vascular bed. Xe CT measurements revealed various kinds of ischaemia around the infarction even in the chronic stages. In mild ischaemia of more than 30 ml/100 g/min, reduction of cerebral blood flow (CBF) was well correlated to the PH/MTT. However, in severe ischaemia between 20 and 30 ml/100 g/ min, changes of CBF were no longer correlated with the pH/MTT. There were cases showing severe reduction of CBF but which showed sufficient blood circulation (moderate value of PH/MTT). Mild reductions of CBF in parallel with decreased blood supply were often found in the peri-infarct area of infarctions in the centrum semiovale. On the other hand, infarctions in the cortico-subcortical region showed severe ischaemia, in even where blood circulation was relatively well sustained

  1. Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Thomsen, C

    2015-01-01

    stable adult patients with CCHD with a medical questionnaire, blood samples, MRI of the cerebrum (n=72), multidetector CT imaging (MDCT) of the thorax (n=76) and pulmonary scintigraphy (ventilation/perfusion/single-photon emission computerised tomography/CT) (n=66). The prevalence of cerebral infarction...

  2. Rhino cerebral mucormycosis in a patient with a myelodysplastic syndrome: Disease course as studied by CT

    International Nuclear Information System (INIS)

    Martin, M.T.; Marcos, F.; Villanueva, J.M.; Vicente, L.

    1996-01-01

    A case of richinocerebral mucormycosis is reported a patient with refractory sideroblastic anemia assessed by means of serial CT; the disorder initially mimicked bacterial rhino sinusitis, coursing later with sinonasal necrosis, orbital involvement and, finally, cerebral involvement. The CT findings are compared with those described in the literature. (Author) 8 refs

  3. Regional cerebral blood flow in Parkinson's disease measured with N-isopropyl-p-[123I]iodoamphetamine (IMP) SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Nishihara, Mamiko; Hayashi, Hiroko; Higuchi, Shoichi; Sakai, Kunio; Ishikawa, Atsushi; Ibayashi, Katsuhiko.

    1992-01-01

    N-isopropyl-p-[ 123 I]iodoamphetamine (IMP) SPECT studies were performed on 21 patients (13 females; 45-73 yrs) with idiopathic Parkinson's disease (PD) and 10 age-matched normal controls (39-69 yrs). Regional cerebral blood flow (rCBF) was quantitatively measured by the arterial blood sampling method. When compared with normal controls, global CBF, and rCBF in the frontal cortex and in the basal ganglia were reduced 22.1% (p 123 I-IMP SPECT imaging is useful for evaluation and follow-up of patients with PD. (author)

  4. Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

    International Nuclear Information System (INIS)

    Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y.

    2005-01-01

    Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61±10 vs 61±8), education periods (8.8±4.9 vs 8.8±4.5), and K-MMSE score (27±1.6 vs 27±1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some PD patients

  5. Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y. [Dong-A University College of medicine, Pusan (Korea, Republic of)

    2005-07-01

    Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61{+-}10 vs 61{+-}8), education periods (8.8{+-}4.9 vs 8.8{+-}4.5), and K-MMSE score (27{+-}1.6 vs 27{+-}1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some

  6. Cerebral blood flow and liver function in patients with encephalopathy due to acute and chronic liver diseases

    DEFF Research Database (Denmark)

    Almdal, T; Schroeder, T; Ranek, L

    1989-01-01

    The purpose of the present investigation was to study changes in cerebral blood flow (CBF) in hepatic encephalopathy, to ascertain whether this was related to the changes in liver function and whether these changes gave any prognostic information. CBF, determined by the intravenous xenon-133 method......, and liver functions, assessed by the prothrombin index, bilirubin concentration, and the galactose elimination capacity, were studied in patients with acute fulminant liver failure and in patients with encephalopathy due to chronic liver diseases--that is, cirrhosis of various etiologies. The CBF range...... any differences between patients with acute or chronic liver diseases or the different degrees of hepatic encephalopathy. In conclusion, a marked reduction of the CBF was seen in hepatic encephalopathy, irrespective of the etiology of the disease....

  7. Interplay Between Age, Cerebral Small Vessel Disease, Parenchymal Amyloid-beta, and Tau Pathology: Longitudinal Studies in Hypertensive Stroke-Prone Rats

    NARCIS (Netherlands)

    Schreiber, S; Drukarch, B.; Garz, C.; Niklass, S.; Stanaszek, L.; Kropf, S.; Bueche, C.; Held, F.; Vielhaber, S.; Attems, J.; Reymann, K.G.; Heinze, H.J.; Carare, R.O.; Wilhelmus, M.M.M.

    2014-01-01

    Background: Accumulation of amyloid-β (Aβ) and hyperphosphorylated tau (ptau) accompany cerebral small vessel disease (CSVD) in the aging brain and in Alzheimer's disease. CSVD is characterized by a heterogeneous spectrum of histopathological features possibly initiated by an endothelial dysfunction

  8. Possible roles of transglutaminases in molecular mechanisms responsible for human neurodegenerative diseases

    Directory of Open Access Journals (Sweden)

    Nicola Gaetano Gatta

    2016-11-01

    Full Text Available Transglutaminases are a family of Ca2+-dependent enzymes which catalyze post-translational modifications of proteins. The main activity of these enzymes is the cross-linking of glutaminyl residues of a protein/peptide substrate to lysyl residues of a protein/peptide co-substrate. In addition to lysyl residues, other second nucleophilic co-substrates may include monoamines or polyamines (to form mono- or bi-substituted/crosslinked adducts or –OH groups (to form ester linkages. In absence of co-substrates, the nucleophile may be water, resulting in the net deamidation of the glutaminyl residue. Transglutaminase activity has been suggested to be involved in molecular mechanisms responsible for both physiological or pathological processes. In particular, transglutaminase activity has been shown to be responsible for human autoimmune diseases, Celiac Disease is just one of them. Interestingly, neurodegenerative diseases, such as Alzheimer’s Disease, Parkinson’s Disease, supranuclear palsy, Huntington’s Disease and other polyglutamine diseases, are characterized in part by aberrant cerebral transglutaminase activity and by increased cross-linked proteins in affected brains. This review describes the possible molecular mechanisms by which these enzymes could be responsible for such diseases and the possible use of transglutaminase inhibitors for patients with diseases characterized by aberrant transglutaminase activity.

  9. Assessment of cortical hemodynamics by multichannel near-infrared spectroscopy in steno-occlusive disease of the middle cerebral artery.

    Science.gov (United States)

    Oldag, Andreas; Goertler, Michael; Bertz, Anne-Katrin; Schreiber, Stefanie; Stoppel, Christian; Heinze, Hans-Jochen; Kopitzki, Klaus

    2012-11-01

    In a pilot study we evaluated near-infrared spectroscopy as to its potential benefit in monitoring patients with steno-occlusive disease of a major cerebral artery for alterations in cortical hemodynamics. Cortical maps of time-to-peak (TTP) in 10 patients unilaterally affected by severe stenosis or occlusion of the middle cerebral artery were acquired by multichannel near-infrared spectroscopy after bolus application of indocyanine green. Hemodynamic manifestations were assessed by comparison between affected and unaffected hemisphere and evaluated for common constituents by principal component analysis. In one patient, TTP values were compared with those obtained by dynamic susceptibility contrast imaging. TTP was increased on the affected hemisphere in 9 patients. Mean difference in TTP between hemispheres was 0.44 second (P<0.05) as compared with a mean lateral difference of 0.12 second found in a control group of 10 individuals. In group analysis a significant rise in TTP was found in the distribution of the affected middle cerebral artery, whereas principal component analysis suggests augmentation of hemodynamic effects toward the border zones as a dominant pattern. A linear correlation of 0.61 between TTP values determined by dynamic susceptibility contrast MRI and near-infrared spectroscopy was found to be statistically significant (P<0.001). Multichannel near-infrared spectroscopy might facilitate detection of disease-related hemodynamic changes as yet only accessible by tomographic imaging modalities. Being indicative for hypoperfusion and collateral flow increased values of TTP, as found to a varying extent in the present patient group, might be of clinical relevance.

  10. Iodine-123 IMP SPECT before and after bypass surgery in a patient with occlusion of left anterior and middle cerebral arteries with basal abnormal telangiectasis (unilateral Moyamoya disease)

    International Nuclear Information System (INIS)

    Honda, Norinari; Machida, Kikuo; Takishima, Teruo; Kaizu, Hiroyuki; Sugimoto, Eiichi

    1987-01-01

    A case of left anterior and middle cerebral arterial occlusion with angiographic features similar to Moyamoya disease was reported. IMP SPECT of the patient revealed the success of bypass surgery clearly. The patient complained of transient right hemiparesis with aphasia 4 times. The cerebral arteriography disclosed occlusions of left anterior and middle cerebral arteries at their proximal portions. Right internal carotid and its branches were normal. I-123 IMP SPECT study showed hypoperfusion in left temporal lobe, basal ganglia with incomplete reperfusion on the delayed (4 hours after injection) SPECT images. After the superficial temporal-middle cerebral artery anastomosis, I-123 IMP SPECT showed improvement of the brain blood flow. I-123 IMP SPECT was very useful in detecting the ischemic areas and evaluating the revascularizing surgery in this case. (author)

  11. Metabolic Response of the Cerebral Cortex Following Gentle Sleep Deprivation and Modafinil Administration

    OpenAIRE

    Petit, Jean-Marie; Tobler, Irene; Kopp, Caroline; Morgenthaler, Florence; Borbély, Alexander A.; Magistretti, Pierre J.

    2010-01-01

    STUDY OBJECTIVES The main energy reserve of the brain is glycogen which is almost exclusively localized in astrocytes. We previously reported that cerebral expression of certain genes related to glycogen metabolism changed following instrumental sleep deprivation in mice. Here we extended our investigations to another set of genes related to glycogen and glucose metabolism. We also compared the effect of instrumentally and pharmacologically induced prolonged wakefulness followed (or not) by 3...

  12. Tracking time-varying cerebral autoregulation in response to changes in respiratory PaCO2

    International Nuclear Information System (INIS)

    Liu, Jia; Simpson, M David; Allen, Robert; Yan, Jingyu

    2010-01-01

    Cerebral autoregulation has been studied by linear filter systems, with arterial blood pressure (ABP) as the input and cerebral blood flow velocity (CBFV—from transcranial Doppler Ultrasound) as the output. The current work extends this by using adaptive filters to investigate the dynamics of time-varying cerebral autoregulation during step-wise changes in arterial PaCO 2 . Cerebral autoregulation was transiently impaired in 11 normal adult volunteers, by switching inspiratory air to a CO 2 /air mixture (5% CO 2 , 30% O 2 and 65% N 2 ) for approximately 2 min and then back to the ambient air, causing step-wise changes in end-tidal CO 2 (EtCO 2 ). Simultaneously, ABP and CBFV were recorded continuously. Simulated data corresponding to the same protocol were also generated using an established physiological model, in order to refine the signal analysis methods. Autoregulation was quantified by the time-varying phase lead, estimated from the adaptive filter model. The adaptive filter was able to follow rapid changes in autoregulation, as was confirmed in the simulated data. In the recorded signals, there was a slow decrease in autoregulatory function following the step-wise increase in PaCO 2 (but this did not reach a steady state within approximately 2 min of recording), with a more rapid change in autoregulation on return to normocapnia. Adaptive filter modelling was thus able to demonstrate time-varying autoregulation. It was further noted that impairment and recovery of autoregulation during transient increases in EtCO 2 occur in an asymmetric manner, which should be taken into account when designing experimental protocols for the study of autoregulation

  13. Correlation of methylenetetrahydrofolate reductase polymorphism with Hcy metabolism and inflammatory response in patients with recurrent cerebral infarction

    Directory of Open Access Journals (Sweden)

    Gai-Zhuang Liu

    2017-07-01

    Full Text Available Objective: To study the correlation of methylenetetrahydrofolate reductase (MTHFR polymorphism with Hcy metabolism and inflammatory response in patients with recurrent cerebral infarction. Methods: 40 patients with recurrent cerebral infarction who were treated in Yulin Third Hospital between December 2013 and December 2016 were selected as recurrent group, 58 patients with primary cerebral infarction were selected as primary group, and 60 healthy volunteers were selected as control group. Peripheral blood MTHFR gene C677T polymorphism and serum levels of Hcy metabolism indexes and inflammatory response indicators were determined. Results: CC genotype constituent ratio of recurrent group was significantly lower than that of primary group and control group while CT genotype and TT genotype constituent ratio were significantly higher than those of primary group and control group; serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in recurrent group and primary group were significantly higher than those in control group while VitB12 and FA levels were significantly lower than those in control group; serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in recurrent group were significantly higher than those in primary group while VitB12 and FA levels were significantly lower than those in primary group. Serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in patients with CC genotype were significantly lower than those in patients with CT genotype and TT genotype while VitB12 and FA levels were significantly higher than those in patients with CT genotype and TT genotype; serum Hcy, HMGB1, sCD40L, YKL-40, Lp-PLA2 and MMP-9 levels in patients with CT genotype were significantly lower than those in patients with TT genotype while VitB12 and FA levels were significantly higher than those in patients with TT genotype. Conclusion: MTHFR gene C677T polymorphism is closely related to the recurrence of cerebral infarction, and allele C

  14. Effect of hypoxia on BOLD fMRI response and total cerebral blood flow in migraine with aura patients

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Hougaard, Anders; Schytz, Henrik W

    2018-01-01

    was measured in the visual cortex ROIs V1-V5. Total cerebral blood flow (CBF) was calculated by measuring the blood velocity in the internal carotid arteries and the basilar artery using phase-contrast mapping (PCM) MRI. Hypoxia induced a greater decrease in BOLD response to visual stimulation in V1-V4 in MA......Experimentally induced hypoxia triggers migraine and aura attacks in patients suffering from migraine with aura (MA). We investigated the blood oxygenation level-dependent (BOLD) signal response to visual stimulation during hypoxia in MA patients and healthy volunteers. In a randomized double......-blind crossover study design, 15 MA patients were allocated to 180 min of normobaric poikilocapnic hypoxia (capillary oxygen saturation 70-75%) or sham (normoxia) on two separate days and 14 healthy volunteers were exposed to hypoxia. The BOLD functional MRI (fMRI) signal response to visual stimulation...

  15. Cine gamma-angiography. Aids for the diagnosis of cerebral vascular disease

    International Nuclear Information System (INIS)

    Grasset, Gilles.

    1975-01-01

    Gamma-angioencephalography allows in a simple examination, the bilateral visualization of the injection of the main cerebral vessels, the regional measurement of transit times and, if it occurs, the observation of the diffusion of the tracer in a lesion. These different steps of the investigation are described and its diagnostic value is discussed. Sup(99m)Tc is the radioisotope used. To increase the accuracy of the qualitative data obtained from the gamma camera, a data processing system is used. Regions of interest are selected over the carotid and cerebral middle arteries. Time function curves are generated for each region of interest. From mathematical models, some pathological aspects of transit curves can be explained [fr

  16. Regional differences of relationships between atrophy and glucose metabolism of cerebral cortex in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Toyama, H.; Uemura, K.; Kanekiyo, S.; Ishii, K.; Ishii, K.

    2002-01-01

    Aim: The purpose of this paper is to estimate a correlation between the extent of atrophy and the decline in the brain function measured with PET study among the patients with Alzheimer's disease by each brain lobe. Materials and Methods: Two groups, the normal controls (male: 8, female: 22 age: 62.4±4.9) and the patients with Alzheimer's disease (male: 6, female: 24, age: 65.9±7.2) participated in this study. The extent of atrophy was evaluated from the extracted gyrus on 2D-projection magnetic resonance imaging (MRI) and the cerebral cortical glucose metabolism was assessed on 2D-projection positron emission tomography (PET) image, and then a relationship between the cerebral atrophy and the function was evaluated by each brain lobe extracted automatically. 2D-projection of PET and MR images were made by means of the Mollweide method which keeps the area of the brain surface. In order to extract brain lobes from each subject automatically, the bitmap with different value by each brain lobe was made from a standard brain image and was automatically transformed to match each subject's brain image by using SPM99. A correlation image was generated between 2D-projection images of glucose metabolism and the area of the sulcus and the gyrus extracted from the correlation between MR and PET images clustered by K-means method. Results: The glucose metabolism of Alzheimer's disease was lower than that of normal control subjects at the frontal, parietal, and temporal lobes with the same extent of atrophy as that of the normal. There was high correlation between the area of gyrus and the glucose metabolism, and the correlation tendency of the Alzheimer's disease was steeper than that of the normal control at the parietal lobe. Conclusions: Combined analysis of regional morphology and function may be useful to distinguish pathological process such as early stage of Alzheimer's disease from normal physiological aging

  17. A patient with cerebral Whipple disease with gastric involvement but no gastrointestinal symptoms: a consequence of local protective immunity?

    Science.gov (United States)

    Prüss, Harald; Katchanov, Juri; Zschenderlein, Rolf; Loddenkemper, Christoph; Schneider, Thomas; Moos, Verena

    2007-08-01

    Whipple disease is a granulomatous infectious disease caused by Tropheryma whipplei. The bacteria accumulate within macrophages, preferentially in the intestinal mucosa. Disease manifestation seems to be linked to immunological abnormalities of macrophages. We describe a patient with cerebral Whipple disease who presented with changes in mental status, confusion, inverse sleep-wake cycle, bilateral ptosis and vertical gaze palsy. Endoscopic biopsy sampling revealed Whipple disease in the gastric antrum but not in the duodenum. Whole blood stimulation displayed reactivity to T. whipplei that was at the lower end of healthy controls while reactivity of duodenal lymphocytes was not diminished. We propose that in cases of neurological symptoms suspicious of Whipple disease with normal duodenal and jenunal findings, biopsy sampling should be extended to the gastric mucosa. The robust reactivity of duodenal lymphocytes may have prevented our patient from developing small bowel disease, whereas the impaired reactivity in peripheral blood lymphocytes might yet explain the bacterial spreading to the central nervous system leading to the rare case of predominant neurological symptoms without relevant systemic involvement.

  18. Inhibitory Effect on Cerebral Inflammatory Response following Traumatic Brain Injury in Rats: A Potential Neuroprotective Mechanism of N-Acetylcysteine

    Directory of Open Access Journals (Sweden)

    Gang Chen

    2008-01-01

    Full Text Available Although N-acetylcysteine (NAC has been shown to be neuroprotective for traumatic brain injury (TBI, the mechanisms for this beneficial effect are still poorly understood. Cerebral inflammation plays an important role in the pathogenesis of secondary brain injury after TBI. However, it has not been investigated whether NAC modulates TBI-induced cerebral inflammatory response. In this work, we investigated the effect of NAC administration on cortical expressions of nuclear factor kappa B (NF-κB and inflammatory proteins such as interleukin-1β (IL-1β, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6, and intercellular adhesion molecule-1 (ICAM-1 after TBI. As a result, we found that NF-κB, proinflammatory cytokines, and ICAM-1 were increased in all injured animals. In animals given NAC post-TBI, NF-κB, IL-1β, TNF-α, and ICAM-1 were decreased in comparison to vehicle-treated animals. Measures of IL-6 showed no change after NAC treatment. NAC administration reduced brain edema, BBB permeability, and apoptotic index in the injured brain. The results suggest that post-TBI NAC administration may attenuate inflammatory response in the injured rat brain, and this may be one mechanism by which NAC ameliorates secondary brain damage following TBI.

  19. Analysis And Quantification Of Cerebral Blood Flow As A Possible Biomarker In Early Alzheimer’s Disease

    Energy Technology Data Exchange (ETDEWEB)

    Goñi, I.; Garcia-Eulate, R.; Fernandez Seara, M.A.; Galiano, A.; Vidorreta, M.; Riverol, M.; Zubieta, J.L.

    2016-07-01

    For the past years, a deep research into possible biomarkers has taken place in order to detect Alzheimer’s disease even before earliest symptoms arise. Cerebral Blood Flow (CBF) is among those, and its measurement can be performed by non-invasive Magnetic Resonance Imaging techniques. This practical work is framed into a bigger study which assesses diagnostic ability of CBF by Arterial Spin Labeling (ASL), and has used phasecontrast generated images to quantify CBF by measuring internal carotid (ICA) and vertebral arteries (VA) blood flow. Age, gender and diagnosis-related changes in CBF have been assessed with statistical methods. Therefore, this work aims to determine if CBF is a suitable parameter for discerning different diagnosis groups: twenty-nine control subjects and seventy-one case subjects including Alzheimer’s disease (AD), mild cognitive impairment (MCI) and subjective memory loss (SML) have been studied. (Author)

  20. Generalized cerebral atrophy seen on MRI in a naturally exposed animal model for creutzfeldt-jakob disease

    Directory of Open Access Journals (Sweden)

    Dasanu Constantin A

    2010-11-01

    Full Text Available Abstract Background Magnetic resonance imaging has been used in the diagnosis of human prion diseases such as sCJD and vCJD, but patients are scanned only when clinical signs appear, often at the late stage of disease. This study attempts to answer the questions "Could MRI detect prion diseases before clinical symptoms appear?, and if so, with what confidence?" Methods Scrapie, the prion disease of sheep, was chosen for the study because sheep can fit into a human sized MRI scanner (and there were no large animal MRI scanners at the time of this study, and because the USDA had, at the time of the study, a sizeable sample of scrapie exposed sheep, which we were able to use for this purpose. 111 genetically susceptible sheep that were naturally exposed to scrapie were used in this study. Results Our MRI findings revealed no clear, consistent hyperintense or hypointense signal changes in the brain on either clinically affected or asymptomatic positive animals on any sequence. However, in all 37 PrPSc positive sheep (28 asymptomatic and 9 symptomatic, there was a greater ventricle to cerebrum area ratio on MRI compared to 74 PrPSc negative sheep from the scrapie exposed flock and 6 control sheep from certified scrapie free flocks as defined by immunohistochemistry (IHC. Conclusions Our findings indicate that MRI imaging can detect diffuse cerebral atrophy in asymptomatic and symptomatic sheep infected with scrapie. Nine of these 37 positive sheep, including 2 one-year old animals, were PrPSc positive only in lymph tissues but PrPSc negative in the brain. This suggests either 1 that the cerebral atrophy/neuronal loss is not directly related to the accumulation of PrPSc within the brain or 2 that the amount of PrPSc in the brain is below the detectable limits of the utilized immunohistochemistry assay. The significance of these findings remains to be confirmed in human subjects with CJD.

  1. Benzodiazepine receptor and cerebral blood flow in early Alzheimer's disease. SPECT study using 123I-Iomazenil and 123I-IMP

    International Nuclear Information System (INIS)

    Kitamura, Shin; Koshi, Yasuhiko; Komiyama, Tasuku; Sakayori, Osamu; Komaba, Yuichi; Ohyama, Masashi; Mishina, Masahiro; Tsuganesawa, Toshikazu; Terashi, Akiro

    1996-01-01

    This study was designed to investigate benzodiazepine receptors (BZR) and cerebral blood flow (CBF) in patients with early Alzheimer's disease. Imaging of BZR and measurement of CBF were performed by SPECT using 123 I-Iomazenil (IMZ) and 123 I-IMP respectively, in seven patients with early Alzheimer's disease and five patients with unilateral left cerebral infarction as controls. The values for the normal cerebral hemisphere (ratio to the contralateral cerebellum) in patients with cerebral infarction were adopted as control values. In patients with Alzheimer's disease, the CBF (ratio to cerebellum) decreased significantly in the frontal cortex and the parietal cortex compared with the control values. There was no significant difference in late IMZ SPECT counts (ratio to cerebellum) and washout (the ratio of late-to-early IMZ SPECT counts) between patients with Alzheimer's disease and the controls. However, the late IMZ SPECT counts and washout decreased in one patient with moderate dementia. There was a significant correlation between the severity of dementia and the late IMZ SPECT counts in the temporal cortex and the parietal cortex. These results suggest that benzodiazepine binding sites are relatively well preserved in patients with early Alzheimer's disease, and reduction of the CBF is caused by neuronal dysfunction rather than by neuronal loss. IMZ SPECT study is useful and necessary for clarifying the pathophysiological state in Alzheimer's disease. (author)

  2. FDG PET in non-pharmacological therapy in Alzheimer's disease; cerebral metabolic increase correlates with clinical improvement after cognitive therapy

    International Nuclear Information System (INIS)

    Na, Hae Ri; Kim, Yu Kyeong; Park, Seong Min; Lee, Seung Hyun; Park, Eun Kyung; Lee, Jung Seok; Kim, Sang Yun; Kim, Sang Eun

    2007-01-01

    In management of AD, pharmacological treatment alone using acetylcholinesterase inhibitor (AChEI) is general consensus, and provides beneficial effect to prolong their progression. Combined non-pharmacological therapy, especially cognitive therapy is recently having attention with expectation of improvement in cognitive ability. This study examined the effect of combined cognitive therapy in AD patients who were maintaining AChEI using FDG PET. Four patients (689 yrs) who diagnosed as probable Alzheimer's disease based on the NINCDS-ADRDA criteria participated in this study. 12-week cognitive therapy comprised seven fields to enhance orientation, memory, recall, visuo-motor organization, categorization and behavior modification/sequencing. They received 45-minute sessions twice per week with maintaining their previous medication. Clinical improvement was assessed by comprehensive neuropsychological tests. Two FDG PET studies were performed before cognitive therapy and in the middle of the therapy, and compared to evaluate the effect of cognitive therapy to cerebral metabolism. Two of 4 patients whose initial cognitive impairment was milder had clinical improvement after 12 weeks, the rest who were more severely impaired failed to have clinical improvement. Regional cerebral hypometabolism on initial PET was correlated with their functional status. Follow up PET of two responders demonstrated the increases in regional metabolism in the temporal and/or frontal cortex, which was associated their functional improvement. Cerebral metabolism in poor responders were minimally increased or no changed. This preliminary data suggests that cognitive therapy is potentially useful to stabilize or improve cognitive and functional performance in AD patients with relatively mild cognitive dysfunction. And FDG PET could demonstrate possible candidates for cognitive therapy and the effect of the therapy

  3. Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

    Directory of Open Access Journals (Sweden)

    Renske Uiterwijk

    2016-12-01

    Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

  4. Neuronal apoptosis, metallothionein expression and proinflammatory responses during cerebral malaria in mice

    DEFF Research Database (Denmark)

    Wiese, Lothar; Kurtzhals, Jørgen A L; Penkowa, Milena

    2006-01-01

    BACKGROUND: Cerebral malaria (CM) is an acute encephalopathy in humans due to the infection with Plasmodium falciparum. Neuro-cognitive impairment following CM occurs in about 10% of the treated survivors, while the precise pathophysiological mechanism remains unknown. Metallothionein I + II (MT......-I + II) are increased during CNS pathology and disorders. As previously shown, MT-I + II are neuroprotective through anti-inflammatory, antioxidant and antiapoptotic functions. We have analyzed neuronal apoptosis and MT-I + II expression in brains of mice with experimental CM. METHODS: C57BL/6j mice...

  5. Apparent brain temperature imaging with multi-voxel proton magnetic resonance spectroscopy compared with cerebral blood flow and metabolism imaging on positron emission tomography in patients with unilateral chronic major cerebral artery steno-occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Nanba, Takamasa; Nishimoto, Hideaki; Murakami, Toshiyuki; Fujiwara, Shunrou; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Open and Transdisciplinary Research Initiatives, Osaka (Japan); Sasaki, Makoto; Uwano, Ikuko [Iwate Medical University, Institute for Biomedical Science, Iwate (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Iwate (Japan)

    2017-09-15

    The purpose of the present study was to determine whether apparent brain temperature imaging using multi-voxel proton magnetic resonance (MR) spectroscopy correlates with cerebral blood flow (CBF) and metabolism imaging in the deep white matter of patients with unilateral chronic major cerebral artery steno-occlusive disease. Apparent brain temperature and CBF and metabolism imaging were measured using proton MR spectroscopy and {sup 15}O-positron emission tomography (PET), respectively, in 35 patients. A set of regions of interest (ROIs) of 5 x 5 voxels was placed on an MR image so that the voxel row at each edge was located in the deep white matter of the centrum semiovale in each cerebral hemisphere. PET images were co-registered with MR images with these ROIs and were re-sliced automatically using image analysis software. In 175 voxel pairs located in the deep white matter, the brain temperature difference (affected hemisphere - contralateral hemisphere: ΔBT) was correlated with cerebral blood volume (CBV) (r = 0.570) and oxygen extraction fraction (OEF) ratios (affected hemisphere/contralateral hemisphere) (r = 0.641). We excluded voxels that contained ischemic lesions or cerebrospinal fluid and calculated the mean values of voxel pairs in each patient. The mean ΔBT was correlated with the mean CBF (r = - 0.376), mean CBV (r = 0.702), and mean OEF ratio (r = 0.774). Apparent brain temperature imaging using multi-voxel proton MR spectroscopy was correlated with CBF and metabolism imaging in the deep white matter of patients with unilateral major cerebral artery steno-occlusive disease. (orig.)

  6. Metabolic response of the cerebral cortex following gentle sleep deprivation and modafinil administration.

    Science.gov (United States)

    Petit, Jean-Marie; Tobler, Irene; Kopp, Caroline; Morgenthaler, Florence; Borbély, Alexander A; Magistretti, Pierre J

    2010-07-01

    The main energy reserve of the brain is glycogen, which is almost exclusively localized in astrocytes. We previously reported that cerebral expression of certain genes related to glycogen metabolism changed following instrumental sleep deprivation in mice. Here, we extended our investigations to another set of genes related to glycogen and glucose metabolism. We also compared the effect of instrumentally and pharmacologically induced prolonged wakefulness, followed (or not) by 3 hours of sleep recovery, on the expression of genes related to brain energy metabolism. Sleep deprivation for 6-7 hours. Animal sleep research laboratory. Adults OF1 mice. Wakefulness was maintained by "gentle sleep deprivation" method (GSD) or by administration of the wakefulness-promoting drug modafinil (MOD) (200 mg/kg i.p.). Levels of mRNAs encoding proteins related to energy metabolism were measured by quantitative real-time PCR in the cerebral cortex. The mRNAs encoding protein targeting to glycogen (PTG) and the glial glucose transporter were significantly increased following both procedures used to prolong wakefulness. Glycogenin mRNA levels were increased only after GSD, while neuronal glucose transporter mRNA only after MOD. These effects were reversed after sleep recovery. A significant enhancement of glycogen synthase activity without any changes in glycogen levels was observed in both conditions. These results indicate the existence of a metabolic adaptation of astrocytes aimed at maintaining brain energy homeostasis during the sleep-wake cycle.

  7. An autopsied case of MV2K + C-type sporadic Creutzfeldt-Jakob disease presenting with widespread cerebral cortical involvement and Kuru plaques.

    Science.gov (United States)

    Iwasaki, Yasushi; Saito, Yufuko; Aiba, Ikuko; Kobayashi, Atsushi; Mimuro, Maya; Kitamoto, Tetsuyuki; Yoshida, Mari

    2017-06-01

    MV2-type sporadic Creutzfeldt-Jakob disease (sCJD), which was previously called "Kuru-plaque variant", was gradually revealed to have a wide spectrum and has been classified into three pathological subtypes: MV2K, MV2C and MV2K + C. We herein describe the detailed clinical findings and neuropathologic observations from an autopsied MV2K + C-type Japanese sCJD case with widespread cerebral cortical pathology and Kuru plaques. In the early stages of the disease, the patient exhibited gait disturbance with ataxia and dysarthria as well as gradual appearance of cognitive dysfunction. Diffusion-weighted images (DWI) on MRI revealed extensive cerebral cortical hyperintensity. Pathologic investigation revealed extensive spongiform change in the cerebral cortex, particularly in the deeper layers. Vacuole size varied, and some were confluent. Prion protein (PrP) immunostaining revealed extensive PrP deposition in the cerebral cortex, basal ganglia, thalamus, cerebellum, brainstem and spinal cord. In the cerebral cortex, synaptic-type, Kuru plaque-like, and coarse plaque-type PrP depositions were mainly observed, along with some perivacuolar-type PrP depositions. Kuru plaques and coarse plaque-type PrP depositions also were observed in the cerebellar cortex. PrP gene analysis revealed no mutations, and polymorphic codon 129 exhibited Met/Val heterozygosity. Western blot analysis revealed a mixture of intermediate-type PrP Sc and type 2 PrP Sc . Based on previous reports regarding MV2-type sCJD and the clinicopathologic findings of the present case, we speculated that it may be possible to clinically distinguish each MV2 subtype. Clinical presentation of the MV2K + C subtype includes predominant cerebral cortical involvement signs with ataxia and DWI hyperintensity of the cerebral cortex on MRI. © 2016 Japanese Society of Neuropathology.

  8. [Immune response of Hansen's disease. Review].

    Science.gov (United States)

    Rada, Elsa; Aranzazu, Nacarid; Convit, Jacinto

    2009-12-01

    Hansen's disease presents a wide spectrum of clinical and histopathological manifestations that reflect the nature of the immunological response of the host towards diverse Mycobacterium leprae components. The immunological system, composed by both innate and adaptive immunology, offers protection towards infections of various etiologies, among them bacterial. Bacteria, of course, have developed multiple strategies for evading host defenses, based on either very complex or simple mechanisms, but with a single purpose: to "resist" host attacks and to be able to survive. We have tried to summarize some recent studies in Hansen's disease, with more emphasis in the inmunology area. We think that in the future, all illnesses should also be very strongly related to other important aspects such as the social, environmental and economic, and whose development is not solved in a laboratory.

  9. Correlated regions of cerebral blood flow with clinical parameters in Parkinson's disease. Comparison using 'Anatomy' and 'Talairach Daemon' software

    International Nuclear Information System (INIS)

    Yoon, Hyun Jin; Cheon, Sang Myung; Jeong, Young Jin; Kang, Do Young

    2012-01-01

    We assign the anatomical names of functional activation regions in the brain, based on the probabilistic cyto-architectonic atlas by Anatomy 1.7 from an analysis of correlations between regional cerebral blood flow (rCBF) and clinical parameters of the non-demented Parkinson's disease (PD) patients by statistical parametric mapping (SPM) 8. We evaluated Anatomy 1.7 of SPM toolbox compared to 'Talairach Daemon' (TD) Client 2.4.2 software. One hundred and thirty-six patients (mean age 60.0±9.09 years; 73 women and 63 men) with non-demented PD were selected. Tc-99m-HMPAO brain single-photon emission computed tomography (SPECT) scans were performed on the patients using a two-head gamma-camera. We analyzed the brain image of PD patients by SPM8 and found the anatomical names of correlated regions of rCBF perfusion with the clinical parameters using TD Client 2.4.2 and Anatomy 1.7. The SPM8 provided a correlation coefficient between clinical parameters and cerebral hypoperfusion by a simple regression method. To the clinical parameters were added age, duration of disease, education period, Hoehn and Yahr (H and Y) stage and Korean mini-mental state examination (K-MMSE) score. Age was correlated with cerebral perfusion in the Brodmann area (BA) 6 and BA 3b assigned by Anatomy 1.7 and BA 6 and pyramis in gray matter by TD Client 2.4.2 with p<0.001 uncorrected. Also, assigned significant correlated regions were found in the left and right lobules VI (Hem) with duration of disease, in left and right lobules VIIa crus I (Hem) with education, in left insula (Ig2), left and right lobules VI (Hem) with H and Y, and in BA 4a and 6 with K-MMSE score with p<0.05 uncorrected by Anatomy 1.7, respectively. Most areas of correlation were overlapped by two different anatomical labeling methods, but some correlation areas were found with different names. Age was the most significantly correlated clinical parameter with rCBF. TD Client found the exact anatomical name by the peak

  10. Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen as mechanisms involved in protection against experimental cerebral malaria.

    Science.gov (United States)

    Bastos, Marcele F; Kayano, Ana Carolina A V; Silva-Filho, João Luiz; Dos-Santos, João Conrado K; Judice, Carla; Blanco, Yara C; Shryock, Nathaniel; Sercundes, Michelle K; Ortolan, Luana S; Francelin, Carolina; Leite, Juliana A; Oliveira, Rafaella; Elias, Rosa M; Câmara, Niels O S; Lopes, Stefanie C P; Albrecht, Letusa; Farias, Alessandro S; Vicente, Cristina P; Werneck, Claudio C; Giorgio, Selma; Verinaud, Liana; Epiphanio, Sabrina; Marinho, Claudio R F; Lalwani, Pritesh; Amino, Rogerio; Aliberti, Julio; Costa, Fabio T M

    2018-03-20

    Cerebral malaria (CM) is a multifactorial syndrome involving an exacerbated proinflammatory status, endothelial cell activation, coagulopathy, hypoxia, and accumulation of leukocytes and parasites in the brain microvasculature. Despite significant improvements in malaria control, 15% of mortality is still observed in CM cases, and 25% of survivors develop neurologic sequelae for life-even after appropriate antimalarial therapy. A treatment that ameliorates CM clinical signs, resulting in complete healing, is urgently needed. Previously, we showed a hyperbaric oxygen (HBO)-protective effect against experimental CM. Here, we provide molecular evidence that HBO targets brain endothelial cells by decreasing their activation and inhibits parasite and leukocyte accumulation, thus improving cerebral microcirculatory blood flow. HBO treatment increased the expression of aryl hydrocarbon receptor over hypoxia-inducible factor 1-α (HIF-1α), an oxygen-sensitive cytosolic receptor, along with decreased indoleamine 2,3-dioxygenase 1 expression and kynurenine levels. Moreover, ablation of HIF-1α expression in endothelial cells in mice conferred protection against CM and improved survival. We propose that HBO should be pursued as an adjunctive therapy in CM patients to prolong survival and diminish deleterious proinflammatory reaction. Furthermore, our data support the use of HBO in therapeutic strategies to improve outcomes of non-CM disorders affecting the brain.-Bastos, M. F., Kayano, A. C. A. V., Silva-Filho, J. L., Dos-Santos, J. C. K., Judice, C., Blanco, Y. C., Shryock, N., Sercundes, M. K., Ortolan, L. S., Francelin, C., Leite, J. A., Oliveira, R., Elias, R. M., Câmara, N. O. S., Lopes, S. C. P., Albrecht, L., Farias, A. S., Vicente, C. P., Werneck, C. C., Giorgio, S., Verinaud, L., Epiphanio, S., Marinho, C. R. F., Lalwani, P., Amino, R., Aliberti, J., Costa, F. T. M. Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen

  11. Reasonable Avoidability, Responsibility and Lifestyle Diseases

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    2012-01-01

    In “Health, Luck and Justice” Shlomi Segall argues for a luck egalitarian approach to justice in health care. As the basis for a just distribution he suggests a principle of Reasonable Avoidability, which he takes to imply that we do not have justice-based reasons to treat diseases brought about...... such as smoking and over-eating, nor that responsibility is ultimately irrelevant for the principle of Reasonable Avoidability. Second, I object to an argument of Segall’s, according to which the size of the health-care costs related to smoking and obesity is irrelevant for whether society reasonably can expect...

  12. Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Elderen, Saskia G.C. van; Brandts, A.; Westenberg, J.J.M.; Grond, J. van der; Buchem, M.A. van; Kroft, L.J.M.; Roos, A. de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Tamsma, J.T.; Romijn, J.A.; Smit, J.W.A. [Leiden University Medical Center, Department of Endocrinology, Leiden (Netherlands)

    2010-05-15

    To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM). We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 {+-} 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension. Mean aortic PWV was 7.1 {+-} 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction (ss= -0.406, P = 0.006), LV stroke volume (ss=-0.407, P = 0.001), LV cardiac output (ss= -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts. Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM. (orig.)

  13. Effects of whole blood viscosity and plasma NOx on cardiac function and cerebral blood flow in children with chronic kidney disease

    Science.gov (United States)

    Buyan, Necla; Akçaboy, Meltem; Göktaş, Tayfun; Kula, Serdar; Nazlıel, Bijen; Çakar, Nilgün; Uncu, Nermin; Çelik, Bülent; Erbaş, Deniz

    2017-11-13

    Background/aim: The aim of the study was to investigate the effects of whole blood viscosity and plasma nitric oxide on cerebral and cardiovascular risks associated with chronic kidney disease. Materials and methods: The study group consisted of 40 pediatric patients and 21 healthy control subjects. Hematologic and biochemical variables, viscosity and plasma nitric oxide levels, echocardiographic findings, and middle cerebral artery blood flow velocity were examined. Results: Viscosity values of patients were significantly lower than those of the control group. Lower values of hematocrit, total protein, and albumin and higher values of ferritin in all patient groups resulted in significantly low viscosity levels. Plasma nitric oxide levels were higher in all patient groups than those in the controls. No statistically significant difference was present in middle cerebral artery blood flow velocity between the patient and control groups. Even when systolic functions were normal, the patient group had significant deterioration in diastolic functions, suggesting morbidity and mortality risks. Conclusions: Cerebral blood flow velocities were not affected by viscosity and nitric oxide levels, suggesting that cerebral circulation has the ability to make adaptive modulation. The metabolism of nitric oxide levels needs further investigation and studies in patients with chronic renal disease.

  14. Host response mechanisms in periodontal diseases

    Directory of Open Access Journals (Sweden)

    Nora SILVA

    2015-06-01

    Full Text Available Periodontal diseases usually refer to common inflammatory disorders known as gingivitis and periodontitis, which are caused by a pathogenic microbiota in the subgingival biofilm, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola that trigger innate, inflammatory, and adaptive immune responses. These processes result in the destruction of the tissues surrounding and supporting the teeth, and eventually in tissue, bone and finally, tooth loss. The innate immune response constitutes a homeostatic system, which is the first line of defense, and is able to recognize invading microorganisms as non-self, triggering immune responses to eliminate them. In addition to the innate immunity, adaptive immunity cells and characteristic cytokines have been described as important players in the periodontal disease pathogenesis scenario, with a special attention to CD4+ T-cells (T-helper cells. Interestingly, the T cell-mediated adaptive immunity development is highly dependent on innate immunity-associated antigen presenting cells, which after antigen capture undergo into a maturation process and migrate towards the lymph nodes, where they produce distinct patterns of cytokines that will contribute to the subsequent polarization and activation of specific T CD4+ lymphocytes. Skeletal homeostasis depends on a dynamic balance between the activities of the bone-forming osteoblasts (OBLs and bone-resorbing osteoclasts (OCLs. This balance is tightly controlled by various regulatory systems, such as the endocrine system, and is influenced by the immune system, an osteoimmunological regulation depending on lymphocyte- and macrophage-derived cytokines. All these cytokines and inflammatory mediators are capable of acting alone or in concert, to stimulate periodontal breakdown and collagen destruction via tissue-derived matrix metalloproteinases, a characterization of the progression of periodontitis as

  15. Host response mechanisms in periodontal diseases

    Science.gov (United States)

    SILVA, Nora; ABUSLEME, Loreto; BRAVO, Denisse; DUTZAN, Nicolás; GARCIA-SESNICH, Jocelyn; VERNAL, Rolando; HERNÁNDEZ, Marcela; GAMONAL, Jorge

    2015-01-01

    Periodontal diseases usually refer to common inflammatory disorders known as gingivitis and periodontitis, which are caused by a pathogenic microbiota in the subgingival biofilm, including Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola that trigger innate, inflammatory, and adaptive immune responses. These processes result in the destruction of the tissues surrounding and supporting the teeth, and eventually in tissue, bone and finally, tooth loss. The innate immune response constitutes a homeostatic system, which is the first line of defense, and is able to recognize invading microorganisms as non-self, triggering immune responses to eliminate them. In addition to the innate immunity, adaptive immunity cells and characteristic cytokines have been described as important players in the periodontal disease pathogenesis scenario, with a special attention to CD4+ T-cells (T-helper cells). Interestingly, the T cell-mediated adaptive immunity development is highly dependent on innate immunity-associated antigen presenting cells, which after antigen capture undergo into a maturation process and migrate towards the lymph nodes, where they produce distinct patterns of cytokines that will contribute to the subsequent polarization and activation of specific T CD4+ lymphocytes. Skeletal homeostasis depends on a dynamic balance between the activities of the bone-forming osteoblasts (OBLs) and bone-resorbing osteoclasts (OCLs). This balance is tightly controlled by various regulatory systems, such as the endocrine system, and is influenced by the immune system, an osteoimmunological regulation depending on lymphocyte- and macrophage-derived cytokines. All these cytokines and inflammatory mediators are capable of acting alone or in concert, to stimulate periodontal breakdown and collagen destruction via tissue-derived matrix metalloproteinases, a characterization of the progression of periodontitis as a stage that

  16. Genetic variants of the NOTCH3 gene in the elderly and magnetic resonance imaging correlates of age-related cerebral small vessel disease

    NARCIS (Netherlands)

    R. Schmidt (Reinhold); M. Zeginigg (Marion); M. Wiltgen (Marco); P. Freudenberger (Paul); K. Petrovic (Katja); M. Cavalieri (Margherita); P. Gider (Pierre); C. Enzinger (Christian); M. Fornage (Myriam); S. Debette (Stéphanie); J.I. Rotter (Jerome); M.A. Ikram (Arfan); L.J. Launer (Lenore)

    2011-01-01

    textabstractCerebral small vessel disease-related brain lesions such as white matter lesions and lacunes are common findings of magnetic resonance imaging in the elderly. These lesions are thought to be major contributors to disability in old age, and risk factors that include age and hypertension

  17. Retinal Macroglial Responses in Health and Disease

    Directory of Open Access Journals (Sweden)

    Rosa de Hoz

    2016-01-01

    Full Text Available Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB, play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD, diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies.

  18. Brain scintigraphy with N-isopropyl [123I] p-iodoamphetamine (123I IMP) in patients with various cerebral diseases

    International Nuclear Information System (INIS)

    Oshibuchi, Masao; Kanda, Teturo; Sato, Mitutaka; Miyagi, Jun; Ohtake, Hisasi; Suhara, Tetuya; Mori, Atuyoshi.

    1988-01-01

    Single photon emission computed tomography(SPECT) with N-isopropyl-p-[ 123 I]-iodoamphet amine(IMP) was utilized in 99 patients with various cerebral diseases and 3 healthy volunteers. By IMP SPECT, demaged area was observed as wider and faster in time than with X-ray CT or MRI. The nidus was visualized as defect of IMP in cases of AVM. In patients with subarachnoid hemorrhage, IMP SPECT was more useful for detecting of post hemorrhagic symptomatic vasospasm compared to X-ray CT or MRI. IMP SPECT was also useful to the differential diagnosis in cases of dementia. Grossed cerebellar diaschisis(CCD) was observed in 26 out of 67 cases (39 %) studied. In epilepsy the low uptake areas of IMP in the bilateral occipital lobes were observed in IMP SPECT. (author)

  19. [Periodontal disease as an early clinical sign of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)].

    Science.gov (United States)

    Luna-Maldonado, E; Aguirre-Acevedo, D C; García-Ospina, G P; Lopera, F

    The clinical signs of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are expressed mainly in the nervous system and recently reports also situate them in the retina. To determine the prevalence and risk of periodontal disease in subjects from families with a history of CADASIL mutation in the department of Antioquia, Colombia. A cross-sectional study was conducted, with subjects being assigned to the CADASIL group or a control group according to genotyping for the R1031C and C455R mutation in Notch3. Each participant voluntarily signed the informed consent document and was submitted to neurological, neuropsychological and periodontal evaluation. No significant differences were found between the two groups according to age, sex, schooling, tobacco smoking, cognitive status, functional status and the presence of natural teeth. The frequency of soft plaque, gingivitis and periodontal disease was significantly higher in the group of carriers of the CADASIL mutation than in the control group. The CADASIL group had six times more risk of having soft plaque above or equal to 20% than the control group. Prevalence of gingivitis above or equal to 10% was observed in all the members of the CADASIL group. The people in the CADASIL group had five times more risk of suffering periodontal disease than the control group. Carriers of the CADASIL mutation displayed a higher prevalence and risk of periodontal disease.

  20. Cerebral blood flow in hypothyroidism: Response to therapy and associated cognitive performance

    International Nuclear Information System (INIS)

    Ilgin, N.; Akdemir, U.O.; Yetkin, I.; Eroglu, A.

    2002-01-01

    Hypothyroidism is often associated with defective memory, psychomotor slowing and depression. However, the relationship between thyroid status, related cognitive state and associated cerebral circulatory and/or metabolic abnormalities have not been elucidated. Purpose: The aim of this study was to evaluate pre-and post-therapy brain perfusion patterns in 9 hypothyroid patients presenting with Hashimoto thyroiditis. Method: Patients were referred on the basis of abnormal levels of anti-thyroglobulin and anti-microsomal antibodies, hypothyroidism and symptoms of cognitive dysfunction. Cognitive performance was tested using Raven's Coloured Progressive Matrices and Bender Gestalt Test. Functional evaluation of the brain was also performed via the methods of electroencephalography (EEG) and single photon emission tomography (SPECT). An initial SPECT study was carried out after I.V. injection of Tc99m-HMPAO and semiquantitative rCBF analysis was performed by drawing irregular regions of interest (ROIs) in three slices. A total number of 12 sector regions of interest placed on the two hemispheres and regional cerebral blood flow (rCBF) was determined using cortical region/cerebellum ratios obtained in each hemisphere. A repeat SPECT study was undertaken in 5 subjects 3-6 months after the initiation of medical therapy. Results: Pre-therapy perfusion data in four patients showed that the cortical ratios were globally depressed at the levels of 0.65-0.85 where these ratios improved quickly to the near normal-above normal levels (range of rCBF improvement as % difference from baseline 25%-45%) within 3-4 months of therapy. Conclusion: These results indicate that brain activity was globally decreased in severe hypothyroidism of short duration which normalized steadily as the hypothyroid state is corrected

  1. Importance of Collateralization in Patients With Large Artery Intracranial Occlusive Disease: Long-Term Longitudinal Assessment of Cerebral Hemodynamic Function

    Directory of Open Access Journals (Sweden)

    Larissa McKetton

    2018-04-01

    Full Text Available Patients with large artery intracranial occlusive disease (LAICOD are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR using blood oxygen level-dependent (BOLD MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients. Here, we report a case of long-term follow-up in a 28-year-old Caucasian female presented to the neurology clinic with a history of TIAs and LAICOD of the right middle cerebral artery (MCA. Initial structural MRI showed a right MCA stenosis and a small right coronal radiate lacunar infarct. Her CVR study showed a large area of impaired CVR with a paradoxical decrease in BOLD signal with hypercapnia involving the right MCA territory indicating intracerebral steal. The patient was managed medically with anticoagulant and antiplatelet therapy and was followed-up for over 9 years with both structural and functional imaging. Cortical thickness (CT measures were longitudinally assessed from a region of interest that was applied to subsequent time points in the cortical region exhibiting steal physiology and in the same region of the contralateral healthy hemisphere. In the long-term follow-up, the patient exhibited improvement in her CVR as demonstrated by the development of collaterals with negligible changes to CT. Management of patients with LAICOD remains challenging since no revascularization strategies have shown efficacy except in patients with moyamoya disease. Management is well

  2. Midlife Systemic Inflammation, Late-Life White Matter Integrity, and Cerebral Small Vessel Disease: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Walker, Keenan A; Power, Melinda C; Hoogeveen, Ron C; Folsom, Aaron R; Ballantyne, Christie M; Knopman, David S; Windham, B Gwen; Selvin, Elizabeth; Jack, Clifford R; Gottesman, Rebecca F

    2017-12-01

    It is currently unclear whether midlife systemic inflammation promotes the development of white matter (WM) abnormalities and small vessel disease in the elderly. We examined the association of midlife systemic inflammation with late-life WM hyperintensity volume, deep and periventricular WM microstructural integrity (fractional anisotropy and mean diffusivity [MD]), cerebral infarcts, and microbleeds in a biracial prospective cohort study. Linear and logistic regression examined the relation between midlife high-sensitivity C-reactive protein (CRP)-a nonspecific marker of inflammation-and brain magnetic resonance imaging markers assessed 21 years later in the Atherosclerosis Risk in Communities Study. We included 1485 participants (baseline age, 56[5]; 28% black). After adjusting for demographic factors and cardiovascular disease, each SD increase in midlife CRP was associated with lower fractional anisotropy (-0.09 SD; 95% confidence interval, -0.15 to -0.02) and greater MD (0.08 SD; 95% confidence interval, 0.03-0.15) in deep WM and lower fractional anisotropy (-0.07 SD; 95% confidence interval, -0.13 to 0.00) in periventricular WM. We found stronger associations between CRP and periventricular WM microstructural integrity among black participants ( P interaction=0.011). Although an association between higher CRP levels and greater WM hyperintensity volume was found only among APOE ε4-positive participants in our primary analysis (0.14 SD; 95% confidence interval, 0.01-0.26; P interaction=0.028), this relationship extended to the entire sample after accounting for differential attrition. Midlife CRP was not associated with the presence of cerebral infarcts or microbleeds in late life. Our findings support the hypothesis that midlife systemic inflammation may promote the development of chronic microangiopathic structural WM abnormalities in the elderly. © 2017 American Heart Association, Inc.

  3. Modeling cerebral blood flow during posture change from sitting to standing

    DEFF Research Database (Denmark)

    Ottesen, Johnny T.; Olufsen, M.; Tran, H.T.

    2004-01-01

    Abstract Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow velocity regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture...... extremities, the brain, and the heart. We use physiologically based control mechanisms to describe the regulation of cerebral blood flow velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. To justify the fidelity of our mathematical model and control...

  4. Effects of the administration of a catalase inhibitor into the fourth cerebral ventricle on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke

    OpenAIRE

    Valenti, Vitor E.; Abreu, Luiz Carlos de; Fonseca, Fernando L. A.; Adami, Fernando; Sato, Monica A.; Vanderlei, Luiz Carlos M.; Ferreira, Lucas Lima; Rodrigues, Luciano M.; Ferreira, Celso

    2013-01-01

    OBJECTIVE: Previous studies have demonstrated a relationship between brain oxidative stress and cardiovascular regulation. We evaluated the effects of central catalase inhibition on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke. METHODS: Male Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SH) (16 weeks old) were implanted with a stainless steel guide cannula leading into the fourth cerebral ventricle (4...

  5. Ectatic and Occlusive Diseases of the Venous Drainage System of Cerebral Arteriovenous Malformations (AVMs) - with Emphasis on Spectacular Shrinking Neurological Deficits after Embolization.

    Science.gov (United States)

    Goto, K

    2005-10-05

    During reviewing cases with AVM, the author noticed that stenotic and occlusive changes of the draining veins are commonly seen in high flow cerebral AVMs. However, little attention has been paid to these venous diseases until ectatic veins, generated in the upstream of the venous system, cause mass effect to the surrounding structures, or redistribution and shunting toward regional veins became insufficient after they are markedly overloaded or occluded. Cases with such venous abnormality are clinically important because of the possibility of dramatic improvement of neurological deficits after embolization of AVMs. Following presenting treatment results of 177 AVM case, the author is going to present five cases with abnormality in the Galenic venous system and two cases with abnormality in cortical veins associating with high flow cerebral AVMs. Consideration will be made on symptomatology and pathophysiologic mechanism of venous abnormalities associating with high flow cerebral AVMs.

  6. Alterations in Cerebral Cortical Glucose and Glutamine Metabolism Precedes Amyloid Plaques in the APPswe/PSEN1dE9 Mouse Model of Alzheimer's Disease

    DEFF Research Database (Denmark)

    Andersen, Jens V; Christensen, Sofie K; Aldana, Blanca I

    2017-01-01

    by mass spectrometry. The ATP synthesis rate of isolated whole-brain mitochondria was assessed by an on-line luciferin-luciferase assay. Significantly increased (13)C labeling of intracellular lactate and alanine and decreased tricarboxylic acid (TCA) cycle activity were observed from cerebral cortical...... rate tended to be decreased in isolated whole-brain mitochondria of APPswe/PSEN1dE9 mice. Thus, several cerebral metabolic changes are evident in the APPswe/PSEN1dE9 mouse prior to amyloid plaque deposition, including altered glucose metabolism, hampered glutamine processing and mitochondrial......Alterations in brain energy metabolism have been suggested to be of fundamental importance for the development of Alzheimer's disease (AD). However, specific changes in brain energetics in the early stages of AD are poorly known. The aim of this study was to investigate cerebral energy metabolism...

  7. Effect of Stress-free Therapy on Cerebral Blood Flow: Comparisons among patients with metabolic cardiovascular disease, healthy subjects and placebo-treated subjects

    Science.gov (United States)

    Ryotokuji, Kenji; Ishimaru, Keisou; Kihara, Kazuhiko; Namiki, Yoshihisa; Nakashima, Takuma; Otani, Satoru

    2014-01-01

    Background and aims: We have developed a Stress-free Therapy® device wherein “Pinpoint Plantar Long-wavelength Infrared Light Irradiation (PP-LILI)” increases peripheral-deep body temperature and blood flow volume and stabilizes blood pressure as well as significantly reduces stress hormones such as adrenocorticotrophic hormone and cortisol without using drugs. Moreover, we have found this therapy to significantly improve blood glucose and insulin resistance in patients with type 2 diabetes. Based on this background of clinical efficacy, we validated changes in cerebral blood flow in patients with metabolic cardiovascular disease and examined the efficacy of Stress-free Therapy® on cerebral blood flow as compared to that in healthy control subjects and placebo-treated patients. Results: The change in cerebral blood flow volume during 15-minute PP-LILI was 5.1 ± 1.8 mL/min in patients with metabolic cardiovascular disease, showing a significant increase (P<0.05) of 3.1 mL/min as compared with the mean blood flow value after resting for 15 minutes. Conclusions: Our results suggested Stress-free Therapy® to significantly increase cerebral blood flow, possibly leading to the prevention of metabolic cardiovascular disease. PMID:24771966

  8. Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2017-02-01

    Full Text Available Introduction: Vasculitis is an inflammation systems may be involved of blood vessels due to various origins. Vessels of the peripheral and/or central nervous. Vasculitis of the CNS is rare and occurs in the context of systemic diseases or as primary angiitis of the CNS. Epidemiology: The overall incidence of primary vasculitis is about 40/1,000,000 persons [excluding giant cell (temporal arteritis, GCA]. Its incidence increases with age. The incidence of GCA is much higher (around 200/1,000,000 persons in the age group[50 years. Clinical Presentation: Clinical and pathological presentation in CNS vasculitis represents a wide spectrum. Among others, headache, cranial nerve affections, encephalopathy, seizures, psychosis, myelitis, stroke, intracranial haemorrhage and aseptic meningoencephalitis are described. Primary and secondary vasculitides leading more frequently to CNS manifestations are discussed. Primary and secondary Vasculitides: Including Giant Cell (Temporal Arteritis , Takayasu arteritis, Polyarteritis nodosa, Primary angiitis of the CNS, Wegener’s granulomatosis, and Connective tissue diseases, such as systemic lupus erythematosus (SLE, scleroderma, rheumatoid arthritis, mixed connective disease and Sjögren syndrome, are systemic immune-mediated diseases that lead to multiple organ affections. Cerebral Vasculitis: Imaging and Differential Diagnosis: Vasculitides represent a heterogeneous group of inflammatory diseases that affect blood vessel walls of varying calibers (inflammatory vasculopathy. Since the devastating symptoms of CNS vasculitis are at least partially reversible, early diagnosis and appropriate treatment are important. In order to establish a differential diagnosis clinical features, disease progression, age of onset, blood results, as well as CSF examinations have to be taken into consideration. Neuroimaging techniques, such as MRI and DSA, play a central role in the diagnosis and disease monitoring .The diagnostic

  9. Evidence for the absence of cerebral glucose-6-phosphatase activity in glycogen storage disease type I (Von Gierke's disease)

    Energy Technology Data Exchange (ETDEWEB)

    Phelps, M.E.; Mazziotta, J.C.; Hawkins, R.A.; Philippart, M.

    1981-01-01

    Glycogen storage disease type I (GSD-I) is characterized by a functional deficit in glucose-6-phosphatase that normally hydrolyzes glucose-6-PO/sub 4/ to glucose. This enzyme is primarily found in liver, kidney, and muscle but it is also present in brain, where it appears to participate in the regulation of cerebral tissue glucose. Since most neurological symptoms in GSD-I patients involve systemic hypoglycemia, previous reports have not examined possible deficiencies in phosphatase activity in the brain. Positron computed tomography, F-18-labeled 2-fluorodeoxyglucose (FDG) and a tracer kinetic model for FDG were used to measure the cortical plasma/tissue forward and reverse transport, phosphorylation and dephosphorylation rate constants, tissue/plasma concentration gradient, tissue concentration turnover rate for this competitive analog of glucose, and the cortical metabolic rates for glucose. Studies were carried out in age-matched normals (N = 13) and a single GSD-I patient. The dephosphorylation rate constant in the GSD-I patient was about one tenth the normal value indicating a low level of cerebral phosphatase activity. The other measured parameters were within normal limits except for the rate of glucose phosphorylation which reflected a cortical glucose metabolic rate one half the normal value. Since glucose transport and tissue glucose concentration was normal, the reduced cortical glucose metabolism probably results from the use of alternative substrates (..beta..-hydroxybutyrate and acetoacetate) which are consistently elevated in the plasma of GSD-I patients.

  10. CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital disease

    International Nuclear Information System (INIS)

    Liu Hui; Zhang Xintang; Wang Jin; Tian Min; He Yuping; Zhao Jinqi; He Qian; Chen Huanjun; Li Fawei

    2012-01-01

    Objective: To investigate CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital heart disease (CCHD). Methods: Preoperative brain CT scan and clinical data in 82 patients suffering from CCHD were analyzed. According to the increased levels of vascular density, patients were divided into 4 groups: normal, mild, moderate and severe. Relationships between the increased levels of vascular density and Hb, RBC, HCT, as well as the degree of cyanosis,were studied. AVONA was carried out to test blood CT value of cerebral sinuses, Hb, RBC and HCT in different groups. Descriptive analysis and linear regression were adopted to study the correlation between blood CT value and Hb concentration. The relationship of increased vascular density to degrees of cyanosis was analysed by Spearman. Results: Among 82 patients, 12 patients (14.6%) were found in the group of normal vascular density and 70 patients (85.4%) in the increased vascular density group. Among 70 patients with increased vascular density, 22 patients (26.8% ) with (55.4 ± 2.6) HU, (169 ±6)g/L of Hb, (5.8 ±0.3) × 10 12 /L of RBC and 0.51 ±0.03 of HCT, 29 patients (35.4%) with (61.3 ± 2.9) HU, (209 ± 15 ) g/L, (7.1 ± 0.4) × 10 12 /L, 0.66 ± 0.06 and 19 patients (23.2%) with (68.8 ± 4.2) HU, (242 ± 23) g/L, (8.3 ± 0.9) × 10 12 /L, 0.78 ± 0.08 were observed in the mild,moderate and severe group,respectively. There were significant differences in distribution of blood CT value (HU), Hb, RBC and HCT in different groups (F=163.263, 134.703, 120.974, 136.541; P<0.01). Blood CT value was positively correlated with Hb concentration (r=0.98, P<0.01). Vascular density was also positively correlated with the degree of cyanosis (r=0.86, P<0.01). Conclusions: Cerebral vascular density of patients suffering from CCHD presented different levels of increases based on CT scan results due to rise of RBC stimulated by anoxia. The increased level of vascular

  11. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  12. Plasma Tumor Necrosis Factor-alpha (TNF-α) Levels Correlate with Disease Severity in Spastic Diplegia, Triplegia, and Quadriplegia in Children with Cerebral Palsy.

    Science.gov (United States)

    Wu, Jianxian; Li, Xueming

    2015-12-11

    BACKGROUND Inflammatory responses in utero and in neonates have been involved in the development of white matter lesions. This study aimed to investigate the role of tumor necrosis factor-alpha (TNF-α) in spastic cerebral palsy. MATERIAL AND METHODS Plasma TNF-α was measured by ELISA in 54 children with spastic cerebral palsy and 28 aged-matched controls. Both groups were split into age subgroups (1-3 vs. 4-12). Gross motor function and activities of daily living were assessed on enrollment and after 6 months of rehabilitation. RESULTS TNF-α was higher in patients with cerebral palsy than in controls in young (P<0.001) and older subjects (P<0.001). TNF-α levels were comparable in both control subgroups (P=0.819). Younger patients with cerebral palsy had significantly higher TNF-α levels compared with older ones (P<0.001). Pre-rehabilitation TNF-α levels correlated with improvements in activities of daily living after rehabilitation (P<0.001). CONCLUSIONS Children with cerebral palsy showed higher plasma levels of TNF-α than controls. In addition, pre-treatment TNF-α levels were correlated with the improvements after rehabilitation therapy.

  13. Cerebral White Matter Hypoperfusion Increases with Small-Vessel Disease Burden. Data From the Third International Stroke Trial.

    Science.gov (United States)

    Arba, Francesco; Mair, Grant; Carpenter, Trevor; Sakka, Eleni; Sandercock, Peter A G; Lindley, Richard I; Inzitari, Domenico; Wardlaw, Joanna M

    2017-07-01

    Leukoaraiosis is associated with impaired cerebral perfusion, but the effect of individual and combined small-vessel disease (SVD) features on white matter perfusion is unclear. We studied patients recruited with perfusion imaging in the Third International Stroke Trial. We rated individual SVD features (leukoaraiosis, lacunes) and brain atrophy on baseline plain computed tomography or magnetic resonance imaging. Separately, we assessed white matter at the level of the lateral ventricles in the cerebral hemisphere contralateral to the stroke for visible areas of hypoperfusion (present or absent) on 4 time-based perfusion imaging parameters. We examined associations between SVD features (individually and summed) and presence of hypoperfusion using logistic regression adjusted for age, sex, baseline National Institutes of Health Stroke Scale, hypertension, and diabetes. A total of 115 patients with median (interquartile range) age of 81 (72-86) years, 78 (52%) of which were male, had complete perfusion data. Hypoperfusion was most frequent on mean transit time (MTT; 63 patients, 55%) and least frequent on time to maximum flow (19 patients, 17%). The SVD score showed stronger independent associations with hypoperfusion (e.g., MTT, odds ratio [OR] = 2.80; 95% confidence interval [CI] = 1.56-5.03) than individual SVD markers (e.g., white matter hypoattenuation score, MTT, OR = 1.49, 95% CI = 1.09-2.04). Baseline blood pressure did not differ by presence or absence of hypoperfusion or across strata of SVD score. Presence of white matter hypoperfusion increased with SVD summed score. The SVD summed score was associated with hypoperfusion more consistently than individual SVD features, providing validity to the SVD score concept. Increasing SVD burden indicates worse perfusion in the white matter. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Total cerebral small vessel disease score and cognitive performance in community-dwelling older adults. Results from the Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Victor J; Ortiz, Jorge G; Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio; Biller, José

    2018-02-01

    Cerebral small vessel disease (SVD) is inversely associated with cognitive performance. However, whether the total SVD score is a better predictor of poor cognitive performance than individual signatures of SVD is inconclusive. We aimed to estimate the combined and independent predictive power of these MRI findings. Atahualpa residents aged ≥60 years underwent brain MRI. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). The presence of moderate-to-severe white matter hyperintensities, deep cerebral microbleeds, lacunar infarcts, and >10 enlarged perivascular spaces was added for estimating the total SVD score ranging from 0 to 4 points. Montreal Cognitive Assessment predictive models were fitted to assess how well the total SVD score or each of its components predicts cognitive performance. Of 351 eligible candidates, 331 (94%) were included. The total SVD score was 0 points in 202 individuals (61%), 1 point in 67 (20%), 2 points in 40 (12%), 3 points in 15 (5%), and 4 points in seven (2%). A generalized lineal model showed an inverse relationship between the total SVD score and the MoCA (p = 0.015). The proportion of variance in the MoCA score explained by the SVD score was 32.8% (R 2  = 0.328). This predictive power was similar for white matter hyperintensities (R 2  = 0.306), microbleeds (R 2  = 0.313), lacunar infarcts (R 2  = 0.323), and perivascular spaces (R 2  = 0.313). This study shows a significant association between the SVD score and worse cognitive performance. The SVD score is a predictor of poor cognitive performance. This predictive power is not better than that of isolated neuroimaging signatures of SVD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  15. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

    Directory of Open Access Journals (Sweden)

    van der Vlugt Maureen J

    2011-02-01

    Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

  16. Endothelial TRPV4 channels mediate dilation of cerebral arteries: impairment and recovery in cerebrovascular pathologies related to Alzheimer's disease

    Science.gov (United States)

    Zhang, Luqing; Papadopoulos, Panayiota; Hamel, Edith

    2013-01-01

    BACKGROUND AND PURPOSE Transient receptor potential vanilloid type 4 (TRPV4) channels are expressed in brain endothelial cells, but their role in regulating cerebrovascular tone under physiological and pathological conditions is still largely unknown. EXPERIMENTAL APPROACH Wild-type (WT) mice and mice that overexpress a mutated form of the human amyloid precursor protein (APP mice, model of increased amyloid β), a constitutively active form of TGF-β1 (TGF mice, model of cerebrovascular fibrosis) or both (APP/TGF mice) were used. Dilations to the selective TRPV4 channel opener GSK1016790A (GSK) or to ACh were measured in posterior cerebral artery segments. KEY RESULTS Both GSK- and ACh-induced dilations virtually disappeared following endothelium denudation in WT mice. These responses were impaired in vessels from APP, TGF and APP/TGF mice compared with WT. Pre-incubation of WT vessels with the selective TRPV4 channel blocker HC-067047, or with small-conductance (SK channel, apamin) and/or intermediate-conductance (IK channel, charybdotoxin, ChTx) Ca2+-sensitive K+ channel blocker abolished GSK-induced dilations and massively decreased those induced by ACh. These treatments had no or limited effects on ACh-induced dilation in vessels from APP, TGF or APP/TGF mice, and IK and SK channel function was preserved in transgenic mice. Antioxidant superoxide dismutase or catalase normalized GSK- and ACh-mediated dilations only in APP brain arteries. Conclusion and Implications We conclude that endothelial TRPV4 channels mediate ACh-induced dilation in cerebral arteries, that they are impaired in models of cerebrovascular pathology and that they are sensitive, albeit in the reversible manner, to amyloid β-induced oxidative stress. PMID:23889563

  17. Associative memory and its cerebral correlates in Alzheimer's disease: Evidence for distinct deficits of relational and conjunctive memory

    Science.gov (United States)

    Bastin, Christine; Bahri, Mohamed Ali; Miévis, Frédéric; Lemaire, Christian; Collette, Fabienne; Genon, Sarah; Simon, Jessica; Guillaume, Bénédicte; Diana, Rachel A.; Yonelinas, Andrew P.; Salmon, Eric

    2014-01-01

    This study investigated the impact of Alzheimer's disease (AD) on conjunctive and relational binding in episodic memory. Mild AD patients and controls had to remember item-color associations by imagining color either as a contextual association (relational memory) or as a feature of the item to be encoded (conjunctive memory). Patients' performance in each condition was correlated with cerebral metabolism measured by FDG-PET. The results showed that AD patients had an impaired capacity to remember item-color associations, with deficits in both relational and conjunctive memory. However, performance in the two kinds of associative memory varied independently across patients. Partial least square analyses revealed that poor conjunctive memory was related to hypometabolism in an anterior temporal-posterior fusiform brain network, whereas relational memory correlated with metabolism in regions of the default mode network. These findings support the hypothesis of distinct neural systems specialized in different types of associative memory and point to heterogeneous profiles of memory alteration in Alzheimer's disease as a function of damage to the respective neural networks. PMID:25172390

  18. Associative memory and its cerebral correlates in Alzheimer׳s disease: evidence for distinct deficits of relational and conjunctive memory.

    Science.gov (United States)

    Bastin, Christine; Bahri, Mohamed Ali; Miévis, Frédéric; Lemaire, Christian; Collette, Fabienne; Genon, Sarah; Simon, Jessica; Guillaume, Bénédicte; Diana, Rachel A; Yonelinas, Andrew P; Salmon, Eric

    2014-10-01

    This study investigated the impact of Alzheimer׳s disease (AD) on conjunctive and relational binding in episodic memory. Mild AD patients and controls had to remember item-color associations by imagining color either as a contextual association (relational memory) or as a feature of the item to be encoded (conjunctive memory). Patients׳ performance in each condition was correlated with cerebral metabolism measured by FDG-PET. The results showed that AD patients had an impaired capacity to remember item-color associations, with deficits in both relational and conjunctive memory. However, performance in the two kinds of associative memory varied independently across patients. Partial Least Square analyses revealed that poor conjunctive memory was related to hypometabolism in an anterior temporal-posterior fusiform brain network, whereas relational memory correlated with metabolism in regions of the default mode network. These findings support the hypothesis of distinct neural systems specialized in different types of associative memory and point to heterogeneous profiles of memory alteration in Alzheimer׳s disease as a function of damage to the respective neural networks. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Chronic disease risk among adults with cerebral palsy: the role of premature sarcopoenia, obesity and sedentary behaviour.

    Science.gov (United States)

    Peterson, M D; Gordon, P M; Hurvitz, E A

    2013-02-01

    Premature declines in function among adults with cerebral palsy (CP) are generally attributed to weakness, spasticity and orthopaedic abnormalities, as well as chronic pain and fatigue. Very little research or clinical attention has been devoted to the confluence and consequences of early muscle wasting and obesity as mediators of secondary comorbidity in this population, and perhaps more importantly, to the role of lifestyle to potentiate these outcomes. At present, there are no national surveillance programmes that monitor chronic health in adults with CP; however, mortality records have demonstrated a greater prevalence of coronary heart disease as compared with the general population. Although by definition, CP is a 'non-progressive' condition, secondary factors such as habitual sedentary behaviour, obesity, and premature sarcoepenia may increase the severity of functional impairment throughout adulthood, and lead to cardiometabolic disease, fragility and/or early mortality. Herein we describe the heightened health risk represented in adults with CP, and discuss the hallmark phenotypic features that coincide with ageing, obesity and cardiometabolic disorders. Moreover, we provide discussion regarding the protective role of habitual physical activity to stimulate anti-inflammatory pathways and to ameliorate global risk. Although physical therapeutic modalities are already widely acknowledged as a vital component to improve movement quality in CP, the purpose of this review was to present a compelling case for the value of lifelong physical activity participation for both function and cardiometabolic health preservation. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  20. A Report of Accelerated Coronary Artery Disease Associated with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy.

    Science.gov (United States)

    Rubin, Courtney B; Hahn, Virginia; Kobayashi, Taisei; Litwack, Andrew

    2015-01-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common heritable form of vascular dementia and it is caused by mutations in the NOTCH3 gene. The neurologic manifestations of CADASIL syndrome have been well characterized; however, here we report one of the first de novo cases of CADASIL-associated coronary artery disease. A 45-year-old woman with a history of CADASIL and remote tobacco use presented with unstable angina. She was found to have diffuse and irregular narrowing of the left anterior descending artery and a drug eluting stent was deployed. Months later, she developed two subsequent episodes of unstable angina, requiring stent placement in the distal left anterior descending artery and the right coronary artery. Though the neurologic manifestations of CADASIL have been well described, these patients may also be predisposed to developing premature coronary artery disease. Patients with CADASIL and their physicians should be aware of this possible association because these patients may not be identified as high risk by traditional cardiovascular risk estimators. These patients may benefit from more aggressive interventions to reduce cardiac risk.

  1. A Report of Accelerated Coronary Artery Disease Associated with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy

    Directory of Open Access Journals (Sweden)

    Courtney B. Rubin

    2015-01-01

    Full Text Available Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is the most common heritable form of vascular dementia and it is caused by mutations in the NOTCH3 gene. The neurologic manifestations of CADASIL syndrome have been well characterized; however, here we report one of the first de novo cases of CADASIL-associated coronary artery disease. A 45-year-old woman with a history of CADASIL and remote tobacco use presented with unstable angina. She was found to have diffuse and irregular narrowing of the left anterior descending artery and a drug eluting stent was deployed. Months later, she developed two subsequent episodes of unstable angina, requiring stent placement in the distal left anterior descending artery and the right coronary artery. Though the neurologic manifestations of CADASIL have been well described, these patients may also be predisposed to developing premature coronary artery disease. Patients with CADASIL and their physicians should be aware of this possible association because these patients may not be identified as high risk by traditional cardiovascular risk estimators. These patients may benefit from more aggressive interventions to reduce cardiac risk.

  2. Novel COL4A1 mutations cause cerebral small vessel disease by haploinsufficiency

    NARCIS (Netherlands)

    Lemmens, R.; Maugeri, A.; Niessen, H.W.M.; Goris, A.; Tousseyn, T.; Demaerel, P.; Corveleyn, A.; Robberecht, W.; van der Knaap, M.S.; Thijs, V.N.; Zwijnenburg, P.J.G.

    2013-01-01

    Mutations in COL4A1 have been identified in families with hereditary small vessel disease of the brain presumably due to a dominant-negative mechanism. Here, we report on two novel mutations in COL4A1 in two families with porencephaly, intracerebral hemorrhage and severe white matter disease caused

  3. Sidestream cigarette smoke effects on cardiovascular responses in conscious rats: involvement of oxidative stress in the fourth cerebral ventricle

    Directory of Open Access Journals (Sweden)

    Valenti Vitor E

    2012-03-01

    Full Text Available Abstract Background Cigarette exposure increases brain oxidative stress. The literature showed that increased brain oxidative stress affects cardiovascular regulation. However, no previous study investigated the involvement of brain oxidative stress in animals exposed to cigarette and its relationship with cardiovascular regulation. We aimed to evaluate the effects of central catalase inhibition on baroreflex and cardiovascular responses in rats exposed to sidestream cigarette smoke (SSCS. Methods We evaluated males Wistar rats (320-370 g, which were implanted with a stainless steel guide cannula into the fourth cerebral ventricle (4th V. Femoral artery and vein were cannulated for mean arterial pressure (MAP and heart rate (HR measurement and drug infusion, respectively. Rats were exposed to SSCS during three weeks, 180 minutes, 5 days/week (CO: 100-300 ppm. Baroreflex was tested with a pressor dose of phenylephrine (PHE, 8 μg/kg, bolus to induce bradycardic reflex and a depressor dose of sodium nitroprusside (SNP, 50 μg/kg, bolus to induce tachycardic reflex. Cardiovascular responses were evaluated before, 5, 15, 30 and 60 minutes after 3-amino-1,2,4-triazole (ATZ, catalase inhibitor, 0.001 g/100 μL injection into the 4th V. Results Central catalase inhibition increased basal HR in the control group during the first 5 minutes. SSCS exposure increased basal HR and attenuated bradycardic peak during the first 15 minutes. Conclusion We suggest that SSCS exposure affects cardiovascular regulation through its influence on catalase activity.

  4. Moderate Physical Activity is Associated with Cerebral Glucose Metabolism in Adults at Risk for Alzheimer's Disease.

    Science.gov (United States)

    Dougherty, Ryan J; Schultz, Stephanie A; Kirby, Taylor K; Boots, Elizabeth A; Oh, Jennifer M; Edwards, Dorothy; Gallagher, Catherine L; Carlsson, Cynthia M; Bendlin, Barbara B; Asthana, Sanjay; Sager, Mark A; Hermann, Bruce P; Christian, Bradley T; Johnson, Sterling C; Cook, Dane B; Okonkwo, Ozioma C

    2017-01-01

    The objective of this study was to investigate the relationship between accelerometer-measured physical activity (PA) and glucose metabolism in asymptomatic late-middle-aged adults. Ninety-three cognitively healthy late-middle-aged adults from the Wisconsin Registry for Alzheimer's Prevention participated in this cross-sectional study. They underwent 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging and wore an accelerometer (ActiGraph GT3X+) to measure free-living PA. Accelerometer data yielded measures of light (LPA), moderate (MPA), and vigorous (VPA) intensity PA. FDG-PET images were scaled to the cerebellum and pons, and cerebral glucose metabolic rate was extracted from specific regions of interest (ROIs) known to be hypometabolic in AD, i.e., hippocampus, posterior cingulate, inferior temporal cortex, and angular gyrus. Regression analyses were utilized to examine the association between PA and glucose metabolism, while adjusting for potential confounds. There were associations between MPA and glucose metabolism in all ROIs examined. In contrast, LPA was not associated with glucose uptake in any ROI and VPA was only associated with hippocampal FDG uptake. Secondary analyses did not reveal associations between sedentary time and glucose metabolism in any of the ROIs. Exploratory voxel-wise analysis identified additional regions where MPA was significantly associated with glucose metabolism including the precuneus, supramarginal gyrus, amygdala, and middle frontal gyrus. These findings suggest that the intensity of PA is an important contributor to neuronal function in a late-middle-aged cohort, with MPA being the most salient. Prospective studies are necessary for fully elucidating the link between midlife engagement in PA and later life development of AD.

  5. Relationship between chronic kidney disease and silent cerebral infarction in patients with Type 2 diabetes.

    Science.gov (United States)

    Bouchi, R; Babazono, T; Yoshida, N; Nyumura, I; Toya, K; Hayashi, T; Hanai, K; Tanaka, N; Ishii, A; Iwamoto, Y

    2010-05-01

    Silent cerebral infarction (SCI) is an independent risk factor for future symptomatic stroke. Although the prevalence of SCI is closely related to kidney function in non-diabetic individuals, evidence is lacking whether albuminuria and/or reduced estimated glomerular filtration rate (eGFR) independently increase the risk of SCI in diabetic patients. We therefore examined the relationships between albuminuria, eGFR and SCI in patients with Type 2 diabetes mellitus (T2DM). We studied 786 T2DM patients with an eGFR > or = 15 ml/min 1.73/m(2), including 337 women and 449 men [mean (+/- sd), age 65 +/- 11 years]. All patients underwent cranial magnetic resonance imaging (MRI) to detect SCI. GFR was estimated using the modified three-variable equation for Japanese subjects. Albuminuria was defined as a first morning urinary albumin-to-creatinine ratio (ACR) > or = 30 mg/g. SCI was detected in 415 (52.8%) of the subjects. The prevalence of SCI was significantly associated with both elevated ACR and decreased eGFR in univariate analysis. In multivariate logistic regression analysis, urinary ACR remained independently associated with SCI after adjusting for conventional cardiovascular risk factors [odds ratio (OR) of urinary ACR per logarithmical value: 1.89, 95% confidence interval (CI) = 1.41-2.51, P < 0.001]; however, eGFR was no longer significantly associated with SCI (OR per ml/min 1.73/m(2) = 0.99, 95% CI = 0.98-1.00, P = 0.095). In conclusion, albuminuria but not decreased eGFR may be an independent predictor of prevalent SCI in patients with T2DM.

  6. Use of 99mTc-HMPAO cerebral tomo-scintigraphy in follow-up of patients afflicted with the Alzheimer's disease and treated by TACRINE

    International Nuclear Information System (INIS)

    Mestas, D.; Catoire, S.; Jalenques, I.; Maublant, J.; Veyre, A.

    1997-01-01

    A simultaneous study of the cognitive functions, single photon emission tomography (SPECT) and quantified electroencephalogram (qEEG) was carried out in 23 patients afflicted with the Alzheimer's disease and pursued during 1 year of treatment by TACRINE. A psycho-metric examination was done at inclusion and one year after; the qEEG was effected at inclusion, 6 months and one year later, while the four SPECT by HMPAO- 99m Tc (925 MBq) examinations were performed at inclusion, 12 weeks, 6 months and one year after. Two qEEG parameters were retained: the posterior average frequency (PAF) and the total spectrum power (TSP). Semi-quantitative measurements of the cerebral blood rate were determined on 4 cortical regions of interest, their average activity being referred to the average maximal activity of the cerebellum. Two variables were analyzed: the lowest value of the ratio (LVR) and the mean value of 4 ratios (MVR). The results produced an evolution significantly correlated to the PAF while psychometric tests and a correlation of the severity of cognitive affliction with the MVR at inclusion and one year after; as for LVR, it occurred in our study the most pertinent for pursuing the evolution of patients. In conclusion, the SPECT and the qEEG applied in parallel to the cognitive functions of the patients treated by TACRINE, appears to be interesting in evaluating the therapeutic response

  7. Determinants of responsiveness to botulinum toxin, casting, and bracing in the treatment of spastic equinus in children with cerebral palsy.

    Science.gov (United States)

    Yap, Rita; Majnemer, Annette; Benaroch, Thierry; Cantin, Marie-Andree

    2010-02-01

    The objective was to determine whether specific intrinsic (age, pattern of cerebral palsy [CP], child's motivation) and extrinsic (number of treatments, parenting stress) characteristics were associated with responsiveness to botulinum toxin A (BoNT-A) injections in children with CP 3 months after injection into the gastrocnemius muscle. Children with hemiplegia or diplegia recruited from a BoNT-A programme were evaluated before and 3 months following injection of BoNT-A into the gastrocnemius. Outcome measures included muscle tone, range of motion, gait pattern, level of ambulation, gross motor function, and functional independence. Determinants of responsiveness to BoNT-A considered were age, number of treatments, distribution of CP, parenting stress, and motivation. Thirty-one children were recruited (17 males, 14 females)--22 with hemiplegia and nine with diplegia. Twenty-eight were classified at Gross Motor Function Classification System (GMFCS) level I and three at level III. The mean age was 6 years 4 months (SD 2y 11mo). Younger age (p=0.015) and fewer number (p=0.024) of BoNT-A treatments were associated with greater change in gross motor function. Child's motivation and parenting stress were significantly associated with improvements in muscle tone (p=0.006-0.017), passive range of motion (p=0.008-0.033), gait pattern (p=0.005-0.042), level of ambulation (p=0.001-0.043), and functional independence (p=0.004-0.027). The results indicate that child, family, and treatment characteristics influence the degree of responsiveness to BoNT-A treatment. The contribution of contextual factors (personal and environmental) on responsiveness may be underappreciated in children with CP.

  8. Cerebral haematocrit measurement

    International Nuclear Information System (INIS)

    Loutfi, Issa.

    1987-01-01

    Regional cerebral haematocrit was measured in a group of sixteen subjects by the single-photon emission computerized tomography method. This group included three normal subjects as controls and thirteen patients affected with ischaemic cerebral disease presenting clinically with transient ischaemic attacks-six patients - or recent cerebral stroke - seven patients. Two intravenous radioactive tracers - technetium-99m labelled autologous red blood cells and Tc-99m human serum albumin were used. Cerebral tomographic imaging was performed using a rotating scintillation camera. The values of cerebral haematocrit obtained, taken as a ratio to venous haematocrit, range between 0.65-0.88 in the subjects studied. As a general finding in normal subjects and in patients with transient ischaemic attacks, no significant difference between right and left hemispheric haematocrit value was noted. However, in the group of patients affected with stroke, a significant difference in the right versus left hemispheric Hct was observed in 3 patients, the higher Hct value corresponding to the affected side. The clinical implication is on the emphasis of cerebral Hct measurement when the measurement of cerebral blood flow or volume is sought. Also the variation in regional Hct value observed in patients with stroke, above mentioned, points to a regulation mechanism of the blood composition for optimal oxygen delivery to the brain that is impaired in these patients. 14 refs. (Author)

  9. Evoked electrical and cerebral vascular responses during sleep and following sleep deprivation.

    Science.gov (United States)

    Schei, Jennifer L; Rector, David M

    2011-01-01

    Neuronal activity elicits vascular dilation, delivering additional blood and metabolites to the activated region. With increasing neural activity, vessels stretch and may become less compliant. Most functional imaging studies assume that limits to vascular expansion are not normally reached except under pathological conditions, with the possibility that metabolism could outpace supply. However, we previously demonstrated that evoked hemodynamic responses were larger during quiet sleep when compared to both waking and rapid eye movement (REM) sleep, suggesting that high basal activity during wake may elicit blunted evoked hemodynamic responses due to vascular expansion limits. We hypothesized that extended brain activity through sleep deprivation will further dilate blood vessels and exacerbate the blunted evoked hemodynamic responses observed during wake, and dampen responses in subsequent sleep. We measured evoked electrical and hemodynamic responses from rats using auditory clicks (0.5s, 10 Hz, 2-13s random ISIs) for 1h following 2, 4, or 6h of sleep deprivation. Time-of-day matched controls were recorded continuously for 7h. Within quiet sleep periods following deprivation, evoked response potential (ERP) amplitude did not differ; however, the evoked vascular response was smaller with longer sleep deprivation periods. These results suggest that prolonged neural activity periods through sleep deprivation may diminish vascular compliance as indicated by the blunted vascular response. Subsequent sleep may allow vessels to relax, restoring their ability to deliver blood. These results also suggest that severe sleep deprivation or chronic sleep disturbances could push the vasculature to critical limits, leading to metabolic deficit and the potential for tissue trauma. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Variability in initial response to standard clopidogrel therapy, delayed conversion to clopidogrel hyper-response, and associated thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms.

    Science.gov (United States)

    Delgado Almandoz, Josser E; Kadkhodayan, Yasha; Crandall, Benjamin M; Scholz, Jill M; Fease, Jennifer L; Tubman, David E

    2014-12-01

    Variability in response to clopidogrel therapy is increasingly being recognized as an important factor in thromboembolic and hemorrhagic complications encountered after neurointerventional procedures. This study aims to determine the variability in response to clopidogrel therapy and associated complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms. We recorded baseline patient characteristics, co-administered medications, P2Y12 reaction units (PRU) values with VerifyNow, clopidogrel dosing, and thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms at our institution during a 19 month period. 100 patients were included in the study, 76 women and 24 men, mean age 57.3 years. 15 patients exhibited an initial clopidogrel hypo-response (PRU >240) and 21 patients an initial clopidogrel hyper-response (PRU <60). 36 patients had a follow-up VerifyNow test performed without changes to the standard 75 mg daily clopidogrel dose, which demonstrated that 59% of patients who had initially been within the target 60-240 PRU range exhibited a delayed conversion to clopidogrel hyper-response. In our cohort, a clopidogrel hypo-response was associated with a significantly increased risk of thromboembolic complications in patients undergoing cerebral aneurysm treatment with stent assistance or the pipeline embolization device (60%, p=0.003), while a clopidogrel hyper-response was associated with a significantly increased risk of major hemorrhagic complications in all patients undergoing endovascular treatment of cerebral aneurysms (11%, p=0.016). We found wide and dynamic variability in response to clopidogrel therapy in patients undergoing endovascular treatment of unruptured cerebral aneurysms, which was significantly associated with thromboembolic and major hemorrhagic complications in our cohort. Published by the BMJ Publishing Group Limited. For permission to use (where

  11. Cerebrovascular reactivity measurement in cerebral small vessel disease: Rationale and reproducibility of a protocol for MRI acquisition and image processing.

    Science.gov (United States)

    Thrippleton, Michael J; Shi, Yulu; Blair, Gordon; Hamilton, Iona; Waiter, Gordon; Schwarzbauer, Christian; Pernet, Cyril; Andrews, Peter Jd; Marshall, Ian; Doubal, Fergus; Wardlaw, Joanna M

    2018-02-01

    Background Impaired autoregulation may contribute to the pathogenesis of cerebral small vessel disease. Reliable protocols for measuring microvascular reactivity are required to test this hypothesis and for providing secondary endpoints in clinical trials. Aims To develop and assess a protocol for acquisition and processing of cerebrovascular reactivity by MRI, in subcortical tissue of patients with small vessel disease and minor stroke. Methods We recruited 15 healthy volunteers, testing paradigms using 1- and 3-min 6% CO 2 challenges with repeat scanning, and 15 patients with history of minor stroke. We developed a protocol to measure cerebrovascular reactivity and delay times, assessing tolerability and reproducibility in grey and white matter areas. Results The 3-min paradigm yielded more reproducible data than the 1-min paradigm (CV respectively: 7.9-15.4% and 11.7-70.2% for cerebrovascular reactivity in grey matter), and was less reproducible in white matter (16.1-24.4% and 27.5-141.0%). Tolerability was similar for the two paradigms, but mean cerebrovascular reactivity and cerebrovascular reactivity delay were significantly higher for the 3-min paradigm in most regions. Patient tolerability was high with no evidence of greater failure rate (1/15 patients vs. 2/15 volunteers withdrew at the first visit). Grey matter cerebrovascular reactivity was lower in patients than in volunteers (0.110-0.234 vs. 0.172-0.313%/mmHg; p < 0.05 in 6/8 regions), as was the white matter cerebrovascular reactivity delay (16.2-43.9 vs. 31.1-47.9 s; p < 0.05 in 4/8 regions). Conclusions An effective and well-tolerated protocol for measurement of cerebrovascular reactivity was developed for use in ongoing and future trials to investigate small vessel disease pathophysiology and to measure treatment effects.

  12. Processamento auditivo e potenciais evocados auditivos de tronco cerebral (BERA Auditory precessing and auditory brainstem response (ABR

    Directory of Open Access Journals (Sweden)

    Marcela Pfeiffer

    2009-01-01

    Full Text Available OBJETIVO: verificar relação existente entre os potenciais auditivos de tronco cerebral e a avaliação comportamental do processamento auditivo. MÉTODOS: foi realizada em um grupo de 60 meninas residentes de Paraíba do Sul na idade de nove a 12 anos com limiares tonais dentro dos padrões de normalidade e timpanometria tipo A com presença dos reflexos acústicos. Os testes utilizados para a avaliação comportamental do processamento auditivo foram: avaliação simplificada do processamento auditivo, teste de fala no ruído, teste de dissílabos alternados e teste dicótico não verbal. Após a avaliação do processamento auditivo, as crianças foram subdivididas em dois grupos, G1 (sem alteração no processamento auditivo e G2 (com alteração no processamento auditivo e submetidas aos potenciais auditivos de tronco cerebral. Os parâmetros utilizados na comparação dos dois grupos foram: latência absoluta das ondas I, III e V; latência interpicos das ondas I-III, I-V, III-V; diferença interaural da latência interpico I-V; e diferença interaural da latência da onda V. RESULTADOS: foram encontradas diferenças estatísticas nos parâmetros de latência interpico das ondas I-V na orelha esquerda (p=0,009, diferença interaural da latência interpico de ondas I-V (p=0,020 e diferença da latência interpico de ondas I e V da orelha direita para a esquerda entre os grupos G1 e G2 (p=0,025. CONCLUSÃO: foi possível encontrar relação dos potenciais evocados auditivos de tronco cerebral com a avaliação comportamental do processamento auditivo nos parâmetros de latência interpico entre as ondas I e V da orelha esquerda e diferença interaural da latência interpico I-V na orelha esquerda.PURPOSE: to investigate the correlation of auditory brainstem response (ABR and behavioral auditory processing evaluation. METHODS: sixty girls, from Paraíba do Sul, ranging from 9 to 12-year-old were evaluated. In order to take part in the study

  13. Effect of ageing on hypoxic exercise cardiorespiratory, muscle and cerebral oxygenation responses in healthy humans.

    Science.gov (United States)

    Puthon, Lara; Bouzat, Pierre; Robach, Paul; Favre-Juvin, Anne; Doutreleau, Stéphane; Verges, Samuel

    2017-04-01

    What is the central question of this study? This study aimed to determine the effect of ageing on cardiorespiratory and tissue oxygenation responses to hypoxia during maximal incremental exercise. What is the main finding and its importance? Older healthy subjects had preserved hypoxic cardiorespiratory and tissue oxygenation responses at rest and during moderate exercise. At maximal exercise, they had a reduced hypoxic ventilatory response but similar maximal power output reduction compared with young individuals. This study suggests that until moderate exercise, hypoxic responses are preserved until the age of 70 years and therefore that ageing is not a contraindication for high-altitude sojourn. This study assessed the effects of ageing on cardiorespiratory and tissue oxygenation responses to hypoxia both at rest and during incremental maximal exercise. Sixteen young (20-30 years old) and 15 older healthy subjects (60-70 years old) performed two maximal incremental cycling tests in normoxia and hypoxia (inspiratory oxygen fraction 12%). Cardiorespiratory responses, prefrontal cortex and quadriceps tissue oxygenation (near-infrared spectroscopy) were measured during exercise as well as during hypercapnia at rest. The hypoxic ventilatory response was similar in young compared with older individuals at rest and during moderate-intensity exercise (50% maximal power output: young 0.9 ± 0.2 versus older 1.1 ± 0.8 l min -1  % -1 ; P > 0.05) but larger in young subjects during high-intensity exercise (maximal power output: 2.2 ± 0.8 versus 1.8 ± 1.1 l min -1  % -1 ; P exercise. During exercise in hypoxia, young subjects showed greater deoxygenation than older subjects, at both the prefrontal cortex and quadriceps levels. The hypoxia-induced reduction in maximal power output (young -32 ± 5% versus older -30 ± 6%; P > 0.05) and the hypercapnic responses did not differ between groups. Older healthy and active individuals below the age of 70

  14. Effects of stimulus mode and ambient temperature on cerebral responses to local thermal stimulation: An EEG study.

    Science.gov (United States)

    Lv, Bin; Su, Chang; Yang, Lei; Wu, Tongning

    2017-03-01

    The physiological responses to human thermal stimulation have been widely investigated, but most of them are mainly concerned about the whole body thermal stimulation. In this study, we investigated the effects of stimulus mode and ambient temperature on cerebral responses during local thermal stimulation on hand. The left hands were stimulated by metal thermostat based and thermostatic water based stimulators at different stimulated temperatures (38°C, 40°C, 42°C and 44°C) and different ambient temperatures (25°C and 32°C). EEG data were recorded over the whole brain during the experiments. Then the statistical comparisons were conducted on the EEG relative power among different experimental sessions. We observed that EEG activities were alternated between thermal stimulated periods and the baseline in all four frequency bands. And there was a higher percentage of delta band power in the right temporal and parietal regions under the ambient temperature of 32°C while compared to 25°C. In addition, the theta band activity under the metal based stimulation showed significantly higher EEG relative power than that under the water based stimulation over the whole brain. Compared with the water based stimulation, there was a lower EEG relative power of the beta band activity during the metal based stimulation in the bilateral frontal and right temporal regions. The experimental results suggested that the neural physiological responses in different EEG frequency bands were sensitive to different influence factors during the local hand thermal stimulation. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. White matter hyperintensities and cerebral amyloidosis: necessary and sufficient for clinical expression of Alzheimer disease?

    Science.gov (United States)

    Provenzano, Frank A; Muraskin, Jordan; Tosto, Giuseppe; Narkhede, Atul; Wasserman, Ben T; Griffith, Erica Y; Guzman, Vanessa A; Meier, Irene B; Zimmerman, Molly E; Brickman, Adam M

    2013-04-01

    Current hypothetical models emphasize the importance of β-amyloid in Alzheimer disease (AD) pathogenesis, although amyloid alone is not sufficient to account for the dementia syndrome. The impact of small-vessel cerebrovascular disease, visualized as white matter hyperintensities (WMHs) on magnetic resonance imaging scans, may be a key factor that contributes independently to AD presentation. To determine the impact of WMHs and Pittsburgh Compound B (PIB) positron-emission tomography-derived amyloid positivity on the clinical expression of AD. Baseline PIB-positron-emission tomography values were downloaded from the Alzheimer's Disease Neuroimaging Initiative database. Total WMH volume was derived on accompanying structural magnetic resonance imaging data. We examined whether PIB positivity and total WMHs predicted diagnostic classification of patients with AD (n = 20) and control subjects (n = 21). A second analysis determined whether WMHs discriminated between those with and without the clinical diagnosis of AD among those who were classified as PIB positive (n = 28). A third analysis examined whether WMHs, in addition to PIB status, could be used to predict future risk for AD among subjects with mild cognitive impairment (n = 59). The Alzheimer's Disease Neuroimaging Initiative public database. The study involved data from 21 normal control subjects, 59 subjects with mild cognitive impairment, and 20 participants with clinically defined AD from the Alzheimer Disease's Neuroimaging Initiative database. Clinical AD diagnosis and WMH volume. Pittsburgh Compound B positivity and increased total WMH volume independently predicted AD diagnosis. Among PIB-positive subjects, those diagnosed as having AD had greater WMH volume than normal control subjects. Among subjects with mild cognitive impairment, both WMH and PIB status at baseline conferred risk for future diagnosis of AD. White matter hyperintensities contribute to the presentation of AD and, in the context of

  16. Association of Aortic Compliance and Brachial Endothelial Function with Cerebral Small Vessel Disease in Type 2 Diabetes Mellitus Patients: Assessment with High-Resolution MRI

    Directory of Open Access Journals (Sweden)

    Yan Shan

    2016-01-01

    Full Text Available Objective. To assess the possible association of aortic compliance and brachial endothelial function with cerebral small vessel disease in type 2 diabetes mellitus (DM2 patients by using 3.0 T high-resolution magnetic resonance imaging. Methods. Sixty-two clinically confirmed DM2 patients (25 women and 37 men; mean age: 56.8±7.5 years were prospectively enrolled for noninvasive MR examinations of the aorta, brachial artery, and brain. Aortic arch pulse wave velocity (PWV, flow-mediated dilation (FMD of brachial artery, lacunar brain infarcts, and periventricular and deep white matter hyperintensities (WMHs were assessed. Pearson and Spearman correlation analysis were performed to analyze the association between PWV and FMD with clinical data and biochemical test results. Univariable logistic regression analyses were used to analyze the association between PWV and FMD with cerebral small vessel disease. Multiple logistic regression analyses were used to find out the independent predictive factors of cerebral small vessel disease. Results. Mean PWV was 6.73±2.00 m/s and FMD was 16.67±9.11%. After adjustment for compounding factors, PWV was found significantly associated with lacunar brain infarcts (OR = 2.00; 95% CI: 1.14–3.2; P<0.05 and FMD was significantly associated with periventricular WMHs (OR = 0.82; 95% CI: 0.71–0.95; P<0.05. Conclusions. Quantitative evaluation of aortic compliance and endothelial function by using high-resolution MRI may be potentially useful to stratify DM2 patients with risk of cerebral small vessel disease.

  17. Neural restrictive silencer factor and choline acetyltransferase expression in cerebral tissue of Alzheimer’s Disease patients: A pilot study

    Science.gov (United States)

    González-Castañeda, Rocío E.; Sánchez-González, Víctor J.; Flores-Soto, Mario; Vázquez-Camacho, Gonzalo; Macías-Islas, Miguel A.; Ortiz, Genaro G.

    2013-01-01

    Decreased Choline Acetyltransferase (ChAT) brain level is one of the main biochemical disorders in Alzheimer’s Disease (AD). In rodents, recent data show that the CHAT gene can be regulated by a neural restrictive silencer factor (NRSF). The aim of the present work was to evaluate the gene and protein expression of CHAT and NRSF in frontal, temporal, entorhinal and parietal cortices of AD patient brains. Four brains from patients with AD and four brains from subjects without dementia were studied. Cerebral tissues were obtained and processed by the guanidine isothiocyanate method for RNA extraction. CHAT and NRSF gene and protein expression were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. CHAT gene expression levels were 39% lower in AD patients as compared to the control group (p 0.05, U test) than in the control subjects. These findings suggest for the first time that in the brain of AD patients high NRSF protein levels are related to low CHAT gene expression levels. PMID:23569405

  18. Analysis of depression and anxiety state and changes of regional cerebral blood flow in patients with Graves' disease

    International Nuclear Information System (INIS)

    Yu Jiangyuan; Li Yaming; Yin Yafu; Li Xuena; Han Chunqi; Li Deshun; Liu Hao; Li Na; Liang Chenrong; Sun Zhenqiu

    2006-01-01

    Objective: To explore the incidence of depression and anxiety state and the changes of regional cerebral blood flow (rCBF) in patients with Graves' disease (GD). Methods: Twenty-one GD patients underwent rCBF SPECT imaging, and their mental state was evaluated by Zung self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS) respectively. Results: Total scores obtained from SDS and SAS were both significantly greater in the GD group than that in the control group (t SDS =7.26, t SAS =5.35, P 3 , FT 4 and TSH levels. In SPECT imaging, GD group had decreased uptake of radioactivity in frontal lobs, temporal lobs, basal ganglia and thalamus mainly. There was also no significant correlation between the decrease of rCBF and SDS or SAS scores. Conclusions: The psychiatric symptoms in GD group are more significant than normal controls, rCBF of GD group decreases mainly in bilateral frontal lobes, temporal lobes, basal ganglia and thalamus. (authors)

  19. Cerebral amyloid angiopathy and its co-occurrence with Alzheimer’s disease and other cerebrovascular neuropathologic changes

    Science.gov (United States)

    Brenowitz, Willa D.; Nelson, Peter T.; Besser, Lilah M.; Heller, Katherine B.; Kukull, Walter A.

    2015-01-01

    We examined the relationship between cerebral amyloid angiopathy (CAA), Alzheimer’s disease neuropathologic changes (ADNC), other vascular brain pathologies, and cognition in a large multi-center autopsy sample. Data was obtained from the National Alzheimer’s Coordinating Center on autopsied subjects (N=3,976) who died between 2005 and 2012. Descriptive statistics and multivariable regression models estimated the associations between CAA and other pathologies, and between CAA severity and cognitive test scores proximal to death. CAA tended to co-occur with ADNC but a substantial minority of cases were discrepant. CAA was absent in 22% (n= 520) of subjects with frequent neuritic plaques but present in 20.9% (n=91) of subjects with no neuritic plaques. In subjects with no/sparse neuritic plaques, non-hemorrhagic brain infarcts were more common in those with CAA pathology than without (P= 0.007). In subjects without the APOE ε4 allele, CAA severity was associated with lower cognition proximal to death, factoring in other pathologies. The presence of CAA in non-AD patients may indicate a distinct cerebrovascular condition. PMID:26239176

  20. Cerebral NIRS as a marker of superior vena cava oxygen saturation in neonates with congenital heart disease.

    Science.gov (United States)

    Ricci, Zaccaria; Garisto, Cristiana; Favia, Isabella; Schloderer, Ulrike; Giorni, Chiara; Fragasso, Tiziana; Picardo, Sergio

    2010-11-01

    To investigate the correlation between cerebral near-infrared spectroscopy (NIRS) (rSO2c) and superior vena cava venous oxygen saturation (ScvO2) in newborn patients with congenital heart disease (CHD). NIRS is a noninvasive method to monitor hemoglobin oxygen saturation using nonpulsatile oximetry. We retrospectively analyzed perioperative data from 100 newborn patients who underwent cardiac surgery for CHD. rSO2c, ScvO2 from 24 h before to 72 h after surgery were recorded. rSO2c had a fair correlation with ScvO2 (r 0.37; P newborn patients with cyanotic and acyanotic CHD provides a continuous noninvasive information with a fair correlation with ScvO2%: some predictable variables (i.e., time from surgery, carbon dioxide, and venous saturation levels), should guide the operators to adjust rSO2c values in terms of ScvO2. Serial measures of ScvO2 seem recommended to tailor rSO2c information on actual venous saturation percentage. © 2010 Blackwell Publishing Ltd.

  1. Elevated levels of hemoglobin A1c are associated with cerebral white matter disease in patients with stroke.

    Science.gov (United States)

    Rozanski, Michal; Richter, Tobias B; Grittner, Ulrike; Endres, Matthias; Fiebach, Jochen B; Jungehulsing, Gerhard J

    2014-04-01

    This study was conducted to investigate the association of cerebral white matter disease (WMD) on MRI with vascular risk factors and laboratory findings in consecutive first acute ischemic stroke patients. Acute ischemic stroke patients underwent MRI ≤24 hours after stroke onset and follow-up on day 2. WMD was scored on fluid attenuated inversion recovery MRI according to the Wahlund score. Vascular risk factors and laboratory parameters were assessed during hospital stay. Univariate and multiple logistic regression analyses were performed. We included 512 patients with first acute ischemic stroke (mean age, 68.5 [SD, 13.2] years; 192 women (37.5%); median National Institutes of Health Stroke Scale on admission, 3 [interquartile range, 1-6]; and median Wahlund score, 4 [interquartile range, 2-9]). WMD was present in 460 (89.8%) patients. In univariate analysis, age, arterial hypertension, reduced estimated glomerular filtration rate, hemoglobin A1c (HbA1c) levels, diabetes mellitus, and female sex were associated with the presence of WMD (Pstroke patients. This may suggest that chronic disturbance of glycemia measured by HbA1c plays a role in the pathophysiology of WMD. http://www.clinicaltrials.gov. Unique identifier: NCT00715533.

  2. Hemoglobin, hematocrit, and changes in cerebral blood flow: the Second Manifestations of ARTerial disease-Magnetic Resonance study.

    Science.gov (United States)

    van der Veen, Pieternella H; Muller, Majon; Vincken, Koen L; Westerink, Jan; Mali, Willem P T M; van der Graaf, Yolanda; Geerlings, Mirjam I

    2015-03-01

    Hemoglobin and hematocrit are important determinants of blood viscosity and arterial oxygen content and may therefore influence cerebral blood flow (CBF). We examined cross-sectional and prospective associations of hemoglobin and hematocrit with CBF in 569 patients with manifest arterial disease (mean age 57 ± 10 years) with available data on magnetic resonance angiography to measure parenchymal CBF. Mean (SD) parenchymal CBF at baseline was 52.3 (9.8) mL/min/100 mL and decreased with 1.5 (11.0) mL/min/100 mL after on average 3.9 years of follow-up. Linear regression analyses showed that greater hemoglobin and hematocrit values were associated with lower baseline parenchymal CBF and more decline in parenchymal CBF over time, independent of cardiovascular risk factors, use of antiplatelet drugs, anticoagulants, or diuretics, and brain measures: adjusted mean differences (95% confidence interval [CI]) in decline in parenchymal CBF between patients in the lower and upper quartiles of hemoglobin and hematocrit were -2.48 (95% CI -3.70 to -1.25) and -3.69 (95% CI -5.45 to -1.94) mL/min/100 mL. Higher hemoglobin and hematocrit were associated with lower baseline parenchymal CBF and a greater decline in parenchymal CBF over time, possibly as a result of physiological compensating mechanisms. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Effects of Shaoyao-Gancao Decoction on Infarcted Cerebral Cortical Neurons: Suppression of the Inflammatory Response following Cerebral Ischemia-Reperfusion in a Rat Model

    Science.gov (United States)

    Jia, Xinling; Yang, Jian; Li, Qing; Yan, Guofeng; Xu, Zhongju; Wang, Jingye

    2016-01-01

    The mechanisms by which Shaoyao-Gancao decoction (SGD) inhibits the production of inflammatory cytokines in serum and brain tissue after cerebral ischemia-reperfusion (CI-RP) in rats were investigated. A right middle cerebral artery occlusion was used to induce CI-RP after which the rats were divided into model (n = 39), SGD (n = 28), clopidogrel (n = 25) and sham operated (n = 34) groups. The Bederson scale was used to evaluate changes in behavioral indices. The levels of IL-1β, TNF-α, MCP-1, IL-10, RANTES, VEGF, and TGF-β1 in the serum and infarcted brain tissues were measured. Nissl body and immunohistochemical staining methods were used to detect biochemical changes in neurons, microglial cells, and astrocytes. Serum levels of VEGF, TNF-α, MCP-1, IL-1β, and IL-10 increased significantly 24 h after CI-RP. In brain tissue, levels of TNF-α and IL-1β significantly increased 24 h after CI-RP, whereas levels of TGF-β1 and MCP-1 were significantly higher 96 h after CI-RP (P < 0.05). SGD or clopidogrel after CI-RP reduced TNF-α and IL-1β levels in brain tissue and serum levels of MCP-1, IL-1β, and IL-10. SGD increased the number of NeuN-positive cells in infarcted brain tissue and reduced the number of IBA1-positive and GFAP-positive cells. The efficacy of SGD was significantly higher than that of clopidogrel. PMID:27413737

  4. Clinical and magnetic resonance observations in cerebral small-vessel disease

    NARCIS (Netherlands)

    Kwa, V.I.H.

    1999-01-01

    The study reported in this thesis tried to address the following questions: 1. Is it possible to detect genetic factors and vascular risk factors that are specifically associated with the development of small- or large-vessel disease? 2. Are the different clinical and MRI manifestations, that are

  5. Gait-related cerebral alterations in patients with Parkinson's disease with freezing of gait

    NARCIS (Netherlands)

    Snijders, A.H.; Leunissen, H.P.; Bakker, M.; Overeem, S.; Helmich, R.C.G.; Bloem, B.R.; Toni, I.

    2011-01-01

    Freezing of gait is a common, debilitating feature of Parkinson’s disease. We have studied gait planning in patients with freezing of gait, using motor imagery of walking in combination with functional magnetic resonance imaging. This approach exploits the large neural overlap that exists between

  6. Gait-related cerebral alterations in patients with Parkinson's disease with freezing of gait

    NARCIS (Netherlands)

    Snijders, A.H.; Leunissen, I.; Bakker, M.; Overeem, S.; Helmich, R.C.G.; Bloem, B.R.; Toni, I.

    2011-01-01

    Freezing of gait is a common, debilitating feature of Parkinson's disease. We have studied gait planning in patients with freezing of gait, using motor imagery of walking in combination with functional magnetic resonance imaging. This approach exploits the large neural overlap that exists between

  7. Patterns of cortical degeneration in an elderly cohort with cerebral small vessel disease.

    NARCIS (Netherlands)

    Reid, A.T.; Norden, A.G.W. van; Laat, K.F. de; Oudheusden, L.J.B. van; Zwiers, M.P.; Evans, A.C.; Leeuw, F.E. de; Kotter, R.

    2010-01-01

    Emerging noninvasive neuroimaging techniques allow for the morphometric analysis of patterns of gray and white matter degeneration in vivo, which may help explain and predict the occurrence of cognitive impairment and Alzheimer's disease. A single center prospective follow-up study (Radboud

  8. Increased cerebral oxygen extraction capacity in patients with Alzheimer’s disease

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Gyldensted, Louise; Nagenthiraja, Kartheeban

    Vascular risk factors are suspected to play a role in the etiology of Alzheimer’s disease. Recently, a model that relates capillary dysfunction to the development of AD was proposed [1]. The model predicts that increased capillary dysfunction leads to increased oxygen extraction in order to support...

  9. In vivo evidence of cerebellar atrophy and cerebral white matter loss in Huntington disease

    DEFF Research Database (Denmark)

    Fennema-Notestine, C; Archibald, S.L.; Jacobsen, M.W.

    2004-01-01

    OBJECTIVE: To investigate the regional pattern of white matter and cerebellar changes, as well as subcortical and cortical changes, in Huntington disease (HD) using morphometric analyses of structural MRI. METHODS: Fifteen individuals with HD and 22 controls were studied; groups were similar in age...

  10. Cerebral serotonin 4 receptors and amyloid-β in early Alzheimer's disease

    DEFF Research Database (Denmark)

    Madsen, Karine; Neumann, Wolf-Julian; Holst, Klaus Kähler

    2011-01-01

    Alzheimer disease (AD) patients in relation to cortical Aß burden. Eleven newly diagnosed untreated AD patients (mean MMSE 24, range 19–27) and twelve age- and gender-matched healthy controls underwent a two-hour dynamic [11C]SB207145 PET scan to measure the binding potential of the 5-HT4 receptor. All AD...

  11. Cerebral blood flow and metabolic patterns as predictors of response to bilateral anterior capsulotomy for obsessive-compulsive disorder: a retrospective study

    International Nuclear Information System (INIS)

    Borbely, K.; Babel, B.; Tron, L.; Nemeth, A.; Pataki, E.; Csigo, E.; Morocz, K.; Lukacs, E.

    2002-01-01

    Aims: Earlier Single Photon Emission Tomography (SPECT) and Positron Emission Tomography (PET) studies of patients with Obsessive-Compulsive Disorder (OCD) have demonstrated abnormal regional Cerebral Blood Flow (rCBF) and Cerebral Glucose Metabolic (rCGlM) pattern in the orbitofrontal-basal ganglia-thalamo-cortical circuits (OBgThC). OCD is characterized by intrusive, repetitive thoughts and/or behaviors that cause marked distress. In case of a severe, and medically and/or psycho therapeutically intractable disease surgical therapy remains the only possible solution. The purpose of this study was to evaluate rCBF and rCGlM patterns as potential predictors of treatment response to bilateral anterior capsulotomy. We performed rCBF SPECT and rCGlM PET studies in 5 patients with severe, intractable OCD before and after (3, 6 and 12 months) surgical therapy. Methods: The assessment included neurological, psychiatrical examination, CT, MRI, and neuropsychological evaluation. 99mTc-HMPAO-SPECT and 18F-FDG-PET studies were carried out with a standard technique for each patient. The data were analyzed visually and by a special region of interests (ROIs) program. The rCBF SPECT and glucose metabolic PET results were compared to clinical and neuropsychological findings. Results: The SPECT and PET measurements showed significant (p<0.05) rCBF and metabolic abnormalities in caudate nuclei, thalamus, singular and orbitofrontal cortex. There was a marked, but individually variable rCBF and rCGlM pattern before and after surgery. Additionally, the preoperative and postoperative rCBF and rCGlM data proved to be concordant with clinical and neuropsychological findings. Conclusion: Both SPECT and PET (before and after surgery) proved to be concordant with clinical and neuropsychological findings. However, rCGlM PET measurements had a higher sensitivity. Patients with higher preoperative rCBF and rCGlM rates of OBgThC circuits were associated with a better postoperative outcome. RCBF

  12. pH-Responsive biodegradable polymeric micelles with anchors to interface magnetic nanoparticles for MR imaging in detection of cerebral ischemic area

    Science.gov (United States)

    Yang, Hong Yu; Jang, Moon-Sun; Gao, Guang Hui; Lee, Jung Hee; Lee, Doo Sung

    2016-06-01

    A novel type of pH-responsive biodegradable copolymer was developed based on methyloxy-poly(ethylene glycol)-block-poly[dopamine-2-(dibutylamino) ethylamine-l-glutamate] (mPEG-b-P(DPA-DE)LG) and applied to act as an intelligent nanocarrier system for magnetic resonance imaging (MRI). The mPEG-b-P(DPA-DE)LG copolymer was synthesized by a typical ring opening polymerization of N-carboxyanhydrides (NCAs-ROP) using mPEG-NH2 as a macroinitiator, and two types of amine-terminated dopamine groups and pH-sensitive ligands were grafted onto a side chain by a sequential aminolysis reaction. This design greatly benefits from the addition of the dopamine groups to facilitate self-assembly, as these groups can act as high-affinity anchors for iron oxide nanoparticles, thereby increasing long-term stability at physiological pH. The mPEG moiety in the copolymers helped the nanoparticles to remain well-dispersed in an aqueous solution, and pH-responsive groups could control the release of hydrophobic Fe3O4 nanoparticles in an acidic environment. The particle size of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles was measured by dynamic light scattering (DLS) and cryo-TEM. The superparamagnetic properties of the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles were confirmed by a superconducting quantum interference device (SQUID). T2-weighted magnetic resonance imaging (MRI) of Fe3O4-loaded mPEG-b-P(DPA-DE)LG phantoms exhibited enhanced negative contrast with an r2 relaxivity of approximately 106.7 mM-1 s-1. To assess the ability of the Fe3O4-loaded mPEG-P(DE-DPA)LG micelles to act as MRI probes, we utilized a cerebral ischemia disease rat model with acidic tissue. We found that a gradual change in contrast in the cerebral ischemic area could be visualized by MRI after 1 h, and maximal signal loss was detected after 24 h post-injection. These results demonstrated that the Fe3O4-loaded mPEG-b-P(DPA-DE)LG micelles can act as pH-triggered MRI probes for diagnostic imaging of acidic

  13. Quantitative perfusion computed tomography measurements of cerebral hemodynamics: Correlation with digital subtraction angiography identified primary and secondary cerebral collaterals in internal carotid artery occlusive disease

    International Nuclear Information System (INIS)

    Cheng Xiaoqing; Tian Jianming; Zuo Changjing; Liu Jia; Zhang Qi; Lu Guangming

    2012-01-01

    Background: The aim of the present study was to assess hemodynamic variations in symptomatic unilateral internal carotid artery occlusion (ICAO) patients with primary collateral flow via circle of Willis or secondary collateral flow via ophthalmic artery and/or leptomeningeal collaterals. Methods: Thirty-eight patients with a symptomatic unilateral ICAO were enrolled in the study. Based on digital subtraction angiography (DSA) findings, patients were classified into 2 groups: primary collateral (n = 14) and secondary collateral (n = 24) groups. Collateral flow hemodynamics were investigated with perfusion computed tomography (PCT) by measuring the cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) in the hemispheres ipsilateral and contralateral to ICAO. Based on the measurements, the ipsilateral to contralateral ratio for each parameter was calculated and compared. Results: Irrespective of the collateral patterns, ipsilateral CBF was not significantly different from that of the contralateral hemisphere (P = 0.285); ipsilateral CBV and TTP was significantly increased compared with those of the contralateral hemisphere (P = 0.000 and P = 0.000 for CBV and TTP, respectively). Furthermore, patients with secondary collaterals had significantly larger ipsilateral-to-contralateral ratios for both CBV (rCBV, P = 0.0197) and TTP (rTTP, P = 0.000) than those of patients with only primary collaterals. These two groups showed no difference in ipsilateral-to-contralateral ratio for CBF (rCBF, P = 0.312). Conclusion: Patients with symptomatic unilateral ICAO in our study were in an autoregulatory vasodilatation status. Moreover, secondary collaterals in ICAO patients were correlated with ipsilateral CBV and delayed TTP that suggested severe hemodynamic impairment, presumably increasing the risk of ischemic events.

  14. Neural response to visual sexual cues in dopamine treatment-linked hypersexuality in Parkinson's disease.

    Science.gov (United States)

    Politis, Marios; Loane, Clare; Wu, Kit; O'Sullivan, Sean S; Woodhead, Zoe; Kiferle, Lorenzo; Lawrence, Andrew D; Lees, Andrew J; Piccini, Paola

    2013-02-01

    Hypersexuality with compulsive sexual behaviour is a significant source of morbidity for patients with Parkinson's disease receiving dopamine replacement therapies. We know relatively little about the pathophysiology of hypersexuality in Parkinson's disease, and it is unknown how visual sexual stimuli, similar to the portrayals of sexuality in the mainstream mass media may affect the brain and behaviour in such susceptible individuals. Here, we have studied a group of 12 patients with Parkinson's disease with hypersexuality using a functional magnetic resonance imaging block design exposing participants to both sexual, other reward-related and neutral visual cues. We hypothesized that exposure to visual sexual cues would trigger increased sexual desire in patients with Parkinson's disease with hypersexuality that would correspond to changes in brain activity in regions linked to dopaminergically stimulated sexual motivation. Patients with Parkinson's disease with hypersexuality were scanned ON and OFF dopamine drugs, and their results were compared with a group of 12 Parkinson's disease control patients without hypersexuality or other impulse control disorders. Exposure to sexual cues significantly increased sexual desire and hedonic responses in the Parkinson's disease hypersexuality group compared with the Parkinson's disease control patients. These behavioural changes corresponded to significant blood oxygen level-dependent signal changes in regions within limbic, paralimbic, temporal, occipital, somatosensory and prefrontal cortices that correspond to emotional, cognitive, autonomic, visual and motivational processes. The functional imaging data showed that the hypersexuality patients' increased sexual desire correlated with enhanced activations in the ventral striatum, and cingulate and orbitofrontal cortices. When the patients with Parkinson's disease with hypersexuality were OFF medication, the functional imaging data showed decreases in activation during

  15. Deep Ocean Mineral Supplementation Enhances the Cerebral Hemodynamic Response during Exercise and Decreases Inflammation Postexercise in Men at Two Age Levels

    Directory of Open Access Journals (Sweden)

    Ching-Yin Wei

    2017-12-01

    Full Text Available Background: Previous studies have consistently shown that oral supplementation of deep ocean minerals (DOM improves vascular function in animals and enhances muscle power output in exercising humans.Purpose: To examine the effects of DOM supplementation on the cerebral hemodynamic response during physical exertion in young and middle-aged men.Design: Double-blind placebo-controlled crossover studies were conducted in young (N = 12, aged 21.2 ± 0.4 years and middle-aged men (N = 9, aged 46.8 ± 1.4 years. The counter-balanced trials of DOM and Placebo were separated by a 2-week washout period. DOM and Placebo were orally supplemented in drinks before, during, and after cycling exercise. DOM comprises desalinated minerals and trace elements from seawater collected ~618 m below the earth's surface.Methods: Cerebral hemodynamic response (tissue hemoglobin was measured during cycling at 75% VO2max using near infrared spectroscopy (NIRS.Results: Cycling time to exhaustion at 75% VO2max and the associated plasma lactate response were similar between the Placebo and DOM trials for both age groups. In contrast, DOM significantly elevated cerebral hemoglobin levels in young men and, to a greater extent, in middle-aged men compared with Placebo. An increased neutrophil to lymphocyte ratio (NLR was observed in middle-aged men, 2 h after exhaustive cycling, but was attenuated by DOM.Conclusion: Our data suggest that minerals and trace elements from deep oceans possess great promise in developing supplements to increase the cerebral hemodynamic response against a physical challenge and during post-exercise recovery for middle-aged men.

  16. BH4 treatment in BH4-responsive PKU patients : Preliminary data on blood prolactin concentrations suggest increased cerebral dopamine concentrations

    NARCIS (Netherlands)

    van Vliet, Danique; Anjema, Karen; Jahja, Rianne; de Groot, Martijn J; Liemburg, Geertje B; Heiner-Fokkema, Rebecca; van der Zee, Eddy A; Derks, Terry G J; Kema, Ido P; van Spronsen, Francjan J

    In phenylketonuria (PKU), cerebral neurotransmitter deficiencies have been suggested to contribute to brain dysfunction. Present treatment aims to reduce blood phenylalanine concentrations by a phenylalanine-restricted diet, while in some patients blood phenylalanine concentrations also respond to

  17. Contractile responses to ergotamine and dihydroergotamine in the perfused middle cerebral artery of rat

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer; Nilsson, Elisabeth; Edvinsson, Lars

    2007-01-01

    , with pEC(50) values of 7.6+/-0.2 for ergotamine and 8.4+/-0.5 for DHE. The responses were blocked by the 5-HT(2A) receptor antagonist ketanserin (concentration 10(-12) to 10(-5) M) and partially with the 5-HT(1B) receptor antagonist BRL-11557PM-B. The 5-HT(1D) receptor antagonist SB-224289-A had...... no significant effect. Using a myograph technique, isolated ring segments of the MCA with intact endothelium were mounted on two metal wires. Neither agonist caused relaxation of resting vessels, however, they both responded by weak contractile responses (26+/-3% of submaximal contractile capacity relative to 60...

  18. Characteristic deterioration of ADAS-Jcog subscale scores and correlations with regional cerebral blood flow reductions in Alzheimer's disease.

    Science.gov (United States)

    Yoshii, Fumihito; Kawaguchi, Chikako; Kohara, Saori; Shimizu, Mie; Onaka, Hiroe; Ryo, Masafuchi; Takahashi, Wakoh

    2018-05-01

    The Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-Jcog) is composed of a number of subscale tasks. However, it is not clear which subscale tasks are most susceptible to impairment in Alzheimer's disease (AD) or what is the relationship between reduction in regional cerebral blood flow (rCBF) and decreased ADAS-Jcog scores. Subjects were 32 AD patients, aged 52-86 years. We examined the relationship between subscale tasks that showed marked score changes and brain regions that showed reduced rCBF over a 2-year period. rCBF was measured by single-photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimer ( 99m Tc-ECD), and the SPECT imaging data were analyzed with the easy Z-score imaging system (eZIS) and voxel-based stereotactic extraction estimation (vbSEE) methods. Total score of ADAS-Jcog deteriorated from 19.5 ± 7.0 to 35.7 ± 15.2 after 2 years. Subscale scores were significantly worse in all fields, particularly in orientation, word recall, remembering test instructions, commands, constructional praxis, and ideational praxis, in that order. Significant correlations were found between (1) word recall and commands and rCBF in the left middle temporal lobe, (2) naming objects/fingers and rCBF in the left temporal (middle, inferior) lobe, and (3) constructional and ideational praxis and rCBF in the right parietal (superior, inferior) lobe, temporal (superior, middle) lobe, angular gyrus, and cingulate gyrus. We identified the brain regions associated with specifically impaired subscales of ADAS-Jcog during progressive deterioration of AD over 2 years.

  19. Cerebral blood flow reactivity to hyperventilation in children with spontaneous occlusion of the circle of Willis (moyamoya disease)

    Energy Technology Data Exchange (ETDEWEB)

    Isobe, Masanori; Kuroda, Satoshi; Kamiyama, Hiroyasu; Abe, Hiroshi (Hokkaido Univ., Sapporo (Japan). School of Medicine); Mitumori, Kenji

    1992-04-01

    To elucidate the relationship between cerebral blood flow (CBF) after hyperventilation (HV) and the re-build-up phenomenon on the encephaloelectrogram (EEG) in children with moyamoya disease, comparative study of CBF immediately after HV and CBF after administration of acetazolamide (Diamox) was examined. CBF was measured by means of single photon emission CT (SPECT) using the {sup 133}Xe inhalation method. The subjects were 11 children (21 hemispheres) with moyamoya disease who were divided into two groups as follows: Bypass group; who underwent STA-MCA anastomosis with other synangiosis. Non-bypass group; who underwent only some synangiosis such as EDAS, EMAS and EMS. Regional CBF (rCBF) after HV of the frontal lobes in the non-bypass group had an evident tendency to show low perfusion compared with CBF in other regions. The correlation between low perfusion area after HV, and areas where the increase of rCB is less after administration of acetazolamide became clear. The strongest relation was observed between low perfusion after HV and re-build-up phenomenon on EEG. On the other hand, rCBF after HV of the frontal lobes in the bypass group had, compared with other regions, no tendency to show low perfusion. From this study and our previous reports, it is assumed that there is some hemodynamics insufficiency in the frontal lobes of the non-bypass group. The reason why the reduction of rCBF was less after HV especially in the frontal lobes of the bypass group is still unknown. But, most of anterior branches of STA were used for the anastomosis and the craniotomy of the bypass group was made in a more anterior position than that of the non-bypass group. These surgical procedures are estimated to bring about a much better collateral blood flow to the frontal lobes. (author).

  20. Deficits in iodine-labelled 3-quinuclidinyl benzilate binding in relation to cerebral blood flow in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Wyper, D.J.; Brown, D.; Patterson, J.; Owens, J.; Hunter, R.; Teasdale, E.; McCulloch, J.

    1993-01-01

    A loss of acetylcholine is one of the most consistent neurochemical findings in Alzheimer's disease (AD) post-mortem, but the debate concerning receptor abnormalities is unresolved. The aim of this investigation was to measure the density of acetylcholine muscarinic receptors in AD patients at various stages in the disease (N=8) by synthesising a radio-iodinated version of quinuclidinyl benzilate QNB, a potent muscarinic antagonist. Deficits were identified by comparison with a control data set obtained from four elderly volunteers and then compared to the deficit in total functional activity in the same brain regions measured using the cerebral perfusion tracer technetium-99m hexamethylpropylene amine oxime. Iodine-123 (R, R)quinuclidinyl benzilate (QNB) was synthesised using a CuI assisted nucleophilic aromatic exchange reaction. 160 MBq of the radioligand (specific activity 400 Ci/mmol: Dose 90 ng/kg) was administered to each subject. Diagnosis of AD was made using the CAMDEX and DSMIIIR criteria with a physical examination, full blood screen, CT and chest X-ray. All subjects were scanned at 21 h post injection on an SME810 emission tomograph. 123 I(R, R)QNB activity in the controls was found to be consistent with the known distribution of muscarinic receptors with no activity in the cerebellum and low activity in the thalamus. In the AD patients deficits in 123 I-QNB binding which exceeded the corresponding total functional regional perfusion deficit were not found in six of the patients and were observed only in the two most severely affected patients, both of whom were untestable on the cognitive battery. This adds weight to the evidence that a major reduction in postsynaptic receptor density takes place only at a very late stage of AD. (orig.)

  1. Influence of the serotonin transporter promoter gene and shyness on children's cerebral responses to facial expressions.

    Science.gov (United States)

    Battaglia, Marco; Ogliari, Anna; Zanoni, Annalisa; Citterio, Alessandra; Pozzoli, Uberto; Giorda, Roberto; Maffei, Cesare; Marino, Cecilia

    2005-01-01

    Childhood shyness can predate social anxiety disorder and may be associated with biased discrimination of facial expressions of emotions. To determine whether childhood shyness, or the serotonin transporter promoter polymorphism genotype, can predict participants' visual event-related potentials in response to expressions of children of similar ages. Study group drawn from an inception cohort of 149 subjects characterized 1 year before the present study by their degree of shyness. Third- and fourth-grade schoolchildren. Forty-nine of the inception cohort children, randomly selected. Latencies and amplitudes of the N400 waveform in response to happy, neutral, and angry expressions. Shyness predicted significantly smaller N400 amplitudes in response to anger (at Pz: P Shyness was significantly different across the 3 genotypes, the SS genotype being associated with higher shyness levels (analysis of variance: F(2,42) = 4.47, P shyness or have 1 or 2 copies of the short allele of the serotonin transporter promoter gene appear to have a different pattern of processing affective stimuli of interpersonal hostility.

  2. Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise

    Directory of Open Access Journals (Sweden)

    Takashi eTarumi

    2014-01-01

    Full Text Available Alzheimer disease (AD and cerebrovascular disease often coexist with advanced age. Mounting evidence indicates that the presence of vascular disease and its risk factors increase the risk of AD, suggesting a potential overlap of the underlying pathophysiological mechanisms. In particular, atherosclerosis, endothelial dysfunction, and stiffening of central elastic arteries have been shown to associate with AD. Currently, there are no effective treatments for the cure and prevention of AD. Vascular risk factors are modifiable via either pharmacological or lifestyle intervention. In this regard, habitual aerobic exercise is increasingly recognized for its benefits on brain structure and cognitive function. Considering the well-established benefits of regular aerobic exercise on vascular health, exercise-related improvements in brain structure and cognitive function may be mediated by vascular adaptations. In this review, we will present the current evidence for the physiological mechanisms by which vascular health alters the structural and functional integrity of the aging brain and how improvements in vascular health, via regular aerobic exercise, potentially benefits cognitive function.

  3. Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise.

    Science.gov (United States)

    Tarumi, Takashi; Zhang, Rong

    2014-01-01

    Alzheimer disease (AD) and cerebrovascular disease often coexist with advanced age. Mounting evidence indicates that the presence of vascular disease and its risk factors increase the risk of AD, suggesting a potential overlap of the underlying pathophysiological mechanisms. In particular, atherosclerosis, endothelial dysfunction, and stiffening of central elastic arteries have been shown to associate with AD. Currently, there are no effective treatments for the cure and prevention of AD. Vascular risk factors are modifiable via either pharmacological or lifestyle intervention. In this regard, habitual aerobic exercise is increasingly recognized for its benefits on brain structure and cognitive function. Considering the well-established benefits of regular aerobic exercise on vascular health, exercise-related improvements in brain structure and cognitive function may be mediated by vascular adaptations. In this review, we will present the current evidence for the physiological mechanisms by which vascular health alters the structural and functional integrity of the aging brain and how improvements in vascular health, via regular aerobic exercise, potentially benefits cognitive function.

  4. Th17 Response and Inflammatory Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Janelle C. Waite

    2012-01-01

    Full Text Available The proinflammatory activity of T helper 17 (Th17 cells can be beneficial to the host during infection. However, uncontrolled or inappropriate Th17 activation has been linked to several autoimmune and autoinflammatory pathologies. Indeed, preclinical and clinical data show that Th17 cells are associated with several autoimmune diseases such as arthritis, multiple sclerosis, psoriasis, and lupus. Furthermore, targeting the interleukin-17 (IL-17 pathway has attenuated disease severity in preclinical models of autoimmune diseases. Interestingly, a recent report brings to light a potential role for Th17 cells in the autoinflammatory disorder adult-onset Still's disease (AOSD. Whether Th17 cells are the cause or are directly involved in AOSD remains to be shown. In this paper, we discuss the biology of Th17 cells, their role in autoimmune disease development, and in AOSD in particular, as well as the growing interest of the pharmaceutical industry in their use as therapeutic targets.

  5. Alcohol sensitizes cerebral responses to the odors of alcoholic drinks: an fMRI study.

    Science.gov (United States)

    Bragulat, Veronique; Dzemidzic, Mario; Talavage, Thomas; Davidson, Dena; O'Connor, Sean J; Kareken, David A

    2008-07-01

    Small, priming doses of alcohol enhance desire to drink, and thus play a role in the loss of control of alcohol consumption. Using functional magnetic resonance imaging (fMRI), we previously showed that alcoholic drink odors (AO; subjects' drinks of choice) induce greater nucleus accumbens (NAc) activity than non-appetitive odors (NApO; grass, leather) in subjects at risk for alcoholism. Here we hypothesized that priming exposure to alcohol would enhance responses to AO in the NAc and orbitofrontal cortex in comparison to NApO (grass, leather) and to the appetitive control odors (ApCO) of chocolate and grape. Ten hazardous drinkers (mean age = 22.7; SD = 2.9, average drinks per drinking day = 5.9, SD = 2.3; drinking days/90 days = 50.4, SD = 13.7) were scanned on a 1.5 T GE Signa MR scanner during intravenous infusion of lactated Ringer's or 6% ethanol in lactated Ringer's that was pharmacokinetically modeled to achieve a constant breath alcohol concentration (BrAC) of 50 mg% throughout imaging. During scanning, subjects sniffed AO, NApO, and ApCO. Alcohol infusion enhanced the contrast between AO and NApO in the NAc, and in orbitofrontal, medial frontal, and precuneus/posterior cingulate regions. The contrast between AO and appetitive control odors (ApCO; chocolate and grape) was similarly larger in the orbital, medial frontal, precuneus, and posterior cingulate/retrosplenial areas, with the most robust finding being a potentiated response in the posterior cingulate/retrosplenial area. The orbital region is similar to an area previously shown to manifest satiety-related decreases in activity induced by food cues. The results suggest that priming exposure to alcohol renders a limbic network more responsive to alcohol cues, potentially enhancing desire to drink.

  6. Regional cerebral blood studies by the xenon-133 inhalation method in cases of cerebrovascular diseases

    International Nuclear Information System (INIS)

    Shimomura, Takahide

    1982-01-01

    rCBF was measured 428 times in 191 patients and 15 healthy volunteers by the Xenon-133 inhalation technique. The two-compartment analysis and the estimate of initial slope index were performed. There was no difference in blood flow between the two hemispheres in the 15 healthy volunteers, whose mean age was 36.5 +- 13.5 years (F 1 , right: 83.1 +- 11.4; left: 85.1 +- 12.1; 1Sl, right: 51.6 +- 6.3; left: 52.4 +- 6.0). Good correlation with a correlation coefficient of 0.965 was observed between the value obtained by the Xenon-133 inhalation and intracarotid methods in 14 patients with brain diseases. Reproducibilities of the Xenon-133 inhalation technique by serial measurement of rCBF at intervals of 30 - 40 minutes and 3 - 5 days were almost the same, with a variation coefficient of 3.7% and a correlation coefficient of 0.98. Repeated rCBF measurement by the Xenon-133 inhalation was performed during a long follow-up period of up to 1 year after bypass surgery. In 28 adult patients with occlusive cerebrovascular disease, CBF values of most patients stabilized in normal range within 3 months after the operation. In 12 patients with Moyamoya disease, CBF values were distributed over a wide range preoperatively, and increased gradually and tended to stabilize in the relatively subnormal range within 3 months after operation. This clinical experience indicates that the Xenon-133 inhalation method is a useful and safe procedure for the determination of rCBF, especially for repeated studies in cases with bypass surgery during long postoperative follow-up periods and for measurement of rCBF in child cases. (J.P.N.)

  7. The DNA-damage response in human biology and disease

    DEFF Research Database (Denmark)

    Jackson, Stephen P; Bartek, Jiri

    2009-01-01

    , signal its presence and mediate its repair. Such responses, which have an impact on a wide range of cellular events, are biologically significant because they prevent diverse human diseases. Our improving understanding of DNA-damage responses is providing new avenues for disease management....

  8. Simulated surgical-type cerebral biopsies from post-mortem brains allows accurate neuropathological diagnoses in the majority of neurodegenerative disease groups

    Science.gov (United States)

    2013-01-01

    Background In theory, cerebral biopsies could provide the diagnosis in a significant proportion of patients with neurodegenerative diseases, however, there are considerable ethical barriers. Previous series of cerebral biopsies have shown variable diagnostic accuracy but have understandably suffered because of lack of post-mortem tissue with which to compare the diagnosis. To determine the accuracy of such biopsies in neurodegenerative disease we took small biopsy-sized samples of predominantly fresh post-mortem brain tissue from frontal and temporal lobes in 62 cases. These were processed as for a biopsy and stained for H&E, p62, tau, Aβ, α-synuclein, and TDP-43. The sections were assessed blind by 3 neuropathologists and the results compared with the final post-mortem diagnosis. Results The agreement and sensitivity in most cases was good especially: controls; Alzheimer’s disease (AD); multiple system atrophy (MSA); frontotemporal lobar degeneration with TDP-43 positive inclusions and/or motor neurone disease (FTLD-TDP/MND); Huntington’s disease (HD); corticobasal degeneration (CBD) / microtubular associated protein tau mutation cases with CBD-like features (CBD/MAPT); and combined AD- Dementia with Lewy Bodies (AD-DLB) where the sensitivity on assessing both brain regions varied between 75-100%. There was poor sensitivity for progressive supranuclear palsy (PSP) and amyotrophic lateral sclerosis (ALS) (both 0%), but moderate sensitivity for pure DLB (60%). The temporal lobe assessment was marginally more accurate than the frontal lobe but these were only slightly worse than both combined. Conclusions The study shows that with certain caveats the cerebral biopsy in life should be a viable method of accurately diagnosing many neurodegenerative diseases. PMID:24252649

  9. Bleeding points in cerebral hemorrhage caused by Moyamoya disease in adults

    International Nuclear Information System (INIS)

    Sasaki, Tatsuya; Sakurai, Yoshiharu; Shimizu, Yukihiko; Ogawa, Akira; Komatsu, Shinro.

    1983-01-01

    Even before the introduction of CT we reported that the intracranial hemorrhage in Moyamoya disease was not subarachnoid hemorrhage but intraventricular hemorrhage and that the bleeding point was the paraventricular subependymal region of lateral ventricles; these findings were based on our experience with three Moyamoya cases in which ventricular hemorrhage occurred and pseudoaneurysms were revealed in the territory of the posterior choroidal artery. Twelve cases with intracranial hemorrhage caused by Moyamoya disease have now been studied by CT in order to determine (1) whether the hemorrhage is subarachnoid or intraventricular, and (2) where the bleeding point is. In the results for the eight cases for which the CT scan was performed within one day after the onset, intraventricular hemorrhage was shown in all cases. The bleeding point was examined in twelve cases; in four cases it was recognized by initial CT only, but if five cases in which ventricular hemorrhage only appeared in the initial CT,follow-up plain and contrast-enhanced CT were necessary. In a total of nine cases, then, bleeding points were recognized. In one case putaminal hemorrhage penetrated into the lateral ventricle, while in eight cases the intracerebral hematoma was located in the paraventricular region of the lateral ventricle, such as at the head of the caudate nucleus or the thalamus. In some cases, small subependymal hematoma projected into the lateral ventricle. In cases with symptoms of intracranial hemorrhage at the onset, the bleeding points were at the paraventricular parenchyma of the lateral ventricle in almost all cases. (author)

  10. Molecular pathophysiology of cerebral edema.

    Science.gov (United States)

    Stokum, Jesse A; Gerzanich, Volodymyr; Simard, J Marc

    2016-03-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. © The Author(s) 2015.

  11. Analysis of cognitive function and regional cerebral blood flow in Parkinson's disease by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Yamamoto, Kiyoshi

    1992-01-01

    To investigate the relationship between alterations of regional cerebral blood flow (rCBF) and cognitive impairment in parkinsonian patients, I studied 41 patients with Parkinson's disease (19 men and 22 women) using single photon emission computed tomography (SPECT) with N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP). I evaluated cognitive function with the Mini-Mental State examination (MMS), the Hasegawa's Dementia Scale (HDS), the Kana-pick up test (KT), and the figure drawing test (FDT). I evaluated motor impairment with the Hoehn and Yahr stage. SPECT scanning was performed with a rotating digital gamma camera TOSHIBA 901-A. A semiquantitative method of assessing regional tracer uptake was used. Regions of interest (ROI: 3x3 pixels, 15.9x15.9 mm 2 ) were drawn on the cerebellar hemispheres, cortical regions (frontal, temporal, parietal and occipital), and basal ganglia bilaterally. The RI count index was expressed as a ratio of activity in each ROI to mean counting rate over cerebellar regions. I considered the RI count index as the index of rCBF in each ROI. There were strong positive correlations between MMS and rCBF of frontal, parietal and occipital lobes (p<0.001). There were positive correlations between HDS and rCBF of frontal (p<0.01), parietal (p<0.001) and occipital lobes (p<0.01). There were positive correlations between KT and rCBF of frontal (p<0.01) and occipital (p<0.05) lobes. There were no correlations between FDT and rCBF. There were negative correlations between the Hoehn and Yahr stage and MMS (p<0.001), HDS (p<0.001), KT (p<0.001) and FDT (p<0.05). There seemed to be a relationship between cognitive function and rCBF of frontal, parietal and occipital cortex, between motor impairment and rCBF of frontal lobe and between cognitive and motor impairments in parkinsonian patients. These findings suggest that intellectual deterioration in Parkinson's disease may be caused by a specific mechanism different from Alzheimer's disease. (author)

  12. Nanomedicine in cerebral palsy

    Science.gov (United States)

    Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

    2013-01-01

    Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. PMID:24204146

  13. Visual space and object space in the cerebral cortex of retinal disease patients.

    Science.gov (United States)

    Goesaert, Elfi; Van Baelen, Marc; Spileers, Werner; Wagemans, Johan; Op de Beeck, Hans P

    2014-01-01

    The lower areas of the hierarchically organized visual cortex are strongly retinotopically organized, with strong responses to specific retinotopic stimuli, and no response to other stimuli outside these preferred regions. Higher areas in the ventral occipitotemporal cortex show a weak eccentricity bias, and are mainly sensitive for object category (e.g., faces versus buildings). This study investigated how the mapping of eccentricity and category sensitivity using functional magnetic resonance imaging is affected by a retinal lesion in two very different low vision patients: a patient with a large central scotoma, affecting central input to the retina (juvenile macular degeneration), and a patient where input to the peripheral retina is lost (retinitis pigmentosa). From the retinal degeneration, we can predict specific losses of retinotopic activation. These predictions were confirmed when comparing stimulus activations with a no-stimulus fixation baseline. At the same time, however, seemingly contradictory patterns of activation, unexpected given the retinal degeneration, were observed when different stimulus conditions were directly compared. These unexpected activations were due to position-specific deactivations, indicating the importance of investigating absolute activation (relative to a no-stimulus baseline) rather than relative activation (comparing different stimulus conditions). Data from two controls, with simulated scotomas that matched the lesions in the two patients also showed that retinotopic mapping results could be explained by a combination of activations at the stimulated locations and deactivations at unstimulated locations. Category sensitivity was preserved in the two patients. In sum, when we take into account the full pattern of activations and deactivations elicited in retinotopic cortex and throughout the ventral object vision pathway in low vision patients, the pattern of (de)activation is consistent with the retinal loss.

  14. Visual space and object space in the cerebral cortex of retinal disease patients.

    Directory of Open Access Journals (Sweden)

    Elfi Goesaert

    Full Text Available The lower areas of the hierarchically organized visual cortex are strongly retinotopically organized, with strong responses to specific retinotopic stimuli, and no response to other stimuli outside these preferred regions. Higher areas in the ventral occipitotemporal cortex show a weak eccentricity bias, and are mainly sensitive for object category (e.g., faces versus buildings. This study investigated how the mapping of eccentricity and category sensitivity using functional magnetic resonance imaging is affected by a retinal lesion in two very different low vision patients: a patient with a large central scotoma, affecting central input to the retina (juvenile macular degeneration, and a patient where input to the peripheral retina is lost (retinitis pigmentosa. From the retinal degeneration, we can predict specific losses of retinotopic activation. These predictions were confirmed when comparing stimulus activations with a no-stimulus fixation baseline. At the same time, however, seemingly contradictory patterns of activation, unexpected given the retinal degeneration, were observed when different stimulus conditions were directly compared. These unexpected activations were due to position-specific deactivations, indicating the importance of investigating absolute activation (relative to a no-stimulus baseline rather than relative activation (comparing different stimulus conditions. Data from two controls, with simulated scotomas that matched the lesions in the two patients also showed that retinotopic mapping results could be explained by a combination of activations at the stimulated locations and deactivations at unstimulated locations. Category sensitivity was preserved in the two patients. In sum, when we take into account the full pattern of activations and deactivations elicited in retinotopic cortex and throughout the ventral object vision pathway in low vision patients, the pattern of (deactivation is consistent with the retinal loss.

  15. Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease. Comparison with dynamic susceptibility contrast-perfusion MR imaging

    International Nuclear Information System (INIS)

    Ida, Kentaro; Akaki, Shiro; Sei, Tetsuro; Kanazawa, Susumu; Tsunoda, Masatoshi

    2006-01-01

    To determine the efficacy of flow-sensitive alternating inversion recovery using half-Fourier single-shot turbo spin-echo (FAIR-HASTE) in detecting cerebral hypoperfusion in chronic carotid occlusive disease, we subjected 12 patients with various degrees of cervical internal carotid artery stenoses and/or occlusion (Stenosis group) and 24 volunteers (Normal group) to FAIR-HASTE. In addition, 10 out of 12 patients in the Stenosis group underwent dynamic susceptibility contrast-perfusion magnetic resonance imaging (DSC-pMRI) before and after revascularization in the dominantly affected side. The absolute asymmetry indexes (AIs) of both cerebral hemispheres in the Normal and Stenosis groups were compared in FAIR-HASTE. In addition, the AIs were compared with those in the Stenosis group before and after revascularization in both FAIR-HASTE and regional cerebral blood flow (rCBF), calculated with DSC-pMRI. A statistically significant difference was recognized between the AIs in the Normal and Stenosis groups (AI=2.25±1.92, 8.09±4.60, respectively; p<0.0001). Furthermore, in the Stenosis group the AIs on both FAIR-HASTE (8.88±4.93, 2.22±1.79, respectively; p=0.0003) and rCBF (7.13±3.57, 1.25±1.33, respectively; p=0.0003) significantly decreased after revascularization. In the Stenosis group, before revascularization, signal intensity on both FAIR-HASTE and rCBF had a tendency to be lower in the dominantly affected side. FAIR-HASTE imaging was useful in the detection and evaluation of cerebral hypoperfusion in chronic occlusive carotid disease. (author)

  16. Baseline characteristic of patients presenting with lacunar stroke and cerebral small vessel disease may predict future development of depression.

    Science.gov (United States)

    Pavlovic, Aleksandra M; Pekmezovic, Tatjana; Zidverc Trajkovic, Jasna; Svabic Medjedovic, Tamara; Veselinovic, Nikola; Radojicic, Aleksandra; Mijajlovic, Milija; Tomic, Gordana; Jovanovic, Zagorka; Norton, Melanie; Sternic, Nada

    2016-01-01

    Cerebral small vessel disease (SVD) is associated with late-onset depression and increases the risk for depression after stroke. We aimed to investigate baseline predictors of depression after long-term follow-up in patients with SVD, initially presenting with first-ever lacunar stroke, free of depression and cognitive impairment. A total of 294 patients with SVD were evaluated 3-5 years after the qualifying event. We analyzed baseline demographic data, vascular risk factors, functional status expressed as a score on modified Rankin Scale (mRS), cognitive status, presence of depression, total number of lacunar infarcts and severity of white matter hyperintensities (WMH) on MRI with Age-Related White Matter Changes scale total score (tARWMC) and Fazekas scale periventricular and deep subcortical scores. On follow-up, depression was registered in 117 (39.8%) SVD patients. At the baseline, patients with depression compared with non-depressed were older (64.4 vs 60.9 years; p = 0.007), had higher mRS score (2.8 ± 0.7 vs 1.5 ± 0.7; p depressed patients more frequently exhibited cognitive decline (75.2% depressed vs 56.5% non-depressed; p = 0.003). No difference was detected in risk factor frequency between groups. Multivariate Cox regression analysis adjusted by age and gender revealed independent predictors of depression: baseline mRS >2 (HR 2.17, 95%CI 1.74-2.72; p cognitive decline on follow-up (HR 1.80, 95%CI 1.12-2.89; p = 0.015). Baseline functional status and severity of WMH and development of cognitive decline predict the occurence of late-onset depression in patients with SVD. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    Full Text Available Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD, a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation.CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM voxel-based morphometry (VBM. Pseudo-continuous arterial spin labeling (pcASL was used to produce cerebral blood flow (CBF images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables.In 30 men with CAD (mean age 65±7 years, VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001. Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak.Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.

  18. Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

    Energy Technology Data Exchange (ETDEWEB)

    Verfaillie, Sander C.J.; Adriaanse, Sofie M.; Binnewijzend, Maja A.A.; Benedictus, Marije R.; Ossenkoppele, Rik [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); Wattjes, Mike P.; Lammertsma, Adriaan A.; Boellaard, Ronald; Berckel, Bart N.M. van; Barkhof, Frederik [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Pijnenburg, Yolande A.L.; Scheltens, Philip [VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Centre, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Centre, Department of Physics and Medical Technology, Amsterdam (Netherlands)

    2015-10-15

    Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [{sup 18}F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD. Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed. Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68). Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. (orig.)

  19. Radiotherapy in primary cerebral lymphoma

    International Nuclear Information System (INIS)

    Legros, L.; Benezery, K.; Lagrange, J.L.

    1999-01-01

    Primary cerebral lymphoma is a rare disease with an unfavorable prognosis. Whole brain radiotherapy has been the standard treatment, but neither the optimal radiation fields nor optimal dose level of the regimen are as yet firmly establisheD. From this review of the literature, it seems that the whole brain must be treated, and a boost to the area of the primary site must be discussed. With regard to dose, the radiation dose-response relationship is not clearly proven. Yet, a minimum dose of 40 Gy is necessary, and the maximum dose is set at 50 Gy because of late neurological sequelae. Because of the poor prognosis of this disease and the risk of late sequelae, other avenues have been explored. Chemotherapy has been studied, seem to have a survival advantage and combinations of radiotherapy and chemotherapy, especially with high-dose methotrexate. Because primary cerebral lymphoma is an uncommon disease, randomized clinical trials that compare radiotherapy alone to chemotherapy plus radiotherapy may not be feasible. Finally, even if chemotherapy seems to have a survival advantage, the regimen of chemotherapy is still a matter of debate. (authors)

  20. Positron emission tomographic scan investigations of Huntington's disease: cerebral metabolic correlates of cognitive function

    International Nuclear Information System (INIS)

    Berent, S.; Giordani, B.; Lehtinen, S.; Markel, D.; Penney, J.B.; Buchtel, H.A.; Starosta-Rubinstein, S.; Hichwa, R.; Young, A.B.

    1988-01-01

    Fifteen drug-free patients with early to mid-stage Huntington's disease (HD) were evaluated with positron emission tomographic (PET) scans of 18 F-2-fluoro-2-deoxy-D-glucose uptake and quantitative measures of neurological function, learning, memory, and general intelligence. In comparison with a group of normal volunteers, the HD patients showed lower metabolism in both caudate (p less than 0.001) and putamen (p less than 0.001) on PET scans. A significant and positive relationship was found between neuropsychological measures of verbal learning and memory and caudate metabolism in the patient group but not in the normal group. Visual-spatial learning did not reflect a similar pattern, but performance intelligence quotient was positively related to both caudate and putamen metabolism in the HD group. Vocabulary level was unrelated to either brain structure. Discussion focuses on these and other observed brain-behavior relationships and on the implications of these findings for general behaviors such as those involved in coping and adaptation

  1. Cerebral metabolic correlates of attention networks in Alzheimer's Disease: A study of the Stroop.

    Science.gov (United States)

    Melrose, Rebecca J; Young, Stephanie; Weissberger, Gali H; Natta, Laura; Harwood, Dylan; Mandelkern, Mark; Sultzer, David L

    2017-11-01

    Patients with Alzheimer's Disease (AD) show difficulties with attention. Cognitive neuroscience models posit that attention can be broken down into alerting, orienting, and executive networks. We used the Stroop Color-Word test to interrogate the neural correlates of attention deficits in AD. We hypothesized that the Word, Color, and Color-Word conditions of the Stroop would all tap into the alerting and orienting networks. The Color-Word condition would additionally tap into the executive network. A ratio of Color-Word to Color naming performance would isolate the executive network from the others. To identify the neural underpinnings of attention in AD we correlated performance on the Stroop with brain metabolic activity. Sixty-six patients with probable AD completed [ 18 F] fluorodeoxyglucose PET scanning and neuropsychological testing. Analysis was conducted with SPM12 (p<0.001 uncorrected, extent threshold 50 voxels). Performance on the Word, Color, and Color-Word conditions directly correlated with metabolic rate in right inferior parietal lobules/intraparietal sulci. The Color-Word/Color ratio revealed associations with metabolic rate in right medial prefrontal cortex and insula/operculum. Overall findings were largely consistent with the hypothesized neuroanatomical substrates of the alerting, orienting, and executive networks. As such, attention deficits in AD reflect compromise to multiple large-scale networks. Published by Elsevier Ltd.

  2. SENSITIVE RESPONSE AND RESISTANCE TO BERY DISEASE ...

    African Journals Online (AJOL)

    AISA

    Seedling hypocotyls and attached green coffee berries of 11 Coffea arabica varieties and a Robusta coffee cultivar, with different levels of resistance to coffee berry disease (Colletotrichum kahawae), were examined under a microscope for differences in the development of infections caused by single-conidium isolates of.

  3. Strengthening response capacity to African infectious disease ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    In addition, this humanitarian disaster has had collateral impact on local economies, health care systems, and regional security. Although the Ebola epidemic ended in January 2016, the risk of future outbreaks remains in the region. Recent assessments of countries in this region have found limited capacity for disease ...

  4. Clinical usefulness of FLAIR MR sequence in the diagnosis of cerebral disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Hyun; Chang, Kee Hyun; Park, Hong Suk; Sim, Jung Suk; Cho, Seong Whi; Yu, In Kyu; Han, Moon Hee [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-07-01

    To evaluate the clinical usefulness and limitation of FLAIR(fluid attenuated inversion recovery) MR sequence in various intracranial pathologic conditions. In prospective fashion, we used a 1.0T MR unit to obtain FLAIR sequence MR images, together with T1-weighted (T1WI), proton-density weighted (PDWI), and T2-weighted spin echo images (T2WI) in 24 patients with various intracranial diseases. Forty-two lesions in 24 patients were classified into three categories : nonhemorrhagic noncavitary lesions (n=20), hemorrhagic lesions (n=10), and cavitary lesions (n=12). Hemorrhagic lesion was divided into two types; type 1 showed high signal intensity on both T1WI and T2WI and type 2 showed marked low signal intensity on T2WI such as hemosiderin. Cavitary lesion was defined as one with signal intensity which paralleled CSF on all pulse sequences. Visually, we compared the lesion conspicuity on FLAIR with that on T2WI. Quantitatively, we also compared lesion/white matter (WM) contrast, lesion/WM contrast to noise ratio(CNR), lesion/CSF contrast, and lesion/CSF CNR on FLAIR with those on T2WI. For visual conspicuity of nonhemorrhagic noncavitary lesions and type 1 hemorrhagic lesions, FLAIR was superior to PDWI and T2WI, but for type 2 hemorrhangic lesions, PDWI and T2WI were superior to FLAIR. For cavitary lesions, there was no significant difference between T2WI and FLAIR. In the quantitative assessment of nonhemorrhagic noncavitary lesions, FLAIR was superior to PDWI for lesion/CSF cnotrast, and CNR, and lesion/WM contrast, but for lesion/WM CNR FLAIR was inferior to PDWI. For lesion/CSF contrast in cavitary lesions, FLAIR was superior to PDWI. There was no significant difference between PDWI and FLAIR for hemorrhagic lesions types 1 and 2. In assessing nonhemorrhagic noncavitary lesions, FLAIR was superior to T2WI for lesion/CSF contrast, but for lesion/WM CNR, FLAIR was inferior to T2WI. In cavitary lesions, T2WI was superior to FLAIR for lesion/WM contrast and CNR. In

  5. Cerebral microbleeds in a neonatal rat model.

    Directory of Open Access Journals (Sweden)

    Brianna Carusillo Theriault

    Full Text Available In adult humans, cerebral microbleeds play important roles in neurodegenerative diseases but in neonates, the consequences of cerebral microbleeds are unknown. In rats, a single pro-angiogenic stimulus in utero predisposes to cerebral microbleeds after birth at term, a time when late oligodendrocyte progenitors (pre-oligodendrocytes dominate in the rat brain. We hypothesized that two independent pro-angiogenic stimuli in utero would be associated with a high likelihood of perinatal microbleeds that would be severely damaging to white matter.Pregnant Wistar rats were subjected to intrauterine ischemia (IUI and low-dose maternal lipopolysaccharide (mLPS at embryonic day (E 19. Pups were born vaginally or abdominally at E21-22. Brains were evaluated for angiogenic markers, microhemorrhages, myelination and axonal development. Neurological function was assessed out to 6 weeks.mRNA (Vegf, Cd31, Mmp2, Mmp9, Timp1, Timp2 and protein (CD31, MMP2, MMP9 for angiogenic markers, in situ proteolytic activity, and collagen IV immunoreactivity were altered, consistent with an angiogenic response. Vaginally delivered pups exposed to prenatal IUI+mLPS had spontaneous cerebral microbleeds, abnormal neurological function, and dysmorphic, hypomyelinated white matter and axonopathy. Pups exposed to the same pro-angiogenic stimuli in utero but delivered abdominally had minimal cerebral microbleeds, preserved myelination and axonal development, and neurological function similar to naïve controls.In rats, pro-angiogenic stimuli in utero can predispose to vascular fragility and lead to cerebral microbleeds. The study of microbleeds in the neonatal rat brain at full gestation may give insights into the consequences of microbleeds in human preterm infants during critical periods of white matter development.

  6. White matter lesions characterise brain involvement in moderate to severe chronic obstructive pulmonary disease, but cerebral atrophy does not.

    Science.gov (United States)

    Spilling, Catherine A; Jones, Paul W; Dodd, James W; Barrick, Thomas R

    2017-06-19

    Brain pathology is relatively unexplored in chronic obstructive pulmonary disease (COPD). This study is a comprehensive investigation of grey matter (GM) and white matter (WM) changes and how these relate to disease severity and cognitive function. T1-weighted and fluid-attenuated inversion recovery images were acquired for 31 stable COPD patients (FEV 1 52.1% pred., PaO 2 10.1 kPa) and 24 age, gender-matched controls. T1-weighted images were segmented into GM, WM and cerebrospinal fluid (CSF) tissue classes using a semi-automated procedure optimised for use with this cohort. This procedure allows, cohort-specific anatomical features to be captured, white matter lesions (WMLs) to be identified and includes a tissue repair step to correct for misclassification caused by WMLs. Tissue volumes and cortical thickness were calculated from the resulting segmentations. Additionally, a fully-automated pipeline was used to calculate localised cortical surface and gyrification. WM and GM tissue volumes, the tissue volume ratio (indicator of atrophy), average cortical thickness, and the number, size, and volume of white matter lesions (WMLs) were analysed across the whole-brain and regionally - for each anatomical lobe and the deep-GM. The hippocampus was investigated as a region-of-interest. Localised (voxel-wise and vertex-wise) variations in cortical gyrification, GM density and cortical thickness, were also investigated. Statistical models controlling for age and gender were used to test for between-group differences and within-group correlations. Robust statistical approaches ensured the family-wise error rate was controlled in regional and local analyses. There were no significant differences in global, regional, or local measures of GM between patients and controls, however, patients had an increased volume (p = 0.02) and size (p = 0.04) of WMLs. In patients, greater normalised hippocampal volume positively correlated with exacerbation frequency (p = 0

  7. Reasonable Avoidability, Responsibility and Lifestyle Diseases

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman

    2012-01-01

    by imprudent behavior such as smoking and over-eating. While I seek to investigate how more precisely we are to understand this principle of Reasonable Avoidability, I also object to it. First, I argue that Segall neither succeeds in showing that individuals quite generally are responsible for behaviors...

  8. Visualization of posture-dependent cerebral blood flow in a patient with Takayasu's disease by means of sup 99m Tc-HMPAO brain single photon emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hayashida, Kohei; Hirose, Yoshiaki; Kaminaga, Tatsurou; Imakita, Satoshi; Uehara, Toshiisa (National Cardiovascular Center, Suita, Osaka (Japan)); Nishimura, Tsunehiko (National Cardiovascular Center, Suita, Osaka (Japan) Osaka Univ. (Japan). Dept. of Tracer Data Analysis)

    1992-11-01

    A case of Takayasu's disease in a 22-year-old woman who complained of severe fainting attacks is presented. Bilateral obstruction of the cervical arteries was confirmed by digital subtraction angiography. Preoperative technetium-99m hexamethylpropylene amine oxime brain SPET in the sitting position showed bilateral hypoactivity in the temporoparietal areas. Subtraction brain SPET showed slightly increased activity in the lying position. The patient has had no fainting attacks since bypass surgery. Postoperative {sup 99m}Tc-HMPAO brain SPET in the sitting position showed normal activity except in the right temporoparietal area. This area was filled in the lying position. {sup 99m}Tc-HMPAO brain SPET is the only technique that can visualize the cerebral blood flow in any position, this capability deriving on the fact that the distribution, of {sup 99m}Tc-HMPAO in the brain is fixed in the first 2-3 min following injection. The use of both sitting and lying {sup 99m}Tc-HMPAO brain SPET is very useful for detecting an abnormality (i.e. an inhomogeneous response due to the fall in perfusion pressure) that could not be seen if the cerebral blood flow were to be assessed only in the lying position. (orig.).

  9. High-Sodium Diet Has Opposing Effects on Mean Arterial Blood Pressure and Cerebral Perfusion in a Transgenic Mouse Model of Alzheimer's Disease.

    Science.gov (United States)

    Taheri, Saeid; Yu, Jin; Zhu, Hong; Kindy, Mark S

    2016-10-04

    Cerebral ionic homeostasis impairment, especially Ca2+, has been observed in Alzheimer's disease (AD) and also with hypertension. Hypertension and AD both have been implicated in impaired cerebral autoregulation. However, the relationship between the ionic homeostasis impairment in AD and hypertension and cerebral blood flow (CBF) autoregulation is not clear. To test the hypothesis that a high-salt diet regimen influences the accumulation of amyloid-β (Aβand CBF) and CBF, exacerbates cognitive decline, and increases the propensity to AD. Double transgenic mice harboring the amyloid-β protein precursor (APPswe), and presenilin-1 (PSEN1) along with control littermates, 2 months of age at initiation of special diet, were divided into 4 groups: Group A, APP/PS1 and Group B, controls fed a high-sodium (4.00%) chow diet for 3 months; Group C, APP/PS1 and Group D, controls fed a low-sodium (0.08%) regular chow diet for 3 months. Mean arterial blood pressure (MAP) and CBF were measured noninvasively using the tail MAP measurement device and magnetic resonance imaging, respectively. Aβ plaques numbers in the cortex and hippocampus of APP/PS1 were quantified. In contrary to controls, APP/PS1 mice fed a high-salt diet did not show markedly elevated mean systolic and diastolic blood pressure (134±4.8 compared with 162±2.8 mmHg, and 114±5.0 compared with 137±20 mmHg, phigh-salt diet increased CBF in both APP/PS1 and controls and did not alter the cerebral tissue integrity. Aβ plaques were significantly reduced in the cortex and hippocampus of mice fed a high-salt diet. These data suggest that a high-salt diet differently affects MAP and CBF in APP/PS1 mice and controls.

  10. Cerebral blood flow and oximetry response to blood transfusion in relation to chronological age in preterm infants.

    Science.gov (United States)

    Banerjee, J; Leung, T S; Aladangady, N

    2016-06-01

    Preterm infants frequently receive blood transfusion (BT) and the aim of this study was to measure the effect of BT on cerebral blood flow and oxygenation in preterm infants in relation to chronological age. Preterm infants undergoing intensive care recruited to three chronological age groups: 1 to 7 (Group 1; n=20), 8 to 28 (Group 2; n=21) & ≥29days of life (Group 3; n=18). Pre and post-BT anterior cerebral artery (ACA) time averaged mean velocity (TAMV) and superior vena cava (SVC) flow were measured. Cerebral Tissue Haemoglobin Index (cTHI) and Oxygenation Index (cTOI) were measured from 15-20min before to 15-20min post-BT using NIRS. Vital parameters and blood pressure were measured continuously. Mean BP increased significantly, and there was no significant change in vital parameters following BT. Pre-BT ACA TAMV was higher in Group 2 and 3 compared to Group 1 (pBlood transfusion increased cTOI and cTHI and decreased ACA TAMV in all groups. PDA had no impact on the baseline cerebral oximetry and blood flow as well as changes following blood transfusion. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Muramyl dipeptide responsive pathways in Crohn's disease

    DEFF Research Database (Denmark)

    Salem, Mohammad; Seidelin, Jakob Benedict; Rogler, Gerhard

    2012-01-01

    ) for the activation of inflammatory pathways involved in the pathogenesis of CD. The importance of this molecule is underscored by the fact that (1) MDP, which is found in most Gram-negative and -positive bacteria, is able to trigger several immunological responses in the intestinal system, and (2) that alterations...... importance of MDP signaling for the pathogenesis of CD. The important aspects of NOD2 and non-NOD2 mediated effects of MDP for the development of CD are highlighted, as well as how alterations in these pathways might translate into the development of new therapeutic strategies....

  12. Progress in Drug Treatment of Cerebral Edema.

    Science.gov (United States)

    Deng, Y Y; Shen, F C; Xie, D; Han, Q P; Fang, M; Chen, C B; Zeng, H K

    2016-01-01

    Cerebral edema causes intracranial hypertension (ICH) which leads to severe outcome of patients in the clinical setting. Effective anti-edema therapy may significantly decrease the mortality in a variety of neurological conditions. At present drug treatment is a cornerstone in the management of cerebral edema. Osmotherapy has been the mainstay of pharmacologic therapy. Mannitol and hypertonic saline (HS) are the most commonly used osmotic agents. The relative safety and efficacy of HS and mannitol in the treatment of cerebral edema and reduction of enhanced ICP have been demonstrated in the past decades. Apart from its osmotic force, HS exerts anti-edema effects partly through inhibition of Na(+)-K(+)-2Cl(-) Cotransporter-1 (NKCC1) and aquaporin 4 (AQP4) expression in astrocytes. Melatonin may also reduce brain edema and exert neuroprotective effect on several central nervous system diseases through inhibition of inflammatory response. The inhibitors of Na/H exchanger, NKCC and AQP4 may attenuate brain edema formation through inhibition of excessive transportation of ion and water from blood into the cerebral tissue. In this review we survey some of the most recent findings in the drug treatment of brain edema focusing on the use of osmotherapy, melatonin and inhibitors of ion cotransporters and water channels. A better understanding of the molecular mechanism of these agents would help to improve in the clinical management of patients with brain edema.

  13. Neuroimaging of cerebral vasculitis

    International Nuclear Information System (INIS)

    Wengenroth, M.; Saam, T.; Haehnel, S.

    2016-01-01

    Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

  14. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  15. [Negative symptoms and cerebral imaging].

    Science.gov (United States)

    Kaladjian, A; Belzeaux, R; Adida, M; Azorin, J-M

    2015-12-01

    A number of neuroanatomical and neurofonctional abnormalities have been evidenced by cerebral imaging studies in patients suffering from schizophrenia. Nevertheless, those specifically associated with the negative symptoms of this disease are still insufficiently known. This work is a review of selected studies that have assessed the brain correlates of negative symptoms in schizophrenia. Approaches using structural imaging have highlighted reduction of gray matter density or cortical thickness associated with negative symptoms, which is rather sparsely distributed within the frontal and temporal regions, localized nevertheless more particularly in the frontal medial and orbitofrontal areas, as well as the amygdalo-hippocampic complex. These deficits are concurrent with a loss of integrity of the principal paths of white matter tracts between frontal and limbic regions. On the other hand, neurofonctional abnormalities associated with negative symptoms involve especially the frontal areas and limbic striatum. A disturbed functioning within the fronto-striatal loops, related to a striatal dopaminergic deficit, may represent a potential explanatory hypothesis of the negative symptoms of schizophrenia, as suggested by studies using Positron Emission Tomography on this topic or neuroimaging studies on the effects of antipsychotics. A better identification of the cerebral abnormalities associated with the negative dimension of schizophrenia, with regard to the lateralization of these abnormalities or to their changes during the course of the disease, could offer new therapeutic modalities for the treatment of this dimension which, until now, remains few responsive to conventional pharmacological treatments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Cellular immune response of infectious bursal disease and ...

    African Journals Online (AJOL)

    Jane

    2011-08-22

    Aug 22, 2011 ... Cellular immune response of infectious bursal disease and Newcastle disease vaccinations in broilers exposed to monochromatic lights. Avesta Sadrzadeh1, Gholamreza Nikbakht Brujeni2, Masoud Livi1, Mohammad Javad Nazari1,. Meysam Tehrani Sharif1, Hossein Hassanpour3* and Nasrin Haghighi3.

  17. Test of inscribed description in the Alzheimer's disease: correlation of neuro-psychology and of cerebral sanguinary rates

    International Nuclear Information System (INIS)

    Houzard, C.; Croisile, B.; Philippon, B.; Hibert, O.; Gogoleva, S.M.; Itti, R.; Cinotti, L.; Wertheimer, H.P.

    1997-01-01

    The alteration of the written description of an image scene constitutes an early and sensible indicator in diagnosing the Alzheimer's disease (AD). Measurements of cerebral blood rates (CBR) by SPECT show characteristic regional anomalies. We have studied correlations between the neuro-psychological tests (NT), parameters of description (description of the image of a thief of crackers) and CBR in patients afflicted by AD. Ten patients afflicted by AD of slow onset (MMSE 20.2± 5.1) were subject to the following NTs: MMSE, Wounded A, Battery of Aphasia, BNT, verbal fluence, gesticulative practice, direct and inversion span, copy of a figure, immediate recall of a figure, immediate recall of a story. The description variables were the length of texts (words, phrases), the items of information, the grammatical, semantic and orthographic errors. The relative variations of CBR were obtained after injection by HMPAO - 99m Tc. The indices of asymmetry were calculated by the method of the regions of interest and the correlations were calculated between the NTs, description variables and L/R asymmetry by SPECT. For the temporal lobes the correlations are significant with: Battery of Aphasia and BNT (p < 0.01), and recall of a story (p < 0.05); in the anterior frontal lobes with: MMSE and direct span (p < 0.05); in the posterior frontal lobes with: Battery of Aphasia (p < 0.05), BNT and recall of a story (p < 0.01). For writing, the grammatical errors are correlated with the anterior frontal asymmetries (p < 0.03); the semantic errors with the anterior and posterior frontal lobes (p < 0.02) and with the temporal lobes (p < 0.05). Our results show a correlations of the frontal and temporal asymmetries with the early degradation of the scores of written semantic errors and the oral tests of language. The grammatical errors appearing later and in severe forms of AD as the attention abilities are connected only to anterior frontal asymmetries. Different functional networks could

  18. Characteristic pattern of cerebral perfusion in patients with the early stage of subcortical vascular dementia compared with Alzheimer's disease

    International Nuclear Information System (INIS)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Cheon, Sang Myung; Kim, Jong Kuk; Kim, Jae Woo

    2004-01-01

    Brain perfusion SPECT has been commonly used to evaluate several different types of dementia. The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVD (mean age; 68.0±7.0 years, educational period; 6.3±5.6 years, CDR; 0.80±0.26). 46 AD (mean age; 69.9±7.4 years, educational period; 5.4±4.7 years, CDR; 0.86±0.23) and 12 normal control subjects (mean age; 67.1±7.7 years, educational period; 6.2±4.2 years) participated in this study. We included the patients with SVD and AD according to NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for probable or possible VD. They were all matched for age, education and clinical dementia scale scores. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and right thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyral regions in patients with SVD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in patients with AD compared with control subjects (uncorrected p<0.01). SVD patients revealed significant hypoperfusion in the right parahippocampal gyrus, right cingulated gyrus, left insula, and both frontal subgyral regions compared with AD patients (uncorrected p<0.01). SVD patients revealed significant hyperperfusion in right superior frontal gyrus, left pre- and postcentral gyri, left paracentral lobule, left precuneus and both medial frontal gyri compared with AD patients (uncorrected p<0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness

  19. 99mTc-HMPAO regional cerebral blood flow and quantitative electroencephalography in Alzheimer's disease: a correlative study.

    Science.gov (United States)

    Rodriguez, G; Nobili, F; Copello, F; Vitali, P; Gianelli, M V; Taddei, G; Catsafados, E; Mariani, G

    1999-04-01

    In this study the neuropsychological status of patients with Alzheimer's disease (AD) was correlated with quantitative electroencephalography (qEEG) and regional cerebral blood flow (rCBF) both in the cortex and in deep gray matter structures. Forty-three outpatients (mean age 72.4 +/- 7.5 y) with probable AD underwent 99mTc-hexamethyl propyleneamine oxime SPECT with a brain-dedicated gamma camera and qEEG (relative values) within 1 mo. Preliminary factorial analysis with promax rotation identified four qEEG bands (2-5.5, 6-7.5, 8-11.5 and 12-22.5 Hz, with no distinction as to topography) and six SPECT regions (the two thalami together, the two parietal cortices together, the right temporal cortex, the right hippocampus, the left hippocampus and the remaining cortical areas together) as the variables with highest statistical power. All these variables and the Mini-Mental Status Examination score (MMSE, a sensitive marker of neuropsychological deficit) were processed by a final factorial analysis and multivariate analysis of variance. Both the 2-5.5 Hz and the 8-11.5 Hz powers were correlated with the perfusion level in the parietal regions of interest (ROls) (P = 0.0009), whereas the 2-5.5 Hz power was correlated with the right hippocampal perfusion level (P = 0.007). The MMSE score was significantly correlated with the perfusion level, both in the right (P = 0.006) and in the left (P = 0.004) hippocampal ROls and in the parietal ROls (P = 0.01); moreover, it was correlated with both the 2-5.5 Hz (P = 0.0005) and the 8-11.5 Hz (P = 0.004) power. rCBF (bilateral parietal perfusion) and qEEG (especially the slowest frequencies, i.e., 2-5.5 Hz) are confirmed to be good descriptors of AD severity. It is especially noteworthy that bilateral hippocampal CBF was the perfusional index best correlated with the MMSE as well as being significantly correlated to qEEG. Hippocampal SPECT imaging appears to be a promising index to improve characterization of AD in respect to

  20. The relationship between the regional cerebral blood flow and the cognitive function and anosmia in patients with Parkinson disease and Alzheimer disease

    International Nuclear Information System (INIS)

    Imamura, Kazuhiro; Matsumoto, Shinjirou; Mabuchi, Naoki; Kobayashi, Yasushi; Okayasu, Naoki; Watanabe, Kenichi

    2009-01-01

    We compared the relationship between regional cerebral blood flow (rCBF) of the olfactory area and the cognitive function and anosmia in patient with Parkinson disease (PD) and in those with Alzheimer disease (AD). Unified Parkinson's disease rating scale (UPDRS) III, mini-mental state examination (MMSE), Hasegawa dementia scale-revised (HDS-R), clinical dementia rating (CDR), Beck depression inventory (BDI) were employed in this study. The subjects included 56 PD patients (average age 71.4±9.69 years), 23 AD patients (average age 73.3±7.12 years), 12 patients with mild cognitive impairment (MCI) (average age 72.5±6.89 years), and 9 age-matched controls (NC) (average age 73.8±6.61 years). Next we intravenously injected 1 ampule of thiamine propyldisulphide (Alinamin) and confirmed anosmia. In addition, we performed 123 I-iofetamine (IMP) single photon emission computed tomography (SPECT) (SEE methods) and statistically determined rCBF of the olfactory area based on the basis of the Z scores of the interest area. Anosmia was detected in approximately 40% of the PD and AD patients. The HDS-R and MMSE scores were significantly higher in patients with anosmia than in those without anosmia; the CDR scores were significantly higher in the former than in the latter. Further, the incidence of anosmia in PD patients and AD patients with MCI increased with an increase in the CDR scores. In order to determine the rCBF of the olfactory area of the PD and AD patients. As to rCBF of the olfactory area, we examined left and right Z scores of hippocampus, parahippocampus, amygdala, and uncus at Talairach level 3 and the scores of the Brodmann area 28, 34, 35, and 36 at Talairach level 5. In patients with anosmia, the Z scores were significantly high in cases with anosmia in all areas except the right Brodmann area 34 in PD patients and the right Brodmann area 28 and bilateral the Brodmann area 34 of both sides in AD patients. Some parts of the olfactory area are closely

  1. Effect of an inhibitor of neuronal nitric oxide synthase 7-nitroindazole on cerebral hemodynamic response and brain excitability in urethane-anesthetized rats

    Czech Academy of Sciences Publication Activity Database

    Brožíčková, Carole; Otáhal, Jakub

    2013-01-01

    Roč. 62, Suppl.1 (2013), S57-S66 ISSN 0862-8408 R&D Projects: GA ČR(CZ) GAP303/10/0999; GA ČR(CZ) GPP304/11/P386; GA ČR(CZ) GBP304/12/G069 Institutional research plan: CEZ:AV0Z50110509 Institutional support: RVO:67985823 Keywords : cerebral hemodynamic response * brain excitability * neuronal nitric oxide synthase * 7-nitroindazole * rat Subject RIV: FH - Neurology Impact factor: 1.487, year: 2013

  2. Plasmodium falciparum EPCR-binding PfEMP1 expression increases with malaria disease severity and is elevated in retinopathy negative cerebral malaria

    DEFF Research Database (Denmark)

    Shabani, Estela; Hanisch, Benjamin; Opoka, Robert O.

    2017-01-01

    Background: Expression of group A and the A-like subset of group B Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is associated with severe malaria (SM). The diversity of var sequences combined with the challenges of distinct classification of patient pathologies has made studying...... the role of distinct PfEMP1 variants on malaria disease severity challenging. The application of retinopathy in the recent years has provided a further method to clinically evaluate children with cerebral malaria (CM). The question of whether children with clinical CM but no retinopathy represent...... a completely different disease process or a subgroup within the spectrum of CM remains an important question in malaria. In the current study, we use newly designed primer sets with the best coverage to date in a large cohort of children with SM to determine the role of var genes in malaria disease severity...

  3. Control modeling and Chinese acupuncture treatment on cerebral circulation.

    Science.gov (United States)

    Yang, Li; Sui, Jinxue; Shi, Hongzhi

    2015-01-01

    Cerebral hemodynamic parameters are related to the occurrence and development of the cerebral vascular diseases. This paper proposes a new possible method for control treatment on cerebral circulation network diseases. Cerebral circulation is taken as a kind of fluid network that should be controlled. The acupuncture treatment in traditional Chinese medicine is used as an actuator, whose design principle is changing the artery pressure and resistance of the cerebral circulation to increase the blood flow, so as to achieve the purpose of treating cerebral circulation diseases. Clinical data of acupuncture and moxibustion treatment has also preliminarily proved the correctness of this method.

  4. Interaction between stress responses and circadian metabolism in metabolic disease.

    Science.gov (United States)

    Yang, Zhao; Kim, Hyunbae; Ali, Arushana; Zheng, Ze; Zhang, Kezhong

    2017-09-01

    Circadian rhythms play crucial roles in orchestrating diverse physiological processes that are critical for health and disease. Dysregulated circadian rhythms are closely associated with various human metabolic diseases, including type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease. Modern lifestyles are frequently associated with an irregular circadian rhythm, which poses a significant risk to public health. While the central clock has a set periodicity, circadian oscillators in peripheral organs, particularly in the liver, can be entrained by metabolic alterations or stress cues. At the molecular level, the signal transduction pathways that mediate stress responses interact with, and are often integrated with, the key determinants of circadian oscillation, to maintain metabolic homeostasis under physiological or pathological conditions. In the liver, a number of nuclear receptors or transcriptional regulators, which are regulated by metabolites, hormones, the circadian clock, or environmental stressors, serve as direct links between stress responses and circadian metabolism. In this review, we summarize recent advances in the understanding of the interactions between stress responses (the endoplasmic reticulum (ER) stress response, the oxidative stress response, and the inflammatory response) and circadian metabolism, and the role of these interactions in the development of metabolic diseases.

  5. The impact of age on cerebral perfusion, oxygenation and metabolism during exercise in humans

    Science.gov (United States)

    Braz, Igor D.

    2015-01-01

    Abstract Age is one of the most important risk factors for dementia and stroke. Examination of the cerebral circulatory responses to acute exercise in the elderly may help to pinpoint the mechanisms by which exercise training can reduce the risk of brain diseases, inform the optimization of exercise training programmes and assist with the identification of age‐related alterations in cerebral vascular function. During low‐to‐moderate intensity dynamic exercise, enhanced neuronal activity is accompanied by cerebral perfusion increases of ∼10–30%. Beyond ∼60–70% maximal oxygen uptake, cerebral metabolism remains elevated but perfusion in the anterior portion of the circulation returns towards baseline, substantively because of a hyperventilation‐mediated reduction in the partial pressure of arterial carbon dioxide (P aC O2) and cerebral vasoconstriction. Cerebral perfusion is lower in older individuals, both at rest and during incremental dynamic exercise. Nevertheless, the increase in the estimated cerebral metabolic rate for oxygen and the arterial–internal jugular venous differences for glucose and lactate are similar in young and older individuals exercising at the same relative exercise intensities. Correction for the age‐related reduction in P aC O2 during exercise by the provision of supplementary CO2 is suggested to remove ∼50% of the difference in cerebral perfusion between young and older individuals. A multitude of candidates could account for the remaining difference, including cerebral atrophy, and enhanced vasoconstrictor and blunted vasodilatory pathways. In summary, age‐related reductions in cerebral perfusion during exercise are partly associated with a lower P aC O2 in exercising older individuals; nevertheless the cerebral extraction of glucose, lactate and oxygen appear to be preserved. PMID:26435295

  6. Role of Aquaporin-4 in Cerebral Edema and Stroke

    OpenAIRE

    Zador, Zsolt; Stiver, Shirley; Wang, Vincent; Manley, Geoffrey T.

    2009-01-01

    Cerebral edema plays a central role in the pathophysiology of many diseases of the central nervous system (CNS) including ischemia, trauma, tumors, inflammation, and metabolic disturbances. The formation of cerebral edema results in an increase in tissue water content and brain swelling which, if unchecked, can lead to elevated intracranial pressure (ICP), reduced cerebral blood flow, and ultimately cerebral herniation and death. Despite the clinical significance of cerebral edema, the mechan...

  7. Endothelium-dependent relaxant responses to selective 5-HT(1B/1D) receptor agonists in the isolated middle cerebral artery of the rat

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Løvland Hoel, Natalie; Nilsson, Elisabeth

    2003-01-01

    perfused. Luminally added 5- hydroxytryptamine (5-HT), sumatriptan and rizatriptan induced maximal dilatations of 22 +/- 4, 10 +/- 2 and 13 +/- 5%, respectively, compared to the resting diameter. The relaxant effect of sumatriptan was blocked by the 5- HT(1B/1D) receptor selective antagonist GR 55562 (10......The vasomotor effects of triptans in the middle cerebral artery (MCA) of rats were studied using the pressurised arteriography method and in vitro vessel baths. Using the arteriograph, MCAs from Sprague-Dawley rats were mounted on two glass micropipettes, pressurised to 85 mm Hg and luminally...... response to 5-HT and triptans. Using the vessel bath technique, MCA segments were mounted on two metal wires. The relaxant responses to sumatriptan could not be reproduced using this model; instead, weak contractile responses (6 +/- 3% of submaximal contractile capacity) were observed. The difference...

  8. CBF and CMRo2 during craniotomy for small supratentorial cerebral tumours in enflurane anaesthesia. A dose-response study

    International Nuclear Information System (INIS)

    Madsen, J.B.; Cold, G.E.; Eriksen, H.O.; Eskesen, V.; Blatt-Lyon, B.

    1986-01-01

    In 14 patients with supratentorial cerebral tumours with midline shift ≤ 10 mm, cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo 2 ) were measured twice on the contralateral side of the craniotomy, using a modification of the Kety and Schmidt method. For induction of anaesthesia, thiopental, fentanyl and pancuronium were used. The anaesthesia was maintained with enflurane 1% in nitrous oxide 67%. Moderate hypocapnia to a level averaging 4.3 kPa was achieved. The patients were divided into two groups. In group 1 (n=7), 1% enflurane was used throughout the anaesthesia, and CBF and CMRo 2 measured about 70 min after induction averaged 30.1 ml 100 g -1 min -1 and 1.98 ml O 2 100 g -1 min -1 , respectively. During the second CBF study 1 h later, CBF and CMRo 2 were unchanged (P>0.05). In group 2 (n=7), the inspiratory enflurane concentration was increased from 1 to 2% after the first CBF measurement. In this group a significant decrease in CMRo 2 was observed, while CBF was unchanged. In six patients EEG was recorded simultaneously with the CBF measurements. In patients subjected to increasing enflurane concentration (Group 2), a suppression in the EEG activity was observed without spike waves. It is concluded that enflurane induces a dose-related decrease in CMRo 2 and suppression in the EEG activity, whereas CBF was unchanged (author)

  9. Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

    Directory of Open Access Journals (Sweden)

    Jacek Staszewski

    2013-01-01

    Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

  10. Mechanisms of cognitive impairment in cerebral small vessel disease: multimodal MRI results from the St George's cognition and neuroimaging in stroke (SCANS study.

    Directory of Open Access Journals (Sweden)

    Andrew J Lawrence

    Full Text Available Cerebral small vessel disease (SVD is a common cause of vascular cognitive impairment. A number of disease features can be assessed on MRI including lacunar infarcts, T2 lesion volume, brain atrophy, and cerebral microbleeds. In addition, diffusion tensor imaging (DTI is sensitive to disruption of white matter ultrastructure, and recently it has been suggested that additional information on the pattern of damage may be obtained from axial diffusivity, a proposed marker of axonal damage, and radial diffusivity, an indicator of demyelination. We determined the contribution of these whole brain MRI markers to cognitive impairment in SVD. Consecutive patients with lacunar stroke and confluent leukoaraiosis were recruited into the ongoing SCANS study of cognitive impairment in SVD (n = 115, and underwent neuropsychological assessment and multimodal MRI. SVD subjects displayed poor performance on tests of executive function and processing speed. In the SVD group brain volume was lower, white matter hyperintensity volume higher and all diffusion characteristics differed significantly from control subjects (n = 50. On multi-predictor analysis independent predictors of executive function in SVD were lacunar infarct count and diffusivity of normal appearing white matter on DTI. Independent predictors of processing speed were lacunar infarct count and brain atrophy. Radial diffusivity was a stronger DTI predictor than axial diffusivity, suggesting ischaemic demyelination, seen neuropathologically in SVD, may be an important predictor of cognitive impairment in SVD. Our study provides information on the mechanism of cognitive impairment in SVD.

  11. Emerging Infectious Diseases-Global Alert-Global Response

    Directory of Open Access Journals (Sweden)

    ASIFUZZAMAN KHAN

    1997-04-01

    Full Text Available "Emerging Infectious Diseases-Global Alert-Global Response". When the term 'alert' is used it indicates an emergency and if we do not respond adeptly, catastrophe becomes imminent. The World Health Day theme of 1997 very aptly draws the attention of both, the providers as well as the consumers of health care facilities, to gear up and engage the entire health machinary to combat these emerging infectious diseases. The problem with which we are confronted is not only the emergence of nearly 30 or more infectious diseases, which have surfaced in the recent past but also the resurfacing or re-emergence of certain diseases, which were believed to have declined or been eliminated.Some of these new diseases, which have emerged in many parts of the world can be short listed as: --     Fatal respiratory viral disease-A variant of Creutzfeldt Jacob Disease (CJD resembling Bovine Spongioform Encephalopathy (BSE-HIV infections/AIDS-     Ebola Haemorrhagic Fever-     Legionnaires' disease-Haemolytic Uraemic Syndrome by E. Coli 0157 - H7-     Lyme disease-     Hepatitis C and E-     New form of Cholera by Vibrio Cholera 0139-     Emerging food borne diseases-     Emerging zoonosesOther sexually transmitted diseases.'

  12. Cerebral metastases from malignant melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, G. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Radiation Oncology Royal Prince Alfred Hospital, Sydney (Australia). Sydney Melanoma Unit); Firth, I. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Medical Oncology); Coates, A. (Royal Prince Alfred Hospital, Sydney (Australia). Department of Radiation Oncology Royal Prince Alfred Hospital, Sydney (Australia). Sydney Melanoma Unit)

    1993-03-01

    A retrospective study was undertaken of factors affecting survival in 129 patients with cerebral metastases from malignant melanoma referred to the Department of Radiation Oncology from June '82-January '90. Their ages ranged from 19-83 years and the time interval form diagnosis of the primary tumour to development of cerebral metastases ranged from 1 month-17 years. Cerebral metastases were apparently solitary in 59 (46%) and multiple in 70 (54%) patients. Craniotomy with resection of tumour was performed in 49 patients, of whom 24 had a solitary cerebral metastasis as the only evidence of disease Most patients (94%) received radiotherapy-course. Median survival of the whole group after detection of cerebral metastases was 5 months (range <1-87+). Univariate analysis indicated that a solitary cerebral metastasis, absence of extracranial disease and tumour resection predicted improved survival, but only surgical intervention was of independent prognostic significance in a multivariate analysis. The effect of cranial irradiation on survival could not be assessed, but the dose of radiation did not influence survival. Of the 10 patients who survived for more than 2 years, 8 had total resection of a solitary cerebral metastasis. (author). 25 refs., 3 figs., 3 tabs.

  13. Cerebral Edema and Cerebral Hemorrhages in Interleukin-10-Deficient Mice Infected with Plasmodium chabaudi

    OpenAIRE

    Sanni, Latifu A.; Jarra, William; Li, Ching; Langhorne, Jean

    2004-01-01

    During a Plasmodium chabaudi infection in interleukin-10 (IL-10) knockout mice, there is greater parasite sequestration, more severe cerebral edema, and a high frequency of cerebral hemorrhage compared with infection of C57BL/6 mice. Anti-tumor necrosis factor alpha treatment ameliorated both cerebral edema and hemorrhages, suggesting that proinflammatory responses contributed to cerebral complications in infected IL-10−/− mice.

  14. The responsible region and the symptomatic threshold of cerebral blood flow and oxygen metabolism for Broca's aphasia using positron emission tomography

    International Nuclear Information System (INIS)

    Kato, Toshiaki; Ujike, Takashi; Kitamura, Shin; Soeda, Toshiyuki; Terashi, Akiro

    1987-01-01

    This study was designed to investigate the responsible region and the symptomatic flow and metabolism threshold for Broca's aphasia. Regional cerebral blood flow (CBF) and oxygen metabolism (CMRO 2 ) were measured by positron emission tomography (PET) using 15 O steady state method in eight patients with Broca's aphasia due to cerebral infarction and thirty patients without aphasia. During scanning, patients closed their eyes and were kept free from any stimuration. X-CT scan revealed abnormal low density in Broca's area which includes cortex and subcortex in the anterior region to Sylvian fissure in three patients with aphasia. In the other five patients with aphasia X-CT scan showed no abnormal low density in Broca's area, showed it in basal ganglionic region and subcortex. PET study revealed reduction of CBF and CMRO 2 in Broca's area in all cases with Broca's aphasia. CBF and CMRO 2 of Broca's area of aphasic patients were compared to those of non aphasic patients to obtain the symptomatic threshold in CBF and CMRO 2 . The values of symptomatic threshold were 20 - 27 ml/100 g/min in CBF and 2.0 ml/100 g/min in CMRO 2 . The symptomatic threshold differed from the threshold for development of abnormal low density on X-CT, therefore the measurement of CBF and CMRO 2 were useful in studying the responsible region for aphasia. (author)

  15. Clinical neurological, electrophysiological, and cerebral CT scan findings in systemic lupus erythematosus.

    Science.gov (United States)

    Omdal, R; Selseth, B; Kløw, N E; Husby, G; Mellgren, S I

    1989-01-01

    Thirty SLE patients underwent clinical neurological examination, electrophysiological studies, cerebral computer tomographic (CT) scans, and blood sampling. Nineteen patients (63%) had clinical neuropsychiatric and 10 patients (33%) had clinical neuromuscular manifestations. Migrainous headache affecting 11 patients (37%) was the most prevalent clinical manifestation. Electrophysiological testing revealed abnormal electroencephalography in 10 patients (33%). Abnormal electromyography and nerve conduction velocity were found in 13 (43%) and 7 (24%) patients respectively. Abnormal visual evoked response was detected in 2 patients. Cerebral CT scans displayed cerebral atrophy in 20 patients (71%), while 6 patients (21%) had cerebral infractions. Disease activity assessed by two different tests revealed a higher prevalence of cerebral infarctions, classical migraine, muscular weakness, and pathological electromyography and nerve conduction velocity in the higher disease activity groups. Cerebral infarctions were only found among anti-Ro negative patients, but apart from this, no significant association could be found between coagulopathy, circulating immune complexes, cryoglobulins, routine immunological tests, medication, and any clinical, electrophysiological or cerebral CT pathology.

  16. Autonomic skin responses in females with Fabry disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Bach, Flemming W.; Feldt-Rasmussen, Ulla

    2009-01-01

    Fabry disease is a genetic lysosomal disorder with dysfunction of the lysosomal enzyme alpha-galactosidase A causing accumulation of glycolipids in multiple organs including the nervous system and with neuropathy as a prominent manifestation. Neurological symptoms include pain and autonomic...... dysfunction. This study examined peripheral autonomic nerve function in 19 female patients with Fabry disease and 19 sex and age-matched controls by measuring (1) sweat production following acetylcholine challenge; (2) the sympathetically mediated vasoconstrictor responses to inspiratory gasp, stress......, and the cold pressor test; and (3) cutaneous blood flow following capsaicin. The vasoconstrictor response to inspiratory gasp was increased in Fabry patients compared to controls (p = 0.03), while the response to cold and mental stress did not change. Female patients with Fabry disease had a reduced sweat...

  17. Silent microemboli related to diagnostic cerebral angiography: a matter of operator's experience and patient's disease

    Energy Technology Data Exchange (ETDEWEB)

    Krings, T. [University Hospital of the Technical University Aachen, Department of Neuroradiology, Aachen (Germany); University Hospital Aachen, Department of Neurosurgery, Aachen (Germany); Willmes, K.; Meister, I.G. [University Hospital Aachen, Department of Neurology, Aachen (Germany); Becker, R.; Mull, M.; Thron, A. [University Hospital of the Technical University Aachen, Department of Neuroradiology, Aachen (Germany); Hans, F.J.; Reinges, M.H.T. [University Hospital Aachen, Department of Neurosurgery, Aachen (Germany)

    2006-06-15

    The aim of the present investigation was to elucidate in a large consecutive patient cohort whether the level of training has an effect on the number of microemboli detected by diffusion-weighted imaging (DWI) and which additional risk factors can be identified. A total of 107 consecutive patients in whom a diagnostic cerebral angiography had been performed were prospectively investigated with DWI; 51 angiographies were performed by experienced neuroradiologists, 56 by neuroradiologists in training. In 12 patients (11.1%), a total of 17 new lesions without any clinically overt neurological symptoms were identified. Of these, 12 patients, 11 (91.7%) with 16 lesions were investigated by junior neuroradiologists. In 11 of 12 patients with DWI abnormalities (91.7%), risk factors could be identified (atherosclerotic vessel wall disease, vasculitis, hypercoagulable states). Experienced neuroradiologists performed 21 of 48 angiographies (43.8%) on patients with the above-mentioned risk factors, whereas junior neuroradiologists performed 27 angiographies in this subgroup (46.2%). The rate of diffusion abnormalities in patients with risk factors was 11/48 (22.9%) - considerably higher than in patients without risk factors (1/59; 1.7%). The level of experience and the nature of the underlying disease are predictors of the occurrence of cerebral ischemic events following neuroangiography. Alternative diagnostic modalities should be employed in patients who are investigated for diseases with the highest risk of angiographic complications (i.e., vasculitis, and arteriosclerotic vessel wall disease). If diagnostic angiography remains necessary in these patients, the highest level of practitioner training is necessary to ensure good patient outcome. (orig.)

  18. Cross sectional PET study of cerebral adenosine A{sub 1} receptors in premanifest and manifest Huntington's disease

    Energy Technology Data Exchange (ETDEWEB)

    Matusch, Andreas; Elmenhorst, David [Institute of Neuroscience and Medicine (INM-2), Juelich (Germany); Saft, Carsten; Kraus, Peter H.; Gold, Ralf [St. Josef Hospital, Ruhr University Bochum, Department of Neurology, Huntington Centre NRW, Bochum (Germany); Hartung, Hans-Peter [Heinrich Heine University Duesseldorf, Department of Neurology, Medical Faculty, Duesseldorf (Germany); Bauer, Andreas [Institute of Neuroscience and Medicine (INM-2), Juelich (Germany); Heinrich Heine University Duesseldorf, Department of Neurology, Medical Faculty, Duesseldorf (Germany)

    2014-06-15

    To study cerebral adenosine receptors (AR) in premanifest and manifest stages of Huntington's disease (HD). We quantified the cerebral binding potential (BP{sub ND}) of the A{sub 1}AR in carriers of the HD CAG trinucleotide repeat expansion using the radioligand [{sup 18} F]CPFPX and PET. Four groups were investigated: (i) premanifest individuals far (preHD-A; n = 7) or (ii) near (preHD-B; n = 6) to the predicted symptom onset, (iii) manifest HD patients (n = 8), and (iv) controls (n = 36). Cerebral A{sub 1}AR values of preHD-A subjects were generally higher than those of controls (by up to 31 %, p <.01, in the thalamus on average). Across stages a successive reduction of A{sub 1}AR BP{sub ND} was observed to the levels of controls in preHD-B and undercutting controls in manifest HD by down to 25 %, p <.01, in the caudatus and amygdala. There was a strong correlation between A{sub 1}AR BP{sub ND} and years to onset. Before onset of HD, the assumed annual rates of change of A{sub 1}AR density were -1.2 % in the caudatus, -1.7 % in the thalamus and -3.4 % in the amygdala, while the corresponding volume losses amounted to 0.6 %, 0.1 % and 0.2 %, respectively. Adenosine receptors switch from supra to subnormal levels during phenoconversion of HD. This differential regulation may play a role in the pathophysiology of altered energy metabolism. (orig.)

  19. Ebola virus disease surveillance and response preparedness in northern Ghana

    Directory of Open Access Journals (Sweden)

    Martin N. Adokiya

    2016-05-01

    Full Text Available Background: The recent Ebola virus disease (EVD outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases. Objective: The objective of this study was to assess the EVD surveillance and response system in northern Ghana. Design: This was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Surveillance and Response reports (August 2014 to March 2015 were collated from each district. Results: In 2014 and 2015, a total of 10 suspected Ebola cases were clinically diagnosed from four districts. Out of the suspected cases, eight died and the cause of death was unexplained. All the 10 suspected cases were reported, none was confirmed. The informants had knowledge on EVD surveillance and data reporting. However, there were gaps such as delayed reporting, low quality protective equipment (e.g. gloves, aprons, inadequate staff, and lack of laboratory capacity. The majority (38/47 of the respondents were not satisfied with EVD surveillance system and response preparedness due to lack of infrared thermometers, ineffective screening, and lack of isolation centres. Conclusion: EVD surveillance and response preparedness is insufficient and the epidemic is a wake-up call for early detection and response preparedness. Ebola surveillance remains

  20. Production rates and turnover of triiodothyronine in rat-developing cerebral cortex and cerebellum. Responses to hypothyroidism

    International Nuclear Information System (INIS)

    Silva, J.E.; Matthews, P.S.

    1984-01-01

    Local 5'-deiodination of serum thyroxine (T4) is the main source of triiodothyronine (T3) for the brain. Since we noted in previous studies that the cerebral cortex of neonatal rats tolerated marked reductions in serum T4 without biochemical hypothyroidism, we examined the in vivo T4 and T3 metabolism in that tissue and in the cerebellum of euthyroid and hypothyroid 2-wk-old rats. We also assessed the contribution of enhanced tissue T4 to T3 conversion and decreased T3 removal from the tissues to the T3 homeostasis in hypothyroid brain. Congenital and neonatal hypothyroidism was induced by adding methimazole to the drinking water. Serum, cerebral cortex (Cx), cerebellum (Cm), liver (L) and kidney (R) concentrations of 125I-T4, 125I-T3(T4), and 131I-T3 were measured at various times after injecting 125I-T4 and 131I-T3. The rate of T3 removal from the tissues was measured after injecting an excess of anti-T3-antibody to rats previously injected with tracer T3. In hypothyroidism, the fractional removal rates and clearances were reduced in all tissues, in cortex and cerebellum by 70%, and in liver and kidney ranging from 30 to 50%. While greater than 80% of the 125I-T3(T4) in the brain tissues of euthyroid rats was locally produced, in hypothyroid cerebral cortex and cerebellum the integrated concentrations of 125I-T3(T4) were 2.7- and 1.5-fold greater than in euthyroid rats

  1. Distributed Cerebral Blood Flow estimation using a spatiotemporal hemodynamic response model and a Kalman-like Filter approach

    KAUST Repository

    Belkhatir, Zehor

    2015-11-23

    This paper discusses the estimation of distributed Cerebral Blood Flow (CBF) using spatiotemporal traveling wave model. We consider a damped wave partial differential equation that describes a physiological relationship between the blood mass density and the CBF. The spatiotemporal model is reduced to a finite dimensional system using a cubic b-spline continuous Galerkin method. A Kalman Filter with Unknown Inputs without Direct Feedthrough (KF-UI-WDF) is applied on the obtained reduced differential model to estimate the source term which is the CBF scaled by a factor. Numerical results showing the performances of the adopted estimator are provided.

  2. Cerebral amyloid angiopathy-related inflammation presenting with steroid-responsive higher brain dysfunction: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Maeda Yasushi

    2011-09-01

    Full Text Available Abstract A 56-year-old man noticed discomfort in his left lower limb, followed by convulsion and numbness in the same area. Magnetic resonance imaging (MRI showed white matter lesions in the right parietal lobe accompanied by leptomeningeal or leptomeningeal and cortical post-contrast enhancement along the parietal sulci. The patient also exhibited higher brain dysfunction corresponding with the lesions on MRI. Histological pathology disclosed β-amyloid in the blood vessels and perivascular inflammation, which highlights the diagnosis of cerebral amyloid angiopathy (CAA-related inflammation. Pulse steroid therapy was so effective that clinical and radiological findings immediately improved. CAA-related inflammation is a rare disease, defined by the deposition of amyloid proteins within the leptomeningeal and cortical arteries associated with vasculitis or perivasculitis. Here we report a patient with CAA-related inflammation who showed higher brain dysfunction that improved with steroid therapy. In cases with atypical radiological lesions like our case, cerebral biopsy with histological confirmation remains necessary for an accurate diagnosis.

  3. Cerebral Hypoxia

    Science.gov (United States)

    ... off. When hypoxia lasts for longer periods of time, it can cause coma, seizures, and even brain death. In brain death, there is no measurable activity in the brain, although cardiovascular function is preserved. Life support is required for respiration. × Definition Cerebral hypoxia ...

  4. Radiopharmaceuticals for cerebral studies

    International Nuclear Information System (INIS)

    Leon Cabana, Alba

    1994-01-01

    For obtain good brain scintillation images in nuclear medicine must be used several radiopharmaceuticals. Cerebral studies give a tumors visual image as well as brain anomalities detection and are helpful in the diagnostic diseases . Are described in this work: a cerebrum radiopharmaceuticals classification,labelled compounds proceeding and Tc 99m good properties in for your fast caption, post administration and blood purification for renal way

  5. Traffic jam at the blood-brain barrier promotes greater accumulation of Alzheimer's disease amyloid-β proteins in the cerebral vasculature.

    Science.gov (United States)

    Agyare, Edward K; Leonard, Sarah R; Curran, Geoffry L; Yu, Caroline C; Lowe, Val J; Paravastu, Anant K; Poduslo, Joseph F; Kandimalla, Karunya K

    2013-05-06

    Amyloid-β (Aβ) deposition in the brain vasculature results in cerebral amyloid angiopathy (CAA), which occurs in about 80% of Alzheimer's disease (AD) patients. While Aβ42 predominates parenchymal amyloid plaques in AD brain, Aβ40 is prevalent in the cerebrovascular amyloid. Dutch mutation of Aβ40 (E22Q) promotes aggressive cerebrovascular accumulation and leads to severe CAA in the mutation carriers; knowledge of how DutchAβ40 drives this process more efficiently than Aβ40 could reveal various pathophysiological events that promote CAA. In this study we have demonstrated that DutchAβ40 shows preferential accumulation in the blood-brain-barrier (BBB) endothelial cells due to its inefficient blood-to-brain transcytosis. Consequently, DutchAβ40 establishes a permeation barrier in the BBB endothelium, prevents its own clearance from the brain, and promotes the formation of amyloid deposits in the cerebral microvessels. The BBB endothelial accumulation of native Aβ40 is not robust enough to exercise such a significant impact on its brain clearance. Hence, the cerebrovascular accumulation of Aβ40 is slow and may require other copathologies to precipitate into CAA. In conclusion, the magnitude of Aβ accumulation in the BBB endothelial cells is a critical factor that promotes CAA; hence, clearing vascular endothelium of Aβ proteins may halt or even reverse CAA.

  6. Traffic Jam at the Blood Brain Barrier Promotes Greater Accumulation of Alzheimer’s Disease Amyloid-β Proteins in the Cerebral Vasculature

    Science.gov (United States)

    Agyare, Edward K.; Leonard, Sarah R.; Curran, Geoffry L.; Yu, Caroline C.; Lowe, Val J.; Paravastu, Anant K.; Poduslo, Joseph F.; Kandimalla, Karunya K.

    2013-01-01

    Amyloid-β (Aβ) deposition in the brain vasculature results in cerebral amyloid angiopathy (CAA), which occurs in about 80% of Alzheimer’s disease (AD) patients. While Aβ42 predominates parenchymal amyloid plaques in AD brain, Aβ40 is prevalent in the cerebrovascular amyloid. Dutch mutation of Aβ40 (E22Q) promotes aggressive cerebrovascular accumulation and leads to severe CAA in the mutation carriers; knowledge of how DutchAβ40 drives this process more efficiently than Aβ40 could reveal various pathophysiological events that promote CAA. In this study we have demonstrated that DutchAβ40 show preferential accumulation in the blood-brain-barrier (BBB) endothelial cells due to its inefficient blood-to-brain transcytosis. Consequently, DutchAβ40 establishes a permeation barrier in the BBB endothelium, prevents its own clearance from the brain and promotes the formation of amyloid deposits in the cerebral microvessels. The BBB endothelial accumulation of native Aβ40 is not robust enough to exercise such a significant impact on its brain clearance. Hence, the cerebrovascular accumulation of Aβ40 is slow and may require other co-pathologies to precipitate into CAA. In conclusion, the magnitude of Aβ accumulation in the BBB endothelial cells is a critical factor that promotes CAA; hence, clearing vascular endothelium of Aβ proteins may halt or even reverse CAA. PMID:23249146

  7. Quantitative analysis of the effects of donepezil on regional cerebral blood flow in Alzheimer's disease by using an automated program, 3DSRT

    Energy Technology Data Exchange (ETDEWEB)

    Tateno, Masaru [Sapporo Medical University, Department of Neuropsychiatry, Sapporo, Hokkaido (Japan); Kobayashi, Seiju; Utsumi, Kumiko [Sunagawa City Medical Center, Department of Psychiatry, Sunagawa (Japan); Morii, Hidetoshi; Fujii, Kazuki [Sunagawa City Medical Center, Department of Radiology, Sunagawa (Japan)

    2008-08-15

    Donepezil, an acetylcholinesterase inhibitor, has been reported to have an effect that improves cerebral blood flow (CBF) alongside its primary effect on memory function. The aim of this study was to investigate the effects of long-term, low-dose donepezil therapy on blood perfusion in Alzheimer's disease (AD) by using a fully automated regional CBF quantification program named 3DSRT. Fifteen subjects with mild to moderate AD according to NINCDS/ADRDA criteria underwent 99mTc-ethylcysteinate dimer (ECD) brain perfusion single photon emission computed tomography (SPECT) twice with an interval of 55.1{+-}11.0 weeks. The dose of donepezil was fixed at 5 mg/day following the induction period (3 mg/day) of 2 weeks. Clinical efficacy of donepezil was assessed by using the Mini-Mental State Examination (MMSE). The results of SPECT imaging under exactly identical conditions were analyzed by 3DSRT, which enables us to perform a very objective assessment. Despite a decrease of the MMSE score from 20.9{+-}4.7 to 18.7{+-}5.7, CBF was increased in almost all cerebral areas except the left temporal segment. The increase was statistically significant in the left callosomarginal, right central, and bilateral pericallosal and lenticular nucleus segments. Thus far, no direct cerebrovascular effects have been reported for donepezil. We hypothesize that these CBF-promoting effects of donepezil might be related to increased neuronal activity and enhanced connection of neurons. (orig.)

  8. Accounting for the role of hematocrit in between-subject variations of MRI-derived baseline cerebral hemodynamic parameters and functional BOLD responses.

    Science.gov (United States)

    Xu, Feng; Li, Wenbo; Liu, Peiying; Hua, Jun; Strouse, John J; Pekar, James J; Lu, Hanzhang; van Zijl, Peter C M; Qin, Qin

    2018-01-01

    Baseline hematocrit fraction (Hct) is a determinant for baseline cerebral blood flow (CBF) and between-subject variation of Hct thus causes variation in task-based BOLD fMRI signal changes. We first verified in healthy volunteers (n = 12) that Hct values can be derived reliably from venous blood T 1 values by comparison with the conventional lab test. Together with CBF measured using phase-contrast MRI, this noninvasive estimation of Hct, instead of using a population-averaged Hct value, enabled more individual determination of oxygen delivery (DO 2 ), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO 2 ). The inverse correlation of CBF and Hct explained about 80% of between-subject variation of CBF in this relatively uniform cohort of subjects, as expected based on the regulation of DO 2 to maintain constant CMRO 2 . Furthermore, we compared the relationships of visual task-evoked BOLD response with Hct and CBF. We showed that Hct and CBF contributed 22%-33% of variance in BOLD signal and removing the positive correlation with Hct and negative correlation with CBF allowed normalization of BOLD signal with 16%-22% lower variability. The results of this study suggest that adjustment for Hct effects is useful for studies of MRI perfusion and BOLD fMRI. Hum Brain Mapp 39:344-353, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. [Treatment choice for patients with hemorrhagic cerebral stroke expected to be in a disabled condition--An analysis of questionnaire responses of patients' families].

    Science.gov (United States)

    Torigoe, Takahiro; Fukuhara, Toru

    2015-01-01

    Many patients with cerebral stroke are successively treated with the latest advances in medical therapies. Surgical hematoma evacuation is a treatment option for patients with hemorrhagic cerebral stroke, however; it may result in a prolonged vegetative state. The difficult choice of whether or not such surgery should be performed is mostly made by the family, frequently in an urgent manner, and nurses need to understand the factors affecting this decision-making. We performed statistical analyses on the responses of 30 patients' families who answered our questionnaire, presuming disabilities after the surgery were expected. Multiple answers were obtained according to the severity of the expected disabilities after the surgery. The refusal of surgery increased as the expected disabilities worsened, and the statistically significant factor affecting the decision-making process was "what they would wish if they suffered a stroke themselves." The 18 nurses working in the neurological ward who responded to the same questionnaire wished surgery more in the case of the patient's cognition being preserved. Since it is rare for patients with stroke to have an advance directive, patients' families have to decide the treatment choice in most cases. In the clinical setting, such decisions frequently need to be made rapidly, however; the decision should be made by speculating on the patients' own will, and it is desirable for medical staff to explain the expected outcomes of the surgery in detail as far as possible.

  10. Response of chickens to oral vaccination with Newcastle disease ...

    African Journals Online (AJOL)

    Thermostable Newcastle disease (ND) vaccine virus strain I2 was investigated for its efficacy as foodborne vaccine, using maize offal as the vehicle. Immune response to vaccination and resistance to challenge were assessed by standard methods. Results showed that following primary vaccination, 40 (64.5%) out of the 62 ...

  11. The DNA-damage response in human biology and disease

    Czech Academy of Sciences Publication Activity Database

    Jackson, S.P.; Bartek, Jiří

    2009-01-01

    Roč. 461, č. 7267 (2009), s. 1071-1078 ISSN 0028-0836 Institutional research plan: CEZ:AV0Z50520514 Keywords : DNA damage response * human disease * cancer Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 34.480, year: 2009

  12. Growth, Yield And Disease Responses Of 12 Cassava Genotypes ...

    African Journals Online (AJOL)

    Growth, Yield And Disease Responses Of 12 Cassava Genotypes Evaluated For Two Cropping Seasons In A Derived Savannah Zone Of South-Eastern Nigeria. ... TMS 96/0304 precluded their recommendation for release while TMS 96/1672 could be recommended for release to farmers. Agro-Science Vol. 7 (2) 2008: pp.

  13. The immune response to Prevotella bacteria in chronic inflammatory disease

    DEFF Research Database (Denmark)

    Larsen, Jeppe Madura

    2017-01-01

    The microbiota plays a central role in human health and disease by shaping immune development, immune responses and metabolism, and by protecting from invading pathogens. Technical advances that allow comprehensive characterization of microbial communities by genetic sequencing have sparked......-8, IL-6 and CCL20, which can promote mucosal Th17 immune responses and neutrophil recruitment. Prevotella-mediated mucosal inflammation leads to systemic dissemination of inflammatory mediators, bacteria and bacterial products, which in turn may affect systemic disease outcomes. Studies in mice...... support a causal role of Prevotella as colonization experiments promote clinical and inflammatory features of human disease. When compared with strict commensal bacteria, Prevotella exhibit increased inflammatory properties, as demonstrated by augmented release of inflammatory mediators from immune cells...

  14. Perturbed and spontaneous regional cerebral blood flow responses to changes in blood pressure after high-level spinal cord injury: the effect of midodrine.

    Science.gov (United States)

    Phillips, Aaron A; Krassioukov, Andrei V; Ainslie, Philip N; Warburton, Darren E R

    2014-03-15

    Individuals with spinal cord injury (SCI) above the T6 spinal segment suffer from orthostatic intolerance. How cerebral blood flow (CBF) responds to orthostatic challenges in SCI is poorly understood. Furthermore, it is unclear how interventions meant to improve orthostatic tolerance in SCI influence CBF. This study aimed to examine 1) the acute regional CBF responses to rapid changes in blood pressure (BP) during orthostatic stress in individuals with SCI and able-bodied (AB) individuals; and 2) the effect of midodrine (alpha1-agonist) on orthostatic tolerance and CBF regulation in SCI. Ten individuals with SCI >T6, and 10 age- and sex-matched AB controls had beat-by-beat BP and middle and posterior cerebral artery blood velocity (MCAv, PCAv, respectively) recorded during a progressive tilt-test to quantify the acute CBF response and orthostatic tolerance. Dynamic MCAv and PCAv to BP relationships were evaluated continuously in the time domain and frequency domain (via transfer function analysis). The SCI group was tested again after administration of 10 mg midodrine to elevate BP. Coherence (i.e., linearity) was elevated in SCI between BP-MCAv and BP-PCAv by 35% and 22%, respectively, compared with AB, whereas SCI BP-PCAv gain (i.e., magnitudinal relationship) was reduced 30% compared with AB (all P midodrine led to improved PCAv responses 30-60 s following tilt (10 ± 3% vs. 4 ± 2% decline; P < 0.05), and a 59% improvement in orthostatic tolerance (P < 0.01). The vertebrobasilar region may be particularly susceptible to hypoperfusion in SCI, leading to increased orthostatic intolerance.

  15. Dental characteristics of children with cerebral palsy

    OpenAIRE

    Stevanović Radoje; Jovičić Olivera

    2004-01-01

    Cerebral palsy is one of the commonest children's physical handicaps with frequency of 1.5-3/1000. Beside many other disturbances, these children may have serious disorders caused by dental diseases. Concerning this fact, the objective of our study was to examine children with cerebral palsy in our country and determine condition of dental health and suggest adequate protective measures. A total of 116 children, 3-18 years old, with cerebral palsy were examined and the results were compared t...

  16. Characterization of early host responses in adults with dengue disease

    Directory of Open Access Journals (Sweden)

    Ling Ling

    2011-08-01

    Full Text Available Abstract Background While dengue-elicited early and transient host responses preceding defervescence could shape the disease outcome and reveal mechanisms of the disease pathogenesis, assessment of these responses are difficult as patients rarely seek healthcare during the first days of benign fever and thus data are lacking. Methods In this study, focusing on early recruitment, we performed whole-blood transcriptional profiling on denguevirus PCR positive patients sampled within 72 h of self-reported fever presentation (average 43 h, SD 18.6 h and compared the signatures with autologous samples drawn at defervescence and convalescence and to control patients with fever of other etiology. Results In the early dengue fever phase, a strong activation of the innate immune response related genes were seen that was absent at defervescence (4-7 days after fever debut, while at this second sampling genes related to biosynthesis and metabolism dominated. Transcripts relating to the adaptive immune response were over-expressed in the second sampling point with sustained activation at the third sampling. On an individual gene level, significant enrichment of transcripts early in dengue disease were chemokines CCL2 (MCP-1, CCL8 (MCP-2, CXCL10 (IP-10 and CCL3 (MIP-1α, antimicrobial peptide β-defensin 1 (DEFB1, desmosome/intermediate junction component plakoglobin (JUP and a microRNA which may negatively regulate pro-inflammatory cytokines in dengue infected peripheral blood cells, mIR-147 (NMES1. Conclusions These data show that the early response in patients mimics those previously described in vitro, where early assessment of transcriptional responses has been easily obtained. Several of the early transcripts identified may be affected by or mediate the pathogenesis and deserve further assessment at this timepoint in correlation to severe disease.

  17. Estimulação cerebral profunda no núcleo subtalâmico para doença de Parkinson Deep brain stimulation of subthalamic nucleous in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    José Augusto Nasser

    2002-03-01

    Full Text Available OBJETIVO: Apresentamos os resultados preliminares da estimulação cerebral profunda crônica no núcleo subtalâmico para os sintomas motores da doença de Parkinson. MÉTODO: 8 pacientes com doença de Parkinson há mais de 5 anos, apresentando tremor incapacitante, oligocinesia e rigidez acentuada com predomínio unilateral, 3 à direita e um à esquerda, refratários �� medicação adequada, foram submetidos ao implante bilateral de eletrodo cerebral profundo permanente subtalâmico, Itrell 2. Estes pacientes foram avaliados segundo as escalas: UPDRS, Schwab e England. RESULTADOS: Os resultados preliminares (6 meses, mostraram melhora significativa dos sinais e sintomas avaliados pelas escalas acima. Não houve complicações com os procedimentos. CONCLUSÃO: Os resultados preliminares indicam que a estimulação subtalâmica é uma boa opção terapêutica, estando de acordo com os resultados da literatura.We present the preliminary results in patients well selected to be implanted by deep brain stimulation (DBS for Parkinsons's disease (PD. METHODS: 8 PD patients with disabled tremor, akinetic/bradikinetic and rigidity, in spite of best therapeutic assay with poor response were referred to surgery. It was implanted DBS Itrell 2. Theses patients were evaluated by the following scales: UPDRS, Schwab and England. RESULTS: The preliminary results in 6 months showed significant improvement of motor performance and it is shown by the scores. There were no complications so far with these procedures. CONCLUSION: The preliminary results indicate that DBS is highly effective, with benefit to those patients and it is according to literature.

  18. Role of Apoptosis in Amplifying Inflammatory Responses in Lung Diseases

    Directory of Open Access Journals (Sweden)

    E.P. Schmidt

    2010-01-01

    Full Text Available Apoptosis is an important contributor to the pathophysiology of lung diseases such as acute lung injury (ALI and chronic obstructive pulmonary disease (COPD. Furthermore, the cellular environment of these acute and chronic lung diseases favors the delayed clearance of apoptotic cells. This dysfunctional efferocytosis predisposes to the release of endogenous ligands from dying cells. These so-called damage-associated molecular patterns (DAMPs play an important role in the stimulation of innate immunity as well as in the induction of adaptive immunity, potentially against autoantigens. In this review, we explore the role of apoptosis in ALI and COPD, with particular attention to the contribution of DAMP release in augmenting the inflammatory response in these disease states.

  19. A Case of Pott’s Disease with Epidural Abscess and Probable Cerebral Tuberculoma following Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Colin B Josephson

    2010-01-01

    Full Text Available Intravesical Bacillus Calmette-Guérin (BCG immunotherapy is an accepted treatment for transitional cell carcinoma of the bladder. Carcinoma in situ of the bladder progresses to invasive muscular disease in approximately 54% of untreated patients, mandating early initiation of therapy once the diagnosis is confirmed. Should BCG treatment fail, an additional course of BCG combined with interferon-alpha, both administered intravesically, is a promising second-line immunotherapy. In greater than 95% of patients, BCG is tolerated without significant morbidity or mortality. However, both early (within three months of the original treatment and late presentations of systemic infection resulting from intravesical BCG treatment have been described. The present study describes the course of a 75-year-old man with a late presentation of BCG vertebral osteomyelitis, discitis, epidural abscess, bilateral psoas abscesses and probable cerebral tuberculoma, following treatment regimens of intravesical BCG followed by intravesical BCG plus interferon-alpha 2b.

  20. Association Between Serum Cystatin C Level and Total Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease in Patients With Acute Lacunar Stroke.

    Science.gov (United States)

    Yang, Song; Cai, Jing; Lu, Rulan; Wu, Jian; Zhang, Min; Zhou, Xianju

    2017-01-01

    Chronic kidney disease (CKD) is associated with cerebral small vessel disease (cSVD). However, the relationship between serum cystatin C (CysC) level, a highly sensitive marker of impaired kidney function, and cSVD has not been fully understood. This study aimed to investigate the association between serum CysC level and total burden of cSVD on magnetic resonance imaging (MRI) in patients with acute lacunar stroke. A total of 210 patients with first-ever acute lacunar stroke occurring within 1 week after onset were included in this study. Serum CysC level, decreased estimated glomerular filtration rate (eGFR), and proteinuria were used to evaluate kidney function. The combined effect of the markers of cSVD on MRI, including lacunar, white matter lesions, cerebral microbleeds, and enlarged perivascular spaces, were used to evaluate the comprehensive cSVD burden. There is a positive association between total cSVD burden and hypertension, low eGFR level, and serum CysC level. After adjustments for potential confounders by ordinal logistic regression, elevated levels of CysC as well as impaired eGFR and the presence of proteinuria were correlated with the burden of total cSVD (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.284-5.403; OR 2.442, 95% CI 1.213-4.918; and OR 2.151, 95% CI 1.162-3.983, respectively). The elevated level of serum CysC is associated with the total burden of cSVD in patients with acute lacunar stroke independent of conventional risk factors. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. Analysis of regional cerebral blood flow and distribution volume in Machado-Joseph disease by iodine-123I IMP single photon emission computed tomography

    International Nuclear Information System (INIS)

    Hayashi, Tsunemi; Nakajima, Takashi; Fukuhara, Nobuyoshi

    2001-01-01

    Machado-Joseph disease (MJD) is an autosomal dominant spinocerebellar ataxia. Its clinical features vary greatly in different generations of the same family. Regional cerebral blood flow (rCBF) and distribution volume (V d ) in the pons, cerebellum, and cerebral cortex were measured in 12 patients with MJD by autoradiography (ARG) and the table look-up (TLU) method of iodine-123 IMP ( 123 I-IMP) single photon emission computed tomography (SPECT). Representative cases were as follows: A 46-year-old woman first experienced gait ataxia at age 38. Computed tomography (CT) and magnetic resonance imaging (MRI) showed no atrophy in the pons or cerebellum, but rCBF measured by the 123 I-IMP SPECT ARG method detected hypoperfusion in the pons, and cerebellar vermis and hemisphere. A 76-year-old woman first experienced gait ataxia at age 69. CT and MRI findings showed severe atrophy in the pons, and cerebellar vermis and hemisphere. Moreover, rCBF was decreased in the pons, whereas it was not decreased in the cerebellar vermis and hemisphere. In the pons of patients with MJD, rCBF was markedly decreased regardless of disease severity. Because this SPECT finding for the pons looked like a 'dot', we have called it the 'pontine dot sign'. In the MJD group, rCBF was significantly decreased in the pons (Student's t test, p d was also significantly decreased in the pons (p d for the pons and age at onset (r=0.59, p d in the cerebellar hemispheres and International Cooperative Ataxia Rating Scale (r=0.644, p d obtained by 123 I-IMP SPECT for patients with MJD identified by gene analysis. Our study shows that SPECT measurement of rCBF and V d is useful for understanding the pathophysiology of MJD. (author)

  2. Effects of angiotensin II receptor blockade on cerebral, cardiovascular, counter-regulatory, and symptomatic responses during hypoglycaemia in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Færch, Louise H; Thorsteinsson, Birger; Tarnow, Lise

    2015-01-01

    INTRODUCTION: High spontaneous activity of the renin-angiotensin system (RAS) results in more pronounced cognitive impairment and more prolonged QTc interval during hypoglycaemia in type 1 diabetes. We tested whether angiotensin II receptor blockade improves cerebral and cardiovascular function...... during hypoglycaemia. METHODS: Nine patients with type 1 diabetes and high spontaneous RAS activity were included in a double-blind, randomised, cross-over study on the effect of angiotensin II receptor antagonist (candesartan 32 mg) or placebo for one week on cognitive function, cardiovascular...... parameters, hormonal counter-regulatory response, substrate mobilisation, and symptoms during hypoglycaemia induced by two hyperinsulinaemic, hypoglycaemic clamps. RESULTS: Compared to placebo, candesartan did neither change performance of the cognitive tests nor the EEG at a plasma glucose concentration...

  3. Reduced response of splenocytes after mitogen-stimulation in the prion protein (PrP) gene-deficient mouse: PrPLP/Doppel production and cerebral degeneration

    International Nuclear Information System (INIS)

    Kim, Chi-Kyeong; Hirose, Yuko; Sakudo, Akikazu; Takeyama, Natsumi; Kang, Chung-Boo; Taniuchi, Yojiro; Matsumoto, Yoshitsugu; Itohara, Shigeyoshi; Sakaguchi, Suehiro; Onodera, Takashi

    2007-01-01

    Splenocytes of wild-type (Prnp +/+ ) and prion protein gene-deficient (Prnp -/- ) mice were treated with various activation stimuli such as T cell mitogen concanavalin A (ConA), phorbol 12-myristate 13-acetate (PMA) + ionomycin (Io), or B cell mitogen lipopolysaccharide (LPS). Cellular prion protein (PrP C ) expression was enhanced following ConA stimulation, but not PMA + Io or LPS in Prnp +/+ splenocytes. Rikn Prnp -/- splenocytes elicited lower cell proliferations than Prnp +/+ or Zrch I Prnp -/- splenocytes after LPS stimulation and showed sporadic nerve cells in the cerebral cortex and deeper structure. Around the degenerated nerve cells, mild vacuolation in the neuropil was observed. This neural alteration correlated well to the suppressed response of B cells in the spleen. The finding that discrete lesions within the central nervous systems induced marked modulation of immune function probably indicates the existence of a delicately balanced neural-endocrine network by PrP C and PrPLP/Doppel

  4. Modeling Cerebral Blood Flow Control During Posture Change from Sitting to Standing

    DEFF Research Database (Denmark)

    Olufsen, Mette; Tran, Hien; Ottesen, Johnny T.

    2004-01-01

    Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture change from sitting...... to standing. The mathematical model uses a compartmental approach to describe pulsatile blood flow and pressure in a number of compartments representing the systemic circulation. Our model includes compartments representing the trunk and upper extremities, the lower extremities, the brain, the atria......, the heart, and venous valves. We use physiologically based control mechanisms to describe the regulation of cerebral blood velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. Beyond active control mechanisms we also have to include certain passive non...

  5. Modeling Cerebral Blood Flow Control During Posture Change from Sitting to Standing

    DEFF Research Database (Denmark)

    Olufsen, Mette; Tran, Hien; Ottesen, Johnny T.

    2004-01-01

    , the heart, and venous valves. We use physiologically based control mechanisms to describe the regulation of cerebral blood velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. Beyond active control mechanisms we also have to include certain passive non-linearities......Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture change from sitting...... in some of the compliance-pressure and resistance-pressure relationships. Futhermore, an acurate and physiologically based submodel, describing the dynamics of how gravity effects the blood distribution during suspine changes, is included. To justify the fidelity of our mathematical model and control...

  6. Molecular Responses to Small Regulating Molecules against Huanglongbing Disease.

    Directory of Open Access Journals (Sweden)

    Federico Martinelli

    Full Text Available Huanglongbing (HLB; citrus greening is the most devastating disease of citrus worldwide. No cure is yet available for this disease and infected trees generally decline after several months. Disease management depends on early detection of symptoms and chemical control of insect vectors. In this work, different combinations of organic compounds were tested for the ability to modulate citrus molecular responses to HLB disease beneficially. Three small-molecule regulating compounds were tested: 1 L-arginine, 2 6-benzyl-adenine combined with gibberellins, and 3 sucrose combined with atrazine. Each treatment contained K-phite mineral solution and was tested at two different concentrations. Two trials were conducted: one in the greenhouse and the other in the orchard. In the greenhouse study, responses of 42 key genes involved in sugar and starch metabolism, hormone-related pathways, biotic stress responses, and secondary metabolism in treated and untreated mature leaves were analyzed. TGA5 was significantly induced by arginine. Benzyladenine and gibberellins enhanced two important genes involved in biotic stress responses: WRKY54 and WRKY59. Sucrose combined with atrazine mainly upregulated key genes involved in carbohydrate metabolism such as sucrose-phosphate synthase, sucrose synthase, starch synthase, and α-amylase. Atrazine also affected expression of some key genes involved in systemic acquired resistance such as EDS1, TGA6, WRKY33, and MYC2. Several treatments upregulated HSP82, which might help protect protein folding and integrity. A subset of key genes was chosen as biomarkers for molecular responses to treatments under field conditions. GPT2 was downregulated by all small-molecule treatments. Arginine-induced genes involved in systemic acquired resistance included PR1, WRKY70, and EDS1. These molecular data encourage long-term application of treatments that combine these regulating molecules in field trials.

  7. An updated dose-response analysis in Hodgkin's disease

    International Nuclear Information System (INIS)

    Vijayakumar, Srinivasan; Myrianthopoulos, L.C.; University of Chicago Center for Radiation Therapy

    1992-01-01

    Although radiotherapy cures a very high percentage of early stage patients with Hodgkin's disease (HD), there is a controversial dichotomy in the dose recommendations believed necessary to achieve >95% local control: Whereas one school of thought is to administer 40-44 Gy, other reports claim equal results with about 36 Gy. It is also not clear what doses are required for various tumor cell burdens. The original recommendation of 40-44 Gy was derived from a retrospective analysis of in-field control of disease from mostly kilovoltage data 3 decades ago. However, there have been many advances in evaluation of the extent of the disease and in radiotherapy-practice since the 1960s. Many more dose-control studies have been published in recent years, necessitating a revisit to the dose-response question in HD. Here dose-control data from the 60s to the 90s are compiled, and the original and updated data are analyzed with the same statistical method to see any differences. Also was performed a similar analysis of dose-control information for subclinical disease, 6 cm disease. Whereas original analysis (1040 sites at risk) suggested 98% in-field control with 44 Gy, the re- analysis including modern megavoltage data (4117 sites at risk) shows that similar in-field control for subclinical disease and disease of 6 cm are, 32.4 Gy (1426 sites at risk), 36.9Gy (1005 sites at risk) and 37.4 Gy (98 sites at risk), respectively. Results of current updated analysis will provide in-field disease control probabilities for different disease burdens and can serve as a guide in deciding dose prescriptions for practising radiation oncologists. (author). 59 refs.; 3 figs.; 6 tabs

  8. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  9. The steady-state response of the cerebral cortex to the beat of music reflects both the comprehension of music and attention.

    Science.gov (United States)

    Meltzer, Benjamin; Reichenbach, Chagit S; Braiman, Chananel; Schiff, Nicholas D; Hudspeth, A J; Reichenbach, Tobias

    2015-01-01

    The brain's analyses of speech and music share a range of neural resources and mechanisms. Music displays a temporal structure of complexity similar to that of speech, unfolds over comparable timescales, and elicits cognitive demands in tasks involving comprehension and attention. During speech processing, synchronized neural activity of the cerebral cortex in the delta and theta frequency bands tracks the envelope of a speech signal, and this neural activity is modulated by high-level cortical functions such as speech comprehension and attention. It remains unclear, however, whether the cortex also responds to the natural rhythmic structure of music and how the response, if present, is influenced by higher cognitive processes. Here we employ electroencephalography to show that the cortex responds to the beat of music and that this steady-state response reflects musical comprehension and attention. We show that the cortical response to the beat is weaker when subjects listen to a familiar tune than when they listen to an unfamiliar, non-sensical musical piece. Furthermore, we show that in a task of intermodal attention there is a larger neural response at the beat frequency when subjects attend to a musical stimulus than when they ignore the auditory signal and instead focus on a visual one. Our findings may be applied in clinical assessments of auditory processing and music cognition as well as in the construction of auditory brain-machine interfaces.

  10. Immune responses of wild birds to emerging infectious diseases.

    Science.gov (United States)

    Staley, M; Bonneaud, C

    2015-05-01

    Over the past several decades, outbreaks of emerging infectious diseases (EIDs) in wild birds have attracted worldwide media attention, either because of their extreme virulence or because of alarming spillovers into agricultural animals or humans. The pathogens involved have been found to infect a variety of bird hosts ranging from relatively few species (e.g. Trichomonas gallinae) to hundreds of species (e.g. West Nile Virus). Here we review and contrast the immune responses that wild birds are able to mount against these novel pathogens. We discuss the extent to which these responses are associated with reduced clinical symptoms, pathogen load and mortality, or conversely, how they can be linked to worsened pathology and reduced survival. We then investigate how immune responses to EIDs can evolve over time in response to pathogen-driven selection using the illustrative case study of the epizootic outbreak of Mycoplasma gallisepticum in wild North American house finches (Haemorhous mexicanus). We highlight the need for future work to take advantage of the substantial inter- and intraspecific variation in disease progression and outcome following infections with EID to elucidate the extent to which immune responses confer increased resistance through pathogen clearance or may instead heighten pathogenesis. © 2015 John Wiley & Sons Ltd.

  11. United Cerebral Palsy

    Science.gov (United States)

    ... your local affiliate Find your local affiliate United Cerebral Palsy United Cerebral Palsy (UCP) is a trusted resource for individuals with Cerebral Palsy and other disabilities and their networks. Individuals with ...

  12. Dysphagia in Parkinson's disease is responsive to levodopa.

    Science.gov (United States)

    Sutton, James P

    2013-03-01

    The role of levodopa in the treatment of dysphagia in Parkinson's disease (PD) has recently been questioned. There are good reasons, however, to "question the question." In this essay, evidence from published literature and clinical experience is presented, as well as a critical review of the first meta-analysis to explore this issue. The evidence presented supports the traditional view that PD dysphagia is responsive to levodopa. Copyright © 2012. Published by Elsevier Ltd.

  13. MRI of sickle cell cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.

    1987-05-01

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT.

  14. MRI of sickle cell cerebral infarction

    International Nuclear Information System (INIS)

    Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.; Pennsylvania Univ., Philadelphia

    1987-01-01

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

  15. Parecoxib is neuroprotective in spontaneously hypertensive rats after transient middle cerebral artery occlusion: a divided treatment response?

    Science.gov (United States)

    Kelsen, Jesper; Kjaer, Katrine; Chen, Gang; Pedersen, Michael; Røhl, Lisbeth; Frøkiaer, Jørgen; Nielsen, Søren; Nyengaard, Jens R; Rønn, Lars Christian B

    2006-12-06

    Anti-inflammatory treatment affects ischemic damage and neurogenesis in rodent models of cerebral ischemia. We investigated the potential benefit of COX-2 inhibition with parecoxib in spontaneously hypertensive rats (SHRs) subjected to transient middle cerebral artery occlusion (tMCAo). Sixty-four male SHRs were randomized to 90 min of intraluminal tMCAo or sham surgery. Parecoxib (10 mg/kg) or isotonic saline was administered intraperitoneally (IP) during the procedure, and twice daily thereafter. Nineteen animals were euthanized after 24 hours, and each hemisphere was examined for mRNA expression of pro-inflammatory cytokines and COX enzymes by quantitative RT-PCR. Twenty-three tMCAo animals were studied with diffusion and T2 weighted MRI within the first 24 hours, and ten of the SHRs underwent follow-up MRI six days later. Thirty-three SHRs were given 5-bromo-2'-deoxy-uridine (BrdU) twice daily on Day 4 to 7 after tMCAo. Animals were euthanized on Day 8 and the brains were studied with free-floating immunohistochemistry for activated microglia (ED-1), hippocampal granule cell BrdU incorporation, and neuronal nuclei (NeuN). Infarct volume estimation was done using the 2D nucleator and Cavalieri principle on NeuN-stained coronal brain sections. The total number of BrdU+ cells in the dentate gyrus (DG) of the hippocampus was estimated using the optical fractionator. We found a significant reduction in infarct volume in parecoxib treated animals one week after tMCAo (p < 0.03). Cortical ADC values in the parecoxib group were markedly less increased on Day 8 (p < 0.01). Interestingly, the parecoxib treated rats were segregated into two subgroups, suggesting a responder vs. non-responder phenomenon. We found indications of mRNA up-regulation of IL-1beta, IL-6, TNF-alpha and COX-2, whereas COX-1 remained unaffected. Hippocampal granule cell BrdU incorporation was not affected by parecoxib treatment. Presence of ED-1+ activated microglia in the hippocampus was related

  16. The unfolded protein response in ischemic heart disease.

    Science.gov (United States)

    Wang, Xiaoding; Xu, Lin; Gillette, Thomas G; Jiang, Xuejun; Wang, Zhao V

    2018-02-20

    Ischemic heart disease is a severe stress condition that causes extensive pathological alterations and triggers cardiac cell death. Accumulating evidence suggests that the unfolded protein response (UPR) is strongly induced by myocardial ischemia. The UPR is an evolutionarily conserved cellular response to cope with protein-folding stress, from yeast to mammals. Endoplasmic reticulum (ER) transmembrane sensors detect the accumulation of unfolded proteins and stimulate a signaling network to accommodate unfolded and misfolded proteins. Distinct mechanisms participate in the activation of three major signal pathways, viz. protein kinase RNA-like ER kinase, inositol-requiring protein 1, and activating transcription factor 6, to transiently suppress protein translation, enhance protein folding capacity of the ER, and augment ER-associated degradation to refold denatured proteins and restore cellular homeostasis. However, if the stress is severe and persistent, the UPR elicits inflammatory and apoptotic pathways to eliminate terminally affected cells. The ER is therefore recognized as a vitally important organelle that determines cell survival or death. Recent studies indicate the UPR plays critical roles in the pathophysiology of ischemic heart disease. The three signaling branches may elicit distinct but overlapping effects in cardiac response to ischemia. Here, we outline the findings and discuss the mechanisms of action and therapeutic potentials of the UPR in the treatment of ischemic heart disease. Copyright © 2018. Published by Elsevier Ltd.

  17. Alternative Strategy for Alzheimer’s Disease: Stress Response Triggers

    Directory of Open Access Journals (Sweden)

    Joan Smith Sonneborn

    2012-01-01

    Full Text Available Stress resistance capacity is a hallmark of longevity protection and survival throughout the plant and animal kingdoms. Latent pathway activation of protective cascades, triggered by environmental challenges to tolerate heat, oxygen deprivation, reactive oxygen species (ROS, diet restriction, and exercise provides tolerance to these stresses. Age-related changes and disease vulnerability mark an increase in damage, like damage induced by environmental challenges. An alternative approach to immunotherapy intervention in Alzheimer’s Disease is the use of mimetics of stress to upregulate endogenous protective cascades to repair age damage, shift the balance of apoptosis to regeneration to promote delay of onset, and even progression of Alzheimer’s disease memory dysfunction. Mimetics of environmental stress, hormetic agents, and triggers, endogenous or engineered, can “trick” activation of expression patterns of repair and rejuvenation. Examples of known candidate triggers of heat response, endogenous antioxidants, DNA repair, exercise, hibernation, and telomeres are available for AD intervention trials. Telomeres and telomerase emerge as major regulators in crossroads of senescence, cancer, and rejuvenation responsive to mimetics of telomeres. Lessons emerge from transgenic rodent models, the long-lived mole rat, clinical studies, and conserved innate pathways of stress resistance. Cross-reaction of benefits of different triggers promises intervention into seemingly otherwise unrelated diseases.

  18. Genetics of Cerebral Vasospasm

    Directory of Open Access Journals (Sweden)

    Travis R. Ladner

    2013-01-01

    Full Text Available Cerebral vasospasm (CV is a major source of morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH. It is thought that an inflammatory cascade initiated by extravasated blood products precipitates CV, disrupting vascular smooth muscle cell function of major cerebral arteries, leading to vasoconstriction. Mechanisms of CV and modes of therapy are an active area of research. Understanding the genetic basis of CV holds promise for the recognition and treatment for this devastating neurovascular event. In our review, we summarize the most recent research involving key areas within the genetics and vasospasm discussion: (1 Prognostic role of genetics—risk stratification based on gene sequencing, biomarkers, and polymorphisms; (2 Signaling pathways—pinpointing key inflammatory molecules responsible for downstream cellular signaling and altering these mediators to provide therapeutic benefit; and (3 Gene therapy and gene delivery—using viral vectors or novel protein delivery methods to overexpress protective genes in the vasospasm cascade.

  19. Deficiency of superoxide dismutase promotes cerebral vascular hypertrophy and vascular dysfunction in hyperhomocysteinemia.

    Directory of Open Access Journals (Sweden)

    Sanjana Dayal

    Full Text Available There is an emerging consensus that hyperhomocysteinemia is an independent risk factor for cerebral vascular disease and that homocysteine-lowering therapy protects from ischemic stroke. However, the mechanisms by which hyperhomocysteinemia produces abnormalities of cerebral vascular structure and function remain largely undefined. Our objective in this study was to define the mechanistic role of superoxide in hyperhomocysteinemia-induced cerebral vascular dysfunction and hypertrophy. Unlike previous studies, our experimental design included a genetic approach to alter superoxide levels by using superoxide dismutase 1 (SOD1-deficient mice fed a high methionine/low folate diet to produce hyperhomocysteinemia. In wild-type mice, the hyperhomocysteinemic diet caused elevated superoxide levels and impaired responses to endothelium-dependent vasodilators in cerebral arterioles, and SOD1 deficiency compounded the severity of these effects. The cross-sectional area of the pial arteriolar wall was markedly increased in mice with SOD1 deficiency, and the hyperhomocysteinemic diet sensitized SOD1-deficient mice to this hypertrophic effect. Analysis of individual components of the vascular wall demonstrated a significant increase in the content of smooth muscle and elastin. We conclude that superoxide is a key driver of both cerebral vascular hypertrophy and vasomotor dysfunction in this model of dietary hyperhomocysteinemia. These findings provide insight into the mechanisms by which hyperhomocysteinemia promotes cerebral vascular disease and ischemic stroke.

  20. Ligustrazine monomer against cerebral ischemia-reperfusion injury

    Directory of Open Access Journals (Sweden)

    Hai-jun Gao

    2015-01-01

    Full Text Available Ligustrazine (2,3,5,6-tetramethylpyrazine is a major active ingredient of the Szechwan lovage rhizome and is extensively used in treatment of ischemic cerebrovascular disease. The mechanism of action of ligustrazine use against ischemic cerebrovascular diseases remains unclear at present. This study summarizes its protective effect, the optimum time window of administration, and the most effective mode of administration for clinical treatment of cerebral ischemia/reperfusion injury. We examine the effects of ligustrazine on suppressing excitatory amino acid release, promoting migration, differentiation and proliferation of endogenous neural stem cells. We also looked at its effects on angiogenesis and how it inhibits thrombosis, the inflammatory response, and apoptosis after cerebral ischemia. We consider that ligustrazine gives noticeable protection from cerebral ischemia/reperfusion injury. The time window of ligustrazine administration is limited. The protective effect and time window of a series of derivative monomers of ligustrazine such as 2-[(1,1-dimethylethyloxidoimino]methyl]-3,5,6-trimethylpyrazine, CXC137 and CXC195 after cerebral ischemia were better than ligustrazine.

  1. Cerebral Small Vessel Disease and Association With Higher Incidence of Depressive Symptoms in a General Elderly Population: The AGES-Reykjavik Study.

    Science.gov (United States)

    van Sloten, Thomas T; Sigurdsson, Sigurdur; van Buchem, Mark A; Phillips, Caroline L; Jonsson, Palmi V; Ding, Jie; Schram, Miranda T; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

    2015-06-01

    The vascular depression hypothesis postulates that cerebral small vessel disease (CSVD) leads to depressive symptoms by disruption of brain structures involved in mood regulation. However, longitudinal data on the association between CSVD and depressive symptoms are scarce. The authors investigated the association between CSVD and incident depressive symptoms. Longitudinal data were taken from the Age, Gene/Environment Susceptibility-Reykjavik Study of 1,949 participants free of dementia and without baseline depressive symptoms (mean age: 74.6 years [SD=4.6]; women, 56.6%). MRI markers of CSVD, detected at baseline (2002-2006) and follow-up (2007-2011), included white matter hyperintensity volume, subcortical infarcts, cerebral microbleeds, Virchow-Robin spaces, and total brain parenchyma volume. Incident depressive symptoms were defined by a score ≥6 on the 15-item Geriatric Depression Scale and/or use of antidepressant medication. Depressive symptoms occurred in 10.1% of the participants. The association for a greater onset of depressive symptoms was significant for participants with 1 standard deviation increase in white matter hyperintensity volume over time, new subcortical infarcts, new Virchow-Robin spaces, 1 standard deviation lower total brain volume at baseline, and 1 standard deviation decreased total brain volume over time, after adjustments for cognitive function and sociodemographic and cardiovascular factors. Results were qualitatively similar when change in the Geriatric Depression Scale score over time was used as the outcome instead of incident depressive symptoms. Most markers of progression of CSVD over time and some markers of baseline CSVD are associated with concurrently developing new depressive symptoms. These findings support the vascular depression hypothesis.

  2. Cerebral small vessel disease is associated with a higher incidence of depressive symptoms in a general elderly population: the AGES-Reykjavik Study

    Science.gov (United States)

    van Sloten, Thomas T; Sigurdsson, Sigurdur; van Buchem, Mark A; Phillips, Caroline L; Jonsson, Palmi V; Ding, Jie; Schram, Miranda T; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

    2015-01-01

    Objective The vascular depression hypothesis postulates that cerebral small vessel disease (CSVD) leads to depressive symptoms via disruption of brain structures involved in mood regulation. However, longitudinal data on the association between CSVD and depressive symptoms are scarce. We investigated the association between CSVD and incident depressive symptoms. Methods Longitudinal data are from the AGES-Reykjavik study of 1,949 participants free of dementia and without baseline depressive symptoms (74.6 years/56.6% women). MRI markers of CSVD, detected at baseline (2002–2006) and follow-up (2007–2011), included white matter hyperintensity volume (WMHV), subcortical infarcts, cerebral microbleeds, Virchow-Robin spaces and total brain parenchyma volume. Incident depressive symptoms were defined by the 15-item Geriatric Depression Scale (GDS-15) score≥6 and(or) use of antidepressant medication. Results Depressive symptoms occurred in 10.1% of the participants. The association for a greater onset of depressive symptoms was significant for participants having a 1 standard deviation increase in WMHV over time, new subcortical infarcts, new Virchow-Robin spaces, a 1 standard deviation lower total brain volume at baseline, or a 1 standard deviation decreased total brain volume over time, after adjustments for cognitive function, socio-demographic and cardiovascular factors. Results were qualitatively similar when change in the GDS-15 over time was used as the outcome instead of incident depressive symptoms. Conclusions Most markers of progression of CSVD over time and some markers of baseline CSVD are associated with concurrently developing new depressive symptoms. This study supports the vascular depression hypothesis. PMID:25734354

  3. Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Gang; Lou, Yaxian; Pan, Zhiying; Liu, Ya [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Nanjing University of Aeronautics and Astronautics, College of Aivil Aviation, Nanjing, Jiangsu (China); Wen, Jiqiu; Li, Xue; Zhang, Zhe [Medical School of Nanjing University, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing, Jiangsu (China); Lu, Hanzhang [University of Texas Southwestern Medical Center, Advanced Imaging Research Center, Dallas, TX (United States); Liu, Wei [Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, Guangdong (China); Liu, Hui [Siemens MR NEA Collaboration, Siemens Ltd., Shanghai (China); Che