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Small vessel cerebrovascular disease

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https://www.readbyqxmd.com/read/28906205/preventing-cognitive-decline-and-dementia-from-cerebral-small-vessel-disease-the-laci-1-trial-protocol-and-statistical-analysis-plan-of-a-phase-iia-dose-escalation-trial-testing-tolerability-safety-and-effect-on-intermediary-endpoints-of-isosorbide-mononitrate
#1
Gordon W Blair, Jason P Appleton, Zhe Kang Law, Fergus Doubal, Katie Flaherty, Richard Dooley, Kirsten Shuler, Carla Richardson, Iona Hamilton, Yulu Shi, Michael Stringer, Julia Boyd, Michael J Thrippleton, Nikola Sprigg, Philip M Bath, Joanna M Wardlaw
Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28906204/context-is-everything-from-cardiovascular-disease-to-cerebral-microbleeds
#2
Andreas Charidimou, Deborah Blacker, Anand Viswanathan
Increasingly, our approach to cerebrovascular disease has become blurred by evidence published in literature often without careful consideration of what this evidence implies for specific patients at hand. In this essay, we analyze key contextual issues in cerebrovascular small vessel disease, in an attempt to highlight the symbolic gap that exists between research and clinical practice, a recurring theme in medicine. We highlight the importance of considering context when using data from epidemiologic, neuroimaging, and biomarker studies in determining relevance to the patient at hand...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28905043/vascular-parkinsonism-and-vascular-dementia-are-associated-with-an-increased-risk-of-vascular-events-or-death
#3
Jacek Staszewski, Renata Piusińska-Macoch, Bogdan Brodacki, Ewa Skrobowska, Katarzyna Macek, Adam Stępień
INTRODUCTION: The natural course of vascular parkinsonism (VaP) and dementia (VaD) due to cerebral small vessel disease (SVD) is not well known. The aim of this single-center study was to evaluate the long-term risk of vascular events, death and dependency in patients with VaP or VaD and to compare it with patients without cerebrovascular disease but with high atherothrombotic risk. MATERIAL AND METHODS: Seventy-eight consecutive, functionally independent patients with MRI features of SVD and with recently diagnosed VaD (n = 50) and VaP (n = 28) and 55 controls (control group - CG) with high 10-year risk of total cardiovascular disease (SCORE ≥ 5%) were prospectively recruited and followed for 24 months...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28870545/arterial-stiffness-and-cognitive-impairment
#4
REVIEW
Xiaoxuan Li, Peiyuan Lyu, Yanyan Ren, Jin An, Yanhong Dong
BACKGROUND: Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28859027/subarachnoid-hemorrhage-revealing-moyamoya-syndrome-in-a-patient-with-may-hegglin-anomaly
#5
Yannick Béjot, José-Luis Barnay, Adrien Chavent, Benoit Daubail, Agnès Jacquin, Apolline Kazemi, Frédéric Ricolfi, Maurice Giroud
INTRODUCTION: Moyamoya syndrome is a rare progressive cerebrovascular occlusive disease for which several associated conditions have been described. CASE REPORT: We report the case of a 76-year-old woman with a history of May-Hegglin anomaly who presented with an isolated unusual diffuse headache. Initial laboratory investigations showed only thrombocytopenia (platelet count 95000/μL). Unenhanced brain computed tomography scan revealed a small subarachnoid hemorrhage in the left frontal lobe...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28798076/perivascular-spaces-glymphatic-dysfunction-and-small-vessel-disease
#6
REVIEW
Humberto Mestre, Serhii Kostrikov, Rupal I Mehta, Maiken Nedergaard
Cerebral small vessel diseases (SVDs) range broadly in etiology but share remarkably overlapping pathology. Features of SVD including enlarged perivascular spaces (EPVS) and formation of abluminal protein deposits cannot be completely explained by the putative pathophysiology. The recently discovered glymphatic system provides a new perspective to potentially address these gaps. This work provides a comprehensive review of the known factors that regulate glymphatic function and the disease mechanisms underlying glymphatic impairment emphasizing the role that aquaporin-4 (AQP4)-lined perivascular spaces (PVSs), cerebrovascular pulsatility, and metabolite clearance play in normal CNS physiology...
September 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28783808/recrudescence-of-deficits-after-stroke-clinical-and-imaging-phenotype-triggers-and-risk-factors
#7
Mehmet A Topcuoglu, Esen Saka, Scott B Silverman, Lee H Schwamm, Aneesh B Singhal
Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon. Objective: To investigate the clinical features, triggers, and risk factors for PSR. Design, Setting, and Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. The study used the Massachusetts General Hospital Research Patient Data Repository to identify patients for the period January 1, 2000, to November 30, 2015, who had a primary or secondary diagnosis of cerebrovascular disease, who underwent magnetic resonance imaging of the brain at least once, and whose inpatient or outpatient clinician note or discharge summary stated the term recrudescence...
September 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28716371/detection-risk-factors-and-functional-consequences-of-cerebral-microinfarcts
#8
REVIEW
Susanne J van Veluw, Andy Y Shih, Eric E Smith, Christopher Chen, Julie A Schneider, Joanna M Wardlaw, Steven M Greenberg, Geert Jan Biessels
Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that is independent of Alzheimer's disease pathology or larger infarcts (ie, lacunar infarcts, and large cortical and non-lacunar subcortical infarcts). Substantial progress has been made with regard to understanding risk factors and functional consequences of cerebral microinfarcts, partly driven by new in-vivo detection methods and the development of animal models that closely mimic multiple aspects of cerebral microinfarcts in human beings...
September 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28715552/large-perivascular-spaces-visible-on-magnetic-resonance-imaging-cerebral-small-vessel-disease-progression-and-risk-of-dementia-the-age-gene-environment-susceptibility-reykjavik-study
#9
Jie Ding, Sigurður Sigurðsson, Pálmi V Jónsson, Gudny Eiriksdottir, Andreas Charidimou, Oscar L Lopez, Mark A van Buchem, Vilmundur Guðnason, Lenore J Launer
Importance: With advancing age, an increased visibility of perivascular spaces (PVSs) on magnetic resonance imaging (MRI) is hypothesized to represent impaired drainage of interstitial fluid from the brain and may reflect underlying cerebral small vessel disease (SVD). However, whether large perivascular spaces (L-PVSs) (>3 mm in diameter) visible on MRI are associated with SVD and cognitive deterioration in older individuals is unknown. Objective: To examine whether L-PVSs are associated with the progression of the established MRI markers of SVD, cognitive decline, and increased risk of dementia...
September 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#10
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28667059/hypercholesterolaemia-and-vascular-dementia
#11
REVIEW
Jason P Appleton, Polly Scutt, Nikola Sprigg, Philip M Bath
Vascular dementia (VaD) is the second commonest cause of dementia. Stroke is the leading cause of disability in adults in developed countries, the second major cause of dementia and the third commonest cause of death. Traditional vascular risk factors-diabetes, hypercholesterolaemia, hypertension and smoking-are implicated as risk factors for VaD. The associations between cholesterol and small vessel disease (SVD), stroke, cognitive impairment and subsequent dementia are complex and as yet not fully understood...
July 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28600443/prevalence-risk-factors-and-consequences-of-cerebral-small-vessel-diseases-data-from-three-asian-countries
#12
COMPARATIVE STUDY
Saima Hilal, Vincent Mok, Young Chul Youn, Adrian Wong, Mohammad Kamran Ikram, Christopher Li-Hsian Chen
BACKGROUND: 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. METHODS: Clinical, cognitive and 3-Tesla brain MRI assessments were performed among participants of three studies from Singapore, Hong Kong and Korea...
August 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28585568/brain-tissue-pulsatility-is-increased-in-mid-life-depression-a-comparative-study-using-ultrasound-tissue-pulsatility-imaging
#13
Thomas Desmidt, Bruno Brizard, Paul-Armand Dujardin, Redouane Ternifi, Jean-Pierre Réméniéras, Frédéric Patat, Frédéric Andersson, Jean-Philippe Cottier, Emilie Vierron, Valérie Gissot, Kang Kim, Howard Aizenstein, Wissam El-Hage, Vincent Camus
Cerebrovascular disease (CVD) is consistently associated with late-life depression but poorly documented in midlife depression. It can be hypothesized that the relatively low sensitivity of conventional neuroimaging techniques does not allow the detection of subtle CVD in midlife depression. We used Tissue Pulsatility Imaging (TPI), a novel ultrasound (US) neuroimaging technique that has demonstrated good sensitivity to detect changes in the pulsatility of small brain volumes, to identify early and subtle changes in brain vascular function in midlife depression...
June 6, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28560150/amyloid-positron-emission-tomography-in-sporadic-cerebral-amyloid-angiopathy-a-systematic-critical-update
#14
REVIEW
Karim Farid, Andreas Charidimou, Jean-Claude Baron
Sporadic cerebral amyloid angiopathy (CAA) is a very common small vessel disease of the brain, showing preferential and progressive amyloid-βdeposition in the wall of small arterioles and capillaries of the leptomeninges and cerebral cortex. CAA now encompasses not only a specific cerebrovascular pathological trait, but also different clinical syndromes - including spontaneous lobar intracerebral haemorrhage (ICH), dementia and 'amyloid spells' - an expanding spectrum of brain parenchymal MRI lesions and a set of diagnostic criteria - the Boston criteria, which have resulted in increasingly detecting CAA during life...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28553163/parkinson-s-disease-might-increase-the-risk-of-cerebral-ischemic-lesions
#15
In-Uk Song, Ji-Eun Lee, Do-Young Kwon, Jeong-Ho Park, Hyeo-Il Ma
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disease in the elderly. Cerebrovascular diseases such as cerebral ischemic lesion (CIL) also commonly occur in elderly adults. However, previous studies on the relationship between PD and cerebrovascular disease have not found consistent results. Therefore, we conducted this study to evaluate whether or not PD is related to an increased prevalence of ischemic cerebrovascular lesions. METHODS: This study recruited 241 patients with PD and 112 healthy controls (HCs)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28549667/epidemiology-of-cerebrovascular-disease-among-chinese-canadians-with-diabetes
#16
REVIEW
Susy Lam, Joseph Y Chu
BACKGROUND: First-generation Chinese Canadians have usually maintained different lifestyles before immigration to North America, and the question of whether Chinese Canadians with type 2 diabetes have a different stroke profile than that of non-Chinese Canadians remains unanswered. OBJECTIVES: To determine whether 1) Chinese Canadians who have had a stroke within the last 15 years are more likely to have diabetes than non-Chinese Canadians and 2) to explore differences in stroke profiles between the 2 cohorts...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28525562/retinal-vein-occlusion-as-the-surrogate-marker-for-premature-brain-aging-in-young-patients
#17
Kwan Hyuk Cho, Chi Kyung Kim, Kyungmi Oh, Seung-Won Oh, Kyu Hyung Park, Sang Jun Park
Purpose: We investigated cerebral small vessel disease (SVD) in patients with incidental retinal vein occlusion (RVO). Methods: This retrospective, case-control, observational trial included 125 patients with RVO who underwent brain magnetic resonance imaging (MRI) and 1105 age-matched controls who underwent comprehensive medical interviews and MRI. Underlying cardiovascular diseases and MRI findings were investigated in the patients with RVO according to age (<60 or ≥60 years) and RVO occlusion level (central or branch)...
May 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28515342/clinical-presentations-and-epidemiology-of-vascular-dementia
#18
REVIEW
Eric E Smith
Cerebrovascular and cardiovascular diseases cause vascular brain injury that can lead to vascular cognitive impairment (VCI). VCI is the second most common neuropathology of dementia and mild cognitive impairment (MCI), accounting for up to one-third of the population risk. It is frequently present along with other age-related pathologies such as Alzheimer's disease (AD). Multiple etiology dementia with both VCI and AD is the single most common cause of later life dementia. There are two main clinical syndromes of VCI: post-stroke VCI in which cognitive impairment is the immediate consequence of a recent stroke and VCI without recent stroke in which cognitive impairment is the result of covert vascular brain injury detected only on neuroimaging or neuropathology...
June 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28503567/cognitive-impairment-in-chronic-kidney-disease-vascular-milieu-and-the-potential-therapeutic-role-of-exercise
#19
REVIEW
Ulf G Bronas, Houry Puzantian, Mary Hannan
Chronic kidney disease (CKD) is considered a model of accelerated aging. More specifically, CKD leads to reduced physical functioning and increased frailty, increased vascular dysfunction, vascular calcification and arterial stiffness, high levels of systemic inflammation, and oxidative stress, as well as increased cognitive impairment. Increasing evidence suggests that the cognitive impairment associated with CKD may be related to cerebral small vessel disease and overall impairment in white matter integrity...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28483775/age-specific-vascular-risk-factor-profiles-according-to-stroke-subtype
#20
Allard J Hauer, Ynte M Ruigrok, Ale Algra, Ewoud J van Dijk, Peter J Koudstaal, Gert-Jan Luijckx, Paul J Nederkoorn, Robert J van Oostenbrugge, Marieke C Visser, Marieke J Wermer, L Jaap Kappelle, Catharina J M Klijn
BACKGROUND: Ischemic and hemorrhagic stroke are increasingly recognized as heterogeneous diseases with distinct subtypes and etiologies. Information on variation in distribution of vascular risk factors according to age in stroke subtypes is limited. We investigated the prevalence of vascular risk factors in stroke subtypes in relation to age. METHODS AND RESULTS: We studied a prospective multicenter university hospital-based cohort of 4033 patients. For patients with ischemic stroke caused by large artery atherosclerosis, small vessel disease, or cardioembolism and for patients with spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage, we calculated prevalences of vascular risk factors in 4 age groups: <55, 55 to 65, 65 to 75, and ≥75 years, and mean differences with 95% CIs in relation to the reference age group...
May 8, 2017: Journal of the American Heart Association
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