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Charlotte Zerna, Amy Y X Yu, Jayesh Modi, Shiel K Patel, Jonathan I Coulter, Eric E Smith, Shelagh B Coutts
BACKGROUND AND PURPOSE: White matter lesions (WML) are associated with cognitive decline, increased stroke risk, and disability in old age. We hypothesized that superimposed acute cerebrovascular occlusion on chronic preexisting injury (leukoaraiosis) leads to worse outcome after minor cerebrovascular event, both using quantitative (volumetric) and qualitative (Fazekas scale) assessment, as well as relative total brain volume. METHODS: WML volume assessment was performed in 425 patients with high-risk transient ischemic attack (TIA; motor/speech deficits >5 minutes) or minor strokes from the CATCH study (CT and MRI in the Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
X X Zhao, C Z Shen, X X Xie, Q Q Xu, X Zhou, Z W Sun
Objective: To explore the change and value of platelet aggregability(PA)in patients with subcortical ischemic vascular disease (SIVD). Methods: A total of 108 patients with SIVD hospitalized in the Department of Neurology of the First Affiliated Hospital of Anhui Medical University from October 2015 to July 2017 were enrolled as SIVD group and 30 healthy cases were also in cluded as normal controlgroup (NC). According to magnetic resonance imaging(MRI), the SIVD group was further divided into two subtypes: lacunar infarction(LI) ( n =31)and leukoaraiosis(LA) ( n =77)...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Sándor Csizmadia, Erika Vörös
Cerebral amyloid angiopathy (CAA) is most commonly recognized by β-amyloid deposition in the small and medium sized vessels of the brain. The 71-year-old female presented with a sudden onset of vertigo and headache. By native computer tomography (CT) examination we found cerebral atrophy and the sign of chronic vascular injury. The complaints of the patient worsened, thus magnetic resonance imaging (MRI) was performed. The MRI scan revealed a bleeding transformation of an ischemic lesion in the right occipital region...
March 2018: Orvosi Hetilap
Philip Benjamin, Sarah Trippier, Andrew J Lawrence, Christian Lambert, Eva Zeestraten, Owen A Williams, Bhavini Patel, Robin G Morris, Thomas R Barrick, Andrew D MacKinnon, Hugh S Markus
BACKGROUND AND PURPOSE: Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in small-vessel disease, but their relationship to cognitive impairment remains uncertain. One reason may be difficulty in distinguishing between lacunes and PvS. We determined the relationship between baseline PvS score and PvS volume with change in cognition over a 5-year follow-up. We compared this to the relationship between baseline lacune count and total lacune volume with cognition...
February 2, 2018: Stroke; a Journal of Cerebral Circulation
Wen-Lei Shi, Yong-Biao Zhang, Wei Wei, Hong-Yan Gao, Yong-Hua Huang
BACKGROUND: Leukoaraiosis, a subtype of cerebral small vessel disease, is a common condition found on CT or MRI in elderly people. Leukoaraiosis is strongly associated with cognitive impairment, mental abnormality, gait disorders and urinary dysfunction. However, the genetic risk of leukoaraiosis is largely unknown. OBJECTIVE: The goal of this study is to identify the loss-of-function mutations for leukoaraiosis in Chinese. METHODS: We performed whole-genome sequencing on 11 leukoaraiosis patients and further validated the candidate mutations and tags of the candidate genes in 304 individuals including 160 patients and 144 healthy controls using Sequenom MassARRAY platform...
February 8, 2018: Biochemical and Biophysical Research Communications
Ying Fu, Yaping Yan
Cerebral small vessel disease (CSVD) is one of the main causes of vascular dementia in older individuals. Apart from risk containment, efforts to prevent or treat CSVD are ineffective due to the unknown pathogenesis of the disease. CSVD, a subtype of stroke, is characterized by recurrent strokes and neurodegeneration. Blood-brain barrier (BBB) impairment, chronic inflammatory responses, and leukocyte infiltration are classical pathological features of CSVD. Understanding how BBB disruption instigates inflammatory and degenerative processes may be informative for CSVD therapy...
2018: Frontiers in Immunology
Eric E Smith, Alona Muzikansky, Cheryl R McCreary, Saima Batool, Anand Viswanathan, Bradford C Dickerson, Keith Johnson, Steven M Greenberg, Deborah Blacker
BACKGROUND: Hypertension is the strongest modifiable risk factor for subcortical ischemic changes and is also a risk factor for Alzheimer's dementia. We used neuroimaging to investigate the pathological basis of early cognitive symptoms in patients with hypertension. METHODS: In this cross-sectional cohort study 67 patients age >60 years with hypertension and Clinical Dementia Rating scale score of 0.5 without dementia, and without history of symptomatic stroke, underwent MRI for measurement of subcortical vascular changes and positron emission tomography (PET) scan with Pittsburgh Compound B (PiB-PET) to detect beta-amyloid deposition...
2018: PloS One
Joan Martí-Fàbregas, Santiago Medrano-Martorell, Elisa Merino, Luis Prats-Sánchez, Rebeca Marín, Raquel Delgado-Mederos, Pol Camps-Renom, Alejandro Martínez-Domeño, Manuel Gómez-Choco, Lidia Lara, Ignacio Casado-Naranjo, David Cánovas, Maria José Torres, Marimar Freijo, Ana Calleja, Yolanda Bravo, Dolores Cocho, Ana Rodríguez-Campello, Beatriz Zandio, Blanca Fuentes, Alicia de Felipe, Laura Llull, José Maestre, María Hernández, Moisès Garcés, Ana Maria De Arce-Borda, Ernest Palomeras, Manuel Rodríguez-Yáñez, Inma Díaz-Maroto, Marta Serrano, Jéssica Fernández-Domínguez, Jordi Sanahuja, Francisco Purroy, Marialuisa Zedde, Jordi Delgado-Mengual, Ignasi Gich
We investigated whether pre-treatment with statins is associated with surrogate markers of amyloid and hypertensive angiopathies in patients who need to start long-term oral anticoagulation therapy. A prospective multicenter study of patients naive for oral anticoagulants, who had an acute cardioembolic stroke. MRI was performed at admission to evaluate microbleeds, leukoaraiosis and superficial siderosis. We collected data on the specific statin compound, the dose and the statin intensity. We performed bivariate analyses and a logistic regression to investigate variables associated with microbleeds...
January 24, 2018: Scientific Reports
Y-F Chen, Y-S Kuo, W-C Wu, S-C Tang, S-F Jiang
AIM: To test the hypothesis that leukoaraiosis (also known as white matter lesion) is associated with cerebral blood flow territory change as revealed by territorial arterial spin-labeling (TASL) magnetic resonance imaging (MRI) in patients with asymptomatic internal carotid artery stenosis (aICAS). MATERIALS AND METHODS: The institutional review board approved this study. Thirty-three patients with aICAS were included prospectively and divided into high-grade (ultrasonographic stenosis ≥70%, n=17) and low-grade (n=16) groups; 16 healthy subjects were also included...
January 9, 2018: Clinical Radiology
Yanyan Liu, Min Zhang, Yuan Chen, Ping Gao, Wenwei Yun, Xianju Zhou
Leukoaraiosis (LA) is common in elderly patients with ischemic stroke on magnetic resonance imaging. In this study, we investigate whether the degree of LA is associated with clinical outcomes and prognosis of patients with middle cerebral artery occlusion following intravenous thrombolytic. Ninety-seven patients were recruited and divided into three groups based on the degree of LA (no, mild and moderate to severe LA) by the Fazekas scale. Clinical outcomes, recurrent stroke, Fugl-Meyer rating scale (FMS) and complications of intravenous thrombolysis were assessed...
December 26, 2017: Brain Research
Q Li, L Q Zhao, F Y Hu
Objective: To investigate the features of cognitive impairment and potential physiopathologic mechanism using neuropsychological assessment and resting state functional magnetic resonance imaging (rs-fMRI) in patients with leukoaraiosis (LA). Methods: A total of 13 patients with LA (LA group) and 13 healthy controls (NC group) from Shanxi Provincial People's Hospital between January and June 2016 were recruited. The two groups were matched for age, sex, education, and vascular risk factors. All the subjects underwent neuropsychological assessment and the scan of rs-fMRI...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yoshiki Hase, Karen Horsburgh, Masafumi Ihara, Raj N Kalaria
Advances in neuroimaging have enabled greater understanding of the progression of cerebral degenerative processes associated with ageing-related dementias. Leukoaraiosis or rarefied white matter (WM) originally described on computed tomography is one of the most prominent changes which occurs in older age. White matter hyperintensities (WMH) evident on magnetic resonance imaging have become commonplace to describe WM changes in relation to cognitive dysfunction, types of stroke injury, cerebral small vessel disease and neurodegenerative disorders including Alzheimer's disease...
December 6, 2017: Journal of Neurochemistry
Jong-Won Chung, Mi Jeong Oh, Yeon Hee Cho, Gyeong Joon Moon, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang
BACKGROUND/AIMS: The aim of the study was to evaluate the differential roles of endothelial dysfunction and inflammation in intracranial atherosclerotic stroke (ICAS). METHODS: We prospectively recruited 262 patients with acute cerebral infarcts caused by ICAS and 75 individuals with no history of stroke as controls. Markers of endothelial dysfunction (asymmetric dimethylarginine, ADMA) and inflammation (lipoprotein-associated phospholipase A2, Lp-PLA2) were measured...
2017: European Neurology
Y Mayasi, R P Goddeau, M Moonis, B Silver, A H Jun-O'Connell, A S Puri, N Henninger
BACKGROUND AND PURPOSE: Prehospital stroke scales may help identify patients likely to have large-vessel occlusion to facilitate rapid triage to thrombectomy-capable stroke centers. Scale misclassification may result in inaccurate decisions and possible harm. Pre-existing leukoaraiosis has been shown to attenuate the association between deficit type and stroke severity. We sought to determine whether leukoaraiosis affects the predictive ability of 5 commonly used large-vessel occlusion scales...
February 2018: AJNR. American Journal of Neuroradiology
M Delva, I Delva
Aim - identify neuroimaging characteristics associated with different post-stroke fatigue (PSF) domains within first 6 months after ischemic strokes. There were enrolled in the study 107 patients with acute ischemic strokes. General PSF and certain PSF domains (global, physical, mental, motivational, activity-related) were measured by multidimensional fatigue inventory-20 (MFI-20) scale at hospital stay, in 1, 3 and 6 months after stroke occurrence. Brain MRI studies included cerebral infarct localization, planimetric measurements of infarct volumes, measurement of brain atrophy indexes (bifrontal, bicaudate, cortical atrophy indexes, width of third ventricle) and evaluation of leukoaraiosis severity, according to Fazekas scale...
October 2017: Georgian Medical News
Uta Hanning, Peter Bernhard Sporns, Rene Schmidt, Thomas Niederstadt, Jens Minnerup, Georg Bier, Stefan Knecht, André Kemmling
PURPOSE: The severity of white matter lesions (WML) is a risk factor of hemorrhage and predictor of clinical outcome after ischemic stroke; however, in contrast to magnetic resonance imaging (MRI) reliable quantification for this surrogate marker is limited for computed tomography (CT), the leading stroke imaging technique. We aimed to present and evaluate a CT-based automated rater-independent method for quantification of microangiopathic white matter changes. METHODS: Patients with suspected minor stroke (National Institutes of Health Stroke scale, NIHSS < 4) were screened for the analysis of non-contrast computerized tomography (NCCT) at admission and compared to follow-up MRI...
October 20, 2017: Clinical Neuroradiology
M V Shestakova, A F Vasilenko, M I Karpova, E A Grigoricheva, N V Epaneshnikova, I V Kochetkov
AIM: To determine the factors of cognitive impairment and non-compliance in patients with chronic heart failure (CHF). MATERIAL AND METHODS: One hundred and fifty-seven patients with CHF and 32 patients without chronic heart failure (controls) were examined. Neuropsychological assessment using a 30-minutes protocol recommended by NINDS-Canadian Stroke Standards (NINDS CSS), magnetic resonance imaging, cognitive ERP and a test of compliance were used. RESULTS AND CONCLUSION: Approximately 62% of patients did not perform medical prescriptions...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
T A Polyakova, A V Arablinsky
Development of laboratory diagnosis and neuroimaging revealed a number of biomarkers for in vivo diagnosis of the most common forms of dementia (Alzheimer's disease, Lewy body dementia and vascular dementia). Currently, the highest diagnostic sensitivity and specificity of molecular biomarkers in the cerebrospinal fluid are detected for Alzheimer's disease. At the same time, the changes according to the magnetic resonance imaging are more prognostically significant for future cognitive decline than cerebrospinal fluid biomarkers...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Qing Lin, Wen-Qing Huang, Qi-Lin Ma, Cong-Xia Lu, Sui-Jun Tong, Jin-Hu Ye, Hui-Nuan Lin, Long Gu, Ke-Hui Yi, Liang-Liang Cai, Chi-Meng Tzeng
Leukoaraiosis (LA) refers to white matter hyperintensities or white matter lesions (WMLs) on magnetic resonance imaging (MRI) scans of the brain; this disease is associated with an increased risk of stroke, dementia, and cognitive decline. The aims of the study are to assess the incidence of LA and its associated risk factors in a Chinese population.A hospital-based cross-sectional study was conducted that included 4683 patients who were 40 years or older. Data collected included age, sex, hypertension, diabetes, smoking, drinking, homocysteine (HCY), and low-density lipoprotein cholesterol (LDL-C) levels in the blood in addition to brain MRI information...
September 2017: Medicine (Baltimore)
David A Dickie, Benjamin Aribisala, Grant Mair, Eivind Berge, Richard I Lindley, Peter Sandercock, Rudiger von Kummer, Anders von Heijne, Andre Peeters, Lesley Cala, Andrew Farrall, Zoe Morris, Nick Bradey, Gillian Potter, Alessandro Adami, Joanna M Wardlaw
Higher blood pressure, blood pressure variability, and leukoaraiosis are risk factors for early adverse events and poor functional outcome after ischemic stroke, but prior studies differed on whether leukoaraiosis was associated with blood pressure variability, including in ischemic stroke. In the Third International Stroke Trial, blood pressure was measured in the acute phase of ischemic stroke immediately prior to randomization, and at 0.5, 1, and 24 h after randomization. Masked neuroradiologists rated index infarct, leukoaraiosis, and atrophy on CT using validated methods...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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