Biomechanical response of the CNS is associated with frailty in NPH-suspected patients.

Frailty is known to predict dementia. However, its link with neurodegenerative alterations of the central nervous system (CNS) is not well understood at present. We investigated the association between the biomechanical response of the CNS and frailty in older adults suspected of normal pressure hydrocephalus (NPH) presenting with markers of multiple co-existing pathologies. The biomechanical response of the CNS was characterized by the CNS elastance coefficient inferred from phase contrast magnetic resonance imaging and intracranial pressure monitoring during a lumbar infusion test. Frailty was assessed with an index of health deficit accumulation. We found a significant association between the CNS elastance coefficient and frailty, with an effect size comparable to that between frailty and age, the latter being the strongest known risk factor for frailty. Results were independent of CSF dynamics, showing that they are not specific to the NPH neuropathological condition. The CNS biomechanical characterization may help to understand how frailty is related to neurodegeneration and detect the shift from normal to pathological brain ageing.

Simulation study of brain blood flow regulation by intra-cortical arterioles in an anatomically accurate large human vascular network: Part I: methodology and baseline flow.

Hemodynamically based functional neuroimaging techniques, such as BOLD fMRI and PET, provide indirect measures of neuronal activity. The quantitative relationship between neuronal activity and the measured signals is not yet precisely known, with uncertainties remaining about the relative contribution by their metabolic and hemodynamic components. Empirical observations have demonstrated the importance of the latter component and suggested that micro-vascular anatomy has a potential influence. The recent development of a 3D computer-assisted method for micro-vascular cerebral network analysis has produced a large quantitative library on the microcirculation of the human cerebral cortex (Cassot et al., 2006), which can be used to investigate the hemodynamic component of brain activation through fluid dynamic modeling. For this purpose, we perform the first simulations of blood flow in an anatomically accurate large human intra-cortical vascular network (~10000 segments), using a 1D non-linear model taking account of the complex rheological properties of blood flow in microcirculation. This model predicts blood pressure, blood flow and hematocrit distributions, as well as volumes of functional vascular territories, and regional flow at voxel and network scales. First, the influence of the prescribed boundary conditions (BCs) on the baseline flow structure is investigated, highlighting relevant lower- and upper-bound BCs. Independent of these BCs, large heterogeneities of baseline flow from vessel to vessel and from voxel to voxel, are demonstrated. These heterogeneities are controlled by the architecture of the intra-cortical vascular network. In particular, a correlation between the blood flow and the proportion of vascular volume occupied by arterioles or venules, at voxel scale, is highlighted. Then, the extent of venous contamination downstream to the sites of neuronal activation is investigated, demonstrating a linear relationship between the catchment surface of the activated area and the diameter of the intra-cortical draining vein.

Simulation study of brain blood flow regulation by intra-cortical arterioles in an anatomically accurate large human vascular network. Part II: flow variations induced by global or localized modifications of arteriolar diameters.

In a companion paper (Lorthois et al., Neuroimage, in press), we perform the first simulations of blood flow in an anatomically accurate large human intra-cortical vascular network (~10000 segments), using a 1D non-linear model taking into account the complex rheological properties of blood flow in microcirculation. This model predicts blood pressure, blood flow and hematocrit distributions, volumes of functional vascular territories, regional flow at voxel and network scales, etc. Using the same approach, we study flow reorganizations induced by global arteriolar vasodilations (an isometabolic global increase in cerebral blood flow). For small to moderate global vasodilations, the relationship between changes in volume and changes in flow is in close agreement with Grubb's law, providing a quantitative tool for studying the variations of its exponent with underlying vascular architecture. A significant correlation between blood flow and vascular structure at the voxel scale, practically unchanged with respect to baseline, is demonstrated. Furthermore, the effects of localized arteriolar vasodilations, representative of a local increase in metabolic demand, are analyzed. In particular, localized vasodilations induce flow changes, including vascular steal, in the neighboring arteriolar trunks at small distances (<300 µm), while their influence in the neighboring veins is much larger (about 1 mm), which provides an estimate of the vascular point spread function. More generally, for the first time, the hemodynamic component of various functional neuroimaging techniques has been isolated from metabolic and neuronal components, and a direct relationship with several known characteristics of the BOLD signal has been demonstrated.

[Usefulness of systematic brain magnetic resonance imaging in children with neurofibromatosis type 1]. / La réalisation systématique de l'imagerie par résonance magnétique cérébrale a-t-elle un intérêt chez l'enfant atteint de neurofibromatose de type 1?

BACKGROUND AND AIM: The aim of this study was to evaluate the usefulness of systematic screening of asymptomatic neurofibromatosis type 1 (NF1) children with magnetic resonance imaging (MRI). PATIENTS AND METHODS: We retrospectively reviewed the MRIs of children diagnosed with NF1 disease according to the National Institutes of Health criteria, who had been followed for at least 1 year by the department of pediatric neurology (Lyon, France). Brain MRI was systematically performed in asymptomatic patients under 6 years of age. RESULTS: One hundred patients with a median follow-up of 3.7 years (range, 1-8.6 years) were reviewed. Brain MRI was performed in a total of 94 children. Nine optic pathway gliomas were detected in symptomatic patients. Six children had symptoms caused by the tumor. Gliomas remained stable in 10 patients; 1 symptomatic glioma in an 8-year-old girl required treatment. Spontaneous regression was seen in 1 patient. CONCLUSION: Our results suggest that MRI screening of asymptomatic children to detect optic pathway gliomas does not improve the therapeutic decision and should not be performed systematically. We suggest further investigation in collaboration with the French NF Network.

Study of bioadhesion on a flat plate with a yeast/glass model system.

The attachment of microorganisms to a surface is a critical first step of biofilm fouling in membrane processes. The shear-induced detachment of baker's yeast in adhesive contact with a plane glass surface was thus experimentally studied, using a specially designed shear stress flow chamber. The yeast was marketed either as rod-shaped pellets (type I yeast) or as spherical pellets (type II yeast). A complete series of experiments for measuring the shear stress necessary to detach a given proportion of individual yeast cells of type I or II was performed under different environmental conditions (ionic strength, contact time). In parallel, the surface physicochemical properties of the cells (surface charge, hydrophobicity, and electron donor and electron acceptor components) were determined. For the first type of yeast cells, which were rather hydrophilic, adhesion to the glass plate was weak. This was due to both electrostatic effects and hydrophilic repulsion. Furthermore, adhesion was not sensitive to any variation of the ionic strength. For yeast of the second type, adhesion was drastically increased. This could be explained by their physicochemical surface properties and especially their hydrophobic and electron acceptor components, which caused strong attractive van der Waals and Lewis acid-base interactions, counterbalancing the electrostatic repulsion. For increasing ionic strengths, adhesion was greater, due to lower electrostatic repulsion. The results were quantified through the definition of a critical wall shear stress ( tau w 50% ) required to detach 50% of the yeast cells initially deposited on the glass surface. The influence of the contact time was also evaluated and it was shown that, whatever the type of yeast, macromolecules such as proteins were released into the extracellular medium due to cell lysis and could contribute to the formation of a conditioning film. As a result, the cells were more strongly stuck to the glass plate.

Maximal wall shear stress in arterial stenoses: application to the internal carotid arteries.

Maximal wall shear stress (MWSS) in the convergent part of a stenosis is calculated by the interactive boundary-layer theory. A dimensional analysis of the problem shows that MWSS depends only on a few measurable parameters. A simple relationship between MWSS and these parameters is obtained, validated, and used to calculate the magnitude of MWSS in a carotid stenosis, as a function of the patency of the circle of Willis and the stenotic pattern. This demonstrates the huge effect of collateral pathways. Elevated MWSS are observed even in moderate stenoses, provided they are associated with a contralateral occlusion, a large anterior, and narrow posterior communicating arteries, suggesting a potential risk of embolus release in this configuration.