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1.
Medicine (Baltimore) ; 99(38): e22305, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957391

RESUMO

RATIONALE: A developmental venous anomaly (DVA) is the most common intracranial congenital anomaly and is mostly asymptomatic. Thrombosis rarely develops in a DVA due to hypercoagulation. We report a case of ischemic stroke in the area of a DVA after minor head trauma in a patient with DVA and without a predisposition thrombosis. PATIENT CONCERNS: A healthy 17-year-old male was admitted to the emergency room due to left hemiparesis, which was caused by a ball hitting the right side of his head during a soccer game. DIAGNOSIS: Brain magnetic resonance (MR) susceptibility-weighted image showed several small veins draining to the central vein in the area from the right posterior putamen to the periventricular white matter. INTERVENTIONS: We diagnosed the patient with an ischemic stroke associated with a DVA and administered antiplatelet agents. The patient's autoantibodies (including antiphospholipid antibody) and factors of blood coagulation were normal. OUTCOMES: The left hemiparesis of the patient worsened by the second day of admission. Moreover, high signal intensity was observed in the DVA region of the diffusion weighted image of brain MR. The patient's symptoms gradually improved afterward, and left hemiparesis recovered fully 3 weeks after the onset. LESSONS: DVAs may predispose to ischemic stroke due to thrombosis and hypercoagulation, although it is rare. It is necessary to consider the possibility of ischemic stroke due to minor head trauma, even without factors causing hypercoagulation.


Assuntos
Concussão Encefálica/complicações , Acidente Vascular Cerebral/etiologia , Adolescente , Concussão Encefálica/diagnóstico por imagem , Ventrículos Cerebrais/diagnóstico por imagem , Ventrículos Cerebrais/patologia , Imagem de Difusão por Ressonância Magnética , Humanos , Angiografia por Ressonância Magnética , Masculino , Inibidores da Agregação de Plaquetas/uso terapêutico , Futebol/lesões , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/tratamento farmacológico
3.
BMC Neurol ; 20(1): 317, 2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32854643

RESUMO

BACKGROUND: The ventricular system plays a vital role in blood-cerebrospinal fluid (CSF) exchange and interstitial fluid-CSF drainage pathways. CSF is formed in the specialized secretory tissue called the choroid plexus, which consists of epithelial cells, fenestrated capillaries and the highly vascularized stroma. Very little is currently known about the role played by the ventricles and the choroid plexus tissue in aging and Alzheimer's disease (AD). METHODS: In this study, we used our state-of-the-art proteomic platform, a liquid chromatography/mass spectrometry (LC-MS/MS) approach coupled with Tandem Mass Tag isobaric labeling to conduct a detailed unbiased proteomic analyses of autopsied tissue isolated from the walls of the inferior horn of the lateral ventricles in AD (77.2 ± 0.6 yrs), age-matched controls (77.0 ± 0.5 yrs), and nonagenarian cases (93.2 ± 1.1 yrs). RESULTS: Ingenuity pathway analyses identified phagosome maturation, impaired tight-junction signaling, and glucose/mannose metabolism as top significantly regulated pathways in controls vs nonagenarians. In matched-control vs AD cases we identified alterations in mitochondrial bioenergetics, oxidative stress, remodeling of epithelia adherens junction, macrophage recruitment and phagocytosis, and cytoskeletal dynamics. Nonagenarian vs AD cases demonstrated augmentation of oxidative stress, changes in gluconeogenesis-glycolysis pathways, and cellular effects of choroidal smooth muscle cell vasodilation. Amyloid plaque score uniquely correlated with remodeling of epithelial adherens junctions, Fc γ-receptor mediated phagocytosis, and alterations in RhoA signaling. Braak staging was uniquely correlated with altered iron homeostasis, superoxide radical degradation and phagosome maturation. CONCLUSIONS: These changes provide novel insights to explain the compromise to the physiological properties and function of the ventricles/choroid plexus system in nonagenarian aging and AD pathogenesis. The pathways identified could provide new targets for therapeutic strategies to mitigate the divergent path towards AD.


Assuntos
Doença de Alzheimer/fisiopatologia , Encéfalo/patologia , Ventrículos Laterais/patologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Doença de Alzheimer/líquido cefalorraquidiano , Ventrículos Cerebrais/patologia , Plexo Corióideo/patologia , Cromatografia Líquida , Feminino , Humanos , Masculino , Placa Amiloide/patologia , Proteômica , Espectrometria de Massas em Tandem
4.
Rinsho Shinkeigaku ; 60(8): 543-548, 2020 Aug 07.
Artigo em Japonês | MEDLINE | ID: mdl-32641631

RESUMO

We describe an additional patient with spastic paraplegia 48 (SPG48). A 52-year-old woman with gradually increasing gait disturbance was admitted to our hospital. When she was 47 years old, acquaintances noted a shuffling gait. Gait worsening was evident at 48 years. Spastic gait was apparent at 50, and she required a walking stick at 54. Her elder brother had similar gait disturbance. No consanguinity was known. Neurologic examination at 52 disclosed spasticity and moderate weakness in the lower limbs. Spasticity and brisk reflexes in all limbs. Laboratory studies including HTLV-1 titer detected no abnormalities. MRI demonstrated mild corpus callosum narrowing and prominent anterior periventricular hyperintensities in fluid attenuation inversion recovery images. In limb muscles, electromyography (EMG) showed a chronic neurogenic pattern including reduced interference. Gene analysis identified compound homozygosity in exon 7 of adaptor-related protein complex 5 subunit zeta 1 (AP5Z1), including a novel frameshift mutation, c.1662_1672del;p.Glu554Hfs*15 in the patient, and a heterozygous missense mutation in asymptomatic family members, including her mother, two siblings, and a daughter. The frameshift mutation is considered a pathogenic variant according to American College of Medical Genetics and Genomics standards and guidelines. Based on clinical features, imaging findings and genetic abnormalities, we diagnosed this patient with SPG48. Mutations in AP5Z1, which encodes the ζ subunit of AP-5, underlie SPG48. The AP-5 adaptor protein complex, which is mutated in SPG48, binds to both spastizin and spatacsin. While hereditary spastic paraplegias generally are clinically and genetically heterogenous, SPG48, SPG11, and SPG15 are clinically similar.


Assuntos
Proteínas Adaptadoras de Transporte Vesicular/genética , Mutação da Fase de Leitura , Paraparesia Espástica/genética , Ventrículos Cerebrais/diagnóstico por imagem , Ventrículos Cerebrais/patologia , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Feminino , Transtornos Neurológicos da Marcha/etiologia , Genes Recessivos , Homozigoto , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica/complicações
5.
Zhonghua Wai Ke Za Zhi ; 58(6): 469-474, 2020 Jun 01.
Artigo em Chinês | MEDLINE | ID: mdl-32498488

RESUMO

Objective: To analyze the prognosis factors of cerebrospinal fluid (CSF) spread after surgery in glioblastoma (GBM) patients when tumors progressed and the effect factors on prognosis. Methods: A retrospective study was conducted on 124 patients who were pathologically diagnosed as glioblastoma after surgery, and found tumor progressed during regularly follow-up at Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University between January 2009 and August 2017.There were 82 males and 42 females, aged 47.9 years(range: 19 to 75 years) .Patients were divided into local recurrence group(96 cases) and CSF spread group (28 cases) .Clinical data were recorded in detail and compared by independent sample t test or χ(2) test.Kaplan-Meier survival curves was used to demonstrated the distribution of progression free survival (PFS) overall survival (OS) and post progression survival (PPS), and differences between local recurrence and CSF spread groups were assessed by Log-rank test.Cox proportion hazard regression analysis was used to identify independent prognostic factors. Results: Logistics regression analysis showed ventricle entry was the only prognosis factor of CSF spread (OR=2.667, 95% CI: 1.128 to 6.304, P=0.025).No significant distinction was observed in PFS between CSF spread group and local recurrence group(7.0 months vs.9.3 months, P=0.066).However, OS and PPS were substantially shortened in CSF spread group (13.0 months vs.23.0 months, P=0.011; 6.0 months vs.11.0 months, P=0.022, respectively).Mutations of isocitrate dehydrogenase gene, distant spread, gross-total resection, Ki-67 index>30% were independent prognostic factors of GBM patients. Conclusions: Ventricle entry is a prognosis factor for CSF spread, after which the median OS and PPS are markedly diminished.However, ventricle entry is not independent prognosis factor shortening survival.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias do Ventrículo Cerebral/secundário , Ventrículos Cerebrais/patologia , Líquido Cefalorraquidiano , Glioblastoma/secundário , Adulto , Idoso , Neoplasias Encefálicas/cirurgia , Análise Fatorial , Feminino , Glioblastoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Estudos Retrospectivos , Adulto Jovem
6.
J Clin Neurosci ; 78: 425-427, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32417128

RESUMO

Intracranial pseudolymphoma is a rare entity. We report the case of a 44 year old female who presented with headaches and was noted to have a right lateral ventricular lesion on a background history of Burkitt's lymphoma. She underwent biopsy of said lesion and was found to have benign reactive lymphoid tissue. This is the third reported case in literature of intracranial pseudolymphoma and the first reported intraventricular lesion.


Assuntos
Pseudolinfoma/diagnóstico , Adulto , Biópsia , Linfoma de Burkitt , Ventrículos Cerebrais/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pseudolinfoma/patologia
7.
J Clin Neurosci ; 78: 333-338, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32360163

RESUMO

Automatic estimations of brain ventricles are needed to assess disease progression in neurodegenerative disorders such as Alzheimer Disease (AD). The objectives of this study are to evaluate the diagnostic performances of an automated volumetric assessment tool in estimating lateral ventricle volumes in AD and to compare this with Cavalieri's principle, which is accepted as the gold standard method. This is across-sectional volumetric study including 25 Alzheimer patients and 25 healthy subjects undergoing magnetic resonance images (MRI) with a 3D turbo spin echo sequence at 1.5 Tesla. The Atlas-based method incorporated MRIStudio software to automatically measure he volumes of brain ventricles. To compare the corresponding measurements, we used manual point-counting and semi-automatic planimetry methods based on Cavalieri's principle. Bland-Altman test results indicated an excellent agreement between Cavalieri's principle and the Atlas-based method in all volumetric measurements (p < 0.05). We obtained a 64% sensitivity and 92% specificity for lateral ventricular volumes according to the Atlas-based method. AD subjects had significantly larger left and right lateral ventricle volume (LVV) when compared to control subjects in respect to three volumetric methods (p < 0.01). Lateral ventricle-to-brain ratio (VBR) statistically increased 49.23% in measurements done with the point-counting method, 45.12% with the planimetry method, and 45.49% with the Atlas-based method in AD patients (p < 0.01). As a result, the Atlas-based method may be used instead of manual volumetry to estimate brain volumes. Additionally, this method provides rapid and accurate estimations of brain ventricular volumes in-vivo examination of MRI.


Assuntos
Doença de Alzheimer/patologia , Ventrículos Cerebrais/patologia , Imagem por Ressonância Magnética/métodos , Tamanho do Órgão , Doença de Alzheimer/diagnóstico , Automação , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Ventrículos Laterais/crescimento & desenvolvimento , Ventrículos Laterais/patologia , Imagem por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Software
8.
J Clin Neurosci ; 76: 240-243, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32295747

RESUMO

Developmental venous anomaly (DVA) is the most common type of intracranial vascular malformation. These lesions are benign and are considered to be non-pathological variants of normal deep parenchymal veins. Although most of them are asymptomatic, a small subset of them located in aqueductal region have been reported to cause obstructive hydrocephalus. The authors present an interesting case of biventricular hydrocephalus secondary to a DVA located on the proximal aqueduct in an adolescent patient. This case is discussed with in corroboration with current literature and management recommendations.


Assuntos
Angioma Venoso do Sistema Nervoso Central/complicações , Ventrículos Cerebrais/patologia , Hidrocefalia/etiologia , Hidrocefalia/patologia , Adolescente , Aqueduto do Mesencéfalo/diagnóstico por imagem , Aqueduto do Mesencéfalo/patologia , Veias Cerebrais/diagnóstico por imagem , Veias Cerebrais/patologia , Ventrículos Cerebrais/diagnóstico por imagem , Feminino , Humanos , Hidrocefalia/diagnóstico por imagem
9.
Sci Rep ; 10(1): 6596, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32313130

RESUMO

Enhancement of endogenous neurogenesis after ischemic stroke may improve functional recovery. We previously demonstrated that medium B, which is a combination with epidermal growth factor (EGF) and fibronectin, can promote neural stem/progenitor cell (NSPC) proliferation and migration. Here, we showed that medium B promoted proliferation and migration of cultured NSPCs onto various 3-dimentional structures. When rat cortical neurons with oxygen glucose deprivation (OGD) were co-cultured with NSPCs, medium B treatment increased neuronal viability and reduced cell apoptosis. In a rat model with transient middle cerebral artery occlusion (MCAO), post-insult intraventricular medium B treatment enhanced proliferation, migration, and neuronal differentiation of NSPCs and diminished cell apoptosis in the infarct brain. In cultured post-OGD neuronal cells and the infarct brain from MCAO rats, medium B treatment increased protein levels of Bcl-xL, Bcl-2, phospho-Akt, phospho-GSK-3ß, and ß-catenin and decreased the cleaved caspase-3 level, which may be associated with the effects of anti-apoptosis. Notably, intraventricular medium B treatment increased neuronal density, improved motor function and reduced infarct size in MCAO rats. In summary, medium B treatment results in less neuronal death and better functional outcome in both cellular and rodent models of ischemic stroke, probably via promotion of neurogenesis and reduction of apoptosis.


Assuntos
Apoptose , Isquemia Encefálica/tratamento farmacológico , Ventrículos Cerebrais/patologia , Fator de Crescimento Epidérmico/uso terapêutico , Fibronectinas/uso terapêutico , Neurogênese , Acidente Vascular Cerebral/tratamento farmacológico , Animais , Apoptose/efeitos dos fármacos , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Ventrículos Cerebrais/fisiopatologia , Modelos Animais de Doenças , Fator de Crescimento Epidérmico/farmacologia , Fibronectinas/farmacologia , Glucose/deficiência , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/patologia , Infarto da Artéria Cerebral Média/fisiopatologia , Ventrículos Laterais/patologia , Ventrículos Laterais/fisiopatologia , Masculino , Células-Tronco Neurais/efeitos dos fármacos , Células-Tronco Neurais/ultraestrutura , Neurogênese/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios/patologia , Oxigênio , Ratos Wistar , Recuperação de Função Fisiológica/efeitos dos fármacos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia
10.
PLoS One ; 15(2): e0227349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32097426

RESUMO

OBJECTIVE: The amount of extravasated blood is an established surrogate marker for subarachnoid hemorrhage (SAH) severity, which varies in different experimental SAH (eSAH) models. A comprehensive eSAH grading system would allow a more reliable correlation of outcome parameters with SAH severity. The aim of this study was to define a severity score for eSAH related to the Fisher-Score in humans. MATERIAL AND METHODS: SAH was induced in 135 male rats using the modified double hemorrhage model. A sham group included 8 rats, in which saline solution instead of blood was injected. Histological analysis with HE(hematoxylin-eosin)-staining for the visualization of blood was performed in all rats on day 5. The amount and distribution of blood within the subarachnoid space and ventricles (IVH) was analyzed. RESULTS: The mortality rate was 49.6% (71/143). In all except five SAH rats, blood was visible within the subarachnoid space. As expected, no blood was detected in the sham group. The following eSAH severity score was established (ESAS-score): grade I: no SAH visible; grade II: local or diffuse thin SAH, no IVH; grade III: diffuse / thick layers of blood, no IVH; grade IV: additional IVH. Grade I was seen in five rats (7.9%), grade II in 28.6% (18/63), grade III in 41.3% (26/63) and grade IV in 22.2% (14/63) of the rats with eSAH. CONCLUSION: The double hemorrhage model allows the induction of a high grade SAH in more than 60% of the rats, making it suitable for the evaluation of outcome parameters in severe SAH.


Assuntos
Ventrículos Cerebrais/patologia , Hemorragia Subaracnóidea/patologia , Espaço Subaracnóideo/patologia , Animais , Modelos Animais de Doenças , Masculino , Ratos Sprague-Dawley , Hemorragia Subaracnóidea/sangue
11.
Int Immunopharmacol ; 80: 106141, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31982825

RESUMO

Neuroinflammation significantly contributes to brain injury and neurological deterioration following intracerebral hemorrhage (ICH). MicroRNA-152(miR-152) was reported to be downregulated in ICH patients and to possess anti-inflammatory properties in other diseases. In this study, we aimed to explore the role of miR-152 in ICH, and the underlying mechanisms, using a collagenase-induced rat ICH model and hemin-exposure as a cell model. We first confirmed that miR-152 was consistently downregulated in both models. Overexpression of miR-152 in microglial BV2 cells reduced hemin-induced inflammatory response and reactive oxygen species (ROS) generation, thus protecting co-cultured neuronal HT22 cells. Moreover, overexpression of miR-152 by intracerebroventricular lentivirus injection in ICH rats significantly alleviated neurodecifits, brain edema, and hematoma. These changes were associated with a marked reduction in ICH-induced neuronal death, as detected by co-staining of NeuN and TUNEL, and ICH-induced neuroinflammation, as revealed by inflammatory cytokine levels as well as by the number of Iba1 positive-stained cells in the perihematomal region. Mechanistically, miR-152 significantly inhibited ICH-induced TXNIP expression, and its overexpression blocked the interaction between TXNIP and NOD-like receptor pyrin domain containing 3(NLRP3), thus inhibiting NLRP3-driven inflammasome activation to attenuate neuroinflammation in vivo and in vitro. Moreover, the results of si-TXNIP transfection further confirmed that TXNIP inhibition was involved in the reduction of NLRP3 inflammasome activation by the overexpression of miR-152. Collectively, the present study demonstrates that miR-152 confers protection against ICH-induced neuroinflammation and brain injury by inhibiting TXNIP-mediated NLRP3 inflammasome activation, indicating a potential strategy for ICH treatment.


Assuntos
Proteínas de Transporte/genética , Proteínas de Ciclo Celular/genética , Hemorragia Cerebral Intraventricular/genética , Inflamassomos/imunologia , MicroRNAs/metabolismo , Tiorredoxinas/genética , Animais , Proteínas de Transporte/metabolismo , Proteínas de Ciclo Celular/metabolismo , Linhagem Celular , Hemorragia Cerebral Intraventricular/induzido quimicamente , Hemorragia Cerebral Intraventricular/imunologia , Hemorragia Cerebral Intraventricular/patologia , Ventrículos Cerebrais/imunologia , Ventrículos Cerebrais/patologia , Técnicas de Cocultura , Modelos Animais de Doenças , Regulação para Baixo/imunologia , Técnicas de Silenciamento de Genes , Hemina/imunologia , Humanos , Inflamassomos/metabolismo , Injeções Intraventriculares , Masculino , Camundongos , MicroRNAs/agonistas , MicroRNAs/antagonistas & inibidores , Colagenase Microbiana/administração & dosagem , Colagenase Microbiana/toxicidade , Microglia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Neurônios , Ligação Proteica/genética , Ligação Proteica/imunologia , RNA Interferente Pequeno/metabolismo , Ratos , Tiorredoxinas/metabolismo
13.
J Neurol ; 267(1): 192-202, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31612322

RESUMO

OBJECTIVE: To investigate the association between new or enlarging T2-weighted (w) white matter (WM) lesions adjacent to the ventricle wall, deep grey matter (DGM) atrophy and lateral ventricular enlargement in multiple sclerosis (MS). METHODS: Patients derived from the Genetic Multiple Sclerosis Associations study. Lateral ventricles and DGM were segmented fully automated at baseline and 5 years follow-up using Automatic Lateral Ventricle delineation (ALVIN) and Multiple Automatically Generated Templates brain segmentation algorithm (MAgeT), respectively. T2w and T1w lesions were manually segmented. To investigate the association between lesion distance to the ventricle wall and the lateral ventricle volume, we parcellated the WM into concentric periventricular bands using FMRIB Software Library. Associations between clinical and MRI parameters were assessed in generalized linear models using generalized estimating equations for repeated measures. RESULTS: We studied 127 MS patients. Lateral ventricles enlarged on average by 2.4%/year. Patients with new/enlarging T2w WM lesions between baseline and follow-up at 5 years had accelerated lateral ventricular enlargement compared with patients without (p = 0.004). This was true in a multivariable analysis adjusted for age, gender, and whole brain atrophy. When looking at the T2w lesions in different periventricular bands, we found the strongest association between new/enlarging T2w lesions and lateral ventricle enlargement for WM lesions adjacent to the ventricle system (p < 0.001). Moreover, and indepedent of new/enlarging WM lesions, DGM atrophy was associated with ventricular enlargement. In a multivariable analysis, this was driven by thalamic atrophy (p < 0.001). CONCLUSION: New/enlarging T2w lesions adjacent to the ventricle system and thalamic atrophy are independently associated with lateral ventricular enlargement in MS.


Assuntos
Ventrículos Cerebrais/patologia , Progressão da Doença , Esclerose Múltipla/patologia , Tálamo/patologia , Substância Branca/patologia , Adulto , Atrofia/patologia , Ventrículos Cerebrais/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Substância Branca/diagnóstico por imagem
14.
Neurobiol Aging ; 86: 27-38, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31733943

RESUMO

Ventricular enlargement (VE) is commonly observed in aging and fragile X-associated tremor/ataxia syndrome (FXTAS), a late-onset neurodegenerative disorder. VE may generate a mechanical force causing structural deformation. In this longitudinal study, we examined the relationships between VE and structural changes in the corpus callosum (CC) and putamen. MRI scans (2-7/person over 0.2-7.5 years) were acquired from 22 healthy controls, 26 unaffected premutation carriers (PFX-), and 39 carriers affected with FXTAS (PFX+). Compared with controls, PFX- demonstrated enlarged fourth ventricles, whereas PFX+ displayed enlargement in both third and fourth ventricles, CC thinning, putamen atrophy/deformation (thinning and increased distance), and accelerated expansions in lateral ventricles. Common for all groups, baseline VE predicted accelerated CC thinning and putamen atrophy/deformation and conversely, baseline CC and putamen atrophy/deformation and enlarged third and fourth ventricles predicted accelerated lateral ventricular expansion. The results suggest a progressive VE within the 4 ventricles as FXTAS develops and a deleterious cycle between VE and brain deformation that may commonly occur during aging and FXTAS progression but become accelerated in FXTAS.


Assuntos
Ataxia/genética , Ataxia/patologia , Ventrículos Cerebrais/patologia , Corpo Caloso/patologia , Proteína do X Frágil de Retardo Mental/genética , Síndrome do Cromossomo X Frágil/genética , Síndrome do Cromossomo X Frágil/patologia , Putamen/patologia , Tremor/genética , Tremor/patologia , Adulto , Idoso , Alcadienos , Atrofia , Ventrículos Cerebrais/diagnóstico por imagem , Corpo Caloso/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Putamen/diagnóstico por imagem
15.
J Pediatr ; 217: 79-85.e1, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31706634

RESUMO

OBJECTIVE: To describe the sonographic characteristics of periventricular hemorrhagic infarction (PVHI) and their association with mortality and neurodevelopmental disability in very preterm infants born in 2008-2013. STUDY DESIGN: Retrospective multicenter observational cohort study. Diagonal PVHI size was measured and severity score assessed. PVHI characteristics were scored and temporal trends were assessed. Neurodevelopmental outcome at 2 years of corrected age was assessed using either the Bayley Scales of Infant and Toddler Development, Third Edition or the Griffiths Mental Development Scales. Multigroup analyses were applied as appropriate. RESULTS: We enrolled 160 infants with median gestational age of 26.6 weeks. PVHI was mostly unilateral (90%), associated with an ipsilateral grade III intraventricular hemorrhage (84%), and located in the parietal lobe (51%). Sixty-four (40%) infants with PVHI died in the neonatal period. Of the survivors assessed at 2 years of corrected age, 65% had normal cognitive and 69% had normal motor outcomes. The cerebral palsy rate was 42%. The composite outcome of death or severe neurodevelopmental disability was observed in 58%, with no trends over the study period (P = .6). Increasing PVHI severity score was associated with death (P < .001). Increasing PVHI size and severity score were negatively associated with gross motor scores (P = .01 and .03, respectively). Trigone involvement was associated with cerebral palsy (41% vs 14%; P = .004). Associated posthemorrhagic ventricular dilation (36%) was an independent risk factor for poorer cognitive and motor outcomes (P < .001 for both). CONCLUSIONS: Increasing PVHI size and severity score were predictive of less optimal gross motor outcome and death in very preterm infants.


Assuntos
Hemorragia Cerebral/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Ventrículos Cerebrais/diagnóstico por imagem , Doenças do Prematuro/diagnóstico por imagem , Hemorragia Cerebral/mortalidade , Hemorragia Cerebral/patologia , Infarto Cerebral/mortalidade , Infarto Cerebral/patologia , Paralisia Cerebral/complicações , Ventrículos Cerebrais/patologia , Pré-Escolar , Deficiências do Desenvolvimento/complicações , Deficiências do Desenvolvimento/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/mortalidade , Doenças do Prematuro/patologia , Masculino , Estudos Retrospectivos , Ultrassonografia
16.
Neurology ; 94(5): e549-e556, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-31748251

RESUMO

OBJECTIVE: To compare the clinical utility of volume-based ratios with the standard linear ratio of Evans index (EI) by examining their associations with gait, cognition, and other patient and imaging variables. METHODS: From MRI scans of 1,774 participants in the Mayo Clinic Study of Aging, we calculated 3 ventricle size measures: Evan index (frontal horn width divided by widest width of skull inner table), total ventricular volume, and frontal horn volume as ratios of total intracranial volume. Gait was measured by a timed 25-foot walk and cognition by a composite of psychometric tests. We also evaluated variables associated with the measures of ventricular size. Further, we evaluated gait and cognition associations with MRI of extraventricular findings seen in normal-pressure hydrocephalus: disproportionate enlargement of subarachnoid space (DESH) and focal sulcal dilations (FSD). RESULTS: Ventricular volume measures had stronger association with gait and cognition measures than EI. In decreasing order of strength of association with ventricle size were DESH, FSD, white matter hyperintensity volume ratio, age, male sex, cortical thickness, and education. Modest evidence was observed that FSD was associated with future decline in gait and cognition. CONCLUSION: Ventricular volume measures are clinically more useful than EI in indicating current and future gait and cognition. Multiple factors are associated with ventricle volume size, including FSD and DESH, suggesting that changes in CSF dynamics may go beyond simple ventriculomegaly.


Assuntos
Ventrículos Cerebrais/diagnóstico por imagem , Cognição/fisiologia , Marcha/fisiologia , Idoso , Idoso de 80 Anos ou mais , Apolipoproteína E4 , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Ventrículos Cerebrais/patologia , Escolaridade , Feminino , Humanos , Hidrocefalia de Pressão Normal/diagnóstico por imagem , Hidrocefalia de Pressão Normal/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Tamanho do Órgão , Substância Branca/diagnóstico por imagem , Substância Branca/patologia
17.
Int J Clin Pract ; 74(2): e13446, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31750588

RESUMO

AIMS AND BACKGROUND: Dementia is diagnosed through a combination of clinical assessment, cognitive assessment tools and neuroimaging. The aim of this retrospective, naturalistic study was to explore the association between the clinical assessment tools used in a memory clinic and the findings of Magnetic Resonance Imaging (MRI) scans in patients with dementia. METHODS: Data were collected through routine clinical practice for all patients assessed at a memory assessment clinic in East Sussex, UK. Included patients had an MRI scan and received a formal diagnosis of dementia. Multinomial logistic regression was used to investigate the associations between atrophy on MRI with age, gender, Cambridge Cognitive Examination (CAMCOG) and Hachinski Ischemic Score (HIS). Ordinal logistic regression was used to study the associations between vascular findings on MRI with age, gender, CAMCOG and HIS. Because of the distribution of HIS scores a cut-off of 1 or greater was used in the regression analysis. RESULTS: Male gender was associated with an increased likelihood of moderate atrophy (relative risk ratio (RRR) = 1.99, 95% confidence interval (CI) = 1.04-3.82), severe atrophy (RRR = 3.04, 95% CI = 1.38-6.68) and regional atrophy (RRR = 2.25, 95% CI = 1.26-4.00) on MRI. An increase of one point on the CAMCOG was associated with a decreased risk of regional atrophy (RRR = 0.98, 95% CI = 0.96-1.00) on MRI. There were no significant associations between age, or HIS, and atrophy on MRI. An increase in age of one year was associated with an increase in severity of vascular pathology reported on MRI (OR = 1.08, 95% CI = 1.05-1.12). Male gender was associated with reduced severity of vascular pathology reported on MRI (OR = 0.53, 95% CI = 0.36-0.78). There were no associations between CAMCOG, or HIS, and vascular pathology on MRI. DISCUSSION: Our data show that CAMCOG was associated with MRI findings of regional atrophy and vascular pathology was greater in older patients. We highlight the importance of using a multi-modal approach to dementia diagnosis.


Assuntos
Cognição , Demência/diagnóstico , Lobo Temporal/patologia , Idoso , Idoso de 80 Anos ou mais , Atrofia/patologia , Ventrículos Cerebrais/patologia , Estudos Transversais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Análise de Regressão , Estudos Retrospectivos
18.
J Neurol Neurosurg Psychiatry ; 91(2): 158-161, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31806724

RESUMO

BACKGROUND: Increased rates of brain atrophy on serial MRI are frequently used as a surrogate marker of disease progression in Alzheimer's disease and other dementias. However, the extent to which they are associated with future risk of dementia in asymptomatic subjects is not clear. In this study, we investigated the relationship between the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score and longitudinal atrophy in middle-aged subjects. MATERIALS AND METHODS: A sample of 167 subjects (aged 40-59 at baseline) from the PREVENT-Dementia programme underwent MRI scans on two separate occasions (mean interval 735 days; SD 44 days). We measured longitudinal rates of brain atrophy using the FSL Siena toolbox. RESULTS: Annual percentage rates of brain volume and ventricular volume change were greater in those with a high (>6) vs low CAIDE score-absolute brain volume percentage loss 0.17% (CI 0.07 to 0.27) and absolute ventricular enlargement 1.78% (CI 1.14 to 2.92) higher in the at risk group. Atrophy rates did not differ between subjects with and without a parental history of dementia, but were significantly correlated with age. Using linear regression, with covariates of age, sex and education, CAIDE score >6 was the only significant predictor of whole brain atrophy rates (p=0.025) while age (p=0.009), sex (p=0.002) and CAIDE>6 (p=0.017) all predicted ventricular expansion rate. CONCLUSION: Our results show that progressive brain atrophy is associated with increased risk of future dementia in asymptomatic middle-aged subjects, two decades before dementia onset.


Assuntos
Atrofia/patologia , Encéfalo/patologia , Ventrículos Cerebrais/patologia , Demência/patologia , Adulto , Fatores Etários , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Testes Neuropsicológicos , Valor Preditivo dos Testes , Fatores de Risco
19.
J Neuropathol Exp Neurol ; 79(1): 113-117, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31794012

RESUMO

Hydrocephalus is a rare and devastating complication of mumps encephalitis. The histopathological correlates of mumps infection in central nervous system tissues are not well-characterized. We present the case of a 54-year-old patient who suffered long-term neuropsychiatric sequelae and hydrocephalus as a consequence of a childhood mumps infection. Brain autopsy revealed significant dilation of the lateral and third ventricles. Aqueductal stenosis was not observed on premortem imaging or on gross examination. Histology revealed loss of ependymal epithelium throughout the aqueduct and ventricular system. Macrophage conglomerates were identified within the cerebral aqueduct at the level of the pons in addition to subjacent periaqueductal gliosis and scattered Rosenthal fibers. Together, these findings support primary ependymal injury as a pathophysiological mechanism in the development of chronic hydrocephalus following mumps infection. Finally, we review the existing literature and discuss potential mechanisms of disease.


Assuntos
Encefalite/complicações , Encefalite/patologia , Hidrocefalia/etiologia , Hidrocefalia/patologia , Caxumba/complicações , Caxumba/patologia , Adolescente , Adulto , Encéfalo/patologia , Aqueduto do Mesencéfalo/patologia , Ventrículos Cerebrais/patologia , Criança , Pré-Escolar , Encefalite/psicologia , Epêndima/patologia , Evolução Fatal , Feminino , Gliose/patologia , Humanos , Hidrocefalia/psicologia , Lactente , Macrófagos/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Caxumba/psicologia , Ponte/patologia , Adulto Jovem
20.
Neuroimage Clin ; 24: 102079, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31795051

RESUMO

OBJECTIVE: To objectively quantify how cerebral volume loss could assist with clinical diagnosis and clinical trial design in the behavioural variant of frontotemporal dementia (bvFTD). METHODS: We applied deformation-based morphometric analyses with robust registration to precisely quantify the magnitude and pattern of atrophy in patients with bvFTD as compared to cognitively normal controls (CNCs), to assess the progression of atrophy over one year follow up and to generate clinical trial sample size estimates to detect differences for the structures most sensitive to change. This study included 203 subjects - 70 bvFTD and 133 CNCs - with a total of 482 timepoints from the Frontotemporal Lobar Degeneration Neuroimaging Initiative. RESULTS: Deformation based morphometry (DBM) revealed significant atrophy in the frontal lobes, insula, medial and anterior temporal regions bilaterally in bvFTD subjects compared to controls with outstanding subcortical involvement. We provide detailed information on regional changes per year. In both cross-sectional analysis and over a one-year follow-up period, ventricle expansion was the most prominent differentiator of bvFTD from controls and a sensitive marker of disease progression. CONCLUSIONS: Automated measurement of ventricular expansion is a sensitive and reliable marker of disease progression in bvFTD to be used in clinical trials for potential disease modifying drugs, as well as possibly to implement in clinical practice. Ventricular expansion measured with DBM provides the lowest published estimated sample size for clinical trial design to detect significant differences over one and two years.


Assuntos
Encéfalo/diagnóstico por imagem , Demência Frontotemporal/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Idoso , Atrofia , Encéfalo/patologia , Estudos de Casos e Controles , Ventrículos Cerebrais/diagnóstico por imagem , Ventrículos Cerebrais/patologia , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Progressão da Doença , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Demência Frontotemporal/patologia , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/patologia , Humanos , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Substância Branca/diagnóstico por imagem , Substância Branca/patologia
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