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1.
Mol Psychiatry ; 23(5): 1385-1392, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-28439103

RESUMO

Age-associated disease and disability are placing a growing burden on society. However, ageing does not affect people uniformly. Hence, markers of the underlying biological ageing process are needed to help identify people at increased risk of age-associated physical and cognitive impairments and ultimately, death. Here, we present such a biomarker, 'brain-predicted age', derived using structural neuroimaging. Brain-predicted age was calculated using machine-learning analysis, trained on neuroimaging data from a large healthy reference sample (N=2001), then tested in the Lothian Birth Cohort 1936 (N=669), to determine relationships with age-associated functional measures and mortality. Having a brain-predicted age indicative of an older-appearing brain was associated with: weaker grip strength, poorer lung function, slower walking speed, lower fluid intelligence, higher allostatic load and increased mortality risk. Furthermore, while combining brain-predicted age with grey matter and cerebrospinal fluid volumes (themselves strong predictors) not did improve mortality risk prediction, the combination of brain-predicted age and DNA-methylation-predicted age did. This indicates that neuroimaging and epigenetics measures of ageing can provide complementary data regarding health outcomes. Our study introduces a clinically-relevant neuroimaging ageing biomarker and demonstrates that combining distinct measurements of biological ageing further helps to determine risk of age-related deterioration and death.


Assuntos
Envelhecimento/fisiologia , Encéfalo/fisiologia , Neuroimagem/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Biomarcadores , Encéfalo/metabolismo , Cognição/fisiologia , Epigênese Genética/genética , Epigenômica/métodos , Feminino , Humanos , Estudos Longitudinais , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade
2.
J Evol Biol ; 29(3): 541-50, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-26749372

RESUMO

Male parents face a choice: should they invest more in caring for offspring or in attempting to mate with other females? The most profitable course depends on the intensity of competition for mates, which is likely to vary with the population sex ratio. However, the balance of pay-offs may vary among individual males depending on their competitive prowess or attractiveness. We tested the prediction that sex ratio and size of the resource holding male provide cues regarding the level of mating competition prior to breeding and therefore influence the duration of a male's biparental caring in association with a female. Male burying beetles, Nicrophorus vespilloides were reared, post-eclosion, in groups that differed in sex ratio. Experimental males were subsequently translocated to the wild, provided with a breeding resource (carcass) and filmed. We found no evidence that sex ratio cues prior to breeding affected future parental care behaviour but males that experienced male-biased sex ratios took longer to attract wild mating partners. Smaller males attracted a higher proportion of females than did larger males, securing significantly more monogamous breeding associations as a result. Smaller males thus avoided competitive male-male encounters more often than larger males. This has potential benefits for their female partners who avoid both intrasexual competition and direct costs of higher mating frequency associated with competing males.


Assuntos
Besouros/fisiologia , Razão de Masculinidade , Comportamento Sexual Animal/fisiologia , Animais , Tamanho Corporal , Besouros/anatomia & histologia , Comportamento Competitivo , Feminino , Masculino , Preferência de Acasalamento Animal
3.
Eur J Neurol ; 23(7): 1202-9, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27094820

RESUMO

BACKGROUND AND PURPOSE: Several studies have reported associations between brain iron deposits (IDs), white matter hyperintensities (WMHs) and cognitive ability in older individuals. Whether the association between brain IDs and cognitive abilities in older people is mediated by or independent of total brain tissue damage represented by WMHs visible on structural magnetic resonance imaging (MRI) was examined. METHODS: Data from 676 community-dwelling individuals from the Lothian Birth Cohort 1936, with Mini-Mental State Examination scores >24, who underwent detailed cognitive testing and multimodal brain MRI at mean age 72.7 years were analysed. Brain IDs were assessed automatically following manual editing. WMHs were assessed semi-automatically. Brain microbleeds were visually counted. Structural equation modelling was used to test for mediation. RESULTS: Overall, 72.8% of the sample had IDs with a median total volume of 0.040 ml (i.e. 0.004% of the total brain volume). The total volume of IDs, significantly and negatively associated with general cognitive function (standardized ß = -0.17, P < 0.01), was significantly and positively associated with WMH volume (std ß = 0.13, P = 0.03). WMH volume had a significant negative association with general cognitive function, independent of IDs (std ß = -0.13, P < 0.01). The association between cognition and IDs in the brain stem (and minimally the total brain iron load) was partially and significantly mediated by WMH volume (P = 0.03). CONCLUSIONS: The negative association between brain IDs and cognitive ability in the elderly is partially mediated by WMHs, with this mediation mainly arising from the iron deposition load in the brain stem. IDs might be an indicator of small vessel disease that predisposes to white matter damage, affecting the neuronal networks underlying higher cognitive functioning.


Assuntos
Envelhecimento/patologia , Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Ferro/metabolismo , Substância Branca/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Envelhecimento/psicologia , Encéfalo/metabolismo , Encéfalo/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos , Substância Branca/metabolismo , Substância Branca/patologia
4.
Biol Lett ; 12(3): 20151064, 2016 03.
Artigo em Inglês | MEDLINE | ID: mdl-26979560

RESUMO

Sexual conflict occurs when selection to maximize fitness in one sex does so at the expense of the other sex. In the burying beetle Nicrophorus vespilloides, repeated mating provides assurance of paternity at a direct cost to female reproductive productivity. To reduce this cost, females could choose males with low repeated mating rates or smaller, servile males. We tested this by offering females a dichotomous choice between males from lines selected for high or low mating rate. Each female was then allocated her preferred or non-preferred male to breed. Females showed no preference for males based on whether they came from lines selected for high or low mating rates. Pairs containing males from high mating rate lines copulated more often than those with low line males but there was a negative relationship between female size and number of times she mated with a non-preferred male. When females bred with their preferred male the number of offspring reared increased with female size but there was no such increase when breeding with non-preferred males. Females thus benefited from being choosy, but this was not directly attributable to avoidance of costly male repeated mating.


Assuntos
Besouros/fisiologia , Preferência de Acasalamento Animal , Animais , Feminino , Masculino
5.
J Evol Biol ; 28(7): 1394-402, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26033457

RESUMO

Male parents spend less time caring than females in many species with biparental care. The traditional explanation for this pattern is that males have lower confidence of parentage, so they desert earlier in favour of pursuing other mating opportunities. However, one recent alternative hypothesis is that prolonged male parental care might also evolve if staying to care actively improves paternity. If this is the case, an increase in reproductive competition should be associated with increased paternal care. To test this prediction, we manipulated the level of reproductive competition experienced by burying beetles, Nicrophorus vespilloides (Herbst, 1783). We found that caregiving males stayed for longer and mated more frequently with their partner when reproductive competition was greater. Reproductive productivity did not increase when males extended care. Our findings provide support for the increased paternity hypothesis. Extended duration of parental care may be a male tactic both protecting investment (in the current brood) and maximizing paternity (in subsequent brood(s) via female stored sperm) even if this fails to maximize current reproductive productivity and creates conflict of interest with their mate via costs associated with increased mating frequency.


Assuntos
Besouros/fisiologia , Comportamento Paterno/fisiologia , Comportamento Sexual Animal , Animais , Comportamento Competitivo/fisiologia , Feminino , Masculino
6.
Mol Psychiatry ; 19(5): 555-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23732878

RESUMO

Associations between brain cortical tissue volume and cognitive function in old age are frequently interpreted as suggesting that preservation of cortical tissue is the foundation of successful cognitive aging. However, this association could also, in part, reflect a lifelong association between cognitive ability and cortical tissue. We analyzed data on 588 subjects from the Lothian Birth Cohort 1936 who had intelligence quotient (IQ) scores from the same cognitive test available at both 11 and 70 years of age as well as high-resolution brain magnetic resonance imaging data obtained at approximately 73 years of age. Cortical thickness was estimated at 81 924 sampling points across the cortex for each subject using an automated pipeline. Multiple regression was used to assess associations between cortical thickness and the IQ measures at 11 and 70 years. Childhood IQ accounted for more than two-third of the association between IQ at 70 years and cortical thickness measured at age 73 years. This warns against ascribing a causal interpretation to the association between cognitive ability and cortical tissue in old age based on assumptions about, and exclusive reference to, the aging process and any associated disease. Without early-life measures of cognitive ability, it would have been tempting to conclude that preservation of cortical thickness in old age is a foundation for successful cognitive aging when, instead, it is a lifelong association. This being said, results should not be construed as meaning that all studies on aging require direct measures of childhood IQ, but as suggesting that proxy measures of prior cognitive function can be useful to take into consideration.


Assuntos
Envelhecimento/patologia , Envelhecimento/psicologia , Encéfalo/patologia , Inteligência , Adolescente , Adulto , Idoso , Criança , Cognição , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Testes de Inteligência , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Análise de Regressão , Fatores Sexuais , Adulto Jovem
7.
Psychol Med ; 43(6): 1197-206, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22785087

RESUMO

BACKGROUND: Clinical depression is associated with reductions in white-matter integrity in several long tracts of the brain. The extent to which these findings are localized or related to depressive symptoms or personality traits linked to disease risk remains unclear. Method Members of the Lothian Birth Cohort 1936 (LBC936) were assessed in two waves at mean ages of 70 and 73 years. At wave 1, they underwent assessments of depressive symptoms and the personality traits of neuroticism and extraversion. Brain diffusion magnetic resonance imaging (MRI) data were obtained at the second wave and mood assessments were repeated. We tested whether depressive symptoms were related to reduced white-matter tract fractional anisotropy (FA), a measure of integrity, and then examined whether high neuroticism or low extraversion mediated this relationship. RESULTS: Six hundred and sixty-eight participants provided useable data. Bilateral uncinate fasciculus FA was significantly negatively associated with depressive symptoms at both waves (standardized ß=0.12-0.16). Higher neuroticism and lower extraversion were also significantly associated with lower uncinate FA bilaterally (standardized ß=0.09-0.15) and significantly mediated the relationship between FA and depressive symptoms. CONCLUSIONS: Trait liability to depression and depressive symptoms are associated with reduced structural connectivity in tracts connecting the prefrontal cortex with the amygdala and anterior temporal cortex. These effects suggest that frontotemporal disconnection is linked to the etiology of depression, in part through personality trait differences.


Assuntos
Transtornos de Ansiedade/patologia , Encéfalo/patologia , Depressão/patologia , Fibras Nervosas Mielinizadas/patologia , Idoso , Anisotropia , Estudos de Coortes , Corpo Caloso/patologia , Imagem de Difusão por Ressonância Magnética , Extroversão Psicológica , Feminino , Giro do Cíngulo/patologia , Humanos , Masculino , Vias Neurais/patologia , Neuroticismo
8.
Mol Psychiatry ; 17(10): 1026-30, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22614288

RESUMO

General intelligence is a robust predictor of important life outcomes, including educational and occupational attainment, successfully managing everyday life situations, good health and longevity. Some neuronal correlates of intelligence have been discovered, mainly indicating that larger cortices in widespread parieto-frontal brain networks and efficient neuronal information processing support higher intelligence. However, there is a lack of established associations between general intelligence and any basic structural brain parameters that have a clear functional meaning. Here, we provide evidence that lower brain-wide white matter tract integrity exerts a substantial negative effect on general intelligence through reduced information-processing speed. Structural brain magnetic resonance imaging scans were acquired from 420 older adults in their early 70s. Using quantitative tractography, we measured fractional anisotropy and two white matter integrity biomarkers that are novel to the study of intelligence: longitudinal relaxation time (T1) and magnetisation transfer ratio. Substantial correlations among 12 major white matter tracts studied allowed the extraction of three general factors of biomarker-specific brain-wide white matter tract integrity. Each was independently associated with general intelligence, together explaining 10% of the variance, and their effect was completely mediated by information-processing speed. Unlike most previously established neurostructural correlates of intelligence, these findings suggest a functionally plausible model of intelligence, where structurally intact axonal fibres across the brain provide the neuroanatomical infrastructure for fast information processing within widespread brain networks, supporting general intelligence.


Assuntos
Mapeamento Encefálico , Encéfalo/anatomia & histologia , Inteligência/fisiologia , Fibras Nervosas Mielinizadas/fisiologia , Vias Neurais/fisiologia , Idoso , Encéfalo/fisiologia , Cognição/fisiologia , Estudos de Coortes , Imagem de Tensor de Difusão , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Processos Mentais/fisiologia , Modelos Estatísticos , Vias Neurais/anatomia & histologia , Testes Neuropsicológicos , População Branca
9.
Nat Genet ; 6(1): 52-6, 1994 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8136835

RESUMO

One of the significant unresolved differences between the karyotypes of humans and African apes is the presence of positively staining G-bands at the ends of many chromosome arms in the chimpanzee and gorilla but absent from human chromosomes. Using a telomere anchored PCR strategy, we have isolated DNA from a subterminal satellite, composed of a 32 basepair A-T rich repeat, from the chimpanzee genome that hybridizes to all the additional terminal bands and at two interstitial sites. The satellite is more abundant in gorillas and is not detected in humans or orangutans. Furthermore, there is no similarity between other chimpanzee telomere-junction clones and human subterminal sequences, and therefore the organization of sequences adjacent to telomeres is very different between these closely related primates.


Assuntos
DNA Satélite/genética , Genoma Humano , Pan troglodytes/genética , Animais , Sequência de Bases , Clonagem Molecular , Primers do DNA/genética , Gorilla gorilla/genética , Humanos , Hibridização in Situ Fluorescente , Cariotipagem , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Pongo pygmaeus/genética , Sequências Repetitivas de Ácido Nucleico , Homologia de Sequência do Ácido Nucleico , Especificidade da Espécie , Telômero
10.
Cytogenet Genome Res ; 122(3-4): 281-91, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19188697

RESUMO

The Alternative Lengthening of Telomeres (ALT) mechanism is utilised by approximately 10% of human tumours and a higher proportion of some types of sarcomas. ALT+ cell lines and tumours show heterogeneous telomere length, extra-chromosomal circular and linear telomeric DNA, ALT associated promyelocytic bodies (APBs), a high frequency of post-replication exchanges in telomeres (designated as telomere-sister chromatid exchanges, T-SCE) and high instability at a GC-rich minisatellite, MS32 (D1S8). It is clear that there is a link between the minisatellite instability and the mechanism that underpins ALT, however currently the nature of this relationship is uncertain. Single molecule analysis of telomeric DNA from ALT+ cell lines and tumours has revealed complex telomere mutations that have not been seen in cell lines or tumours that express telomerase. These complex telomere mutations cannot be explained by T-SCE but must arise by another inter-molecular process. The break-induced replication (BIR) model that may explain the observed high frequency of T-SCE and the presence of complex telomere mutations is reviewed.


Assuntos
Neoplasias/genética , Telomerase/genética , Telomerase/metabolismo , Processamento Alternativo , Linhagem Celular , DNA/genética , DNA Fúngico/genética , DNA de Neoplasias/genética , Instabilidade Genômica , Humanos , Mutação , Neoplasias/enzimologia , Análise de Sequência com Séries de Oligonucleotídeos , Fenótipo , Recombinação Genética , Saccharomyces cerevisiae/enzimologia , Sarcoma/enzimologia , Sarcoma/genética , Telômero/genética , Telômero/ultraestrutura
12.
Curr Opin Insect Sci ; 28: 8-12, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30551771

RESUMO

The emergence of family groups is associated with conflict over the allocation of food or other limited resources. Understanding the mechanisms mediating the resolution of such conflict is a major aim in behavioral ecology. Most empirical work on familial conflict has focused on birds. Here, we highlight how recent work on insects provides new and exciting insights into how such conflict is resolved. This work shows that conflict resolution can be more complex than traditionally envisioned, often involving multiple mechanisms. For example, it shows that the resolution of sexual conflict involves a combination of behavioral negotiation, direct assessment of partner's state, and manipulation using anti-aphrodisiacs or prenatal maternal effects. Furthermore, it highlights that there is a shift from the traditional emphasis on conflict (and competition) to a greater emphasis on the balance between conflict on the one hand and cooperation on the other.


Assuntos
Evolução Biológica , Insetos/fisiologia , Animais , Conflito Psicológico , Comportamento Cooperativo , Comportamento Social
13.
J Nutr Health Aging ; 21(9): 971-979, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29083437

RESUMO

BACKGROUND: Iodine deficiency is one of the three key micronutrient deficiencies highlighted as major public health issues by the World Health Organisation. Iodine deficiency is known to cause brain structural alterations likely to affect cognition. However, it is not known whether or how different (lifelong) levels of exposure to dietary iodine influences brain health and cognitive functions. METHODS: From 1091 participants initially enrolled in The Lothian Birth Cohort Study 1936, we obtained whole diet data from 882. Three years later, from 866 participants (mean age 72 yrs, SD±0.8), we obtained cognitive information and ventricular, hippocampal and normal and abnormal tissue volumes from brain structural magnetic resonance imaging scans (n=700). We studied the brain structure and cognitive abilities of iodine-rich food avoiders/low consumers versus those with a high intake in iodine-rich foods (namely dairy and fish). RESULTS: We identified individuals (n=189) with contrasting diets, i) belonging to the lowest quintiles for dairy and fish consumption, ii) milk avoiders, iii) belonging to the middle quintiles for dairy and fish consumption, and iv) belonging to the middle quintiles for dairy and fish consumption. Iodine intake was secured mostly though the diet (n=10 supplement users) and was sufficient for most (75.1%, median 193 µg/day). In individuals from these groups, brain lateral ventricular volume was positively associated with fat, energy and protein intake. The associations between iodine intake and brain ventricular volume and between consumption of fish products (including fish cakes and fish-containing pasties) and white matter hyperintensities (p=0.03) the latest being compounded by sodium, proteins and saturated fats, disappeared after type 1 error correction. CONCLUSION: In this large Scottish older cohort, the proportion of individuals reporting extreme (low vs. high)/medium iodine consumption is small. In these individuals, low iodine-rich food intake was associated with increased brain volume shrinkage, raising an important hypothesis worth being explored for designing appropriate guidelines.


Assuntos
Encéfalo/patologia , Cognição/fisiologia , Dieta/efeitos adversos , Iodo/deficiência , Idoso , Animais , Estudos de Coortes , Comportamento Exploratório , Feminino , Humanos , Isótopos de Iodo , Masculino
15.
J Nutr Health Aging ; 19(1): 64-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25560818

RESUMO

CONTEXT: Brain Iron Deposits (IDs) are associated with neurodegenerative diseases and impaired cognitive function in later life, but their cause is unknown. Animal studies have found evidence of relationships between dietary iron, calorie and cholesterol intake and brain iron accumulation. OBJECTIVES: To investigate the relationship between iron, calorie, and cholesterol intake, blood indicators of iron status, and brain IDs in humans. DESIGN, SETTING AND PARTICIPANTS: Cohort of 1063 community-dwelling older individuals born in 1936 (mean age 72.7years, SD=0.7) with dietary information, results from blood sample analyses and brain imaging data contemporaneously in old age. MEASUREMENTS: Magnetic Resonance Imaging was used to assess regional volumes of brain IDs in basal ganglia, brainstem, white matter, thalamus, and cortex/border with the corticomedullary junction, using a fully automatic assessment procedure followed by individual checking/correction where necessary. Haemoglobin, red cell count, haematocrit, mean cell volume, ferritin and transferrin were obtained from blood samples and typical daily intake of iron, calories, and cholesterol were calculated from a validated food-frequency questionnaire. RESULTS: Overall, 72.8% of the sample that had valid MRI (n=676) had brain IDs. The median total volume of IDs was 40mm3, inter-quartile range (IQR)=196. Basal ganglia IDs (median=35, IQR=159.5 mm3), were found in 70.6% of the sample. IDs in the brainstem were found in 12.9% of the sample, in the cortex in 1.9%, in the white matter in 6.1% and in the thalamus in 1.0%. The median daily intake of calories was 1808.5kcal (IQR=738.5), of cholesterol was 258.5mg (IQR=126.2) and of total iron was 11.7mg (IQR=5). Iron, calorie or cholesterol intake were not directly associated with brain IDs. However, caloric intake was associated with ferritin, an iron storage protein (p=0.01). CONCLUSION: Our results suggest that overall caloric, iron and cholesterol intake are not associated with IDs in brains of healthy older individuals but caloric intake could be associated with iron storage. Further work is required to corroborate our findings on other samples and investigate the underlying mechanisms of brain iron accumulation.


Assuntos
Encéfalo/metabolismo , Dieta/estatística & dados numéricos , Ferro da Dieta/análise , Ferro da Dieta/metabolismo , Imageamento por Ressonância Magnética , Neuroimagem , Idoso , Envelhecimento/metabolismo , Encéfalo/anatomia & histologia , Colesterol/administração & dosagem , Colesterol/metabolismo , Cognição/fisiologia , Estudos de Coortes , Ingestão de Energia , Contagem de Eritrócitos , Índices de Eritrócitos , Feminino , Ferritinas/sangue , Hematócrito , Hemoglobinas/análise , Humanos , Ferro da Dieta/administração & dosagem , Masculino , Doenças Neurodegenerativas , Inquéritos e Questionários , Transferrina/análise
16.
Proc Biol Sci ; 247(1318): 57-67, 1992 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-1348122

RESUMO

We describe a simple polymerase chain reaction (PGR)-based method for isolating short stretches of nontelomeric DNA adjacent to arrays of telomere repeat units, in principle applicable to any species for which the telomere repeat sequence is known. Application of this approach to human DNA resulted in the isolation of many candidate telomere junction clones, at least some of which were shown to be derived from telomere-adjacent regions. Most of the isolated clones detect multiple sequences in the human genome which represent one or a few sequence families present at the ends of most or all autosomes and variably truncated before the start of the telomere repeat array. Substantial sequence divergence between different members of these sequence families suggests a low rate of sequence homogenization by telomere exchange processes. The pseudoautosomal telomere junction has also been isolated and contains a shortened version of a recently described family of short interspersed repetitive elements (SINEs), only 14 base pairs (b.p.) from the start of the telomere.


Assuntos
DNA/isolamento & purificação , Telômero/fisiologia , Sequência de Bases , Southern Blotting , Clonagem Molecular , DNA/genética , DNA Satélite/genética , Biblioteca Gênica , Humanos , Dados de Sequência Molecular , Oligodesoxirribonucleotídeos , Plasmídeos , Reação em Cadeia da Polimerase/métodos , Sequências Repetitivas de Ácido Nucleico , Mapeamento por Restrição , Homologia de Sequência do Ácido Nucleico , Telômero/ultraestrutura
17.
EXS ; 58: 1-19, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1831152

RESUMO

Since 1985, DNA typing systems have played an increasingly important role in many aspects of human genetics, most notably in forensic and legal medicine. This article reviews the development of multilocus and single locus minisatellite DNA probes, and more recently the use of PCR to amplify hypervariable DNA loci, as well as discussing the biological properties of the unstable regions of DNA which form the basis of almost all DNA fingerprinting systems.


Assuntos
Impressões Digitais de DNA , Sequência de Bases , DNA Satélite , Humanos , Dados de Sequência Molecular , Mutação , Reação em Cadeia da Polimerase
18.
Clin Oncol (R Coll Radiol) ; 11(5): 303-20, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10591819

RESUMO

In 1989, linear accelerator (linac)-based cranial stereotactic radiation therapy ('radiosurgery') was introduced in the UK at St Bartholomew's Hospital; a new, relocatable stereotactic frame was first used at the same time, allowing fractionated stereotactic radiotherapy. In the first decade of clinical practice using this technology, some 200 patients with blood vessel tumours/malformations have been treated, together with another 200 suffering from other conditions. The usefulness of this technique for cerebral arteriovenous malformations (AVM) has been demonstrated, and also a significant cure rate for AVM of >3 cm diameter (which is larger than for those previously reported after treatment on the gamma unit), albeit attended by a higher complication rate. The epilepsy associated with AVM is much improved by successful radiotherapy. The usefulness of radiosurgery for glomus tumours has been confirmed and new data published on the efficacy of the technique for haemangioblastoma, with new radiation therapy strategies designed for patients with von Hippel-Lindau disease. The acoustic neuroma treatment results have included improvements in hearing (a result not reported in the gamma unit literature), which are ascribed to the lower internal dose gradient within the target volume. Fractionation will, it is argued, also lead to sparing of the special sensory cochlear nerve. The risks of radiosurgery to the brainstem for chordoma of the mid-clivus are reduced by using a 'spacer' technique for the prepontine space. For meningiomas involving the cavernous sinus, conventionally fractionated radiotherapy is recommended when the meningeal base diameter exceeds 3.0 cm and radiosurgery (utilizing fractionation where appropriate) is advised for smaller lesions. Thus far, radiosurgery indications for pituitary adenomas have been restricted to recurrences after conventional radiotherapy, usually those in the cavernous sinus. In therapy for recurrent craniopharyngioma, it is argued that fractionation delivered via the relocatable frame will be important, particularly when the disease envelops the optic chiasma. For semicystic/semisolid craniopharyngiomas, the stereotactic delivery of colloidal yttrium-90 into a cystic element is useful, while stereotactic radiosurgery is delivered to the solid component. Staff at this centre consider that radiosurgery for low-grade gliomas, perhaps as boost therapy after conventional fractionation, is worthy of more research. We have been extremely selective in the use of radiosurgery for brain metastases (2% of patients, compared with about 30% in some Gamma Knife units), but future indications may become broader, probably using it as a booster technique after whole-brain conventionally-fractionated radiotherapy. Positron emission tomography scanning, co-registered with magnetic resonance imaging, allows the 'boost' concept in radiosurgery to become a sophisticated and accurate reality. Post-radiosurgical sequelae have been placed within a standard framework classification. New observations are being made with regard to subacute reactions: late-responding intrinsic and extra-axial tumours may swell in the subacute period, prior to shrinkage, and be attended by symptomatic surrounding brain oedema.


Assuntos
Neoplasias Encefálicas/cirurgia , Malformações Arteriovenosas Intracranianas/cirurgia , Radiocirurgia/métodos , Adenoma/cirurgia , Angioma Venoso do Sistema Nervoso Central/cirurgia , Cordoma/cirurgia , Craniofaringioma/cirurgia , Humanos , Meningioma/cirurgia , Neoplasias Hipofisárias/cirurgia , Radiocirurgia/instrumentação , Estudos Retrospectivos , Reino Unido
19.
AJNR Am J Neuroradiol ; 35(1): 55-62, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23811980

RESUMO

BACKGROUND AND PURPOSE: White matter hyperintensities are characteristic of old age and identifiable on FLAIR and T2-weighted MR imaging. They are typically separated into periventricular or deep categories. It is unclear whether the innermost segment of periventricular white matter hyperintensities is truly abnormal or is imaging artifacts. MATERIALS AND METHODS: We used FLAIR MR imaging from 665 community-dwelling subjects 72-73 years of age without dementia. Periventricular white matter hyperintensities were visually allocated into 4 categories: 1) thin white line; 2) thick rim; 3) penetrating toward or confluent with deep white matter hyperintensities; and 4) diffuse ill-defined, labeled as "subtle extended periventricular white matter hyperintensities." We measured the maximum intensity and width of the periventricular white matter hyperintensities, mapped all white matter hyperintensities in 3D, and investigated associations between each category and hypertension, stroke, diabetes, hypercholesterolemia, cardiovascular disease, and total white matter hyperintensity volume. RESULTS: The intensity patterns and morphologic features were different for each periventricular white matter hyperintensity category. Both the widths (r = 0.61, P < .001) and intensities (r = 0.51, P < .001) correlated with total white matter hyperintensity volume and with each other (r = 0.55, P < .001) for all categories with the exception of subtle extended periventricular white matter hyperintensities, largely characterized by evidence of erratic, ill-defined, and fragmented pale white matter hyperintensities (width: r = 0.02, P = .11; intensity: r = 0.02, P = .84). The prevalence of hypertension, hypercholesterolemia, and neuroradiologic evidence of stroke increased from periventricular white matter hyperintensity categories 1 to 3. The mean periventricular white matter hyperintensity width was significantly larger in subjects with hypertension (mean difference = 0.5 mm, P = .029) or evidence of stroke (mean difference = 1 mm, P < .001). 3D mapping revealed that periventricular white matter hyperintensities were discontinuous with deep white matter hyperintensities in all categories, except only in particular regions in brains with category 3. CONCLUSIONS: Periventricular white matter hyperintensity intensity levels, distribution, and association with risk factors and disease suggest that in old age, these are true tissue abnormalities and therefore should not be dismissed as artifacts. Dichotomizing periventricular and deep white matter hyperintensities by continuity from the ventricle edge toward the deep white matter is possible.


Assuntos
Ventrículos Cerebrais/patologia , Imagem de Tensor de Difusão/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Fibras Nervosas Mielinizadas/patologia , Idoso , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
20.
Transl Psychiatry ; 4: e449, 2014 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-25247594

RESUMO

Genetic polymorphisms in the APOE ɛ and TOMM40 '523' poly-T repeat gene loci have been associated with significantly increased risk of Alzheimer's disease. This study investigated the independent effects of these polymorphisms on human cognitive ageing, and the extent to which nominally significant associations with cognitive ageing were mediated by previously reported genetic associations with brain white matter tract integrity in this sample. Most participants in the Lothian Birth Cohort 1936 completed a reasoning-type intelligence test at age 11 years, and detailed cognitive/physical assessments and structural diffusion tensor brain magnetic resonance imaging at a mean age of 72.70 years (s.d.=0.74). Participants were genotyped for APOE ɛ2/ɛ3/ɛ4 status and TOMM40 523 poly-T repeat length. Data were available from 758-814 subjects for cognitive analysis, and 522-543 for mediation analysis with brain imaging data. APOE genotype was significantly associated with performance on several different tests of cognitive ability, including general factors of intelligence, information processing speed and memory (raw P-values all<0.05), independently of childhood IQ and vascular disease history. Formal tests of mediation showed that several significant APOE-cognitive ageing associations--particularly those related to tests of information processing speed--were partially mediated by white matter tract integrity. TOMM40 523 genotype was not associated with cognitive ageing. A range of brain phenotypes are likely to form the anatomical basis for significant associations between APOE genotype and cognitive ageing, including white matter tract microstructural integrity.


Assuntos
Apolipoproteínas E/genética , Transtornos Cognitivos/genética , Poli T/genética , Polimorfismo Genético/genética , Substância Branca/fisiologia , Idoso , Envelhecimento/genética , Envelhecimento/fisiologia , Imagem de Tensor de Difusão , Feminino , Frequência do Gene/genética , Humanos , Masculino , Testes Neuropsicológicos
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