Global and regional putamen volume loss in patients with heart failure

Abstract

AimsHeart failure (HF) is accompanied by diminished cognitive, motor, learning, emotional, and planning deficits, which are associated with increased morbidity and mortality. A basal ganglia structure, the putamen, serves many functions that are affected in HF, but its global or localized structural integrity is unknown. Our aim was to evaluate global and regional putamen volume differences in HF over control subjects. Methods and resultsWe collected two high-resolution T1-weighted scans from 16 HF patients (age, 54.1 + 8.3 years; 12 males; left ventricular ejection fraction, 27.8 + 6.8%) and 32 control subjects (52.4 + 7.3 years; 24 males) using a 3.0 T magnetic resonance imaging scanner. After realigning, averaging, and reorienting the T1-weighted volumes into a common space, the structures were manually outlined, tracings were normalized for head size, volumes calculated, and surface models generated. Demographic data were compared between groups with x 2 and independent samples t-tests, global putamen volumes were evaluated using independent samples t-tests, and regional differences were examined with surface morphometry. No significant differences in age or sex appeared between groups, but body mass index differed significantly (P ¼ 0.008). Heart failure patients showed significantly lower left (controls vs. HF; 4842.1 + 740.0 vs. 4224.1 + 894.4 mm 3 , P ¼ 0.014) and right (4769.3 + 651.9 vs. 4193.7 + 876.2 mm 3 , P ¼ 0.014) global putamen volumes than controls, with localized reductions in bilateral rostral, mid-dorsal, and medial-caudal regions (left, P , 0.003; right, P , 0.0002). ConclusionPutamen structures showed global and localized volume reductions in HF over controls. The localized volume losses suggest deficits in motor and neuropsychological functions, which are evident in HF subjects, and may be due to hypoxic and ischaemic processes targeting these areas.--

Clinical imaging in regenerative medicine

“…In a cell therapy for Parkinson’s disease, transplantation of only ~138,000 fetal neural cells showed efficacy, increasing dopamine release from 25% to 62% of normal levels 19 . However, replacement or regeneration of an anatomical region, such as the putamen, may require ~7 × 10 6 cells 20, 21 .…”

Affective Brain Areas and Sleep-Disordered Breathing

“…More precise morphometry analyses have been used for subcortical structures, and include manual tracing of high resolution T1-weighted images, incorporating those tracings into mathematical maps that can be averaged across healthy subjects, and statistical comparisons of surface maps with the patient groups (Narr et al 2004; Thompson, Schwartz & Toga 1996). We have used such procedures for hippocampal surface mapping (Macey et al 2009; Harper et al 2012) and basal ganglia structures (Kumar et al 2009a; Kumar et al 2011b). Other procedures involve simple manual measurements to assess volumes of small structures, such as the mammillary bodies and fornix fibers (Kumar et al 2008a; Kumar et al 2009b; Kumar et al 2009e).…”

“…HF, OSA, and CCHS are all accompanied by insular and cingulate cortex and hippocampal injury, principal structures involved in mediating dyspnea, although the precise subregions vary with condition (Macey et al 2012b; Kumar et al 2012a; Kumar et al 2011c; Kumar et al 2011b; Kumar et al 2011a; Kumar et al 2010; Woo et al 2009; Macey et al 2009; Kumar et al 2009c; Macey et al 2008; Kumar et al 2006; Kumar et al 2005; Woo et al 2003; Macey et al 2002; Kumar et al 2008a; Kumar et al 2008b). Damage in those areas apparently contributes to enhancing or inhibiting that sensation.…”

Foundational Concepts for Cardiac Neuromodulation

“…Peripheral neural networks for cardiac control include intrinsic cardiac and extracardiac-intrathoracic (e.g., stellate and middle cervical) ganglia. These ganglia contain all the necessary neural machinery for reflex control of the heart (afferent, efferent and local circuit interneurons for information processing) [2].Centrally located neural networks involved in cardiac control include elements of the spinal cord, brainstem and higher centers up to and including the insular cortex [7][8][9]. These top-down contributions to control involve projections from preganglionic soma located in the brainstem (parasympathetic) and spinal cord (sympathetic) toward the heart with both regions (nucleus Ambiguus and intermediolateral cell column) impacted by interconnections with brainstem (e.g., nucleus tractus solitaries) and higher centers (e.g., hypothalamus, limbic system).…”