Imaging in sepsis-associated encephalopathy—insights and opportunities

Stubbs, Daniel; Yamamoto, Adam Kenji; Menon, David

doi:10.1038/nrneurol.2013.177

Cited by 81 publications

(73 citation statements)

References 100 publications

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“…The high coefficient of variation is at least partially driven by the single female subject included in the study (Subject #3), which had the highest SERT‐ir axon density values of all subjects in all four nuclei (Figure ). No previous studies have examined sex differences in serotonergic innervation, so it is unclear whether the high serotonergic density of this subject is associated with sex differences, or whether another variable such as sepsis as a cause of death, which is associated with neuropathological changes including neurotransmitter imbalance (Stubbs, Yamamoto, & Menon, ), may be implicated.…”

Section: Discussionmentioning

confidence: 95%

Serotonergic innervation of the human amygdala and evolutionary implications

Lew

Hanson

Groeniger

et al. 2019

American J Phys Anthropol

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Objectives: The serotonergic system is involved in the regulation of socio-emotional behavior and heavily innervates the amygdala, a key structure of social brain circuitry.We quantified serotonergic axon density of the four major nuclei of the amygdala in humans, and examined our results in light of previously published data sets in chimpanzees and bonobos.Materials and methods: Formalin-fixed postmortem tissue sections of the amygdala from six humans were stained for serotonin transporter (SERT) utilizing immunohistochemistry. SERT-immunoreactive (ir) axon fiber density in the lateral, basal, accessory basal, and central nuclei of the amygdala was quantified using unbiased stereology.Nonparametric statistical analyses were employed to examine differences in SERT-ir axon density between amygdaloid nuclei within humans, as well as differences between humans and previously published data in chimpanzees and bonobos.Results: Humans displayed a unique pattern of serotonergic innervation of the amygdala, and SERT-ir axon density was significantly greater in the central nucleus compared to the lateral nucleus. SERT-ir axon density was significantly greater in humans compared to chimpanzees in the basal, accessory basal, and central nuclei. SERT-ir axon density was greater in humans compared to bonobos in the accessory basal and central nuclei. Conclusions:The human pattern of SERT-ir axon distribution in the amygdala complements the redistribution of neurons in the amygdala in human evolution. The present findings suggest that differential serotonergic modulation of cognitive and autonomic pathways in the amygdala in humans, bonobos, and chimpanzees may contribute to species-level differences in social behavior. K E Y W O R D Samygdala, brain evolution, serotonin, social behavior

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Section: Discussionmentioning

confidence: 95%

Serotonergic innervation of the human amygdala and evolutionary implications

Lew

Hanson

Groeniger

et al. 2019

American J Phys Anthropol

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“…When severe, it can lead to stupor and coma [46,[49][50][51]. Magnetic resonance imaging (MRI) and computerized tomography (CT) have shown that SAE manifests as extracranial abnormalities and neurological disease-like changes [52]. In addition, MRI has revealed diverse brain injuries, ischemic lesion, and white matter hyperintensities in the paraventricular or paramedian regions [53].…”

Section: Sepsis-associated Encephalopathymentioning

confidence: 99%

Inflammasome and Cognitive Symptoms in Human Diseases: Biological Evidence from Experimental Research

Cheon

Kim

et al. 2020

IJMS

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Cognitive symptoms are prevalent in the elderly and are associated with an elevated risk of developing dementia. Disease-driven changes can cause cognitive disabilities in memory, attention, and language. The inflammasome is an innate immune intracellular complex that has a critical role in the host defense system, in that it senses infectious pathogen-associated and endogenous danger-associated molecular patterns. An unbalanced or dysregulated inflammasome is associated with infectious, inflammatory, and neurodegenerative diseases. Due to its importance in such pathological conditions, the inflammasome is an emerging drug target for human diseases. A growing number of studies have revealed links between cognitive symptoms and the inflammasome. Several studies have shown that reducing the inflammasome component mitigates cognitive symptoms in diseased states. Therefore, understanding the inflammasome regulatory mechanisms may be required for the prevention and treatment of cognitive symptoms. The purpose of this review is to discuss the current understanding of the inflammasome and its relationships with cognitive symptoms in various human diseases.

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“…These imaging modalities include contrast-based perfusion computed tomography (CT), positron emission tomography (PET), single-photon emission CT (SPECT), xenon-based perfusion CT, and perfusion-weighted magnetic resonance imaging (MRI). 32,43,78 Newer blood oxygen level dependent– and arterial spin labeling–based functional MRI techniques have been utilized to study CBF and perfusion abnormalities in sepsis. 79 Provocative techniques such as inducing hypercarbia or administering acetazolamide can be used in conjunction with MRI, PET, and xenon or standard perfusion CT scanning.…”

Section: Cbf Autoregulationmentioning

confidence: 99%

Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care

Goodson

Rosenblatt

Rivera‐Lara

et al. 2016

J Intensive Care Med

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Cerebral blood flow (CBF) autoregulation maintains consistent blood flow across a range of blood pressures (BPs). Sepsis is a common cause of systemic hypotension and cerebral dysfunction. Guidelines for BP management in sepsis are based on historical concepts of CBF autoregulation that have now evolved with the availability of more precise technology for its measurement. In this article, we provide a narrative review of methods of monitoring CBF autoregulation, the cerebral effects of sepsis, and the current knowledge of CBF autoregulation in sepsis. Current guidelines for BP management in sepsis are based on a goal of maintaining mean arterial pressure (MAP) above the lower limit of CBF autoregulation. Bedside tools are now available to monitor CBF autoregulation continuously. These data reveal that individual BP goals determined from CBF autoregulation monitoring are more variable than previously expected. In patients undergoing cardiac surgery with cardiopulmonary bypass, for example, the lower limit of autoregulation varied between a MAP of 40 to 90 mm Hg. Studies of CBF autoregulation in sepsis suggest patients frequently manifest impaired CBF autoregulation, possibly a result of BP below the lower limit of autoregulation, particularly in early sepsis or with sepsis-associated encephalopathy. This suggests that the present consensus guidelines for BP management in sepsis may expose some patients to both cerebral hypoperfusion and cerebral hyperperfusion, potentially resulting in damage to brain parenchyma. The future use of novel techniques to study and clinically monitor CBF autoregulation could provide insight into the cerebral pathophysiology of sepsis and offer more precise treatments that may improve functional and cognitive outcomes for survivors of sepsis.

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Imaging in sepsis-associated encephalopathy—insights and opportunities

Cited by 81 publications

References 100 publications

Serotonergic innervation of the human amygdala and evolutionary implications

Serotonergic innervation of the human amygdala and evolutionary implications

Inflammasome and Cognitive Symptoms in Human Diseases: Biological Evidence from Experimental Research

Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care

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