In Vivo Imaging of Venous Side Cerebral Small-Vessel Disease in Older Adults: An MRI Method at 7T

Shaaban, C. Elizabeth; Aizenstein, Howard J.; Jorgensen, Dana; MacCloud, Rebecca L.; Meckes, Nicole; Erickson, Kirk I.; Glynn, Nancy W.; Mettenburg, Joseph; Guralnik, Jack M.; Newman, Anne B.; Ibrahim, Tamer S.; Laurienti, Paul J.; Vallejo, Abbe N.; Rosano, Caterina

doi:10.3174/ajnr.a5327

Cited by 41 publications

(44 citation statements)

References 43 publications

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“…Second, the deep capillary plexus is aligned along the course of the macular venules and drain into the superficial venules ( 20 ) and has been suggested to be involved in the venous side of circulation ( 21 ). Previous literature using the fundus camera reported on venular widening in patients with WMH ( 22 – 24 ); Ikram et al ( 25 ) showed that larger venular diameters were associated with the progression of WMH, while De Jong et al ( 26 ) reported that venular widening reflects lower arteriolar oxygen saturation and suggested that venular diameter reflects a lower oxygen supply to the brain. Since changes in the DCP were significantly different among the two groups, our results suggest that the DCP reflects the lower oxygen saturation and also indicates the progression of the disease as previously reported.…”

Section: Discussionmentioning

confidence: 99%

Structural and Microvascular Changes in the Macular Are Associated With Severity of White Matter Lesions

Peng

Kwapong

et al. 2020

Front. Neurol.

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Purpose: This study aimed to characterize the microvascular and structural changes in the macular that occur in white matter hyperintensities (WMH) using optical coherence tomographic angiography. We also aimed to explore the association between macular microvascular and structural changes with focal markers of brain tissue on MRI in WMH using the Fazekas scale. Methods: This study enrolled healthy participants who were stroke- and dementia-free. MRI was used to image the cerebral white matter lesions, and Fazekas scale was used to evaluate the severity of the white matter lesions. Optical coherence tomography angiography (OCT-A) was used to image the radial peripapillary capillaries (RPCs), macular capillary plexuses [superficial capillary plexus (SCP) and deep capillary plexus (DCP)] and thickness around the optic nerve head, peripapillary retinal nerve fiber layer (pRNFL). Results: Seventy-four participants were enrolled and divided into two groups according to their Fazekas score (Fazekas scores ≤ 1 and ≥2). Participants with Fazekas score ≥2 showed significantly reduced RPC density ( P = 0.02) and DCP density ( P = 0.012) when compared with participants with Fazekas score ≤ 1. Participants with Fazekas score ≥2 showed reduced pRNFL ( P = 0.004) when compared to participants with Fazekas score ≤ 1. Fazekas scores were significantly associated with the pRNFL thickness (Rho = −0.389, P = 0.001), RPC density (Rho = −0.248, P = 0.035), and DCP density (Rho = −0.283, P = 0.015), respectively. Conclusions: Microvascular impairment and neuro-axonal damage are associated with the disease cascade in WMH. We have shown that RPC and DCP densities are significantly affected, and these impairments are associated with the severity of the disease and cognitive function. OCT-A could be a useful tool in quantifying the retinal capillary densities in WMH.

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Section: Discussionmentioning

confidence: 99%

Structural and Microvascular Changes in the Macular Are Associated With Severity of White Matter Lesions

Peng

Kwapong

et al. 2020

Front. Neurol.

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“…With aging, the ability of the oligodendrocytes to regenerate myelin sheaths decreases [40] . To what degree pallor represents loss of myelin sheaths or loss of myelin secondary to axonal loss remains unresolved [44] . In aged primates, cognitive impairment exacerbated by hypertension is associated with myelin damage and microglial changes within the white matter ( Box 3 ).…”

Section: Neuropathological Changes That Underlie Wmhsmentioning

confidence: 99%

White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities

Alber

Alladi

Bae

et al. 2019

A&D Transl Res & Clin Interv

317

293

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White matter hyperintensities (WMHs) are frequently seen on brain magnetic resonance imaging scans of older people. Usually interpreted clinically as a surrogate for cerebral small vessel disease, WMHs are associated with increased likelihood of cognitive impairment and dementia (including Alzheimer's disease [AD]). WMHs are also seen in cognitively healthy people. In this collaboration of academic, clinical, and pharmaceutical industry perspectives, we identify outstanding questions about WMHs and their relation to cognition, dementia, and AD. What molecular and cellular changes underlie WMHs? What are the neuropathological correlates of WMHs? To what extent are demyelination and inflammation present? Is it helpful to subdivide into periventricular and subcortical WMHs? What do WMHs signify in people diagnosed with AD? What are the risk factors for developing WMHs? What preventive and therapeutic strategies target WMHs? Answering these questions will improve prevention and treatment of WMHs and dementia.

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“…An early cerebral microvascular study observed that arterioles become more tortuous in some of SVD earlier states [80]. The visualization of the venous side of the cerebral microvascular pathology was not possible without contrast; therefore, the alterations of the venules due to small vessel disease were rarely investigated and thus poorly understood [81]. The increase in susceptibility (T2*) at the Ultrahigh field (7 T) MR imaging enables the visualization of venous microcirculation [82, 83].…”

Section: Neuroimaging Of Microvascular Mechanism In Small Vessel Diseasementioning

confidence: 99%

Neuroimaging of Small Vessel Disease in Late-Life Depression

Farhat

Theiss

Santini

et al. 2019

Advances in Experimental Medicine and Biology

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Cerebral small vessel disease is associated with late-life depression, cognitive impairment, executive dysfunction, distress, and loss of life for older adults. Late-life depression is becoming a substantial public health burden, and a considerable number of older adults presenting to primary care have significant clinical depression. Even though white matter hyperintensities are linked with small vessel disease, white matter hyperintensities are nonspecific to small vessel disease and can co-occur with other brain diseases. Advanced neuroimaging techniques at the ultrahigh field magnetic resonance imaging are enabling improved characterization, identification of cerebral small vessel disease and are elucidating some of the mechanisms that associate small vessel disease with late-life depression.

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In Vivo Imaging of Venous Side Cerebral Small-Vessel Disease in Older Adults: An MRI Method at 7T

Cited by 41 publications

References 43 publications

Structural and Microvascular Changes in the Macular Are Associated With Severity of White Matter Lesions

Structural and Microvascular Changes in the Macular Are Associated With Severity of White Matter Lesions

White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities

Neuroimaging of Small Vessel Disease in Late-Life Depression

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