Physiological instability is linked to mortality in primary central nervous system lymphoma: A case–control <scp>fMRI</scp> study

Poltojainen, Valter; Kemppainen, Janette; Keinänen, Nina; Bode, Michaela K.; Isokangas, Juha-Matti; Kuitunen, Hanne; Nikkinen, Juha; Sonkajärvi, Eila; Korhonen, Vesa; Tuovinen, Timo; Järvelä, Matti; Huotari, Niko; Raitamaa, Lauri; Kananen, Janne; Korhonen, Tommi; Tetri, Sami; Kuittinen, Outi; Kiviniemi, Vesa

doi:10.1002/hbm.25901

Cited by 6 publications

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“…Regarding the connection between obesity and brain diseases, MREG scans have identified abnormal brain pulsations and variations in AD, demonstrating significant clinical relevance [ 18 , 19 ]. Moreover, early alterations in physiological brain pulsations show potential as predictive biomarkers for disease progression, notably in primary CNS lymphoma, where early pre-treatment MREG scans have been capable of predicting treatment outcomes [ 20 ]. In narcolepsy, cardiac and respiratory pulse variance decreases, while VLF increases compared to controls [ 21 ].…”

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confidence: 99%

Association of body-mass index with physiological brain pulsations across adulthood – a fast fMRI study

Raitamaa,

Kautto,

Tuunanen

et al. 2024

Int J Obes

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Background/objective Obesity is a risk factor for several brain-related health issues, and high body-mass index (BMI) is associated with an increased risk for several neurological conditions, including cognitive decline and dementia. Cardiovascular, respiratory, and vasomotor brain pulsations have each been shown to drive intracranial cerebrovascular fluid (CSF) flow, which is linked to the brain metabolite efflux that sustains homeostasis. While these three physiological pulsations are demonstrably altered in numerous brain diseases, there is no previous investigation of the association between physiological brain pulsations and BMI. Subjects/methods We measured the amplitudes of the physiological brain pulsations using amplitude of low frequency fluctation (ALFF) based method with resting-state functional magnetic resonance imaging via high temporal resolution whole-brain magnetic resonance encephalography (MREG) in 115 healthy subjects. We next undertook multiple linear regression to model the BMI effect voxel-wise whole-brain on very low frequency (VLF), respiration, cardiovascular, and respiratory induced modulation of cardiovascular pulsation amplitudes with age, pulse pressure, and gender as nuisance variables. Results In our study population, BMI was positively associated with the amplitudes of vasomotor, respiratory, and respiratory induced modulations of cardiovascular pulsations (p < 0.05), while negatively associated with the amplitudes of cardiovascular pulsations (p < 0.05). Conclusions The findings suggest that BMI is a significant factor in alterations of cardiovascular pulsation of neurofluids. As physiological pulsations are the drivers of CSF flow and subsequent metabolite clearance, these results emphasize the need for further research into the mechanisms through which obesity affects brain clearance.

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Section: Introductionmentioning

confidence: 99%

Association of body-mass index with physiological brain pulsations across adulthood – a fast fMRI study

Raitamaa,

Kautto,

Tuunanen

et al. 2024

Int J Obes

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Physiological instability is linked to mortality in primary central nervous system lymphoma: A case–control fMRI study

Poltojainen

Kemppainen

Keinänen

et al. 2022

Human Brain Mapping

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Primary central nervous system lymphoma (PCNSL) is an aggressive brain disease where lymphocytes invade along perivascular spaces of arteries and veins. The invasion markedly changes (peri)vascular structures but its effect on physiological brain pulsations has not been previously studied. Using physiological magnetic resonance encephalography (MREG BOLD ) scanning, this study aims to quantify the extent to which (peri)vascular PCNSL involvement alters the stability of physiological brain pulsations mediated by cerebral vasculature. Clinical implications and relevance were explored. In this study, 21 PCNSL patients (median 67y; 38% females) and 30 healthy age‐matched controls (median 63y; 73% females) were scanned for MREG BOLD signal during 2018–2021. Motion effects were removed. Voxel‐by‐voxel Coefficient of Variation (CV) maps of MREG BOLD signal was calculated to examine the stability of physiological brain pulsations. Group‐level differences in CV were examined using nonparametric covariate‐adjusted tests. Subject‐level CV alterations were examined against control population Z‐score maps wherein clusters of increased CV values were detected. Spatial distributions of clusters and findings from routine clinical neuroimaging were compared [contrast‐enhanced, diffusion‐weighted, fluid‐attenuated inversion recovery (FLAIR) data]. Whole‐brain mean CV was linked to short‐term mortality with 100% sensitivity and 100% specificity, as all deceased patients revealed higher values ( n = 5, median 0.055) than surviving patients ( n = 16, median 0.028) ( p < .0001). After adjusting for medication, head motion, and age, patients revealed higher CV values (group median 0.035) than healthy controls (group median 0.024) around arterial territories ( p ≤ .001). Abnormal clusters (median 1.10 × 10 5 mm 3 ) extended spatially beyond FLAIR lesions (median 0.62 × 10 5 mm 3 ) with differences in volumes ( p = .0055).

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Respiratory brain impulse propagation in focal epilepsy

Elabasy

Suhonen

Rajna

et al. 2023

Sci Rep

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Respiratory brain pulsations pertaining to intra-axial hydrodynamic solute transport are markedly altered in focal epilepsy. We used optical flow analysis of ultra-fast functional magnetic resonance imaging (fMRI) data to investigate the velocity characteristics of respiratory brain impulse propagation in patients with focal epilepsy treated with antiseizure medication (ASM) (medicated patients with focal epilepsy; ME, n = 23), drug-naïve patients with at least one seizure (DN, n = 19) and matched healthy control subjects (HC, n = 75). We detected in the two patient groups (ME and DN) several significant alterations in the respiratory brain pulsation propagation velocity, which showed a bidirectional change dominated by a reduction in speed. Furthermore, the respiratory impulses moved more in reversed or incoherent directions in both patient groups vs. the HC group. The speed reductions and directionality changes occurred in specific phases of the respiratory cycle. In conclusion, irrespective of medication status, both patient groups showed incoherent and slower respiratory brain impulses, which may contribute to epileptic brain pathology by hindering brain hydrodynamics.

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Physiological instability is linked to mortality in primary central nervous system lymphoma: A case–control fMRI study

Cited by 6 publications

References 50 publications

Association of body-mass index with physiological brain pulsations across adulthood – a fast fMRI study

Association of body-mass index with physiological brain pulsations across adulthood – a fast fMRI study

Physiological instability is linked to mortality in primary central nervous system lymphoma: A case–control fMRI study

Respiratory brain impulse propagation in focal epilepsy

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