Transcranial Doppler Pulsatility Indices as a Measure of Diffuse Small‐Vessel Disease

Kidwell, Chelsea S.; El‐Saden, Suzie; Livshits, Zhanna; Martin, Neil A.; Glenn, Thomas C.; Saver, Jeffrey L.

doi:10.1111/j.1552-6569.2001.tb00039.x

Cited by 144 publications

(159 citation statements)

References 33 publications

Supporting

Mentioning

143

Contrasting

Unclassified

Order By: Relevance

“…At the initial stages, since these MR signal intensity changes are localized in a very small region associated with cerebral small vessel damage (Inzitari, 2003;Kidwell et al, 2001;Pantoni, 2002;Pugh and Lipsitz, 2002;Schmidt et al, 2002;van Swieten et al, 1991), such minute changes might appear as fluctuations of signal intensity and be difficult to evaluate by conventional methods. Multifractal analysis can provide a good quantitative evaluation of such fluctuations in the signal intensity of the images.…”

Section: Discussionmentioning

confidence: 99%

Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis

et al. 2006

View full text Add to dashboard Cite

Multifractal analysis based on generalized concepts of fractals has been applied to evaluate biological tissues composed of complex structures. This type of analysis can provide a precise quantitative description of a broad range of heterogeneous phenomena. Previously, we applied multifractal analysis to describe heterogeneity in white matter signal fluctuation on T2-weighted MR images as a new method of texture analysis and established Da as the most suitable index for evaluating white matter structural complexity (Takahashi et al. J. Neurol. Sci., 2004; 225: 33À37). Considerable evidence suggests that pathophysiological processes occurring in deep white matter regions may be partly responsible for cognitive deterioration and dementia in elderly subjects. We carried out a multifractal analysis in a group of 36 healthy elderly subjects who showed no evidence of atherosclerotic risk factors to examine the microstructural changes of the deep white matter on T2-weighted MR images. We also performed conventional texture analysis, i.e., determined the standard deviation of signal intensity divided by mean signal intensity (SD/MSI) for comparison with multifractal analysis. Next, we examined the association between the findings of these two types of texture analysis and the ultrasonographically measured intima -media thickness (IMT) of the carotid arteries, a reliable indicator of early carotid atherosclerosis. The severity of carotid IMT was positively associated with Da in the deep white matter region. In addition, this association remained significant after excluding 12 subjects with visually detectable deep white matter hyperintensities on MR images. However, there was no significant association between the severity of carotid IMTand SD/MSI. These results indicate the potential usefulness of applying multifractal analysis to conventional MR images as a new approach to detect the microstructural changes of apparently normal white matter during the early stages of atherosclerosis. D

show abstract

Section: Discussionmentioning

confidence: 99%

Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Our findings suggest that the vasculature of 30 to 40-yearold polysubstance abusers might be compromised, thus putting them at risk for cerebrovascular accidents (Strandgaard, 1993;Jamrozik et al, 2000), small vessel diseases (Lee et al, 2000;Kidwell et al, 2001), and/or cognitive impairments (Anstey and Smith, 1999;Rabbitt and Lowe, 2000). Our study reveals that treatment with methadone can reduce these abnormalities, although this therapeutic approach did not normalize these measures.…”

Section: Discussionmentioning

confidence: 60%

“…Chronic hypertensives (Cho et al, 1997) and diabetic patients (Lee et al, 2000) have been reported to have PI increases, which correspond to means of 0.89 (standard deviation not given) and 0.87+0.22, respectively. Middle cerebral artery PI values were found to be correlated with MRI measures of small vessel diseases characterized by periventricular hyperintensity (PI cutoff point for detection: 1.17), deep white matter hyperintensity (PI cutoff point for detection: 0.96), and lacunar disease (PI cutoff point for detection: 0.96) (Kidwell et al, 2001). When considered with these observations, our findings suggest that the repeated use of heroin and cocaine may contribute to a state of vascular insufficiency with a mean PI value of 0.98 that cannot be completely reversed by methadone.…”

Section: Discussionmentioning

confidence: 96%

Methadone Treatment Induces Attenuation of Cerebrovascular Deficits Associated with the Prolonged Abuse of Cocaine and Heroin

Herning

Better

Tate

et al. 2002

Neuropsychopharmacol

View full text Add to dashboard Cite

Opiate replacement therapy has been useful in reducing heroin use and in keeping patients in treatment programs. However, neuropsychological and neurophysiological effects of this treatment regimen have not been evaluated systematically. To determine whether methadone treatment reduces the magnitude of cerebral blood flow alternations in polysubstance (heroin and cocaine) abusers, we compared blood flow parameters in control subjects (n ¼ 26), polysubstance abusers (n ¼ 28) maintained on methadone for 24 weeks, and polysubstance abusers (n ¼ 22) who were not seeking treatment. Blood flow velocity was recorded from the anterior and middle cerebral arteries using transcranial Doppler sonography on an outpatient visit. The pulsatility index, a measure of cerebrovascular resistance, was significantly (po0.05) increased in both groups of polysubstance abusers compared to control subjects. Increased pulsatility in the two groups of substance abusers suggests constriction of the small cortical arteries. Nevertheless, the methadonemaintained polysubstance abusers had significantly lower pulsatility values than the nontreatment substance-abusing group. These findings suggest that maintenance on methadone might have significant beneficial neurovascular effects on this population of patients.

show abstract

“…Failure to cushion systolic pulsation due to arterial wall stiffening, results in larger amplitude of intracranial blood beating and microvasculature damage [43;44], and consequent endothelial cell shedding, myocyte damage, BBB failure and vessel rupture [45]. In general, accumulating diffuse microangiopathic disease promotes increased vascular resistance [46][47][48] escalating hypertension and impaired venous outflow [43;49].…”

Section: Discussionmentioning

confidence: 99%

P2‐107: Intracranial Atherosclerosis as a contributing factor to Alzheimer's disease Dementia

Kokjohn

Maarouf

Sabbagh

et al. 2009

Alzheimer's & Dementia

View full text Add to dashboard Cite

Background-A substantial body of evidence amassed from epidemiologic, correlative and experimental studies strongly associates atherosclerotic vascular disease (AVD) with Alzheimer's disease (AD). Depending on the precise interrelationship between AVD and AD, systematic application of interventions to maintain vascular health and function as a component of standard AD therapy offers the prospect of mitigating what is presently the inexorable course of dementia. To assess this hypothesis it is vital to rigorously establish the measures of AVD that are most strongly associated with an AD diagnosis.Methods-A precise neuropathological diagnosis was established for all subjects using a battery of genetic, clinical, and histological methods. The severity of atherosclerosis in the circle of Willis (CW) was quantified by direct digitized measurement of arterial occlusion in postmortem specimens and compared between AD and non-demented control (NDC) groups by calculating a corresponding index of occlusion. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptAlzheimers Dement. Author manuscript; available in PMC 2012 July 1. Results-Atherosclerotic occlusion of the CW arteries was more extensive in the AD group than the NDC group. Statistically significant differences were also observed between control and AD groups with regard to Braak stage, total plaque score, total NFT score, total white matter rarefaction score, brain weight, MMSE scores and apolipoprotein E allelic frequencies.Conclusions-Our results, combined with a consideration of the multifaceted impacts of impaired cerebral circulation, suggest an immediate need for prospective clinical trials to assess the efficacy of AD prevention using anti-atherosclerotic agents.

show abstract

Transcranial Doppler Pulsatility Indices as a Measure of Diffuse Small‐Vessel Disease

Abstract: Elevation in PIs as measured by TCD shows strong correlation with MRI evidence of small-vessel disease. TCD may be a useful physiologic index of the presence and severity of diffuse small-vessel disease.

Cited by 144 publications

References 33 publications

Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis

Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis

Methadone Treatment Induces Attenuation of Cerebrovascular Deficits Associated with the Prolonged Abuse of Cocaine and Heroin

P2‐107: Intracranial Atherosclerosis as a contributing factor to Alzheimer's disease Dementia

Contact Info

Product

Resources

About