Neuro-co-Cardiological Diseases and Aging Population: Frontiers in pathology, diagnostic methods and treatment targets

Editors

Shuo Wang

Beijing Tiantan Hospital, Capital Medical University

Zhao Jizong

Beijing Tiantan Hospital, Capital Medical University

Hiroyuki Kinouchi

University of Yamanashi

Xiaolin Chen

Capital Medical University

Jun Wu

Beijing Tiantan Hospital, Capital Medical University

Impact

Certain vascular risk factors underlie the pathological mechanisms of VaMCI.

Review

15 March 2023

Multimodality neuroimaging in vascular mild cognitive impairment: A narrative review of current evidence

Qiuping Liu

and

Xuezhu Zhang

The vascular mild cognitive impairment (VaMCI) is generally accepted as the premonition stage of vascular dementia (VaD). However, most studies are focused mainly on VaD as a diagnosis in patients, thus neglecting the VaMCI stage. VaMCI stage, though, is easily diagnosed by vascular injuries and represents a high-risk period for the future decline of patients’ cognitive functions. The existing studies in China and abroad have found that magnetic resonance imaging technology can provide imaging markers related to the occurrence and development of VaMCI, which is an important tool for detecting the changes in microstructure and function of VaMCI patients. Nevertheless, most of the existing studies evaluate the information of a single modal image. Due to the different imaging principles, the data provided by a single modal image are limited. In contrast, multi-modal magnetic resonance imaging research can provide multiple comprehensive data such as tissue anatomy and function. Here, a narrative review of published articles on multimodality neuroimaging in VaMCI diagnosis was conducted，and the utilization of certain neuroimaging bio-markers in clinical applications was narrated. These markers include evaluation of vascular dysfunction before tissue damages and quantification of the extent of network connectivity disruption. We further provide recommendations for early detection, progress, prompt treatment response of VaMCI, as well as optimization of the personalized treatment plan.

3,798 views

2 citations

The survival analysis for the factors related to postoperative bleeding. (A) The survival analysis of SMT/non-SMT for PB. (B) The survival analysis of surgical methods for PB. (C) The survival analysis of different aneurysm sizes for PB. (D) The survival analysis of bifurcation/sidewall for PB. PB, postoperative bleeding; SMT, standard methylprednisolone treatment; FD, flow diverter.

Original Research

18 April 2023

Methylprednisolone is related to lower incidence of postoperative bleeding after flow diverter treatment for unruptured intracranial aneurysm

Linggen Dong

, 8 more and

Ming Lv

1,462 views

0 citations

Subgroup analysis for the impact of ePWV on the SLI. The dots and lines indicate the estimates of the odds ratios of SLI for ePWV and the corresponding 95% confidence intervals, respectively. The multivariate logistic model adjusted for age, sex, smoking, DM, CAOD, hyperlipidemia, statin medication, fasting glucose and eGFR, except for the variable that is stratified. None of the stratified variables significantly modified the impact of ePWV on the risk of SLI (all P for interaction > 0.05). CAOD, coronary artery occlusive disease; DM, diabetes mellitus; ePWV, estimated pulse wave velocity; eGFR, estimated glomerular filtration rate; SLI, silent lacunar infarct.

Original Research

25 January 2023

Association between estimated pulse wave velocity and silent lacunar infarct in a Korean population

Yaping Zhou

, 2 more and

Xiuli Shang

Aims: Previous studies have proposed the estimated pulse wave velocity (ePWV) as a simple and cost-effective measure of arterial stiffness. Since arterial stiffness plays a role in the progression of silent lacunar infarct (SLI), our present work aims to evaluate the association between ePWV and the presence of SLI.

Methods: The present work was based on a cross-section study. Our study included 1,011 neurologically healthy Korean participants. The SLI was evaluated using brain magnetic resonance images (MRI). The ePWV was derived from a published equation using age and mean blood pressure (MBP). Logistic regression analyses were performed to investigate the association between ePWV and SLI. The linear relationship and robustness were evaluated using smooth curve fitting and subgroup analyses, respectively.

Results: The prevalence of SLI was 11.87%. After fully adjusting for covariates, per 1 m/s increase of ePWV casted 31% additional risk for SLI (P = 0.009). When dividing the ePWV into quartiles, the top quartile had 4.01 times risk compared with the bottom quartile. The increasing trend across the quartiles was statistically significant (P for trend < 0.001). Consistently, smooth curve fitting revealed that the risk of SLI elevated linearly with the increase of ePWV. Finally, subgroup analysis suggested that the association was robust in several sub-populations divided by age, sex, smoking, hypertension, diabetes mellitus (DM), coronary artery occlusive disease (CAOD), hyperlipidemia, and statin medication (all P for interaction > 0.05).

Conclusion: The current study revealed an independent and positive association between ePWV and the presence of SLI in a neurologically healthy Korean population.

2,120 views

3 citations

Original Research

04 January 2023

Relationships between cerebral small vessel diseases markers and cognitive performance in stroke-free patients with atrial fibrillation

Wendan Tao

, 6 more and

Ming Liu

Background: Atrial fibrillation (AF) is related to an increased risk of cognitive dysfunction. Besides clinically overt stroke, AF can damage the brain via several pathophysiological mechanisms. We aimed to assess the potential mediating role of cerebral small vessel disease (SVD) and cognitive performance in individuals with AF.

Methods: Stroke-free individuals with AF from the cardiological outpatient clinic at West China Hospital of Sichuan University were recruited. Extensive neuropsychological testing tools were assessed including global function, domains of attention, executive functions, learning, and memory. 3 T magnetic resonance imaging (MRI) was used for SVD markers assessment of white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVS). The correlation between SVD markers and cognitive measures was analyzed by multivariate linear regression models.

Results: We finally enrolled 158 participants, of whom 95 (60.1%) were males. In multivariate models, the presence of lacunes independently associated with Montreal Cognitive Assessment (Model 1: ß = 0.52, Model 2: ß = 0.55), Rey Auditory Verbal Learning Test-immediate and delayed recall (Model 1: ß = 0.49; ß = 0.69; Model 2: ß = 0.53; ß = 0.73) as well as Stroop-A_correct (Model 1: ß = 0.12; Model 2: ß = 0.13), while total WMH severity independently associated with Stroop_time-A (Model 1: ß = 0.24; Model 3: ß = 0.27), Stroop_time-B (Model 1: ß = 0.17; Model 3: ß = 0.17), Stroop_time-C (Model 1: ß = 0.22; Model 3: ß = 0.21) and Shape Trail Test-A (Model 1: ß = 0.17; Model 3: ß = 0.16).

Conclusion: In our cohort of stroke-free individuals with AF, lacunes, and WMHs were independently associated with cognitive decline while EPVS and CMBs did not show significance. Assessment of SVD MRI markers might be valuable for cognition risk stratification and facilitate optimal management of patients with AF.

2,246 views

7 citations