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Impaired cerebrovascular reactivity is associated with recurrent stroke in patients with severe intracranial arterial stenosis: A C02 BOLD fMRI study. J Neuroradiol 2021; 48:339-345. [DOI: 10.1016/j.neurad.2020.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 11/20/2022]
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Vagné V, Le Bars E, Deverdun J, Rossel O, Perrey S, Costalat V, Guiraud D. Quantitative assessment of near-infrared spectroscopy time course under hypercapnia using an a priori model-based fitting. Comput Biol Med 2020; 118:103638. [PMID: 32174314 DOI: 10.1016/j.compbiomed.2020.103638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Partial arterial pressure of carbon dioxide (CO2) modulates cerebral blood flow through a vasoreactivity mechanism. Near infrared spectroscopy (NIRS) can be used to record these changes in cerebral hemodynamics. However, no laterality comparison of the NIRS signal has been performed despite being a prerequisite for the use of such a method in a vasoreactivity monitoring context. We propose to investigate the NIRS signal laterality in response to a CO2-inhalation-based hypercapnia paradigm in healthy volunteers. METHODS Eleven healthy volunteers (6 women, 5 men, mean age: 31 ± 11) underwent a 3-block-design inhalation paradigm: normoxia (5min, "baseline") - hypercapnia (2min, "stimulation") - normoxia (5min, "post-stimulation"). NIRS signal was measured using a two-channel oximeter (INVOS 5100C, Medtronic, USA) with sensors placed symmetrically on both left and right sides on each subject's forehead. Additional heart rate (HR) monitoring was performed simultaneously. Based on the NIRS mean signal pattern, an a priori model of parametric identification was applied for each channel to quantify parameters of interest (amplitude, time delay, excitation and post-stimulation time) for each inhalation block. RESULTS HR increased significantly during the stimulation block. The quality of the model was satisfactory: mean absolute errors between modeled and experimental signals were lower than the resolution of the device. No significant lateralization was found between left and right values of most of the parameters. CONCLUSION Due to the lack of lateralization, this parametric identification of NIRS responses to hypercapnia could bring light to a potential asymmetry and be used as a biomarker in patients with cerebrovascular diseases.
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Affiliation(s)
- Victor Vagné
- ARNGDC, Association de Recherche en Neuroimagerie de Gui De Chauliac, CHU Montpellier, Montpellier, France.
| | - Emmanuelle Le Bars
- Departement de Neuroradiologie, CHU Montpellier, Montpellier, France; I2FH, Institut d'Imagerie Fonctionnelle Humaine, CHU Montpellier, Montpellier, France
| | - Jérémy Deverdun
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, CHU Montpellier, Montpellier, France
| | - Olivier Rossel
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, CHU Montpellier, Montpellier, France
| | - Stéphane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mine Alès, Montpellier, France
| | - Vincent Costalat
- Departement de Neuroradiologie, CHU Montpellier, Montpellier, France
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Xiao ZP, Jin K, Wan JQ, Lin Y, Pan YH, Jin YC, Zhang XH. Measurement of cerebrovascular reserve by multimodal imaging for cerebral arterial occlusion or stenosis patients: protocol of a prospective, randomized, controlled clinical study. Trials 2020; 21:49. [PMID: 31915058 PMCID: PMC6950822 DOI: 10.1186/s13063-019-3967-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/06/2019] [Indexed: 12/01/2022] Open
Abstract
Background Cerebrovascular reactivity (CVR) is the change in cerebral blood flow in response to a vaso-active stimulus, and may assist the treatment strategy of ischemic stroke. However, previous studies reported that a therapeutic strategy for stroke mainly depends on the degree of vascular stenosis with steady-state vascular parameters (e.g., cerebral blood flow and CVR). Hence, measurement of CVR by multimodal imaging techniques may improve the treatment of ischemic stroke. Methods/design This is a prospective, randomized, controlled clinical trial that aimed to examine the capability of multimodal imaging techniques for the evaluation of CVR to improve treatment of patients with ischemic stroke. A total of 66 eligible patients will be recruited from Renji Hospital, Shanghai Jiaotong University School of Medicine. The patients will be categorized based on CVR into two subgroups as follows: CVR > 10% group and CVR < 10% group. The patients will be randomly assigned to medical management, percutaneous transluminal angioplasty and stenting, and intracranial and extra-cranial bypass groups in a 1:1:1 ratio. The primary endpoint is all adverse events and ipsilateral stroke recurrence at 6, 12, and 24 months after management. The secondary outcomes include the CVR, the National Institute of Health stroke scale and the Modified Rankin Scale at 6, 12, and 24 months. Discussion Measurement of cerebrovascular reserve by multimodal image is recommended by most recent studies to guide the treatment of ischemic stroke, and thus its efficacy and evaluation accuracy need to be established in randomized controlled settings. This prospective, parallel, randomized, controlled registry study, together with other ongoing studies, should present more evidence for optimal individualized accurate treatment of ischemic stroke. Trial registration Chinese Clinical Trial Registry, ID: ChiCTR-IOR-16009635; Registered on 16 October 2016. All items are from the World Health Organization Trial Registration Data Set and registration in the Chinese Clinical Trial Registry: ChiCTR-IOR-16009635.
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Affiliation(s)
- Zhi-Peng Xiao
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Ke Jin
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Jie-Qing Wan
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Yong Lin
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Yao-Hua Pan
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Yi-Chao Jin
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China
| | - Xiao-Hua Zhang
- Department of Neurosurgery, Renji Hospital, School of Medicine of Shanghai JiaoTong University, Shanghai, 200127, People's Republic of China.
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Qureshi AI, Saleem MA, Naseem N, Wallery SS. A New Technique for the Assessment of Cerebral Vasodilatory Capacity as Part of Catheter-Based Cerebral Angiography. J Stroke Cerebrovasc Dis 2018; 27:1822-1827. [PMID: 29571761 DOI: 10.1016/j.jstrokecerebrovasdis.2018.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 02/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated the value of cerebral vasodilatory capacity assessment for risk stratification in patients with extracranial arterial stenosis or occlusion. We describe a new method that assesses cerebral vasodilatory capacity as part of catheter-based cerebral angiography. METHODS We assessed regional cerebral blood volume (rCBV) in the arterial distribution of interest using a controlled contrast injection through a diagnostic catheter placed in the common carotid or the subclavian artery. rCBV maps were created using predefined algorithm based on contrast distribution in the venous phase (voxel size 0.466 mm3) into high, intermediate, low, and no detectable rCBV regions. rCBV maps were acquired again after the administration of intra-arterial nicardipine (1.5-2.5 mg), and percentage increases of the area of various grades of rCBV were calculated. RESULTS Three patients with internal carotid artery stenosis (32% - 64% in severity) and 1 patient with extracranial vertebral artery stenosis (46% in severity) were assessed. There was a variable but consistent increase in the area of high rCBV in the ipsilateral hemisphere in 3 patients with internal carotid artery flow (5.5%-24.5%) and the cerebellum (9.6%) in 1 patient with vertebral artery flow assessments. The increase in high rCBV was most prominent in the patient who received 2.5 mg (24.5%) and least prominent in a patient who received 1.5 mg (5.5%) of intra-arterial nicardipine. There was a concurrent reduction in areas of intermediate and low rCBV (shift) in 3 patients, and there was an increase in all areas of rCBV grades (addition) in 1 patient. CONCLUSIONS Selective assessment of cerebral vasodilatory response in the affected arterial distribution is feasible during catheter-based cerebral angiography.
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Affiliation(s)
- Adnan I Qureshi
- Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota; University of Illinois and Mercyhealth, Rockford, Illinois
| | - Muhammad A Saleem
- Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota; Mercyhealth, Janesville, Wisconsin.
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Berberat J, Montali M, Gruber P, Pircher A, Hlavica M, Wang F, Killer HP, Remonda L. Modulation of the Emotional Response to Viewing Strabismic Children in Mothers-Measured by fMRI. Clin Neuroradiol 2017; 29:87-94. [PMID: 28913609 DOI: 10.1007/s00062-017-0625-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 08/28/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Strabismus influences not only the individual with nonparallel eyes but also the observer. It has previously been demonstrated by fMRI that adults viewing images of strabismic adults have a negative reaction to the images as demonstrated by limbic activation, especially activation of the left amygdala. The aim of this study was to see if mothers would have a similar reaction to viewing strabismic children and whether or not that reaction would be different in mothers of strabismic children. METHODS Healthy mothers of children with strabismus (n = 10, Group I) and without strabismus (n = 15, Group II) voluntarily underwent fMRI at 3T. Blood oxygen level dependent signal responses to viewing images of strabismic and non-strabismic children were analyzed. RESULTS Group II, while viewing images of strabismic children, showed significantly increased activation of the limbic network (p < 0.05) and bilateral amygdala activation. Group I showed considerably less limbic activation, compared to the group II, and had no amygdala activation. Both groups revealed statically significant activation in the FEF (frontal eye field) when they were viewing images of strabismic children as compared to when they were viewing children with parallel eyes. The activated FEF area for Group II was much larger than for group I. CONCLUSION Mothers of non-strabismic children showed similar negative emotional fMRI patterns as adults did while viewing strabismic adults. Strabismus is an interpersonal organic issue for the observer, which also impacts the youngest members of our society.
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Affiliation(s)
- J Berberat
- Neuroradiology, Cantonal Hospital, Tellstrasse 25, 5001, Aarau, Switzerland.
| | - M Montali
- Neuroradiology, Cantonal Hospital, Tellstrasse 25, 5001, Aarau, Switzerland
| | - P Gruber
- Neuroradiology, Cantonal Hospital, Tellstrasse 25, 5001, Aarau, Switzerland
| | - A Pircher
- Ophthalmology, Cantonal Hospital, Aarau, Switzerland
| | - M Hlavica
- Neuroradiology, Cantonal Hospital, Tellstrasse 25, 5001, Aarau, Switzerland
| | - F Wang
- Department of Ophthalmology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Ophthalmology, New York Eye and Ear Infirmary of Mt. Sinai, New York, NY, USA
| | - H P Killer
- Ophthalmology, Cantonal Hospital, Aarau, Switzerland
| | - L Remonda
- Neuroradiology, Cantonal Hospital, Tellstrasse 25, 5001, Aarau, Switzerland
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Dargazanli C, Mantilla D, Wiesspeiner U, Ayrignac X, Costalat V. Intracranial stenting after the Wingspan withdrawal in France: Clinical experience using a low profile coronary stent. J Neuroradiol 2017; 44:165-167. [PMID: 28168991 DOI: 10.1016/j.neurad.2016.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/11/2016] [Accepted: 12/21/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Cyril Dargazanli
- Department of neuroradiology, Montpellier university hospital center, Gui-de-Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
| | - Daniel Mantilla
- Department of neuroradiology, Montpellier university hospital center, Gui-de-Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Department of neuroradiology, Clinica Foscal, Fundacion Oftalmologica de Santander, Clinica Ardila Lulle, Bucaramanga, Colombia
| | - Ulrike Wiesspeiner
- Department of neuroradiology, Montpellier university hospital center, Gui-de-Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Department of radiology, division of neuroradiology, Medical university of Graz, Graz, Austria
| | - Xavier Ayrignac
- Department of neurology, Montpellier university hospital center, Gui-de-Chauliac hospital, 34295 Montpellier, France
| | - Vincent Costalat
- Department of neuroradiology, Montpellier university hospital center, Gui-de-Chauliac hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
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Pavilla A, Arrigo A, Colombani S, Mejdoubi M. Absolute and regional cerebral perfusion assessment feasibility in head-down position with arterial spin-labeling magnetic resonance. A preliminary report on healthy subjects. J Neuroradiol 2016; 43:392-397. [DOI: 10.1016/j.neurad.2016.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/21/2015] [Accepted: 03/05/2016] [Indexed: 10/21/2022]
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Ding J, Wang X. Intra- and extracranial atherosclerotic disease: casting a new light on emerging trends. Neurol Res 2016; 38:937-41. [PMID: 27367590 DOI: 10.1080/01616412.2016.1196871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Intra- and extracranial atherosclerotic stenosis has been shown to be associated with an increased risk of secondary stroke mortality. Advances in invasive and non-invasive imaging modalities have improved analysis of hemodynamic changes and allowed better delineation of the integrity of intracranial collateralization and plague morphology in patients with artery stenosis. This review focuses on new imaging modalities and clinical applications of currently available techniques, and provides significant insight into future directions in comprehensive analysis of intra- and extracranial atherosclerotic stenosis.
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Affiliation(s)
- Jing Ding
- a Department of Neurology , Zhongshan Hospital, Fudan University , Shanghai , China
| | - Xin Wang
- a Department of Neurology , Zhongshan Hospital, Fudan University , Shanghai , China.,b Institute of Brain Science State Key Laboratory of Medical Neurobiology , Shanghai , China
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