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Lahna D, Roese N, Woltjer R, Boespflug EL, Schwartz D, Grinstead J, Dodge HH, Wall R, Kaye JA, Rooney WD, Silbert LC. Postmortem 7T MRI for guided histopathology and evaluation of cerebrovascular disease. J Neuropathol Exp Neurol 2022; 82:57-70. [PMID: 36343095 PMCID: PMC9764082 DOI: 10.1093/jnen/nlac103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Postmortem (PM) magnetic resonance imaging (MRI) can serve as a bridge between in vivo imaging and histology by connecting MRI observed macrostructural findings to histological staining and microstructural changes. Data were acquired from 20 formalin-fixed brains including T2, T1, PD, and T2*-weighted images of left hemispheres and 6-mm-thick coronal slices. Tissue slices were bisected, aligned to MR images and used to guide histological sampling. Markers of myelin and oligodendroglia alterations were semiquantitatively rated and compared within white matter hyperintensities (WMHs) and normal-appearing white matter. Tissue priors were created from 3T in vivo data and used to guide segmentation of WMH. PM WMH and hemisphere volumes were compared to volumes derived from in vivo data. PM T2 WMH and T1 hemisphere volumes were correlated with in vivo 3T FLAIR WMH and T1 hemisphere volumes. WMH showed significant myelin loss, decreased GFAP expression and increased vimentin expression. MR-visible perivascular spaces and cortical microvascular lesions were successfully captured on histopathological sections. PM MRI can quantify cerebrovascular disease burden and guide tissue sampling, allowing for more comprehensive characterization of cerebrovascular disease that may be used to study etiologies of age-related cognitive change.
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Affiliation(s)
- David Lahna
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Natalie Roese
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Randy Woltjer
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA
| | - Erin L Boespflug
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Daniel Schwartz
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Hiroko H Dodge
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel Wall
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA
| | - Jeffrey A Kaye
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Lisa C Silbert
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA
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2
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Lahna D, Schwartz DL, Woltjer R, Black SE, Roese N, Dodge H, Boespflug EL, Keith J, Gao F, Ramirez J, Silbert LC. Venous Collagenosis as Pathogenesis of White Matter Hyperintensity. Ann Neurol 2022; 92:992-1000. [PMID: 36054513 PMCID: PMC9671829 DOI: 10.1002/ana.26487] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/05/2022] [Accepted: 08/13/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Periventricular white matter hyperintensities (pvWMHs) are commonly observed on MRI in older individuals and are associated with cognitive and motor decline. The etiology of pvWMH remains unknown. Venous collagenosis has been implicated, which may also interfere with perivascular fluid flow leading to dilation of perivascular spaces (PVS). Here, we examine relationships between in vivo pvWMH volume and ex vivo morphological quantification of collagenosis and the PVS in veins and arteries. METHODS Brain tissue from 25 Oregon Alzheimer's Disease Research Center subjects was selected to cover the full range of WMH burden. Tissue from white matter abutting the ventricle was stained with Masson's trichrome and smooth muscle actin. An automated hue based algorithm identified and segmented vessel into collagenized vessel walls, lumen, and PVS. Multiple linear regressions with pvWMH volume as the dependent variable and either collagen thickness or PVS width were performed with covariates of vessel diameter, age at death, sex, and interval between MRI and death. RESULTS PVS width and collagen thickness were significantly correlated in both arteries (r = 0.21, p = 0.001) and veins (r = 0.23, p = 0.001). Increased venous collagen (p = 0.017) was a significant predictor of higher pvWMH burden while arterial collagen was not (p = 0.128). Neither PVS width in arteries (p = 0.937) nor veins (p = 0.133) predicted pvWMH burden. INTERPRETATION These findings are consistent with a model in which venous collagenosis mediates the relationship between vascular risk factors and pvWMH. This study confirms the importance of changes to the venous system in contributing to MRI white matter lesions commonly observed with advanced age. ANN NEUROL 2022;92:992-1000.
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Affiliation(s)
- David Lahna
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon
| | - Daniel L Schwartz
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon,Advanced Imaging Research Center, OHSUPortlandOregon
| | | | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, LC Campbell Cognitive NeurologySunnybrook Research Institute, University of TorontoTorontoOntario (ON)Canada,Heart & Stroke FoundationCanadian Partnership for Stroke RecoveryTorontoOntarioCanada,Department of Medicine (Neurology)Sunnybrook Health Sciences Centre and University of TorontoOntarioCanada
| | - Natalie Roese
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon
| | - Hiroko Dodge
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon
| | - Erin L Boespflug
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon
| | - Julia Keith
- Department of Anatomic Pathology, Sunnybrook Health Sciences CenterUniversity of TorontoTorontoOntarioCanada
| | - Fuqiang Gao
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, LC Campbell Cognitive NeurologySunnybrook Research Institute, University of TorontoTorontoOntario (ON)Canada,Heart & Stroke FoundationCanadian Partnership for Stroke RecoveryTorontoOntarioCanada
| | - Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Program, LC Campbell Cognitive NeurologySunnybrook Research Institute, University of TorontoTorontoOntario (ON)Canada,Heart & Stroke FoundationCanadian Partnership for Stroke RecoveryTorontoOntarioCanada
| | - Lisa C Silbert
- NIA‐Layton Aging and Alzheimer's Disease Research Center, OHSUPortlandOregon
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Schwartz DL, Boespflug EL, Lahna D, Dodge HH, Roese NE, Baker SL, Woltjer R, Jagust WJ, Kaye J, Silbert LC. The regional and local relationships between amyloid and MRI‐visible perivascular spaces in white matter differ according to amyloid load: An ADNI study. Alzheimers Dement 2020. [DOI: 10.1002/alz.046186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Daniel L Schwartz
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
- Oregon Health & Science University Portland OR USA
| | | | - David Lahna
- Oregon Health & Science University Portland OR USA
| | - Hiroko H Dodge
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | | | | | | | | | - Jeffrey Kaye
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Lisa C Silbert
- Oregon Center for Aging & Technology (ORCATECH) Portland OR USA
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4
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Roese NE, Woltjer R, Lahna D, Schwartz DL, Krajbich V, Boespflug EL, Silbert LC. Astrocyte changes in MRI‐guided immunohistochemistry of white matter hyperintensities in advanced aging. Alzheimers Dement 2020. [DOI: 10.1002/alz.043933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Natalie E. Roese
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Randy Woltjer
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - David Lahna
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Daniel L. Schwartz
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Victoria Krajbich
- Oregon Health & Science University Portland OR USA
- Oregon Health and Science University Portland OR USA
| | - Erin L. Boespflug
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Lisa C. Silbert
- Oregon Health & Science University Portland OR USA
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
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5
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Lahna D, Schwartz DL, Woltjer R, Black SE, Roese NE, Dodge HH, Boespflug EL, Keith J, Gao F, Ramirez J, Silbert LC. Perivascular space dilation in white matter mediates a significant relationship between white matter hyperintensity burden and venous collagenosis. Alzheimers Dement 2020. [DOI: 10.1002/alz.045432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- David Lahna
- Oregon Health & Science University Portland OR USA
| | | | - Randy Woltjer
- NIA‐Layton Aging & Alzheimer's Disease Center Portland OR USA
| | - Sandra E. Black
- L.C.Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre Toronto ON Canada
| | | | | | | | - Julia Keith
- Sunnybrook Health Sciences Centre University of Toronto Toronto ON Canada
| | - Fuqiang Gao
- Sunnybrook Research Institute Toronto ON Canada
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Research Unit Toronto ON Canada
| | - Lisa C. Silbert
- Oregon Center for Aging & Technology (ORCATECH) Portland OR USA
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6
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Piantino J, Boespflug EL, Schwartz DL, Luther M, Morales AM, Lin A, Fossen RV, Silbert L, Nagel BJ. Characterization of MR Imaging-Visible Perivascular Spaces in the White Matter of Healthy Adolescents at 3T. AJNR Am J Neuroradiol 2020; 41:2139-2145. [PMID: 33033050 DOI: 10.3174/ajnr.a6789] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/17/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Perivascular spaces play a role in cerebral waste removal and neuroinflammation. Our aim was to provide data regarding the burden of MR imaging-visible perivascular spaces in white matter in healthy adolescents using an automated segmentation method and to establish relationships between common demographic characteristics and perivascular space burden. MATERIALS AND METHODS One hundred eighteen 12- to 21-year-old subjects underwent T1- and T2-weighted 3T MR imaging as part of the National Consortium on Alcohol and Neurodevelopment in Adolescence. Perivascular spaces were identified in WM on T2-weighted imaging using a local heterogeneity approach coupled with morphologic constraints, and their spatial distribution and geometric characteristics were assessed. RESULTS MR imaging-visible perivascular spaces were identified in all subjects (range, 16-287). Males had a significantly higher number of perivascular spaces than females: males, mean, 98.4 ± 50.5, versus females, 70.7 ± 36.1, (P < .01). Perivascular space burden was bilaterally symmetric (r > 0.4, P < .01), and perivascular spaces were more common in the frontal and parietal lobes than in the temporal and occipital lobes (P < .01). Age and pubertal status were not significantly associated with perivascular space burden. CONCLUSIONS Despite a wide range of burden, perivascular spaces are present in all healthy adolescents. Perivascular space burden is higher in adolescent males than in females, regardless of age and pubertal status. In this population, perivascular spaces are highly symmetric. Although widely reported as a feature of the aging brain, awareness of the presence of perivascular spaces in a cohort of healthy adolescents provides the foundation for further research regarding the role of these structural variants in health and disease.
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Affiliation(s)
- J Piantino
- From the Department of Pediatrics (J.P., M.L.), Division of Child Neurology, Doernbecher Children's Hospital
| | - E L Boespflug
- Department of Neurology (E.L.B., D.L.S., L.S.), Layton Aging and Alzheimer's Disease Center
| | - D L Schwartz
- Department of Neurology (E.L.B., D.L.S., L.S.), Layton Aging and Alzheimer's Disease Center.,Advanced Imaging Research Center (D.L.S.)
| | - M Luther
- From the Department of Pediatrics (J.P., M.L.), Division of Child Neurology, Doernbecher Children's Hospital
| | - A M Morales
- Department of Psychiatry (A.M.M., R.V.F., B.J.N.)
| | - A Lin
- Department of Emergency Medicine (A.L.), Center for Policy and Research in Emergency Medicine
| | - R V Fossen
- Department of Psychiatry (A.M.M., R.V.F., B.J.N.)
| | - L Silbert
- Department of Neurology (E.L.B., D.L.S., L.S.), Layton Aging and Alzheimer's Disease Center.,Department of Neurology (L.S.), Portland Veterans Affairs Medical Center, Portland, Oregon
| | - B J Nagel
- Department of Psychiatry (A.M.M., R.V.F., B.J.N.)
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7
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Boespflug EL, Simon MJ, Leonard E, Grafe M, Woltjer R, Silbert LC, Kaye JA, Iliff JJ. Targeted Assessment of Enlargement of the Perivascular Space in Alzheimer's Disease and Vascular Dementia Subtypes Implicates Astroglial Involvement Specific to Alzheimer's Disease. J Alzheimers Dis 2019; 66:1587-1597. [PMID: 30475760 DOI: 10.3233/jad-180367] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Waste clearance from the brain parenchyma occurs along perivascular pathways. Enlargement of the perivascular space (ePVS) is associated with pathologic features of Alzheimer's disease (AD), although the mechanisms and implications of this dilation are unclear. Fluid exchange along the cerebral vasculature is dependent on the perivascular astrocytic water channel aquaporin-4 (AQP4) and loss of perivascular AQP4 localization is found in AD. We directly measured ePVS in postmortem samples of pathologically characterized tissue from participants who were cognitively intact or had AD or mixed dementia (vascular lesions with AD). We found that both AD and mixed dementia groups had significantly increased ePVS compared to cognitively intact subjects. In addition, we found increased global AQP4 expression of the AD group over both control and mixed dementia groups and a qualitative reduction in perivascular localization of AQP4 in the AD group. Among these cases, increasing ePVS burden was associated with the presence of tau and amyloid-β pathology. These findings are consistent with the existing evidence of ePVS in AD and provide novel information regarding differences in AD and vascular dementia and the potential role of astroglial pathology in ePVS.
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Affiliation(s)
- Erin L Boespflug
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Matthew J Simon
- Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Emmalyn Leonard
- Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Marjorie Grafe
- Pathology Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Randall Woltjer
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA.,Pathology Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Lisa C Silbert
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey A Kaye
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey J Iliff
- Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.,Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
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8
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Schwartz DL, Boespflug EL, Lahna DL, Pollock J, Roese NE, Silbert LC. Autoidentification of perivascular spaces in white matter using clinical field strength T 1 and FLAIR MR imaging. Neuroimage 2019; 202:116126. [PMID: 31461676 PMCID: PMC6819269 DOI: 10.1016/j.neuroimage.2019.116126] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/18/2019] [Accepted: 08/23/2019] [Indexed: 11/18/2022] Open
Abstract
Recent interest in enlarged perivascular spaces (ePVS) in the brain, which can be visualized on MRI and appear isointense to cerebrospinal fluid on all sequence weightings, has resulted in the necessity of reliable algorithms for automated segmentation to allow for whole brain assessment of ePVS burden. However, several publicly available datasets do not contain sequences required for recently published algorithms. This prospective study presents a method for identification of enlarged perivascular spaces (ePVS) in white matter using 3T T1 and FLAIR MR imaging (MAPS-T1), making the algorithm accessible to groups with valuable sets of limited data. The approach was applied identically to two datasets: 1) a repeated measurement in a dementia-free aged human population (N = 14), and 2) an aged sample of multisite ADNI datasets (N = 30). ePVS segmentation was accomplished by a stepwise local homogeneity search of white matter-masked T1-weighted data, constrained by FLAIR hyperintensity, and further constrained by width, volume, and linearity measurements. Pearson's r was employed for statistical testing between visual (gold standard) assessment and repeated measures in cohort one. Visual ePVS counts were significantly correlated with MAPS-T1 (r = .72, P < .0001). Correlations between repeated measurements in cohort one were significant for both visual and automated methods in the single visually-rated slice (MAPS-T1: r = .87, P < .0001, visual: (r = .86, P < .0001) and for whole brain assessment (MAPS-T1: r = .77, P = .001). Results from each cohort were manually inspected and found to have positive predictive values of 77.5% and 87.5%, respectively. The approach described in this report is an important tool for detailed assessment of ePVS burden in white matter on routinely acquired MRI sequences.
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Affiliation(s)
- Daniel L Schwartz
- Oregon Health & Science University, Layton Aging and Alzheimer's Disease Center, Neurology, USA; Oregon Health & Science University, Advanced Imaging Research Center, USA.
| | - Erin L Boespflug
- Oregon Health & Science University, Layton Aging and Alzheimer's Disease Center, Neurology, USA.
| | - David L Lahna
- Oregon Health & Science University, Layton Aging and Alzheimer's Disease Center, Neurology, USA
| | | | - Natalie E Roese
- Oregon Health & Science University, Layton Aging and Alzheimer's Disease Center, Neurology, USA
| | - Lisa C Silbert
- Oregon Health & Science University, Layton Aging and Alzheimer's Disease Center, Neurology, USA; Portland Veterans Affairs Medical Center, Neurology, USA
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Opel RA, Christy A, Boespflug EL, Weymann KB, Case B, Pollock JM, Silbert LC, Lim MM. Effects of traumatic brain injury on sleep and enlarged perivascular spaces. J Cereb Blood Flow Metab 2019; 39:2258-2267. [PMID: 30092696 PMCID: PMC6827121 DOI: 10.1177/0271678x18791632] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clearance of perivascular wastes in the brain may be critical to the pathogenesis of amyloidopathies. Enlarged perivascular spaces (ePVS) on MRI have also been associated with amyloidopathies, suggesting that there may be a mechanistic link between ePVS and impaired clearance. Sleep and traumatic brain injury (TBI) both modulate clearance of amyloid-beta through glymphatic function. Therefore, we sought to evaluate the relationship between sleep, TBI, and ePVS on brain MRI. A retrospective study was performed in individuals with overnight polysomnography and 3T brain MRI consented from a single site (n = 38). Thirteen of these individuals had a medically confirmed history of TBI. ePVS were visually assessed by blinded experimenters and analyzed in conjunction with sleep metrics and TBI status. Overall, individuals with shorter total sleep time had significantly higher ePVS burden. Furthermore, individuals with TBI showed a stronger relationship between sleep and ePVS compared to the non-TBI group. These results support the hypothesis that ePVS may be modulated by sleep and TBI, and may have implications for the role of the glymphatic system in ePVS.
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Affiliation(s)
- Ryan A Opel
- VA Portland Health Care System, Portland, OR, USA
| | - Alison Christy
- Division of Pediatric Neurology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Erin L Boespflug
- Department of Neurology; Layton Aging and Alzheimer's Disease Center; Oregon Health & Science University, Portland, OR, USA
| | - Kristianna B Weymann
- VA Portland Health Care System, Portland, OR, USA.,School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Brendan Case
- Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, USA
| | - Jeffery M Pollock
- Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, USA
| | - Lisa C Silbert
- VA Portland Health Care System, Portland, OR, USA.,Department of Neurology; Layton Aging and Alzheimer's Disease Center; Oregon Health & Science University, Portland, OR, USA
| | - Miranda M Lim
- VA Portland Health Care System, Portland, OR, USA.,Department of Neurology; Department of Behavioral Neuroscience; Department of Medicine; Oregon Institute of Occupational Health Sciences; Oregon Health & Science University, Portland, OR, USA
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Lahna D, Boespflug EL, Woltjer RL, Schwartz D, Black SE, Roese N, Keith J, Gao F, Ramirez J, Silbert LC. P4-348: VENOUS COLLAGENOSIS AS PATHOGENESIS OF WHITE MATTER HYPERINTENSITIES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David Lahna
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
- Oregon Health & Science University; Portland OR USA
| | - Erin L. Boespflug
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
- Oregon Health & Science University; Portland OR USA
| | | | | | | | - Natalie Roese
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
- Oregon Health & Science University; Portland OR USA
| | - Julia Keith
- Sunnybrook Health Sciences Centre; University of Toronto; Toronto ON Canada
| | - Fuqiang Gao
- Sunnybrook Research Institute; Toronto ON Canada
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Research Unit; Sunnybrook Research Institute; Toronto ON Canada
| | - Lisa C. Silbert
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
- Oregon Health & Science University; Portland OR USA
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Boespflug EL, Lahna D, Woltjer RL, Schwartz D, Roese N, Grinstead J, Kaye JA, Rooney WD, Silbert L. P4-514: TRACKING ENLARGED PERIVASCULAR SPACES FROM CLINICAL MRI TO POST-MORTEM MRI GUIDED HISTOPATHOLOGY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Erin L. Boespflug
- Oregon Health & Science University; Portland OR USA
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
| | - David Lahna
- Oregon Health & Science University; Portland OR USA
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
| | | | | | | | | | - Jeffrey A. Kaye
- Oregon Health & Science University; Portland OR USA
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
| | | | - Lisa Silbert
- Oregon Health & Science University; Portland OR USA
- NIA-Layton Aging & Alzheimer's Disease Center; Portland OR USA
- Portland Veterans Affairs Medical Center; Portland OR USA
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12
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Schwartz D, Boespflug EL, Lahna D, Silbert LC. IC‐P‐168: ENLARGED PERIVASCULAR SPACE SEGMENTATION USING ENHANCED MORPHOLOGICAL ASSESSMENT ON SINGLE SEQUENCE MRI. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - David Lahna
- Layton Aging and Alzheimer's Disease CenterPortlandORUSA
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Schwartz D, Boespflug EL, Lahna D, Silbert LC. P3‐381: ENLARGED PERIVASCULAR SPACE SEGMENTATION USING ENHANCED MORPHOLOGICAL ASSESSMENT ON SINGLE SEQUENCE MRI. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Erin L. Boespflug
- Oregon Health & Science UniversityPortlandORUSA
- NIA-Layton Aging & Alzheimer's Disease CenterPortlandORUSA
| | - David Lahna
- NIA-Layton Aging & Alzheimer's Disease CenterPortlandORUSA
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Lahna D, Woltjer R, Grinstead J, Boespflug EL, Schwartz D, Kaye JA, Rooney WD, Silbert LC. IC‐P‐056: POSTMORTEM 7T MRI FOR GUIDED HISTOLOGY AND TISSUE SEGMENTATION. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- David Lahna
- Layton Aging and Alzheimer's Disease CenterPortlandORUSA
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Boespflug EL, Schwartz D, Lahna D, Silbert LC. IC‐P‐060: REGIONAL AND MORPHOLOGICAL CHARACTERISTICS OF ENLARGED PERIVASCULAR SPACES IN RELATIONSHIP TO AMYLOID PET AND CSF Aβ IN ADNI DATASETS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Erin L. Boespflug
- Oregon Health & Science UniversityPortlandORUSA
- NIA-Layton Aging and Alzheimer's Disease CenterPortlandORUSA
| | | | - David Lahna
- NIA-Layton Aging and Alzheimer's Disease CenterPortlandORUSA
| | - Lisa C. Silbert
- NIA-Layton Aging and Alzheimer's Disease CenterPortlandORUSA
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Promjunyakul NO, Dodge HH, Lahna D, Boespflug EL, Kaye JA, Rooney WD, Silbert LC. Baseline NAWM structural integrity and CBF predict periventricular WMH expansion over time. Neurology 2018; 90:e2119-e2126. [PMID: 29769375 DOI: 10.1212/wnl.0000000000005684] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 03/26/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aimed to describe and compare baseline cerebral blood flow (CBF) and microstructural characteristics of normal-appearing white matter (NAWM) within the vulnerable periventricular white matter hyperintensity (PVWMH) penumbra region in predicting white matter hyperintensity (WMH) growth over time. METHODS Fifty-two patients, aged 82.8 years, underwent serial brain MRI, including pulsed arterial spin labeling and diffusion tensor imaging (DTI). New WMH and persistent NAWM voxels in relation to WMH penumbra at follow-up were identified. Mean baseline CBF and DTI variables of the new WMH and persistent NAWM voxels were computed. Univariate analyses with paired t tests were performed. Generalized estimating equation analyses were used to compare the relationships of baseline CBF, and structural penumbras with WMH growth, controlling for confounders. RESULTS Low baseline CBF and fractional anisotropy, and high mean diffusivity (MD), were independently associated with new PVWMH voxels, with MD being the best predictor of WMH growth. A separate model demonstrated that radial diffusivity had the strongest relationship with WMH growth compared with CBF and axial diffusivity. CONCLUSION CBF and DTI measures independently predict WMH growth over time. DTI is a more sensitive predictor of WMH growth than CBF, with WMH progression likely due to demyelinating injury secondary to low perfusion. Findings support the use of MD as a sensitive marker of NAWM vulnerability in future trials aimed at preserving WM integrity.
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Affiliation(s)
- Nutta-On Promjunyakul
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR.
| | - Hiroko H Dodge
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
| | - David Lahna
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
| | - Erin L Boespflug
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
| | - Jeffrey A Kaye
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
| | - William D Rooney
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
| | - Lisa C Silbert
- From the Department of Neurology (N.P., H.H.D., D.L., E.L.B., J.A.K., L.C.S.) and Advanced Imaging Research Center (W.D.R.), Oregon Health & Science University, Portland; Department of Neurology (H.H.D.), University of Michigan, Ann Arbor; and Department of Neurology (J.A.K., L.C.S.), Veterans Affairs Medical Center, Portland, OR
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Boespflug EL, Eliassen JC, Dudley JA, Shidler MD, Kalt W, Summer SS, Stein AL, Stover AN, Krikorian R. Enhanced neural activation with blueberry supplementation in mild cognitive impairment. Nutr Neurosci 2018; 21:297-305. [PMID: 28221821 PMCID: PMC6093614 DOI: 10.1080/1028415x.2017.1287833] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Preclinical studies have shown that blueberry supplementation can improve cognitive performance and neural function in aged animals and have identified associations between anthocyanins and such benefits. Preliminary human trials also suggest cognitive improvement in older adults, although direct evidence of enhancement of brain function has not been demonstrated. In this study, we investigated the effect of blueberry supplementation on regional brain activation in older adults at risk for dementia. METHODS In a randomized, double-blind, placebo-controlled trial we performed pre- and post-intervention functional magnetic resonance imaging during a working memory (WM) task to assess the effect of blueberry supplementation on blood oxygen level-dependent (BOLD) signal in older adults with mild cognitive impairment, a risk condition for dementia. RESULTS Following daily supplementation for 16 weeks, blueberry-treated participants exhibited increased BOLD activation in the left pre-central gyrus, left middle frontal gyrus, and left inferior parietal lobe during WM load conditions (corrected P < 0.01). There was no clear indication of WM enhancement associated with blueberry supplementation. Diet records indicated no between-group difference in anthocyanin consumption external to the intervention. DISCUSSION These data demonstrate, for the first time, enhanced neural response during WM challenge in blueberry-treated older adults with cognitive decline and are consistent with prior trials showing neurocognitive benefit with blueberry supplementation in this at-risk population.
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Affiliation(s)
- Erin L Boespflug
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - James C Eliassen
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - Jonathan A Dudley
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - Marcelle D Shidler
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - Wilhelmina Kalt
- Atlantic Food and Horticultural Research Centre,
Agriculture & Agri-Food Canada, Kentville, Nova Scotia B4N 1J5
| | - Suzanne S Summer
- Clinical Translational Research Center, Cincinnati
Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH
45229
| | - Amanda L Stein
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - Amanda N Stover
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
| | - Robert Krikorian
- Department of Psychiatry & Behavioral Neuroscience,
University of Cincinnati Academic Health Center, Cincinnati, OH 45267-0559
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Boespflug EL, Iliff JJ. The Emerging Relationship Between Interstitial Fluid-Cerebrospinal Fluid Exchange, Amyloid-β, and Sleep. Biol Psychiatry 2018; 83:328-336. [PMID: 29279202 PMCID: PMC5767516 DOI: 10.1016/j.biopsych.2017.11.031] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/28/2022]
Abstract
Amyloid-β (Aβ) plaques are a key histopathological hallmark of Alzheimer's disease (AD), and soluble Aβ species are believed to play an important role in the clinical development of this disease. Emerging biomarker data demonstrate that Aβ plaque deposition begins decades before the onset of clinical symptoms, suggesting that understanding the biological determinants of the earliest steps in the development of AD pathology may provide key opportunities for AD treatment and prevention. Although a clinical association between sleep disruption and AD has long been appreciated, emerging clinical studies and insights from the basic neurosciences have shed important new light on how sleep and Aβ homeostasis may be connected in the setting of AD. Aβ, like many interstitial solutes, is cleared in part through the exchange of brain interstitial fluid and cerebrospinal fluid along a brain-wide network of perivascular pathways recently termed the glymphatic system. Glymphatic function is primarily a feature of the sleeping brain, rather than the waking brain, and is slowed in the aging and posttraumatic brain. These changes may underlie the diurnal fluctuations in interstitial and cerebrospinal fluid Aβ levels observed in both the rodent and the human. These and other emerging studies suggest that age-related sleep disruption may be one key factor that renders the aging brain vulnerable to Aβ deposition and the development of AD. If this is true, sleep may represent a key modifiable risk factor or therapeutic target in the preclinical phases of AD.
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Affiliation(s)
- Erin L Boespflug
- Department of Neurology, Oregon Health & Science University, Portland, Oregon; Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon
| | - Jeffrey J Iliff
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
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Boespflug EL, Schwartz DL, Lahna D, Pollock J, Iliff JJ, Kaye JA, Rooney W, Silbert LC. MR Imaging-based Multimodal Autoidentification of Perivascular Spaces (mMAPS): Automated Morphologic Segmentation of Enlarged Perivascular Spaces at Clinical Field Strength. Radiology 2017; 286:632-642. [PMID: 28853674 DOI: 10.1148/radiol.2017170205] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To describe a fully automated segmentation method that yields object-based morphologic estimates of enlarged perivascular spaces (ePVSs) in clinical-field-strength (3.0-T) magnetic resonance (MR) imaging data. Materials and Methods In this HIPAA-compliant study, MR imaging data were obtained with a 3.0-T MR imager in research participants without dementia (mean age, 85.3 years; range, 70.4-101.2 years) who had given written informed consent. This method is built on (a) relative normalized white matter, ventricular and cortical signal intensities within T1-weighted, fluid-attenuated inversion recovery, T2-weighted, and proton density data and (b) morphologic (width, volume, linearity) characterization of each resultant cluster. Visual rating was performed by three raters, including one neuroradiologist, after established single-section guidelines. Correlations between visual counts and automated counts, as well session-to-session correlation of counts within each participant, were assessed with the Pearson correlation coefficient r. Results There was a significant correlation between counts by visual raters and automated detection of ePVSs in the same section (r = 0.65, P < .001; r = 0.69, P < .001; and r = 0.54, P < .01 for raters 1, 2, and 3, respectively). With regard to visual ratings and whole-brain count consistency, average visual rating scores were highly correlated with automated detection of total burden volume (r = 0.58, P < .01) and total ePVS number (r = 0.76, P < .01). Morphology of clusters across 28 data sets was consistent with published radiographic estimates of ePVS; mean width of clusters segmented was 3.12 mm (range, 1.7-13.5 mm). Conclusion This MR imaging-based method for multimodal autoidentification of perivascular spaces yields individual whole-brain morphologic characterization of ePVS in clinical MR imaging data and is an important tool in the detailed assessment of these features. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Erin L Boespflug
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - Daniel L Schwartz
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - David Lahna
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - Jeffrey Pollock
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - Jeffrey J Iliff
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - Jeffrey A Kaye
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - William Rooney
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
| | - Lisa C Silbert
- From the Department of Neurology (E.L.B., D.L.S., D.L., J.A.K., L.C.S.), Advanced Imaging Research Center (E.L.B., D.L.S., W.R.), Department of Radiology (J.P.), and Department of Anesthesiology and Perioperative Medicine (J.J.I.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098
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Boespflug EL, McNamara RK, Eliassen JC, Schidler MD, Krikorian R. Fish Oil Supplementation Increases Event-Related Posterior Cingulate Activation in Older Adults with Subjective Memory Impairment. J Nutr Health Aging 2016; 20:161-9. [PMID: 26812512 DOI: 10.1007/s12603-015-0609-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the effects of long-chain omega-3 (LCn-3) fatty acids found in fish oil, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on cortical blood oxygen level-dependent (BOLD) activity during a working memory task in older adults with subjective memory impairment. DESIGN Randomized, double-blind, placebo-controlled study. SETTING Academic medical center. PARTICIPANTS Healthy older adults (62-80 years) with subjective memory impairment, but not meeting criteria for mild cognitive impairment or dementia. INTERVENTION Fish oil (EPA+DHA: 2.4 g/d, n=11) or placebo (corn oil, n=10) for 24 weeks. MEASUREMENTS Cortical BOLD response patterns during performance of a sequential letter n-back working memory task were determined at baseline and week 24 by functional magnetic resonance imaging (fMRI). RESULTS At 24 weeks erythrocyte membrane EPA+DHA composition increased significantly from baseline in participants receiving fish oil (+31%, p ≤ 0.0001) but not placebo (-17%, p=0.06). Multivariate modeling of fMRI data identified a significant interaction among treatment, visit, and memory loading in the right cingulate (BA 23/24), and in the right sensorimotor area (BA 3/4). In the fish oil group, BOLD increases at 24 weeks were observed in the right posterior cingulate and left superior frontal regions during memory loading. A region-of-interest analysis indicated that the baseline to endpoint change in posterior cingulate cortex BOLD activity signal was significantly greater in the fish oil group compared with the placebo group during the 1-back (p=0.0003) and 2-back (p=0.0005) conditions. Among all participants, the change in erythrocyte EPA+DHA during the intervention was associated with performance in the 2-back working memory task (p = 0.01), and with cingulate BOLD signal during the 1-back (p = 0.005) with a trend during the 2-back (p = 0.09). Further, cingulate BOLD activity was related to performance in the 2-back condition. CONCLUSION Dietary fish oil supplementation increases red blood cell omega-3 content, working memory performance, and BOLD signal in the posterior cingulate cortex during greater working memory load in older adults with subjective memory impairment suggesting enhanced neuronal response to working memory challenge.
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Affiliation(s)
- E L Boespflug
- Robert Krikorian, PhD, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, PH: 513-558-2455, FX: 513-558-0877, EM:
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Boespflug EL, Eliassen J, Welge J, Krikorian R. Associative learning and regional white matter deficits in mild cognitive impairment. J Alzheimers Dis 2015; 41:421-30. [PMID: 24614901 DOI: 10.3233/jad-131682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While diagnostic criteria for Alzheimer's disease (AD) include neuroimaging biomarkers, there remains no definitive biomarker of mild cognitive impairment (MCI). MCI is a risk factor for AD that may be amenable to early intervention. Early decline in white matter (WM) integrity identified by diffusion tensor imaging (DTI) is a predictor of future progression of neurodegeneration. OBJECTIVE Identify regionally specific WM differences between individuals with MCI and those with age-associated memory impairment (AAMI) and relationships with specific memory decrements. METHODS DTI and neuropsychological data were acquired from 38 participants (23 MCI and 15 AAMI). A region of interest approach was used to evaluate regional differences between groups and correlative relationships with performance on memory tasks. RESULTS Fornix WM had higher mean (MD), radial (DR), and axial (DA) diffusivity in MCI participants relative to AAMI. Temporal stem (TS) WM had higher MD and DR in MCI than in AAMI. In MCI, TS MD and DR varied, while fornix MD and DR was uniformly high, and in AAMI, TS MD and DR were uniformly low and fornix MD and DR varied. In MCI, TS MD and DA were inversely associated with associative learning but not list learning. CONCLUSIONS In addition to supporting prior evidence implicating the fornix in early AD pathology, these data implicate a profile of neurodegeneration associated with early MCI. Further, they suggest that associative learning tasks are more sensitive to early neurodegeneration and may be useful in identifying individuals at risk for AD.
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Affiliation(s)
- Erin L Boespflug
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - James Eliassen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Jeffrey Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, Cincinnati, OH, USA Department of Environmental Health (Division of Epidemiology & Biostatistics), University of Cincinnati Academic Health Center, Cincinnati, OH, USA
| | - Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, Cincinnati, OH, USA
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Krikorian R, Boespflug EL, Dudley JA, Norris MM, Chu WJ, Summer SS, Eliassen JC. Enhanced cerebral bioenergetics with dietary ketosis in Mild Cognitive Impairment. ACTA ACUST UNITED AC 2014. [DOI: 10.3233/nua-140044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Robert Krikorian
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - Erin L. Boespflug
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan A. Dudley
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Matthew M. Norris
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
| | - Wen-Jang Chu
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
| | - Suzanne S. Summer
- Clinical Translational Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - James C. Eliassen
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
- Center for Imaging Research, University of Cincinnati, Cincinnati, OH, USA
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Boespflug EL, Storrs J, Sadat-Hossieny S, Eliassen J, Shidler M, Norris M, Krikorian R. Full diffusion characterization implicates regionally disparate neuropathology in mild cognitive impairment. Brain Struct Funct 2014; 219:367-79. [PMID: 23344962 PMCID: PMC3880601 DOI: 10.1007/s00429-013-0506-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 01/06/2013] [Indexed: 10/27/2022]
Abstract
Diffusion tensor imaging (DTI) is used to detect tissue pathology. In Alzheimer's disease (AD) research, DTI has been used to elucidate differences in disease stages and to track progression over time and clinical severity. Many of these studies have identified the fornix as particularly vulnerable in the early stages of pathology associated with memory decline in prodromal AD. Emerging research suggests principal tensor components, axial (DA) and radial (DR) diffusivity, are more sensitive to underlying tissue pathology than are mean diffusivity (MD) and fractional anisotropy (FA). Given the established regionally specific tissue decline in MCI, we examined components of the full diffusion tensor (MD, FA, DR, and DA) for sensitivity to regional pathology associated with specific memory deficits in 18 individuals with MCI. We investigated multiple regions of interest, including fornix, temporal stem, and control regions for association with severity of impairment on multiple memory measures, including a type of neuropsychological task shown to be particularly sensitive to early memory decline in MCI. Better paired associate learning was selectively associated with lower DA (β = -0.663, p = 0.003), but not with DR, MD, or FA of the temporal stems. Conversely, better paired associate learning was associated with lower DR (β = -0.523, p = 0.026), higher FA (β = 0.498, p = 0.036), and lower MD (β = -0.513, p = 0.030), but not DA in the fornix. No association was found for control regions, or for control cognitive measures. These findings suggest disparate pathology of temporal stems and fornix white matter in association with early memory impairment in MCI. Further, they highlight the methodological importance of evaluating the full tensor, rather than only summative metrics in research using DTI.
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Affiliation(s)
- Erin L. Boespflug
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - Judd Storrs
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - Sara Sadat-Hossieny
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - James Eliassen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - Marcelle Shidler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - Matthew Norris
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
| | - Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center, PO Box 670559, Cincinnati, OH 45267-0559, USA
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Krikorian R, Boespflug EL, Fleck DE, Stein AL, Wightman JD, Shidler MD, Sadat-Hossieny S. Concord grape juice supplementation and neurocognitive function in human aging. J Agric Food Chem 2012; 60:5736-42. [PMID: 22468945 DOI: 10.1021/jf300277g] [Citation(s) in RCA: 140] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Polyphenol compounds found in berry fruits, in particular flavonoids, have been associated with health benefits including improvement in cognition and neuronal function with aging. Concord grape juice contains polyphenols, including anthocyanins and flavanols, and previous research has shown improvement in a number of human health conditions with grape juice supplementation. In the current study, older adult subjects with mild cognitive impairment consumed Concord grape juice or placebo for 16 weeks and were administered assessments of memory function and brain activation pre- and postintervention. Participants who consumed grape juice showed reduced semantic interference on memory tasks. Relatively greater activation in anterior and posterior regions of the right hemisphere was also observed with functional magnetic resonance imaging in the grape juice treated subjects. These findings provide further evidence that Concord grape juice can enhance neurocognitive function in older adults with mild memory decline.
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Affiliation(s)
- Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Academic Health Center , P.O. Box 670559, Cincinnati, Ohio 45267-0559, United States
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Bernstein JA, Hastings L, Boespflug EL, Allendorfer JB, Lamy M, Eliassen JC. Alteration of brain activation patterns in nonallergic rhinitis patients using functional magnetic resonance imaging before and after treatment with intranasal azelastine. Ann Allergy Asthma Immunol 2011; 106:527-32. [PMID: 21624753 DOI: 10.1016/j.anai.2011.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 02/21/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although nonallergic rhinitis (NAR) patients tend to be more sensitive to chemical/olfactory stimuli, a suprathreshold olfactory response or the presence of specific olfactory receptor genes do not explain why their symptoms are triggered by such exposures. OBJECTIVE To investigate differential neurogenic responses to azelastine in NAR patients, using functional magnetic resonance imaging (fMRI) in response to specific olfactory triggers. METHODS A longitudinal study design on 12 subjects with a physician diagnosis of NAR previously demonstrated to be clinically responsive to intranasal azelastine (Astelin) was performed. Subjects underwent fMRI during exposure to unpleasant (hickory smoke) and pleasant (vanilla) odorants while off and then on azelastine for 2 weeks. The olfactory fMRI paradigm consisted of a visually triggered sniff every 21 seconds with synchronized delivery of a 4 second pulse of odorant. Each odorant was presented 18 times over 4-6-minute fMRI runs. Continuous fresh air was presented to wash out each odorant after presentation. RESULTS Nonallergic rhinitis patients exhibited increased blood flow to several regions of the brain in response to both pleasant and unpleasant odorants, specifically in odor-sensitive regions, while off intranasal azelastine. Treatment with intranasal azelastine significantly attenuated blood flow to regions of the brain relevant to either olfactory sensation or sensory processing in response to these odorants compared with fresh air. CONCLUSION The general reduction compared with increase in brain activation in NAR patients on versus off azelastine suggests that a possible effect of this medication may be reduction of brain responses to odorants.
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Affiliation(s)
- Jonathan A Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy Section, University of Cincinnati College of Medicine, Ohio, USA.
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Abstract
Insulin resistance is implicated in the pathophysiological changes associated with Alzheimer's disease, and pharmaceutical treatments that overcome insulin resistance improve memory function in subjects with mild cognitive impairment (MCI) and early Alzheimer's disease. Chromium (Cr) supplementation improves glucose disposal in patients with insulin resistance and diabetes. We sought to assess whether supplementation with Cr might improve memory and neural function in older adults with cognitive decline. In a placebo-controlled, double-blind trial, we randomly assigned 26 older adults to receive either chromium picolinate (CrPic) or placebo for 12 weeks. Memory and depression were assessed prior to treatment initiation and during the final week of treatment. We also performed functional magnetic resonance imaging (fMRI) scans on a subset of subjects. Although learning rate and retention were not enhanced by CrPic supplementation, we observed reduced semantic interference on learning, recall, and recognition memory tasks. In addition, fMRI indicated comparatively increased activation for the CrPic subjects in right thalamic, right temporal, right posterior parietal, and bifrontal regions. These findings suggest that supplementation with CrPic can enhance cognitive inhibitory control and cerebral function in older adults at risk for neurodegeneration.
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Affiliation(s)
- Robert Krikorian
- Department of Psychiatry, University of Cincinnati College of Medicine, PO Box 670559, Cincinnati, Ohio 45267-0559, USA.
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Cook KF, Cella D, Boespflug EL, Amtmann D. Is less more? A preliminary investigation of the number of response categories in self-reported pain. Patient Relat Outcome Meas 2010; 2010:9-18. [PMID: 21709756 PMCID: PMC3121108 DOI: 10.2147/prom.s7584] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to conduct a preliminary investigation of the number of response options for self-reports of pain interference. Responses to interference items of the 11-category Brief Pain Inventory (BPI) were obtained in a sample of 434 persons from two sites and modeled using the partial credit model. In successive calibrations, response categories were collapsed and new scores were generated. Scores based on two to three categories produced poor results. Four to five categories yielded better results. However, scoring using more than five categories did not appreciably improve the reliability, person separation, or validity of scores. These results suggest that fewer response categories—as few as five or six–may function as well as the 11 response categories that are conventionally used. The results are preliminary since the number of response categories actually presented was not manipulated in the study design. Future research should compare the reliability and validity of scores based on the BPI interference items when items are presented with the conventionally 11-response format, versus presentation with fewer response options.
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Affiliation(s)
- Karon F Cook
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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Eliassen JC, Boespflug EL, Lamy M, Allendorfer J, Chu WJ, Szaflarski JP. Brain-mapping techniques for evaluating poststroke recovery and rehabilitation: a review. Top Stroke Rehabil 2008; 15:427-50. [PMID: 19008203 DOI: 10.1310/tsr1505-427] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Brain-mapping techniques have proven to be vital in understanding the molecular, cellular, and functional mechanisms of recovery after stroke. This article briefly summarizes the current molecular and functional concepts of stroke recovery and addresses how various neuroimaging techniques can be used to observe these changes. The authors provide an overview of various techniques including diffusion-tensor imaging (DTI), magnetic resonance spectroscopy (MRS), ligand-based positron emission tomography (PET), single-photon emission computed tomography (SPECT), regional cerebral blood flow (rCBF) and regional metabolic rate of glucose (rCMRglc) PET and SPECT, functional magnetic resonance imaging (fMRI), near infrared spectroscopy (NIRS), electroencephalography (EEG), magnetoencephalography (MEG), and transcranial magnetic stimulation (TMS). Discussion in the context of poststroke recovery research informs about the applications and limitations of the techniques in the area of rehabilitation research. The authors also provide suggestions on using these techniques in tandem to more thoroughly address the outstanding questions in the field.
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Affiliation(s)
- James C Eliassen
- Center for Imaging Research, University of Cincinnati Academic Health Center, Cincinnati, Ohio, USA
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