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Decreased diffusivity along the perivascular space and cerebral hemodynamic disturbance in adult moyamoya disease 成人莫亚莫亚病的血管周围空间弥散性降低和脑血流动力学紊乱
Pub Date : 2024-04-04 DOI: 10.1177/0271678x241245492
Shoko Hara, Junko Kikuta, Kaito Takabayashi, Koji Kamagata, Shihori Hayashi, Motoki Inaji, Yoji Tanaka, Masaaki Hori, Kenji Ishii, Tadashi Nariai, Toshiaki Taoka, Shinji Naganawa, Shigeki Aoki, Taketoshi Maehara
Moyamoya disease (MMD) causes cerebral arterial stenosis and hemodynamic disturbance, the latter of which may disrupt glymphatic system activity, the waste clearance system. We evaluated 46 adult patients with MMD and 33 age- and sex-matched controls using diffusivity along the perivascular space (ALPS) measured with diffusion tensor imaging (ALPS index), which may partly reflect glymphatic system activity, and multishell diffusion MRI to generate freewater maps. Twenty-three patients were also evaluated via 15O-gas positron emission tomography (PET), and all patients underwent cognitive tests. Compared to controls, patients (38.4 (13.2) years old, 35 females) had lower ALPS indices in the left and right hemispheres (1.94 (0.27) vs. 1.65 (0.25) and 1.94 (0.22) vs. 1.65 (0.19), P < 0.001). While the right ALPS index showed no correlation, the left ALPS index was correlated with parenchymal freewater ( ρ = −0.47, P < 0.001); perfusion measured with PET (cerebral blood flow, ρ = 0.70, P < 0.001; mean transit time, ρ = −0.60, P = 0.003; and oxygen extraction fraction, ρ = −0.52, P = 0.003); and cognitive tests (trail making test part B for executive function; ρ = −0.37, P = 0.01). Adult patients with MMD may exhibit decreased glymphatic system activity, which is correlated with the degree of hemodynamic disturbance, increased interstitial freewater, and cognitive dysfunction, but further investigation is needed.
莫亚莫亚病(MMD)会导致脑动脉狭窄和血液动力学紊乱,后者可能会破坏废物清除系统--甘油系统的活动。我们利用弥散张量成像(ALPS 指数)测量的沿血管周围空间的弥散性(ALPS)(ALPS 指数可能部分反映了甘油系统的活动)和多壳弥散核磁共振成像(Multishell diffusion MRI)生成自由水图,对 46 名 MMD 成年患者和 33 名年龄和性别匹配的对照组患者进行了评估。此外,还对 23 名患者进行了 15O 气体正电子发射断层扫描(PET)评估,并对所有患者进行了认知测试。与对照组相比,患者(38.4 (13.2)岁,35 位女性)左右半球的 ALPS 指数较低(1.94 (0.27) vs. 1.65 (0.25) 和 1.94 (0.22) vs. 1.65 (0.19),P < 0.001)。虽然右侧 ALPS 指数没有相关性,但左侧 ALPS 指数与实质游离水(ρ = -0.47,P <0.001)、PET 测量的灌注(脑血流,ρ = 0.70,P <0.001;平均转运时间,ρ = -0.60,P = 0.003;氧萃取分数,ρ = -0.52,P = 0.003);以及认知测试(执行功能的线索制作测试 B 部分;ρ = -0.37,P = 0.01)。多发性硬化症成人患者可能表现出甘油系统活动减少,这与血液动力学紊乱程度、间质游离水增加和认知功能障碍有关,但还需要进一步研究。
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引用次数: 0
RNF213 variant and autophagic impairment: A pivotal link to endothelial dysfunction in moyamoya disease RNF213变体和自噬功能障碍:莫亚莫亚病内皮功能障碍的关键环节
Pub Date : 2024-04-04 DOI: 10.1177/0271678x241245557
Hee Sun Shin, Geun Hwa Park, Eun Sil Choi, So Young Park, Da Sol Kim, Jaerak Chang, Ji Man Hong
Moyamoya disease (MMD) is closely associated with the Ring Finger Protein 213 ( RNF213), a susceptibility gene for MMD. However, its biological function remains unclear. We aimed to elucidate the role of RNF213 in the damage incurred by human endothelial cells under oxygen-glucose deprivation (OGD). We analyzed autophagy in peripheral blood mononuclear cells (PBMCs) derived from patients carrying either RNF213 wildtype (WT) or variant (p.R4810K). Subsequently, human umbilical vein endothelial cells (HUVECs) were transfected with RNF213 WT (HUVECWT) or p.R4810K (HUVECR4810K) and exposed to OGD for 2 h. Immunoblotting was used to analyze autophagy marker proteins, and endothelial function was analyzed by tube formation assay. Autophagic vesicles were observed using transmission electron microscopy. Post-OGD exposure, we administered rapamycin and cilostazol as potential autophagy inducers. The RNF213 variant group during post-OGD exposure (vs. pre-OGD) showed autophagy inhibition, increased protein expression of SQSTM1/p62 ( p < 0.0001) and LC3-II ( p = 0.0039), and impaired endothelial function ( p = 0.0252). HUVECR4810K during post-OGD exposure (versus pre-OGD) showed a remarkable increase in autophagic vesicles. Administration of rapamycin and cilostazol notably restored the function of HUVECR4810K and autophagy. Our findings support the pivotal role of autophagy impaired by the RNF213 variant in MMD-induced endothelial cell dysfunction.
莫亚莫亚病(MMD)与环指蛋白 213(RNF213)密切相关,RNF213 是莫亚莫亚病的易感基因。然而,其生物学功能仍不清楚。我们的目的是阐明 RNF213 在氧-葡萄糖剥夺(OGD)条件下对人类内皮细胞造成的损伤中的作用。我们分析了携带 RNF213 野生型(WT)或变异型(p.R4810K)患者的外周血单核细胞(PBMC)的自噬情况。随后,用 RNF213 WT(HUVECWT)或 p.R4810K(HUVECR4810K)转染人脐静脉内皮细胞(HUVECs),并暴露于 OGD 2 小时。使用透射电子显微镜观察自噬囊泡。暴露于OGD后,我们使用雷帕霉素和西洛他唑作为潜在的自噬诱导剂。RNF213 变异组在暴露于 OGD 后(与暴露于 OGD 前相比)表现出自噬抑制、SQSTM1/p62 蛋白表达增加(p < 0.0001)和 LC3-II 蛋白表达增加(p = 0.0039)以及内皮功能受损(p = 0.0252)。在暴露于 OGD 后(与 OGD 前相比),HUVECR4810K 的自噬囊泡显著增加。服用雷帕霉素和西洛他唑可显著恢复 HUVECR4810K 的功能和自噬作用。我们的研究结果表明,RNF213变体损害的自噬在MMD诱导的内皮细胞功能障碍中起着关键作用。
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引用次数: 0
Functional magnetic resonance imaging signal has sub-second temporal accuracy 功能磁共振成像信号具有亚秒级时间精度
Pub Date : 2024-03-21 DOI: 10.1177/0271678x241241136
Yi-Tien Li, Hsin-Ju Lee, Fa-Hsuan Lin
Neuronal activation sequence information is essential for understanding brain functions. Extracting such timing information from blood-oxygenation-level-dependent functional magnetic resonance imaging (fMRI) signals is confounded by local cerebral vascular reactivity (CVR), which varies across brain locations. Thus, detecting neuronal synchrony as well as inferring inter-regional causal modulation using fMRI signals can be biased. Here we used fast fMRI measurements sampled at 10 Hz to measure the fMRI latency difference between visual and sensorimotor areas when participants engaged in a visuomotor task. The regional fMRI timing was calibrated by subtracting the CVR latency measured by a breath-holding task. After CVR calibration, the fMRI signal at the lateral geniculate nucleus (LGN) preceded that at the visual cortex by 496 ms, followed by the fMRI signal at the sensorimotor cortex with a latency of 464 ms. Sequential LGN, visual, and sensorimotor cortex activations were found in each participant after the CVR calibration. These inter-regional fMRI timing differences across and within participants were more closely related to the reaction time after the CVR calibration. Our results suggested the feasibility of mapping brain activity using fMRI with accuracy in hundreds of milliseconds.
神经元激活序列信息对于了解大脑功能至关重要。从依赖于血氧水平的功能性磁共振成像(fMRI)信号中提取这种时间信息会受到局部脑血管反应性(CVR)的干扰,因为CVR在大脑不同位置会有所不同。因此,利用 fMRI 信号检测神经元同步性以及推断区域间因果调制可能会出现偏差。在这里,我们使用以 10 Hz 频率采样的快速 fMRI 测量方法来测量参与者在进行视觉运动任务时视觉区域和感觉运动区域之间的 fMRI 延迟差异。通过减去憋气任务测得的 CVR 延迟,对区域 fMRI 时间进行校准。校准 CVR 后,外侧膝状核(LGN)的 fMRI 信号比视觉皮层的信号早 496 毫秒,其次是感觉运动皮层的 fMRI 信号,延迟时间为 464 毫秒。在 CVR 校准后,每位受试者都发现了 LGN、视觉和感觉运动皮层的连续激活。参与者之间和参与者内部的这些区域间 fMRI 时间差异与 CVR 校准后的反应时间关系更为密切。我们的研究结果表明,使用 fMRI 以数百毫秒的精度绘制大脑活动图是可行的。
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引用次数: 0
Measurement of glucose metabolism in the occipital lobe and frontal cortex after oral administration of [1-13C]glucose at 9.4 T. 在 9.4 T 下口服[1-13C]葡萄糖后测量枕叶和额叶皮层的葡萄糖代谢。
Pub Date : 2022-10-01 Epub Date: 2022-05-27 DOI: 10.1177/0271678X221104540
Theresia Ziegs, Johanna Dorst, Loreen Ruhm, Nikolai Avdievitch, Anke Henning

For the first time, labeling effects after oral intake of [1-13C]glucose are observed in the human brain with pure 1H detection at 9.4 T. Spectral time series were acquired using a short-TE 1H MRS MC-semiLASER (Metabolite Cycling semi Localization by Adiabatic SElective Refocusing) sequence in two voxels of 5.4 mL in the frontal cortex and the occipital lobe. High-quality time-courses of [4-13C]glutamate, [4-13C]glutamine, [3-13C]glutamate + glutamine, [2-13C] glutamate+glutamine and [3-13C]aspartate for individual volunteers and additionally, group-averaged time-courses of labeled and non-labeled brain glucose could be obtained. Using a one-compartment model, mean metabolic rates were calculated for each voxel position: The mean rate of the TCA-cycle (Vtca) value was determined to be 1.36 and 0.93 μmol min-1 g-1, the mean rate of glutamine synthesis (Vgln) was calculated to be 0.23 and 0.45 μmol min-1 g-1, the mean exchange rate between cytosolic amino acids and mitochondrial Krebs cycle intermediates (Vx) rate was found to be 0.57 and 1.21 μmol min-1 g-1 for the occipital lobe and the frontal cortex, respectively. These values were in agreement with previously reported data. Altogether, it can be shown that this most simple technique combining oral administration of [1-13C]Glc with pure 1H MRS acquisition is suitable to measure metabolic rates.

这是首次在 9.4 T 下通过纯 1H 检测观察到人脑在口服 [1-13C]glucose 后的标记效应。使用短程 1H MRS MC-semiLASER(通过绝热选择性重聚焦进行代谢物循环半定位)序列在额叶皮层和枕叶的两个 5.4 mL 的体素中获取了光谱时间序列。该研究获得了志愿者个人的[4-13C]谷氨酸、[4-13C]谷氨酰胺、[3-13C]谷氨酸+谷氨酰胺、[2-13C]谷氨酸+谷氨酰胺和[3-13C]天冬氨酸的高质量时间序列,以及标记和非标记脑葡萄糖的组平均时间序列。利用单室模型,计算出每个体素位置的平均代谢率:TCA循环的平均速率(Vtca)分别为1.36和0.93 μmol min-1 g-1,谷氨酰胺合成的平均速率(Vgln)分别为0.23和0.45 μmol min-1 g-1,细胞膜氨基酸与线粒体克雷布斯循环中间产物之间的平均交换速率(Vx)分别为0.57和1.21 μmol min-1 g-1。这些数值与之前报道的数据一致。总之,可以证明这种结合口服 [1-13C]Glc 和纯 1H MRS 采集的最简单技术适用于测量代谢率。
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引用次数: 0
pH and proton-sensitive receptors in brain ischemia. 脑缺血中的 pH 值和质子敏感受体
Pub Date : 2022-08-01 Epub Date: 2022-03-18 DOI: 10.1177/0271678X221089074
Xiang-Ming Zha, Zhi-Gang Xiong, Roger P Simon

Extracellular proton concentration is at 40 nM when pH is 7.4. In disease conditions such as brain ischemia, proton concentration can reach µM range. To respond to this increase in extracellular proton concentration, the mammalian brain expresses at least three classes of proton receptors. Acid-sensing ion channels (ASICs) are the main neuronal cationic proton receptor. The proton-activated chloride channel (PAC), which is also known as (aka) acid-sensitive outwardly rectifying anion channel (ASOR; TMEM206), mediates acid-induced chloride currents. Besides proton-activated channels, GPR4, GPR65 (aka TDAG8, T-cell death-associated gene 8), and GPR68 (aka OGR1, ovarian cancer G protein-coupled receptor 1) function as proton-sensitive G protein-coupled receptors (GPCRs). Though earlier studies on these GPCRs mainly focus on peripheral cells, we and others have recently provided evidence for their functional importance in brain injury. Specifically, GPR4 shows strong expression in brain endothelium, GPR65 is present in a fraction of microglia, while GPR68 exhibits predominant expression in brain neurons. Here, to get a better view of brain acid signaling and its contribution to ischemic injury, we will review the recent findings regarding the differential contribution of proton-sensitive GPCRs to cerebrovascular function, neuroinflammation, and neuronal injury following acidosis and brain ischemia.

当 pH 值为 7.4 时,细胞外质子浓度为 40 nM。在脑缺血等疾病情况下,质子浓度可达 µM 范围。为了应对细胞外质子浓度的增加,哺乳动物大脑至少会表达三类质子受体。酸感应离子通道(ASIC)是神经元的主要阳离子质子受体。质子激活的氯离子通道(PAC)又称(又名)酸敏感外向整流阴离子通道(ASOR;TMEM206),介导酸诱导的氯离子电流。除了质子激活通道外,GPR4、GPR65(又名 TDAG8,T 细胞死亡相关基因 8)和 GPR68(又名 OGR1,卵巢癌 G 蛋白偶联受体 1)也具有质子敏感性 G 蛋白偶联受体(GPCR)的功能。虽然早期对这些 GPCR 的研究主要集中在外周细胞,但我们和其他人最近提供的证据表明了它们在脑损伤中的重要功能。具体地说,GPR4 在脑内皮细胞中有较强的表达,GPR65 存在于部分小胶质细胞中,而 GPR68 则主要在脑神经元中表达。在此,为了更好地了解脑酸信号转导及其对缺血性损伤的贡献,我们将回顾最近关于质子敏感型 GPCR 在酸中毒和脑缺血后对脑血管功能、神经炎症和神经元损伤的不同贡献的研究结果。
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引用次数: 0
Choroid plexus function in neurological homeostasis and disorders: The awakening of the circadian clocks and orexins. 脉络丛在神经系统稳态和失调中的功能:昼夜节律钟和奥曲肽的唤醒。
Pub Date : 2022-07-01 Epub Date: 2022-03-17 DOI: 10.1177/0271678X221082786
Jennaya Christensen, Crystal Li, Richelle Mychasiuk

As research regarding the role of circadian rhythms, sleep, and the orexinergic system in neurodegenerative diseases is growing, it is surprising that the choroid plexus (CP) remains underappreciated in this realm. Despite its extensive role in the regulation of circadian rhythms and orexinergic signalling, as well as acting as the primary conduit between cerebrospinal fluid (CSF) and the circulatory system, providing a mechanism by which toxic waste molecules can be removed from the brain, the CP has been largely unexplored in neurodegeneration. In this review, we explore the role of the CP in maintaining brain homeostasis and circadian rhythms, regulating CSF dynamics, and how these functions change across the lifespan, from development to senescence. In addition, we examine the relationship between the CP, orexinergic signalling, and the glymphatic system, highlighting gaps in the literature and areas that require immediate exploration. Finally, we assess current knowledge, including possible therapeutic strategies, regarding the role of the CP in neurological disorders, such as traumatic brain injury, migraine, Alzheimer's disease, and multiple sclerosis.

随着有关昼夜节律、睡眠和奥曲肽能系统在神经退行性疾病中的作用的研究日益增多,令人惊讶的是,脉络丛(CP)在这一领域仍未得到足够重视。尽管脉络丛在调节昼夜节律和奥曲肽能信号传导方面发挥着广泛的作用,并且是脑脊液(CSF)和循环系统之间的主要通道,提供了一种将有毒废物分子排出大脑的机制,但脉络丛在神经退行性疾病中的作用在很大程度上仍未得到研究。在这篇综述中,我们探讨了脑脊髓膜促性腺激素在维持大脑稳态和昼夜节律、调节脑脊髓膜促性腺激素动态方面的作用,以及这些功能在从发育到衰老的整个生命周期中是如何变化的。此外,我们还研究了脑脊髓膜促肾上腺皮质激素、矿氨酸能信号传导和肾上腺系统之间的关系,强调了文献中的空白和需要立即探索的领域。最后,我们评估了目前有关脑损伤、偏头痛、阿尔茨海默病和多发性硬化症等神经系统疾病中 CP 作用的知识,包括可能的治疗策略。
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引用次数: 0
An intravascular perspective on hyper-acute neutrophil, T-cell and platelet responses: Similarities between human and experimental stroke 超急性中性粒细胞,t细胞和血小板反应的血管内视角:人类和实验中风的相似性
Pub Date : 2022-06-08 DOI: 10.1177/0271678X221105764
G. Stoll, Michael K. Schuhmann, B. Nieswandt, Alexander M. Kollikowski, M. Pham
In stroke patients, local sampling of pial blood within the occluded vasculature before recanalization by mechanical thrombectomy emerged as powerful tool enabling insights into ultra-early stroke pathophysiology. Thereby, a strong intravascular inflammatory response hallmarked by hyper-acute neutrophil recruitment, altered lymphocyte composition and platelet activation could be observed. These human findings mirror experimental stroke. Here, neutrophil and T-cell activation are driven by platelets involving engagement of platelet glycoprotein receptor (GP)Ib, GPVI and CD84 as well as α-granule release orchestrating infarct progression. Thus, targeting of early intravascular inflammation may evolve as a new therapeutic strategy to augment the effects of recanalization.
在脑卒中患者中,在机械取栓再通之前,在闭塞的血管内局部取样头部血液,成为了解超早期脑卒中病理生理学的有力工具。因此,可以观察到以超急性中性粒细胞募集、淋巴细胞组成改变和血小板活化为特征的强烈血管内炎症反应。这些人类发现反映了实验性中风。在这里,中性粒细胞和t细胞的活化是由血小板驱动的,涉及血小板糖蛋白受体(GP)Ib、GPVI和CD84以及α-颗粒释放协调梗死进展。因此,靶向早期血管内炎症可能会成为一种新的治疗策略,以增强再通的效果。
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引用次数: 4
Post-mortem correlates of Virchow-Robin spaces detected on in vivo MRI 活体MRI检测到的Virchow-Robin空间的死后相关性
Pub Date : 2022-05-17 DOI: 10.1177/0271678X211067455
L. Haider, S. Hametner, Verena Endmayr, S. Mangesius, Andrea Eppensteiner, J. Frischer, J. E. Iglesias, F. Barkhof, G. Kasprian
The purpose of our study is to quantify the extent to which Virchow-Robin spaces (VRS) detected on in vivo MRI are reproducible by post-mortem MRI. Double Echo Steady State 3T MRIs were acquired post-mortem in 49 double- and 32 single-hemispheric formalin-fixed brain sections from 12 patients, who underwent conventional diagnostic 1.5 or 3T MRI in median 22 days prior to death (25% to 75%: 12 to 134 days). The overlap of in vivo and post-mortem VRS segmentations was determined accounting for potential confounding factors. The reproducibility of VRS found on in vivo MRI by post-mortem MRI, in the supratentorial white matter was in median 80% (25% to 75%: 60 to 100). A lower reproducibility was present in the basal ganglia, with a median of 47% (25% to 75%: 30 to 50). VRS segmentations were histologically confirmed in one double hemispheric section. Overall, the majority of VRS found on in vivo MRI was stable throughout death and formalin fixation, emphasizing the translational potential of post-mortem VRS studies.
我们研究的目的是量化在体内MRI上检测到的Virchow-Robin空间(VRS)在死后MRI上可重现的程度。12例患者在死亡前中位22天(25% ~ 75%:12 ~ 134天)接受常规1.5或3T MRI诊断,在死后对49个双半球和32个单半球福尔马林固定脑切片进行双回声稳态3T MRI扫描。考虑到潜在的混杂因素,确定了体内和死后VRS片段的重叠。通过死后MRI在体内MRI上发现的VRS在幕上白质中的再现性中位数为80%(25%至75%:60至100)。基底节区重现性较低,中位数为47%(25% ~ 75%:30 ~ 50)。一个双半球切片的VRS分节在组织学上得到证实。总体而言,在体内MRI上发现的大多数VRS在死亡和福尔马林固定期间是稳定的,强调了死后VRS研究的转化潜力。
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引用次数: 4
Validation, kinetic modeling, and test-retest reproducibility of [18F]SynVesT-1 for PET imaging of synaptic vesicle glycoprotein 2A in mice [18F]SynVesT-1用于小鼠突触囊泡糖蛋白2A PET成像的验证、动力学建模和重测再现性
Pub Date : 2022-05-14 DOI: 10.1177/0271678X221101648
Daniele Bertoglio, Franziska Zajicek, Stef De Lombaerde, A. Miranda, S. Stroobants, Yuchuan Wang, C. Dominguez, I. Muñoz-Sanjuán, J. Bard, Longbin Liu, J. Verhaeghe, S. Staelens
Alterations in synaptic vesicle glycoprotein 2 A (SV2A) have been associated with several neuropsychiatric and neurodegenerative disorders. Therefore, SV2A positron emission tomography (PET) imaging may provide a unique tool to investigate synaptic density dynamics during disease progression and after therapeutic intervention. This study aims to extensively characterize the novel radioligand [18F]SynVesT-1 for preclinical applications. In C57Bl/6J mice (n = 39), we assessed the plasma profile of [18F]SynVesT-1, validated the use of a noninvasive image-derived input function (IDIF) compared to an arterial input function (AIF), performed a blocking study with levetiracetam (50 and 200 mg/kg, i.p.) to verify the specificity towards SV2A, examined kinetic models for volume of distribution (VT) quantification, and explored test-retest reproducibility of [18F]SynVesT-1 in the central nervous system (CNS). Plasma availability of [18F]SynVesT-1 decreased rapidly (13.4 ± 1.5% at 30 min post-injection). VT based on AIF and IDIF showed excellent agreement (r2 = 0.95, p < 0.0001) and could be reliably estimated with a 60-min acquisition. The blocking study resulted in a complete blockade with no suitable reference region. Test-retest analysis indicated good reproducibility (mean absolute variability <10%). In conclusion, [18F]SynVesT-1 is selective for SV2A with optimal kinetics representing a candidate tool to quantify CNS synaptic density non-invasively.
突触囊泡糖蛋白2a (SV2A)的改变与几种神经精神和神经退行性疾病有关。因此,SV2A正电子发射断层扫描(PET)成像可以提供一种独特的工具来研究疾病进展期间和治疗干预后的突触密度动态。本研究旨在广泛表征新型放射配体[18F]SynVesT-1的临床前应用。在C57Bl/6J小鼠(n = 39)中,我们评估了[18F]SynVesT-1的血浆谱,验证了非侵入性图像输入功能(IDIF)与动脉输入功能(AIF)的使用,进行了左乙曲坦(50和200 mg/kg, i.p)的阻断研究,以验证对SV2A的特异性,检查了体积分布(VT)量化的动力学模型,并探讨了[18F]SynVesT-1在中枢神经系统(CNS)中的重复性。[18F]SynVesT-1的血浆利用率在注射后30分钟迅速下降(13.4±1.5%)。基于AIF和IDIF的VT显示出极好的一致性(r2 = 0.95, p < 0.0001),并且可以通过60分钟的采集可靠地估计。阻断研究的结果是完全阻断,没有合适的参考区域。重测分析表明重复性好(平均绝对变异性<10%)。总之,[18F]SynVesT-1对SV2A具有选择性,具有最佳动力学,是一种非侵入性量化CNS突触密度的候选工具。
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引用次数: 6
Increased interictal synchronicity of respiratory related brain pulsations in epilepsy 癫痫患者呼吸相关脑搏动间期同步性增高
Pub Date : 2022-05-14 DOI: 10.1177/0271678X221099703
Janne Kananen, Matti Järvelä, V. Korhonen, Timo Tuovinen, N. Huotari, L. Raitamaa, H. Helakari, T. Väyrynen, V. Raatikainen, M. Nedergaard, H. Ansakorpi, J. Jacobs, P. LeVan, V. Kiviniemi
Respiratory brain pulsations have recently been shown to drive electrophysiological brain activity in patients with epilepsy. Furthermore, functional neuroimaging indicates that respiratory brain pulsations have increased variability and amplitude in patients with epilepsy compared to healthy individuals. To determine whether the respiratory drive is altered in epilepsy, we compared respiratory brain pulsation synchronicity between healthy controls and patients. Whole brain fast functional magnetic resonance imaging was performed on 40 medicated patients with focal epilepsy, 20 drug-naïve patients and 102 healthy controls. Cerebrospinal fluid associated respiratory pulsations were used to generate individual whole brain respiratory synchronization maps, which were compared between groups. Finally, we analyzed the seizure frequency effect and diagnostic accuracy of the respiratory synchronization defect in epilepsy. Respiratory brain pulsations related to the verified fourth ventricle pulsations were significantly more synchronous in patients in frontal, periventricular and mid-temporal regions, while the seizure frequency correlated positively with synchronicity. The respiratory brain synchronicity had a good diagnostic accuracy (ROCAUC = 0.75) in discriminating controls from medicated patients. The elevated respiratory brain synchronicity in focal epilepsy suggests altered physiological effect of cerebrospinal fluid pulsations possibly linked to regional brain water dynamics involved with interictal brain physiology.
呼吸性脑搏动最近被证明可以驱动癫痫患者的脑电生理活动。此外,功能性神经影像学显示,与健康个体相比,癫痫患者的呼吸性脑脉动变异性和幅度增加。为了确定呼吸驱动是否在癫痫中改变,我们比较了健康对照组和患者的呼吸性脑脉冲同步性。对40例局灶性癫痫患者、20例drug-naïve患者和102例健康对照进行全脑快速功能磁共振成像。脑脊液相关的呼吸脉动被用来生成个体全脑呼吸同步图,并在组间进行比较。最后,我们分析了癫痫呼吸同步性缺陷的发作频率效应和诊断准确性。与已证实的第四脑室脉动相关的呼吸性脑脉动在患者额叶区、脑室周围区和颞中区具有明显的同步性,而癫痫发作频率与同步性呈正相关。呼吸脑同步性在区分对照组和用药患者方面具有较好的诊断准确性(ROCAUC = 0.75)。局灶性癫痫患者呼吸性脑同步性升高提示脑脊液脉动的生理作用改变,可能与涉及间歇期脑生理的区域脑水动力学有关。
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引用次数: 4
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Journal of Cerebral Blood Flow & Metabolism
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