Cerebral circulation - cognition and behavior最新文献

{"title":"Advantages and challenges of using arterial spin labelling MRI to monitor cerebral blood flow in multi-centre clinical trials of neurodegenerative disease: Comment","authors":"Hinpetch Daungsupawong , Viroj Wiwanitkit","doi":"10.1016/j.cccb.2025.100382","DOIUrl":"10.1016/j.cccb.2025.100382","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"8 ","pages":"Article 100382"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling the contributions of cerebrovascular-related white matter integrity markers to cognitive aging","authors":"Elmira Agah ,&nbsp;Sarah T. Farias ,&nbsp;David K. Johnson ,&nbsp;Charles DeCarli ,&nbsp;Pauline Maillard","doi":"10.1016/j.cccb.2025.100395","DOIUrl":"10.1016/j.cccb.2025.100395","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the independent and joint associations of five markers of white matter integrity, including white matter hyperintensities (WMH), extracellular free water (FW), fractional anisotropy (FA), peak width of skeletonized mean diffusivity (PSMD), and Diffusion tensor image analysis along the perivascular space index (ALPS) on cognitive performance and its trajectory in cognitively diverse individuals.</div></div><div><h3>Methods</h3><div>574 participants from the University of California, Davis Alzheimer’s Disease Research Center (UCD ADRC) longitudinal cohort, aged 77 ± 7 years received yearly comprehensive clinical evaluations and a baseline MRI exam. Baseline MRI measures, including WMH, FW, FA, PSMD, and ALPS, were computed for each individual and used as independent variables to explain baseline and change in episodic memory (EM) and executive function (EF) using linear regression with stepwise adjustment. Bayesian Model Averaging (BMA) was then applied to derive robust estimates of each marker’s contribution to cognition and its longitudinal trajectory, accounting for their joint inclusion in the same model.</div></div><div><h3>Results</h3><div>Analyses showed that higher baseline WMH, FW, and PSMD, as well as lower FA and ALPS, were significantly associated with poorer cognitive performance (<em>p</em> &lt; 0.05). These associations remained robust after adjusting for relevant covariates—including age, sex, education, hypertension, diabetes, and hippocampal volume—except for FA and ALPS, which were no longer associated with EM (p &gt; 0.05). Higher baseline WMH, FW, and PSMD, and lower FA, were also significantly associated with annual decline in EF and EM, whereas ALPS showed no association with cognitive change (p &gt; 0.05). After covariate adjustment, these associations remained significant, except for PSMD and FA which were no longer significantly associated with EM trajectory. Joint modeling using BMA identified FW and WMH as the most likely contributors to both baseline performance and change in EF and EM, with posterior inclusion probabilities exceeding 50 %.</div></div><div><h3>Conclusions</h3><div>This study identified both cross-sectional and longitudinal associations between five markers of white matter integrity and cognitive performance and decline. Using BMA—a method designed to disentangle the specific contribution of each marker while accounting for multicollinearity—we found that, among the five markers, FW and WMH emerged as the most probable candidates to explain the course of cognitive decline in EM and EF.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100395"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the origin of cerebral small vessel disease: MRI markers of cSVD in young adults with hypertension","authors":"M.H. Snijders ,&nbsp;E. Janssen ,&nbsp;E. Verburgt ,&nbsp;A. ter Telgte ,&nbsp;T.N.A. van den Berg ,&nbsp;M.C. Maas ,&nbsp;F.J.A. Meijer ,&nbsp;A.M. Tuladhar ,&nbsp;N.P. Riksen ,&nbsp;J. Deinum ,&nbsp;F.E. de Leeuw","doi":"10.1016/j.cccb.2025.100397","DOIUrl":"10.1016/j.cccb.2025.100397","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral small vessel disease (cSVD) contributes to stroke and cognitive decline, with MRI markers of cSVD increasing with age. Hypertension is an important risk factor for cSVD in older adults but its impact in younger individuals remains less clear. This study investigates whether MRI markers of cSVD are more prevalent in young hypertensive individuals compared to normotensive controls.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 60 patients with hypertension and 21 controls aged 18–55 years underwent 3T MRI to assess cSVD markers: white matter hyperintensities (WMH), lacunes, and microbleeds. Group differences were assessed using <em>t</em>-tests, chi-square tests, or non-parametric methods. We examined associations between blood pressure and cSVD markers using multivariable regression models, including linear, logistic, ordinal logistic, and penalized logistic regression, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>Patients with hypertension were older (median (IQR) 35.6 (29.6–41.4) years vs 29.2 (27.8–33.2) years), had a higher BMI, and lower education levels while proportion of females was similar. Deep WMH burden was significantly higher in hypertensive participants (median Fazekas score: 1 [IQR: 0–1] vs 0 [IQR: 0–0]; <em>p</em> &lt; 0.001). Hypertension increased odds of deep WMH (OR 5.49, <em>p</em> = 0.011). Lacunes and microbleeds were rare and observed only in hypertensive participants. Duration since hypertension diagnosis was not significantly associated with WMH volume (β=7.27, <em>p</em> = 0.111) after adjusting for age.</div></div><div><h3>Conclusion</h3><div>WMH are more prevalent in young adults with hypertension, suggesting early microvascular brain changes. These findings underscore the importance of early detection and treatment of hypertension to potentially prevent long-term cerebrovascular changes.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100397"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral small vessel disease lesion segmentation methods: A systematic review","authors":"Jolene Phelps ,&nbsp;Manpreet Singh ,&nbsp;Cheryl R. McCreary ,&nbsp;Caroline Dallaire-Théroux ,&nbsp;Ryan G. Stein ,&nbsp;Zacharie Potvin-Jutras ,&nbsp;Dylan X. Guan ,&nbsp;Jeng-liang D. Wu ,&nbsp;Amelie Metz ,&nbsp;Eric E. Smith","doi":"10.1016/j.cccb.2025.100396","DOIUrl":"10.1016/j.cccb.2025.100396","url":null,"abstract":"<div><div>Cerebral small vessel disease (CSVD) can manifest as brain lesions visible on magnetic resonance imaging, including white matter hyperintensities (WMH), cerebral microbleeds (CMB), perivascular spaces (PVS), lacunes, and recent small subcortical infarcts (RSSI). Detection and segmentation of these imaging markers can provide valuable information on brain health, including prevention and treatment of dementia. However, manual segmentation is cumbersome, especially for large cohorts in research studies. There has been extensive research into the development of automated tools using machine learning to increase accuracy and efficiency in lesion segmentation. This systematic review aimed to summarize novel automated methods developed over the last 10 years that segment CSVD lesion types and have been validated on a population with or at risk for CSVD (<em>e.g.,</em> older adults, those with cognitive disorders, or those with vascular risk factors). A search on Web of Science and PubMed yielded 2764 studies, of which 89 were included after screening and full text review. 59 of these methods segmented WMH, 23 detected or classified CMB, 6 detected or segmented PVS, 5 detected, classified, or segmented lacunes, and 2 segmented RSSI. Of these, 30 studies (23 for WMH, 5 for CMB, 1 for PVS, and 1 for lacunes) included links to download code or pre-trained models, including one commercial tool, and one that relied on a commercial tool for input. Overall, this review found good evidence for high quality tools available for WMH segmentation, with fewer tools available to accurately segment other CSVD lesion types.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100396"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of carotid artery stenosis on cortical microinfarcts, white matter integrity, and brain volume: An interhemispheric comparison within the population-based Rotterdam Study","authors":"Frank J. Wolters ,&nbsp;Meike W. Vernooij ,&nbsp;Gennady V. Roshchupkin ,&nbsp;M․Arfan Ikram ,&nbsp;Maryam Kavousi ,&nbsp;Peter J. Koudstaal ,&nbsp;Aad van der Lugt ,&nbsp;Daniel Bos","doi":"10.1016/j.cccb.2025.100391","DOIUrl":"10.1016/j.cccb.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>Carotid artery stenosis could contribute to gradual loss of brain function through chronic hypoxia and ischemia.</div></div><div><h3>Methods</h3><div>We included consecutive participants of the population-based Rotterdam Study with unilateral ≥50 % stenosis at the carotid artery bifurcation on time-of-flight carotid MR angiography, and compared between hemispheres the presence of ischemic lesions, tissue volumes, and white matter integrity on structural brain MRI.</div></div><div><h3>Results</h3><div>Among 50 participants (mean age 76 years, 50 % women), flow was lower in the affected carotid artery than on the unaffected side (160mL/min versus 202mL/min; flow reduction [95 %CI] per 1 % increase in stenosis: 1.7 mL/min [1.0–2.5]). Twelve individuals had radiographic evidence of cortical infarction, of whom 8 had cortical microinfarcts, all on the side of the stenosis (<em>P</em> = 0.001). Downstream of the stenotic artery, parenchymal volume was lower than in the contralateral hemisphere (mean difference: -2.7 mL [-4.9;-0.4]), similar for grey and white matter. Differences were most profound in the frontoparietal lobes, and increased with severity of stenosis to roughly 5 mL in individuals with ≥70 % stenosis. White matter hyperintensity volume and microstructural integrity did not differ between hemispheres.</div></div><div><h3>Conclusions</h3><div>Carotid artery stenosis is associated with downstream presence of cortical microinfarcts as well as lower parenchymal tissue volume.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100391"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in vascular risk assessment and management across UK memory/brain health clinics: a cross-sectional survey","authors":"Ross A. Dunne ,&nbsp;Lieza Exalto ,&nbsp;Simon Young ,&nbsp;Atticus Hainsworth ,&nbsp;Vanessa Raymont","doi":"10.1016/j.cccb.2025.100476","DOIUrl":"10.1016/j.cccb.2025.100476","url":null,"abstract":"<div><h3>Introduction</h3><div>Vascular risk factors (VRFs) are major, actionable contributors to cognitive dysfunction across the spectrum from vascular cognitive impairment (VCI) to mixed pathologies. Reflecting this, international and UK guidance recommend systematic identification and treatment of VRFs as part of routine care—providing clear levers for memory/brain health services to integrate risk assessment, lifestyle support and pharmacotherapy. **Objective:** To characterise current UK brain health/memory clinic practice in VRF assessment, documentation and downstream management, to inform standardisation of a pragmatic “minimum VRF dataset” and facilitate better data collection under circumstances of increased workload across health services.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional questionnaire of UK clinics routinely assessing cognition.Descriptive statistics are reported. Clinics were approached through the Dementia Platforms UK mailing list and members of the UK Brain Health Coalition were also contacted.</div></div><div><h3>Results</h3><div>Six clinics (mean 222, median 250 new referrals/year) responded to the first wave questionnaire. Overall they estimated that a mean 20.8% (range 5–50%) of referrals had pure or mixed VCI features. Five of six clinics (83%) reported routine VRF assessment for all new patients. Commonly assessed VRFs were diabetes/HbA1c, dyslipidaemia, smoking status, prior stroke/TIA, physical activity, and alcohol use (each 5/6, 83%); blood pressure, BMI/obesity, and sleep apnoea were assessed by 4/6 (67%); pulse-wave velocity and atrial fibrillation by 2/6 (33%); carotid stenosis and peripheral vascular disease by 1/6 (17%). Direct interventions provided within clinics included antihypertensives (3/6), statins (2/6), antiplatelets (2/6), and anticoagulants (1/6). VRFs were documented “always/usually” in 5/6 services. Only 2/6 reported staff training in VRF assessment within the past two years; 2/6 audited VRF assessment rates (with a further 1/6 planning to). Top barriers were time constraints (5/6), unclear guidelines (4/6), and equipment/resources (3/6). Facilitators most often cited were additional staff training (4/6), clear protocols/pathways (3/6), better IT integration (3/6), and administrative support (3/6).</div></div><div><h3>Conclusions</h3><div>UK memory / brain health clinics view VRF assessment as essential, but practice remains heterogeneous, with limited training and audit. Standardising a minimum VRF dataset and embedding clear referral/treatment pathways—supported by training, IT templates, and admin capacity—may improve consistency and impact.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100476"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of in-vivo arteriolosclerosis with Brain Age Gap and vascular risk behaviors","authors":"Anna Marseglia ,&nbsp;Caroline Dartora ,&nbsp;Eric Westman ,&nbsp;Konstantinos Arfanakis ,&nbsp;Ana W Capuano","doi":"10.1016/j.cccb.2025.100470","DOIUrl":"10.1016/j.cccb.2025.100470","url":null,"abstract":"<div><h3>Introduction</h3><div>Individuals age at different rates despite similar neuropathological burdens—some show accelerated cognitive decline, others preserve brain structure. Brain Age Gap (BAG) captures this variability in biological brain aging and has been linked to vascular risk behaviors and greater small vessel disease burden. ARTS is an in-vivo imaging marker of cerebral arteriolosclerosis, reflecting cumulative vascular risk exposure. Yet, to what extent ARTS influence BAG remains unclear. This study investigates the associations between BAG and ARTS, postmortem markers of athero-/arteriolosclerosis, vascular risk behaviors, and cognitive changes related to their interplay.</div></div><div><h3>Methods</h3><div>A total of 1,134 dementia-free individuals (mean age 79.0 ± 6.8) from four cohorts—ROS, MAP, MARS, LATC, Clinical Core of the Rush ADRC—with brain MRI were included in the study. Brain Age Gap (BAG) was computed as the difference between MRI- derived biological brain age (via deep learning) and chronological age. ARTS score was obtained from in-vivo MRI to assess arteriolosclerosis likelihood. Vascular risk behaviors (smoking, heart failure, hypertension, diabetes) were self-reported at baseline. Generalized linear models (GLM) were used, adjusting for age at MRI, sex, and education.</div></div><div><h3>Results</h3><div>Participants were 79 years of age at the MRI measure (SD=6.8), and 85% (n=966) were women. Greater ARTS score was associated with higher BAG, indicating older-appearing brains (β=2.79, SE 0.66, p&lt;0.001). BAG was associated with smoking (β = 0.71, SE = 0.26, p = 0.007) and coronary heart failure (β = 0.97, SE = 0.54, p = 0.057). When ARTS was added, the association with coronary heart failure attenuated (β = 1.13, SE = 0.59, p = 0.074), while the link with smoking remained. No interaction between ARTS and sex was observed.</div></div><div><h3>Conclusions</h3><div>ARTS is linked to older-appearing brains, potentially reflecting the lasting imprint of vascular risk exposure. Our findings support BAG as a potential imaging marker of accelerated brain aging, spotlighting the influence of often modifiable vascular risk factors in shaping brain health. The cognitive consequences of this brain-vascular aging</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100470"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct Sodium Signatures in Vascular Dementia and Alzheimer’s Disease: A Potential Diagnostic Biomarker","authors":"Sasha Philbert ,&nbsp;Jingshu Xu ,&nbsp;Stephanie Church ,&nbsp;Richard Unwin ,&nbsp;Federico Roncaroli ,&nbsp;Garth Cooper","doi":"10.1016/j.cccb.2025.100496","DOIUrl":"10.1016/j.cccb.2025.100496","url":null,"abstract":"<div><h3>Introduction</h3><div>Vascular dementia (VaD) is the second most common cause of cognitive impairment amongst the elderly. However, there are no known disease-modifying therapies for VaD and an absence of effective clinical biomarkers that can accurately distinguish between VaD and Alzheimer’s disease (AD). A clinical marker of this nature would help future VaD clinical trials by helping ensure cohorts are comprised of VaD patients only, thus, leading to more efficient therapies. Metal dysregulation has been shown in several age-related dementias, with disease-specific patterns throughout the brain. Here, we investigated metal and protein levels in VaD to distinguish VaD from AD.</div></div><div><h3>Methods</h3><div>We employed inductively coupled plasma-mass spectrometry and liquid chromatography mass spectrometry to quantify the levels of essential metals and proteins in post-mortem VaD brain tissue (n = 10) and age-/sex-matched controls (n = 10) from seven brain regions. These data were compared with our data using the same methodology on AD patient samples. Proteomic data from the same VaD cases were used to identify possible sodium pathways.</div></div><div><h3>Results</h3><div>We observed elevated wet-weight cerebral sodium levels in VaD brain tissue in six of the seven regions analysed. Importantly, this widespread cerebral sodium elevation was not observed in AD, which instead showed a more localised elevation of sodium (3/7 brain regions, including the hippocampus, entorhinal cortex, and middle temporal gyrus). Corresponding proteomics on the same VaD tissue revealed protein expression changes, which map onto regions with elevated sodium.</div></div><div><h3>Conclusions</h3><div>These data imply widespread sodium dyshomeostasis in VaD brain tissue, which differs from AD, and may regulate – or be regulated by – specific protein expression changes. Furthermore, this cerebral sodium discrepancy between VaD and AD may have the potential as a diagnostic biomarker and help aid the clinical differentiation between VaD and AD.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100496"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the role of neuroinflammation and microglia on cerebrovascular function in Alzheimer's disease","authors":"Oliver Milner ,&nbsp;Robbie Fisher ,&nbsp;Daniel Asby ,&nbsp;James Armstrong ,&nbsp;Delphine Boche ,&nbsp;Scott Miners","doi":"10.1016/j.cccb.2025.100482","DOIUrl":"10.1016/j.cccb.2025.100482","url":null,"abstract":"<div><h3>Introduction</h3><div>Vessel-associated microglia (VAMs) have recently been identified as key regulators of cerebrovascular function implicated in blood-brain barrier (BBB) breakdown and impaired cerebral blood flow in Alzheimer’s disease (AD). We have explored the hypothesis that microglia migrate to the cerebral vasculature and exacerbate vascular damage associated with systemic infection and neuroinflammation.</div></div><div><h3>Methods</h3><div>We performed immunofluorescent labelling of FFPE sections from the superior temporal cortex of AD and control cases ± terminal systemic infection (N = 60). To characterise the density and phenotype of VAMs in each cohort, we immuno-labelled sections for CD31, CD68, Iba1 and HLA-DR. These measures were correlated with biochemical markers of cerebral perfusion, BBB integrity, and brain cytokine levels in corresponding frozen tissue from the same cases.</div><div>To explore microglial-cerebrovascular signalling, we exposed 3D co-cultures of HUVECs, pericytes, and microglia cultures to Aβ42 (1 uM), LPS (1 ug/mL) and Aβ42 and LPS in combination. Live cell imaging was used to assess microglial motility in response to vascular injury-conditioned media. Microarray analysis of the vascular co-culture media was conducted to identify signalling factors involved in microglial-cerebrovascular crosstalk.</div></div><div><h3>Results</h3><div>Immunofluorescence labelling showed an enrichment of Iba1+ve (p &lt; 0.05) and HLA-DR+ve (p &lt; 0.05) VAMs in AD. CD68 labelling revealed that VAMs were proportionally more phagocytic in AD alone (p &lt; 0.05) and in the presence of systemic infection (p &lt; 0.05). VAMs density was associated with markers of cerebral perfusion, BBB breakdown, and levels of brain cytokines. HMC3 microglia motility was increased upon exposure to HUVEC-pericyte media stimulated with AD-conditions. We will present data from the microarray to highlight specific signalling pathways influencing alterations in CAM motility.</div></div><div><h3>Conclusions</h3><div>We have shown that VAM density is increased in response to systemic infection and AD and is associated with neuroinflammation and markers of cerebral hypoperfusion and BBB breakdown. These studies provide further evidence that VAMs play an essential role in regulating cerebrovascular function in AD.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100482"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning applications in vascular neuroimaging for the diagnosis and prognosis of cognitive impairment and dementia: a systematic review and meta- analysis","authors":"Valerie Lohner ,&nbsp;Amanpreet Badhwar ,&nbsp;David J. Llewellyn ,&nbsp;Timothy Rittman ,&nbsp;Sheena Waters ,&nbsp;Jose Bernal ,&nbsp;Vascular Imaging Subgroup of the Imaging Working Group","doi":"10.1016/j.cccb.2025.100416","DOIUrl":"10.1016/j.cccb.2025.100416","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral small vessel disease (CSVD) is a common neurological condition that contributes to strokes, dementia, disability, and mortality worldwide. We conducted a systematic review and meta-analysis to investigate the use of neuroimaging CSVD markers in machine learning (ML)-based diagnosis and prognosis of cognitive impairment and dementia and identify both methodological changes over time and barriers to clinical translation.</div></div><div><h3>Methods</h3><div>Following the PRISMA guidelines, we systematically searched for original studies using both neuroimaging CSVD markers and ML methods for diagnosing and prognosing neurodegenerative diseases (preregistration in PROSPERO: CRD42022366767). Each paper was independently reviewed by a pair of reviewers at all stages, with a third consulted to resolve conflicts. We meta-analysed the ability of ML models to distinguish healthy controls from Alzheimer’s dementia and cognitive impairment, using area under the curve (AUC) as the performance metric.</div></div><div><h3>Results</h3><div>We identified 75 studies: 43 on diagnosis, 27 on prognosis, and 5 on both. Nearly 60% of studies were published in the past two years, reflecting a growing interest in using CSVD markers in ML-based diagnosis and prognosis of neurodegenerative diseases, especially Alzheimer’s dementia. This rising interest may be linked to the strong performance of such models: according to our meta-analysis, ML approaches using CSVD markers perform well in differentiating healthy controls from Alzheimer’s dementia (AUC 0.88 [95%-CI 0.85–0.92]) and cognitive impairment (AUC 0.84 [95%-CI 0.74–0.95]). The growing interest has unfortunately not been matched by methodological rigour: only 16 studies met the criteria for inclusion in the meta-analysis due to inconsistent reporting, just five assessed the generalisability of their models on external datasets, and six lacked clear diagnostic criteria.</div></div><div><h3>Conclusions</h3><div>Interest in incorporating CSVD markers into ML models for neurodegenerative disease classification is on the rise, and their performance suggests that this is worth further exploration. Serious methodological issues, including inconsistent reporting, limited generalisability testing, and potential biases, are unfortunately common and hinder further adoption. Our targeted recommendations provide a roadmap to accelerate the integration of ML into clinical practice.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"9 ","pages":"Article 100416"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}