Choroid plexus vascular reactivity in moyamoya: Implications for choroid plexus regulation in ischemic stress

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2023-10-26 DOI:10.1111/jon.13161

Caleb Han, Spencer Waddle, Maria Garza, Larry T. Davis, Jarrod J. Eisma, Wesley T. Richerson, Matthew Fusco, Rohan Chitale, Chelsea Custer, Colin D. McKnight, Lori C. Jordan, Manus J. Donahue

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引用次数: 0

Abstract

Background and Purpose

Choroid plexus (ChP) hyperemia has been observed in patients with intracranial vasculopathy and to reduce following successful surgical revascularization. This observation may be attributable to impaired vascular reserve of the ChP or other factors, such as the ChP responding to circulating markers of stress. We extend this work to test the hypothesis that vascular reserve of the ChP is unrelated to intracranial vasculopathy.

Methods

We performed hypercapnic reactivity (blood oxygenation level-dependent; echo time = 35 ms; spatial resolution = 3.5 × 3.5 × 3.5 mm, repetition time = 2000 ms) and catheter angiography assessments of ChP reserve capacity and vascular patency in moyamoya patients (n = 53) with and without prior surgical revascularization. Time regression analyses quantified maximum cerebrovascular reactivity and reactivity delay time in ChP and cortical flow territories of major intracranial vessels with steno-occlusion graded as <70%, 70%-99%, and occlusion using Warfarin-Aspirin-Symptomatic-Intracranial-Disease stenosis grading criteria. Analysis of variance (significance: two-sided Bonferroni-corrected p < .05) was applied to evaluate cortical and ChP reactivity, after accounting for end-tidal carbon dioxide change, for differing vasculopathy categories.

Results

In patients without prior revascularization, arterial vasculopathy was associated with reduced cortical reactivity and lengthened reactivity delay (p ≤ .01), as expected. Regardless of surgical history, the ChP reactivity metrics were not significantly related to the degree of proximal stenosis, consistent with ChP reactivity being largely preserved in this population.

Conclusions

Findings are consistent with ChP reactivity in moyamoya not being dependent on observed vasculopathy. Future work may investigate the extent to which ChP hyperemia in chronic ischemia reflects circulating markers of glial or ischemic stress.

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烟雾病的脉络丛血管反应性：对缺血性应激中脉络丛调节的意义。

背景和目的：在颅内血管病患者中观察到脉络丛（ChP）充血，并在成功的手术血运重建后减少充血。这一观察结果可能归因于ChP的血管储备受损或其他因素，如ChP对循环应激标志物的反应。我们扩展了这项工作来检验ChP的血管储备和颅内血管病变无关的假设。方法：我们对既往有或无手术血运重建的烟雾患者（n=53）进行了高碳酸血症反应性（血氧水平依赖性；回声时间=35ms；空间分辨率=3.5×3.5×3.5mm，重复时间=200ms）和导管血管造影术评估ChP储备能力和血管通畅性。时间回归分析量化了狭窄闭塞的颅内主要血管ChP和皮层流动区的最大脑血管反应性和反应性延迟时间。结果：在既往未进行血运重建的患者中，动脉血管病变与皮层反应性降低和反应性延迟延长有关（p≤.01），正如预期的那样。无论手术史如何，ChP反应性指标与近端狭窄程度没有显著相关性，这与该人群中ChP反应率基本保持一致。结论：研究结果与烟雾中ChP反应性一致，不依赖于观察到的血管病变。未来的工作可能会研究慢性缺血中ChP充血在多大程度上反映神经胶质或缺血应激的循环标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!