Journal of Cerebral Blood Flow and Metabolism最新文献_第2页

Type 2 diabetes abates retrograde collateral flow and promotes leukocyte adhesion following ischemic stroke. 2型糖尿病减少缺血性卒中后逆行侧枝血流并促进白细胞粘附。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-09-01 Epub Date: 2025-05-29 DOI: 10.1177/0271678X251338203

Yoshimichi Sato, Yuya Kato, Atsushi Kanoke, Jennifer Y Sun, Yasuo Nishijima, Ruikang K Wang, Michael Stryker, Hidenori Endo, Jialing Liu

{"title":"Type 2 diabetes abates retrograde collateral flow and promotes leukocyte adhesion following ischemic stroke.","authors":"Yoshimichi Sato, Yuya Kato, Atsushi Kanoke, Jennifer Y Sun, Yasuo Nishijima, Ruikang K Wang, Michael Stryker, Hidenori Endo, Jialing Liu","doi":"10.1177/0271678X251338203","DOIUrl":"10.1177/0271678X251338203","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is associated with impaired leptomeningeal collateral compensation and poor stroke outcome. Neutrophils tethering and rolling on endothelium after stroke can also independently reduce flow velocity. However, the chronology and topological changes in collateral circulation in T2DM is not yet defined. Here, we describe the spatial and temporal blood flow dynamics and vessel diameter changes in pial arteries and veins and leukocyte-endothelial adhesion following middle cerebral artery (MCA) stroke using two-photon microscopy in awake control and T2DM mice. Relative to control mice, T2DM mice already exhibited smaller pial vessels with reduced flow velocity prior to stroke. Following stroke, T2DM mice displayed persistently reduced blood flow in pial arteries and veins, resulting in a poor recovery of downstream penetrating arterial flow and a sustained deficit in microvascular flow. There was also persistent increase of leukocyte adhesion to the endothelium of veins, coincided with elevated neutrophils infiltration into brain parenchyma in T2DM mice compared to control mice after stroke. Our data suggest that T2DM-induced increase in inflammation and chronic remodeling of leptomeningeal vessels may contribute to the observed hemodynamics deficiency after stroke and subsequent poor stroke outcome.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1684-1701"},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The brain's "dark energy" puzzle upgraded: [¹⁸F]FDG uptake, delivery and phosphorylation, and their coupling with resting-state brain activity. 大脑的“暗能量”谜题升级了：[18F]FDG的摄取、传递和磷酸化，以及它们与静息状态大脑活动的耦合。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-09-01 Epub Date: 2025-05-15 DOI: 10.1177/0271678X251329707

Tommaso Volpi, John J Lee, Andrei G Vlassenko, Manu S Goyal, Maurizio Corbetta, Alessandra Bertoldo

{"title":"The brain's \"dark energy\" puzzle upgraded: [18F]FDG uptake, delivery and phosphorylation, and their coupling with resting-state brain activity.","authors":"Tommaso Volpi, John J Lee, Andrei G Vlassenko, Manu S Goyal, Maurizio Corbetta, Alessandra Bertoldo","doi":"10.1177/0271678X251329707","DOIUrl":"10.1177/0271678X251329707","url":null,"abstract":"The brain's resting-state energy consumption is expected to be driven by spontaneous activity. We previously used 50 resting-state fMRI (rs-fMRI) features to predict [18F]FDG SUVR as a proxy of glucose metabolism. Here, we expanded on our effort by estimating [18F]FDG kinetic parameters Ki (irreversible uptake), K1 (delivery), k3 (phosphorylation) in a large healthy control group (n = 47). Describing the parameters' spatial distribution at high resolution (216 regions), we showed that K1 is the least redundant (strong posteromedial pattern), and Ki and k3 have relevant differences (occipital cortices, cerebellum, thalamus). Using multilevel modeling, we investigated how much spatial variance of [18F]FDG parameters could be explained by a combination of a) rs-fMRI variables, b) cerebral blood flow (CBF) and metabolic rate of oxygen (CMRO2) from 15O PET. Rs-fMRI-only models explained part of the individual variance in Ki (35%), K1 (14%), k3 (21%), while combining rs-fMRI and CMRO2 led to satisfactory description of Ki (46%) especially. Ki was sensitive to both local rs-fMRI variables (ReHo) and CMRO2, k3 to ReHo, K1 to CMRO2. This work represents a comprehensive assessment of the complex underpinnings of brain glucose consumption, and highlights links between 1) glucose phosphorylation and local brain activity, 2) glucose delivery and oxygen consumption.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1799-1815"},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accurate and fully automated diameter measurements of Circle of Willis arteries on MRA imaging. 在MRA成像上精确全自动测量Willis动脉圈直径。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-09-01 Epub Date: 2025-05-05 DOI: 10.1177/0271678X251338972

Julia Huck, Davy Vanderweyen, Tatjana Rundek, Mitchell Sv Elkind, Jose Gutierrez, Maxime Descoteaux, Kevin Whittingstall

{"title":"Accurate and fully automated diameter measurements of Circle of Willis arteries on MRA imaging.","authors":"Julia Huck, Davy Vanderweyen, Tatjana Rundek, Mitchell Sv Elkind, Jose Gutierrez, Maxime Descoteaux, Kevin Whittingstall","doi":"10.1177/0271678X251338972","DOIUrl":"10.1177/0271678X251338972","url":null,"abstract":"The Circle of Willis (CW), visualized via Magnetic Resonance Angiography (MRA), is crucial for assessing cerebral circulation. Accurate artery identification is essential not only for detecting stenosis and pathological changes but also for understanding vascular adaptations in healthy aging. Manual CW assessment is time-consuming, necessitating automated alternatives. This study evaluates intracranial artery diameter estimations from the Express IntraCranial Arteries Breakdown (eICAB) toolbox against manual measurements. eICAB was tested on 631 participants from the Northern Manhattan Study (NOMAS) with 1.5T MRA images (0.293 × 0.293 × 1 mm resolution). We analyzed eICAB's detection and diameter estimation accuracy of the Internal Carotid (ICA), Basilar (BA), Anterior Cerebral (ACA), Middle Cerebral (MCA), Posterior Cerebral (PCA), and Posterior Communicating (PCom). eICAB showed over 95% accuracy in detecting major arteries except for PCA and PCom (∼80%). Diameter discrepancies were generally ≤0.5 mm, with ICA and BA reaching 1 mm. Spearman correlation (p ≪ 0.05) confirmed strong agreement between automated and manual measurements. Resampling at 0.2083 mm improved precision. eICAB accurately identifies CW arteries and estimates diameters, demonstrating strong clinical and research potential.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1774-1784"},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of hypertension on cerebral small vessel disease: A post-mortem study of microvascular pathology from normal-appearing white matter into white matter hyperintensities. 高血压对脑血管疾病的影响：从正常白质到白质高信号的微血管病理尸检研究

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-09-01 Epub Date: 2025-04-12 DOI: 10.1177/0271678X251333256

Gemma Solé-Guardia, Anne Janssen, Rowan Wolters, Tren Dohmen, Benno Küsters, Jurgen Ahr Claassen, Frank-Erik de Leeuw, Maximilian Wiesmann, Jose Gutierrez, Amanda J Kiliaan

{"title":"Impact of hypertension on cerebral small vessel disease: A post-mortem study of microvascular pathology from normal-appearing white matter into white matter hyperintensities.","authors":"Gemma Solé-Guardia, Anne Janssen, Rowan Wolters, Tren Dohmen, Benno Küsters, Jurgen Ahr Claassen, Frank-Erik de Leeuw, Maximilian Wiesmann, Jose Gutierrez, Amanda J Kiliaan","doi":"10.1177/0271678X251333256","DOIUrl":"10.1177/0271678X251333256","url":null,"abstract":"Cerebral small vessel disease (SVD) is diagnosed through imaging hallmarks like white matter hyperintensities (WMH). Novel hypotheses imply that endothelial dysfunction, blood-brain barrier (BBB) disruption and neurovascular inflammation contribute to conversion of normal-appearing white matter (NAWM) into WMH in hypertensive individuals. Aiming to unravel the association between chronic hypertension and the earliest WMH pathogenesis, we characterized microvascular pathology in periventricular NAWM into WMH in post-mortem brains of individuals with and without hypertension. Our second aim was to delineate the NAWM-WMH transition from NAWM towards the center of WMH using deep learning, refining WMH segmentation capturing increases in FLAIR signal. Finally, we aimed to demonstrate whether these processes may synergistically contribute to WMH pathogenesis by performing voxel-wise correlations between MRI and microvascular pathology. Larger endothelium disruption, BBB damage and neurovascular inflammation were observed in individuals with hypertension. We did not observe gradual BBB damage nor neurovascular inflammation along the NAWM-WMH transition. We found a strong correlation between BBB damage and neurovascular inflammation in all individuals in both periventricular NAWM and WMH. These novel findings suggest that endothelium disruption, BBB damage and neurovascular inflammation are major contributors to SVD progression, but being already present in NAWM in hypertension.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1717-1730"},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deciphering the brain glucose metabolism: A gateway to innovative stroke therapies. 解读脑葡萄糖代谢：创新中风治疗的途径。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-09-01 Epub Date: 2025-05-29 DOI: 10.1177/0271678X251346277

Didier F Pisani, Nicolas Blondeau

{"title":"Deciphering the brain glucose metabolism: A gateway to innovative stroke therapies.","authors":"Didier F Pisani, Nicolas Blondeau","doi":"10.1177/0271678X251346277","DOIUrl":"10.1177/0271678X251346277","url":null,"abstract":"Stroke is the leading cause of physical disability and death among adults in most Western countries. Consecutive to a vascular occlusion, cells face a brutal reduction in supply of oxygen and glucose and thus an energy failure, which in turn triggers cell death mechanisms. Among brain cells, neurons are the most susceptible to ischemia because of their high metabolic demand and low reservoir of energy substrates. In neurons, glycolysis uses glucose coming from blood or from glycogen stored in astrocytes, underlying the deep astrocyte-neuron metabolic cooperation. During ischemia, both the aerobic and anaerobic pathways and thus energy production are compromised, which disrupts proper cell functioning, notably Na+/K+ ATPase and mitochondria. This results in altered Ca2+ homeostasis and overproduction of ROS, the latter being further exacerbated during the reperfusion phase. Consequently, glucose metabolism in the different brain cell populations plays a central role in injury and recovery after stroke, and has recently emerged as a promising target for therapeutic intervention. In this context, the overall objective of this article is to review the interconnections between stroke and brain glucose metabolism and to explore how its targeting may offer new therapeutic opportunities in addressing the global stroke epidemic.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1635-1653"},"PeriodicalIF":4.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory influence on cerebral blood flow and blood volume - A 4D flow MRI study. 呼吸对脑血流量和血容量的影响——4D血流MRI研究。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-08-01 Epub Date: 2025-01-30 DOI: 10.1177/0271678X251316395

Pontus Söderström, Anders Eklund, Nina Karalija, Britt M Andersson, Katrine Riklund, Lars Bäckman, Jan Malm, Anders Wåhlin

{"title":"Respiratory influence on cerebral blood flow and blood volume - A 4D flow MRI study.","authors":"Pontus Söderström, Anders Eklund, Nina Karalija, Britt M Andersson, Katrine Riklund, Lars Bäckman, Jan Malm, Anders Wåhlin","doi":"10.1177/0271678X251316395","DOIUrl":"10.1177/0271678X251316395","url":null,"abstract":"Variations in cerebral blood flow and blood volume interact with intracranial pressure and cerebrospinal fluid dynamics, all of which play a crucial role in brain homeostasis. A key physiological modulator is respiration, but its impact on cerebral blood flow and volume has not been thoroughly investigated. Here we used 4D flow MRI in a population-based sample of 65 participants (mean age = 75 ± 1) to quantify these effects. Two gating approaches were considered, one using respiratory-phase and the other using respiratory-time (i.e. raw time in the cycle). For both gating methods, the arterial inflow was significantly larger during exhalation compared to inhalation, whereas the venous outflow was significantly larger during inhalation compared to exhalation. The cerebral blood volume variation per respiratory cycle was 0.83 [0.62, 1.13] ml for respiratory-phase gating and 0.78 [0.59, 1.02] ml for respiratory-time gating. For comparison, the volume variation of the cardiac cycle was 1.01 [0.80, 1.30] ml. Taken together, our results clearly demonstrate respiratory influences on cerebral blood flow. The corresponding vascular volume variations appear to be of the same order of magnitude as those of the cardiac cycle, highlighting respiration as an important modulator of cerebral blood flow and blood volume.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1531-1542"},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

CTP-defined collaterals is a better predictor of intracranial atherosclerotic stenosis-related large-vessel occlusion than multiphase CTA-defined collaterals. ctp定义的侧支比多期cta定义的侧支更能预测颅内动脉粥样硬化性狭窄相关的大血管闭塞。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-08-01 Epub Date: 2025-03-13 DOI: 10.1177/0271678X251325389

Guangchen He, Runjianya Ling, Liming Wei, Haitao Lu, Yi Gu, Yueqi Zhu

{"title":"CTP-defined collaterals is a better predictor of intracranial atherosclerotic stenosis-related large-vessel occlusion than multiphase CTA-defined collaterals.","authors":"Guangchen He, Runjianya Ling, Liming Wei, Haitao Lu, Yi Gu, Yueqi Zhu","doi":"10.1177/0271678X251325389","DOIUrl":"10.1177/0271678X251325389","url":null,"abstract":"The optimal neuroimaging modalities for differentiating intracranial atherosclerotic stenosis-related large vessel occlusion (ICAS-LVO) from embolism related LVO remain uncertain. This study aimed to address this question by directly comparing collateral circulation using either baseline CT perfusion (CTP) or multiphase CT angiogram (mCTA) to define collaterals. We retrospectively analyzed consecutive patients with acute large vessel occlusion from October 2021 to December 2023. All patients underwent CTP before endovascular therapy, and mCTA was reconstructed from CTP data. In-situ ICAS-LVO was confirmed by a neuro-interventional radiologist. Favorable collateral circulation was defined as a collateral index <0.4 on CTP or a collateral score ≥3 on mCTA. Of 377 patients, 72 (19%) had ICAS-LVO. Patients with only a collateral score ≥3 did not show significantly higher odds of ICAS-LVO (P = 0.681). In contrast, those with a collateral index <0.4 but not favorable mCTA collateral had higher odds of ICAS-LVO (OR2.69, 95%CI [1.07-7.01], P = 0.037). Subgroup analysis showed that a collateral grading scale ≥3 may not predict ICAS-LVO within 6 hours, whereas CTP's predictive performance remained consistently strong in both early and late windows. CTP defined favorable collaterals of collateral index <0.4 demonstrate greater predictive value for ICAS-LVO compared to mCTA, especially within an early time window.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1569-1580"},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Two possible hemodynamic mechanisms underlying the growth of cerebral aneurysms depending on their size: The NHO CFD ABO study. 脑动脉瘤生长的两种可能的血流动力学机制取决于它们的大小：NHO CFD ABO研究。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-08-01 Epub Date: 2025-03-13 DOI: 10.1177/0271678X251325972

Shunichi Fukuda, Yuji Shimogonya, Aoi Watanabe, Naohiro Yonemoto, Miyuki Fukuda, Akihiro Yasoda

{"title":"Two possible hemodynamic mechanisms underlying the growth of cerebral aneurysms depending on their size: The NHO CFD ABO study.","authors":"Shunichi Fukuda, Yuji Shimogonya, Aoi Watanabe, Naohiro Yonemoto, Miyuki Fukuda, Akihiro Yasoda","doi":"10.1177/0271678X251325972","DOIUrl":"10.1177/0271678X251325972","url":null,"abstract":"Cerebral aneurysm rupture has a poor prognosis, and growing aneurysms are prone to rupture. We therefore conducted a prospective observational study to clarify hemodynamics inducing aneurysm growth, which are poorly understood. Computational fluid dynamics analysis was performed using the patient-specific arterial geometry and flow velocities. Hemodynamic metrics were compared by multivariate analysis between aneurysms enlarged ≥1 mm and stable aneurysms. We enrolled 481 patients. For aneurysms <4 mm, the time-averaged wall shear stress (WSS) was significantly higher in growing aneurysms for the whole aneurysm, neck, body and parent artery, and transverse WSS was significantly higher on the neck and parent artery. In aneurysms ≥4 mm, the normalized transverse WSS was significantly higher in growing aneurysms for the whole aneurysm and dome. Aneurysms <4 mm were likely to show whole-aneurysm growth, while aneurysms ≥4 mm were enlarged at the dome. There may exist two hemodynamic mechanisms for aneurysm growth depending on size. Aneurysms <4 mm may grow near the neck with high magnitudes and multi-directional WSS disturbances, while aneurysms ≥4 mm may grow on the dome with enhanced multi-directional WSS disturbance. These results may be useful in considering indications for surgical treatment. They may help resolve two conflicting hemodynamic rupture theories.","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1581-1592"},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From mechanism to classification: Understanding a novel model of cerebral small vessel disease. 从机制到分类：了解一种新的脑血管疾病模型。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-08-01 Epub Date: 2025-04-11 DOI: 10.1177/0271678X251326373

Masato Kanazawa, Masahiro Hatakeyama

引用次数: 0

Treatment for moyamoya disease with hyperhomocysteinemia. 烟雾病伴高同型半胱氨酸血症的治疗。

IF 4.5 2区医学

Journal of Cerebral Blood Flow and Metabolism Pub Date : 2025-08-01 Epub Date: 2025-03-13 DOI: 10.1177/0271678X251325676

Gan Gao, Si-Meng Liu, Fang-Bin Hao, Min-Jie Wang, Qian-Nan Wang, Ri-Miao Yang, Qing-Bao Guo, Xiao-Peng Wang, Jing-Jie Li, Cong Han, Lian Duan, Jian-Ning Zhang

{"title":"Treatment for moyamoya disease with hyperhomocysteinemia.","authors":"Gan Gao, Si-Meng Liu, Fang-Bin Hao, Min-Jie Wang, Qian-Nan Wang, Ri-Miao Yang, Qing-Bao Guo, Xiao-Peng Wang, Jing-Jie Li, Cong Han, Lian Duan, Jian-Ning Zhang","doi":"10.1177/0271678X251325676","DOIUrl":"10.1177/0271678X251325676","url":null,"abstract":"This study aimed to investigate the impact of controlling serum homocysteine on improving surgical outcomes in patients with moyamoya disease (MMD) and hyperhomocysteinemia. In this prospective observational cohort study, 477 patients with MMD post-encephaloduroarteriosynangiosis are divided into the HHcy-MMD post-control group (n = 193), HHcy-MMD uncontrolled group (n = 91), and MMD group (n = 193), with the HHcy-MMD post-control group further subdivided into good (homocysteine 0-10 μmol/L, n = 121) and general (homocysteine 10-15 μmol/L, n = 72) control groups. The differences in imaging and long-term clinical prognosis among the three groups were compared. No significant differences were noted in the Matsushima grade after encephaloduroarteriosynangiosis between the MMD group and HHcy-MMD post-control group (P > 0.05); however, there was a significant difference between the HHcy-MMD post-control group and HHcy-MMD uncontrolled group (P < 0.001). A significant difference was noted between the good and general control groups in the Matsushima grade (P = 0.025) and long-term follow-up clinical outcomes (P = 0.035). The area under the curve of homocysteine levels for predicting adverse clinical outcomes was 85.48% (95% confidence interval: 80.31-90.65%). Effective control of serum Hcy level after EDAS surgery in Moyamoya disease patients with HHcy may lead to better prognosis.Clinical Trial Registration: This study was registered at ClinicalTrials.gov (NCT03613701).","PeriodicalId":15325,"journal":{"name":"Journal of Cerebral Blood Flow and Metabolism","volume":" ","pages":"1469-1478"},"PeriodicalIF":4.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0