Translational Stroke Research最新文献

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Inverse Association between the Body Mass Index and the Incidence of Unruptured Intracranial Aneurysms-Insights from the Hamburg City Health Population Study. 身体质量指数与未破裂颅内动脉瘤发病率之间的反向关系--汉堡市健康人口研究的启示。
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-11-04 DOI: 10.1007/s12975-024-01305-1
Paul Steffen, Laurens Winkelmeier, Christian Heitkamp, Christian Thaler, Gabriel Broocks, Vincent Geest, Tobias D Faizy, Caspar Brekenfeld, Jens Fiehler, Thomas Lindner, Maria T Nawka
{"title":"Inverse Association between the Body Mass Index and the Incidence of Unruptured Intracranial Aneurysms-Insights from the Hamburg City Health Population Study.","authors":"Paul Steffen, Laurens Winkelmeier, Christian Heitkamp, Christian Thaler, Gabriel Broocks, Vincent Geest, Tobias D Faizy, Caspar Brekenfeld, Jens Fiehler, Thomas Lindner, Maria T Nawka","doi":"10.1007/s12975-024-01305-1","DOIUrl":"https://doi.org/10.1007/s12975-024-01305-1","url":null,"abstract":"<p><p>Overweight/obese patients experience a lower incidence of subarachnoid hemorrhage (SAH) compared to non-overweight patients, even though elevated body mass index (BMI) has been associated with various SAH risk factors. Given that intracranial aneurysms are a primary cause of SAH, a potential protective effect of a high BMI on intracranial aneurysms is likely but remains insufficiently investigated. This population-based MRI study aims to conduct detailed analyses on risk factors associated with the incidence of unruptured intracranial aneurysms (UIA). Retrospective analysis of subjects enrolled in the prospective Hamburg City Health study who underwent intracranial magnetic resonance imaging (MRI) was done. MRI scans were screened for UIA using time-of-flight angiography. Subject data including medical history, laboratory examinations, and risk factors for UIA were collected, and a multivariable logistic regression model was used to investigate the relationship between risk factors and UIA incidence. 2688 subjects (mean (IQR) age, 65 (58-71); 1176 female (43.8%) were included. An UIA was detected in 214 subjects with an incidence of 10.6% (6.0%) in females (males). Determinants for UIA were female sex (OR 2.00, 95%CI 1.45-2.77, p < 0.001), hypertension (OR 1.48, 95%CI 1.08-2.04, p = 0.015), smoking (OR 1.41, 95%CI 1.03-1.95, p = 0.036), and BMI (OR 0.95, 95%CI 0.91-0.98, p = 0.004). Among subjects with UIA, 9.4% with a BMI > 25 had multiple aneurysms, compared to 21.6% with BMI ≤ 25 (p = 0.012). This study suggests that a high BMI exhibits a protective effect on UIA incidence and the development of multiple aneurysms. Additionally, the data confirms established risk factors for UIA development, such as female sex, hypertension, and smoking.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568657","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 Surgical Revascularization on Regression of Enlarged Perivascular Spaces in Adult Moyamoya Disease. 手术血管重建对成人莫亚莫亚病血管周围扩大空间消退的影响
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-08 DOI: 10.1007/s12975-024-01303-3
Shusuke Yamamoto, Takuya Akai, Daina Kashiwazaki, Kunitaka Maruyama, Emiko Hori, Naoki Akioka, Kyo Noguchi, Satoshi Kuroda
{"title":"Impact of Surgical Revascularization on Regression of Enlarged Perivascular Spaces in Adult Moyamoya Disease.","authors":"Shusuke Yamamoto, Takuya Akai, Daina Kashiwazaki, Kunitaka Maruyama, Emiko Hori, Naoki Akioka, Kyo Noguchi, Satoshi Kuroda","doi":"10.1007/s12975-024-01303-3","DOIUrl":"https://doi.org/10.1007/s12975-024-01303-3","url":null,"abstract":"<p><p>Previous studies have suggested that enlarged perivascular spaces (EPVSs) are potential radiological markers of cerebral ischemia in moyamoya disease (MMD). However, serial changes in EPVSs after surgical revascularization have not yet been clarified. We aimed to elucidate the postoperative changes in EPVSs in adult patients with MMD, clinical and radiological factors affecting the number of EPVSs, and the degree of postoperative changes. We counted the EPVSs in the centrum semiovale in each hemisphere on a T2-weighted MRI performed before surgery. EPVSs were quantified 3 months and 2 years after combined bypass surgery in surgically treated patients and compared with the number of EPVSs before surgery. We performed multivariate logistic regression analysis to identify the clinical and radiological factors associated with the number of EPVSs. This study included 120 hemispheres of 65 adults with MMD. Older age (P < 0.01), posterior cerebral artery (PCA) involvement (P < 0.01), and cerebral blood flow (CBF) impairment (P = 0.02) were significantly associated with a large number of EPVSs. The number of EPVSs markedly decreased at 3 months and 2 years after surgery compared with that before surgery (P < 0.01). PCA involvement (P = 0.04) and CBF impairment (P = 0.02) were independent predictors of the regression of EPVSs after surgery. The number of EPVSs in the centrum semiovale was closely associated with age, PCA involvement, and CBF impairment in adult patients with MMD, which remarkably regressed after surgical revascularization, especially in the hemispheres with PCA involvement and CBF impairment. EPVSs are reversible radiological markers reflecting impaired cerebral hemodynamics in adult patients with MMD.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393548","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
The Role of Complement C1qa in Experimental Intracerebral Hemorrhage. 补体 C1qa 在实验性脑出血中的作用
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-07 DOI: 10.1007/s12975-024-01302-4
Xiongjie Fu, Fenghui Ye, Yingfeng Wan, Guohua Xi, Ya Hua, Richard F Keep
{"title":"The Role of Complement C1qa in Experimental Intracerebral Hemorrhage.","authors":"Xiongjie Fu, Fenghui Ye, Yingfeng Wan, Guohua Xi, Ya Hua, Richard F Keep","doi":"10.1007/s12975-024-01302-4","DOIUrl":"https://doi.org/10.1007/s12975-024-01302-4","url":null,"abstract":"<p><p>Evidence indicates that the complement system is activated and plays a role in brain injury after intracerebral hemorrhage (ICH). Most studies have focused on the role of C3, C5 and the membrane attack complex. The purpose of this study was to investigate the potential impact of complement C1q, a key upstream component of the classical pathway, on ICH-induced brain injury. Wild-type (WT) and C1qa knock out (KO) mice were compared using an autologous blood injection ICH model. Magnetic resonance imaging (MRI) was performed on days 1, 3 and 7 and brains harvested on days 3 and 7 for immunohistochemistry to examine brain injury mechanisms. WT and C1qa KO mice also received an intracerebral injection of thrombin, a key factor in ICH-induced brain injury. Following MRI scans, brains were harvested for immunohistochemistry on day 1. In comparison to WT mice, C1qa KO mice had reduced hematoma erythrolysis and neutrophil infiltration after ICH. However, they also had delayed hematoma clearance, which was associated with reduced induction of phagocytic multinuclear giant cells, and increased perihematomal neuronal damage. After thrombin injection, C1qa KO mice had smaller lesion volumes, less neuronal loss, reduced neutrophil infiltration, and less BBB damage. C1qa knockout has beneficial and detrimental effects on ICH-induced brain injury mechanisms, but a consistent beneficial effect after thrombin injection. Strategies to balance the roles of C1q after ICH may represent a promising therapeutic direction.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381705","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
Genome-Wide DNA Methylation Profiling Reveals Low Methylation Variability in Moyamoya Disease. 全基因组DNA甲基化分析揭示了莫亚莫亚病的低甲基化变异性
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-02 DOI: 10.1007/s12975-024-01299-w
Kikutaro Tokairin, Masaki Ito, Alex G Lee, Mario Teo, Shihao He, Michelle Y Cheng, Gary K Steinberg
{"title":"Genome-Wide DNA Methylation Profiling Reveals Low Methylation Variability in Moyamoya Disease.","authors":"Kikutaro Tokairin, Masaki Ito, Alex G Lee, Mario Teo, Shihao He, Michelle Y Cheng, Gary K Steinberg","doi":"10.1007/s12975-024-01299-w","DOIUrl":"10.1007/s12975-024-01299-w","url":null,"abstract":"<p><p>Moyamoya disease (MMD) is a chronic cerebrovascular disorder that can lead to stroke and neurological dysfunctions. Given the largely sporadic nature and the role of gene-environment interactions in various diseases, we examined epigenetic modifications in MMD. We performed genome-wide DNA methylation using Illumina 850 K Methylation EPIC BeadChip, in two racially distinct adult female cohorts: a non-Asian cohort (13 MMD patients and 7 healthy controls) and an Asian cohort (14 MMD patients and 3 healthy controls). An additional external cohort with both sexes (females: 5 MMD patients and 5 healthy controls, males: 5 MMD patients and 5 healthy controls) was included for validation. Our findings revealed strikingly low DNA methylation variability between MMD patients and healthy controls, in both MMD female cohorts. In the non-Asian cohort, only 6 probes showed increased variability versus 647 probes that showed decreased variability. Similarly, in the Asian cohort, the MMD group also displayed a reduced methylation variability across all 2845 probes. Subsequent analysis showed that these differentially variable probes are located on genes involved in key biological processes such as methylation and transcription, DNA repair, cytoskeletal remodeling, natural killer cell signaling, cellular growth, and migration. These findings mark the first observation of low methylation variability in any disease, contrasting with the high variability observed in other disorders. This reduced methylation variability in MMD may hinder patients' adaptability to environmental shifts, such as hemodynamic stress, thereby influencing vascular homeostasis and contributing to MMD pathology. These findings offer new insights into the mechanisms of MMD and potential treatment strategies.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362137","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
SARS-CoV-2 Spike Protein Exacerbates Thromboembolic Cerebrovascular Complications in Humanized ACE2 Mouse Model. SARS-CoV-2 Spike 蛋白加剧人源化 ACE2 小鼠模型的血栓栓塞性脑血管并发症
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-02 DOI: 10.1007/s12975-024-01301-5
Stan P Heath, Veronica C Hermanns, Maha Coucha, Mohammed Abdelsaid
{"title":"SARS-CoV-2 Spike Protein Exacerbates Thromboembolic Cerebrovascular Complications in Humanized ACE2 Mouse Model.","authors":"Stan P Heath, Veronica C Hermanns, Maha Coucha, Mohammed Abdelsaid","doi":"10.1007/s12975-024-01301-5","DOIUrl":"10.1007/s12975-024-01301-5","url":null,"abstract":"<p><p>COVID-19 increases the risk for acute ischemic stroke, yet the molecular mechanisms are unclear and remain unresolved medical challenges. We hypothesize that the SARS-CoV-2 spike protein exacerbates stroke and cerebrovascular complications by increasing coagulation and decreasing fibrinolysis by disrupting the renin-angiotensin-aldosterone system (RAAS). A thromboembolic model was induced in humanized ACE2 knock-in mice after one week of SARS-CoV-2 spike protein injection. hACE2 mice were treated with Losartan, an angiotensin receptor (AT<sub>1</sub>R) blocker, immediately after spike protein injection. Cerebral blood flow and infarct size were compared between groups. Vascular-contributes to cognitive impairments and dementia was assessed using a Novel object recognition test. Tissue factor-III and plasminogen activator inhibitor-1 were measured using immunoblotting to assess coagulation and fibrinolysis. Human brain microvascular endothelial cells (HBMEC) were exposed to hypoxia with/without SARS-CoV-2 spike protein to mimic ischemic conditions and assessed for inflammation, RAAS balance, coagulation, and fibrinolysis. Our results showed that the SARS-CoV-2 spike protein caused an imbalance in the RAAS that increased the inflammatory signal and decreased the RAAS protective arm. SARS-CoV-2 spike protein increased coagulation and decreased fibrinolysis when coincident with ischemic insult, which was accompanied by a decrease in cerebral blood flow, an increase in neuronal death, and a decline in cognitive function. Losartan treatment restored RAAS balance and reduced spike protein-induced effects. SARS-CoV-2 spike protein exacerbates inflammation and hypercoagulation, leading to increased neurovascular damage and cognitive dysfunction. However, the AT<sub>1</sub>R blocker, Losartan, restored the RAAS balance and reduced COVID-19-induced thromboembolic cerebrovascular complications.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362138","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
Intracerebral Administration of a Novel Self-Assembling Peptide Hydrogel Is Safe and Supports Cell Proliferation in Experimental Intracerebral Haemorrhage. 一种新型自组装肽水凝胶在实验性脑出血中的脑内给药是安全的,并支持细胞增殖。
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-01 Epub Date: 2023-10-18 DOI: 10.1007/s12975-023-01189-7
Faye Bolan, Ben R Dickie, James R Cook, Josephine M Thomas, Emmanuel Pinteaux, Stuart M Allan, Alberto Saiani, Catherine B Lawrence
{"title":"Intracerebral Administration of a Novel Self-Assembling Peptide Hydrogel Is Safe and Supports Cell Proliferation in Experimental Intracerebral Haemorrhage.","authors":"Faye Bolan, Ben R Dickie, James R Cook, Josephine M Thomas, Emmanuel Pinteaux, Stuart M Allan, Alberto Saiani, Catherine B Lawrence","doi":"10.1007/s12975-023-01189-7","DOIUrl":"10.1007/s12975-023-01189-7","url":null,"abstract":"<p><p>Intracerebral haemorrhage (ICH) is the deadliest form of stroke, but current treatment options are limited, meaning ICH survivors are often left with life-changing disabilities. The significant unmet clinical need and socioeconomic burden of ICH mean novel regenerative medicine approaches are gaining interest. To facilitate the regeneration of the ICH lesion, injectable biomimetic hydrogels are proposed as both scaffolds for endogenous repair and delivery platforms for pro-regenerative therapies. In this paper, the objective was to explore whether injection of a novel self-assembling peptide hydrogel (SAPH) Alpha2 was feasible, safe and could stimulate brain tissue regeneration, in a collagenase-induced ICH model in rats. Alpha2 was administered intracerebrally at 7 days post ICH and functional outcome measures, histological markers of damage and repair and RNA-sequencing were investigated for up to 8 weeks. The hydrogel Alpha2 was safe, well-tolerated and was retained in the lesion for several weeks, where it allowed infiltration of host cells. The hydrogel had a largely neutral effect on functional outcomes and expression of angiogenic and neurogenic markers but led to increased numbers of proliferating cells. RNAseq and pathway analysis showed that ICH altered genes related to inflammatory and phagocytic pathways, and these changes were also observed after administration of hydrogel. Overall, the results show that the novel hydrogel was safe when injected intracerebrally and had no negative effects on functional outcomes but increased cell proliferation. To elicit a regenerative effect, future studies could use a functionalised hydrogel or combine it with an adjunct therapy.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":"986-1004"},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11364698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49682704","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
Clopidogrel Is Associated with Reduced Likelihood of Aneurysmal Subarachnoid Hemorrhage: a Multi-Center Matched Retrospective Analysis. 氯吡格雷与降低动脉瘤性蛛网膜下腔出血几率有关:一项多中心匹配回顾性分析。
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-01 Epub Date: 2023-07-20 DOI: 10.1007/s12975-023-01179-9
Joseph S Hudson, Kamil W Nowicki, Brandon Lucke-Wold, Zachary C Gersey, William S Dodd, Ali Alattar, David J McCarthy, Prateek Agarwal, Zain Mehdi, Michael J Lang, David M Hasan, Brian L Hoh, Bradley A Gross
{"title":"Clopidogrel Is Associated with Reduced Likelihood of Aneurysmal Subarachnoid Hemorrhage: a Multi-Center Matched Retrospective Analysis.","authors":"Joseph S Hudson, Kamil W Nowicki, Brandon Lucke-Wold, Zachary C Gersey, William S Dodd, Ali Alattar, David J McCarthy, Prateek Agarwal, Zain Mehdi, Michael J Lang, David M Hasan, Brian L Hoh, Bradley A Gross","doi":"10.1007/s12975-023-01179-9","DOIUrl":"10.1007/s12975-023-01179-9","url":null,"abstract":"<p><p>Maladaptive inflammation underlies the formation and rupture of human intracranial aneurysms. There is a growing body of evidence that anti-inflammatory pharmaceuticals may beneficially modulate this process. Clopidogrel (Plavix) is a commonly used irreversible P2Y12 receptor antagonist with anti-inflammatory activity. In this paper, we investigate whether clopidogrel is associated with the likelihood of aneurysm rupture in a multi-institutional propensity-matched cohort analysis. Patients presenting for endovascular treatment of their unruptured intracranial aneurysms and those presenting with aneurysm rupture between 2015 and 2019 were prospectively identified at two quaternary referral centers. Patient demographics, comorbidities, and medication usage at the time of presentation were collected. Patients taking clopidogrel or not taking clopidogrel were matched in a 1:1 fashion with respect to location, age, smoking status, aneurysm size, aspirin usage, and hypertension. A total of 1048 patients with electively treated aneurysms or subarachnoid hemorrhages were prospectively identified. Nine hundred twenty-one patients were confirmed to harbor aneurysms during catheter-based diagnostic angiography. A total of 172/921 (19%) patients were actively taking clopidogrel at the time of presentation. Three hundred thirty-two patients were matched in a 1:1 fashion. A smaller proportion of patients taking clopidogrel at presentation had ruptured aneurysms than those who were not taking clopidogrel (6.6% vs 23.5%, p < .0001). Estimated treatment effect analysis demonstrated that clopidogrel usage decreased aneurysm rupture risk by 15%. We present, to the best of our knowledge, the first large-scale multi-institutional analysis suggesting clopidogrel use is protective against intracranial aneurysm rupture. It is our hope that these data will guide future investigation, revealing the pathophysiologic underpinning of this association.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":"936-940"},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9835212","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
Use of Tirofiban to Prevent Ischemic Events in Patients with CYP2C19 Loss-of-Function Alleles during Flow Diversion of Intracranial Aneurysm: A Multicenter Cohort Study. 使用替罗非班预防颅内动脉瘤血流分流过程中 CYP2C19 功能缺失等位基因患者的缺血事件:一项多中心队列研究。
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-01 Epub Date: 2023-07-31 DOI: 10.1007/s12975-023-01171-3
Yangyang Zhou, Huibin Kang, Wenqiang Li, Bin Luo, Chao Wang, Ruhang Xie, Yongnan Zhu, Qichen Peng, Yisen Zhang, Jian Liu, Ying Zhang, Shiqing Mu, Sheng Guan, Wenfeng Feng, Xinjian Yang
{"title":"Use of Tirofiban to Prevent Ischemic Events in Patients with CYP2C19 Loss-of-Function Alleles during Flow Diversion of Intracranial Aneurysm: A Multicenter Cohort Study.","authors":"Yangyang Zhou, Huibin Kang, Wenqiang Li, Bin Luo, Chao Wang, Ruhang Xie, Yongnan Zhu, Qichen Peng, Yisen Zhang, Jian Liu, Ying Zhang, Shiqing Mu, Sheng Guan, Wenfeng Feng, Xinjian Yang","doi":"10.1007/s12975-023-01171-3","DOIUrl":"10.1007/s12975-023-01171-3","url":null,"abstract":"<p><p>To analyze the effect of tirofiban on ischemic events in CYP2C19 loss-of-function (LOF) allele carriers during pipeline embolization device (PED) implantation. Demographic information, imaging data, ischemic complications, CYP2C19 genotyping, and platelet function test results were collected from patients with PED-treated intracranial aneurysms at three centers. Multivariate logistic regression was used to analyze risk factors for ischemic events. Patients were grouped according to LOF alleles and antiplatelet drugs, the baseline information of LOF allele carriers and non-carriers were compared, and the efficacy of tirofiban was analyzed by comparing the incidence of ischemic events in each group. In total, 278 patients were included in the study, 24 of whom had an ischemic event. 157 (56.5%) patients carried the LOF allele and were more likely to develop resistance to clopidogrel (P < 0.001) and hypertension (P = 0.010). Multivariate logistic regression analysis revealed that the independent risk factors for ischemic events were age of > 55 years (OR = 3.308, P = 0.028), LOF alleles (OR = 3.960, P = 0.036), and clopidogrel nonresponsiveness (OR = 3.301, P = 0.014). For LOF allele carriers, prophylactic use of tirofiban after PED implantation helped to reduce ischemic events (4.3% vs. 16.4%, P = 0.039). This study supports CYP2C19 genotyping before flow diversion because LOF alleles increase the risk of ischemic events. Prophylactic use of tirofiban may help reduce ischemic events in LOF allele carriers.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":"902-909"},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898076","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
Neurobehavioral Impairments Predict Specific Cerebral Damage in Rat Model of Subarachnoid Hemorrhage. 大鼠蛛网膜下腔出血模型的神经行为障碍可预测特定的脑损伤
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-01 Epub Date: 2023-07-26 DOI: 10.1007/s12975-023-01180-2
Daniel G Lynch, Kevin A Shah, Keren Powell, Steven Wadolowski, Willians Tambo, Joshua J Strohl, Prashin Unadkat, David Eidelberg, Patricio T Huerta, Chunyan Li
{"title":"Neurobehavioral Impairments Predict Specific Cerebral Damage in Rat Model of Subarachnoid Hemorrhage.","authors":"Daniel G Lynch, Kevin A Shah, Keren Powell, Steven Wadolowski, Willians Tambo, Joshua J Strohl, Prashin Unadkat, David Eidelberg, Patricio T Huerta, Chunyan Li","doi":"10.1007/s12975-023-01180-2","DOIUrl":"10.1007/s12975-023-01180-2","url":null,"abstract":"<p><p>Subarachnoid hemorrhage (SAH) is a severe form of stroke that can cause unpredictable and diffuse cerebral damage, which is difficult to detect until it becomes irreversible. Therefore, there is a need for a reliable method to identify dysfunctional regions and initiate treatment before permanent damage occurs. Neurobehavioral assessments have been suggested as a possible tool to detect and approximately localize dysfunctional cerebral regions. In this study, we hypothesized that a neurobehavioral assessment battery could be a sensitive and specific method for detecting damage in discrete cerebral regions following SAH. To test this hypothesis, a behavioral battery was employed at multiple time points after SAH induced via an endovascular perforation, and brain damage was confirmed via postmortem histopathological analysis. Our results demonstrate that impairment of sensorimotor function accurately predict damage in the cerebral cortex (AUC 0.905; sensitivity 81.8%; specificity 90.9%) and striatum (AUC 0.913; sensitivity 90.1%; specificity 100%), while impaired novel object recognition is a more accurate indicator of damage to the hippocampus (AUC 0.902; sensitivity 74.1%; specificity 83.3%) than impaired reference memory (AUC 0.746; sensitivity 72.2%; specificity 58.0%). Tests for anxiety-like and depression-like behaviors predict damage to the amygdala (AUC 0.900; sensitivity 77.0%; specificity 81.7%) and thalamus (AUC 0.963; sensitivity 86.3%; specificity 87.8%), respectively. This study suggests that recurring behavioral testing can accurately predict damage in specific brain regions, which could be developed into a clinical battery for early detection of SAH damage in humans, potentially improving early treatment and outcomes.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":"950-969"},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9921457","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
Longitudinal Morphometric Changes in the Corticospinal Tract Shape After Hemorrhagic Stroke. 出血性脑卒中后皮质脊髓束形状的纵向形态变化
IF 3.8 2区 医学
Translational Stroke Research Pub Date : 2024-10-01 Epub Date: 2023-06-13 DOI: 10.1007/s12975-023-01168-y
Seth B Boren, Sean I Savitz, Nicole Gonzales, Khader Hasan, Andrea Becerril-Gaitan, Vahed Maroufy, Yuan Li, James Grotta, Emily A Steven, Ching-Jen Chen, Clark W Sitton, Jaroslaw Aronowski, Muhammad E Haque
{"title":"Longitudinal Morphometric Changes in the Corticospinal Tract Shape After Hemorrhagic Stroke.","authors":"Seth B Boren, Sean I Savitz, Nicole Gonzales, Khader Hasan, Andrea Becerril-Gaitan, Vahed Maroufy, Yuan Li, James Grotta, Emily A Steven, Ching-Jen Chen, Clark W Sitton, Jaroslaw Aronowski, Muhammad E Haque","doi":"10.1007/s12975-023-01168-y","DOIUrl":"10.1007/s12975-023-01168-y","url":null,"abstract":"<p><p>Deep intracerebral hemorrhage (ICH) exerts a direct force on corticospinal tracts (CST) causing shape deformation. Using serial MRI, Generalized Procrustes Analysis (GPA), and Principal Components Analysis (PCA), we temporally evaluated the change in CST shape. Thirty-five deep ICH patients with ipsilesional-CST deformation were serially imaged on a 3T-MRI with a median imaging time of day-2 and 84 of onset. Anatomical and diffusion tensor images (DTI) were acquired. Using DTI color-coded maps, 15 landmarks were drawn on each CST and the centroids were computed in 3 dimensions. The contralesional-CST landmarks were used as a reference. The GPA outlined the shape coordinates and we superimposed the ipsilesional-CST shape at the two-time points. A multivariate PCA was applied to identify eigenvectors associated with the highest percentile of change. The first three principal components representing CST deformation along the left-right (PC1), anterior-posterior (PC2), and superior-inferior (PC3) respectively were responsible for 57.9% of shape variance. The PC1 (36.1%, p < 0.0001) and PC3 (9.58%, p < 0.01) showed a significant deformation between the two-time points. Compared to the contralesional-CST, the ipsilesional PC scores were significantly (p < 0.0001) different only at the first-timepoint. A significant positive association between the ipsilesional-CST deformation and hematoma volume was observed. We present a novel method to quantify CST deformation caused by ICH. Deformation most often occurs in left-right axis (PC1) and superior-inferior (PC3) directions. As compared to the reference, the significant temporal difference at the first time point suggests CST restoration over time.</p>","PeriodicalId":23237,"journal":{"name":"Translational Stroke Research","volume":" ","pages":"893-901"},"PeriodicalIF":3.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9976979","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}
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