Cerebral circulation - cognition and behavior最新文献

{"title":"Recognizing, managing, and preventing cognitive sequelae after stroke. A narrative review","authors":"Leonardo Pantoni ,&nbsp;Slaven Pikija ,&nbsp;Tuyen Van Nguyen ,&nbsp;Michael Brainin","doi":"10.1016/j.cccb.2026.100543","DOIUrl":"10.1016/j.cccb.2026.100543","url":null,"abstract":"<div><div>Post-stroke cognitive impairment (PSCI) affects up to one-third of stroke survivors and is a major contributor to long-term disability and reduced quality of life. Its heterogeneous phenotype reflects the interplay of acute cerebrovascular injury with chronic vascular pathology, inflammation, blood–brain barrier dysfunction, and, in many patients, coexisting neurodegeneration. Clinical manifestations vary according to lesion location and most commonly involve executive and attentional deficits, with variable impairment of memory, language, visuospatial function, and neuropsychiatric domains. Cognitive trajectories range from partial early recovery to persistent or progressive decline.</div><div>Diagnosis remains challenging because covert cerebrovascular disease and overlapping neurodegenerative processes may mimic or amplify deficits. A stepwise diagnostic strategy combining focused cognitive screening, neuropsychological assessment when indicated, and neuroimaging is therefore recommended. In many acute stroke settings, CT continues to serve as the routine first-line modality, whereas MRI allows more detailed characterization where available. Emerging adjuncts include fluid biomarkers of neuroaxonal injury, inflammation, and vascular brain injury, as well as digital and telephone-based tools that may support longitudinal monitoring in selected populations.</div><div>Treatment options remain limited. Non-pharmacological interventions, including cognitive rehabilitation, physical activity, and multimodal neurorehabilitation, are central to current management, although PSCI-specific high-quality evidence is scarce. Prevention is essential and should focus on vascular risk-factor control, lifestyle modification, cognitive reserve, and social engagement.</div><div>This narrative review synthesizes current evidence on the mechanisms, presentation, diagnosis, and management of PSCI and highlights priorities for harmonized care pathways and the routine integration of cognitive health into stroke care.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100543"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147746603","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":"Cross-sectional investigation of choroid plexus calcification, cardiovascular risk score, and APOEε4 Status in cognitively normal cohort","authors":"Sarah Jun ,&nbsp;Xiuyuan Hugh Wang ,&nbsp;Liangdong Zhou ,&nbsp;Ilker Ozsahin ,&nbsp;Thomas Maloney ,&nbsp;Edward Spector ,&nbsp;Seyed Hani Hojjati ,&nbsp;Emily Tanzi ,&nbsp;Qolamreza Ray Razlighi ,&nbsp;Yi Li ,&nbsp;Gloria C Chiang ,&nbsp;Mony J de Leon ,&nbsp;Henry Rusinek ,&nbsp;Lidia Glodzik ,&nbsp;Tracy Butler","doi":"10.1016/j.cccb.2026.100537","DOIUrl":"10.1016/j.cccb.2026.100537","url":null,"abstract":"<div><div>The choroid plexus (CP), known for producing cerebrospinal fluid, is increasingly implicated in the pathogenesis of Alzheimer’s disease (AD). Neuroimaging studies document structural CP alterations in aging and AD. One such alteration, calcium deposition, increases with age and is typically considered benign, though the mechanism and clinical significance of CP calcification remain uncertain. Given established association between peripheral vascular calcification and cardiovascular risk, we hypothesized that the volume of calcium within CP would correlate with systemic cardiovascular health. Based on prior findings of APOEε4-specific associations between CP calcium and neurodegeneration, participants were stratified by APOEε4 status, a strong genetic risk factor for AD also implicated in cardiovascular disease. In this retrospective analysis of 105 adults (mean age 58.9 years; 39 APOEε4+), we examined whether CP calcium correlates with cardiovascular risk in cognitively normal adults. CP calcium was quantified using a previously validated MRI–CT method. Spearman correlations assessed the association of CP calcium and Framingham Cardiovascular Risk Score (FCRS), as well as individual cardiovascular risk factors. Overall, CP calcium was not associated with FCRS. Among APOEε4− subjects, CP calcium correlated positively with FCRS (<em>ρ</em> = 0.26, p = 0.03). Conversely, APOEε4+ subjects showed an unexpected inverse correlation between CP calcium and systolic blood pressure (<em>ρ</em> = −0.38, p = 0.02). Greater CP calcium in association with higher FCRS in APOEε4− individuals mirrors the established link between CAC and cardiovascular risk, suggesting potential for CP calcium as an intracranial marker of vascular health. Divergent findings in APOEε4+ carriers may reflect CP-specific pathways relevant to APOEε4-driven AD pathogenesis.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100537"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599892","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":"Structural brain injury on magnetic resonance imaging in heart failure and identifying patients at high-risk","authors":"Wenyi Tang,&nbsp;Qing Xie,&nbsp;Zihong Huang,&nbsp;Mengjiao Shao,&nbsp;Taoyu Jia,&nbsp;Feng Hu,&nbsp;Ani Wang,&nbsp;Fang Zhou,&nbsp;Zhiling Zhu,&nbsp;Yutao Pan,&nbsp;Lizi Jin,&nbsp;Cunxue Pan,&nbsp;Jian Chen","doi":"10.1016/j.cccb.2026.100555","DOIUrl":"10.1016/j.cccb.2026.100555","url":null,"abstract":"<div><h3>Background</h3><div>Structural brain injury characteristics in heart failure (HF) and risk factors for such injury are poorly defined.</div></div><div><h3>Methods</h3><div>143 consecutive patients with HF who underwent brain magnetic resonance imaging after a HF diagnosis were enrolled. Brain imaging assessments included cerebral infarcts, white matter hyperintensities (WMH), and cerebral atrophy. Logistic regression was used to identify predictors of brain lesions. Cluster analysis was applied to investigate potential phenotypes.</div></div><div><h3>Results</h3><div>Among HF patients, 20.3% had large brain infarcts and 51.0% had lacunes. In those without large infarcts, most showed WMHs (93.9%) and cerebral atrophy (72.8%). Smoking (OR: 5.069, P=0.004), diabetes (OR: 3.140, P=0.028), and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) ≥900 pg/mL (OR: 3.472, P=0.023) were associated with large brain infarcts. Age (OR: 1.075, P=0.002), hypertension (OR: 3.075, P=0.019), higher plasma fibrinogen level (OR: 2.039, P=0.012), and increased serum high-density lipoprotein cholesterol (HDL-C; OR: 7.100, P=0.041) predicted higher WMH Scheltens score. Age (OR: 1.132, P&lt;0.001) and an increased systemic immune-inflammation index (SII; OR: 1.001, P=0.029) were associated with pronounced cerebral atrophy. Cluster analysis revealed that a subtype characterized by higher systemic inflammation, poorer nutrition, and worse cardiac, renal, and hepatic function was associated with a greater risk of lacunar infarcts and atrophy.</div></div><div><h3>Conclusions</h3><div>Structural brain abnormalities are common in HF. Smoking, diabetes, and elevated NT-proBNP predict large brain infarcts; age, hypertension, elevated fibrinogen, and higher HDL-C are associated with WMH severity; and age and SII are linked to cerebral atrophy. A clinical subtype with heightened inflammation and poorer nutrition may face increased risk of brain injury.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100555"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148657716","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":"Gadolinium- and water-based blood-brain barrier dysfunction measures in patients with sporadic small vessel disease","authors":"Michael S Stringer ,&nbsp;Xingfeng Shao ,&nbsp;Hedok Lee ,&nbsp;Antoine Vallatos ,&nbsp;Carmen Arteaga-Reyes ,&nbsp;Una Clancy ,&nbsp;Francesca Chappell ,&nbsp;Cameron Manning ,&nbsp;Maria Valdes-Hernandez ,&nbsp;Daniela Jaime Garcia ,&nbsp;Rosalind Brown ,&nbsp;Fergus N Doubal ,&nbsp;Helene Benveniste ,&nbsp;Michael J Thrippleton ,&nbsp;Danny JJ Wang ,&nbsp;Joanna M Wardlaw ,&nbsp;Mild Stroke Study 3 study group","doi":"10.1016/j.cccb.2026.100528","DOIUrl":"10.1016/j.cccb.2026.100528","url":null,"abstract":"<div><h3>Background</h3><div>Subtle blood-brain barrier (BBB) leakage has been detected in small vessel disease (SVD). While established methods rely on gadolinium-based contrast agents (GBCA), diffusion-weighted arterial spin labelling (DW-ASL) is a promising alternative which assesses water exchange rate (<em>k_w</em>) without injected contrast. However, DW-ASL has not been widely applied in sporadic SVD. We aimed to determine how <em>k_w</em> varied with GBCA BBB leakage measures, baseline and 1-year change in SVD burden.</div></div><div><h3>Methods</h3><div>We recruited patients with mild ischaemic stroke (lacunar or cortical) all characterised for SVD features. We assessed <em>k_w</em> using DW-ASL and GBCA measures of BBB leakage (permeability-surface area product (<em>PS</em>), blood plasma volume and exchange rate of GBCA) using dynamic-contrast enhanced MRI. We used separate linear regression models to assess how <em>k_w</em> varied with GBCA-derived metrics, baseline and 1-year change in WMH volume in co-variate-adjusted analyses.</div></div><div><h3>Results</h3><div>We included 24 with complete MRI (61±10 years; 71% male). Patients with higher <em>k_w</em> tended to have more severe baseline SVD (e.g. subcortical grey matter (SGM): B=14.59 min^-1/%WMH volume, 95% confidence interval (95%CI)=-1.00,28.18, p=0.04) and greater 1-year increase (B=0.0013 %WMH volume increase/min^-1, 95%CI=-0.0001, 0.0026, p=0.06). We generally found <em>k_w</em> and GBCA BBB leakage measures were not meaningfully associated (e.g. SGM <em>k_w</em>∼<em>PS</em>: B=-0.23 min^-1/10^-4 min^-1, 95%CI=-7.47, 7.01, p=0.95).</div></div><div><h3>Conclusion</h3><div>BBB water exchange estimated using DW-ASL tended to be greater with higher WMH burden and progression, suggesting <em>k_w</em> may be a sensitive measure of BBB dysfunction in SVD. However, non-concordance between <em>k_w</em> and GBCA metrics suggests the two methods probe different aspects of BBB function.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100528"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037917","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":"Gender-dependent association between cardiovascular health and cognitive function in chinese older adults: a community based cohort study","authors":"Bowen Wang ,&nbsp;Yi Zeng ,&nbsp;Virginia Byers Kraus ,&nbsp;Xin Gao ,&nbsp;Jixiang Ma ,&nbsp;Xuemei Bai ,&nbsp;Jun Na ,&nbsp;Wei Zhe ,&nbsp;Zhaoxue Yin","doi":"10.1016/j.cccb.2025.100524","DOIUrl":"10.1016/j.cccb.2025.100524","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the gender-dependent association of cardiovascular health, assessed by Life’s Essential 8 (LE8), with cognitive function in Chinese older adults.</div></div><div><h3>Methods</h3><div>Logistic regression was used to explore the relationships between LE8 scores and incident cognitive impairment as well as cognitive decline. Gender differences were examined by subgroup analyses. A generalized linear model (GLM) was used to assess the mean difference of Mini-Mental State Examination (MMSE) scores across LE8 groups.</div></div><div><h3>Results</h3><div>Based on logistic regression, LE8 scores were inversely correlated with prevalence of baseline cognitive impairment (<em>OR</em> = 0.49, 95%<em>CI</em>: 0.30,0.84). Higher LE8 scores were associated with reduced risk of incident cognitive impairment among participants with normal cognition at baseline (<em>OR</em> = 0.56, 95%<em>CI</em>: 0.31,0.99), although there was no significant relationship between high LE8 scores and cognitive decline. Based on subgroup analyses, there was a significant gender-based association of LE8 with incident cognitive impairment (<em>P</em> = 0.022), but not with cognitive decline (<em>P</em> = 0.424). In the female subgroup, higher LE8 scores were associated with low risk of incident cognitive impairment (<em>OR</em> = 0.29, 95%<em>CI</em>: 0.13,0.64). Based on GLM analysis, the adjusted mean MMSE score of the high LE8 group was higher than that of the low LE8 group among all participants with follow-up (adjusted mean difference = 0.44, 95%<em>CI</em>: 0.03,0.85); similar results were observed among those with normal cognition at baseline.</div></div><div><h3>Conclusion</h3><div>A higher LE8 score was significantly associated with better cognitive function in Chinese female but not male older adults.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100524"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926825","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":"The international society of vascular behavioural and cognitive disorders: highlights from VasCog 2025 in the UK.","authors":"Anna Marseglia ,&nbsp;Roxana O. Carare ,&nbsp;Jessica L. Teeling ,&nbsp;Saima Hilal ,&nbsp;Vera Yuan Cai ,&nbsp;Russell Chander ,&nbsp;Hugues Chabriat ,&nbsp;Deborah Gustafson ,&nbsp;Atticus H. Hainsworth ,&nbsp;Gurpreet Kaur Hansra ,&nbsp;Sarah-Naomi James ,&nbsp;Audrey Low ,&nbsp;Julie Ottoy ,&nbsp;Satoshi Saito ,&nbsp;Annemieke ter Telgte ,&nbsp;Hilde van den Brink ,&nbsp;Frank J. Wolters ,&nbsp;Prashanthi Vemuri","doi":"10.1016/j.cccb.2025.100525","DOIUrl":"10.1016/j.cccb.2025.100525","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100525"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926855","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":"Age-inappropriate white matter injury reveals hidden cerebral small vessel disease burden and mortality risk","authors":"Pei-Lin Lee ,&nbsp;Wen-Yu Ou Yang ,&nbsp;Kun-Hsien Chou ,&nbsp;Wei-Ju Lee ,&nbsp;Chen-Yuan Kuo ,&nbsp;Shing-Huei Lin ,&nbsp;Liang-Kung Chen ,&nbsp;Ching-Po Lin ,&nbsp;Chih-Ping Chung","doi":"10.1016/j.cccb.2026.100548","DOIUrl":"10.1016/j.cccb.2026.100548","url":null,"abstract":"<div><h3>Objective</h3><div>White matter hyperintensities (WMH) are a core marker of cerebral small vessel disease (CSVD), but their interpretation is limited by strong age-dependence. We hypothesized that WMH burden disproportionate to age- and sex-expected norms had clinical significance by reflecting disease burden and outcomes.</div></div><div><h3>Methods</h3><div>We developed an age- and sex-referenced normative model of WMH using hierarchical Bayesian regression in 2544 neurologically healthy community-dwelling adults from Taiwan and Japan (50.0–92.1 years, 1319 women). Individualized WMH deviation scores were applied to 1237 community-dwelling participants. Participants were classified into four normative model–defined WMH deviation categories: low, mild, moderate, and high. We tested associations of WMH deviation with vascular risk profiles, cognitive performance, gray matter volumes, and all-cause mortality.</div></div><div><h3>Results</h3><div>Higher WMH deviation identified individuals who were not older but had more adverse vascular profiles. Each one-level increase in WMH deviation was associated with lower global cognition (MMSE β = –0.179, FDR-p = 0.034), poorer verbal memory (β = –0.121, FDR-p = 0.034), and worse visuospatial function (β = –0.330, FDR-p = 0.049), as well as reduced global gray matter (β = –4.180, FDR-p &lt; 0.001) and lower hippocampal and thalamic volumes (all FDR-p ≤ 0.002). During a mean follow-up of 9.4 years, high WMH deviation was associated with increased all-cause mortality after adjustment for age, sex, hypertension, and diabetes (hazard ratio 1.72, 95% CI 1.05–2.82), despite younger age.</div></div><div><h3>Interpretation</h3><div>WMH deviation from age- and sex-expected norms provides clinically-relevant information identifying individuals at increased risk of neurodegeneration and mortality.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100548"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214632","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":"Response to the correspondence regarding “age-inappropriate white matter injury reveals hidden cerebral small vessel disease burden and mortality risk”","authors":"Pei-Lin Lee,&nbsp;Wen-Yu Ou Yang,&nbsp;Kun-Hsien Chou,&nbsp;Wei-Ju Lee,&nbsp;Chen-Yuan Kuo,&nbsp;Shing-Huei Lin,&nbsp;Liang-Kung Chen,&nbsp;Ching-Po Lin,&nbsp;Chih-Ping Chung","doi":"10.1016/j.cccb.2026.100552","DOIUrl":"10.1016/j.cccb.2026.100552","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100552"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426879","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":"Air pollution, neighbourhood walkability and cerebrovascular small vessel disease in patients with cardiovascular disorders along the heart-brain axis","authors":"Ina Rissanen,&nbsp;Erik J. Timmermans,&nbsp;Jeroen de Bresser,&nbsp;Esther E. Bron,&nbsp;Anna E. Leeuwis,&nbsp;Majon Muller,&nbsp;Matthias J.P. van Osch,&nbsp;Betty M. Tijms,&nbsp;Geert Jan Biessels,&nbsp;Ilonca Vaartjes,&nbsp;on behalf of the Heart-Brain Connection Consortium","doi":"10.1016/j.cccb.2026.100565","DOIUrl":"10.1016/j.cccb.2026.100565","url":null,"abstract":"<div><h3>Background</h3><div>We investigated if ambient air pollution and neighbourhood walkability associate with presence and progression of cerebral small vessel disease (CSVD) in patients with cardiovascular disorders along the heart-brain axis.</div></div><div><h3>Methods</h3><div>Data from patients with heart failure, carotid occlusive disease, or vascular cognitive impairment (30% women; mean age 69.0 years) of the Heart-Brain Connection study were used. Brain parenchymal fraction (BPF), white matter hyperintensity fraction (WMH), cerebral blood flow (CBF), and incident vascular lesions were assessed with 3T brain MRI at baseline (n = 300) and at two years follow-up (n = 181). Incident clinical cerebrovascular events were assessed with questionnaires and telephone interviews up to five years. Annual residential nitrogen dioxide (NO₂; µg/m³) concentration was linked to participants at baseline. Neighbourhood walkability was measured using the Dutch walkability index within a 500-m Euclidean buffer around each residential-area centroid (range 0–100). Associations were analyzed using age- and sex-adjusted logistic regression and repeated-measures linear mixed models.</div></div><div><h3>Results</h3><div>At baseline, no association was found between NO₂ or walkability and BPF, WMH, CBF, infarcts or microbleeds. Walkability (per 10 units) was associated with lower odds for having infarcts at baseline (OR 0.82, 95%CI 0.96–0.99) and attenuated age-related WMH increases by 0.01 SD (95%CI 0.00–0.02) per year. In longitudinal analyses, no associations between NO₂ or walkability and progression of vascular brain lesions, cerebrovascular events, or mortality were found.</div></div><div><h3>Conclusion</h3><div>Although air pollution and neighbourhood walkability were not strongly associated with CSVD progression, stroke, or mortality, higher walkability appeared to modestly attenuate age-related increases in WMH.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100565"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159486","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":"Deep learning retinal imaging model identifies poor brain health among older adults without dementia","authors":"Bonnie Yin Ka Lam ,&nbsp;An Ran Ran ,&nbsp;Yuan Cai ,&nbsp;Huijing Zheng ,&nbsp;Jize Wei ,&nbsp;Yuen Tung Ng ,&nbsp;Michael Ying Hong Chan ,&nbsp;Ha Ying Chiu ,&nbsp;Ho Ko ,&nbsp;Carol Y. Cheung ,&nbsp;Vincent Chung Tong Mok","doi":"10.1016/j.cccb.2026.100529","DOIUrl":"10.1016/j.cccb.2026.100529","url":null,"abstract":"<div><h3>Introduction</h3><div>The i-Cog Brain Health is a validated deep learning model for differentiating Alzheimer’s disease dementia from cognitively unimpaired subjects based on retinal photographs. This study aimed to apply the i-Cog Brain Health in subjects without dementia and assess whether this tool may detect alterations in the retinal vessel network in healthy older adults.</div></div><div><h3>Methods</h3><div>Community subjects were recruited from the BEAT AD (<strong>B</strong>rain Health <strong>E</strong>valuation <strong>A</strong>nd <strong>T</strong>ailor-made Measures for Prevention of <strong>A</strong>lzheimer’s <strong>D</strong>isease) service programme. Clinical data, vascular risk factors, lifestyle information and cognitive function were assessed. Tailor-made recommendations were provided to optimise risk factor control. Fundus photographs were obtained using the Topcon NW500 non-mydriatic retinal camera. Subjects were classified into positive or negative using i-Cog Brain Health based on quantitative measurements of retinal vessels.</div></div><div><h3>Results</h3><div>Among the 185 subjects (mean age: 68.14 ± 5.17 years; males: 32.97%), 29 (15.68%) were classified as positive by i-Cog Brain Health. Those subjects were significantly older (<em>p</em> = 0.001) and had wider venular branching width (<em>p</em> = 0.008). Regression analyses showed the venule branching coefficient significantly predicted i-Cog Brain Health positive cases (OR 1.54, 95% CI: 1.05–2.27, <em>p</em> = 0.027), after adjustments for age and mean arterial pressure.</div></div><div><h3>Conclusions</h3><div>The i-Cog Brain Health reflected older age and wider venular branching width, which are associated with dementia. The i-Cog Brain Health showed the potential to differentiate retinal features associated with dementia at an early stage and serve as a risk stratification tool.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100529"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037916","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}