Cerebral circulation - cognition and behavior最新文献

{"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":"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":"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":"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}

{"title":"Evaluation of cerebrovascular reactivity impairment using resting-state BOLD MRI in symptomatic patients with unilateral intracranial artery occlusion","authors":"Yi Shan ,&nbsp;Ya-yan Yin ,&nbsp;Bi-xiao Cui ,&nbsp;Shao-zhen Yan ,&nbsp;Yue Zhang ,&nbsp;Bin Yang ,&nbsp;Yan Ma ,&nbsp;Jie Lu","doi":"10.1016/j.cccb.2026.100532","DOIUrl":"10.1016/j.cccb.2026.100532","url":null,"abstract":"<div><h3>Objectives</h3><div>Cerebral vascular reactivity (CVR) is an independent predictor of poor prognosis for patients with symptomatic middle cerebral artery (MCA)/internal carotid artery (ICA) occlusion. This study assessed CVR impairment using resting-state blood oxygenation level-dependent (RS BOLD) MRI in this population and aimed to identify feasible pre-surgical markers.</div></div><div><h3>Methods</h3><div>The study included 45 patients with symptomatic unilateral MCA/ICA occlusion and 20 healthy controls. Of these, 16 underwent extracranial-intracranial (EC-IC) bypass with follow-up MRI. RS BOLD data were collected using a 3.0 T PET/MR system. Voxel-wise CVR maps were computed with a general linear model, and the mean CVR in the MCA perfusion territory was calculated. Interhemispheric CVR asymmetry index (CVR-AI) was assessed. Group differences were analyzed, and ROC analysis was used to evaluate CVR's diagnostic performance. Pearson correlation was used to assess relationships between baseline CVR and post-surgical changes.</div></div><div><h3>Results</h3><div>Affected-side CVR was significantly lower compared to the contralateral side and controls (<em>P</em> &lt; 0.01). Individual analysis showed significant differences in the proportions of decreased, normal, and increased CVR between the affected and contralateral sides (<em>P</em> &lt; 0.0001). CVR-AI showed high predictive efficiency for discriminating patients from controls (AUC = 0.762). Post-surgery, the affected-side CVR increased significantly, whereas CVR-AI decreased but remained higher than in controls (<em>P</em> &lt; 0.05). Preoperative CVR-AI positively correlated with post-surgery affected-side CVR increase (<em>R</em> = 0.725) and CVR-AI decrease (<em>R</em> = 0.635).</div></div><div><h3>Conclusion</h3><div>This study proposes CVR-AI as a novel imaging marker for pre-surgical evaluation in patients with unilateral intracranial arterial occlusion.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100532"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277867","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":"Defining patient-reported outcomes and priorities for clinical trials in CADASIL through an international survey","authors":"Nikolaos Karvelas ,&nbsp;Sheila Connor ,&nbsp;Andria Burroso ,&nbsp;Ki Coale ,&nbsp;Mariana Lemos Duarte ,&nbsp;Yuguang Xiong ,&nbsp;Liqhwa Ncube ,&nbsp;Claudia Kunney ,&nbsp;Debarag Banerjee ,&nbsp;Michael Kennedy ,&nbsp;Sarah McDaniels ,&nbsp;Pedro de Lencastre ,&nbsp;Jane Gunther ,&nbsp;Bert Kasiske ,&nbsp;Fanny M. Elahi","doi":"10.1016/j.cccb.2026.100534","DOIUrl":"10.1016/j.cccb.2026.100534","url":null,"abstract":"<div><h3>Background</h3><div>A major challenge faced by clinical trials for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the heterogeneity of symptoms and variable progression pace, while treatments should attenuate symptoms that bother patients most. To this end, we set to describe the symptomatic landscape for CADASIL with the ultimate goal of developing Patient Reported Outcomes (PRO) for clinical trials.</div></div><div><h3>Methods</h3><div>A survey was compiled through iterative consensus meetings between patients, family members, CADASIL clinicians, and patient advocacy group members (cureCADASIL). The final questionnaire included demographic information, subjective symptom severity ratings, medication use and lifestyle factors. Data were collected over a period of 16 months from 11/2023 to 3/2025 and analyzed through descriptive and quantitative methods.</div></div><div><h3>Results</h3><div>We collected 226 responses from 25 countries. The average age of responders was 52 (SD 12) years, and 158 (69.9 %) identified as women. Out of all symptoms, fatigue was reported as the most frequent (86.3 %), and most bothersome (14.2 %). Symptom severity differed across age groups only for headaches, with younger participants reporting higher scores (Kruskal–Wallis χ² = 8.64, p = 0.03). All symptoms were intercorrelated, with strongest clustering among congruent categories such as slowed thinking, cognitive fog, and memory complaints (Spearman’s ρ ≥ 0.70, adjusted p &lt; 0.001). Medication use was widespread: 156 participants (69 %) reported prescription medications, 116 (51.3 %) over-the-counter drugs, and 128 (56.6 %) supplements.</div></div><div><h3>Conclusions</h3><div>By identifying symptom domains most salient to patients, our study provides a foundation for the development of PRO tools in CADASIL.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100534"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357615","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 and vascular alterations of deep cervical lymph nodes in amyloid PET-positive Alzheimer's disease patients","authors":"Tae Hyung Kim ,&nbsp;Jin Geun Kwon ,&nbsp;Jimmy Sung-Chuan Chao ,&nbsp;Jae Woo Kim ,&nbsp;Changsik John Pak ,&nbsp;Hyunsuk Peter Suh ,&nbsp;Jae-Sung Lim ,&nbsp;Joon Pio Hong","doi":"10.1016/j.cccb.2026.100533","DOIUrl":"10.1016/j.cccb.2026.100533","url":null,"abstract":"<div><h3>Background</h3><div>Impaired clearance of brain-derived waste via the glymphatic–lymphatic system has been implicated in Alzheimer’s disease (AD) pathogenesis. Although animal studies highlight the role of deep cervical lymph nodes (dCLNs) in draining brain interstitial solutes, their characteristics in AD patients remain unknown. This study assessed structural and vascular alterations of dCLNs in AD using high-frequency color Doppler ultrasound (HFCDU).</div></div><div><h3>Methods</h3><div>Twenty-five patients with amyloid PET–positive AD and 25 age-matched cognitively normal controls underwent HFCDU of dCLNs at neck zone 2–5. Lymph node number, shape, morphology, vascularity (via Superb Microvascular Imaging, SMI), and Solbiati index were quantified. Between-group differences were analyzed using logistic regression and receiver operating characteristic (ROC) analyses, and a simplified diagnostic score was developed from discriminative features.</div></div><div><h3>Results</h3><div>A total of 482 lymph nodes were analyzed (210 from AD, 272 from controls). AD patients had fewer oval-shaped nodes (50% vs. 83%, p&lt;0.001), more irregular morphology (23% vs. 1%, p&lt;0.001), and less distinct internal structure (40% vs. 57%, p&lt;0.001). In Zone 5, they also had fewer nodes (2.4 ± 1.8 vs. 3.8 ± 2.6, p=0.034) and reduced SMI positivity (75% vs. 91%, p=0.006). The count of oval, moderately vascularized (SMI ≤7) nodes in Zone 5 best discriminated AD (AUC=0.79). A composite score integrating these parameters yielded AUC=0.81 (sensitivity 64%, specificity 84%).</div></div><div><h3>Conclusions</h3><div>HFCDU demonstrated distinct morphological and vascular abnormalities of dCLNs in AD, particularly in Zone 5, suggesting impaired lymphatic drainage contributes to AD pathology and supporting lymphatic imaging as a potential biomarker for the failure of lymphatic drainage of the brain.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100533"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357640","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":"Evaluating regional and global diffusion measures as biomarkers for vascular contributions to cognitive impairment and dementia","authors":"Sheelakumari Raghavan ,&nbsp;Scott A. Przybelski ,&nbsp;Robert I. Reid ,&nbsp;Michael G. Kamykowski ,&nbsp;Jonathan Graff-Radford ,&nbsp;Val J. Lowe ,&nbsp;David S. Knopman ,&nbsp;Clifford R. Jack Jr ,&nbsp;Ronald C. Petersen ,&nbsp;Prashanthi Vemuri","doi":"10.1016/j.cccb.2025.100526","DOIUrl":"10.1016/j.cccb.2025.100526","url":null,"abstract":"<div><h3>Background</h3><div>Diffusion MRI (dMRI) has been proposed for quantifying early tissue changes in cerebral small vessel disease (SVD). We evaluated the regional dependance of predictors of white matter (WM) damage and compared the utility of longitudinal WM changes in the commonly available diffusion MRI measures for vascular contribution to cognitive impairment and dementia (VCID) prevention trials.</div></div><div><h3>Methods</h3><div>We included 718 participants (mean age: 71.1(9.6) years, 56 % males) with at least two dMRI scans, amyloid-PET, and structural imaging. We computed single-shell dMRI measures (fractional anisotropy, mean diffusivity, free water, peak-width skeletonized mean diffusivity (PSMD) and assessed: i) regional dependance of predictors of baseline WM damage using voxel-level analyses; ii) longitudinal associations between dMRI measures and cognition; and iii) sample size estimates for a hypothetical clinical trial considering the regional and global dMRI measures as markers for VCID. We also included white matter hyperintensities (WMH) and our recently proposed composite vascular WM score (combination of WMH and fractional anisotropy of the genu) as a comparison.</div></div><div><h3>Results</h3><div>Vascular risk was consistently associated with dMRI changes in the genu of the corpus callosum. All SVD markers correlated with cognitive performance longitudinally. Global free water and the composite score provided the smallest sample size estimates, especially in participants with prevalent vascular disease (aged 70–89).</div></div><div><h3>Conclusions</h3><div>dMRI markers had significant frontal lobe changes due to vascular risk and were sensitive to cognitive decline. The composite vascular WM score, global free water, and WMH emerged as promising VCID biomarkers, but further validation is needed in multiple populations.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100526"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926826","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}