Cerebral circulation - cognition and behavior最新文献

{"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}

{"title":"Imaging markers of vascular cognitive impairment: Current advances and future directions","authors":"Marco Duering ,&nbsp;Prashanthi Vemuri","doi":"10.1016/j.cccb.2026.100538","DOIUrl":"10.1016/j.cccb.2026.100538","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100538"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241290","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":"Comment on “Age-inappropriate white matter injury reveals hidden cerebral small vessel disease burden and mortality risk”","authors":"Madhuri Tribhuvan,&nbsp;Shashikant N. Phatke","doi":"10.1016/j.cccb.2026.100551","DOIUrl":"10.1016/j.cccb.2026.100551","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100551"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426833","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":"Beyond cognition in post-stroke cognitive impairment: neuropsychiatric symptoms and stroke-specific cognitive screening","authors":"Polona Rus Prelog,&nbsp;Matija Zupan,&nbsp;Senta Frol","doi":"10.1016/j.cccb.2026.100553","DOIUrl":"10.1016/j.cccb.2026.100553","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"11 ","pages":"Article 100553"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148570567","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":"Reflections on the Hungarian Oxford Cognitive Screen in post-stroke cognitive care","authors":"Polona Rus Prelog ,&nbsp;Matija Zupan ,&nbsp;Senta Frol","doi":"10.1016/j.cccb.2026.100539","DOIUrl":"10.1016/j.cccb.2026.100539","url":null,"abstract":"","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100539"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600028","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":"Associations between retinal microvasculature and cognition in middle-aged adults with type 1 diabetes without overt neurological symptoms","authors":"Iiris Kyläheiko ,&nbsp;Aleksi Tarkkonen ,&nbsp;Linda Kuusela ,&nbsp;Juha Martola ,&nbsp;Teemu I. Paajanen ,&nbsp;Jussi Virkkala ,&nbsp;Ward Fickweiler ,&nbsp;George L. King ,&nbsp;Jennifer K. Sun ,&nbsp;Joni A. Turunen ,&nbsp;Marika I. Eriksson ,&nbsp;Per-Henrik Groop ,&nbsp;Lena M. Thorn ,&nbsp;Turgut Tatlisumak ,&nbsp;Jukka Putaala ,&nbsp;Hanna Jokinen ,&nbsp;Daniel Gordin ,&nbsp;FinnDiane Study Group","doi":"10.1016/j.cccb.2026.100536","DOIUrl":"10.1016/j.cccb.2026.100536","url":null,"abstract":"<div><h3>Aims</h3><div>Type 1 diabetes is a risk factor for retinal microvascular pathology, cerebral small vessel disease (cSVD), and cognitive deficits. In older individuals with type 1 diabetes, decreased vessel densities of superficial (SCP) and deep (DCP) retinal capillary plexuses have been associated with cognitive impairment. We assessed whether these associations are already evident in midlife among individuals without overt neurological symptoms. We also investigated whether cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs), manifestations of cSVD, modify these associations.</div></div><div><h3>Methods</h3><div>We measured vessel density of the SCP and DCP, and area of foveal avascular zone (FAZ) in macular 3×3 mm optical coherence tomography angiography (OCTA) images and performed a comprehensive neuropsychological assessment and brain MRI in 153 adults with type 1 diabetes (age 46.4±7.5 years, diabetes duration 30.7±10.1 years).</div></div><div><h3>Results</h3><div>In univariate analyses, SCP, DCP, and FAZ were related to measures of processing speed and executive functions (standardized <em>β</em> ranged from –0.29 to –0.19, <em>p</em>-values from &lt;0.001 to 0.018). However, after adjusting for age and relevant clinical markers, only association between FAZ and a sensitive working memory task (standardized <em>β</em>=–0.25, <em>p</em>&lt;0.05) remained significant. In interaction analyses, CMBs and WMHs did not modify these associations.</div></div><div><h3>Conclusions</h3><div>Enlarged FAZ was associated with poorer working memory performance independently of confounding factors. Otherwise, age largely explained the associations between retinal microvascular structure and cognition in middle-aged individuals with type 1 diabetes without any overt neurological symptoms.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100536"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600029","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":"Relevance of cerebral microbleeds with leaky blood brain barrier in traumatic brain injury and protective role of interferon-gamma: A cohort study","authors":"Xuan Vinh To ,&nbsp;Javier Urriola ,&nbsp;Viktor Vegh ,&nbsp;Patrick Donnelly ,&nbsp;Liam Maclachlan ,&nbsp;Kate Mahady ,&nbsp;Eduardo Miguel Apellaniz ,&nbsp;Ryan Lim ,&nbsp;Guido Gonzalez ,&nbsp;Ricardo Wenger ,&nbsp;Paul Cumming ,&nbsp;Craig Winter ,&nbsp;Fatima Nasrallah","doi":"10.1016/j.cccb.2025.100523","DOIUrl":"10.1016/j.cccb.2025.100523","url":null,"abstract":"<div><h3>Objectives</h3><div>Cerebral microbleeds (CMBs), which present as foci of hypointensities on T2*-weighted Magnetic Resonance Imaging (MRI) are associated with weakened vessel walls. CMBs are also a frequent finding in traumatic brain injury (TBI) in association with poor outcome. We investigated whether a combination of susceptibility weighted imaging (SWI) and dynamic contrast enhanced (DCE) MRI could accurately identify characteristics of CMBs that are most relevant to TBI.</div></div><div><h3>Materials and Methods</h3><div>Thirty TBI patients were recruited from a neurosurgical unit. We acquired structural three-dimensional T1-weighted, T2-weighted dark fluid, SWI, and DCE-MRI images on a 3T MRI. DCE-MRI data was fitted for a linear graphic (Patlak-Gjedde) model to calculate voxel-wise volume transfer constant (K^trans) maps. K^trans ranges of normal-appearing brain (NAB) areas were quantified and two sub-classes of CMBs—leaky and non-leaky CMBs—were identified. Characteristics and spatial distribution of the quantified imaging metrics and the immunological blood panel results were then compared across mild versus moderate–severe TBI groups, as classified by Glasgow Coma Scale.</div></div><div><h3>Results</h3><div>More severe TBI was associated with CMBs exhibiting leaky BBB as quantified by DCE-MRI. Higher blood levels of interferon gamma (IFN-γ) were associated with lower number of CMBs in TBI patients at more than 8 days post-TBI.</div></div><div><h3>Discussion</h3><div>combined DCE-MRI and SWI confirmed that CMBs with leaky BBBs are more prevalent in moderate-severe TBIs compared. Higher levels of IFN-γ appeared to have been associated with fewer CMBs in the sub-acute stage of TBI.</div></div>","PeriodicalId":72549,"journal":{"name":"Cerebral circulation - cognition and behavior","volume":"10 ","pages":"Article 100523"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712147","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}