Reinier Wp Tack, Nelleke Tolboom, Bas Meyer Viol, Sandeep Sv Golla, Bart Nm van Berckel, Irene C van der Schaaf, Ronald Boellaard, Alberto de Luca, Martine Je van Zandvoort, Johanna Ma Visser-Meily, Elly M Hol, Gabriel Je Rinkel, Mervyn DI Vergouwen
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Patients underwent neuropsychological evaluation, translocator protein 18 kDA (TSPO) positron emission tomography (PET) imaging using [<sup>18</sup>F]DPA-714 to determine neuroinflammation, and brain diffusion kurtosis imaging (DKI) to determine microstructural damage. We compared TSPO PET binding potential, mean kurtosis (MK), kurtosis anisotropy (KA), axial kurtosis (AK), and radial kurtosis (RA) between groups and determined which metric was correlated with individual cognitive tests.</p><p><strong>Results: </strong>We included 27 patients with aSAH; 14 with and 13 without cognitive impairment. Whole-brain TSPO binding potential was similar between groups (mean BP<sub>ND</sub>: -0.046 [95% confidence interval (CI): -0.105; 0.013] vs -0.047 [95% CI -0.108; 0.014], p = 0.98) and there were no regional differences. Those with cognitive impairment had a lower whole-brain MK (mean MK 0.70 [95% CI: 0.69-0.72] vs 0.73 [95% CI: 0.72-0.74], p = 0.03) and whole-brain AK (mean AK 0.81 [95% CI: 0.78-0.83] vs 0.86 [0.84-0.87], p = 0.04). Left thalamic MK and AK were correlated with tests of verbal memory (r = 0.60-0.67, p < 0.01), while other correlation tests were non-significant.</p><p><strong>Conclusion: </strong>Our results do not support the hypothesis that long-term cognitive impairment after aSAH is caused by long-term neuroinflammation. 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We aimed to determine whether long-term neuroinflammation or microstructural brain damage is associated with cognitive impairment after aSAH.</p><p><strong>Methods: </strong>In this prospective cohort study, we included patients >3 years after aSAH between 2020 and 2022. Patients underwent neuropsychological evaluation, translocator protein 18 kDA (TSPO) positron emission tomography (PET) imaging using [<sup>18</sup>F]DPA-714 to determine neuroinflammation, and brain diffusion kurtosis imaging (DKI) to determine microstructural damage. We compared TSPO PET binding potential, mean kurtosis (MK), kurtosis anisotropy (KA), axial kurtosis (AK), and radial kurtosis (RA) between groups and determined which metric was correlated with individual cognitive tests.</p><p><strong>Results: </strong>We included 27 patients with aSAH; 14 with and 13 without cognitive impairment. Whole-brain TSPO binding potential was similar between groups (mean BP<sub>ND</sub>: -0.046 [95% confidence interval (CI): -0.105; 0.013] vs -0.047 [95% CI -0.108; 0.014], p = 0.98) and there were no regional differences. Those with cognitive impairment had a lower whole-brain MK (mean MK 0.70 [95% CI: 0.69-0.72] vs 0.73 [95% CI: 0.72-0.74], p = 0.03) and whole-brain AK (mean AK 0.81 [95% CI: 0.78-0.83] vs 0.86 [0.84-0.87], p = 0.04). Left thalamic MK and AK were correlated with tests of verbal memory (r = 0.60-0.67, p < 0.01), while other correlation tests were non-significant.</p><p><strong>Conclusion: </strong>Our results do not support the hypothesis that long-term cognitive impairment after aSAH is caused by long-term neuroinflammation. 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引用次数: 0
摘要
动脉瘤性蛛网膜下腔出血（aSAH）的幸存者通常有认知障碍，这可能是由长期炎症引起的。我们的目的是确定长期神经炎症或脑微结构损伤是否与aSAH后的认知障碍有关。方法：在这项前瞻性队列研究中，我们纳入了2020年至2022年aSAH后3年的患者。患者接受神经心理学评估、转运蛋白18 kDA （TSPO）正电子发射断层扫描（PET）成像（使用[18F]DPA-714检测神经炎症）和脑弥散峰度成像（DKI）检测微结构损伤。我们比较了各组之间的TSPO PET结合电位、平均峰度（MK）、峰度各向异性（KA）、轴向峰度（AK）和径向峰度（RA），并确定哪个指标与个体认知测试相关。结果纳入27例aSAH患者；14人有认知障碍，13人没有认知障碍。两组间全脑TSPO结合电位相似(平均BPND -0.046 [95% CI -0.105；0.013 vs -0.047 [95% CI -0.108；0.014], p = 0.98)，无区域差异。认知障碍患者的全脑MK（平均MK 0.70 [95% CI 0.69-0.72] vs 0.73 [95% CI 0.72-0.74], p = 0.03）和全脑AK（平均AK 0.81 [95% CI 0.78-0.83] vs 0.86 [0.84-0.87], p = 0.04）较低。左丘脑MK、AK与言语记忆测验呈显著相关（r = 0.60 ~ 0.67, p < 0.01），其他测验均无显著相关。结论sour结果不支持aSAH后长期认知障碍是由长期神经炎症引起的假说。相反，微观结构损伤可能起作用。
Neuroinflammation in long-term cognitive impairment after aneurysmal subarachnoid hemorrhage.
Background: Survivors of aneurysmal subarachnoid hemorrhage (aSAH) often have cognitive impairment, which may be caused by long-term inflammation. We aimed to determine whether long-term neuroinflammation or microstructural brain damage is associated with cognitive impairment after aSAH.
Methods: In this prospective cohort study, we included patients >3 years after aSAH between 2020 and 2022. Patients underwent neuropsychological evaluation, translocator protein 18 kDA (TSPO) positron emission tomography (PET) imaging using [18F]DPA-714 to determine neuroinflammation, and brain diffusion kurtosis imaging (DKI) to determine microstructural damage. We compared TSPO PET binding potential, mean kurtosis (MK), kurtosis anisotropy (KA), axial kurtosis (AK), and radial kurtosis (RA) between groups and determined which metric was correlated with individual cognitive tests.
Results: We included 27 patients with aSAH; 14 with and 13 without cognitive impairment. Whole-brain TSPO binding potential was similar between groups (mean BPND: -0.046 [95% confidence interval (CI): -0.105; 0.013] vs -0.047 [95% CI -0.108; 0.014], p = 0.98) and there were no regional differences. Those with cognitive impairment had a lower whole-brain MK (mean MK 0.70 [95% CI: 0.69-0.72] vs 0.73 [95% CI: 0.72-0.74], p = 0.03) and whole-brain AK (mean AK 0.81 [95% CI: 0.78-0.83] vs 0.86 [0.84-0.87], p = 0.04). Left thalamic MK and AK were correlated with tests of verbal memory (r = 0.60-0.67, p < 0.01), while other correlation tests were non-significant.
Conclusion: Our results do not support the hypothesis that long-term cognitive impairment after aSAH is caused by long-term neuroinflammation. Instead, microstructural damage may play a role.
期刊介绍：
The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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