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1. A Brain Care Score for Dementia and Stroke: Data from the UK Biobank Cohort (P10-15.002)

Author

Singh, Sanjula, primary, Oreskovic, Tin, additional, Carr, Sinclair, additional, Papier, Keren, additional, Conroy, Megan, additional, Senff, Jasper, additional, Chemali, Zeina, additional, Gutierrez-Martinez, Leidys, additional, Parodi, Livia, additional, Mayerhofer, Ernst, additional, Marini, Sandro, additional, Nunley, Courtney, additional, Newhouse, Amy, additional, Ouyang, An, additional, Brouwers, Bart, additional, Westover, Brandon, additional, Rivier, Cyprien, additional, Falcone, Guido, additional, Howard, Virgina, additional, Howard, George, additional, Pikula, Aleksandra, additional, Ibrahim, Sarah, additional, Sheth, Kevin, additional, Yechoor, Nirupama, additional, Lazar, Ronald, additional, Anderson, Christopher, additional, Fricchione, Gregory, additional, Littlejohns, Thomas, additional, and Rosand, Jonathan, additional

Published
2024
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2. A Brain Care Score for Risk of Late-life Depression: Data from the UK Biobank Cohort (P10-15.001)

Author

Singh, Sanjula, primary, Rivier, Cyprien, additional, Oreskovic, Tin, additional, Carr, Sinclair, additional, Papier, Keren, additional, Chemali, Zeina, additional, Gutierrez-Martinez, Leidys, additional, Mallick, Akashleena, additional, Parodi, Livia, additional, Mayerhofer, Ernst, additional, Senff, Jasper, additional, Kourkoulis, Christina, additional, Marini, Sandro, additional, Clocchiatti-Tuozzo, Santiago, additional, Nunley, Courtney, additional, Newhouse, Amy, additional, Ouyang, An, additional, Westover, Brandon, additional, Lazar, Ronald, additional, Pikula, Aleksandra, additional, Ibrahim, Sarah, additional, Brouwers, Bart, additional, Howard, Virgina, additional, Howard, George, additional, Yechoor, Nirupama, additional, van Duijn, Cornelia, additional, Littlejohns, Thomas, additional, Sheth, Kevin, additional, Rosand, Jonathan, additional, Gricchione, Gregory, additional, Anderson, Christopher, additional, and Falcone, Guido, additional

Published
2024
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3. Brain Care Score and Neuroimaging Markers of Brain Health in Asymptomatic Middle-Age Persons.

Author

Rivier, Cyprien A., Singh, Sanjula, Senff, Jasper, Tack, Reinier W., Marini, Sandro, Clocchiatti-Tuozzo, Santiago, Shufan Huo, Renedo, Daniela, Papier, Keren, Conroy, Megan, Littlejohns, Thomas J., Chemali, Zeina, Kourkoulis, Christina, Payabvash, Seyedmehdi, Newhouse, Amy, Westover, M. Brandon, Lazar, Ronald M., Pikula, Aleksandra, Ibrahim, Sarah, and Howard, Virginia J.

Published
2024
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4. Insulin-like growth factor-1 and risk of Alzheimer dementia and brain atrophy

Author

Westwood, Andrew J, Beiser, Alexa, DeCarli, Charles, Harris, Tamara B, Chen, Tai C, He, Xue-mei, Roubenoff, Ronenn, Pikula, Aleksandra, Au, Rhoda, Braverman, Lewis E, Wolf, Philip A, Vasan, Ramachandran S, and Seshadri, Sudha

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Prevention, Neurodegenerative, Dementia, Acquired Cognitive Impairment, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Aging, Clinical Research, Brain Disorders, Alzheimer's Disease, Neurological, Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Atrophy, Brain, Female, Humans, Insulin-Like Growth Factor I, Magnetic Resonance Imaging, Male, Middle Aged, Proportional Hazards Models, Psychiatric Status Rating Scales, Residence Characteristics, Retrospective Studies, Risk, Cognitive Sciences, Neurology & Neurosurgery, Clinical sciences
Abstract

ObjectiveTo relate serum insulin-like growth factor-1 (IGF-1) to risk of Alzheimer disease (AD) dementia and to brain volumes in a dementia-free community sample spanning middle and older ages.MethodsDementia-free Framingham participants from generation 1 (n = 789, age 79 ± 4 years, 64% women) and generation 2 (n = 2,793, age 61 ± 9 years, 55% women; total = 3,582, age 65 ± 11 years, 57% women) had serum IGF-1 measured in 1990-1994 and 1998-2001, respectively, and were followed prospectively for incident dementia and AD dementia. Brain MRI was obtained in stroke- and dementia-free survivors of both generations 1 (n = 186) and 2 (n = 1,867) during 1999-2005. Baseline IGF-1 was related to risk of incident dementia using Cox models and to total brain and hippocampal volumes using linear regression in multivariable models adjusted for age, sex, APOE ε4, plasma homocysteine, waist-hip ratio, and physical activity.ResultsMean IGF-1 levels were 144 ± 60 μg/L in generation 1 and 114 ± 37 μg/L in generation 2. We observed 279 cases of incident dementia (230 AD dementia) over a mean follow-up of 7.4 ± 3.1 years. Persons with IGF-1 in the lowest quartile had a 51% greater risk of AD dementia (hazard ratio = 1.51, 95% confidence interval: 1.14-2.00; p = 0.004). Among persons without dementia, higher IGF-1 levels were associated with greater total brain volumes (β/SD increment in IGF-1 was 0.55 ± 0.24, p = 0.025; and 0.26 ± 0.06, p < 0.001, for generations 1 and 2, respectively).ConclusionLower serum levels of IGF-1 are associated with an increased risk of developing AD dementia and higher levels with greater brain volumes even among middle-aged community-dwelling participants free of stroke and dementia. Higher levels of IGF-1 may protect against subclinical and clinical neurodegeneration.

Published
2014

6. Global Differences in Risk Factors, Etiology, and Outcome of Ischemic Stroke in Young Adults—A Worldwide Meta-analysis

Author

Jacob, Mina A., primary, Ekker, Merel S., additional, Allach, Youssra, additional, Cai, Mengfei, additional, Aarnio, Karoliina, additional, Arauz, Antonio, additional, Arnold, Marcel, additional, Bae, Hee-Joon, additional, Bandeo, Lucrecia, additional, Barboza, Miguel A., additional, Bolognese, Manuel, additional, Bonardo, Pablo, additional, Brouns, Raf, additional, Chuluun, Batnairamdal, additional, Chuluunbatar, Enkhzaya, additional, Cordonnier, Charlotte, additional, Dagvajantsan, Byambasuren, additional, Debette, Stephanie, additional, Don, Adi, additional, Enzinger, Chris, additional, Ekizoglu, Esme, additional, Fandler-Höfler, Simon, additional, Fazekas, Franz, additional, Fromm, Annette, additional, Gattringer, Thomas, additional, Hora, Thiago F., additional, Jern, Christina, additional, Jood, Katarina, additional, Kim, Young Seo, additional, Kittner, Steven, additional, Kleinig, Timothy, additional, Klijn, Catharina J.M., additional, Kõrv, Janika, additional, Kumar, Vinod, additional, Lee, Keon-Joo, additional, Lee, Tsong-Hai, additional, Maaijwee, Noortje A.M., additional, Martinez-Majander, Nicolas, additional, Marto, João Pedro, additional, Mehndiratta, Man M., additional, Mifsud, Victoria, additional, Montanaro, Vinícius, additional, Pacio, Gisele, additional, Patel, Vinod B., additional, Phillips, Matthew C., additional, Piechowski-Jozwiak, Bartlomiej, additional, Pikula, Aleksandra, additional, Ruiz-Sandoval, Jose, additional, von Sarnowski, Bettina, additional, Swartz, Richard H., additional, Tan, Kay-Sin, additional, Tanne, David, additional, Tatlisumak, Turgut, additional, Thijs, Vincent, additional, Viana-Baptista, Miguel, additional, Vibo, Riina, additional, Wu, Teddy Y., additional, Yesilot, Nilüfer, additional, Waje-Andreassen, Ulrike, additional, Pezzini, Alessandro, additional, Putaala, Jukka, additional, Tuladhar, Anil M., additional, and de Leeuw, Frank-Erik, additional

Published
2022
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7. Global Differences in Risk Factors, Etiology, and Outcome of Ischemic Stroke in Young Adults—A Worldwide Meta-analysis

Author

Mina A. Jacob, Merel S. Ekker, Youssra Allach, Mengfei Cai, Karoliina Aarnio, Antonio Arauz, Marcel Arnold, Hee-Joon Bae, Lucrecia Bandeo, Miguel A. Barboza, Manuel Bolognese, Pablo Bonardo, Raf Brouns, Batnairamdal Chuluun, Enkhzaya Chuluunbatar, Charlotte Cordonnier, Byambasuren Dagvajantsan, Stephanie Debette, Adi Don, Chris Enzinger, Esme Ekizoglu, Simon Fandler-Höfler, Franz Fazekas, Annette Fromm, Thomas Gattringer, Thiago F. Hora, Christina Jern, Katarina Jood, Young Seo Kim, Steven Kittner, Timothy Kleinig, Catharina J.M. Klijn, Janika Kõrv, Vinod Kumar, Keon-Joo Lee, Tsong-Hai Lee, Noortje A.M. Maaijwee, Nicolas Martinez-Majander, João Pedro Marto, Man M. Mehndiratta, Victoria Mifsud, Vinícius Montanaro, Gisele Pacio, Vinod B. Patel, Matthew C. Phillips, Bartlomiej Piechowski-Jozwiak, Aleksandra Pikula, Jose Ruiz-Sandoval, Bettina von Sarnowski, Richard H. Swartz, Kay-Sin Tan, David Tanne, Turgut Tatlisumak, Vincent Thijs, Miguel Viana-Baptista, Riina Vibo, Teddy Y. Wu, Nilüfer Yesilot, Ulrike Waje-Andreassen, Alessandro Pezzini, Jukka Putaala, Anil M. Tuladhar, Frank-Erik de Leeuw, Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Adolescent, Incidence, lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], 610 Medicine & health, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Stroke, Young Adult, Risk Factors, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), Research Article, Ischemic Stroke
Abstract

Background and ObjectivesThere is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional health care services. We studied the global distribution of risk factors, causes, and 3-month mortality of young patients with ischemic stroke, by performing a patient data meta-analysis from different cohorts worldwide.MethodsWe performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18–50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.ResultsWe included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas “other determined stroke” and “undetermined stroke” were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42–4.36).DiscussionEthnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve health care facilities in LMICs.

Published
2022
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8. Global impact of the COVID-19 pandemic on stroke care and intravenous thrombolysis (1462)

Author

Nguyen, Thanh, primary, Qureshi, Muhammad, additional, Martins, Sheila, additional, Yamagami, Hiroshi, additional, Qiu, Zhongming, additional, Mansour, Ossama, additional, Czlonkowska, Anna, additional, Abdalkader, Mohamad, additional, Sathya, Anvitha, additional, de Sousa, Diana Aguiar, additional, Demeestere, Jelle, additional, Mikulik, Robert, additional, Vanacker, Peter, additional, Siegler, James, additional, Korv, Janika, additional, Biller, Jose, additional, Liang, Conrad, additional, Sangha, Navdeep, additional, Zha, Alicia, additional, Czap, Alexandra, additional, Holmstedt, Christine, additional, Turan, Tanya, additional, Grant, Cheryl, additional, Ntaios, George, additional, Malhotra, Konard, additional, Tayal, Ashis, additional, Loochtan, Aaron, additional, Mistry, Eva, additional, Alexandrov, Anne, additional, Huang, David, additional, Yaghi, Shadi, additional, Raz, Eytan, additional, Sheth, Sunil, additional, Frankel, Michael, additional, Lamou, Eric Gueumekane Bila, additional, Aref, Hany, additional, Elbassiouny, Ahmed, additional, Hassan, Farouk, additional, Mustafa, Wessam, additional, Menecie, Tarek, additional, Shokri, Hossam, additional, Roushdy, Tamer, additional, Sarfo, Fred Stephen, additional, Alabi, Tolulope, additional, Arabambi, Babawale, additional, Nwazor, Ernest, additional, Sunmonu, Taofiki Ajao, additional, Wahab, Kolawole W., additional, Mohammed, Haythem Hussein, additional, Adebayo, Philip B., additional, Riahi, Anis, additional, Ben Sassi, Samia, additional, Gwaunza, Lenon, additional, Rahman, Aminur, additional, Ai, Zhibing, additional, Bai, Fanghui, additional, Duan, Zhenhui, additional, Hao, Yonggang, additional, Huang, Wenguo, additional, Li, Guangwen, additional, Li, Wei, additional, Liu, Ganzhe, additional, Luo, Jun, additional, Shang, Xianjin, additional, Sui, Yi, additional, Tian, Ling, additional, Wen, Hongbin, additional, Wu, Bo, additional, Yan, Yuying, additional, Yuan, Zhengzhou, additional, Zhang, Hao, additional, Zhang, Jun, additional, Zhao, Wenlong, additional, Zi, Wenjie, additional, Leung, Thomas K., additional, Sahakyan, David, additional, Chugh, Chandril, additional, Huded, Vikram, additional, Menon, Bindu, additional, Pandian, Jeyaraj, additional, Sylaja, P.N., additional, Usman, Fritz Sumantri, additional, Farhoudi, Mehdi, additional, Sadeghi-Hokmabadi, Elyar, additional, Reznik, Anna, additional, Sivan-Hoffman, Rotem, additional, Horev, Anat, additional, Ohara, Nobuyuki, additional, Sakai, Nobuyuki, additional, Watanabe, Daisuke, additional, Yamamoto, Ryoo, additional, Doijiri, Ryosuke, additional, Tokuda, Naoki, additional, Yamada, Takehiro, additional, Terasaki, Tadashi, additional, Yazawa, Yukako, additional, Uwatoko, Takeshi, additional, Dembo, Tomohisa, additional, Shimizu, Hisao, additional, Sugiura, Yuri, additional, Miyashita, Fumio, additional, Fukuda, Hiroki, additional, Miyake, Kosuke, additional, Shimbo, Junsuke, additional, Sugimura, Yusuke, additional, Yagita, Yoshika, additional, Takenobu, Yohei, additional, Matsumaru, Yuji, additional, Yamada, Satoshi, additional, Kono, Ryuhei, additional, Kanamaru, Takuya, additional, Yamazaki, Hidekazu, additional, Sakaguchi, Manabu, additional, Todo, Kenichi, additional, Yamamoto, Nobuaki, additional, Sonodda, Kazutaka, additional, Yoshida, Tomoko, additional, Hashimoto, Hiroyuki, additional, Nakahara, Ichiro, additional, Faizullina, Kamila, additional, Kamenova, Saltanat, additional, Kondybayeva, Aida, additional, Zhanuzakov, Murat, additional, Baek, Jang-Hyun, additional, Hwang, Yangha, additional, Lee, Si Baek, additional, Moon, Jusun, additional, Park, Hyungjong, additional, Seo, Jung Hwa, additional, Seo, Kwon-Duk, additional, Young, Chang Jun, additional, Ahdab, Rechdi, additional, Aziz, Zariah Abdul, additional, Zaidi, Wan Asyraf Wan, additional, Basri, Hamidon Bin, additional, Chung, Law Wan, additional, Husin, Mazlina, additional, Ibrahim, Aznita Binti, additional, Ibrahim, Khairul Azmi, additional, Looi, Irene, additional, Tan, Wee Yong, additional, Yahya, Wan Nur Nafisah Wan, additional, Groppa, Stanislav, additional, Leahu, Pavel, additional, Al Hashmi, Amal, additional, Imam, Yehai Z., additional, Akhtar, Naveed, additional, Oliver, Christian, additional, Kandyba, Dmitriy, additional, Alhazzani, Adel, additional, Al-Jehani, Hosam, additional, Tham, Carol Huilian, additional, Mamauag, Marlie Jane, additional, Narayanaswamy, Ram, additional, Chen, Chih-Hao, additional, Tang, Sung-Chun, additional, Churojana, Anchalee, additional, Aykaç, Ozlem, additional, Özdemir, Atilla Özcan, additional, Hussain, Syed Irteza, additional, John, Seby, additional, Le Vu, Huynh, additional, Tran, Anh Duc, additional, Nguyen, Huy Hoang, additional, Thong, Pham Nhu, additional, Nguyen, Thang, additional, Nguyen, Trung, additional, Gattringer, Thomas, additional, Enzinger, Christian, additional, Killer-Oberpfalzer, Monika, additional, Bellante, Flavio, additional, De Blauwe, Sofie, additional, Van Hooren, Geert, additional, De Raedt, Sylvie, additional, Dusart, Anne, additional, Ligot, Noemie, additional, Rutgers, Matthieu, additional, Yperzeele, Laetitia, additional, Alexiev, Filip, additional, Sakelarova, Teodora, additional, Bedekovic, Marina Roje, additional, Budincevic, Hrvoje, additional, Cindric, Igor, additional, Hucika, Zlatko, additional, Ozretic, David, additional, Saric, Majda Seferovic, additional, Pfeifer, František, additional, Karpowicz, Igor, additional, Cernik, David, additional, Sramek, Martin, additional, Skoda, Miroslav, additional, Hlavacova, Helena, additional, Klecka, Lukas, additional, Koutny, Martin, additional, Vaclavik, Dan, additional, Skoda, Ondrej, additional, Fiksa, Jan, additional, Hanelova, Katerina, additional, Nevsimalova, Miroslava, additional, Rezek, Robert, additional, Prochazka, Petr, additional, Krejstova, Gabriela, additional, Neumann, Jiri, additional, Vachova, Marta, additional, Brzezanski, Henry, additional, Hlinovsky, David, additional, Tenora, Dusan, additional, Jura, Rene, additional, Jurak, Lubomir, additional, Novak, Jan, additional, Novak, Ales, additional, Topinka, Zdenek, additional, Fibrich, Petr, additional, Sobolova, Helena, additional, Volny, Ondrej, additional, Christensen, Hanne Krarup, additional, Drenck, Nicolas, additional, Iversen, Helle, additional, Simonsen, Claus, additional, Truelsen, Thomas, additional, Wienecke, Troels, additional, Vibo, Riina, additional, Gross-Paju, Katrin, additional, Toomsoo, Toomas, additional, Antsov, Katrin, additional, Caparros, Francois, additional, Cordonnier, Charlotte, additional, Dan, Maria, additional, Faucheux, Jean-Marc, additional, Mechtouff, Laura, additional, Eker, Omer, additional, Lesaine, Emillie, additional, Ondze, Basile, additional, Pico, Fernando, additional, Pop, Raoul, additional, Rouanet, Francois, additional, Gubeladze, Tatuli, additional, Khinikadze, Mirza, additional, Lobjanidze, Nina, additional, Tsiskaridze, Alexander, additional, Nagel, Simon, additional, Ringleb, Peter Arthur, additional, Rosenkranz, Michael, additional, Schmidt, Holger, additional, Sedghi, Annahita, additional, Siepmann, Timo, additional, Szabo, Kristina, additional, Thomalla, Gotz, additional, Palaiodimou, Lina, additional, Sagris, Dimitrios, additional, Kargiotis, Odysseas, additional, Kaliaev, Artem, additional, Liebeskind, David, additional, Hassan, Ameer, additional, Ranta, Anna, additional, Devlin, Thomas, additional, Zaidat, Osama, additional, Castonguay, Alicia, additional, Jovin, Tudor, additional, Tsivgoulis, Georgios, additional, Malik, Amer, additional, Ma, Alice, additional, Campbell, Bruce, additional, Kleinig, Timothy, additional, Wu, Teddy, additional, Gongora, Fernando, additional, Lavados, Pablo, additional, Olavarria, Veronica, additional, Lereis, Virginia Pujol, additional, Corredor, Angel, additional, Barbosa, Diana Mantilla, additional, Bayona, Hernan, additional, Barrientos, Jose Domingo, additional, Patino, Mauricio, additional, Thijs, Vincent, additional, Pirson, Anne, additional, Kristoffersen, Espen Saxhaug, additional, Patrik, Michel, additional, Fischer, Urs, additional, Bernava, Gianmarco, additional, Renieri, Leonardo, additional, Strambo, Davide, additional, Ayo-Martin, Oscar, additional, Montaner, Joan, additional, Karlinski, Michal, additional, Cruz-Culebras, Antonio, additional, Luchowski, Piotr, additional, Krastev, Georgi, additional, Arenillas, Juan, additional, Gralla, Jan, additional, Mangiafico, Salvatore, additional, Blasco, Jordi, additional, Fonseca, Luisa, additional, Silva, M. Luis, additional, Kwan, Joseph, additional, Banerjee, Soma, additional, Sangalli, Davide, additional, Frisullo, Giovanni, additional, Yavagal, Dileep, additional, Uyttenboogaart, Maarten, additional, Bandini, Fabio, additional, Adami, Alessandro, additional, de Lecina, Maria Alonso, additional, Arribas, Miguel Angel Tola, additional, Ferreira, Paulo, additional, Cruz, Vitor Tedim, additional, Nunes, Ana Paiva, additional, Marto, Joao Pedro, additional, Rodrigues, Miguel, additional, Melo, Teresa, additional, Saposnik, Gustavo, additional, Scott, Courtney Anne, additional, Shuaib, Ashfaq, additional, Khosravani, Houman, additional, Fields, Thalia, additional, Shoamanesh, Ashkan, additional, Catanese, Luciana, additional, Mackey, Ariane, additional, Hill, Michael, additional, Etherton, Mark, additional, Rost, Natalia, additional, Lutsep, Helmi, additional, Lee, Vivien, additional, Mehta, Brijesh, additional, Pikula, Aleksandra, additional, Simmons, Marc, additional, Macdougall, Lisa, additional, Silver, Brian, additional, Khandelwal, Priyank, additional, Morris, Jane, additional, Novakovic-White, Roberta, additional, Ramakrishnan, Pankajavalli, additional, Shah, Ruchir, additional, Altschul, Dorothea, additional, Almufti, Fawaz, additional, Amaya, Pablo, additional, Ordonez, Carlos Eduardo Rivera, additional, Lara, Osvalda, additional, Kadota, Liliana Rodriguez, additional, Rivera, Ligia Ibeth Portillo, additional, Novarro, Nelson, additional, Escobar, Luis Diaz, additional, Melgarejo, Donoband, additional, Cardozo, Analia, additional, Blanco, Anmylene, additional, Zelaya, Javier Adolfo, additional, Luraschi, Adriana, additional, Gonzalez, Victor Hugo Navia, additional, Almeida, Juan, additional, Conforto, Adriana, additional, Almeida, Marcele Schettini, additional, de Deus Silva, Leonardo, additional, Cuervo, Daissy Liliana Mora, additional, Zetola, Viviane Flumignan, additional, Martins, Rodrigo Targa, additional, Valler, Lenise, additional, Giacomini, Luidia Varrone, additional, Cardoso, Fabricio Buchdid, additional, Sahathevan, Ramesh, additional, Hair, Casey, additional, Hankey, Graeme, additional, Salazar, Daniel, additional, Lima, Fabricio Oliveira, additional, Mont’Alverne, Francisco, additional, Iman, Danny Moises Barrientos, additional, Magalhaes, Pedro, additional, Longo, Alexandre, additional, Rebello, Leticia, additional, Falup-Pecurariu, Cristian, additional, Mazya, Michael, additional, Wisniewska, Anna, additional, Fryze, Waldemar, additional, Kazmierski, Radoslaw, additional, Wisniewska, Malgorzata, additional, Horoch, Ewa, additional, Sienkiewicz-Jarosz, Halina, additional, Fudala, Malgorzata, additional, Rogoziewicz, Marcin, additional, Brola, Waldemar, additional, Sobolewski, Piotr, additional, Kaczorowski, Rafal, additional, Stepien, Adam, additional, Klivenyi, Peter, additional, Szapary, Laszlo, additional, van den Wijngaard, Ido, additional, Demchuk, Andrew, additional, Abraham, Michael, additional, Alvarado-Ortiz, Tony, additional, Kaushal, Ritesh, additional, Ortega-Gutierrez, Santiago, additional, Farooqui, Mudassir, additional, Bach, Ivo, additional, Badruddin, Aamir, additional, Barazangi, Nobl, additional, Nguyen, Claude, additional, Brereton, Charmaine, additional, Choi, Jae H., additional, Dharmadhikari, Sushrut, additional, Desai, Kinjal, additional, Doss, Vinodh, additional, Edgell, Randall, additional, Linares, Guillermo, additional, Frei, Donald, additional, Chaturvedi, Seemant, additional, Gandhi, Dheeraj, additional, Chaudhry, Saqib, additional, Choe, Hana, additional, Grigoryan, Mikayel, additional, Gupta, Rishi, additional, Helenius, Johanna, additional, Voetsch, Barbara, additional, Khwaja, Ayaz, additional, Khoury, Naim, additional, Kim, Benny S., additional, Kleindorfer, Dawn, additional, McDermott, Molly, additional, Koyfman, Feliks, additional, Leung, Lester, additional, Linfante, Italo, additional, Male, Shailesh, additional, Masoud, Hesham, additional, Min, Jiangyong, additional, Mittal, Manoj, additional, Multani, Sumeet, additional, Nahab, Fadi, additional, Nalleballe, Krishna, additional, Rahangdale, Rahul, additional, Rafael, Jose, additional, Rothstein, Aaron, additional, Ruland, Sean, additional, Sharma, Malveeka, additional, Singh, Abishek, additional, Starosciak, Amy, additional, Strasser, Sheryl, additional, Szeder, Viktor, additional, Teleb, Mohamed, additional, Tsai, Jenny, additional, Mohammaden, Mahmoud, additional, Pineda-Franks, Carissa, additional, Asyraf, Wan, additional, Nguyen, Trung QuocH, additional, Tarkanyi, Gabor, additional, Haussen, Diogo, additional, Balaguera, Oscar, additional, Vasquez, Alejandro Rodriguez, additional, and Nogueira, Raul, additional

Published
2021
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9. Atrial cardiopathy in patients with embolic strokes of unknown source and other stroke etiologies

Author

Anna Woo, Rosane Nisenbaum, Angelo Dave Javier, Shirin Jalini, Aleksandra Pikula, and Rajasumi Rajalingam

Subjects
Adult, Male, medicine.medical_specialty, Tomography Scanners, X-Ray Computed, Heart Diseases, Cross-sectional study, Population, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Left atrial enlargement, Humans, cardiovascular diseases, 030212 general & internal medicine, Young adult, education, Stroke, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, business.industry, Brain, Magnetic resonance imaging, Retrospective cohort study, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Cross-Sectional Studies, Intracranial Embolism, Etiology, Cardiology, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

ObjectiveTo investigate the prevalence and clinical determinants of atrial cardiopathy in patients with embolic stroke of unknown source (ESUS) and compare with other established stroke etiologies.MethodsIn a cross-sectional study of 846 consecutive patients with ischemic stroke, we compared the prevalence of atrial cardiopathy (defined by p-wave terminal force in V1 >5,000 µV·ms or severe left atrial enlargement) between ESUS patients and patients with large artery atherosclerosis (LAA) and small vessel disease (SVD) strokes. Baseline characteristics were also compared between ESUS and cardioembolic (CE) patients.ResultsOf all, 158 (19%) patients met ESUS diagnostic criteria, while others were classified into LAA (n = 224, 26%), SVD (n = 154, 18%), and CE (n = 310, 37%). The prevalence of atrial cardiopathy was higher in ESUS patients compared to noncardioembolic stroke patients (26.6% vs 12.1% in LAA vs 16.9% in SVD; p = 0.001). ESUS patients were younger, were less hypertensive, and had higher cholesterol and low-density lipoprotein levels, but also had less left ventricular or atrial abnormalities when compared to CE patients.ConclusionThe prevalence of atrial cardiopathy was high in ESUS patients compared with patients with nonembolic strokes. Interestingly, ESUS patients were also clinically different from CE patients. While the presence of atrial cardiopathy may reflect a unique mechanism of thromboembolism in ESUS patients, it is still unclear if they may benefit from anticoagulation, or if the presence of atrial cardiopathy in this population could serve as a risk-stratifying marker for stroke recurrence. Further efforts are necessary to provide better characterization of the ESUS population in order to develop better stroke preventive strategies.

Published
2018

10. Recurrent vascular events in lacunar stroke patients with metabolic syndrome and/or diabetes

Author

Leslie A. McClure, Carlos S. Kase, Aleksandra Pikula, Oscar R. Benavente, Thanh N. Nguyen, Viken L. Babikian, Jose R. Romero, Shuhan Zhu, Helena Lau, and Carole L. White

Subjects
Male, medicine.medical_specialty, Lacunar stroke, Article, Diabetes Complications, Recurrence, Risk Factors, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, Prospective Studies, cardiovascular diseases, Myocardial infarction, Prospective cohort study, Stroke, Aged, Metabolic Syndrome, business.industry, Hazard ratio, Middle Aged, medicine.disease, United States, Surgery, Stroke, Lacunar, Cohort, Female, Neurology (clinical), Metabolic syndrome, business
Abstract

Objectives: We used a prospective clinical trial to examine the risks conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent strokes in the Secondary Prevention of Small Subcortical Strokes (SPS3) study cohort. Methods: The SPS3 trial enrolled 3,020 patients with lacunar strokes. Participants were stratified into groups of METS only, DM only, both, or neither using American Heart Association/National Heart, Lung, and Blood Institute and World Health Organization guidelines. Annualized event rates of strokes, myocardial infarction (MI), and all-cause mortality were calculated, and hazard ratios (HRs) referencing the “neither” group were computed, controlling for significantly associated baseline characteristics. Results: Among 2,999 participants, 25% had METS only, 6% had DM only, 32% had both conditions, and 37% had neither. Over a median of 3.8 years of follow-up, there were 274 recurrent strokes (240 ischemic, 34 hemorrhagic) and 74 MIs; among the 240 ischemic strokes, 134 (56%) were lacunar. The rates of any recurrent stroke (HR 1.7, 95% confidence interval [CI] 1.3–2.3) or lacunar stroke (HR 2.4, 95% CI 1.5–3.7) were significantly higher for those with concurrent METS and DM compared with those who had neither. Risk of incident MI was higher in participants with DM (HR 2.8, 95% CI 1.1–7.0) or concurrent DM and METS (HR 2.6, 95% CI 1.4–4.9). Conclusion: METS and DM were significant comorbid conditions in lacunar stroke patients and they were associated with stroke recurrence. In patients with lacunar infarcts, a vigilant approach to prevent development of DM in those with METS may be a potential strategy to reduce recurrent strokes.

Published
2015
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11. Lipid and lipoprotein measurements and the risk of ischemic vascular events: Framingham Study

Author

Alexa S. Beiser, Aleksandra Pikula, Qiong Yang, Sudha Seshadri, Philip A. Wolf, Jayandra J. Himali, Jing Wang, Margaret Kelly-Hayes, and Carlos S. Kase

Subjects
Male, Pathology, medicine.medical_specialty, Myocardial Infarction, Article, Brain Ischemia, Cohort Studies, Framingham Heart Study, Risk Factors, Internal medicine, Humans, Medicine, Prospective Studies, Myocardial infarction, Prospective cohort study, Stroke, Triglycerides, Aged, Aged, 80 and over, Framingham Risk Score, business.industry, Cholesterol, HDL, Hazard ratio, Cholesterol, LDL, Middle Aged, medicine.disease, Massachusetts, Cohort, Cardiology, Female, lipids (amino acids, peptides, and proteins), Neurology (clinical), business, Biomarkers, Follow-Up Studies, Cohort study
Abstract

To examine the relationship between plasma lipid measurements and incident ischemic vascular events (ischemic stroke [IS], and as a positive control, myocardial infarction [MI]) in a community cohort.In 6,276 stroke-free Framingham participants (aged 64 ± 10 years, 56% female), we related plasma lipid levels (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and TC/HDL-C ratio) measured at the original cohort 15th (1977-1979) and 20th examination cycles (1986-1990) and (TC, HDL-C, TC/HDL-C ratio, triglycerides [TG], and low-density lipoprotein cholesterol [LDL-C]) measured at the offspring fourth examination (1995-1998), to 10-year risk of incident IS and MI. Utilizing genome-wide genotyping in the same subjects, we used mendelian randomization methods to assess whether observed associations were incidental or causal.During a mean follow-up of 9 years, 301 participants experienced incident IS. In multivariable-adjusted analyses, HDL-C ≤40 mg/dL and TC/HDL ratio ≥5 were associated with increased risk of IS (hazard ratio [95% confidence interval]: 1.59 [1.23-2.05], p0.001 and 1.47 [1.15-1.87], p0.001), but not TC or LDL-C. In adjusted analysis, a strong association between TG and IS was diminished. In the MI-free sample (n = 5,875, aged 64 ± 10 years, 58% female; 403 MI events), all lipid markers were associated with MI risk. A genetic risk score comprising 47 known determinants of circulating HDL-C was not associated with IS.In a middle-aged to elderly community sample, we observed that low HDL-C and high TC/HDL-C ratio, but not LDL-C or TG were associated with risk of incident IS. We observed the usual associations between lipids and risk of MI. Our findings suggest an important, but less likely causal, role of HDL-C over other lipid biomarkers for optimal stroke risk stratification.

Published
2015
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14. Red blood cell ω-3 fatty acid levels and markers of accelerated brain aging

Author

Charles DeCarli, Sudha Seshadri, Aleksandra Pikula, Rhoda Au, William S. Harris, Alexa S. Beiser, Phillip A. Wolf, Zaldy S. Tan, Stéphanie Debette, Ramachandran S. Vasan, Jayandra J. Himali, and Sander J. Robins

Subjects
Apolipoprotein E, Gerontology, Male, medicine.medical_specialty, Aging, Erythrocytes, Neuropsychological Tests, Framingham Heart Study, Cognition, Alzheimer Disease, Risk Factors, Internal medicine, Fatty Acids, Omega-3, Dementia, Medicine, Humans, Omega 3 fatty acid, Brain aging, Aged, Aged, 80 and over, business.industry, Brain, Articles, Middle Aged, medicine.disease, Eicosapentaenoic acid, Red blood cell, Endocrinology, medicine.anatomical_structure, Biochemistry, Docosahexaenoic acid, Female, Neurology (clinical), Alzheimer's disease, Psychology, business, Body mass index
Abstract

Objective: Higher dietary intake and circulating levels of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have been related to a reduced risk for dementia, but the pathways underlying this association remain unclear. We examined the cross-sectional relation of red blood cell (RBC) fatty acid levels to subclinical imaging and cognitive markers of dementia risk in a middle-aged to elderly community-based cohort. Methods: We related RBC DHA and EPA levels in dementia-free Framingham Study participants (n = 1,575; 854 women, age 67 ± 9 years) to performance on cognitive tests and to volumetric brain MRI, with serial adjustments for age, sex, and education (model A, primary model), additionally for APOE ϵ4 and plasma homocysteine (model B), and also for physical activity and body mass index (model C), or for traditional vascular risk factors (model D). Results: Participants with RBC DHA levels in the lowest quartile (Q1) when compared to others (Q2–4) had lower total brain and greater white matter hyperintensity volumes (for model A: β ± SE = −0.49 ± 0.19; p = 0.009, and 0.12 ± 0.06; p = 0.049, respectively) with persistence of the association with total brain volume in multivariable analyses. Participants with lower DHA and ω-3 index (RBC DHA+EPA) levels (Q1 vs Q2–4) also had lower scores on tests of visual memory (β ± SE = −0.47 ± 0.18; p = 0.008), executive function (β ± SE = −0.07 ± 0.03; p = 0.004), and abstract thinking (β ± SE = −0.52 ± 0.18; p = 0.004) in model A, the results remaining significant in all models. Conclusion: Lower RBC DHA levels are associated with smaller brain volumes and a “vascular” pattern of cognitive impairment even in persons free of clinical dementia.

Published
2012

17. Association of parental dementia with cognitive and brain MRI measures in middle-aged adults

Author

Charles DeCarli, Jayandra J. Himali, Rhoda Au, Sanford Auerbach, Alexa S. Beiser, Aleksandra Pikula, Sudha Seshadri, Philip A. Wolf, and Stéphanie Debette

Subjects
Male, Parents, medicine.medical_specialty, Heterozygote, Offspring, Apolipoprotein E4, Cohort Studies, Cognition, Alzheimer Disease, Internal medicine, medicine, Dementia, Humans, Effects of sleep deprivation on cognitive performance, Prospective Studies, Psychiatry, Alleles, Aged, Language, Memory Disorders, Brain, Odds ratio, Articles, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Space Perception, Brain size, Visual Perception, Female, Neurology (clinical), Verbal memory, Alzheimer's disease, Atrophy, Psychology
Abstract

Studies of autosomal dominant Alzheimer disease (AD) have shown structural and cognitive changes in mutation carriers decades prior to clinical disease. Whether such changes are detectable in offspring of persons with sporadic dementia remains unknown. We related prospectively verified parental dementia to brain MRI and cognitive testing in the offspring, within a 2-generational community-based cohort.A total of 717 Framingham offspring (mean age: 59 +/- 8 years) were studied. In multivariate analyses, we compared offspring with and without verified parental dementia (and AD) for 1) performance on tests of memory, abstract reasoning, and cognitive flexibility, and 2) volumetric brain MRI measures of total cerebral brain volume (TCBV), hippocampal volume (HV), and white matter hyperintensity volume (WMHV), assessed cross-sectionally and longitudinally.When testing the association of parental dementia and AD with baseline cognitive performance, we observed an interaction of parental dementia and AD with APOE epsilon4 status (p0.002). In APOE epsilon4 carriers only (n = 165), parental dementia was associated with poorer scores on tests of verbal memory (beta = -1.81 +/- 0.53, p0.001) and visuospatial memory (beta = -1.73 +/- 0.47, p0.001). These associations were stronger for parental AD (beta = -1.97 +/- 0.52, p0.001, beta = -1.95 +/- 0.48, p0.001), equivalent to 14-16 years of brain aging. Among APOE epsilon4 carriers, offspring of participants with dementia were also more likely to show an annual decline in TCBV in the top quartile (odds ratio = 4.67 [1.26-17.30], p = 0.02). Regardless of APOE epsilon4 status, participants with parental dementia were more likely to be in the highest quartile of decline in executive function test scores (odds ratio = 1.61 [1.02-2.53], p = 0.04).Among middle-aged carriers of the APOE epsilon4 allele, parental dementia and Alzheimer disease were associated with poorer verbal and visuospatial memory and a higher rate of global brain atrophy.

Published
2009

22. Cerebral Microbleeds in Young Stroke Patients (P04.063)

Author

Shoamanesh, Ashkan, primary, Catanese, Luciana, additional, Rayhill, Melissa, additional, Salem, Rony, additional, Lau, Helena, additional, Romero, Jose, additional, Babikian, Viken, additional, Benavente, Oscar, additional, Kase, Carlos, additional, and Pikula, Aleksandra, additional

Published
2013
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31. Walking Speed, Handgrip Strength and Risk of Dementia and Stroke: The Framingham Offspring Study (S24.003)

Author

Sudha Seshadri, Érica C. S. Camargo, Alexa S. Beiser, Carlos S. Kase, Margaret Kelly-Hayes, Philip A. Wolf, Zaldy S. Tan, Charles DeCarli, Rhoda Au, and Aleksandra Pikula

Subjects
medicine.medical_specialty, Framingham Risk Score, business.industry, Proportional hazards model, Logistic regression, medicine.disease, Preferred walking speed, Grip strength, Framingham Heart Study, Physical therapy, Medicine, Dementia, Neurology (clinical), business, Stroke
Abstract

Objective: We explored the association of two simple office based tests, walking speed (WS) and hand grip strength (HGS), with the risks of incident dementia and stroke/TIA, and with brain MRI and cognition. Background Frailty and lower physical performance are frequent findings in persons with a wide range of subclinical and clinical brain injuries, and have been associated with an increased risk of dementia in the elderly. However, their predictive value in a middle-aged community sample is uncertain. Design/Methods: Stroke- and dementia-free Framingham Offspring (n=2,410; mean age 62, 54% female) had WS, HGS, brain MRI and cognitive function assessed between 1999 and 2005. We related age-standardized HGS and WS to baseline volumetric brain MRI and age- and education-standardized cognitive function using multivariable logistic regression, and to incident stroke and dementia on follow-up using Cox models. All analyses were adjusted for age, sex and vascular risk factors. Results: Over a follow-up period of up to 11years 34 persons developed incident dementia (28 AD) and 79 incident stroke/TIA. Slower WS was associated with a higher risk of dementia (HR=1.50[95%CI 1.07-2.11]/SDU,p=0.020) as well as with lower total cerebral brain volume[TCBV] (β=-0.17±0.06,p=0.007) and poorer performance on tests of memory (visual reproduction[VR],β=-0.06±0.02,p=0.009; paired associate learning[PAS],β=-0.07±0.02,p= Conclusions: In a middle-aged community sample, WS and HGS were associated, respectively, with the risks of incident dementia and of stroke/TIA and with markers of subclinical brain injury. Thus WS and HGS might serve as clinical markers of the need for a more detailed assessment of brain function. Supported by: The dedication of the Framingham Heart Study participants, the National Heart, Lung and Blood Institute9s Framingham Heart Study (Contract No. N01-HC-25195) and by grants from the National Institute of Neurological Disorders and Stroke (NS17950) and the National Institute on Aging (AG08122, AG16495, AG033193, AG031287, P30AG013846). Disclosure: Dr. Camargo has nothing to disclose. Dr. Beiser has nothing to disclose. Dr. Tan has nothing to disclose. Dr. Au has nothing to disclose. Dr. DeCarli has received personal compensation for activities wtih Merck Pharmaceutical, Avanir, Bayer Pharmaceuticals, and Pfizer as a consultant.Dr. DeCarli has received personal compensation in an editorial capacity for Alzheimer9s Disease and Associated Disorders.Dr. DeCarli has received research support from Merck. Dr. Pikula has nothing to disclose. Dr. Kelly-Hayes has nothing to disclose. Dr. Kase has nothing to disclose. Dr. Wolf has nothing to disclose. Dr. Seshadri has nothing to disclose.

Published
2012
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34. Teaching NeuroImages: Cerebral arteriovenous malformation in hereditary hemorrhagic telangiectasia

Author

Aleksandra Pikula, Thanh N. Nguyen, and Jorge L. Almodovar

Subjects
Adult, Intracranial Arteriovenous Malformations, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Physical examination, Lip telangiectasia, Dysarthria, Right gaze, medicine, Humans, Telangiectasia, medicine.diagnostic_test, business.industry, Arteriovenous malformation, medicine.disease, Cerebral Angiography, nervous system diseases, Female, Telangiectasia, Hereditary Hemorrhagic, Neurology (clinical), Radiology, medicine.symptom, Tomography, X-Ray Computed, business, Cerebral angiography
Abstract

A 41-year-old woman with a history of recurrent epistaxis presented with left hemiplegia, right gaze deviation, and dysarthria. Physical examination confirmed skin and lip telangiectasia (figure 1). Her son had pulmonary arteriovenous malformation (AVM). Her …

Published
2009
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