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11. Cerebral Blood Flow Patterns in Patients With Low‐Flow Carotid Artery Stenosis, a 4D‐PCMRI Assessment.

Author

Zarrinkoob, Laleh, Myrnäs, Sanne, Wåhlin, Anders, Eklund, Anders, and Malm, Jan

Subjects
ANTERIOR cerebral artery, INTERNAL carotid artery, OPHTHALMIC artery, CAROTID artery diseases, CIRCLE of Willis
Abstract

Background: Compromised cerebral blood flow can contribute to future ischemic events in patients with symptomatic carotid artery disease. However, there is limited knowledge of the effects on cerebral hemodynamics resulting from a reduced internal carotid artery (ICA) blood flow rate (BFR). Purpose: Investigate how reduced ICA‐BFR, relates to BFR in the cerebral arteries. Study Type: Prospective. Subjects: Thirty‐eight patients, age 72 ± 6 years (11 female). Field Strength/Sequence: 3‐Tesla, four‐dimensional phase‐contrast magnetic resonance imaging (4D‐PCMRI). Assessment: Patients with ischemic stroke or transient ischemic attack were evaluated regarding the degree of stenosis. 4D‐PCMRI was used to measure cerebral BFR in 38 patients with symptomatic carotid stenosis (≥50%). BFR in the cerebral arteries was assessed in two subgroups based on symptomatic ICA‐BFR: reduced ICA‐flow (<160 mL/minutes) and preserved ICA‐flow (≥160 mL/minutes). BFR laterality was defined as a difference in the paired ipsilateral‐contralateral arteries. Statistical Tests: Patients were grouped based on ICA‐BFR (reduced vs. preserved). Statistical tests (independent sample t‐test/paired t‐test) were used to compare groups and hemispheres. Significance was determined at P < 0.05. Results: The degree of stenosis was not significantly different, 80% (95% confidence interval [CI] = 73%–87%) in the reduced ICA‐flow vs. 72% (CI = 66%–76%) in the preserved ICA‐flow; P = 0.09. In the reduced ICA‐flow group, a significantly reduced BFR was found in the ipsilateral middle cerebral artery and anterior cerebral artery (A1), while significantly increased in the contralateral A1. Retrograde BFR was found in the posterior communicating artery and ophthalmic artery. Significant BFR laterality was present in all paired arteries in the reduced ICA‐flow group, contrasting the preserved ICA‐flow group (P = 0.14–0.93). Data Conclusions: 4D‐PCMRI revealed compromised cerebral BFR due to carotid stenosis, not possible to detect by solely analyzing the degree of stenosis. In patients with reduced ICA‐flow, collaterals were not sufficient to maintain symmetrical BFR distribution to the two hemispheres. Evidence Level: 2 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Published
2024
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19. Cerebral arterial stiffness is linked to white matter hyperintensities and perivascular spaces in older adults : a 4D flow MRI study

Author

Björnfot, Cecilia, Eklund, Anders, Larsson, Jenny, Hansson, William, Birnefeld, Johan, Garpebring, Anders, Qvarlander, Sara, Koskinen, Lars-Owe D., Malm, Jan, Wåhlin, Anders, Björnfot, Cecilia, Eklund, Anders, Larsson, Jenny, Hansson, William, Birnefeld, Johan, Garpebring, Anders, Qvarlander, Sara, Koskinen, Lars-Owe D., Malm, Jan, and Wåhlin, Anders

Abstract

White matter hyperintensities (WMH), perivascular spaces (PVS) and lacunes are common MRI features of small vessel disease (SVD). However, no shared underlying pathological mechanism has been identified. We investigated whether SVD burden, in terms of WMH, PVS and lacune status, was related to changes in the cerebral arterial wall by applying global cerebral pulse wave velocity (gcPWV) measurements, a newly described marker of cerebral vascular stiffness. In a population-based cohort of 190 individuals, 66–85 years old, SVD features were estimated from T1-weighted and FLAIR images while gcPWV was estimated from 4D flow MRI data. Additionally, the gcPWV’s stability to variations in field-of-view was analyzed. The gcPWV was 10.82 (3.94) m/s and displayed a significant correlation to WMH and white matter PVS volume (r = 0.29, p < 0.001; r = 0.21, p = 0.004 respectively from nonparametric tests) that persisted after adjusting for age, blood pressure variables, body mass index, ApoB/A1 ratio, smoking as well as cerebral pulsatility index, a previously suggested early marker of SVD. The gcPWV displayed satisfactory stability to field-of-view variations. Our results suggest that SVD is accompanied by changes in the cerebral arterial wall that can be captured by considering the velocity of the pulse wave transmission through the cerebral arterial network.

Published
2024
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20. Human brain clearance imaging : pathways taken by magnetic resonance imaging contrast agents after administration in cerebrospinal fluid and blood

Author

van Osch, Matthias J. P., Wåhlin, Anders, Scheyhing, Paul, Mossige, Ingrid, Hirschler, Lydiane, Eklund, Anders, Mogensen, Klara, Gomolka, Ryszard, Radbruch, Alexander, Qvarlander, Sara, Decker, Andreas, Nedergaard, Maiken, Mori, Yuki, Eide, Per Kristian, Deike, Katerina, Ringstad, Geir, van Osch, Matthias J. P., Wåhlin, Anders, Scheyhing, Paul, Mossige, Ingrid, Hirschler, Lydiane, Eklund, Anders, Mogensen, Klara, Gomolka, Ryszard, Radbruch, Alexander, Qvarlander, Sara, Decker, Andreas, Nedergaard, Maiken, Mori, Yuki, Eide, Per Kristian, Deike, Katerina, and Ringstad, Geir

Abstract

Over the last decade, it has become evident that cerebrospinal fluid (CSF) plays a pivotal role in brain solute clearance through perivascular pathways and interactions between the brain and meningeal lymphatic vessels. Whereas most of this fundamental knowledge was gained from rodent models, human brain clearance imaging has provided important insights into the human system and highlighted the existence of important interspecies differences. Current gold standard techniques for human brain clearance imaging involve the injection of gadolinium-based contrast agents and monitoring their distribution and clearance over a period from a few hours up to 2 days. With both intrathecal and intravenous injections being used, which each have their own specific routes of distribution and thus clearance of contrast agent, a clear understanding of the kinetics associated with both approaches, and especially the differences between them, is needed to properly interpret the results. Because it is known that intrathecally injected contrast agent reaches the blood, albeit in small concentrations, and that similarly some of the intravenously injected agent can be detected in CSF, both pathways are connected and will, in theory, reach the same compartments. However, because of clear differences in relative enhancement patterns, both injection approaches will result in varying sensitivities for assessment of different subparts of the brain clearance system. In this opinion review article, the "EU Joint Programme – Neurodegenerative Disease Research (JPND)" consortium on human brain clearance imaging provides an overview of contrast agent pharmacokinetics in vivo following intrathecal and intravenous injections and what typical concentrations and concentration–time curves should be expected. This can be the basis for optimizing and interpreting contrast-enhanced MRI for brain clearance imaging. Furthermore, this can shed light on how molecules may exchange between blood, brain, and CSF.

Published
2024
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21. Dopamine D1-receptor organization contributes to functional brain architecture

Author

Pedersen, Robin, Johansson, Jarkko, Nordin, Kristin, Rieckmann, Anna, Wåhlin, Anders, Nyberg, Lars, Bäckman, Lars, Salami, Alireza, Pedersen, Robin, Johansson, Jarkko, Nordin, Kristin, Rieckmann, Anna, Wåhlin, Anders, Nyberg, Lars, Bäckman, Lars, and Salami, Alireza

Abstract

Recent work has recognized a gradient-like organization in cortical function, spanning from primary sensory to transmodal cortices. It has been suggested that this axis is aligned with regional differences in neurotransmitter expression. Given the abundance of dopamine D1-receptors (D1DR), and its importance for modulation and neural gain, we tested the hypothesis that D1DR organization is aligned with functional architecture, and that inter-regional relationships in D1DR co-expression modulate functional cross talk. Using the world's largest dopamine D1DR-PET and MRI database (N = 180%, 50% female), we demonstrate that D1DR organization follows a unimodal–transmodal hierarchy, expressing a high spatial correspondence to the principal gradient of functional connectivity. We also demonstrate that individual differences in D1DR density between unimodal and transmodal regions are associated with functional differentiation of the apices in the cortical hierarchy. Finally, we show that spatial co-expression of D1DR primarily modulates couplings within, but not between, functional networks. Together, our results show that D1DR co-expression provides a biomolecular layer to the functional organization of the brain.

Published
2024
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37. Salvage High-Dose Chemotherapy for Relapsed Pure Seminoma in the Last 10 Years: Results From the European Society for Blood and Marrow Transplantation Series 2002-2012

Author

Necchi, Andrea, Lo Vullo, Salvatore, Bregni, Marco, Rosti, Giovanni, Mariani, Luigi, Raggi, Daniele, Giannatempo, Patrizia, Secondino, Simona, Schumacher, Kathrin, Massard, Christophe, Kanfer, Edward, Oechsle, Karin, Laszlo, Daniele, Michieli, Mariagrazia, Ifrah, Norbert, Mercier, Melanie, Crysandt, Martina, Wuchter, Patrick, Nagler, Arnon, Wahlin, Anders, Martino, Massimo, Badoglio, Manuela, Pedrazzoli, Paolo, and Lanza, Francesco

Published
2017
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46. REBOOT IV - Acute effects of physical exercise on cognition, brain structure, brain activity and cerebral blood flow measured by MRI

Author

Olivo, Gaia, Lövdén, Martin, Helsing, Marie, Nilsson, Jonna, Lebedev, Alexander, Tarassova, Olga, Ekblom, Maria, Ekblom, Örjan, Garzon, Benjamin, and Wåhlin, Anders

Abstract

This project aims at investigating the effect of acute physical exercise at moderate intensity on cognitive performance, cerebral blood flow, brain structure, and brain activity in older adults.

Published
2022
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48. 5‐Year Associations among Cerebral Arterial Pulsatility, Perivascular Space Dilation, and White Matter Lesions

Author

Vikner, Tomas, primary, Karalija, Nina, additional, Eklund, Anders, additional, Malm, Jan, additional, Lundquist, Anders, additional, Gallewicz, Nikodemus, additional, Dahlin, Magnus, additional, Lindenberger, Ulman, additional, Riklund, Katrine, additional, Bäckman, Lars, additional, Nyberg, Lars, additional, and Wåhlin, Anders, additional

Published
2022
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49. Longitudinal Dopamine D2 Receptor Changes and Cerebrovascular Health in Aging

Author

Karalija, Nina, primary, Johansson, Jarkko, additional, Papenberg, Goran, additional, Wåhlin, Anders, additional, Salami, Alireza, additional, Köhncke, Ylva, additional, Brandmaier, Andreas M., additional, Andersson, Micael, additional, Axelsson, Jan, additional, Riklund, Katrine, additional, Lövdén, Martin, additional, Lindenberger, Ulman, additional, Bäckman, Lars, additional, and Nyberg, Lars, additional

Published
2022
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50. Individual Quality Assessment of Autografting by Probability Estimation for Clinical Endpoints: A Prospective Validation Study from the European Group for Blood and Marrow Transplantation

Author

Lanza, Francesco, Campioni, Diana C., Hellmann, Andrzej, Milone, Giuseppe, Wahlin, Anders, Walewski, Jan, Spedini, Pierangelo, Fiamenghi, Cristina, Cuneo, Antonio, Knopińska, Wanda, Swierkowska-Czeneszew, Monica, Petriz, Jordi, Fruehauf, Stefan, Farge, Dominique, Mohty, Mohamad, Passweg, Jacob, Ruuto, Tapani, Madrigal, Alejandro, and Johnsen, Hans E.

Published
2013
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