دورية أكاديمية
Association of Extent of Transverse Sinus Stenosis With Cerebral Glymphatic Clearance in Patients With Idiopathic Intracranial Hypertension.
| العنوان: | Association of Extent of Transverse Sinus Stenosis With Cerebral Glymphatic Clearance in Patients With Idiopathic Intracranial Hypertension. |
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| المؤلفون: | Schartz D; From the Department of Imaging Sciences (D.S., A.K., J.Z.), University of Rochester Medical Center; Department of Biomedical Engineering (A.F.), University of Rochester; and Department of Neurosurgery (M.B.), University of Rochester Medical Center, NY., Finkelstein A; From the Department of Imaging Sciences (D.S., A.K., J.Z.), University of Rochester Medical Center; Department of Biomedical Engineering (A.F.), University of Rochester; and Department of Neurosurgery (M.B.), University of Rochester Medical Center, NY., Bender M; From the Department of Imaging Sciences (D.S., A.K., J.Z.), University of Rochester Medical Center; Department of Biomedical Engineering (A.F.), University of Rochester; and Department of Neurosurgery (M.B.), University of Rochester Medical Center, NY., Kessler A; From the Department of Imaging Sciences (D.S., A.K., J.Z.), University of Rochester Medical Center; Department of Biomedical Engineering (A.F.), University of Rochester; and Department of Neurosurgery (M.B.), University of Rochester Medical Center, NY., Zhong J; From the Department of Imaging Sciences (D.S., A.K., J.Z.), University of Rochester Medical Center; Department of Biomedical Engineering (A.F.), University of Rochester; and Department of Neurosurgery (M.B.), University of Rochester Medical Center, NY. |
| المصدر: | Neurology [Neurology] 2024 Jul 09; Vol. 103 (1), pp. e209529. Date of Electronic Publication: 2024 Jun 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0401060 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-632X (Electronic) Linking ISSN: 00283878 NLM ISO Abbreviation: Neurology Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Minneapolis. |
| مواضيع طبية MeSH: | Glymphatic System*/diagnostic imaging , Glymphatic System*/physiopathology , Pseudotumor Cerebri*/physiopathology , Pseudotumor Cerebri*/diagnostic imaging , Transverse Sinuses*/diagnostic imaging, Humans ; Female ; Male ; Adult ; Retrospective Studies ; Constriction, Pathologic/diagnostic imaging ; Constriction, Pathologic/physiopathology ; Young Adult ; Middle Aged ; Magnetic Resonance Imaging ; Diffusion Tensor Imaging |
| مستخلص: | Background and Objectives: Idiopathic intracranial hypertension (IIH) is a neurologic disorder characterized by symptoms of elevated intracranial pressure in the absence of a clear cause. There is a developing theory that IIH may, in part, be related to abnormal cerebral glymphatic clearance. In addition, transverse sinus stenosis (TSS) is a common finding in IIH of unclear pathophysiologic significance. Similarly, whether or not TSS is associated with glymphatic outflow in IIH is unknown. The aim of this investigation was to explore the possible association between glymphatic outflow and extent of TSS in patients with IIH. Methods: The study cohort consisted of patients with IIH and healthy controls who were retrospectively identified from our tertiary care institution located in upstate New York from 2016 to 2023. Patients with IIH were included if they had brain MRIs completed with sufficient sequences for analysis. Brain MRIs were computationally analyzed using diffusion tensor imaging analysis along the perivascular space technique to quantify the glymphatic function in patients with IIH. Glymphatic clearance, the primary outcome, was then correlated with the degree of TSS on MR venography using 2 different scoring systems, the 'Farb score' and 'Carvalho score.' Results: Overall, 81 patients with IIH (70 [86%] female, mean age 29.8 years [SD: 8.2 years], mean BMI 41 [SD: 8.4]) and 10 normal controls were identified with sufficient imaging. Based on the Carvalho TSS score, IIH patients without TSS had significantly lower glymphatic clearance than healthy controls (mean ALPS index: 1.196 [SD: 0.05] vs 1.238 [SD: 0.04], respectively; p = 0.018). Furthermore, IIH patients with TSS had significantly lower glymphatic outflow than healthy controls (1.129 [SD: 0.07] vs 1.238 [SD: 0.04], respectively; p < 0.0001) and IIH patients without TSS (1.129 [SD: 0.07] vs 1.196 [SD: 0.05], respectively; p < 0.0001). In addition, there was a significant association between increasing extent of TSS and declining glymphatic clearance ( p < 0.0001, R = 0.62). Finally, IIH patients with severe TSS had significantly lower glymphatic flow than IIH patients with mild stenosis (1.121 [SD: 0.07] vs 1.178 [SD: 0.05], respectively; p < 0.0001). These findings were similarly recapitulated using the Farb TSS scoring system. Discussion: These preliminary findings suggest that the extent of TSS is associated with the degree of glymphatic clearance in IIH, providing novel insights into IIH pathophysiology. Further research is required to clarify the possible causal relationship between TSS and impaired glymphatic clearance in IIH. |
| تواريخ الأحداث: | Date Created: 20240604 Date Completed: 20240604 Latest Revision: 20240604 |
| رمز التحديث: | 20240605 |
| DOI: | 10.1212/WNL.0000000000209529 |
| PMID: | 38833652 |
| قاعدة البيانات: | MEDLINE |
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