scholarly journals Magnetic Resonance Image Feature Analysis under Deep Learning in Diagnosis of Neurological Rehabilitation in Patients with Cerebrovascular Diseases

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xue Li ◽  
Wenjun Ji ◽  
Hufei Chang ◽  
Chunyan Yang ◽  
Zhao Rong ◽  
...  
Keyword(s):  
Deep Learning ◽  
Cognitive Impairment ◽  
Magnetic Resonance ◽  
Cerebrovascular Disease ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Image Feature ◽  
Neurological Rehabilitation ◽  
Neurological Evaluation ◽  
The Impact

To explore the impact of magnetic resonance imaging (MRI) image features based on deep learning algorithms on the neurological rehabilitation of patients with cerebrovascular diseases, eighty patients with acute cerebrovascular disease were selected as the research objects. According to whether the patients were with vascular cognitive impairment (VCI), they were divided into VCI group (34 cases) and non-VCI group (46 cases). In addition, based on the convolutional neural network (CNN), a new multimodal CNN image segmentation algorithm was proposed. The algorithm was applied to the segmentation of MRI images of patients with vascular cognitive impairment (VCI) and compared with the segmentation results of CNN and fully CNN (FCN). As a result, the segmentation results of the three different algorithms showed that the Dice coefficient, accuracy, and recall of the multimodal CNN algorithm were 0.78 ± 0.24, 0.81 ± 0.28, and 0.88 ± 0.32, respectively, which were significantly increased compared to those of other two algorithms ( P  < 0.05). The neurological evaluation results showed that the MMSE and MoCA scores of VCI patients were 15.4 and 14.6 ± 5.31, respectively, which were significantly lower than those of the non-VCI group ( P  < 0.05). The TMT-a and TMT-b scores of VCI patients were 221.7 and 385.9, respectively, which were significantly higher than those of the non-VCI group ( P  < 0.05). The FA and MD values of nerve function-related fibers shown in the MRI images of the VCI group were significantly different from those of the non-VCI group ( P  < 0.05). Therefore, the neurological recovery process of VCI patients was affected by multiple neurocognitive-related fiber structures. To sum up, the multimodal CNN algorithm can sensitively and accurately reflect the degree of neurological impairment in patients with cerebrovascular disease and can be applied to disease diagnosis and neurological evaluation of VCI patients.

scholarly journals Cognitive impairment, dizziness, and unsteadiness in hypertensive patients

2020 ◽  
Vol 12 (5) ◽  
pp. 92-97
Author(s):  
L. M. Antonenko ◽  
N. V. Vakhnina ◽  
D. O. Gromova
Keyword(s):  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Brain Damage ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Treatment And Prevention ◽  
Cerebral Microangiopathy ◽  
Selection Of

Hypertension is a widespread disease related to modifiable vascular risk factors for stroke and chronic cerebrovascular diseases. The pathogenetic basis of brain damage in hypertension is cerebral microangiopathy that leads to vascular cognitive impairment (CI), instability, and falls. Microcirculatory changes in the presence of hypertension at the initial stages of cerebrovascular disease occur without visible clinical manifestations of brain damage. Pathogenetically justified treatment used at an early stage of the disease makes it possible to achieve good results in the prevention of vascular brain damage. An important aspect of selecting effective therapy is the competent diagnosis of the causes of dizziness and instability, which can be caused not only by brain damage, but also by peripheral vestibular system diseases. Early diagnosis of vascular CI, selection of adequate therapy, and prevention of their further progression are of great importance. The studies performed have shown the high efficacy of vinpocetine (Cavinton®) that has a multifactorial mechanism of action in the treatment and prevention of CI, dizziness, and instability caused by cerebrovascular disease.

scholarly journals Progression in Vascular Cognitive Impairment: Pathogenesis, Neuroimaging Evaluation, and Treatment

2018 ◽  
Vol 28 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Xin Zhang ◽  
Jiabin Su ◽  
Chao Gao ◽  
Wei Ni ◽  
Xinjie Gao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Functional Neuroimaging ◽  
Neuropsychological Testing ◽  
Vascular Cognitive Impairment ◽  
Neurological Rehabilitation ◽  
Vessel Occlusion ◽  
Cerebral Vascular Disease ◽  
Clinical Evaluations ◽  
Neurologic Disorders ◽  
Neurological Protection

Vascular cognitive impairment (VCI) defines an entire spectrum of neurologic disorders from mild cognitive impairment to dementia caused by cerebral vascular disease. The pathogenesis of VCI includes ischemic factors (e.g., large vessel occlusion and small vessel dysfunction); hemorrhagic factors (e.g., intracerebral hemorrhage and subarachnoid hemorrhage); and other factors (combined with Alzheimer’s disease). Clinical evaluations of VCI mainly refer to neuropsychological testing and imaging assessments, including structural and functional neuroimaging, with different advantages. At present, the main treatment for VCI focuses on neurological protection, cerebral blood flow reconstruction, and neurological rehabilitation, such as pharmacological treatment, revascularization, and cognitive training. In this review, we discuss the pathogenesis, neuroimaging evaluation, and treatment of VCI.

Hemodynamics in Alzheimer’s Disease and Vascular Cognitive Impairment and Dementia

2020 ◽  
pp. 302-330
Author(s):  
Francis Cambronero ◽  
Angela L. Jefferson
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Vascular System ◽  
Clinical Symptoms ◽  
Vascular Dysfunction ◽  
Critical Role ◽  
Vascular Cognitive Impairment ◽  
Aging Adults

Hemodynamic impairment is a prominent feature in aging, vascular cognitive impairment and dementia, and Alzheimer’s disease, including patterned changes in cerebral blood flow (CBF) that can be detected prior to concomitant pathologies. These CBF abnormalities drive vascular dysfunction through a variety of biological pathways and ultimately contribute to cerebrovascular disease associated with cognitive impairment. Importantly, the co-existence of cerebrovascular disease and Alzheimer’s disease is exceedingly common and worsens the progression of clinical symptoms, likely through accelerating neurotoxic protein deposition and the loss of cerebrovascular integrity. Emerging evidence further suggests that the brain may be more susceptible to subclinical cardiovascular dysfunction in aging adults, particularly since the accumulation of cardiovascular risk factors over the lifespan creates a more vulnerable vascular system. Although age-associated CBF dysregulation has varied and complex origins, it undoubtedly serves a critical role in the early progression of neurodegenerative disease and may help explain the considerable overlap between the most common clinical dementias.

scholarly journals Vascular cognitive impairment (VCI): Progress towards knowledge and treatment

2010 ◽  
Vol 4 (1) ◽  
pp. 4-13 ◽  
Author(s):  
Silvia Di Legge ◽  
Vladimir Hachinski
Keyword(s):  
Cognitive Impairment ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cognitive Outcome ◽  
Cognitive Domains ◽  
Mitochondrial Dna Damage ◽  
Complex Interactions ◽  
Dementia Syndrome ◽  
Data Elements ◽  
The Impact

Abstract Until recently, the study of cognitive impairment as a manifestation of cerebrovascular disease (CVD) has been hampered by the lack of common standards for assessment. The term vascular cognitive impairment (VCI) encompasses all levels of cognitive decline associated with CVD from mild deficits in one or more cognitive domains to crude dementia syndrome. VCI incorporates the complex interactions among classic vascular risk factors (i.e. arterial hypertension, high cholesterol, and diabetes), CVD subtypes, and Alzheimer's Disease (AD) pathology. VCI may be the earliest, commonest, and subtlest manifestation of CVD and can be regarded as a highly prevalent and preventable syndrome. However, cognition is not a standardized outcome measure in clinical trials assessing functional ability after stroke. Furthermore, with the exception of anti-hypertensive medications, the impact of either preventive or acute stroke treatments on cognitive outcome is not known. Although clinical, epidemiological, neuroimaging, and experimental data support the VCI concept, there is a lack of integrated knowledge on the role played by the most relevant pathophysiological mechanisms involved in several neurological conditions including stroke and cognitive impairment such as excitotoxicity, apoptosis, mitochondrial DNA damage, oxidative stress, disturbed neurotransmitter release, and inflammation. For this reason, in 2006 the National Institute of Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) defined a set of data elements to be collected in future studies aimed at defining VCI etiology, clinical manifestations, predictive factors, and treatment. These recommendations represent the first step toward developing diagnostic criteria for VCI based on sound knowledge rather than on hypotheses. The second step will be to integrate all studies using the agreed methodologies. This is likely to accelerate the search for answers.

scholarly journals The etiology, manifestations, and therapy of chronic cerebrovascular diseases

2020 ◽  
Vol 12 (5) ◽  
pp. 84-91
Author(s):  
A. G. Gogoleva ◽  
V. V. Zakharov
Keyword(s):  
Cognitive Impairment ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
International Standards ◽  
Amyloid Angiopathy ◽  
Neuroradiological Diagnosis ◽  
Genetically Determined

The paper presents the current etiopathogenetic classification of chronic cerebrovascular diseases (CVD) and discusses the role of hypertension, cerebral amyloid angiopathy, and genetically determined syndromes in the development of this pathological condition. It gives recommendations for the neuroradiological diagnosis of chronic CVD in accordance with the international standards. The paper discusses the clinical manifestations of chronic CVD, primarily vascular cognitive impairment. It discusses international guidelines for the examination and treatment of patients with chronic CVD, as well as the rules for stroke prevention in this patient cohort. The possibilities of pathogenetically based therapy in decreasing the severity of vascular cognitive impairment in the presence of chronic CVD are also highlighted.

scholarly journals Biomarkers of vascular cognitive impairment

2021 ◽  
Vol 20 (3) ◽  
pp. 2677
Author(s):  
O. V. Zimnitskaya ◽  
E. Yu. Mozheyko ◽  
M. M. Petrova
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Web Of Science ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Adequate Treatment ◽  
Genetic Biomarkers

There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.

scholarly journals Therapeutic Potential of Remote Ischemic Conditioning in Vascular Cognitive Impairment

2021 ◽  
Vol 15 ◽  
Author(s):  
Rui Xu ◽  
Qianyan He ◽  
Yan Wang ◽  
Yi Yang ◽  
Zhen-Ni Guo
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Processing ◽  
Therapeutic Potential ◽  
Recurrent Stroke ◽  
Neurovascular Unit ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning ◽  
Social Burden

Vascular cognitive impairment (VCI) is a heterogeneous disease caused by a variety of cerebrovascular diseases. Patients with VCI often present with slower cognitive processing speed and poor executive function, which affects their independence in daily life, thus increasing social burden. Remote ischemic conditioning (RIC) is a non-invasive and efficient intervention that triggers endogenous protective mechanisms to generate neuroprotection. Over the past decades, evidence from basic and clinical research has shown that RIC is promising for the treatment of VCI. To further our understanding of RIC and improve the management of VCI, we summarize the evidence on the therapeutic potential of RIC in relation to the risk factors and pathobiologies of VCI, including reducing the risk of recurrent stroke, decreasing high blood pressure, improving cerebral blood flow, restoring white matter integrity, protecting the neurovascular unit, attenuating oxidative stress, and inhibiting the inflammatory response.

Vascular dementia

2017 ◽  
Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Vascular Dementia ◽  
Vascular Cognitive Impairment ◽  
Mental Capacity ◽  
Dementia Patient

Patients with cerebrovascular disease can develop dementia in the absence of stroke symptoms or as a consequence to stroke. In this chapter, concepts, classification, and definitions of vascular dementia are outlined with a discussion of the overlap between vascular dementia and Alzheimer's disease. Investigation of the vascular dementia patient for treatable causes and to inform management is discussed as there are sections on therapy, promoting independence, and assessments of mental capacity. Depression is common in vascular dementia and a section is dedicated to the assessment and management of this. The concept of mild vascular cognitive impairment is also discussed.

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