scholarly journals Brain Lesion Volume and Capacity for Consent in Stroke Trials

Stroke ◽  
2008 ◽  
Vol 39 (8) ◽  
pp. 2336-2340 ◽  
Author(s):  
Krishna A. Dani ◽  
Michael T. McCormick ◽  
Keith W. Muir
Keyword(s):  
Brain Lesion ◽  
Lesion Volume ◽  
Capacity For Consent

scholarly journals Neuroprotective role of lactate in rat neonatal hypoxia-ischemia

2020 ◽  
pp. 0271678X2090835 ◽  
Author(s):  
Hélène Roumes ◽  
Ursule Dumont ◽  
Stéphane Sanchez ◽  
Leslie Mazuel ◽  
Jordy Blanc ◽  
...  
Keyword(s):  
Neuroprotective Effect ◽  
Waste Product ◽  
Brain Lesion ◽  
Complete Recovery ◽  
Long Term Memory ◽  
Lesion Volume ◽  
Apparent Diffusion Coefficients ◽  
Hypoxia Ischemia

Hypoxic-ischemic (HI) encephalopathy remains a major cause of perinatal mortality and chronic disability in newborns worldwide (1–6 for 1000 births). The only current clinical treatment is hypothermia, which is efficient for less than 60% of babies. Mainly considered as a waste product in the past, lactate, in addition to glucose, is increasingly admitted as a supplementary fuel for neurons and, more recently, as a signaling molecule in the brain. Our aim was to investigate the neuroprotective effect of lactate in a neonatal (seven day old) rat model of hypoxia-ischemia. Pups received intra-peritoneal injection(s) of lactate (40 μmol). Size and apparent diffusion coefficients of brain lesions were assessed by magnetic resonance diffusion-weighted imaging. Oxiblot analyses and long-term behavioral studies were also conducted. A single lactate injection induced a 30% reduction in brain lesion volume, indicating a rapid and efficient neuroprotective effect. When oxamate, a lactate dehydrogenase inhibitor, was co-injected with lactate, the neuroprotection was completely abolished, highlighting the role of lactate metabolism in this protection. After three lactate injections (one per day), pups presented the smallest brain lesion volume and a complete recovery of neurological reflexes, sensorimotor capacities and long-term memory, demonstrating that lactate administration is a promising therapy for neonatal HI insult.

Depressive Disorders in Long-Term Survivors of Stroke

1994 ◽  
Vol 164 (3) ◽  
pp. 380-386 ◽  
Author(s):  
Michael Sharpe ◽  
Keith Hawton ◽  
Valerie Seagroatt ◽  
John Bamford ◽  
Allan House ◽  
...  
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Functional Dependence ◽  
Brain Lesion ◽  
Lesion Volume ◽  
Community Based ◽  
A Prospective Study ◽  
Long Term Survivors ◽  
Stroke Register

Sixty surviving patients from a community-based stroke register who had computerised tomography (CT) scan evidence of a single brain lesion were interviewed three to five years after their first ever stroke. Depression (DSM–III–R major depression, partially resolved major depression, and dysthymia) was present in 11 (18%) of the patients and was associated with impaired physical and cognitive functioning, greater age, residence in an institution, absence of a close personal relationship, and larger original brain lesion. Of these variables, only functional dependence (odds ratio 16.4; confidence interval 1.6–170), larger lesion volume (6.6; 1–50), and female sex (8; 1.1–56) remained significantly associated with depression after controlling for all other variables. We conclude that depression in long-term survivors of stroke has many of the same associations as depression in non-stroke elderly populations. Depression in long-term stroke survivors may also be associated with larger original brain lesions, although this requires confirmation in a prospective study.

Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

2013 ◽  
Vol 20 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Antonio Giorgio ◽  
Maria Laura Stromillo ◽  
Maria Letizia Bartolozzi ◽  
Francesca Rossi ◽  
Marco Battaglini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Stepwise Multiple Regression ◽  
Lesion Volume ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

scholarly journals Incorporating Domain Knowledge Into the Fuzzy Connectedness Framework: Application to Brain Lesion Volume Estimation in Multiple Sclerosis

2007 ◽  
Vol 26 (12) ◽  
pp. 1670-1680 ◽  
Author(s):  
M.A. Horsfield ◽  
R. Bakshi ◽  
M. Rovaris ◽  
M.A. Rocca ◽  
V.S.R. Dandamudi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Domain Knowledge ◽  
Brain Lesion ◽  
Volume Estimation ◽  
Lesion Volume ◽  
Fuzzy Connectedness

scholarly journals Elevated brain lesion volumes in older adults who use calcium supplements: a cross-sectional clinical observational study

2014 ◽  
Vol 112 (2) ◽  
pp. 220-227 ◽  
Author(s):  
Martha E. Payne ◽  
Douglas R. McQuoid ◽  
David C. Steffens ◽  
John J. B. Anderson
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Brain Lesion ◽  
Lesion Volume ◽  
Cross Sectional ◽  
Supplement Use ◽  
Established Risk Factor ◽  
Automated Technique ◽  
Dietary Supplement Use ◽  
Randomised Controlled

Recent studies have implicated Ca supplements in vascular risk elevation, and therefore these supplements may also be associated with the occurrence of brain lesions (or hyperintensities) in older adults. These lesions represent damage to brain tissue that is caused by ischaemia. In the present cross-sectional clinical observational study, the association between Ca-containing dietary supplement use and lesion volumes was investigated in a sample of 227 older adults (60 years and above). Food and supplemental Ca intakes were assessed with the Block 1998 FFQ; participants with supplemental Ca intake above zero were categorised as supplement users. Lesion volumes were determined from cranial MRI (1·5 tesla) scans using a semi-automated technique; volumes were log-transformed because they were non-normal. ANCOVA models revealed that supplement users had greater lesion volumes than non-users, even after controlling for food Ca intake, age, sex, race, years of education, energy intake, depression and hypertension (Ca supplement use: β = 0·34, se 0·10, F1,217= 10·98, P= 0·0011). The influence of supplemental Ca use on lesion volume was of a magnitude similar to that of the influence of hypertension, a well-established risk factor for lesions. Among the supplement users, the amount of supplemental Ca was not associated with lesion volume (β = − 0·000035, se 0·00 015, F1,139= 0·06, P= 0·81). The present study demonstrates that the use of Ca-containing dietary supplements, even low-dose supplements, by older adults may be associated with greater lesion volumes. Evaluation of randomised controlled trials is warranted to determine whether this relationship is a causal one.

Differential association of cortical, subcortical and spinal cord damage with multiple sclerosis disability milestones: A multiparametric MRI study

2021 ◽  
pp. 135245852110202
Author(s):  
Milagros Hidalgo de la Cruz ◽  
Paola Valsasina ◽  
Alessandro Meani ◽  
Antonio Gallo ◽  
Claudio Gobbi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Structural Damage ◽  
Brain Lesion ◽  
Three Dimensional ◽  
Cerebellar Atrophy ◽  
Cervical Cord ◽  
Lesion Volume ◽  
Cross Sectional ◽  
Lesion Number ◽  
Cord Lesion

Background: In multiple sclerosis (MS), cortical, subcortical and infratentorial structural damage may have a differential contribution to clinical disability according to disease phases. Purpose: To determine the relative contributions of cortical, deep (D) grey matter (GM), cerebellar and cervical cord damage to MS disability milestones. Methods: Multi-centre 3T brain and cervical cord T2- and three-dimensional (3D) T1-weighted images were acquired from 198 MS patients (139 relapsing-remitting (RR) MS, 59 progressive (P) MS) and 67 healthy controls. Brain/cord lesion burden, cortical thickness (CTh), DGM and cerebellar volumetry and cord cross-sectional area (CSA) were quantified. Random forest analyses identified predictors of expanded disability status scale (EDSS) disability milestones (EDSS = 3.0, 4.0 and 6.0). Results: MS patients had widespread atrophy in all investigated compartments versus controls ( p-range: ⩽0.001–0.05). Informative determinants of EDSS = 3.0 were cord CSA, brain lesion volume, frontal CTh and thalamic and cerebellar atrophy (out-of-bag (OOB) accuracy = 0.84, p-range: ⩽0.001–0.05). EDSS = 4.0 was mainly predicted by cerebellar and cord atrophy, frontal and sensorimotor CTh and cord lesion number (OOB accuracy = 0.84, p-range: ⩽0.001–0.04). Cervical cord CSA ( p = 0.001) and cord lesion number ( p = 0.003) predicted EDSS = 6.0 (OOB accuracy = 0.77). Conclusion: Brain lesion burden, cortical and thalamic atrophy were the main determinants of EDSS = 3.0 and 4.0, while cord damage played a major contribution to EDSS = 6.0.

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