Does cerebrospinal fluid pulsation affect diffusion-weighted imaging thermometry? A study in healthy volunteers

Diffusion-weighted imaging (DWI)-based thermometry offers potential as a noninvasive method for measuring temperatures deep inside the human brain. However, DWI might be influenced by the pulsatile flow of cerebrospinal fluid (CSF). This study aimed to investigate the influence of such pulsations on DWI thermometry in healthy individuals. A total of 104 participants (50 men, 54 women; mean [± standard deviation] age, 44.2 ± 14.3 years; range 21–69 years) were investigated. DWI-based brain temperature (T_DWI) was acquired at three speeds (maximum and minimum speeds of ascending flow and random timing at the cerebral aqueduct) of CSF pulsation using a 3-T magnetic resonance imaging scanner. Magnetic resonance spectroscopy (MRS)-based temperature (T_MRS) at the thalamus was also obtained as a reference standard for brain temperature. The three different CSF pulsatile flows were monitored by heart rate during the scan. The difference between reference temperature and brain temperature (ΔT = T_DWI– T_MRS) along with the three CSF speeds were statistically compared using Student's matched pair t-test. No significant difference in ΔT was evident among CSF speeds (p > 0.05). No significant linear correlation between ΔT and CSF flow speed at the cerebral aqueduct was observed. Using DWI thermometry with clinical acquisition settings, which utilizes mean values within thresholds, no effect of CSF pulsation speed was observed in the estimation of ΔT.     

New experimental model of acute aqueductal blockage in cats: Effects on cerebrospinal fluid pressure and the size of brain ventricles

It is generally assumed that cerebrospinal fluid (CSF) is secreted in the brain ventricles, and so after an acute blockage of the aqueduct of Sylvius an increase in the ventricular CSF pressure and dilation of isolated ventricles may be expected. We have tested this hypothesis in cats. After blocking the aqueduct, we measured the CSF pressure in both isolated ventricles and the cisterna magna, and performed radiographic monitoring of the cross-sectional area of the lateral ventricle. The complete aqueductal blockage was achieved by implanting a plastic cannula into the aqueduct of Sylvius through a small tunnel in the vermis of the cerebellum in the chloralose-anesthetized cats. After the reconstitution of the occipital bone, the CSF pressure was measured in the isolated ventricles via a plastic cannula implanted in the aqueduct of Sylvius and in the cisterna magna via a stainless steel cannula. During the following 2 h, the CSF pressures in the isolated ventricles and cisterna magna were identical to those in control conditions. We also monitored the ventricular cross-sectional area by means of radiography for 2 h after the aqueductal blockage and failed to observe any significant changes. When mock CSF was infused into isolated ventricles to imitate the CSF secretion, the gradient of pressure between the ventricle and cisterna magna developed, and disappeared as soon as the infusion was terminated. However, when mock CSF was infused into the cisterna magna at various rates, the resulting increased subarachnoid CSF pressure was accurately transmitted across the brain parenchyma into the CSF of isolated ventricles. The lack of the increase in the CSF pressure and ventricular dilation during 2 h of aqueductal blockage suggests that aqueductal obstruction by itself does not lead to development of hypertensive acute hydrocephalus in cats.     

Evaluation of extracranial blood flow in Parkinson disease

Decreased cerebral flow velocities in Parkinsonian patients were reported previously. Because of the limited data on vascular changes in Parkinson disease (PD), which may have a vascular etiology, we aimed to disclose any possible cerebral hemodynamic alteration in Parkinsonian patients. We prospectively evaluated 28 non-demented, idiopathic parkinsonian patients and 19 age and sex matched controls with Doppler sonography. Flow volumes, peak systolic flow velocities, and cross-sectional areas of vertebral and internal carotid arteries (ICA) were measured and compared between patients and controls. Correlation of patient age and disease duration with Doppler parameters was observed; and each Doppler parameter of patients within each Hoehn-Yahr scale was compared. There was no significant difference of measured parameters between groups. No correlation was found between disease duration and age with flow volume, cross-sectional area or peak systolic velocity. Hoehn-Yahr scale was not found having significant relation with Doppler parameters. Values of vertebral, internal carotid and cerebral blood flow volumes (CBF), peak systolic velocities, and cross-sectional areas were not significantly different between Parkinsonian patients and age and sex matched controls. Although regional blood flow decreases may be seen as reported previously, Parkinson disease is not associated with a flow volume or velocity alteration of extracranial cerebral arteries.     

Interferon‐Related Transcriptome Alterations in the Cerebrospinal Fluid Cells of Aicardi‐Goutières Patients†

Aicardi–Goutières syndrome (AGS) is a rare interferon (IFN)‐related encephalopathy with onset during the first year of life. AGS, is clinically characterized by progressive microcephaly, bilateral basal ganglia calcification, cerebral atrophy, cerebrospinal fluid (CSF), lymphocytosis, delayed development of psychomotor abilities with pyramidal–extrapyramidal syndrome and mimics congenital viral infections. Microarray analysis examining the expression of 18 880 human genes has been applied to the CSF lymphocytes of 20 AGS cases (age 4.5 ± 4.4 years, mean ± standard deviation) characterized by high IFN‐alpha levels in CSF and 20 matched controls (age 4.4 ± 4.3 years, mean ± standard deviation). Gene‐expression data reveal significant differences between AGS cases and controls for all controls and 18 AGS cases. The two AGS cases unclassified as compared with controls were both older than 7 years. AGS cases presented upregulation of genes involved in IFN‐dependent pathways and lymphocyte functions, paralleled by the downregulation of genes encoding for angiopoietic activities. The cystatin F and DNAJ genes, having a negative feedback on IFN pathways, underwent a progressive age‐related increase in their expression. These gene‐expression signature parallels a progressive attenuation of clinical symptoms with age. Obtained results provide evidence that exposure to IFN‐alpha is harmful for developing brain.     

Lower levels of cerebrospinal fluid amyloid beta (Abeta) in non-demented Indian controls

Prevalence of Alzheimer's disease in Indian population is lower than in developed countries. To determine whether limitation of amyloid beta (Abeta) concentration may be responsible for lower rate of incidence, we measured the levels of Abeta in cerebrospinal fluid (CSF) collected from 72 non-demented individuals ranging in the age from 20 years to 65 years. These samples were segregated into three groups ranging from 20-35 years, 36-50 years and 51-65 years of age. Levels of Abeta could be detected in all the age groups and they were much lower than the values reported in literature from the developed countries. No significant difference in the average level of Ass was observed with increase in age.     

Obstructive sleep apnea as a risk factor for silent cerebral infarction

Previous studies have suggested that obstructive sleep apnea (OSA) may be a risk factor for stroke. In this study, we assessed that OSA is an independent risk factor of silent cerebral infarction (SCI) in the general population, and in a non‐obese population. This study recruited a total of 746 participants (252 men and 494 women) aged 50–79 years as part of the Korean Genome and Epidemiology Study (KoGES); they underwent polysomnography, brain magnetic resonance imaging and health screening examinations. SCI was assessed by subtypes and brain regions, and lacunar infarction represented lesions <15 mm in size in the penetrating arteries. Moderate–severe OSA was determined by apnea–hypopnea index ≥15. The results indicated that 12.06% had moderate–severe OSA, 7.64% of participants had SCI and 4.96% had lacunar infarction. Moderate–severe OSA was associated positively with SCI [odds ratio (OR): 2.44, 95% confidence interval (CI): 1.03–5.80] and lacunar infarction (OR: 3.48, 95% CI: 1.31–9.23) in the age ≥65‐year group compared with those with non‐OSA. Additionally, in the basal ganglia, OSA was associated with an increase in the odds for SCI and lacunar infarction in all age groups, and especially in the ≥65‐year age group. In the non‐obese participants, OSA was also associated positively with SCI in the ≥65‐year age group, lacunar infarction in all age groups, and especially in the ≥65‐year age group. There was also a positive association with the basal ganglia. Moderate–severe OSA was associated positively with SCI and lacunar infarction in elderly participants. Treatment of OSA may reduce new first‐time cerebrovascular events and recurrences.     

Body mass index,overweight and obesity in married and never married men and women in Poland

The study examined the relationship between marital status and the body mass index (BMI) and the prevalence of overweight and obesity in the Polish population. The sample included 2,266 men and 4,122 women, 25–60 years of age, who were occupationally active inhabitants of Wroclaw, in southwestern Poland. Marital status was defined by two categories: never married and presently married, and two groups in each category were established on the basis of educational level: well‐educated (12 or more years in school) and poorly educated (less than 12 years in school). The subjects were also divided into four age groups: 25–30, 31–40, 41–50, and 51–60 years. Height and weight were measured and the BMI was calculated. Three categories of the BMI were established: normal, BMI < 25.0 kg/m², overweight, BMI ≥ 25 < 30 kg/m², and obese, BMI ≥ 30 kg/m². In each age and educational group, married individuals had a higher BMI than those who were never married. With the exception of well‐educated males 51–60 years, differences in the BMI between married and never married individuals increased with age. In general, married men and women were more likely to be overweight and obese than never married individuals. The results indicated a significant association (P < 0.001) between marital status and the BMI in both sexes. After age, marital status was the most important predictor of overweight/obesity among men (P < 0.001), whereas educational level did not have a significant role. Among women, age, marital status, and education were significantly (P < 0.001) related to the BMI. Am. J. Hum. Biol. 14:468–475, 2002.© 2002 Wiley‐Liss, Inc.     

Sex dimorphism in gray/white matter volume and diffusion tensor during normal aging

The purpose of this study is to elucidate sex differences in global and regional gray/white matter volume, mean diffusivity (MD), and fractional anisotropy (FA) during normal aging using voxel‐based analysis. We studied 245 healthy right‐handed subjects with a wide range of ages (115 women, 22–70 years; 130 men, 21–71 years). Regarding global effects, inclusion of a quadratic age term improved the fit to data for white matter fraction and MD, but not for global gray matter volume/fraction or FA. Regarding regional effects, we found anterior‐dominant volume loss, FA decrease predominantly in the anterior white matter, and MD increase predominantly in perisylvian regions and periventricular white matter against age for both sexes. Compared with women, we found a steeper FA decline for men in the right inferior fronto‐temporal areas, extending to the anterior cingulate cortex, and an accelerated MD increase for men in the bilateral frontal, temporal, and parietal areas. There was no area in which interaction of sex with age was significant for regional volume, or in which a steeper FA decline or accelerated MD increase for women was significant. Our results provide strong evidence of sex dimorphism in global and focal diffusion characteristics during normal aging. Copyright © 2010 John Wiley & Sons, Ltd.     

三维超声心动图对慢性肾脏疾病患者左心房容积和功能的评价

目的探究在评价慢性肾脏疾病(CKD)患者的左心房容积及功能中三维超声心动图(3DE)的应用价值。方法选择CKD 2~5期非透析慢性肾脏疾病患者101例,其中男性58例,女性43例;年龄20~65岁,平均年龄42.68岁。依据患者的肾小球滤过率(GFR)水平分为CKD 2~5组,其中CKD 2组(CKD 2期,GFR 60~89 mL/min)24例,CKD 3组(CKD 3期,GFR 30~59 m L/min)26例,CKD 4组(CKD 4期,GFR 15~29 mL/min)25例,CKD 5组(CKD 5期,GFR <15 mL/min)26例。同时另选择25例正常受试者作为对照组,其中男性15例,女性10例;年龄26~64岁,平均年龄43.85岁。对全容积3DE图像进行采集,采用软件脱机分析,收集左心房各3DE的容积参数,具体包括左心房前后径(LAD)、左心室舒张末期的前后径(LVIDd)、舒张末期的室间隔厚度(LAVImax)、收缩前容积指数(LAVIp)和最小容积指数(LAVImin),并计算左心房总排空指数(LAVItotal)、主动排空指数(LAVIact)、被动排空指数(LAVIpass)、主动排空分数(LAAEF)、被动排空分数(LAPEF)、总排空分数(LATEF),对比各组间不同参数的差异情况。结果左心房储备功能3DE容积参数比较:CKD各组LAVImax、LAVIp与对照组相比明显增高,且CKD 4组和CKD 5组增高更明显(P <0.05)。CKD 4组和CKD 5组LAVImin与对照组、CKD 2组和CKD 3组相比明显增高(P <0.05)。CKD 4组和CKD 5组LAVItotal、LATEF与对照组相比有明显增高(P <0.05)。左心房管道功能3DE容积参数比较:CKD各组LAPEF与对照组相比有明显降低,其中CKD 5组降低更明显(P <0.05)。左心房助力泵功能3DE容积参数比较:CKD各组LAVIact与对照组相比明显降低,其中CKD 5组降低更明显(P <0.05)。结论 CKD各期患者左心房储备、助力泵功能和容积指数均有明显增加,同时左心房的管道功能明显下降。3DE对早期评估CKD患者左心房容积与功能有着重要价值。     

Age‐related pattern of body density and body composition of Japanese men and women 18–59 years of age

Age‐related patterns of body size and composition were studied in a cross‐sectional sample of Japanese adults 18–59 years of age. Height, weight, the body mass index (BMI), body density (BD), percentage body fat (%Fat), fat mass (FM), fat‐free mass (FFM), and the sum of seven skinfold thicknesses (SF) of 288 men and 552 women were considered. Body density was measured by underwater weighing densitometry. Mean values of height, weight, BMI, BD, %Fat, FM, FFM, and SF of males were 169.0 cm, 65.3 kg, 22.8 kg/m², 1.0600 g/ml, 17.0%, 11.4 kg, 53.9 kg, and 95.0 mm, respectively, while corresponding values for females were 157.4 cm, 52.9 kg, 21.4 kg/m², 1.0420 g/ml, 24.4%, 13.1 kg, 39.7 kg, and 128.2 mm, respectively. Height, BD, and FFM correlated negatively with age in both sexes, while weight, BMI, %Fat, FM, and SF correlated positively with age. The highest BD and the lowest %Fat were observed in males ages 20 to <25 years (G20) and in females 25 to <30 years (G25). The lowest BD and highest %Fat were observed in G50 in both sexes. Correlations among parameters of body size and composition were stable with age in each sex. Height correlated negatively with BMI and %Fat in females, but not in males. In males, FM started to increase between G20 and G25 and continued to increase until G50, while SF and BMI remained stable during this period. In females, FM accumulation started around 30 years of age and continued until G50 and was accompanied by increases in SF and BMI. Am. J. Hum. Biol. 14:743–752, 2002. © 2002 Wiley‐Liss, Inc.     

Cine-PC MR in assessment of cerebrospinal fluid velocity in the aqueduct of the midbrain correlated with intracranial pressure--initial study

We assessed the changes in cerebrospinal fluid (CSF) hydrodynamics caused by barriers to CSF circulation, and determined the relationship between CSF velocity and intracranial pressure in the aqueduct of the midbrain. This was determined by correlating the CSF peak flow velocity with the intracranial pressure (ICP) obtained from a lumbar puncture (LP) procedure. The CSF peak flow velocity was measured by finger pulse-gated cine-phase contrast (PC) MR scan 8-12 hours after LP was performed in 28 patients. All patients were divided into 2 groups based on the directional patterns of the CSF net flow in the aqueduct of the midbrain over one cardiac cycle. The CSF peak net velocity (V_net) was then correlated with ICP utilizing Pearson correlation analysis method, with significance difference assigned at the 5% level. Routine MR scanning revealed no abnormal findings in the brain when the direction of the CSF net flow is caudal. V_net in the aqueduct of the midbrain was correlated positively with ICP (y(V) = 0.011 + 0.002×(ICP), r = 0.69, p < 0.01). However, varying degrees of the hydrocephalus were observed in those patients who demonstrated a cranial direction of the CSF net flow. Our results indicate that non-invasive measurement of the CSF peak flow with cine-PC MR imaging can be related to the change of CSF circulation caused by the obstructions to the CSF circulation in the patients with various neurological disorders. This unique method may be a substantially useful tool to assess the changes in the ICP in the directional pattern.     

Levels of IL-15 in serum and cerebrospinal fluid of patients with Behçet's disease

Interleukin‐15 (IL‐15) is a novel proinflammatory cytokine, involved in the pathogenesis of inflammatory/autoimmune disease. The objective of our study was to measure serum and cerebrospinal fluid (CSF) IL‐15 levels in patients with Behçet's disease (BD). CSF/serum IL‐15 ratio was introduced to assess the origin of elevated IL‐15 levels. We measured serum and CSF‐IL‐15 levels in 40 patients with BD (20 patients in active stage). Inflammatory and non‐inflammatory neurological disease patients acted as controls. Active BD patients have significantly higher serum IL‐15 levels (median 10.4 pg/ml; range 5.3–17.4) compared with BD in remission (6.05 pg/ml; 4–10.4) and healthy controls (4.65 pg/ml; 3.9–6.2). Similar serum IL‐15 levels were found in active neuro‐BD and inflammatory neurological disease (9.5 pg/ml; 5–13). Elevated levels of IL‐15 were observed in CSF samples from neuro‐BD patients (11 pg/ml; 8.5–15) and inflammatory neurological disease patients (10 pg/ml; 6.5–14) compared with patients with non‐inflammatory neurological disease (4 pg/ml; 4–5.5; P < 0.001). Vascular cerebral BD lesions were associated with high CSF/serum IL‐15 ratio. Our findings suggest that IL‐15 is involved in BD inflammatory process, particularly in vasculitis foci, as an elevated CSF/serum IL‐15 ratio characterizes vascular cerebral lesions.     

Historical demographic and epidemiological studies of aging in American Samoans

American Samoan mortality records, from 1920 through 1988, and epidemiological survey data from 1976 are used to examine demographic definitions of the elderly in different time periods and to examine the association of body habitus and blood pressure with mortality among middle-aged and older Samoans. In the 1920s, the average Samoan lived 24 years, but over 50% of deaths occurred prior to age 15. In the 1980s the average Samoan lived about 54 years and 50% of deaths occurred after age 58. The common definition for matua (an elder or true old one) was 50 years in 1962, an age to which only 17% of the population lived in the 1920s; this value increased to 60–65 years by 1976, when 53% of the population survived to age 50 years and 34% to age 65 years. These data suggest that quantitative demographic factors may have constrained Samoan cultural definitions of matua i.e., “elderliness” during the 20th century. Among middleaged and older Samoans who died between 1976 and 1980, body weight, body mass index (BMI), and systolic and diastolic blood pressure were differentially associated with cause-specific mortality by age and sex. None of these risk factors was associated with mortality in older men, but BMI and systolic pressure were significanlty lower among middle-aged men who died. In contrast, all four risk factors were associated positively with mortality in middle-aged women, but in older women only systolic pressure was.     

Quantification of myocardial blood flow and flow reserve in rats using arterial spin labeling MRI: comparison with a fluorescent microsphere technique

To quantify noninvasively myocardial blood flow (MBF) and MBF reserve in isoflurane‐anesthetized rats using the Look‐Locker flow‐alternating inversion recovery gradient‐echo arterial spin labeling technique (LLFAIRGE‐ASL), and to compare the results with the fluorescent microsphere (FM) technique. Male Wistar rats (weight = 200–240 g, n = 21) were anesthetized with 2.0% isoflurane. Hemodynamic parameters were recorded. In seven rats, MBF was assessed on a Bruker Biospec 4.7T MR system using an ECG‐ and respiration‐gated LLFAIRGE‐ASL (pixel size = 234 × 468µm², TE = 1.52ms) at rest and during adenosine infusion (140 µg/kg/min). A mixture of 200 000 FM was injected into a second group of rats at rest and during adenosine infusion (n = 7 each), under similar physiologic conditions. Hearts and skeletal muscle samples were processed for fluorescence spectroscopy. Two‐tailed unpaired, paired Student's t‐test and ANOVA were used to compare groups. MBF measured with LLFAIRGE‐ASL was 5.2 ± 1.0 mL/g/min at rest and 13.3 ± 3.0 mL/g/min during adenosine infusion. Results obtained with fluorescent microspheres yielded 5.9 ± 2.3 mL/g/min (nonsignificant vs. LLFAIRGE‐ASL, p = 0.9) at rest and 13.1 ± 2.1 mL/g/min (nonsignificant vs. LLFAIRGE‐ASL, p = 0.4) during adenosine infusion. Myocardial blood flow reserve measured using LLFAIRGE‐ASL and FM were not significantly different (2.5 ± 0.6 vs. 2.4 ± 0.9, respectively; p = 0.8). Hemodynamic parameters during the experiments were not different between the groups. The myocardial blood flow reserve determined under isoflurane anesthesia was 2.5 ± 0.6, which was not different from the value obtained with FM. LLFAIRGE‐ASL provided MBF maps with high spatial resolution in rats under isoflurane anesthesia. LLFAIRGE‐ASL is a noninvasive measure to assess myocardial blood flow reserve and provides an interesting tool for cardiovascular research. Copyright © 2011 John Wiley & Sons, Ltd.     

Taurine chloramine inhibits functional responses of human eosinophils in vitro

Background Eosinophils are prominent effectors of allergic inflammation. Taurine‐chloramine (TauCl), a derivative of the amino acid taurine, shows antioxidant properties in different cell systems but its effects on eosinophils have not been reported. Objective To study the effects of TauCl and taurine on functional responses of isolated human eosinophils activated by different stimuli. Methods Human eosinophils were purified from the blood of healthy donors by a magnetic bead separation system. The effects of TauCl and taurine (0.1–1 mm ) were investigated on the generation of superoxide anion (ferricytochrome‐c reduction microassay), calcium signal (fluorimetry), p47^phox–p67^phox translocation (Western blot), leukotriene C₄ (LTC₄) production (enzymeimmunoassay), eosinophil peroxidase (EPO) release (spectrophotometry), eosinophil cationic protein (ECP) release (radioimmunoassay), apoptosis (flow cytometry with annexin V‐propidium iodide), and nuclear factor‐κB (NF‐κB) activation (Western blot). Results TauCl inhibited superoxide anion generation triggered by N‐formyl‐Met–Leu–Phe (fMLP; 30 nm ), phorbol myristate acetate (1 nm ) and serum opsonized zymosan (0.5 mg/mL) with similar potency (IC₅₀～200 μm ) for the three stimuli, while taurine (0.1–1 mm ) was scarcely effective. TauCl but not taurine inhibited p47^phox–p67^phox translocation. TauCl (200 μm ) and taurine (1 mm ) did not modify the [Ca²⁺]_i responses to fMLP. TauCl inhibited the release of EPO (IC₅₀～200 μm ) and reduced ECP and LTC₄ production from fMLP‐activated eosinophils while taurine was without significant effects. TauCl (1 mm ) did not change constitutive apoptosis but significantly attenuated the ability of granulocyte‐monocyte colony‐stimulating factor (GM‐CSF) and IL‐5 to prevent apoptosis. The activation of eosinophil NF‐κB induced by GM‐CSF and IL‐5 was suppressed by TauCl. Conclusion Taurine is without significant in vitro effects on human eosinophil functions but its derivative TauCl inhibits oxidative burst and generation of inflammatory mediators, and reverses the survival effect produced by inflammatory cytokines. Therefore, endogenous TauCl may help to suppress excessive inflammatory response in eosinophils at inflammatory sites.     

Structural and resting‐state MRI detects regional brain differences in young and mid‐age healthy APOE‐e4 carriers compared with non‐APOE‐e4 carriers

The presence of the e4 allele of the apolipoprotein E (APOE) gene is the best‐known genetic risk factor for Alzheimer's disease. In this study, we investigated the link between functional and behavioural differences and regional brain volume and cortical thickness differences in those who carry the e4 allele (e4+) and those who only carry the e3 allele (e3/e3). We studied these genotype populations in two age groups: a young group (average age, 21 years) and a mid‐age group (average age, 50 years). High‐resolution T₁‐weighted MRI scans were analysed with Freesurfer to measure regional white matter brain volume and cortical thickness differences between genotype groups at each age. These data were correlated with behavioural findings in the same cohort. Resting‐state MRI was also conducted to identify differences in underlying brain functional connectivity. We found that there was a positive correlation between the thickness of the parahippocampal cortex in young e4+ individuals and performance on an episodic memory task. Young e4+ individuals also showed a positive correlation between white matter volume in the left anterior cingulate and performance on a covert attention task. At mid‐age, e4+ individuals had structural differences relative to e3/e3 individuals in these areas: the parahippocampal cortex was thicker and white matter volume in the left anterior cingulate was greater than in e3/e3 individuals. We discuss the possibility that an over‐engagement with these regions by e4+ individuals in youth may have a neurogenic effect that is observable later in life. The cuneus appears to be an important region for APOE‐driven differences in the brain, with greater functional connectivity among young e3/e3 individuals and greater white matter volume in young e4+ individuals. Copyright © 2016 John Wiley & Sons, Ltd.     

The Relationship of Cerebral Vessel Pathology to Brain Microinfarcts

The relationship of cerebral vessel pathology to brain microinfarcts is not fully understood. We examined associations of cerebral vessel pathology with microinfarcts among community‐dwelling persons who came to autopsy. Brain specimens were derived from 1,066 deceased subjects (mean age‐at‐death = 88 years, 65% women) participating in a cohort study of aging. Microinfarcts were classified by number, age and location. Severity of vessel pathologies was graded semi‐quantitatively. Almost a third of subjects (n = 300; 28%) had at least one chronic microinfarct, including 128 cortical only, 120 subcortical only, and 47 with both. Moderate‐to‐severe atherosclerosis was present in 430 (41%) subjects, arteriolosclerosis in 382 (36%), and amyloid angiopathy in 374 (35%). The odds of one or multiple microinfarct(s) was increased for more severe atherosclerosis (OR =1.22; 95%CI: 1.03–1.45), arteriolosclerosis (OR =1.18; 95%CI: 1.02–1.37) and amyloid angiopathy (OR =1.13; 95%CI: 1.00–1.28). Separately, the odds of subcortical microinfarct(s) was increased for atherosclerosis (OR =1.49; 95%CI: 1.20–1.84) and arteriolosclerosis (OR =1.39; 95%CI: 1.16–1.67) but not amyloid angiopathy; whereas the odds of cortical microinfarct(s) was increased for amyloid angiopathy (OR =1.26; 95%CI: 1.09–1.46) only. While cerebral vessel pathologies are associated with microinfarct burden, atherosclerosis and arteriolosclerosis are associated with subcortical microinfarcts, and amyloid angiopathy with cortical microinfarcts.     

Study of normal volumetric variation in the putamen with age and sex using magnetic resonance imaging

Putamen volume is seen to alter in neurological and psychiatric disorders like Parkinson's disease, depression, schizophrenia, Alzheimer's disease, and in individuals treated with antipsychotics. To establish a trend in volume changes in pathologic states, studies on factors influencing normal variation in a given population become essential. This study aimed to evaluate the normal variations in putamen volume in the Indian population and correlate them with the effects of age and sex. Bilateral symmetry was also evaluated. The study included MR images of 98 individuals aged 10–87 years. Axial sections of T2‐weighted spin echo sequences were used to estimate putamen volume. The putamen was delineated manually and its volume was estimated using Cavalieri's principle. Linear regression and paired t‐test were used to analyze data. Bilateral putamen volume reduced with age in both sexes. This was statistically significant (P < 0.05) except for the left putamen volume in males. There was no significant age‐adjusted effect of sex on putamen volume in both hemispheres (P > 0.05). Age and sex interaction was not found to be statistically significant. Hemispherical asymmetry was not established as the difference between the right and left putamen volume did not reach statistical significance in both males and females (P > 0.05). In conclusion, this study demonstrated an age related decline in the volumes of both putamen in males and females. The rate of volume reduction was not affected by sex. The study failed to establish a significant sex difference and hemispherical asymmetry in putamen volume. Clin. Anat. 30:461–466, 2017. © 2017 Wiley Periodicals, Inc.     

Evaluation of two assays for CXCL13 analysis in cerebrospinal fluid for laboratory diagnosis of Lyme neuroborreliosis

We evaluated the diagnostic performance of two assays, one bead‐based assay and one enzyme‐linked immunosorbent assay (ELISA), for the determination of CXCL13 levels in cerebrospinal fluid (CSF) from patients with suspected Lyme neuroborreliosis (LNB). Patients investigated for LNB were retrospectively included (n = 132): 35 with definite LNB, 8 with possible LNB with CSF pleocytosis but normal antibody index (AI), 6 with possible LNB with elevated AI but no CSF pleocytosis and 83 non‐LNB patients. CSF samples had been drawn before antibiotic treatment and were analysed for CXCL13 by Quantikine ELISA (R&D Systems) and recomBead (Mikrogen). Receiver operating characteristic analyses based on the definite LNB and non‐LNB groups revealed a best performance cut‐off of 56 pg/mL for Quantikine and 158 pg/mL for recomBead (sensitivity and specificity 100% for both assays). When applying these cut‐off levels on the study groups, the two assays performed equally well regarding sensitivity and specificity. In the group of patients with pleocytosis but negative AI, the majority of whom were children with short symptom duration, the CXCL13 analysis supported the LNB diagnosis in half of the cases. We consider CSF‐CXCL13 analysis a useful diagnostic tool, in addition to Borrelia‐specific AI, in laboratory diagnostics of LNB.     

Epidemiology of herpes zoster and its relationship to varicella in Japan: A 10‐year survey of 48,388 herpes zoster cases in Miyazaki prefecture

From 1997 to 2006, a total of 48,388 patients with herpes zoster, ranging from a 3‐month‐old girl to a 102‐year‐old woman, were monitored at the 46 dermatology clinics in the Miyazaki Prefecture, which has a population of about 1.2 million. The mean herpes zoster incidence was 4.15/1,000 person‐years, ranging from 1.96 to 7.84/1,000 person‐years among different age groups, and the herpes zoster incidence was significantly higher in females (4.58) than in males (3.67). The incidence by age group was 1.96–2.86/1,000 person‐years below the age of 50 years, and it increased to 5.23–7.84/1,000 person‐years in persons 50–59 and older, with a trough in the ages 30–39, forming the small and large peaks. Females showed a significantly higher incidence than males, and the difference between the sexes was small below age 40 but greater at 40–49, 50–59, and 60–69. The incidence of herpes zoster was highest in August and lowest in winter, mirroring the prevalence of varicella. The number of herpes zoster cases at 60 years and older increased more than in the population from 1997 to 2006, and this increased incidence of herpes zoster in the 60–69 years and older, especially in females, might have raised the rate in contrast to the stable incidence below the age of 60 years. This large‐scale survey clarifies the epidemiology of herpes zoster by age, gender, and season in relation to the prevalence of varicella in the Miyazaki Prefecture in Japan. J. Med. Virol. 81:2053–2058, 2009. © 2009 Wiley‐Liss, Inc.