颈内动脉狭窄血管内支架置入术对缺血性脑血管病患者血管内皮功能的影响

目的探讨颈内动脉狭窄血管内支架置入术对缺血性脑血管病患者血管内皮功能的影响。方法选取我院2012-05—2014-05收治的86例颈内动脉狭窄缺血性脑血管病患者为研究对象,随机将所有患者分为实验组(43例)和对照组(43例),对照组给予常规西药进行保守治疗,实验组在对照组的基础上实施血管内支架置入术,比较治疗前后2组患者的认知功能变化、血浆中ET-1、vWF、NO水平的变化以及总治愈率。结果治疗前,2组认知功能的各个方面差异均无统计学意义(P0.05),治疗后2组记忆力、回忆能力、语言能力评分差异有统计学意义(P0.05),定向能力、注意力与计算能力评分差异无统计学意义(P0.05),但认知功能总分差异有统计学意义(P0.05);治疗前2组血浆中ET-1、vWF、NO水平差异无统计学意义(P0.05),治疗后2的ET-1、vWF水平均明显升高(P0.05),NO水平明显降低(P0.05),且实验组变化幅度显著高于对照组(P0.05);对照组总治愈率79.07%,实验组为95.35%,实验组显著高于对照组,差异有统计学意义(P0.05)。结论血管内支架置入术对颈内动脉狭窄缺血性脑血管患者的内皮功能有轻微的损伤,但可有效改善患者的认知功能,提高总体疗效。     

经颅多普勒超声结合二氧化碳试验评价颈内动脉狭窄患者的脑血管反应

目的:检测颈内动脉(intracranial artery,ICA)狭窄患者的脑血管反应性(CVR),探讨其狭窄程度与脑血管反应性之间的关系,以期为临床治疗及预防提供依据.方法:对不同程度ICA狭窄患者,采用德国DWL型经颅多普勒超声(TCD)检测仪,结合二氧化碳试验分别测得过度换气、吸入CO2气体、屏气后的大脑中动脉(MCA)的脑血流速度以计算CVR.结果:①病例组中ICA-MCA狭窄患者通过过度换气、吸入CO2气体、屏气后MCA的最大速度变化率、平均速度变化率均显著低于对照组(P＜0.05);②病例组轻、中、高度ICA狭窄或者闭塞ICA-MCA狭窄患者吸入CO2气体后各组MCA血流速度增加率依次减低,并且两两比较,P＜0.05,差异有显著意义.ICA-MCA狭窄患者由于血管狭窄、闭塞、血流受阻使CVR功能降低,狭窄程度越重,CVR功能越差,发生低灌注的危险性越大.结论:经颅多普勒超声检测CVR可行,可作为评估CVR的简便手段之一.     

Association between lymphotoxin alpha (-252 A/G and -804 C/A) gene polymorphisms and risk of stroke in North Indian population: a hospital-based case-control study

Purpose: Lymphotoxin alpha (LTA), a proinflammatory cytokine, plays an important role in promoting atherosclerosis which is an independent risk factor for stroke. Recent genetic studies have suggested that polymorphisms in the LTA gene, which affect its expression and biological function, may contribute to the development of stroke. The aim of this case-control study was to determine the association between LTA (-252 A/G and -804 C/A) gene polymorphisms and risk of stroke. Methods: Genotyping was determined by using SNaPshot method for 250 ischemic stroke (IS) patients, 250 age and sex matched IS free controls, 100 intracerebral hemorrhage (ICH) patients and 100 age and sex matched ICH free controls. Conditional logistic regression analysis with adjusting multiple demographic and risk factor variables was used to calculate the strength of association between LTA (-252 A/G and -804 C/A) gene polymorphisms and risk of stroke. The linkage disequilibrium (LD) was analyzed by using HaploView 4.2 software. Results: The distribution of LTA (-252 A/G and -804 C/A) genotypes was consistent with Hardy–Weinberg equilibrium. Adjusted conditional logistic regression analysis showed no significant association between LTA (-252 A/G and -804 C/A) gene polymorphisms and risk of both IS and ICH. Based on Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, a significant association between LTA -252 A/G gene polymorphism and small vessel disease subtype of IS under dominant model (OR, 2.06; 95% CI, 1.03–4.12; p value 0.04) with the risk of IS was observed. No LD was observed for both single nucleotide polymorphisms (SNPs) in north Indian population. Conclusion: Neither -252 G/A nor -804 C/A polymorphism of the LTA gene was found to be associated with overall stroke as well as any subtype of IS excluding SVD in North Indian population.     

Cognitive and emotional empathy in typical and impaired readers and its relationship to reading competence

Studies indicate a strong relationship between empathy and language skills, but the relationship between reading and empathy remains elusive, although a shared neural substrate (the temporoparietal junction; TPJ) has been implicated in both reading and empathy. Motivated by these observations, the purpose of the current study was to examine empathic skills in a large spectrum of reading abilities, including typical readers and individuals with dyslexia, and their relationship to reading competence. We administered the Intrapersonal Reactivity Index (IRI) test, which differentiates between two subscales of empathy (cognitive and emotional empathy), to a group of participants with dyslexia and typical readers. Results indicate that the general reading score (average z scores of all reading tests) was significantly positively correlated with empathic scores. In addition, tests of specific reading abilities—decoding, reading fluency, and reading-related measures of phonological awareness—were significantly positively correlated with empathic scores. Finally, participants with dyslexia who showed low reading abilities had significantly lower scores in total empathy and cognitive empathy, as measured by the IRI test, than did typical participants with high reading abilities. Taken together, these results indicate a strong association between reading-related skills and empathic abilities and may point to involvement of the TPJ in both empathy and reading.     

Short‐ and long‐term reproducibility of BOLD signal change induced by breath‐holding at 1.5 and 3 T

Cerebrovascular reactivity (CVR) can give insight into the cerebrovascular function. CVR can be estimated by measuring a blood‐oxygen‐level‐dependent (BOLD) response combined with breath‐holding (BH). The reproducibility of this technique has been addressed and existing studies have focused on short‐term reproducibility using a 3 T magnetic resonance imaging (MRI) system. However, little is known about the long‐term reproducibility of this procedure and the corresponding reproducibility using a 1.5 T MRI system. Here, we systematically examined the short‐ and long‐term reproducibility of BOLD responses to BH across field strengths. Nine subjects participated in three MRI sessions separated by 30 minutes (sessions 1 and 2: short term) and 68–92 days (sessions 1 and 3, long term) at both 1.5 and 3 T MRI. Our findings revealed that significant differences between field strengths were detected in the activated gray matter volume and BOLD signal change (both P < 0.001), with smaller magnitudes at 1.5 T. However, activation patterns were reproducible, independent of the time interval, brain region or field strength. All interscan coefficient of variation values were below the 33% fiducial limit, and the intraclass correlation coefficient values were above 0.4, which is usually considered the acceptability limit in functional studies. These findings suggest that the response of BOLD signal to BH for assessing CVR is reproducible over time at 1.5 and 3 T. This technique can be considered a tool for monitoring longitudinal changes in patients with cerebrovascular diseases, and its use should be encouraged for clinical 1.5 T MRI systems.     

Perceived social support mediates the association between attachment and cardiovascular reactivity in young adults

To understand the influence of social relationships on cardiovascular responses to stress, the present study investigated perceived affectionate support as a mediating variable explaining the association between specific attachment bonds (i.e., mother, father, partner, best friend) and cardiovascular reactivity (CVR). Utilizing a standardized stress testing protocol, 138 young adults completed measures of attachment and social support, with continuous cardiovascular measurements obtained using the Finometer Pro hemodynamic monitor. Results showed that the association between anxious and avoidant attachment and reactivity were mediated by perceived affectionate support; insecure attachment was linked to lower levels of perceived social support, which in turn was associated with lower CVR. For anxious attachment, this was noted only for mothers (SBP: B = −0.94, 95% CI [−1.94, −0.20]; DBP: B = −0.57, [−1.27, −0.10]), fathers (SBP: B = −0.72, [−1.42, −0.17]; DBP: B = −0.48, [−1.01, −0.13]), and best friends (SBP: B = −0.64, [−1.23, −0.18]; DBP: B = −0.40, [−0.81, −0.12]). For avoidant attachment, it was evident only for fathers (SBP: B = −0.70, [−1.33, −0.17]; DBP: B = −0.48, [−0.92, −0.15]) and partners (SBP: B = −0.78, [−1.64, −0.09]; DBP: B = −0.53, [−1.10, −0.11]). These findings suggest that insecure attachment is associated with lower levels of reactivity, which have been linked to negative health outcomes such as poor self-reported health, depression, and obesity. Overall, this research expands on the support and relationship science literature by incorporating under-researched aspects of social relationships (i.e., specific attachment styles) and focusing on the mechanisms by which they are associated with physiological stress responses.     

Hypertension fails to disrupt white matter integrity in young or aged Fisher (F44) Cyp1a1Ren2 transgenic rats

Hypertension is linked with an increased risk of white matter hyperintensities; however, recent findings have questioned this association. We examined whether hypertension and additional cerebrovascular risk factors impacted on white matter integrity in an inducible hypertensive rat. No white matter hyperintensities were observed on magnetic resonance imaging either alone or in conjunction with ageing and high-fat diet. Aged hypertensive rats that were fed a high-fat diet had moderately reduced fractional anisotropy in the corpus callosum with no overt pathological features. Herein we show that moderate hypertension alone or with additional risk factors has minimal impact on white matter integrity in this model.