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Using MRI to Understand Disease States that Occur at the Interface of the Brain and the Cerebral Circulation

使用 MRI 了解大脑和脑循环接口处发生的疾病状态

基本信息

批准号：
10465000
负责人：
Richard Leigh
金额：
$ 89.09万
依托单位：
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10465000
关键词：
Acute Blood - brain barrier anatomy Blood Vessels Brain Brain imaging Cell Communication Cells Cellular Structures Cerebral Ischemia Cerebrovascular Circulation Cerebrovascular Disorders Chronic Cognition Cognitive Cohort Studies Complex Dementia Development Diagnosis Diffusion Magnetic Resonance Imaging Disease Enrollment Extracellular Space Goals Image Impaired cognition Injury Lesion Light Link Magnetic Resonance Imaging Measures Mission Monitor Morbidity - disease rate Natural History Pathogenesis Pathologic Patients Populations at Risk Protocols documentation Recording of previous events Research Risk Stroke Structure Techniques Time Tissues Vascular Cognitive Impairment Water Movements White Matter Hyperintensity blood-brain barrier disruption cohort experience imaging biomarker improved mortality neurovascular new therapeutic target novel novel therapeutics post stroke prevent processing speed response response to injury stroke patient vascular cognitive impairment and dementia vasogenic edema white matter white matter injury

项目摘要

The Neuro Vascular Brain Imaging (NVBI) unit studies pathologic states that occur at the interface between blood vessels and the brain. This encompasses acute cerebral ischemia caused by an occluded blood vessel as well as chronic cerebral ischemia that can be associated with dementia. Specifically, the NVBI unit is investigating why some patients who have had a stroke subsequently develop cognitive decline and dementia in association with changes on their MRI. This phenomenon is being studied in protocol 18-N-0020, The Natural History of Blood-Brain Barrier Disruption in Stroke Patients with White Matter Hyperintensities (A Cohort Study). This study is currently enrolling and is listed on https://clinicaltrials.gov/ct2/show/NCT03366129. It has long been known that changes seen on MRI, often referred to as white matter hyperintensities (WMH), are a hallmark for vascular cognitive impairment and dementia (VCID). However, it is not fully understood why these lesions develop, and thus we do not currently have a way to stop their progression. It is clear that progression (expansion) of WMH is associated with worsening cognition. The NVBI is studying what causes WMH to progress using novel imaging biomarkers. Blood-brain barrier (BBB) imaging is being employed to determine if disruption of the BBB precedes the progression of WMH. The BBB results from a complex interaction of cells and cell structures and serves as the gateway between the blood vessels and the brain. When it becomes dysfunctional, cells and molecules can enter the brain that otherwise would not cross the BBB; additionally, a dysfunctional BBB may prevent facilitated transport out of the brain. Microstructural white matter injury is also being studied using diffusion tensor imaging (DTI). DTI is a noninvasive technique that measures the direction and magnitude of water movement in the extracellular space. DTI can reflect transient response to injury such as vasogenic edema in addition to more permanent changes such as white matter microstructural degradation. DTI changes precede WMH, and global meausures are more closely linked to cognitive processing speed. DTI is sensitive to both the acute microstructural tissue changes in stroke and the chronic changes that contribute to WMH and vascular cognitive impairment. The primary objective of our research is to determine if patients with a history of previous stroke and WMH on MRI will experience progression of their WMH in a manner that can be predicted by disruption of their BBB and/or changes in microstructure detected using MRI prior to the progression. This would allow us to identify patients at risk for cognitive decline and may shed light on its mechanisms which could help identify targets for treatment. By elucidating the genesis of WMH, we aim to reduce the morbidity and mortality associated with cerebrovascular disease.

神经血管脑成像（NVBI）单元研究发生在血管和大脑之间界面的病理状态。这包括由血管闭塞引起的急性脑缺血，以及可能与痴呆相关的慢性脑缺血。具体来说，NVBI部门正在调查为什么一些中风患者随后会出现认知能力下降和痴呆症，这与他们的MRI变化有关。该现象正在18-N-0020方案中进行研究，《脑白质高信号卒中患者血脑屏障破坏的自然史（队列研究）》。这项研究目前正在招募中，并在https://clinicaltrials.gov/ct2/show/NCT03366129上列出。