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C DeCarli

Publications and source records attributed to C DeCarli.

69 records · Page 4Linked to original sources
PubMed1991

Abnormal brain glucose metabolism in Alzheimer's disease, as measured by position emission tomography.

Resting glucose metabolism in the association neocortices, measured with positron emission tomography (PET), is disturbed early and throughout the course of Alzheimer's disease (AD), whereas resting metabolism in the primary sensory and motor neocortices is relatively spared. Neocortical metabolic asymmetries precede and predict appropriate deficits in neocortically-mediated cognitive functions in the initial course of disease, indicating that PET can be used for the early diagnosis and characterization of AD. Metabolic abnormalities of the neocortices in late-stage AD correlate with regional densities of neurofibrillary tangles but not of senile plaques post mortem, suggesting that tangle formation is important in disease pathogenesis. Despite demonstrating reduced resting glucose metabolism, visual association areas demonstrate equivalent (as percent baseline) blood flow responses in mildly-moderately demented AD patients and controls who are performing a face matching task. Thus, viability and integrity of this cortical circuitry is retained into the intermediate stages of the disease, and glucose delivery to the AD brain can be increased.

Alzheimer Disease↗
PubMed1991

Brain growth and cognitive improvement in children with human immunodeficiency virus-induced encephalopathy after 6 months of continuous infusion zidovudine therapy.

The ventricular area at the level of the foramen of Monro was measured from axial x-ray computed tomography (CT) scans obtained prior to and 6 months after the initiation of continuous infusion of zidovudine (ZDV) in eight children with human immunodeficiency virus-induced encephalopathy. Evidence of moderate to severe central atrophy was present on initial CT scans (p less than 0.05). Ventricular area and ventricular brain area ratio (VBR) decreased after ZDV therapy in seven of eight children (mean decrease of 21.5 and 20%, respectively, p less than 0.05). The degree of decrease in VBR correlated with reductions in cerebrospinal fluid (CSF) protein concentration (r = 0.93, p less than 0.01), but not lymphocyte T4 or T8 counts. Intelligence quotients (IQs) improved in all seven children tested (mean improvement of 17.7%, p less than 0.01) and correlated significantly with reductions in CSF protein concentration (r = -0.85, p = 0.003). The magnitude of IQ changes was not significantly correlated with the magnitude of changes in ventricular area. We conclude that the cognitive improvement of HIV encephalopathy seen after 6 months of continuous infusion of ZDV is accompanied by reduction in brain atrophy and decreased CSF protein, suggesting an ameliorating effect of ZDV on the pathogenesis of AIDS encephalopathy in children.

AIDS Dementia Complex↗
PubMed1990

White matter hyperintensities in dementia of Alzheimer's type and in healthy subjects without cerebrovascular risk factors. A magnetic resonance imaging study.

T2-weighted (0.5 T) magnetic resonance images were used to study the prevalence of subcortical white matter hyperintensities (WMHIs) in 22 patients with dementia of Alzheimer's type (DAT), 20 age-matched older healthy control subjects, and 10 younger healthy control subjects. Exclusionary criteria for all groups included cerebrovascular risk factors. All subjects had Hachinski Ischemic Index scores of less than 2 and computed tomographic scans showing no infarct. The WMHIs were classified as periventricular WMHIs or deep WMHIs and graded 0 through 3 (0 indicated absent, and 3, severe). For the group with DAT and older control subjects, periventricular WMHIs and deep WMHIs were graded 2 or 3 in fewer than 17% and 27% of subjects, respectively, whereas in the younger control subjects, all ratings were grade 1 or less. Serum cholesterol and systolic blood pressure values, although within the normal range, were elevated significantly in older control subjects when compared with those in younger control subjects. No significant differences in WMHI ratings, blood pressure, cholesterol, or triglyceride levels were found between patients with DAT and age-matched control subjects. Systolic blood pressure levels correlated with the severity of periventricular WMHIs only in older control subjects. Age correlated with periventricular WMHIs and deep WMHIs within both the older control subjects and the patients with DAT. There was no significant correlation between WMHIs and the severity of dementia in the group with DAT. These results suggest that, in subjects screened for cerebrovascular risk factors, WMHIs are rare and occur with identical frequency in patients with DAT as in age-matched healthy control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Diminished submandibular salivary flow in dementia of the Alzheimer type.

Dementia of the Alzheimer Type (DAT) is the most common type of dementia among the elderly. Alzheimer's disease is a major public health problem, yet little is known about the potential oral consequences of the disease. Because saliva is believed to be essential for the preservation of oral health and function, salivary gland fluid output was evaluated in a population of essentially healthy patients with early-stage DAT. Unstimulated and stimulated parotid and submandibular salivary gland secretions were collected from 28 nonmedicated and otherwise healthy DAT patients, and 35 age-matched healthy controls. Submandibular saliva flow rates were significantly lower among the patients with DAT compared to controls, while parotid flow rates did not differ. The results suggest a selective impairment in submandibular gland function in essentially healthy patients with early-stage DAT.

Aged↗
PubMed1987

Free light chains in multiple sclerosis and infections of the CNS.

The intrathecal humoral immune response was analyzed in 83 patients with MS and 35 patients with acute CNS infections. CSF free kappa chains and CSF free lambda chains were quantified by radioimmunoassay; CSF IgG and albumin were measured by electroimmunodiffusion. The MS patients were characterized by higher levels of free kappa chains; free kappa:free lambda chain ratio; free kappa chain:albumin ratio; and IgG:albumin ratio. There were no differences in the level of free lambda chains or absolute concentration of IgG. A significant correlation was observed between free kappa chains and total IgG in MS and between free lambda chains and total IgG in infections, suggesting that the immune response was predominantly IgG-kappa in MS and IgG-lambda in infections.

Adolescent↗
PubMed1986

Serum magnesium levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin.

To study the effect of hypomagnesemia on control of atrial fibrillation (AF), serum magnesium levels were determined in 45 consecutive patients with symptomatic AF; 20% were hypomagnesemic (serum magnesium less than 1.5 mEq/liter). In a blinded treatment protocol, hypomagnesemic patients required twice the amount of intravenous digoxin to effect control of AF (p less than 0.05). Underlying diagnoses, blood chemistries and the use of other medications that could affect digoxin therapy were similar for the 2 groups. Diuretic therapy before inclusion into the study was not significantly associated with hypomagnesemia. Thus, hypomagnesemia is common among patients with symptomatic AF. Moreover, it appears to interfere with the effect of intravenous digoxin on AF. These results suggest that monitoring of serum magnesium and, where necessary, replacement of magnesium deficiency may be beneficial in patients with symptomatic AF for whom digoxin therapy is being contemplated.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Local histogram correction of MRI spatially dependent image pixel intensity nonuniformity.

We describe a computationally straightforward post-hoc statistical method of correcting spatially dependent image pixel intensity nonuniformity based on differences in local tissue intensity distributions. Pixel intensity domains for the various tissues of the composite image are identified and compared to the distributions of local samples. The nonuniformity correction is calculated as the difference of the local sample median from the composite sample median for the tissue class most represented by the sample. The median was chosen to reduce the effecters on determining the sample statistic and to allow a sample size small enough to accurately estimate the spatial variance of the image intensity nonuniformity. The method was designed for application to two-dimensional images. Simulations were used to estimate optimal conditions of local histogram kernel size and to test the accuracy of the method under known spatially dependent nonuniformities. The method was also applied to correct a phantom image and cerebral MRIs from 15 healthy subjects. Results show that the method accurately models simulated spatially dependent image intensity differences. Further analysis of clinical MR data showed that the variance of pixel intensities within the cerebral MRI slices and the variance of slice volumes within individuals were significantly reduced after nonuniformity correction. Improved brain-cerebrospinal fluid segmentation was also obtained. The method significantly reduced the variance of slice volumes within individuals, whether it was applied to the native images or images edited to remove nonbrain tissues. This statistical method was well behaved under the assumptions and the images tested. The general utility of the method was not determined, but conditions for testing the method under a variety of imaging sequences is discussed. We believe that this algorithm can serve as a method for improving MR image segmentation for clinical and research applications.

Adult↗
PubMedDate not supplied

Correspondence of closest gradient voxels--a robust registration algorithm.

A robust, automatic volume registration algorithm based on intensity gradients is presented. This algorithm can successfully perform registrations under conditions of unrelated intervolume voxel intensities, significant object displacements, and/or significant amounts of missing data. It also allows the user to visualize the registration convergence, clearly illustrating any source of registration errors. This algorithm consists of a matching algorithm based on iteratively finding the correspondence of the closest voxels containing a high three-dimensional intensity gradient magnitude. This algorithm was tested by registering T2-weighted MR volumes that had undergone varying displacement transformations to simultaneously acquired proton-density volumes. These transformations involved rotations of up to 25 degrees followed by translations of up to 25 mm along the axis of rotation. For all registrations, the mean registration error was less than one-fifth of a voxel and the mean registration time was less than 30 minutes. In conclusion, this algorithm is shown to be a powerful method of sequence-independent MR volume registration that is simple to both use and understand.

Algorithms↗
PubMedDate not supplied

NAD(P)H:quinone oxidoreductase activity is increased in hippocampal pyramidal neurons of patients with Aalzheimer's disease.

NAD(P)H:quinone oxidoreductase (QR) catalyzes the two-electron reduction of quinones, preventing their participation in redox cycling and subsequent generation of reactive oxygen species. Pretreatment of neuroblastoma cells with compounds, such as tert-butylhydroquinone and dimethyl fumarate, that increase QR expression protect cells from oxidative stress-induced cell death by glutamate, H(2)O(2,) and dopamine. The potential neuroprotective role of QR as well as the evidence for oxidative stress-induced neuronal cell death in Alzheimer's disease (AD) led us to examine the expression pattern of QR from AD and control patients. Histochemical staining of hippocampal sections from AD patients revealed QR activity in pyramidal neurons. The presence of QR protein in these neurons also was confirmed by immunoreactivity. In control patients, hippocampal pyramidal neurons were negative for both QR enzymatic activity and QR immunoreactivity. In addition, the QR positive neurons of AD patients were selectively located in areas where neuronal populations exhibited tau immunostaining. Our data demonstrate that QR is up-regulated in hippocampal pyramidal neurons of AD patients. We hypothesize that this is part of a neuroprotective system up-regulated in response to the AD process. Understanding this system may lead to further insights into the pathogenesis and potential new avenues of treatment for AD.

Aged↗
PubMedDate not supplied

Method for quantification of brain, ventricular, and subarachnoid CSF volumes from MR images.

We describe a simple, rapid, and semiautomated method of MR analysis based on mathematical modeling of MR pixel intensity histograms. The method is shown to be accurate and reliable for regional analysis of brain, central, and subarachnoid CSF volumes. Application of the method to five young and six older subjects revealed significant age-related changes in regional brain volumes whereas no difference was found for traced central CSF volumes or subarachnoid CSF volumes. We conclude that this is a simple method that can be applied to further studies of quantification of brain structure in healthy aging and brain disease.

Adult↗
PubMedDate not supplied

Cerebral magnetic resonance image segmentation using data fusion.

OBJECTIVE: A semiautomated method is described for segmenting dual echo MR head scans into gray and white matter and CSF. The method is applied to brain scans of 80 healthy children and adolescents. MATERIALS AND METHODS: A probabilistic data fusion equation was used to combine simultaneously acquired T2-weighted and proton density head scans for tissue segmentation. The fusion equation optimizes the probability of a voxel being a particular tissue type, given the corresponding probabilities from both images. The algorithm accounts for the intensity inhomogeneities present in the images by fusion of local regions of the images. RESULTS: The method was validated using a phantom (agarose gel with iron oxide particles) and hand-segmented images. Gray and white matter volumes for subjects aged 20-30 years were close to those previously published. White matter and CSF volume increased and gray matter volume decreased significantly across ages 4-18 years. White matter, gray matter, and CSF volumes were larger for males than for females. Males and females showed similar change of gray and white matter volumes with age. CONCLUSION: This simple, reliable, and valid method can be employed in clinical research for quantification of gray and white matter and CSF volumes in MR head scans. Increase in white matter volume may reflect ongoing axonal growth and myelination, and gray matter reductions may reflect synaptic pruning or cell death in the age span of 4-18 years.

Adolescent↗
PubMedDate not supplied

Relationship of family history scores for stroke and hypertension to quantitative measures of white-matter hyperintensities and stroke volume in elderly males.

White-matter hyperintensities (WMHI) are frequently associated with cerebrovascular risk factors in the elderly, particularly hypertension, and have been interpreted as a subclinical form of ischemic brain damage. WMHI, clinical stroke and blood pressures show significant genetic influences. The objective of this study was to determine whether a relationship exists between family history of stroke and/or hypertension in first degree relatives and WMHI in the elderly. WMHI and stroke (CVA) volumes were quantified from brain MRI performed on 414 white, male twins born between 1917 and 1927 (average age 72.3 +/- 2.9 years). WMHI, adjusted for age and head size, was significantly correlated with the family history score (r = 0.21, p < 0.001). Dividing the family history scores into quintiles revealed significant differences in WMHI by quintile mean (p < 0.05). Subjects in the highest quintile of family history score had the highest mean WMHI. Recalculation of the family history score, by only counting relatives reported to have had a clinical stroke as a positive event, revealed a nonsignificant correlation with WMHI, but the correlation of the family history score with MRI CVA volume was significant (p < 0.05). Stepwise multivariate analysis including ApoE status, current smoking status, smoking packyear history, Doppler ankle/arm blood pressure ratios, current and long term hypertensive status and current systolic and diastolic pressures indicated that the stroke/hypertension family history score was the single best predictor (p < 0.01) of WMHI volumes. Family history was not an independent predictor of CVA volume.

Aged↗
PubMedDate not supplied

Assessment of whole-brain vasodilatory capacity with acetazolamide challenge at 1.5 T using dynamic contrast imaging with frequency-shifted burst.

PURPOSE: To determine whether whole-brain acetazolamide-induced changes in regional cerebral blood volume (rCBV) can be assessed on a conventional gradient 1.5-T MR system using 3-D dynamic susceptibility contrast-enhanced MR imaging. METHODS: A 3-D frequency-shifted (FS) burst technique was used to assess the intravascular first pass of contrast agent. Changes in rCBV were calculated in 40 volunteers before and after acetazolamide (n = 30) or saline (n = 10) injection using customized analysis software on an independent workstation. A single-section gradient-echo technique with better spatial resolution was used in one additional volunteer to examine the effect of partial volume averaging on calculation of absolute rCBV. RESULTS: A statistically significant increase in rCBV (gray matter = 23%, white master = 32.5%) was noted after acetazolamide compared with saline. Baseline fractional CBVs were 22% +/- 3% for gray matter and 12% +/- 2% for white matter. Partial volume averaging was probably responsible for a systematic but linear overestimation of absolute rCBV. CONCLUSION: Acetazolamide-induced changes in rCBV can be assessed using 3-D dynamic susceptibility contrast-enhanced MR imaging with FS-burst on a conventional gradient 1.5-T MR system. Values obtained with this technique overestimate absolute rCBV but are systematically biased and can be used for intersubject and intrasubject ratio comparisons.

Acetazolamide↗