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    Jugular venous reflux and white matter abnormalities in Alzheimer's disease: a pilot study

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    Publication date
    2014
    Author
    Chung, C.P.
    Beggs, Clive B.
    Wang, P.N.
    Bergsland, N.
    Shepherd, Simon J.
    Cheng, C.Y.
    Ramasamy, D.P.
    Dwyer, Michael G.
    Hu, H.H.
    Zivadinov, R.
    Keyword
    Aged
    Aged, 80 and over
    Alzheimer Disease, complications
    Case-Control Studies
    Female
    Humans
    Image Processing, Computer-Assisted
    Jugular Veins, pathology
    Leukoencephalopathies
    Magnetic Resonance Imaging
    Male
    Mental Status Schedule
    Middle Aged
    Mild Cognitive Impairment
    Pilot Projects
    Retrospective Studies
    Statistics, Nonparametric
    Taiwan
    Ultrasonography, Doppler, Duplex
    Alzheimer's disease
    Doppler ultrasonography
    Jugular veins
    Leukoaraiosis
    Show allShow less
    Peer-Reviewed
    yes
    
    Metadata
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    Abstract
    To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age- and gender-matched controls. Duplex ultrasonography and 1.5T MRI scanning was applied to quantify cerebral WMCs [T2 white matter (WM) lesion and dirty-appearing-white-matter (DAWM)]. Subjects with severe JVR had more frequently hypertension (p = 0.044), more severe WMC, including increased total (p = 0.047) and periventricular DAWM volumes (p = 0.008), and a trend for increased cerebrospinal fluid volumes (p = 0.067) compared with the other groups. A significantly decreased (65.8%) periventricular DAWM volume (p = 0.01) in the JVR-positive AD individuals compared with their JVR-negative counterparts was detected. There was a trend for increased periventricular and subcortical T2 WMC lesion volumes in the JVR-positive AD individuals compared with their JVR-negative counterparts (p = 0.073). This phenomenon was not observed in either the control or MCI groups. In multiple regression analysis, the increased periventricular WMC lesion volume and decreased DAWM volume resulted in 85.7% sensitivity and 80% specificity for distinguishing between JVR-positive and JVR-negative AD patients. These JVR-WMC association patterns were not seen in the control and MCI groups. Therefore, this pilot study suggests that there may be an association between JVR and WMCs in AD patients, implying that cerebral venous outflow impairment might play a role in the dynamics of WMCs formation in AD patients, particularly in the periventricular regions. Further longitudinal studies are needed to confirm and validate our findings.
    URI
    http://hdl.handle.net/10454/10614
    Version
    Accepted Manuscript
    Citation
    Chung, C. P., Beggs, C., Wang, P. N., Bergsland, N., Shepherd, S., Cheng, C. Y., Ramasamy, D. P., Dwyer, M. G., Hu, H. H. and Zivadinov, R. (2014) Jugular venous reflux and white matter abnormalities in Alzheimer's disease: a pilot study. Journal of Alzheimers Disease. 39(3): 601-9.
    Link to publisher’s version
    https://doi.org/10.3233/JAD-131112
    Type
    Journal Article
    Collections
    Engineering and Informatics Publications

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