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    Jugular venous reflux and brain parenchyma volumes in elderly patients with mild cognitive impairment and Alzheimer's disease

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    Publication date
    2013
    Author
    Beggs, Clive B.
    Chung, C.P.
    Bergsland, N.
    Wang, P.N.
    Shepherd, Simon J.
    Cheng, C.Y.
    Dwyer, Michael G.
    Hu, H.H.
    Zivadinov, R.
    Keyword
    Aged
    ; Alzheimer disease
    ; Brain
    ; Case-control studies
    ; Female
    ; Humans
    ; Jugular veins
    ; Male
    ; Middle aged
    ; Mild cognitive impairment
    ; Organ size
    ; Taiwan
    Show allShow less
    Rights
    (c) 2013 Beggs et al. This is an Open Access article distributed under the terms of the Creative Commons CC-BY License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    To determine whether or not jugular venous reflux (JVR) is associated with structural brain parenchyma changes in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD). 16 AD patients (mean (SD): 81.9 (5.8) years), 33 MCI patients (mean (SD): 81.4 (6.1) years) and 18 healthy elderly controls (mean (SD): 81.5 (3.4) years) underwent duplex ultrasonography and magnetic resonance imaging scans to quantify structural brain parenchyma changes. Normalized whole brain (WB), gray matter (GM) and white matter (WM) volumes were collected, together with CSF volume. JVR was strongly associated with increased normalized WB (p = 0.014) and GM (p = 0.002) volumes across all three subject groups. There was a trend towards increased WB and GM volumes, which was accompanied by decreased CSF volume, in the JVR-positive subjects in both the MCI and AD groups. When the MCI and AD subjects were aggregated together significant increases were observed in both normalized WB (p = 0.009) and GM (p = 0.003) volumes for the JVR-positive group. No corresponding increases were observed for the JVR-positive subjects in the control group. Through receiver operating characteristic analysis of the brain volumetric data it was possible to discriminate between the JVR-positive and negative AD subjects with reasonable accuracy (sensitivity = 71.4%; specificity = 88.9%; p = 0.007). JVR is associated with intracranial structural changes in MCI and AD patients, which result in increased WB and GM volumes. The neuropathology of this unexpected and counterintuitive finding requires further investigation, but may suggest that JVR retrogradely transmits venous hypertension into the brain and leads to brain tissues swelling due to vasogenic edema.
    URI
    http://hdl.handle.net/10454/9626
    Version
    Published version
    Citation
    Beggs C, Chung C-P, Bergsland N et al (2013) Jugular venous reflux and brain parenchyma volumes in elderly patients with mild congitive impairment and Alzheimer's disease. BMC Neurology. 13: 157-164.
    Link to publisher’s version
    http://dx.doi.org/10.1186/1471-2377-13-157
    Type
    Article
    Collections
    Engineering and Digital Technology Publications

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