Browsing by Author "Mijajlovic, M. (55404306300)"

Objective: Elevated plasma total homocysteine (tHcy) is an independent risk factor for ischemic stroke and has been linked to cerebral small vessel disease (SVD), in particular. Controversy persists as to whether increased tHcy is associated with functional status and cognitive decline in these patients. Methods: Plasma tHcy, MTHFR polymorphism, vascular risk factors, functional and cognitive status and severity of lesions on MRI, assessed with the Age-Related White Matter Changes (ARWMC) visual grading scale, were analyzed in 95 patients with SVD and 41 healthy control subjects. Results: Plasma tHcy levels were higher in patients with SVD (14.4 ± 5.0 μmol/L) compared to healthy SVD-free controls (8.9 ± 3.9 μmol/L). In SVD patients, tHcy levels strongly correlated with cognitive status (age-adjusted risk 5.8, 95% CI 1.3-25.3, p = 0.015), functional status (age-adjusted risk 3.2, 95% CI 1.2-8.8, p = 0.022) and severity of MRI lesions (age-adjusted risk 1.2, 95% CI 1.1-1.4; p = 0.004). Only total ARWMC score was independently associated with increased tHcy levels (OR 1.2, 95%CI 1.1-1.4, p = 0.004). Independent predictors of WMC occurrence were tHcy levels (OR 1.2, 95%CI 1.1-1.3, p = 0.003) and mRS score (OR 2.2, 95%CI 1.2-4.1, p = 0.017). Conclusions: In patients with cerebral SVD there is a positive association of increased plasma tHcy levels with clinical status and severity of WMC. © 2011 Elsevier B.V. All rights reserved.

Aim: The aim of this study was to determine the bilateral distribution of proton metabolites along the long axis of the hippocampus. Materials and methods: Forty-one healthy volunteers were examined using a 1.5 T magnetic resonance imaging system, using proton three-dimensional spectroscopic imaging (3D CSI) of the left and the right hippocampus separately. Three dominant signals were measured: choline (Cho), total creatine (tCr), and n-acetylaspartate (NAA) and expressed as ratios of Cho:tCr, NAA:tCr, NAA:Cho and NAA:(Cho+tCr). We compared the data from three hippocampal regions: head, body and tail. Results: Lower NAA:tCr ratios were found in head compared with the body (p<0.05) and in the head compared with the tail (p<0.05) bilaterally. Lower NAA:Cho and NAA:(Cho+tCr) ratios were found in the head compared with the body (p<0.05), in the body compared with the tail (p<0.05), and in the head compared with the tail (p<0.05) bilaterally. There was no statistically significant difference between the left and the right hippocampus. Conclusion: Ratios of NAA:tCr, NAA:Cho, and NAA:(Cho+tCr) in hippocampal tissue were significantly higher posteriorly than anteriorly. As the differences are present in healthy volunteers, the appearance in patients related to approximate voxel positioning within hippocampi may result in false-positive results. © 2010 The Royal College of Radiologists.