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

BACKGROUND: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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

Exploring miniature insect brains using micro-CT scanning techniques

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Volumetric magnetic resonance imaging quantification of longitudinal brain changes in abstinent alcoholics.

Magnetic resonance imaging (MRI) of the brain was performed on a group of 24 recently detoxified, male alcoholics approximately 1 month after their date of last drink. The imaging was repeated 3 months later, at which point 9 subjects had resumed drinking and 15 had maintained abstinence. Contrasts between these two drinking groups revealed that, despite comparable baseline values, the Abstainers exhibited volumetric white matter increases and cerebrospinal fluid reductions over the follow-up interval, whereas the Drinkers did not show significant change on either of these MRI indices. These results provide the first evidence suggestive of significant volumetric white matter increase with abstinence

Volumetric magnetic resonance imaging quantification of longitudinal brain changes in abstinent alcoholics.

Magnetic resonance imaging (MRI) of the brain was performed on a group of 24 recently detoxified, male alcoholics approximately 1 month after their date of last drink. The imaging was repeated 3 months later, at which point 9 subjects had resumed drinking and 15 had maintained abstinence. Contrasts between these two drinking groups revealed that, despite comparable baseline values, the Abstainers exhibited volumetric white matter increases and cerebrospinal fluid reductions over the follow-up interval, whereas the Drinkers did not show significant change on either of these MRI indices. These results provide the first evidence suggestive of significant volumetric white matter increase with abstinence

Olfactory loss in alcoholics: correlations with cortical and subcortical MRI indices.

The relationship between olfactory identification ability and MRI volumetric indices of specific cortical and subcortical brain regions was investigated in 36 recently detoxified male alcoholics. The results of correlational analyses between MRI indices and score on the University of Pennsylvania Smell Identification Test (UPSIT) revealed that impairment in olfactory identification was associated with elevated cortical and ventricular CSF volumes as well as with reduced tissue volumes in the cortical and subcortical grey matter. The volume of the thalamus was found to be a significant unique predictor of UPSIT score, even after accounting for variance shared with other MRI indices. These findings provide the first empirical support for existing hypotheses that olfactory loss in alcoholic subjects may be mediated by both cortical and subcortical structures

Olfactory loss in alcoholics: correlations with cortical and subcortical MRI indices.

The relationship between olfactory identification ability and MRI volumetric indices of specific cortical and subcortical brain regions was investigated in 36 recently detoxified male alcoholics. The results of correlational analyses between MRI indices and score on the University of Pennsylvania Smell Identification Test (UPSIT) revealed that impairment in olfactory identification was associated with elevated cortical and ventricular CSF volumes as well as with reduced tissue volumes in the cortical and subcortical grey matter. The volume of the thalamus was found to be a significant unique predictor of UPSIT score, even after accounting for variance shared with other MRI indices. These findings provide the first empirical support for existing hypotheses that olfactory loss in alcoholic subjects may be mediated by both cortical and subcortical structures

Assessment of olfactory deficits in detoxified alcoholics.

Olfactory functioning was evaluated in 37 male detoxified alcoholics and in 21 age-matched nonalcoholic controls using the University of Pennsylvania Smell Identification Test (UPSIT). Of the original subjects, 23 alcoholics and 14 controls returned for reevaluation 3-4 months following initial testing. The results showed that alcoholics had significantly lower UPSIT scores than did the controls, both at baseline and follow-up testing. Thirty-two percent of the alcoholics' UPSIT scores, in comparison to five percent of the controls' scores, fell into the clinically impaired range. Although current smoking patterns correlated significantly with UPSIT indices, comparisons limited to nonsmokers still indicated that the alcoholics were significantly impaired on this olfactory task. Correlational analyses indicated that olfactory performance was unrelated to alcoholics' scores on visuoconceptual and language tasks. Correlations with MR-derived indices of CSF volume showed a highly significant relationship between UPSIT scores and cortical sulcal volumes. Additionally, alcoholics (N = 15) who remained abstinent had significantly higher scores at follow-up than those who were not abstinent (N = 8). These findings demonstrate that alcoholism is associated with basic olfactory impairments which are only partially reversible with abstinence and that cortical structures play an important role in this sensory loss