Occurrence Of Cerebrovascular Diseases Research Articles

Menstrual phase influences cerebrovascular responsiveness in females but may not affect sex differences.

Background and aims: Sex differences in the rate and occurrence of cerebrovascular diseases (e.g., stroke) indicate a role for female sex hormones (i.e., oestrogen and progesterone) in cerebrovascular function and regulation. However, it remains unclear how cerebrovascular function differs between the sexes, and between distinct phases of the menstrual cycle. This study aimed to compare cerebrovascular-CO2 responsiveness in 1) females during the early follicular (EF), ovulatory (O) and mid-luteal (ML) phases of their menstrual cycle; and 2) males compared to females during phases of lower oestrogen (EF) and higher oestrogen (O). Methods: Eleven females (25 ± 5years) complete experimental sessions in the EF (n = 11), O (n = 9) and ML (n = 11) phases of the menstrual cycle. Nine males (22 ± 3years) completed two experimental sessions, approximately 2weeks apart for comparison to females. Middle and posterior cerebral artery velocity (MCAv, PCAv) was measured at rest, during two stages of hypercapnia (2% and 5% CO2 inhalation) and hypocapnia (voluntary hyperventilation to an end-tidal CO2 of 30 and 24mmHg). The linear slope of the cerebral blood velocity response to changes in end-tidal CO2 was calculated to measure cerebrovascular-CO2 responsiveness.. Results: In females, MCAv-CO2 responsiveness to hypocapnia was lower during EF (-.78 ± .45cm/s/mmHg) when compared to the O phase (-1.17 ± .52cm/s/mmHg; p < .05) and the ML phase (-1.30 ± .82; p < .05). MCAv-CO2 responsiveness to hypercapnia and hypo-to-hypercapnia, and PCAv-CO2 responsiveness across the CO2 range were similar between menstrual phases (p ≥ .20). MCAv-CO2 responsiveness to hypo-to hypercapnia was greater in females compared to males (3.12 ± .91cm/s/mmHg vs. 2.31 ± .46cm/s/mmHg; p = .03), irrespective of menstrual phase (EF or O). Conclusion: Females during O and ML phases have an enhanced vasoconstrictive capacity of the MCA compared to the EF phase. Additionally, biological sex differences can influence cerebrovascular-CO2 responsiveness, dependent on the insonated vessel.

Infectious agent as a trigger mechanism of atherosclerosis and сerebrovascular diseases

Background and Aims : A deep understanding of the role of the infectious factor that precedes and develops atherosclerosis and cerebrovascular diseases (CVD) is important for the prevention and treatment measures. The aim is to evaluate the role of the infectious factor in the occurrence of atherosclerosis and CVD, to determine its impact on the clinical course.

Muscle dysfunction in the long coronavirus disease 2019 syndrome: Pathogenesis and clinical approach.

In long coronavirus disease 2019 (long COVID‐19), involvement of the musculoskeletal system is characterised by the persistence or appearance of symptoms such as fatigue, muscle weakness, myalgia, and decline in physical and functional performance, even at 4 weeks after the onset of acute symptoms of COVID‐19. Muscle injury biomarkers are altered during the acute phase of the disease. The cellular damage and hyperinflammatory state induced by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection may contribute to the persistence of symptoms, hypoxaemia, mitochondrial damage, and dysregulation of the renin‐angiotensin system. In addition, the occurrence of cerebrovascular diseases, involvement of the peripheral nervous system, and harmful effects of hospitalisation, such as the use of drugs, immobility, and weakness acquired in the intensive care unit, all aggravate muscle damage. Here, we review the multifactorial mechanisms of muscle tissue injury, aggravating conditions, and associated sequelae in long COVID‐19.

Stroke in Male-to-Female Transgenders: A Systematic Review and Meta-Analysis

ABSTRACT:Background:The effect of hormonal therapy has been extensively studied in women. However, similar data on male-to-female (MTF) transgenders, another important population that receives hormonal therapy is lacking. Existing studies in MTF transgenders are skewed toward mental health and health-harming behaviors while few have focused on chronic health conditions. Our study aims to review the existing data on stroke in MTF transgenders and perform a quantitative analysis on the frequency of this condition in this special population.Methods:PubMed, Cochrane, Scopus, Embase, ClinicalTrials.gov, and Web of Science were systematically searched for studies that reported data on the occurrence of cerebrovascular diseases in MTF transgenders. We reported the hormonal regimens, clinical characteristics, and outcomes of stroke in MTF transgenders. A meta-analysis of proportions was performed by the random-effects model to compute for the frequency of cerebrovascular events in MTF transgenders.Results:Fourteen studies were included in the qualitative analysis while five studies were included in the quantitative analysis. A total of 109 MTF transgenders (Mean 14; range 1–53) suffered a cerebrovascular event. Random-effect modeling analysis showed an overall estimated frequency of 2% for cerebrovascular events in transgenders with a moderate degree of heterogeneity (I2 = 62%).Conclusion:Hormonal therapy in MTF transgenders may confer cardiovascular risks in this population. However, more population-based studies that include clinical characteristics and outcomes of chronic health diseases in MTF transgenders are warranted. Such studies may be crucial in directing future guidelines on the health care and management of MTF transgenders.

Potential mechanisms of cerebrovascular diseases in COVID-19 patients.

Since the outbreak of coronavirus disease 2019 (COVID-19) in 2019, it is gaining worldwide attention at the moment. Apart from respiratory manifestations, neurological dysfunction in COVID-19 patients, especially the occurrence of cerebrovascular diseases (CVD), has been intensively investigated. In this review, the effects of COVID-19 infection on CVD were summarized as follows: (I) angiotensin-converting enzyme 2 (ACE2) may be involved in the attack on vascular endothelial cells by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), leading to endothelial damage and increased subintimal inflammation, which are followed by hemorrhage or thrombosis; (II) SARS-CoV-2 could alter the expression/activity of ACE2, consequently resulting in the disruption of renin-angiotensin system which is associated with the occurrence and progression of atherosclerosis; (III) upregulation of neutrophil extracellular traps has been detected in COVID-19 patients, which is closely associated with immunothrombosis; (IV) the inflammatory cascade induced by SARS-CoV-2 often leads to hypercoagulability and promotes the formation and progress of atherosclerosis; (V) antiphospholipid antibodies are also detected in plasma of some severe cases, which aggravate the thrombosis through the formation of immune complexes; (VI) hyperglycemia in COVID-19 patients may trigger CVD by increasing oxidative stress and blood viscosity; (VII) the COVID-19 outbreak is a global emergency and causes psychological stress, which could be a potential risk factor of CVD as coagulation, and fibrinolysis may be affected. In this review, we aimed to further our understanding of CVD-associated COVID-19 infection, which could improve the therapeutic outcomes of patients. Personalized treatments should be offered to COVID-19 patients at greater risk for stroke in future clinical practice.

Occurrence of Cerebrovascular Diseases Decreased after the Great East Japan Earthquake and Tsunami of 2011

Background: A temporary increase in the occurrence of cerebrovascular diseases (CVDs) after the Great East Japan Earthquake and Tsunami of 2011 was reported; however, no studies have been conducted to investigate long-term effects. We assessed the long-term impact of the disaster on the incidence of CVDs. Methods: Incidence data for CVDs from 2008 to 2017 were acquired from the population-based Stroke Registry with an inventory survey of Iwate Prefecture, Japan. Part of the coastal area in Iwate Prefecture was mildly flooded and the other part was severely flooded. Age-adjusted incidence rates of CVDs (according to the Japanese standard population) were calculated for each area. The relative risk (RR) of incidence based on the years before the disaster (2008–2010), adjusted by stratified age groups, was calculated for the year of the disaster (2011), and the years after the disaster (2012–2017) in each area. Results: The age-adjusted incidence rates gradually decreased in all areas, with the exception of a temporary increase among men who lived on the coast the year the disaster occurred. The adjusted RR in the disaster year were not significant in any area and those of the postdisaster years were 0.91 (95% CI 0.87–0.96) for all inland men, 0.93 (0.89–0.97) for all inland women, 0.85 (0.78–0.93) for all coastal men, 0.87 (0.81–0.94) for all coastal women, 0.88 (0.80–0.98) for men at mildly flooded coast, 0.82 (0.75–0.89) for women at mildly flooded coast, 0.79 (0.68–0.91) for men at severely flooded coast, and 0.98 (0.86–1.11) for women at severely flooded coast. Conclusions: The occurrence of CVDs in the flooded coastal areas did not increase in the year of the Great East Japan Earthquake and Tsunami; furthermore, it decreased for men according to the severity of flood damage in the subsequent years; this can be attributed to supportive activities for the tsunami victims and the migration of the population.

Diagonal earlobe crease (Frank's sign) and increased risk of cerebrovascular diseases: review of the literature and implications for clinical practice.

Diagonal earlobe crease (DELC) or Frank's sign is a diagonal crease in the earlobe that extends diagonally from the tragus to the edge of the auricle with an angle of approximately 45°. Although its presence increases with advancing age, several studies have shown an independent association between DELC and cardiovascular diseases as well as peripheral vascular diseases. DELC has also been demonstrated to increase the risk of cerebrovascular events (mostly ischaemic stroke), probably through atherosclerotic mechanisms. A systematic literature search was conducted using PubMed and Embase to identify studies investigating the relationship between DELC and the occurrence of cerebrovascular diseases. We identified 5 articles (1469 subjects included). Since the presence of DELC can be easily evaluated, patients with the Frank's sign should undergo a diagnostic workup to detect vascular risk factors and implement preventative therapies.

Circadian variation and seasonal differences in occurrence of acute ischemic strokes

Morocco is a country with clear seasonal variations in weather conditions. Seasonal and circadian variations in the occurrence of cerebrovascular diseases have been of interest in several studies, reported to climate changes, but discrepant results made the conclusions unclear. The aim of the study is to observe the seasonal and circadian variation in ischemic stroke onset among our population. This is an observational study based on cases of stroke recruited from a prospectively collected database, conducted between January 2018 and December 2018 in the Department of Neurology, at Ibn Rochd university hospital. All patients with a diagnosis of ischemic stroke and having a definitive time and month of onset were included in the study. The categorization of the year was distributed into months and seasons. The time of onset was subdivided into one hourly interval and 4 quadrants of 6 hourly intervals. A total of 363 patients were included in the study. Mean age of patients was 66 years. Male to female ratio was 1,14. The rate of occurrence of stroke was highest in the morning 06 h–12 h hours (p < 005) compared with other times of the day. It was lowest in the nighttime period 00 h–6 h quadrant compared with other quadrants (Fig1). Annual distribution of stroke was without any variation. No difference was found by dichotomizing the groups into four 3 month periods (Fig2).These data support the presence of a circadian pattern in the onset of stroke, with a significantly higher risk in the morning, probably explained by the circadian changes in pathophysiologic causes of stroke.

Chronic cerebrovascular diseases: pathogenetic mechanisms, clinical manifestations, and approaches to therapy

The paper gives data on the incidence of cerebrovascular diseases (CVD) and the pathogenetic mechanisms of their development in various common somatic diseases, such as hypertension, atherosclerotic lesions in the great arteries of the head, and diabetes mellitus. It considers data on the occurrence of CVD in more rare diseases, such as hereditary diseases, hyperhomocysteinemia, and migraine. It is noted that the currently available data suggest that that the pathogenetic mechanisms of CVD are heterogeneous and that there are diverse types of cerebral ischemic lesions and their clinical manifestations. Therefore, therapeutic strategies for CVD should take into account not only the clinical features of the disease, but also the mechanisms of its development. The main areas of therapy are highlighted. The use of vasobral to treat CVD is discussed.

Intense Fear Induces Low‐Frequency Oscillation of Cerebral Blood Flow, Arterial Pressure, and Sympathetic Nerve Activity in Conscious Rats

A traumatic event, such as disaster, causes intense fear, which potentially leads to an increase in occurrence of cerebrovascular diseases. Little information is available regarding why intense fear causes cerebrovascular diseases. The present study aimed to measure cerebral blood flow, arterial pressure, and sympathetic nerve activity during intense fear conditioning in conscious rats. Wistar rats were chronically instrumented with a probe made with glass fiber for measuring hippocampal cerebral blood flow. Electrodes for measurements of renal (RSNA) and lumbar sympathetic nerve activity (LSNA) were inserted, as well as for an electroencephalogram, electromyogram, and electrocardiogram. A catheter was inserted for measuring systemic arterial pressure. Standard fear‐conditioning trials, in which a tone was paired with a brief electrical shock (5 mA, 2 s), were performed in rats two times per day over 3 days. Oscillation of arterial pressure with an amplitude of 15.7 mmHg and frequency of 0.075 Hz was induced by exposing a tone without electrical shock in fear‐conditioned rats. Arterial pressure oscillation was associated with synchronized oscillation of hippocampal cerebral blood flow, RSNA, and LSNA. Coherence between arterial pressure and hippocampal cerebral blood flow, RSNA, and LSNA was significantly increased at low frequency (0–1 Hz) compared with naive rats. These data suggest that intense fear can trigger disorder of sympathetic regulation of arterial pressure, causing low‐frequency oscillation of arterial pressure and synchronized changes in cerebral blood flow. This may be one of the causes of cerebrovascular disease induced by intense fear.Support or Funding InformationJSPS GrantThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Influence of the Great East Japan Earthquake and Tsunami 2011 on Occurrence of Cerebrovascular Diseases in Iwate, Japan

Little information is available regarding the occurrence of cerebrovascular diseases after tsunamis. This study was performed to determine the influence of the tsunami damage caused by the Great East Japan earthquake on occurrence of cerebrovascular diseases. Subjects from the coastline and inland areas of Iwate Prefecture who developed cerebrovascular diseases before and after the disaster were included in the analysis. Standardized incidence ratios of 2011 against the previous 3 years were calculated in two 4-week periods before and four 4-week periods after the disaster, according to stroke subtype, sex, age group, and flood damage. The standard incidence ratio for cerebrovascular diseases was 1.20 (1.00-1.40) in the first 4-week period after the disaster and was not significant in other periods. The standard incidence ratios in the first 4-week period for cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage were 1.22 (0.98-1.46), 1.15 (0.76-1.55), and 1.20 (0.52-1.88), respectively. These values were 1.51 (1.19-1.88) for men, 1.35 (1.06-1.64) for subjects aged ≥ 75 years, and 1.35 (1.06-1.64) for the high flooding areas. The standard incidence ratio of cerebral infarction in the first 4-week period for men aged ≥ 75 years in the high flooding areas was 2.34 (1.34-3.34). In the areas highly flooded by the tsunami caused by the Great East Japan earthquake, the occurrence of cerebral infarction among elderly men more than doubled in the first 4 weeks after the disaster.

The Influence of Aging and Nutrition on the Occurrence of Cerebrovascular Diseases

The Influence of Aging and Nutrition on the Occurrence of Cerebrovascular Diseases

韓国の食物摂取構造に関する研究

The authors performed principle component analysis on the data of Korean (1969-1990) and Japanese (1949-1990) intakes of foods of different groups and compared changes in intakes over time. Although the analysis revealed that both Korea and Japan shifted from a diet which had put much importance on a staple food to one which stressed a variety of food items, it wasn't until between 1985 and 1990 that the Korean diet became comparable to Japan's diet between 1963 and 1965. While Korea shifted within the vegetable-oriented intake type, Japan shifted from the potato bean-oriented intake type to the vegetable-oriented one. In order to grasp the diet components of contemporary Korea, the authors performed a principal component analysis, using the 1988-1990 intake of different food groups in 14 regional blocks (n= 41). The analysis revealed that the first principle component indicated either the modern diet type or the traditional diet type. The second principle component indicated that the subsidiary food was either the fresh vegetable/seafood type or the processed vegetable/livestock type. The third component indicated either the fresh food type or the stored food type. Furthermore, the relationship between the 9 commonest diseases and diet in Korea showed that the occurrence of cerebrovascular diseases, malignant neoplasm of stomach, hypertensive diseases, malignant neoplasm of lung, and diabetes mellitus was lower among people with a modern diet, while it was higher among those with the traditional diet. And thier relationship showed that the occurrence of cerebrovascular diseases, malignant neoplasm of liver, ischemic heart diseases, and tuberculosis of respiratory system was lower among those with a diet of processed vegetables/ livestock type as the subsidiary food, while on the other hand, it was higher among those with a fresh vegetables/seafood type as the subsidiary food. In addition, among the food groups, the correlation of meat with all diseases, except ischemic heart diseases, that of eggs with all diseases, except diabetes mellitus, that of milk products with all diseases, except malignant neoplasm of liver and ischemic heart diseases, and that of processed vegetables with malignant neoplasm of liver and tuberculosis of respiratory system had a significant negative correlation coefficient, while the correlation of cereals with cerebrovascular diseases, maligant neoplasm of stomach, hypertensive diseases, malignant neoplasm of liver, and diabetes mellitus, and that of vegetables with cerebrovascular disease, malignant neoplasm of liver, ischemic heart diseases, and tuberculosis of respiratory system had a significant positive correlation coefficient.