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Article ; Online: "Is It The Same Patient?" Evidence of Significant Cardiac Amyloid Regression.

Bienstock, Solomon W / Ferrández-Escarabajal, Marcos / Hadley, Michael / Sanz, Javier / LaRocca, Gina

European heart journal. Cardiovascular Imaging

2023

Language	English
Publishing date	2023-11-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jead323
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Article ; Online: Significant Regression of Plasmacytoma by Cardiac Magnetic Resonance.

Ferrández-Escarabajal, Marcos / Bienstock, Solomon W / Hadley, Michael / Sanz, Javier / LaRocca, Gina

European heart journal. Cardiovascular Imaging

2023

Language	English
Publishing date	2023-12-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2638345-7
ISSN	2047-2412 ; 2047-2404
ISSN (online)	2047-2412
ISSN	2047-2404
DOI	10.1093/ehjci/jead349
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Article ; Online: Posterior circulation ischaemic stroke diagnosis and management.

Schneider, Anna M / Neuhaus, Ain A / Hadley, Gina / Balami, Joyce S / Harston, George W / DeLuca, Gabriele C / Buchan, Alastair M

Clinical medicine (London, England)

2024 Volume 23, Issue 3, Page(s) 219–227

Abstract: This narrative review provides an overview of the posterior circulation and the clinical features of common posterior circulation stroke (PCS) syndromes in the posterior arterial territories and how to distinguish them from mimics. We outline the ... ...

Abstract	This narrative review provides an overview of the posterior circulation and the clinical features of common posterior circulation stroke (PCS) syndromes in the posterior arterial territories and how to distinguish them from mimics. We outline the hyperacute management of patients with suspected PCS with emphasis on how to identify those who are likely to benefit from intervention based on imaging findings. Finally, we review advances in treatment options, including developments in endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT), and the principles of medical management and indications for neurosurgery. Observational and randomised clinical trial data have been equivocal regarding EVT in PCS, but more recent studies strongly support its efficacy. There have been concomitant advances in imaging of posterior stroke to guide optimal patient selection for thrombectomy. Recent evidence suggests that clinicians should have a heightened suspicion of posterior circulation events with the resultant implementation of timely, evidence-based management.
MeSH term(s)	Humans ; Stroke/diagnosis ; Stroke/therapy ; Brain Ischemia/diagnosis ; Brain Ischemia/therapy ; Ischemic Stroke ; Administration, Intravenous ; Patient Selection
Language	English
Publishing date	2024-02-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmed.2022-0499
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Zs.A 5439: Show issues

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Article: Regional contribution of vascular dysfunction in white matter dementia: clinical and neuropathological insights.

Pansieri, Jonathan / Hadley, Gina / Lockhart, Andrew / Pisa, Marco / DeLuca, Gabriele C

Frontiers in neurology

2023 Volume 14, Page(s) 1199491

Abstract: The maintenance of adequate blood supply and vascular integrity is fundamental to ensure cerebral function. A wide range of studies report vascular dysfunction in white matter dementias, a group of cerebral disorders characterized by substantial white ... ...

Abstract	The maintenance of adequate blood supply and vascular integrity is fundamental to ensure cerebral function. A wide range of studies report vascular dysfunction in white matter dementias, a group of cerebral disorders characterized by substantial white matter damage in the brain leading to cognitive impairment. Despite recent advances in imaging, the contribution of vascular-specific regional alterations in white matter dementia has been not extensively reviewed. First, we present an overview of the main components of the vascular system involved in the maintenance of brain function, modulation of cerebral blood flow and integrity of the blood-brain barrier in the healthy brain and during aging. Second, we review the regional contribution of cerebral blood flow and blood-brain barrier disturbances in the pathogenesis of three distinct conditions: the archetypal white matter predominant neurocognitive dementia that is vascular dementia, a neuroinflammatory predominant disease (multiple sclerosis) and a neurodegenerative predominant disease (Alzheimer's). Finally, we then examine the shared landscape of vascular dysfunction in white matter dementia. By emphasizing the involvement of vascular dysfunction in the white matter, we put forward a hypothetical map of vascular dysfunction during disease-specific progression to guide future research aimed to improve diagnostics and facilitate the development of tailored therapies.
Language	English
Publishing date	2023-06-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1199491
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Article: Commentary: Rapalink-1 Increased Infarct Size in Early Cerebral Ischemia-Reperfusion With Increased Blood-Brain Barrier Disruption.

Beard, Daniel J / Hadley, Gina / Sutherland, Brad A / Buchan, Alastair M

Frontiers in physiology

2021 Volume 12, Page(s) 761556

Language	English
Publishing date	2021-09-22
Publishing country	Switzerland
Document type	Journal Article ; Comment
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2021.761556
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Article ; Online: Head injury in the elderly.

Hadley, Gina / Billingsley, Sarah / Nakagawa, Seneka / Durkin, Christopher

Clinical medicine (London, England)

2019 Volume 19, Issue 5, Page(s) 428–429

MeSH term(s)	Aged ; Brain Injuries ; Craniocerebral Trauma ; Humans ; Physicians
Language	English
Publishing date	2019-09-12
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmedicine.19-5-428a
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Article ; Online: Posterior circulation ischaemic stroke diagnosis and management.

Schneider, Anna M / Neuhaus, Ain A / Hadley, Gina / Balami, Joyce S / Harston, George W / DeLuca, Gabriele C / Buchan, Alastair M

Clinical medicine (London, England)

2023 Volume 23, Issue 3, Page(s) 219–227

Abstract	This narrative review provides an overview of the posterior circulation and the clinical features of common posterior circulation stroke (PCS) syndromes in the posterior arterial territories and how to distinguish them from mimics. We outline the hyperacute management of patients with suspected PCS with emphasis on how to identify those who are likely to benefit from intervention based on imaging findings. Finally, we review advances in treatment options, including developments in endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT), and the principles of medical management and indications for neurosurgery. Observational and randomised clinical trial data have been equivocal regarding EVT in PCS, but more recent studies strongly support its efficacy. There have been concomitant advances in imaging of posterior stroke to guide optimal patient selection for thrombectomy. Recent evidence suggests that clinicians should have a heightened suspicion of posterior circulation events with the resultant implementation of timely, evidence-based management.
MeSH term(s)	Humans ; Stroke/diagnosis ; Stroke/therapy ; Stroke/complications ; Brain Ischemia/diagnosis ; Brain Ischemia/therapy ; Brain Ischemia/complications ; Endovascular Procedures/methods ; Thrombectomy/methods ; Ischemic Stroke/complications ; Treatment Outcome ; Thrombolytic Therapy/methods
Language	English
Publishing date	2023-05-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2048646-7
ISSN	1473-4893 ; 1470-2118
ISSN (online)	1473-4893
ISSN	1470-2118
DOI	10.7861/clinmed.2022-0499
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Zs.A 5439: Show issues

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Article ; Online: A role for vessel-associated extracellular matrix proteins in multiple sclerosis pathology.

Pisa, Marco / Watson, Joseph L / Spencer, Jonathan I / Niblett, Guy / Mahjoub, Yasamin / Lockhart, Andrew / Yates, Richard L / Yee, Sydney A / Hadley, Gina / Ruiz, Jennifer / Esiri, Margaret M / Kessler, Benedict / Fischer, Roman / DeLuca, Gabriele C

Brain pathology (Zurich, Switzerland)

2024 , Page(s) e13263

Abstract: Multiple sclerosis (MS) is unsurpassed for its clinical and pathological hetherogeneity, but the biological determinants of this variability are unknown. HLA-DRB1*15, the main genetic risk factor for MS, influences the severity and distribution of MS ... ...

Abstract	Multiple sclerosis (MS) is unsurpassed for its clinical and pathological hetherogeneity, but the biological determinants of this variability are unknown. HLA-DRB115, the main genetic risk factor for MS, influences the severity and distribution of MS pathology. This study set out to unravel the molecular determinants of the heterogeneity of MS pathology in relation to HLA-DRB115 status. Shotgun proteomics from a discovery cohort of MS spinal cord samples segregated by HLA-DRB15 status revealed overexpression of the extracellular matrix (ECM) proteins, biglycan, decorin, and prolargin in HLA-DRB15-positive cases, adding to established literature on a role of ECM proteins in MS pathology that has heretofore lacked systematic pathological validation. These findings informed a neuropathological characterisation of these proteins in a large autopsy cohort of 41 MS cases (18 HLA-DRB115-positive and 23 HLA-DRB115-negative), and seven non-neurological controls on motor cortical, cervical and lumbar spinal cord tissue. Biglycan and decorin demonstrate a striking perivascular expression pattern in controls that is reduced in MS (-36.5%, p = 0.036 and - 24.7%, p = 0.039; respectively) in lesional and non-lesional areas. A concomitant increase in diffuse parenchymal accumulation of biglycan and decorin is seen in MS (p = 0.015 and p = 0.001, respectively), particularly in HLA-DRB1*15-positive cases (p = 0.007 and p = 0.046, respectively). Prolargin shows a faint parenchymal pattern in controls that is markedly increased in MS cases where a perivascular deposition pattern is observed (motor cortex +97.5%, p = 0.001; cervical cord +49.1%, p = 0.016). Our findings point to ECM proteins and the vascular interface playing a central role in MS pathology within and outside the plaque area. As ECM proteins are known potent pro-inflammatory molecules, their parenchymal accumulation may contribute to disease severity. This study brings to light novel factors that may contribute to the heterogeneity of the topographical variation of MS pathology.
Language	English
Publishing date	2024-04-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1051484-3
ISSN	1750-3639 ; 1015-6305
ISSN (online)	1750-3639
ISSN	1015-6305
DOI	10.1111/bpa.13263
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Zs.A 3585: Show issues

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Article ; Online: Cognitive decline and diabetes: a systematic review of the neuropathological correlates accounting for cognition at death.

Hadley, Gina / Zhang, Jiali / Harris-Skillman, Eva / Alexopoulou, Zoi / DeLuca, Gabriele C / Pendlebury, Sarah T

Journal of neurology, neurosurgery, and psychiatry

2022 Volume 93, Issue 3, Page(s) 246–253

Abstract: Given conflicting findings in epidemiologic studies, we determined the relative contributions of different neuropathologies to the excess risk of cognitive decline in diabetes mellitus (DM) through a systematic review of the literature. Included studies ... ...

Abstract	Given conflicting findings in epidemiologic studies, we determined the relative contributions of different neuropathologies to the excess risk of cognitive decline in diabetes mellitus (DM) through a systematic review of the literature. Included studies compared subjects with and without DM and reported neuropathological outcomes accounting for cognition at death. Data on Alzheimer's disease (AD) pathology, cerebrovascular disease and non-vascular, non-AD pathology were extracted from each study. Eleven studies (n=6 prospective cohorts, n=5 retrospective post-mortem series, total n=6330) met inclusion criteria. All 11 studies quantified AD changes and 10/11 measured cerebrovascular disease: macroscopic lesions (n=9), microinfarcts (n=8), cerebral amyloid angiopathy (CAA, n=7), lacunes (n=6), white matter disease (n=5), haemorrhages (n=4), microbleeds (n=1), hippocampal microvasculature (n=1). Other pathology was infrequently examined. No study reported increased AD pathology in DM, three studies showed a decrease (n=872) and four (n= 4018) showed no difference, after adjustment for cognition at death. No study reported reduced cerebrovascular pathology in DM. Three studies (n=2345) reported an increase in large infarcts, lacunes and microinfarcts. One study found lower cognitive scores in DM compared to non-DM subjects despite similar cerebrovascular and AD-pathology load suggesting contributions from other neuropathological processes. In conclusion, lack of an association between DM and AD-related neuropathology was consistent across studies, irrespective of methodology. In contrast to AD, DM was associated with increased large and small vessel disease. Data on other pathologies such as non-AD neurodegeneration, and blood-brain-barrier breakdown were lacking. Further studies evaluating relative contributions of different neuropathologies to the excess risk of DM are needed.
MeSH term(s)	Aged, 80 and over ; Brain/pathology ; Cognition/physiology ; Cognitive Dysfunction/etiology ; Cognitive Dysfunction/pathology ; Diabetes Complications/pathology ; Diabetes Mellitus/pathology ; Female ; Humans ; Male
Language	English
Publishing date	2022-01-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	3087-9
ISSN	1468-330X ; 0022-3050
ISSN (online)	1468-330X
ISSN	0022-3050
DOI	10.1136/jnnp-2021-328158
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Article ; Online: Advances in Coronary Computed Tomographic Angiographic Imaging of Atherosclerosis for Risk Stratification and Preventive Care.

Bienstock, Solomon / Lin, Fay / Blankstein, Ron / Leipsic, Jonathon / Cardoso, Rhanderson / Ahmadi, Amir / Gelijns, Annetine / Patel, Krishna / Baldassarre, Lauren A / Hadley, Michael / LaRocca, Gina / Sanz, Javier / Narula, Jagat / Chandrashekhar, Y S / Shaw, Leslee J / Fuster, Valentin

JACC. Cardiovascular imaging

2023 Volume 16, Issue 8, Page(s) 1099–1115

Abstract: The diagnostic evaluation of coronary artery disease is undergoing a dramatic transformation with a new focus on atherosclerotic plaque. This review details the evidence needed for effective risk stratification and targeted preventive care based on ... ...

Abstract	The diagnostic evaluation of coronary artery disease is undergoing a dramatic transformation with a new focus on atherosclerotic plaque. This review details the evidence needed for effective risk stratification and targeted preventive care based on recent advances in automated measurement of atherosclerosis from coronary computed tomography angiography (CTA). To date, research findings support that automated stenosis measurement is reasonably accurate, but evidence on variability by location, artery size, or image quality is unknown. The evidence for quantification of atherosclerotic plaque is unfolding, with strong concordance reported between coronary CTA and intravascular ultrasound measurement of total plaque volume (r >0.90). Statistical variance is higher for smaller plaque volumes. Limited data are available on how technical or patient-specific factors result in measurement variability by compositional subgroups. Coronary artery dimensions vary by age, sex, heart size, coronary dominance, and race and ethnicity. Accordingly, quantification programs excluding smaller arteries affect accuracy for women, patients with diabetes, and other patient subsets. Evidence is unfolding that quantification of atherosclerotic plaque is useful to enhance risk prediction, yet more evidence is required to define high-risk patients across varied populations and to determine whether such information is incremental to risk factors or currently used coronary computed tomography techniques (eg, coronary artery calcium scoring or visual assessment of plaque burden or stenosis). In summary, there is promise for the utility of coronary CTA quantification of atherosclerosis, especially if it can lead to targeted and more intensive cardiovascular prevention, notably for those patients with nonobstructive coronary artery disease and high-risk plaque features. The new quantification techniques available to imagers must not only provide sufficient added value to improve patient care, but also add minimal and reasonable cost to alleviate the financial burden on our patients and the health care system.
MeSH term(s)	Humans ; Female ; Coronary Artery Disease/diagnostic imaging ; Computed Tomography Angiography ; Plaque, Atherosclerotic ; Coronary Angiography/methods ; Constriction, Pathologic ; Predictive Value of Tests ; Atherosclerosis ; Coronary Vessels/diagnostic imaging ; Risk Assessment
Language	English
Publishing date	2023-05-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2491503-8
ISSN	1876-7591 ; 1936-878X
ISSN (online)	1876-7591
ISSN	1936-878X
DOI	10.1016/j.jcmg.2023.02.002
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