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In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus

PURPOSE: Impaired ability to remove toxic metabolites from central nervous system may be an important link between cerebral and ophthalmic degenerative diseases. The aim of the present study was to compare the glymphatic function in the visual pathway in patients with idiopathic normal pressure hydr...

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Autores principales: Jacobsen, Henrik Holvin, Sandell, Tiril, Jørstad, Øystein Kalsnes, Moe, Morten C., Ringstad, Geir, Eide, Per Kristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683855/
https://www.ncbi.nlm.nih.gov/pubmed/33201186
http://dx.doi.org/10.1167/iovs.61.13.24
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author Jacobsen, Henrik Holvin
Sandell, Tiril
Jørstad, Øystein Kalsnes
Moe, Morten C.
Ringstad, Geir
Eide, Per Kristian
author_facet Jacobsen, Henrik Holvin
Sandell, Tiril
Jørstad, Øystein Kalsnes
Moe, Morten C.
Ringstad, Geir
Eide, Per Kristian
author_sort Jacobsen, Henrik Holvin
collection PubMed
description PURPOSE: Impaired ability to remove toxic metabolites from central nervous system may be an important link between cerebral and ophthalmic degenerative diseases. The aim of the present study was to compare the glymphatic function in the visual pathway in patients with idiopathic normal pressure hydrocephalus (iNPH), a neurodegenerative dementia subtype, with a reference group. METHODS: We compared 31 subjects with Definite iNPH (i.e., shunt-responsive) with 13 references in a prospective and observational study. After intrathecal injection of the magnetic contrast agent gadobutrol (Gadovist, 0.5 mL, 1.0 mmol/mL, Bayer Pharma AG), serving as a tracer, consecutive magnetic resonance imaging (MRI) scans were obtained (next 24–48 hours). The normalized MRI T1 signal recorded in the cerebrospinal fluid (CSF) and along the visual pathway served as a semi-quantitative measure of tracer enrichment. Gadobutrol does not penetrate the blood-brain barrier and is thus confined to the extravascular space. Overnight measurements of pulsatile intracranial pressure were used as a surrogate marker for the intracranial compliance. RESULTS: The tracer enriched the prechiasmatic cistern similarly in both groups, but clearance was delayed in the iNPH group. Moreover, both delayed enrichment and clearance of the tracer were observed in the visual pathway in the iNPH subjects. The enrichment in the visual pathway and the CSF correlated. Individuals with elevated pulsatile intracranial pressure showed reduced enrichment within the visual pathway. CONCLUSIONS: There was delayed enrichment and clearance of a tracer in the visual pathway of iNPH patients, which suggests impaired glymphatic function in the visual pathway in this disease.
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spelling pubmed-76838552020-11-25 In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus Jacobsen, Henrik Holvin Sandell, Tiril Jørstad, Øystein Kalsnes Moe, Morten C. Ringstad, Geir Eide, Per Kristian Invest Ophthalmol Vis Sci Visual Neuroscience PURPOSE: Impaired ability to remove toxic metabolites from central nervous system may be an important link between cerebral and ophthalmic degenerative diseases. The aim of the present study was to compare the glymphatic function in the visual pathway in patients with idiopathic normal pressure hydrocephalus (iNPH), a neurodegenerative dementia subtype, with a reference group. METHODS: We compared 31 subjects with Definite iNPH (i.e., shunt-responsive) with 13 references in a prospective and observational study. After intrathecal injection of the magnetic contrast agent gadobutrol (Gadovist, 0.5 mL, 1.0 mmol/mL, Bayer Pharma AG), serving as a tracer, consecutive magnetic resonance imaging (MRI) scans were obtained (next 24–48 hours). The normalized MRI T1 signal recorded in the cerebrospinal fluid (CSF) and along the visual pathway served as a semi-quantitative measure of tracer enrichment. Gadobutrol does not penetrate the blood-brain barrier and is thus confined to the extravascular space. Overnight measurements of pulsatile intracranial pressure were used as a surrogate marker for the intracranial compliance. RESULTS: The tracer enriched the prechiasmatic cistern similarly in both groups, but clearance was delayed in the iNPH group. Moreover, both delayed enrichment and clearance of the tracer were observed in the visual pathway in the iNPH subjects. The enrichment in the visual pathway and the CSF correlated. Individuals with elevated pulsatile intracranial pressure showed reduced enrichment within the visual pathway. CONCLUSIONS: There was delayed enrichment and clearance of a tracer in the visual pathway of iNPH patients, which suggests impaired glymphatic function in the visual pathway in this disease. The Association for Research in Vision and Ophthalmology 2020-11-17 /pmc/articles/PMC7683855/ /pubmed/33201186 http://dx.doi.org/10.1167/iovs.61.13.24 Text en Copyright 2020 The Authors http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License.
spellingShingle Visual Neuroscience
Jacobsen, Henrik Holvin
Sandell, Tiril
Jørstad, Øystein Kalsnes
Moe, Morten C.
Ringstad, Geir
Eide, Per Kristian
In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title_full In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title_fullStr In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title_full_unstemmed In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title_short In Vivo Evidence for Impaired Glymphatic Function in the Visual Pathway of Patients With Normal Pressure Hydrocephalus
title_sort in vivo evidence for impaired glymphatic function in the visual pathway of patients with normal pressure hydrocephalus
topic Visual Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683855/
https://www.ncbi.nlm.nih.gov/pubmed/33201186
http://dx.doi.org/10.1167/iovs.61.13.24
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