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      Gradual Carotid Artery Stenosis in Mice Closely Replicates Hypoperfusive Vascular Dementia in Humans

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          Abstract

          Background

          Existing rodent models of vascular cognitive impairment (VCI) show abrupt changes in cerebral blood flow (CBF) and do not reliably replicate the clinical pathogenesis of VCI. We therefore aimed to develop a mouse model of VCI where CBF is gradually reduced, followed by subsequent progressive motor and cognitive impairment, after surgical intervention.

          Methods and Results

          Adult C57BL/6J male mice were subjected to gradual common carotid artery stenosis (GCAS) surgery by using an ameroid constrictor vessel‐constricting device with an inner diameter of 0.75 mm. The common carotid arteries narrowed gradually after gradual constriction of ameroid constrictors over 28 days after GCAS, with subsequent 79.3% area stenosis as a result of smooth muscle cell proliferation and macrophage infiltration in the tunica intima. The 28‐day survival rate was 91%. Arterial spin labeling demonstrated gradual and continuous reduction of cortical and subcortical CBF (ratio to the preoperative value) to 54.6% and 51.5%, respectively, over 28 days. However, magnetic resonance angiography showed increment of collateral flow signals in the leptomeningeal artery. Rarefaction and proliferation of astrocytes and microglia, with loss of oligodendrocytes, were found in the white matter at 32 days. Hippocampal neuronal loss was observed in only 25% of GCAS mice, consistent with lack of abnormalities in the Morris water maze test. The rotarod test showed motor impairment, and the Y‐maze test showed working memory deficits.

          Conclusions

          The GCAS model successfully generated gradual and continuous CBF reduction over 28 days, with replication of key histological, radiological, and behavioral features associated with cerebral hypoperfusion leading to VCI.

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          Most cited references21

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          White matter lesions and glial activation in a novel mouse model of chronic cerebral hypoperfusion.

          Cerebrovascular white matter (WM) lesions are closely associated with cognitive impairment and gait disorders in the elderly. We have successfully established a mouse model of chronic cerebral hypoperfusion that may provide new strategies for the molecular analysis of cerebrovascular WM lesions. Adult C57Bl/6 male mice were subjected to bilateral common carotid artery stenosis (BCAS) using external microcoils with varying inner diameters from 0.16 to 0.22 mm. Cerebral blood flow (CBF) in the frontal cortices was measured by laser-Doppler flowmetry at 2 hours and at 1, 3, 7, 14, and 30 days after BCAS. The brains were then removed and examined at 30 days with histological stains and immunohistochemistry for markers of microglia and astroglia. At 2 hours, the CBF values (ratio to the preoperative value) did not change in the 0.22 mm group but decreased significantly to 77.3+/-13.4% in the 0.20 mm group, 67.3+/-18.5% in the 0.18 mm group, and 51.4+/-11.5% in the 0.16 mm group. At day 1, the CBF began to recover in all groups but remained significantly lower until 14 days in comparison to the control group. In the 0.20 mm and 0.18 mm groups, WM lesions occurred after 14 days without any gray matter involvement. These lesions were the most intense in the corpus callosum adjacent to the lateral ventricle but were mild in the anterior commissure and optic tract. In contrast, 4 of 5 mice developed some gray matter changes in the 0.16 mm group. The proliferation of activated microglia and astroglia was observed in the WM beyond 3 days after BCAS. WM lesions were successfully induced after chronic cerebral hypoperfusion with relative preservation of the visual pathway. These features in this mouse model are appropriate for cognitive assessment and genetic analysis, and it may provide a powerful tool to understand the pathophysiology of WM lesions.
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            Subcortical ischaemic vascular dementia.

            Vascular dementia is the second most common type of dementia. The subcortical ischaemic form (SIVD) frequently causes cognitive impairment and dementia in elderly people. SIVD results from small-vessel disease, which produces either arteriolar occlusion and lacunes or widespread incomplete infarction of white matter due to critical stenosis of medullary arterioles and hypoperfusion (Binswanger's disease). Symptoms include motor and cognitive dysexecutive slowing, forgetfulness, dysarthria, mood changes, urinary symptoms, and short-stepped gait. These manifestations probably result from ischaemic interruption of parallel circuits from the prefrontal cortex to the basal ganglia and corresponding thalamocortical connections. Brain imaging (computed tomography and magnetic resonance imaging) is essential for correct diagnosis. The main risk factors are advanced age, hypertension, diabetes, smoking, hyperhomocysteinaemia, hyperfibrinogenaemia, and other conditions that can cause brain hypoperfusion such as obstructive sleep apnoea, congestive heart failure, cardiac arrhythmias, and orthostatic hypotension. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL)and some forms of cerebral amyloid angiopathy have a genetic basis. Treatment is symptomatic and prevention requires control of treatable risk factors.
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              Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping.

              S. H. Kim (1995)
              Relative cerebral blood flow changes can be measured by a novel simple blood flow measurement technique with endogenous water protons as a tracer based on flow-sensitive alternating inversion recovery (FAIR). Two inversion recovery (IR) images are acquired by interleaving slice-selective inversion and nonselective inversion. During the inversion delay time after slice-selective inversion, fully magnetized blood spins move into the imaging slice and exchange with tissue water. The signal enhancement (FAIR image) measured by the signal difference between two images is directly related to blood flow. For functional MR imaging studies, two IR images are alternatively and repeatedly acquired during control and task periods. Relative signal changes in the FAIR images during the task periods represent the relative regional cerebral blood flow changes. The FAIR technique has been successfully applied to functional brain mapping studies in humans during finger opposition movements. The technique is capable of generating microvascular-based functional maps.
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                Author and article information

                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                22 February 2016
                February 2016
                : 5
                : 2 ( doiID: 10.1002/jah3.2016.5.issue-2 )
                : e002757
                Affiliations
                [ 1 ] Department of Stroke and Cerebrovascular DiseasesNational Cerebral and Cardiovascular Center SuitaJapan
                [ 2 ] Department of NeurologyNational Hospital Organization Minami Kyoto Hospital JoyoJapan
                [ 3 ] Department of Investigative RadiologyNational Cerebral and Cardiovascular Center SuitaJapan
                [ 4 ] Department of Regenerative MedicineNational Cerebral and Cardiovascular Center SuitaJapan
                [ 5 ] Institute of NeuroscienceNewcastle University Campus for Ageing & Vitality NewcastleUK
                Author notes
                [*] [* ] Correspondence to: Masafumi Ihara, MD, PhD, FACP, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center; 5‐7‐1 Fujishiro‐dai, Suita, Osaka 565‐8565, Japan. E‐mail: ihara@ 123456ncvc.go.jp
                Article
                JAH31368
                10.1161/JAHA.115.002757
                4802480
                26903005
                3de363b7-bc02-4e38-b36a-64f208711b02
                © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 20 October 2015
                : 13 January 2016
                Page count
                Pages: 12
                Funding
                Funded by: Ministry of Health, Labour and Welfare
                Award ID: 0605‐1
                Funded by: Ministry of Education, Culture, Sports, Science and Technology
                Award ID: 23390233
                Award ID: 26640034
                Award ID: 25461867
                Funded by: Takeda Science Foundation
                Categories
                Original Research
                Original Research
                Stroke
                Custom metadata
                2.0
                jah31368
                February 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.8.4 mode:remove_FC converted:03.03.2016

                Cardiovascular Medicine
                ameroid constrictor,carotid artery stenosis,mouse,subcortical ischemic vascular dementia,vascular cognitive impairment,cognitive impairment,cerebrovascular disease/stroke,animal models of human disease,atherosclerosis,stenosis

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