TY - JOUR AU - Csiszar, Anna AU - Ungvari, Anna AU - Patai, Roland AU - Gulej, Rafal AU - Yabluchanskiy, Andriy AU - Benyo, Zoltan AU - Kovacs, Illes AU - Sotonyi, Peter AU - Kirkpartrick, Angelia C AU - Prodan, Calin I AU - Liotta, Eric M AU - Zhang, Xin A AU - Tóth, Péter József AU - Tarantini, Stefano AU - Sorond, Farzaneh A AU - Ungvari, Zoltan TI - Atherosclerotic burden and cerebral small vessel disease : exploring the link through microvascular aging and cerebral microhemorrhages JF - GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE) J2 - GEROSCIENCE PY - 2024 SN - 2509-2715 DO - 10.1007/s11357-024-01139-7 UR - https://m2.mtmt.hu/api/publication/34804161 ID - 34804161 N1 - * Megosztott szerzőség AB - Cerebral microhemorrhages (CMHs, also known as cerebral microbleeds) are a critical but frequently underestimated aspect of cerebral small vessel disease (CSVD), bearing substantial clinical consequences. Detectable through sensitive neuroimaging techniques, CMHs reveal an extensive pathological landscape. They are prevalent in the aging population, with multiple CMHs often being observed in a given individual. CMHs are closely associated with accelerated cognitive decline and are increasingly recognized as key contributors to the pathogenesis of vascular cognitive impairment and dementia (VCID) and Alzheimer's disease (AD). This review paper delves into the hypothesis that atherosclerosis, a prevalent age-related large vessel disease, extends its pathological influence into the cerebral microcirculation, thereby contributing to the development and progression of CSVD, with a specific focus on CMHs. We explore the concept of vascular aging as a continuum, bridging macrovascular pathologies like atherosclerosis with microvascular abnormalities characteristic of CSVD. We posit that the same risk factors precipitating accelerated aging in large vessels (i.e., atherogenesis), primarily through oxidative stress and inflammatory pathways, similarly instigate accelerated microvascular aging. Accelerated microvascular aging leads to increased microvascular fragility, which in turn predisposes to the formation of CMHs. The presence of hypertension and amyloid pathology further intensifies this process. We comprehensively overview the current body of evidence supporting this interconnected vascular hypothesis. Our review includes an examination of epidemiological data, which provides insights into the prevalence and impact of CMHs in the context of atherosclerosis and CSVD. Furthermore, we explore the shared mechanisms between large vessel aging, atherogenesis, microvascular aging, and CSVD, particularly focusing on how these intertwined processes contribute to the genesis of CMHs. By highlighting the role of vascular aging in the pathophysiology of CMHs, this review seeks to enhance the understanding of CSVD and its links to systemic vascular disorders. Our aim is to provide insights that could inform future therapeutic approaches and research directions in the realm of neurovascular health. LA - English DB - MTMT ER - TY - JOUR AU - Picetti, Edoardo AU - Demetriades, Andreas K. AU - Catena, Fausto AU - Aarabi, Bizhan AU - Abu-Zidan, Fikri M. AU - Alves, Oscar L. AU - Ansaloni, Luca AU - Armonda, Rocco A. AU - Badenes, Rafael AU - Bala, Miklosh AU - Balogh, Zsolt J. AU - Barbanera, Andrea AU - Bertuccio, Alessandro AU - Biffl, Walter L. AU - Bouzat, Pierre AU - Buki, Andras AU - Castano-Leon, Ana Maria AU - Cerasti, Davide AU - Citerio, Giuseppe AU - Coccolini, Federico AU - Coimbra, Raul AU - Coniglio, Carlo AU - Costa, Francesco AU - De Iure, Federico AU - Depreitere, Bart AU - Fainardi, Enrico AU - Fehlings, Michael J. AU - Gabrovsky, Nikolay AU - Godoy, Daniel Agustin AU - Gruen, Peter AU - Gupta, Deepak AU - Hawryluk, Gregory W. J. AU - Helbok, Raimund AU - Hossain, Iftakher AU - Hutchinson, Peter J. AU - Iaccarino, Corrado AU - Inaba, Kenji AU - Ivanov, Marcel AU - Kaprovoy, Stanislav AU - Kirkpatrick, Andrew W. AU - Klein, Sam AU - Kolias, Angelos AU - Konovalov, Nikolay A. AU - Lagares, Alfonso AU - Lippa, Laura AU - Loza-Gomez, Angelica AU - Luoto, Teemu M. AU - Maas, Andrew I. R. AU - Maciejczak, Andrzej AU - Maier, Ronald V. AU - Marklund, Niklas AU - Martin, Matthew J. AU - Melloni, Ilaria AU - Mendoza-Lattes, Sergio AU - Meyfroidt, Geert AU - Munari, Marina AU - Napolitano, Lena M. AU - Okonkwo, David O. AU - Otomo, Yasuhiro AU - Papadopoulos, Marios C. AU - Petr, Ondra AU - Peul, Wilco C. AU - Pudkrong, Aichholz K. AU - Qasim, Zaffer AU - Rasulo, Frank AU - Reizinho, Carla AU - Ringel, Florian AU - Rizoli, Sandro AU - Rostami, Elham AU - Rubiano, Andres M. AU - Russo, Emanuele AU - Sarwal, Aarti AU - Schwab, Jan M. AU - Servadei, Franco AU - Sharma, Deepak AU - Sharif, Salman AU - Shiban, Ehab AU - Shutter, Lori AU - Stahel, Philip F. AU - Taccone, Fabio S. AU - Terpolilli, Nicole A. AU - Thomé, Claudius AU - Tóth, Péter József AU - Tsitsopoulos, Parmenion P. AU - Udy, Andrew AU - Vaccaro, Alexander R. AU - Varon, Albert J. AU - Vavilala, Monica S. AU - Younsi, Alexander AU - Zackova, Monika AU - Zoerle, Tommaso AU - Robba, Chiara TI - Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS) JF - WORLD JOURNAL OF EMERGENCY SURGERY J2 - WJES VL - 19 PY - 2024 IS - 1 PG - 10 SN - 1749-7922 DO - 10.1186/s13017-023-00525-4 UR - https://m2.mtmt.hu/api/publication/34521154 ID - 34521154 AB - Background: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. Methods: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. Results: A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). Conclusions: This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients. © 2024, The Author(s). LA - English DB - MTMT ER - TY - JOUR AU - Mukli, Péter AU - Pinto, Camila B AU - Owens, Cameron D AU - Csípő, Tamás AU - Lipécz, Ágnes AU - Szarvas, Zsófia AU - Péterfi, Anna AU - Langley, Ana Clara da Costa Pinaffi AU - Hoffmeister, Jordan AU - Rácz, Frigyes Sámuel AU - Perry, Jonathan W AU - Tarantini, Stefano AU - Nyúl-Tóth, Ádám AU - Sorond, Farzaneh A AU - Yang, Yuan AU - James, Judith A AU - Kirkpatrick, Angelia C AU - Prodan, Calin I AU - Tóth, Péter József AU - Galindo, Juliette AU - Gardner, Andrew W AU - Sonntag, William E AU - Csiszar, Anna AU - Ungvári, Zoltán István AU - Yabluchanskiy, Andriy TI - Impaired Neurovascular Coupling and Increased Functional Connectivity in the Frontal Cortex Predict Age-Related Cognitive Dysfunction JF - ADVANCED SCIENCE J2 - ADV SCI VL - 11 PY - 2024 IS - 10 PG - 18 SN - 2198-3844 DO - 10.1002/advs.202303516 UR - https://m2.mtmt.hu/api/publication/34477401 ID - 34477401 AB - Impaired cerebrovascular function contributes to the genesis of age-related cognitive decline. In this study, the hypothesis is tested that impairments in neurovascular coupling (NVC) responses and brain network function predict cognitive dysfunction in older adults. Cerebromicrovascular and working memory function of healthy young (n = 21, 33.2±7.0 years) and aged (n = 30, 75.9±6.9 years) participants are assessed. To determine NVC responses and functional connectivity (FC) during a working memory (n-back) paradigm, oxy- and deoxyhemoglobin concentration changes from the frontal cortex using functional near-infrared spectroscopy are recorded. NVC responses are significantly impaired during the 2-back task in aged participants, while the frontal networks are characterized by higher local and global connection strength, and dynamic FC (p < 0.05). Both impaired NVC and increased FC correlate with age-related decline in accuracy during the 2-back task. These findings suggest that task-related brain states in older adults require stronger functional connections to compensate for the attenuated NVC responses associated with working memory load. LA - English DB - MTMT ER - TY - JOUR AU - Faakye, Janet AU - Nyúl-Tóth, Ádám AU - Murányi, Mihály AU - Gulej, Rafal AU - Csik, Boglarka AU - Shanmugarama, Santny AU - Tarantini, Stefano AU - Negri, Sharon AU - Prodan, Calin AU - Mukli, Peter AU - Yabluchanskiy, Andriy AU - Conley, Shannon AU - Tóth, Péter József AU - Csiszar, Anna AU - Ungvári, Zoltán István TI - Preventing spontaneous cerebral microhemorrhages in aging mice : a novel approach targeting cellular senescence with ABT263/navitoclax JF - GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE) J2 - GEROSCIENCE VL - 46 PY - 2024 SP - 21 EP - 37 PG - 17 SN - 2509-2715 DO - 10.1007/s11357-023-01024-9 UR - https://m2.mtmt.hu/api/publication/34415989 ID - 34415989 AB - Emerging evidence from both clinical and preclinical studies underscores the role of aging in potentiating the detrimental effects of hypertension on cerebral microhemorrhages (CMHs, or cerebral microbleeds). CMHs progressively impair neuronal function and contribute to the development of vascular cognitive impairment and dementia. There is growing evidence showing accumulation of senescent cells within the cerebral microvasculature during aging, which detrimentally affects cerebromicrovascular function and overall brain health. We postulated that this build-up of senescent cells renders the aged cerebral microvasculature more vulnerable, and consequently, more susceptible to CMHs. To investigate the role of cellular senescence in CMHs' pathogenesis, we subjected aged mice, both with and without pre-treatment with the senolytic agent ABT263/Navitoclax, and young control mice to hypertension via angiotensin-II and L-NAME administration. The aged cohort exhibited a markedly earlier onset, heightened incidence, and exacerbated neurological consequences of CMHs compared to their younger counterparts. This was evidenced through neurological examinations, gait analysis, and histological assessments of CMHs in brain sections. Notably, the senolytic pre-treatment wielded considerable cerebromicrovascular protection, effectively delaying the onset, mitigating the incidence, and diminishing the severity of CMHs. These findings hint at the potential of senolytic interventions as a viable therapeutic avenue to preempt or alleviate the consequences of CMHs linked to aging, by counteracting the deleterious effects of senescence on brain microvasculature. LA - English DB - MTMT ER - TY - JOUR AU - Lendvai-Emmert, Dominika AU - Magyar-Sümegi, Zsófia Dina AU - Hegedüs, Emőke AU - Szarka, Nikolett AU - Fazekas, Bálint AU - Amrein, Krisztina AU - Czeiter, Endre AU - Büki, András AU - Ungvári, Zoltán István AU - Tóth, Péter József TI - Mild traumatic brain injury-induced persistent blood–brain barrier disruption is prevented by cyclosporine A treatment in hypertension JF - FRONTIERS IN NEUROLOGY J2 - FRONT NEUR VL - 14 PY - 2023 PG - 9 SN - 1664-2295 DO - 10.3389/fneur.2023.1252796 UR - https://m2.mtmt.hu/api/publication/34392087 ID - 34392087 N1 - This work was supported by grants from the National Research, Development and Innovation Office (OTKA K-134555 and OTKA FK-123798 to PT), the Hungarian Academy of Sciences Bolyai Research Scholarship (to PT), National Clinical Neuroscience Laboratory (RRF-2.3.1-21-2022-00011), the Thematic Excellence Program 2021 Health sub-program of the Ministry for Innovation and Technology in Hungary, within the framework of the EGA-16 project of the University of Pecs (to PT), the National Institute on Aging (RF1AG072295, R01AG055395, R01AG068295, and K01-AG073614), the National Institute of Neurological Disorders and Stroke (R01NS100782), the National Cancer Institute (R01CA255840). LA - English DB - MTMT ER - TY - JOUR AU - Park, Soojin AU - Beqiri, Erta AU - Smielewski, Peter AU - Aries, Marcel ED - Abecasis, Francisco / Collaborator ED - Agrawal, Shruti / Collaborator ED - Appavu, Brian / Collaborator ED - Balu, Ramani / Collaborator ED - Brady, Ken / Collaborator ED - Brunsch, Celina / Collaborator ED - Budohoski, Karol / Collaborator ED - Czigler, András / Collaborator ED - Depreitere, Bart / Collaborator ED - Dias, Celeste / Collaborator ED - Enblad, Per / Collaborator ED - Ercole, Ari / Collaborator ED - Figaji, Anthony / Collaborator ED - Foreman, Brandon / Collaborator ED - Frisvold, Shirin K / Collaborator ED - Gallagher, Clare / Collaborator ED - Griesdale, Donald / Collaborator ED - Helbok, Raimund / Collaborator ED - Helmy, Adel / Collaborator ED - Hoedemaekers, Cornelia / Collaborator ED - Kirschen, Matthew / Collaborator ED - Kooi, Elisabeth / Collaborator ED - Kramer, Andreas / Collaborator ED - Lavinio, Andrea / Collaborator ED - Lee, Jennifer K / Collaborator ED - McCredie, Victoria / Collaborator ED - Menon, David K / Collaborator ED - Meyfroidt, Geert / Collaborator ED - Nelson, David / Collaborator ED - Petersen, Nils / Collaborator ED - de Riva, Nicolas / Collaborator ED - Rivera-Lara, Lucia / Collaborator ED - Robba, Chiara / Collaborator ED - Schubert, Gerrit / Collaborator ED - Schuhmann, Martin U / Collaborator ED - Sekhon, Mypinder S / Collaborator ED - Skola, Josef / Collaborator ED - Steiner, Luzius A / Collaborator ED - Wettervik, Teodor Svedung / Collaborator ED - Taccone, Fabio S / Collaborator ED - Tóth, Péter József / Collaborator ED - Weiss, Miriam / Collaborator ED - Wolf, Stefan / Collaborator ED - Zeiler, Frederick / Collaborator ED - Ziai, Wendy / Collaborator TI - Inaugural State of the Union : Continuous Cerebral Autoregulation Monitoring in the Clinical Practice of Neurocritical Care and Anesthesia JF - NEUROCRITICAL CARE J2 - NEUROCRIT CARE PY - 2023 SN - 1541-6933 DO - 10.1007/s12028-023-01860-9 UR - https://m2.mtmt.hu/api/publication/34335003 ID - 34335003 AB - How continuous cerebral autoregulation (CCA) knowledge should be optimally gained and interpreted is still an active area of research and refinement. We now experience a unique situation of having indices clinically available before definitive evidence of benefit or practice guidelines, in a moment when high rates of institutional variability exist both in the application of monitoring as well as in monitoring-guided treatments. Responses from 47 international clinicians, experts in this field, were collected with polling and discussion of the results. The clinical use of CCA in critical illness was not universal among experts, with 34% not using it. Of those who use a CCA index in clinical practice, 64% use intracranial pressure-based Pressure Reactivity index (PRx). There seems to exist a considerable trust in the physiologic plausibility of CCA to guide individual arterial blood pressure and cerebral perfusion pressure therapy and provide benefit, regardless of the difficulty of proving this. A total of 59% feel the need for phase II and III prospective studies but would continue to use CCA information in their practice even if randomized controlled trials (RCTs) did not show clear clinical benefit. There was nearly universal interest to participate in an RCT, with agreement that the research community must together determine end points and interventions to reduce wasted effort and time, and that investigations should include the following: the most appropriate way of inclusion of CCA into the clinical workflow; whether CCA-guided interventions should be prophylactic, proactive; or reactive; and whether a CCA-centric (unimodal) or a multimodal monitoring-integrated tiered therapy approach should be adopted. Pediatric and neonatal populations were highlighted as having urgent need and even more plausibility than adults. On the whole, the initiative was enthusiastically embraced by the experts, with the general feeling that a strong push should be now made by the community to convert the plausible benefits of CCA monitoring, already implemented in some centers, into a more standardized and RCT-validated clinical reality. LA - English DB - MTMT ER - TY - JOUR AU - Faakye, Janet AU - Nyúl-Tóth, Ádám AU - Gulej, Rafal AU - Csik, Boglarka AU - Tarantini, Stefano AU - Shanmugarama, Santny AU - Prodan, Calin AU - Mukli, Peter AU - Yabluchanskiy, Andriy AU - Conley, Shannon AU - Tóth, Péter József AU - Csiszar, Anna AU - Ungvári, Zoltán István TI - Imaging the time course, morphology, neuronal tissue compression, and resolution of cerebral microhemorrhages in mice using intravital two-photon microscopy : insights into arteriolar, capillary, and venular origin JF - GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE) J2 - GEROSCIENCE VL - 45 PY - 2023 IS - 5 SP - 2851 EP - 2872 PG - 22 SN - 2509-2715 DO - 10.1007/s11357-023-00839-w UR - https://m2.mtmt.hu/api/publication/34039024 ID - 34039024 N1 - * Megosztott szerzőség AB - Cerebral microhemorrhages (CMHs, microbleeds), a manifestation of age-related cerebral small vessel disease, contribute to the pathogenesis of cognitive decline and dementia in older adults. Histological studies have revealed that CMHs exhibit distinct morphologies, which may be attributed to differences in intravascular pressure and the size of the vessels of origin. Our study aimed to establish a direct relationship between the size/morphology of CMHs and the size/anatomy of the microvessel of origin. To achieve this goal, we adapted and optimized intravital two-photon microscopy-based imaging methods to monitor the development of CMHs in mice equipped with a chronic cranial window upon high-energy laser light-induced photodisruption of a targeted cortical arteriole, capillary, or venule. We assessed the time course of extravasation of fluorescently labeled blood and determined the morphology and size/volume of the induced CMHs. Our findings reveal striking similarities between the bleed morphologies observed in hypertension-induced CMHs in models of aging and those originating from different targeted vessels via multiphoton laser ablation. Arteriolar bleeds, which are larger (> 100 μm) and more widely dispersed, are distinguished from venular bleeds, which are smaller and exhibit a distinct diffuse morphology. Capillary bleeds are circular and smaller (< 10 μm) in size. Our study supports the concept that CMHs can occur at any location in the vascular tree, and that each type of vessel produces microbleeds with a distinct morphology. Development of CMHs resulted in immediate constriction of capillaries, likely due to pericyte activation and constriction of precapillary arterioles. Additionally, tissue displacement observed in association with arteriolar CMHs suggests that they can affect an area with a radius of ~ 50 μm to ~ 100 μm, creating an area at risk for ischemia. Longitudinal imaging of CMHs allowed us to visualize reactive astrocytosis and bleed resolution during a 30-day period. Our study provides new insights into the development and morphology of CMHs, highlighting the potential clinical implications of differentiating between the types of vessels involved in the pathogenesis of CMHs. This information may help in the development of targeted interventions aimed at reducing the risk of cerebral small vessel disease-related cognitive decline and dementia in older adults. LA - English DB - MTMT ER - TY - JOUR AU - Hossain, Iftakher AU - Younsi, Alexander AU - Castaño Leon, Ana Maria AU - Lippa, Laura AU - Tóth, Péter József AU - Terpolilli, Nicole AU - Tobieson, Lovisa AU - Latini, Francesco AU - Raabe, Andreas AU - Depreitere, Bart AU - Rostami, Elham TI - Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice JF - BRAIN AND SPINE J2 - BRAIN SPINE VL - 3 PY - 2023 PG - 6 SN - 2772-5294 DO - 10.1016/j.bas.2023.101731 UR - https://m2.mtmt.hu/api/publication/33749702 ID - 33749702 N1 - * Megosztott szerzőség LA - English DB - MTMT ER - TY - JOUR AU - Nagy, Szilvia Anett AU - Ivic, Ivan AU - Tóth, Péter József AU - Komoly, Sámuel AU - Kiss, Tamás AU - Pénzes, Máté AU - Málnási Csizmadia, András AU - Dóczi, Tamás Péter AU - Perlaki, Gábor AU - Orsi, Gergely TI - Post-reperfusion acute MR diffusion in stroke is a potential predictor for clinical outcome in rats JF - SCIENTIFIC REPORTS J2 - SCI REP VL - 13 PY - 2023 IS - 1 PG - 11 SN - 2045-2322 DO - 10.1038/s41598-023-32679-1 UR - https://m2.mtmt.hu/api/publication/33742456 ID - 33742456 N1 - * Megosztott szerzőség AB - Middle cerebral artery occlusion (MCAO) models show substantial variability in outcome, introducing uncertainties in the evaluation of treatment effects. Early outcome predictors would be essential for prognostic purposes and variability control. We aimed to compare apparent diffusion coefficient (ADC) MRI data obtained during MCAO and shortly after reperfusion for their potentials in acute-phase outcome prediction. Fifty-nine male rats underwent a 45-min MCAO. Outcome was defined in three ways: 21-day survival; 24 h midline-shift and neurological scores. Animals were divided into two groups: rats surviving 21 days after MCAO (survival group, n = 46) and rats dying prematurely (non-survival/NS group, n = 13). At reperfusion, NS group showed considerably larger lesion volume and lower mean ADC of the initial lesion site (p < 0.0001), while during occlusion there were no significant group differences. At reperfusion, each survival animal showed decreased lesion volume and increased mean ADC of the initial lesion site compared to those during occlusion (p < 10-6), while NS group showed a mixed pattern. At reperfusion, lesion volume and mean ADC of the initial lesion site were significantly associated with 24 h midline-shift and neurological scores. Diffusion MRI performed soon after reperfusion has a great impact in early-phase outcome prediction, and it works better than the measurement during occlusion. LA - English DB - MTMT ER - TY - JOUR AU - Sebestyén, Gabriella AU - Lendvai-Emmert, Dominika AU - Tamás, Viktória AU - Csendes, Márk Lajos AU - Magyar-Sümegi, Zsófia Dina AU - Tóth, Péter József AU - Büki, András TI - Neuronavigated theta burst stimulation for achieve safer tumor resection near motor speech area – case study JF - CLINICAL NEUROPHYSIOLOGY J2 - CLIN NEUROPHYSIOL VL - 141 PY - 2022 SP - S145 EP - S146 PG - 1 SN - 1388-2457 DO - 10.1016/j.clinph.2022.07.384 UR - https://m2.mtmt.hu/api/publication/33121609 ID - 33121609 LA - English DB - MTMT ER -