TY - JOUR AU - Csizek, Zsófia AU - Mikó-Baráth, Eszter AU - Budai, Anna AU - Frigyik, Bela Andras AU - Pusztai, Á. AU - Nemes, Vanda Ágnes AU - Závori, L. AU - Fülöp, Diána AU - Czigler, András AU - Guth, Kitti AU - Buzás, Péter AU - Piñero, D.P. AU - Jandó, Gábor TI - Artificial intelligence-based screening for amblyopia and its risk factors: comparison with four classic stereovision tests JF - FRONTIERS IN MEDICINE J2 - FRONT MED VL - 10 PY - 2023 PG - 14 SN - 2296-858X DO - 10.3389/fmed.2023.1294559 UR - https://m2.mtmt.hu/api/publication/34502046 ID - 34502046 N1 - Funding Agency and Grant Number: Hungarian Brain Research Program 2 [2017-1.2.1.-NKP2017]; Thematic Excellence Program 2021 Health Sub-programme of the Ministry for Innovation and Technology in Hungary [TKP2021-EGA-16, OTKA K108747]; New National Excellence Program of the Ministry for Innovation and Technology [UNKP-19-3]; Ministry of Economy, Industry and Competitiveness of Spain [RYC-2016-20471] Funding text: The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Hungarian Brain Research Program 2 (2017-1.2.1.-NKP2017) (GJ, PB). Thematic Excellence Program 2021 Health Sub-programme of the Ministry for Innovation and Technology in Hungary, within the framework of the EGA-16 project of the University of Pecs (TKP2021-EGA-16) (GJ, PB). OTKA K108747 (PB). New National Excellence Program of the Ministry for Innovation and Technology (UNKP-19-3) (ZC). Ministry of Economy, Industry and Competitiveness of Spain within the program Ramon y Cajal, RYC-2016-20471 (DP). The funding organizations had no role in the design or conduct of this research. LA - English DB - MTMT ER - TY - THES AU - Czigler, András TI - Regulation of cerebral blood flow in humans: ex vivo and in vivo studies PY - 2022 SP - 67 UR - https://m2.mtmt.hu/api/publication/33118201 ID - 33118201 LA - English DB - MTMT ER - TY - JOUR AU - Tóth, Luca AU - Czigler, András AU - Hegedüs, Emőke AU - Komáromy, Hedvig AU - Amrein, Krisztina AU - Czeiter, Endre AU - Yabluchanskiy, Andriy AU - Koller, Ákos AU - Orsi, Gergely AU - Perlaki, Gábor AU - Schwarcz, Attila AU - Büki, András AU - Ungvári, Zoltán István AU - Tóth, Péter József TI - Age-related decline in circulating IGF-1 associates with impaired neurovascular coupling responses in older adults. JF - GEROSCIENCE: OFFICIAL JOURNAL OF THE AMERICAN AGING ASSOCIATION (AGE) J2 - GEROSCIENCE VL - 44 PY - 2022 IS - 6 SP - 2771 EP - 2783 PG - 13 SN - 2509-2715 DO - 10.1007/s11357-022-00623-2 UR - https://m2.mtmt.hu/api/publication/33032134 ID - 33032134 AB - Impairment of moment-to-moment adjustment of cerebral blood flow (CBF) to the increased oxygen and energy requirements of active brain regions via neurovascular coupling (NVC) contributes to the genesis of age-related cognitive impairment. Aging is associated with marked deficiency in the vasoprotective hormone insulin-like growth factor-1 (IGF-1). Preclinical studies on animal models of aging suggest that circulating IGF-1 deficiency is causally linked to impairment of NVC responses. The present study was designed to test the hypotheses that decreases in circulating IGF-1 levels in older adults also predict the magnitude of age-related decline of NVC responses. In a single-center cross-sectional study, we enrolled healthy young (n = 31, 11 female, 20 male, mean age: 28.4 + / - 4.2 years) and aged volunteers (n = 32, 18 female, 14 male, mean age: 67.9 + / - 4.1 years). Serum IGF-1 level, basal CBF (phase contrast magnetic resonance imaging (MRI)), and NVC responses during the trail making task (with transcranial Doppler sonography) were assessed. We found that circulating IGF-1 levels were significantly decreased with age and associated with decreased basal CBF. Age-related decline in IGF-1 levels predicted the magnitude of age-related decline in NVC responses. In conclusion, our study provides additional evidence in support of the concept that age-related circulating IGF-1 deficiency contributes to neurovascular aging, impairing CBF and functional hyperemia in older adults. LA - English DB - MTMT ER - TY - JOUR AU - Tóth, Luca AU - Czigler, András AU - Horváth, Péter AU - Szarka, Nikolett AU - Környei, Bálint Soma AU - Tóth, Arnold AU - Schwarcz, Attila AU - Ungvári, Zoltán István AU - Büki, András AU - Tóth, Péter József TI - The effect of mild traumatic brain injury on cerebral microbleeds in aging JF - FRONTIERS IN AGING NEUROSCIENCE J2 - FRONT AGING NEUROSCI VL - 13 PY - 2021 PG - 7 SN - 1663-4365 DO - 10.3389/fnagi.2021.717391 UR - https://m2.mtmt.hu/api/publication/32172268 ID - 32172268 AB - A traumatic brain injury (TBI) induces the formation of cerebral microbleeds (CMBs), which are associated with cognitive impairments, psychiatric disorders, and gait dysfunctions in patients. Elderly people frequently suffer TBIs, especially mild brain trauma (mTBI). Interestingly, aging is also an independent risk factor for the development of CMBs. However, how TBI and aging may interact to promote the development of CMBs is not well established. In order to test the hypothesis that an mTBI exacerbates the development of CMBs in the elderly, we compared the number and cerebral distribution of CMBs and assessed them by analysing susceptibility weighted (SW) MRI in young (25 ± 10 years old, n = 18) and elder (72 ± 7 years old, n = 17) patients after an mTBI and in age-matched healthy subjects (young: 25 ± 6 years old, n = 20; aged: 68 ± 5 years old, n = 23). We found significantly more CMBs in elder patients after an mTBI compared with young patients; however, we did not observe a significant difference in the number of cerebral microhemorrhages between aged and aged patients with mTBI. The majority of CMBs were found supratentorially (lobar and basal ganglion). The lobar distribution of supratentorial CMBs showed that aging enhances the formation of parietal and occipital CMBs after mTBIs. This suggests that aging and mTBIs do not synergize in the induction of the development of CMBs, and that the different distribution of mTBI-induced CMBs in aged patients may lead to specific age-related clinical characteristics of mTBIs. LA - English DB - MTMT ER - TY - CHAP AU - Tóth, Luca AU - Czigler, András AU - Viktoria, Kovacs AU - Szarka, Nikolett AU - Tóth, Péter József ED - Csiszár, Beáta ED - Hankó, Csilla ED - Kajos, Luca Fanni ED - Mező, Emerencia TI - Evaluation of neurovascular coupling by transcranial doppler ultrasound system T2 - Medical Conference for PhD Students and Experts of Clinical Sciences 2021 PB - University of Pécs, Doctoral Student Association CY - Pécs SN - 9789634296539 PY - 2021 SP - 92 EP - 92 PG - 1 UR - https://m2.mtmt.hu/api/publication/32131009 ID - 32131009 LA - English DB - MTMT ER - TY - CHAP AU - Márton, F. Schandl AU - Vass, Réka Anna AU - Czigler, András AU - Kvárik, Tímea AU - Dorottya, Balika AU - Eszter, Horányi AU - Reglődi, Dóra AU - Ertl, Tibor ED - Csiszár, Beáta ED - Hankó, Csilla ED - Kajos, Luca Fanni ED - Mező, Emerencia TI - Cardiovascular effects of neonatal hyperglycemia-experimental study T2 - Medical Conference for PhD Students and Experts of Clinical Sciences 2021 PB - University of Pécs, Doctoral Student Association CY - Pécs SN - 9789634296539 PY - 2021 SP - 66 EP - 66 PG - 1 UR - https://m2.mtmt.hu/api/publication/32130294 ID - 32130294 LA - English DB - MTMT ER - TY - CHAP AU - Czigler, András AU - Fedriga, Marta AU - Beqiri, Erta AU - Lalou, Afroditi D AU - Calviello, Leanne A AU - Cabeleira, Manuel AU - Tóth, Péter József AU - Smielewski, Peter AU - Czosnyka, Marek ED - Depreitere, Bart ED - Meyfroidt, Geert ED - Güiza, Fabian TI - Errors and Consequences of Inaccurate Estimation of Mean Blood Flow Velocity in Cerebral Arteries T2 - Intracranial Pressure and Neuromonitoring XVII PB - Springer Science+Business Media CY - Cham SN - 9783030594367 T3 - ACTA NEUROCHIRURGICA SUPPLEMENTA, ISSN 0065-1419 ; 131. PY - 2021 SP - 23 EP - 25 PG - 3 DO - 10.1007/978-3-030-59436-7_5 UR - https://m2.mtmt.hu/api/publication/31961972 ID - 31961972 AB - Many transcranial Doppler ultrasonography devices estimate the mean flow velocity (FVm) by using the traditional formula (FVsystolic + 2 × FVdiastolic)/3 instead of a more accurate formula calculating it as the time integral of the current flow velocities divided by the integration period. We retrospectively analyzed flow velocity and intracranial pressure signals containing plateau waves (transient intracranial hypertension), which were collected from 14 patients with a traumatic brain injury. The differences in FVm and its derivative pulsatility index (PI) calculated with the two different methods were determined. We found that during plateau waves, when the intracranial pressure (ICP) rose, the error in FVm and PI increased significantly from the baseline to the plateau (from 4.6 ± 2.4 to 9.8 ± 4.9 cm/s, P < 0.05). Similarly, the error in PI also increased during plateau waves (from 0.11 ± 0.07 to 0.44 ± 0.24, P < 0.005). These effects were most likely due to changes in the pulse waveform during increased ICP, which alter the relationship between systolic, diastolic, and mean flow velocities. If a change in the mean ICP is expected, then calculation of FVm with the traditional formula is not recommended. LA - English DB - MTMT ER - TY - CHAP AU - Calviello, Leanne Alexis AU - Zeiler, Frederick A AU - Donnelly, Joseph AU - Czigler, András AU - Lavinio, Andrea AU - Hutchinson, Peter J AU - Czosnyka, Marek AU - Smielewski, Peter ED - Depreitere, Bart ED - Meyfroidt, Geert ED - Güiza, Fabian TI - Cerebrovascular Consequences of Elevated Intracranial Pressure After Traumatic Brain Injury T2 - Intracranial Pressure and Neuromonitoring XVII PB - Springer Science+Business Media CY - Cham SN - 9783030594367 T3 - ACTA NEUROCHIRURGICA SUPPLEMENTA, ISSN 0065-1419 ; 131. PY - 2021 SP - 43 EP - 48 PG - 6 DO - 10.1007/978-3-030-59436-7_10 UR - https://m2.mtmt.hu/api/publication/31961971 ID - 31961971 N1 - Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom Division of Anesthesia, University of Cambridge, Cambridge, United Kingdom Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada Department of Neurosurgery, University of Pécs, Pécs, Hungary Division of Anesthesia, Department of Medicine, Addenbrooke’s Hospital, Cambridge, United Kingdom Cited By :3 Export Date: 1 February 2024 CODEN: ANCSB Correspondence Address: Smielewski, P.; Division of Neurosurgery, United Kingdom; email: ps10011@cam.ac.uk AB - We compared various descriptors of cerebral hemodynamics in 517 patients with traumatic brain injury (TBI) who had, on average, elevated (>23 mmHg) or normal (<15 mmHg) intracranial pressure (ICP). In a subsample of 193 of those patients, transcranial Doppler ultrasound (TCD) recordings were made. Arterial blood pressure (ABP), cerebral blood flow velocity (CBFV), cerebral autoregulation indices based on TCD (the mean flow index (Mx; the coefficient of correlation between the the cerebral perfusion pressure CPP and flow velocity) and the autoregulation index (ARI)), and the pressure reactivity index (PRx) were compared between groups. We also analyzed the TCD-based cerebral blood flow (CBF) index (diastolic CBFV/mean CBFV), the spectral pulsatility index (sPI), and the critical closing pressure (CrCP). Finally, we also looked at brain tissue oxygenation (cerebral oxygen partial tension (PbtO2)) in 109 patients. The mean cerebral perfusion pressure (CPP) was lower in the group with elevated ICP (p < 0.01), despite a higher mean arterial pressure (MAP) (p < 0.005) and worse autoregulation (as assessed with the Mx, ARI, and PRx indices), greater CrCP, a lower CBF index, and a higher sPI (all with p values of <0.001). Neither the mean CBFV nor PbtO2 reached significant differences between groups. Mortality in the group with elevated ICP was almost three times greater than that in the group with normal ICP (45% versus 17%). Elevated ICP affects cerebral autoregulation. When autoregulation is not working properly, the brain is exposed to ischemic insults whenever CPP falls. LA - English DB - MTMT ER - TY - CHAP AU - Czigler, András AU - Calviello, Leanne A AU - Zeiler, Frederick A AU - Tóth, Péter József AU - Smielewski, Peter AU - Czosnyka, Marek ED - Depreitere, Bart ED - Meyfroidt, Geert ED - Güiza, Fabian TI - Usability of Noninvasive Counterparts of Traditional Autoregulation Indices in Traumatic Brain Injury. T2 - Intracranial Pressure and Neuromonitoring XVII PB - Springer Science+Business Media CY - Cham SN - 9783030594367 T3 - ACTA NEUROCHIRURGICA SUPPLEMENTA, ISSN 0065-1419 ; 131. PY - 2021 SP - 163 EP - 166 PG - 4 DO - 10.1007/978-3-030-59436-7_33 UR - https://m2.mtmt.hu/api/publication/31961970 ID - 31961970 AB - The pressure reactivity index (PRx) and the pulse amplitude index (PAx) are invasively determined parameters that are commonly used to describe autoregulation following traumatic brain injury (TBI). Using a transcranial Doppler ultrasound (TCD) technique, it is possible to approximate cerebral arterial blood volume (CaBV) solely from cerebral blood flow velocities, and further, to calculate non-invasive markers of autoregulation. In this brief study, we aimed to investigate whether the estimation of relative CaBV with different models could describe the cerebrovascular reactivity of TBI patients. PRx, PAx and their non-invasive counterparts (nPRx and nPAx) were calculated retrospectively from data collected during the monitoring of TBI patients. CaBV, an essential parameter for the calculation of nPRx and nPAx, was determined with both a continuous flow forward (CFF) model-considering a non-pulsatile blood outflow from the brain-and a pulsatile flow forward (PFF) model, presuming a pulsatile outflow. We found that the estimated CaBV demonstrates good coherence with ICP and that nPRx and nPAx can describe cerebrovascular reactivity similarly to PRx and PAx. Continuous monitoring with TCD is difficult, so the usability of PRx and PAx is limited. However, they might become useful for clinicians in the near future owing to rapid advances in these technologies. LA - English DB - MTMT ER - TY - CHAP AU - Beqiri, Erta AU - Ercole, Ari AU - Aries, Marcel J AU - Cabeleira, Manuel AU - Czigler, András AU - Liberti, Annalisa AU - Tas, Jeanette AU - Donnelly, Joseph AU - Liu, Xiuyun AU - Fedriga, Marta AU - Chu, Ka Hing AU - Zeiler, Frederick A AU - Czosnyka, Marek AU - Smielewski, Peter ED - Depreitere, Bart ED - Meyfroidt, Geert ED - Güiza, Fabian TI - Optimal Cerebral Perfusion Pressure Assessed with a Multi-Window Weighted Approach Adapted for Prospective Use : A Validation Study T2 - Intracranial Pressure and Neuromonitoring XVII PB - Springer Science+Business Media CY - Cham SN - 9783030594367 T3 - ACTA NEUROCHIRURGICA SUPPLEMENTA, ISSN 0065-1419 ; 131. PY - 2021 SP - 181 EP - 185 PG - 5 DO - 10.1007/978-3-030-59436-7_36 UR - https://m2.mtmt.hu/api/publication/31961969 ID - 31961969 AB - Pressure reactivity index (PRx)-cerebral perfusion pressure (CPP) relationships over a given time period can be used to detect a value of CPP at which PRx shows the best autoregulation (optimal CPP, or CPPopt). Algorithms for continuous assessment of CPPopt in traumatic brain injury (TBI) patients reached the desired high yield with a multi-window approach (CPPopt_MA). However, the calculations were tested on retrospective manually cleaned datasets. Moreover, CPPopt false-positive values can be generated from non-physiological variations of intracranial pressure (ICP) and arterial blood pressure (ABP). Therefore, the algorithm robustness was improved, making it suitable for prospective bedside application (COGiTATE trial).To validate the CPPopt revised algorithm in a large single-centre retrospective cohort of TBI patients.840 TBI patients were included. CPPopt yield, stability and ability to discriminate outcome groups were compared to CPPopt_MA and the Brain Trauma Foundation (BTF) guideline reference.CPPopt yield was lower than CPPopt_MA yield (85% and 90%, p < 0.001), but, importantly, with increased stability (p < 0.0001). The ∆(CPP-CPPopt) could distinguish the mortality and survival outcome (t = -6.7, p < 0.0001) with a statistical significance higher than the ∆CPP calculated with the guideline reference (CPP-60) (t = -4.5, p < 0.0001).This study validates, on a large cohort of patients, the new algorithm proposed for prospective use of CPPopt as a CPP target at bedside. LA - English DB - MTMT ER -