Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers

Abstract Vascular cognitive decline may be caused by micro-emboli generated by carotid plaque instability. We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger...

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Veröffentlicht in:Ultrasound in medicine & biology 2016-04, Vol.42 (4), p.909-918
Hauptverfasser: Wang, Xiao, Jackson, Daren C, Mitchell, Carol C, Varghese, Tomy, Wilbrand, Stephanie M, Rocque, Brandon G, Hermann, Bruce P, Dempsey, Robert J
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container_issue 4
container_start_page 909
container_title Ultrasound in medicine & biology
container_volume 42
creator Wang, Xiao
Jackson, Daren C
Mitchell, Carol C
Varghese, Tomy
Wilbrand, Stephanie M
Rocque, Brandon G
Hermann, Bruce P
Dempsey, Robert J
description Abstract Vascular cognitive decline may be caused by micro-emboli generated by carotid plaque instability. We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke–Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z -scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant ( p  
doi_str_mv 10.1016/j.ultrasmedbio.2015.11.025
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We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke–Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z -scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant ( p  &lt; 0.05), indicating that these indices have good utility in predicting cognitive impairment. Maximum lateral strain indices provided an area under the curve of 0.85 for symptomatic patients and 0.68 for asymptomatic patients. Our results indicate the important relationship of maximum strain indices to cognitive function and the feasibility of using maximum strain indices to predict cognitive decline with inclusion of the adventitia layer into the segmentation of plaque.</description><identifier>ISSN: 0301-5629</identifier><identifier>EISSN: 1879-291X</identifier><identifier>DOI: 10.1016/j.ultrasmedbio.2015.11.025</identifier><identifier>PMID: 26778288</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adult ; Adventitia ; Aged ; Aged, 80 and over ; Algorithms ; Asymptomatic Diseases ; Carotid Plaque ; Carotid Stenosis - complications ; Carotid Stenosis - diagnostic imaging ; Cognitive Dysfunction - complications ; Cognitive Dysfunction - diagnostic imaging ; Diagnosis, Differential ; Elasticity imaging ; Elasticity Imaging Techniques - methods ; Elastography ; Female ; Humans ; Male ; Middle Aged ; Motion tracking ; Multi-level ; Pattern Recognition, Automated - methods ; Radiology ; Reproducibility of Results ; Sensitivity and Specificity ; Strain imaging ; Vascular cognitive impairment</subject><ispartof>Ultrasound in medicine &amp; biology, 2016-04, Vol.42 (4), p.909-918</ispartof><rights>World Federation for Ultrasound in Medicine &amp; Biology</rights><rights>2016 World Federation for Ultrasound in Medicine &amp; Biology</rights><rights>Copyright © 2016 World Federation for Ultrasound in Medicine &amp; Biology. 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We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke–Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z -scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant ( p  &lt; 0.05), indicating that these indices have good utility in predicting cognitive impairment. Maximum lateral strain indices provided an area under the curve of 0.85 for symptomatic patients and 0.68 for asymptomatic patients. 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biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Xiao</au><au>Jackson, Daren C</au><au>Mitchell, Carol C</au><au>Varghese, Tomy</au><au>Wilbrand, Stephanie M</au><au>Rocque, Brandon G</au><au>Hermann, Bruce P</au><au>Dempsey, Robert J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers</atitle><jtitle>Ultrasound in medicine &amp; biology</jtitle><addtitle>Ultrasound Med Biol</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>42</volume><issue>4</issue><spage>909</spage><epage>918</epage><pages>909-918</pages><issn>0301-5629</issn><eissn>1879-291X</eissn><abstract>Abstract Vascular cognitive decline may be caused by micro-emboli generated by carotid plaque instability. We previously found that maximum strain indices in carotid plaque were significantly correlated with cognitive function. In the work described here, we examined these associations with a larger sample size, as well as evaluated the performance of these maximum strain indices in predicting cognitive impairment. Ultrasound-based strain imaging and cognition assessment were conducted on 75 human patients. Patients underwent one of two standardized cognitive test batteries, either the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) or the National Institute of Neurologic Disorder and Stroke–Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards (60 min). Scores were standardized within each battery to allow these data to be combined across all participants. Radiofrequency signals for ultrasound strain imaging were acquired on the carotid arteries using either a Siemens Antares with a VFX 13-5 linear array transducer or a Siemens S2000 with an 18 L6 linear array transducer. The same hierarchical block-matching motion tracking algorithm developed in our laboratory was used to estimate accumulated axial, lateral, and shear strain indices in carotid plaque, with inclusion of adventitia regardless of the ultrasound system and transducer used. Associations between cognitive z -scores and maximum strain indices were examined using Pearson's correlation coefficients. Maximum strain indices were also employed to predict cognitive impairment using receiver operating characteristic analysis. All correlations between maximum strain indices and total cognition were statistically significant ( p  &lt; 0.05), indicating that these indices have good utility in predicting cognitive impairment. Maximum lateral strain indices provided an area under the curve of 0.85 for symptomatic patients and 0.68 for asymptomatic patients. Our results indicate the important relationship of maximum strain indices to cognitive function and the feasibility of using maximum strain indices to predict cognitive decline with inclusion of the adventitia layer into the segmentation of plaque.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>26778288</pmid><doi>10.1016/j.ultrasmedbio.2015.11.025</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Adventitia
Aged
Aged, 80 and over
Algorithms
Asymptomatic Diseases
Carotid Plaque
Carotid Stenosis - complications
Carotid Stenosis - diagnostic imaging
Cognitive Dysfunction - complications
Cognitive Dysfunction - diagnostic imaging
Diagnosis, Differential
Elasticity imaging
Elasticity Imaging Techniques - methods
Elastography
Female
Humans
Male
Middle Aged
Motion tracking
Multi-level
Pattern Recognition, Automated - methods
Radiology
Reproducibility of Results
Sensitivity and Specificity
Strain imaging
Vascular cognitive impairment
title Classification of Symptomatic and Asymptomatic Patients with and without Cognitive Decline Using Non-invasive Carotid Plaque Strain Indices as Biomarkers
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