Jugular venous reflux and white matter abnormalities in alzheimer's disease

A pilot study

Chih Ping Chung, Clive Beggs, Pei N. Wang, Niels Bergsland, Simon Shepherd, Chun Yu Cheng, Deepa P. Ramasamy, Michael G. Dwyer, Han Hwa Hu, Pei N. Wang

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age-and gender-matched controls. Duplex ultrasonography and 1.5T MRI scanning was applied to quantify cerebral WMCs [T2 white matter (WM) lesion and dirty-appearing-white-matter (DAWM)]. Subjects with severe JVR had more frequently hypertension (p = 0.044), more severe WMC, including increased total (p = 0.047) and periventricular DAWM volumes (p = 0.008), and a trend for increased cerebrospinal fluid volumes (p = 0.067) compared with the other groups. A significantly decreased (65.8%) periventricular DAWM volume (p = 0.01) in the JVR-positive AD individuals compared with their JVR-negative counterparts was detected. There was a trend for increased periventricular and subcortical T2 WMC lesion volumes in the JVR-positive AD individuals compared with their JVR-negative counterparts (p = 0.073). This phenomenon was not observed in either the control or MCI groups. In multiple regression analysis, the increased periventricular WMC lesion volume and decreased DAWM volume resulted in 85.7% sensitivity and 80% specificity for distinguishing between JVR-positive and JVR-negative AD patients. These JVR-WMC association patterns were not seen in the control and MCI groups. Therefore, this pilot study suggests that there may be an association between JVR and WMCs in AD patients, implying that cerebral venous outflow impairment might play a role in the dynamics of WMCs formation in AD patients, particularly in the periventricular regions. Further longitudinal studies are needed to confirm and validate our findings. Supplementary Material.

Original languageEnglish
Pages (from-to)601-609
Number of pages9
JournalJournal of Alzheimer's Disease
Volume39
Issue number3
DOIs
Publication statusPublished - Jan 1 2014
Externally publishedYes

Fingerprint

Alzheimer Disease
Neck
White Matter
Longitudinal Studies
Cerebrospinal Fluid
Ultrasonography
Regression Analysis
Hypertension
Sensitivity and Specificity

Keywords

  • Alzheimer's disease
  • Doppler ultrasonography
  • jugular veins
  • leukoaraiosis
  • magnetic resonance imaging

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Chung, C. P., Beggs, C., Wang, P. N., Bergsland, N., Shepherd, S., Cheng, C. Y., ... Wang, P. N. (2014). Jugular venous reflux and white matter abnormalities in alzheimer's disease: A pilot study. Journal of Alzheimer's Disease, 39(3), 601-609. https://doi.org/10.3233/JAD-131112

Jugular venous reflux and white matter abnormalities in alzheimer's disease : A pilot study. / Chung, Chih Ping; Beggs, Clive; Wang, Pei N.; Bergsland, Niels; Shepherd, Simon; Cheng, Chun Yu; Ramasamy, Deepa P.; Dwyer, Michael G.; Hu, Han Hwa; Wang, Pei N.

In: Journal of Alzheimer's Disease, Vol. 39, No. 3, 01.01.2014, p. 601-609.

Research output: Contribution to journalArticle

Chung, CP, Beggs, C, Wang, PN, Bergsland, N, Shepherd, S, Cheng, CY, Ramasamy, DP, Dwyer, MG, Hu, HH & Wang, PN 2014, 'Jugular venous reflux and white matter abnormalities in alzheimer's disease: A pilot study', Journal of Alzheimer's Disease, vol. 39, no. 3, pp. 601-609. https://doi.org/10.3233/JAD-131112
Chung, Chih Ping ; Beggs, Clive ; Wang, Pei N. ; Bergsland, Niels ; Shepherd, Simon ; Cheng, Chun Yu ; Ramasamy, Deepa P. ; Dwyer, Michael G. ; Hu, Han Hwa ; Wang, Pei N. / Jugular venous reflux and white matter abnormalities in alzheimer's disease : A pilot study. In: Journal of Alzheimer's Disease. 2014 ; Vol. 39, No. 3. pp. 601-609.
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abstract = "To determine whether jugular venous reflux (JVR) is associated with cerebral white matter changes (WMCs) in individuals with Alzheimer's disease (AD), we studied 12 AD patients 24 mild cognitive impairment (MCI) patients, and 17 elderly age-and gender-matched controls. Duplex ultrasonography and 1.5T MRI scanning was applied to quantify cerebral WMCs [T2 white matter (WM) lesion and dirty-appearing-white-matter (DAWM)]. Subjects with severe JVR had more frequently hypertension (p = 0.044), more severe WMC, including increased total (p = 0.047) and periventricular DAWM volumes (p = 0.008), and a trend for increased cerebrospinal fluid volumes (p = 0.067) compared with the other groups. A significantly decreased (65.8{\%}) periventricular DAWM volume (p = 0.01) in the JVR-positive AD individuals compared with their JVR-negative counterparts was detected. There was a trend for increased periventricular and subcortical T2 WMC lesion volumes in the JVR-positive AD individuals compared with their JVR-negative counterparts (p = 0.073). This phenomenon was not observed in either the control or MCI groups. In multiple regression analysis, the increased periventricular WMC lesion volume and decreased DAWM volume resulted in 85.7{\%} sensitivity and 80{\%} specificity for distinguishing between JVR-positive and JVR-negative AD patients. These JVR-WMC association patterns were not seen in the control and MCI groups. Therefore, this pilot study suggests that there may be an association between JVR and WMCs in AD patients, implying that cerebral venous outflow impairment might play a role in the dynamics of WMCs formation in AD patients, particularly in the periventricular regions. Further longitudinal studies are needed to confirm and validate our findings. Supplementary Material.",
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