Structural Stability of Carotid Plaque and Symptomatology

颈动脉斑块的结构稳定性和症状学

• 批准号: 8416383
• 负责人: ROBERT J DEMPSEY
• 金额: $ 30.08万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-15 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8416383
• 关键词: Address; Affect; Aging; American; Area; Arterial Fatty Streak; Atherosclerosis; Atrophic; Blood Vessels; Brain; Cardiac; Carotid Artery Plaques; Carotid Atherosclerotic Disease; Carotid Endarterectomy; Cerebrovascular Circulation; Cerebrovascular Disorders; Cerebrum; Characteristics; Cholesterol; Clinical; Cognition; Cognitive; Defect; Deposition; Development; Disease; Distal; Elasticity; Embolism; Endarterectomy; Functional disorder; Future; Health; Hemorrhage; Histopathology; Human; Impaired cognition; Individual; Injury; Ipsilateral; Ischemia; Lead; Magnetic Resonance Imaging; Measurable; Measurement; Measures; Mechanics; Methods; Motion; Motor; Operative Surgical Procedures; Patient Monitoring; Patients; Perfusion; Relative (related person); Risk; Role; Sensory; Side; Site; Source; Specimen; Speech; Spin Labels; Stroke; Surface; Symptoms; System; Therapeutic Embolization; Thrombosis; Thrombus; Time; Ulcer; Ultrasonography; Vision; aging population; angiogenesis; cerebral atrophy; clinically relevant; gray matter; ischemic lesion; novel marker; prevent; public health relevance; treatment strategy; white matter

DESCRIPTION (provided by applicant): This study examines the issue of "silent" strokes in the relationship between the structural stability of atherosclerotic carotid plaque and the development of nonmotor symptomatology, including brain atrophy and cognitive decline. It addresses the question of the role of carotid emboli in "silent" stroke and their cognitive sequelae. The study uses human carotid endarterectomy patients to study three specific aims. The first uses ultrasound to relate plaque elasticity and its development of mechanical strain features with pulsation and the histopathophysiology of the plaque for ulcer, hemorrhage and thinning of stabilizing fibrous cap at the point of these mechanical strain features. The second examines ultrasound detected elasticity strain features in the plaques and the presence of transcranial Doppler TCD detectable microemboli. The third looks at ultrasound strain deficits, microemboli, cognitive decline and brain MRI evidence of focal and generalized atrophy. Understanding the structural plaque abnormalities, which render a carotid plaque mechanically unstable and at risk of embolization will demonstrate a pathophysiologic mechanism in individuals who are likely to suffer not only classic episodic major strokes, but also functional progressive decline from the contribution of microemboli to cerebral "silent" stroke and cognitive decline.

描述（由申请人提供）：本研究探讨了“无声”中风问题与颈动脉粥样硬化斑块结构稳定性与非运动症状（包括脑萎缩和认知能力下降）发展之间关系的问题。它解决了颈动脉栓塞在“无声”中风及其认知后遗症中的作用问题。该研究利用人类颈动脉内膜切除术患者来研究三个具体目标。第一种方法使用超声波将斑块弹性及其机械应变特征的发展与脉动以及斑块的组织病理生理学联系起来，以了解这些机械应变特征点处的溃疡、出血和稳定纤维帽的变薄。第二个检查超声检测斑块中的弹性应变特征以及经颅多普勒 TCD 可检测微栓塞的存在。第三个研究着眼于超声应变缺陷、微栓塞、认知能力下降以及局灶性和全身性萎缩的脑部 MRI 证据。了解导致颈动脉斑块机械不稳定并面临栓塞风险的结构斑块异常，将证明个体的病理生理机制，这些个体不仅可能遭受典型的阵发性重大中风，而且可能因微栓塞对大脑的贡献而导致功能进行性衰退。 “沉默”中风和认知能力下降。