Related resources
Search for item elsewhere
University researcher(s)
Paradoxical embolization: a potential cause of cerebral damage in Alzheimer's disease?
Purandare N, Oude Voshaar R, Burns AS, Velupandian UM, McCollum CN
Neurol Res. 2006;28( 6):679-84.
Access to files
Full-text and supplementary files are not available from Manchester eScholar. Use our list of Related resources to find this item elsewhere. Alternatively, request a copy from the Library's Document supply service.
Abstract
BACKGROUND: There are considerable overlaps between vascular dementia and Alzheimer's disease (AD), with a suggestion that cerebrovascular disease (CVD) contributes to the neurodegenerative pathology of AD. Paradoxical embolization of venous emboli into the systemic circulation through a venous to arterial circulation shunt (v-aCS), the most commonly a patent foramen ovale (PFO), is known to cause cryptogenic stroke in younger people. We reviewed the potential role of paradoxical embolization in AD. METHODS: A review of the literature on paradoxical embolization in neurological disorders and techniques to detect v-aCS and PFO, supplemented by data from our own studies. RESULTS: Before our research, the role of paradoxical embolism in dementia had not been studied. The potential role of embolization in cerebral damage was highlighted by studies in patients undergoing coronary artery bypass or carotid surgery. Paradoxical embolization was found to occur in patients with cryptogenic stroke, migraine, decompression sickles and during hip surgery. The methods for detecting v-aCS or PFO had not been standardized. We found 'significant' v-aCS (equivalent to PFO) in 32% of AD patients compared with 22% of controls, but the study was not sufficiently powered to test the statistic significance of this difference. In AD, there was evidence of an association between 'significant' v-aCS and the severity of white matter hyperintensities on magnetic resonance imaging (MRI). CONCLUSION: Paradoxical embolization through a v-aCS may be a potentially preventable or treatable cause of CVD in AD.
Keyword(s)
Cerebrovascular Circulation; Humans; Research Support, Non-U.S. Gov't; complications: Embolism, Paradoxical; etiology: Alzheimer Disease; etiology: Cerebrovascular Disorders