Oscar H Del Brutto1, Robertino M Mera2, María de la Luz Andrade3, Verónica Espinosa4, Pablo R Castillo5, Mauricio Zambrano6, Juan A Nader3. 1. School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador. 2. Gastroenterology Department, Vanderbilt University, Nashville, TN. 3. Department of Neurology, Hospital Medica Sur, Mexico City, Mexico. 4. Department of Imaging, Hospital Medica Sur, Mexico City, Mexico. 5. Sleep Disorders Center, Mayo Clinic College of Medicine, Jacksonville, FL. 6. Community Center, the Atahualpa Project, Atahualpa, Ecuador.
Abstract
PURPOSE: To assess the role of temporal bone characteristics in transcranial Doppler (TCD) insonation failures in Amerindians living in rural Ecuador. METHODS: We evaluated thickness and texture of temporal bones in community-dwelling Amerindians ≥65 years old undergoing TCD. Using receiver operator characteristics curve analysis and generalized estimating equations, we investigated factors associated with insonation failures. RESULTS: Of 65 participants (mean age 74.7 ± 6.7 years, 60% women), 32 (49%) had uni- or bilateral insonation failure through temporal windows. Considering temporal bones independently, 57 of 130 (44%) had poor insonation. Mean thickness was higher (4.7 ± 1.2 versus 2.7 ± 0.9, p < 0.0001), and texture more often heterogeneous (93% versus 22%, p < 0.0001) in bones with poor acoustic windows. Thickness, better predicting poor insonation, was ≥3.6 mm if used alone, and ≥2.7 mm if used together with heterogeneous texture. For every millimeter of increase in thickness, subjects were 2.9 times more likely to have insonation failures. Per se, heterogeneous texture increased by 3.2 times the odds for poor insonation. In all models, being woman increased the odds for poor insonation by six to nine times. CONCLUSIONS: Temporal bone thickness and texture are independent predictors of TCD insonation failure in Amerindians.
PURPOSE: To assess the role of temporal bone characteristics in transcranial Doppler (TCD) insonation failures in Amerindians living in rural Ecuador. METHODS: We evaluated thickness and texture of temporal bones in community-dwelling Amerindians ≥65 years old undergoing TCD. Using receiver operator characteristics curve analysis and generalized estimating equations, we investigated factors associated with insonation failures. RESULTS: Of 65 participants (mean age 74.7 ± 6.7 years, 60% women), 32 (49%) had uni- or bilateral insonation failure through temporal windows. Considering temporal bones independently, 57 of 130 (44%) had poor insonation. Mean thickness was higher (4.7 ± 1.2 versus 2.7 ± 0.9, p < 0.0001), and texture more often heterogeneous (93% versus 22%, p < 0.0001) in bones with poor acoustic windows. Thickness, better predicting poor insonation, was ≥3.6 mm if used alone, and ≥2.7 mm if used together with heterogeneous texture. For every millimeter of increase in thickness, subjects were 2.9 times more likely to have insonation failures. Per se, heterogeneous texture increased by 3.2 times the odds for poor insonation. In all models, being woman increased the odds for poor insonation by six to nine times. CONCLUSIONS: Temporal bone thickness and texture are independent predictors of TCD insonation failure in Amerindians.
Authors: Vojtech Novotny; Aliona Nacu; Christopher E Kvistad; Annette Fromm; Gesche F Neckelmann; Andrej N Khanevski; Haakon Tobro; Ulrike Waje-Andreassen; Halvor Naess; Lars Thomassen; Nicola Logallo Journal: Transl Stroke Res Date: 2017-11-08 Impact factor: 6.829
Authors: Joseph Kamtchum-Tatuene; Henry C Mwandumba; Gloria Mwangalika Kachingwe; Laura J Bonnett; Noel Kayange; Tom Solomon; Laura A Benjamin Journal: PLoS One Date: 2020-02-07 Impact factor: 3.240