Saadat Kamran1, Adnan Khan2, Abdul Salam3, Naveed Akhtar4, Ioannis Petropoulos2, Georgios Ponirakis2, Blessy Babu3, Pooja George3, Ashfaq Shuaib3, Rayaz A Malik2. 1. Neuroscience Institute, Hamad General Hospital, Doha, Qatar; Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar. Electronic address: skamranmd@hotmail.com. 2. Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar. 3. Neuroscience Institute, Hamad General Hospital, Doha, Qatar. 4. Neuroscience Institute, Hamad General Hospital, Doha, Qatar; Weill Cornell Medicine-Qatar, Qatar Foundation, Education City, Doha, Qatar.
Abstract
PURPOSE: The presence of white matter hyperintensities (WMH) on MRI imaging confers an increased risk of stroke, dementia, and death. Corneal confocal microscopy (CCM) can detect nerve injury non-invasively and may be a useful surrogate marker for WMH. The objective is to determine whether corneal nerve pathology identified using CCM is associated with the presence of WMH in patients with acute ischemic stroke. METHODS: This is a cross-sectional study where 196 consecutive individuals with acute ischemic stroke were enrolled and underwent neurological examination, MRI brain imaging and CCM. Participants underwent blinded quantification of WMH and corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL). RESULTS: The prevalence of hypertension [P = .013] was significantly higher and CNFD [P = .031] was significantly lower in patients with WMH compared to those without WMH. CNFD and CNFL were significantly lower in patients with DM without WMH [P = .008, P = .019] and in patients with DM and WMH [P = .042, P = .024] compared to patients without DM or WMH, respectively. In a multivariate model, a 1-unit decrease in the CNFD increased the risk of WMH by 6%, after adjusting for age, DM, gender, dyslipidemia, metabolic syndrome, smoking, and HbA1c. DM was associated with a decrease in all CCM parameters but was not a significant independent factor associated with WMH. CONCLUSIONS: CCM demonstrates corneal nerve pathology, which is associated with the presence of WMH in participants with acute ischemic stroke. CCM may be a useful surrogate imaging marker for the presence and severity of WMHs.
PURPOSE: The presence of white matter hyperintensities (WMH) on MRI imaging confers an increased risk of stroke, dementia, and death. Corneal confocal microscopy (CCM) can detect nerve injury non-invasively and may be a useful surrogate marker for WMH. The objective is to determine whether corneal nerve pathology identified using CCM is associated with the presence of WMH in patients with acute ischemic stroke. METHODS: This is a cross-sectional study where 196 consecutive individuals with acute ischemic stroke were enrolled and underwent neurological examination, MRI brain imaging and CCM. Participants underwent blinded quantification of WMH and corneal nerve fiber density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fiber length (CNFL). RESULTS: The prevalence of hypertension [P = .013] was significantly higher and CNFD [P = .031] was significantly lower in patients with WMH compared to those without WMH. CNFD and CNFL were significantly lower in patients with DM without WMH [P = .008, P = .019] and in patients with DM and WMH [P = .042, P = .024] compared to patients without DM or WMH, respectively. In a multivariate model, a 1-unit decrease in the CNFD increased the risk of WMH by 6%, after adjusting for age, DM, gender, dyslipidemia, metabolic syndrome, smoking, and HbA1c. DM was associated with a decrease in all CCM parameters but was not a significant independent factor associated with WMH. CONCLUSIONS: CCM demonstrates corneal nerve pathology, which is associated with the presence of WMH in participants with acute ischemic stroke. CCM may be a useful surrogate imaging marker for the presence and severity of WMHs.
Authors: Gulfidan Bitirgen; Zehra Akpinar; Ali Ulvi Uca; Ahmet Ozkagnici; Ioannis N Petropoulos; Rayaz A Malik Journal: Transl Vis Sci Technol Date: 2020-12-21 Impact factor: 3.283
Authors: Adnan Khan; Ajay Menon; Naveed Akhtar; Saadat Kamran; Ahmad Muhammad; Georgios Ponirakis; Hoda Gad; Ioannis N Petropoulos; Faisal Wadiwala; Blessy Babu; Adeeb M Narangoli; Pablo G Bermejo; Hanadi Al Hamad; Marwan Ramadan; Peter Woodruff; Mark Santos; Maher Saqqur; Ashfaq Shuaib; Rayaz A Malik Journal: Sci Rep Date: 2021-10-05 Impact factor: 4.379
Authors: Ioannis N Petropoulos; Gulfidan Bitirgen; Maryam Ferdousi; Alise Kalteniece; Shazli Azmi; Luca D'Onofrio; Sze Hway Lim; Georgios Ponirakis; Adnan Khan; Hoda Gad; Ibrahim Mohammed; Yacob E Mohammadi; Ayesha Malik; David Gosal; Christopher Kobylecki; Monty Silverdale; Handrean Soran; Uazman Alam; Rayaz A Malik Journal: Front Pain Res (Lausanne) Date: 2021-08-19