Publications by authors named "Dixon Yang"
Article Synopsis
- The study examines how diet patterns relate to the risk of intracranial atherosclerosis (ICAD) in people with existing hypertension or a history of myocardial infarction.
- A total of 676 older adults were autopsied, and none showed a direct link between overall diet and atherosclerosis, though hypertension was found to increase the risk of ICAD.
- Notably, individuals with a healthier diet (like the MIND or Mediterranean diet) had lower chances of severe ICAD, especially among those with a history of myocardial infarction.
Introduction: Intracranial atherosclerotic disease (ICAD) of the large cerebral arteries, a leading cause of stroke worldwide, is increasingly implicated in cognitive impairment and neurodegeneration among the general population; however, the underlying pathophysiologic mechanisms in this relationship remain unknown.
Methods: In this narrative review, we aim to provide an overview of the epidemiology and pathophysiology of ICAD, the evidence that relates ICAD to neurodegeneration, putative mechanisms, and future research directions. We synthesized available evidence on PubMed up to August 2024.
Article Synopsis
- Intracranial atherosclerotic disease (ICAD) is a leading cause of stroke, particularly affecting East Asian and non-White populations more than those of European descent.
- ICAD not only raises the risk of stroke but also contributes to dementia and cognitive decline, with a notably high recurrence rate of over 20% for those with severe stenosis (≥70%).
- Diagnosis primarily involves lumen-based imaging techniques, although newer methods like high-resolution vessel wall MRI may improve the identification of ICAD compared to other artery conditions.
Background: Inflammation contributes to atherosclerosis but is incompletely characterized in intracranial large artery stenosis (ICAS). We hypothesized that immune markers would be associated with ICAS and modify the risk ICAS confers on future vascular events.
Methods: This study included a subsample of stroke-free participants in the prospective NOMAS (Northern Manhattan Study), who had blood samples analyzed with a 60-plex immunoassay (collected from 1993 to 2001) and ICAS assessment with time-of-flight magnetic resonance angiography (obtained from 2003 to 2008).
Mediterranean-style diet and intracranial large artery stenosis in the Northern Manhattan Study.
J Stroke Cerebrovasc Dis
October 2023
Objectives: Given Mediterranean-style diet (MeDi) reduces risk of cardiovascular events, we hypothesized MeDi may also be protective against intracranial large artery stenosis (ICAS), a common cause of stroke worldwide.
Methods: This cross-sectional study included stroke-free participants of the Northern Manhattan Study, a diverse population-based study of stroke risk factors. We represented MeDi continuously (range 0-8) based on enrollment food frequency questionnaires, excluding alcohol consumption.
Current perspectives on the clinical management of cryptogenic stroke.
Expert Rev Neurother
March 2023
Article Synopsis
- - Cryptogenic stroke is an ischemic stroke with no identified cause, making up about 25% of all ischemic strokes, which poses challenges for secondary prevention strategies.
- - The review highlights various classification systems for stroke types, diagnostic methods, potential mechanisms behind cryptogenic strokes, and their treatment implications based on research available until December 2022.
- - Ongoing research aims to improve diagnosis and identify specific subgroups within cryptogenic strokes that could be targeted for therapy, with advancements in technology potentially helping to clarify unknown causes.
Background: We examined the association between asymptomatic intracranial artery stenosis (aICAS) and cortical thickness using brain magnetic resonance morphometry in two cohorts.
Methods: This cross-sectional study included stroke-free participants from the Northern Manhattan Study (NOMAS) and the National Alzheimer's Coordinating Center (NACC). We represented the predictor aICAS in NOMAS as a continuous global stenosis score reflecting an overall burden of stenosis (possible range 0-44) assessed by magnetic resonance angiography and in NACC as a dichotomous autopsy-determined Circle of Willis (CoW) atherosclerosis (none-mild vs moderate-severe).
Background: Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort.
Methods: This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment.
Background: Limited data exists evaluating predictors of long-term outcomes after hospitalization for COVID-19.
Methods: We conducted a prospective, longitudinal cohort study of patients hospitalized for COVID-19. The following outcomes were collected at 6 and 12-months post-diagnosis: disability using the modified Rankin Scale (mRS), activities of daily living assessed with the Barthel Index, cognition assessed with the telephone Montreal Cognitive Assessment (t-MoCA), Neuro-QoL batteries for anxiety, depression, fatigue and sleep, and post-acute symptoms of COVID-19.
Article Synopsis
- Post-acute sequelae of COVID-19 (PASC) affects around 50% of patients, leading to a variety of symptoms that may persist for up to a year after infection.
- Researchers conducted a study with 242 hospitalized COVID-19 patients to categorize symptoms and identify effective treatment strategies using cluster analysis and logistic regression.
- Three distinct symptom groups emerged: Cluster1 (few symptoms), Cluster2 (many symptoms with high anxiety/depression), and Cluster3 (breathing and cognitive issues), with Cluster2 requiring the most interventions and showing the worst outcomes.
This scientific commentary refers to 'Vessel wall magnetic resonance and arterial spin labelling imaging in the management of presumed inflammatory intracranial arterial vasculopathy', by Benjamin et al. (https://doi.org/10.
View Article and Find Full Text PDFIntroduction: Alzheimer's disease (AD) and cerebral small vessel disease (CVSD) both contribute to age-related cognitive decline but can be difficult to clinically distinguish at early stages. At mild cognitive impairment (MCI), we investigated brain MRI volumetric differences in white matter hyperintensities (WMH), frontal and temporal lobe volumes between neuropathologically defined groups of cerebral arteriolosclerosis alone (pARTE), AD alone (pAD), and mixed (ADARTE).
Methods: From the National Alzheimer's Coordinating Center, we defined neuropathology groups of pARTE ( = 18), pAD ( = 36), and ADARTE ( = 55) who had MRI brain volumetrics within 1 year of clinical evaluation with Clinical Dementia Rating score of 0.
Background And Objective: Little is known about trajectories of recovery 12 months after hospitalization for severe COVID-19.
Methods: We conducted a prospective, longitudinal cohort study of patients with and without neurologic complications during index hospitalization for COVID-19 from March 10, 2020, to May 20, 2020. Phone follow-up batteries were performed at 6 and 12 months after COVID-19 onset.
Introduction: Genetic and imaging studies demonstrate a link between vascular morphology and migraine with aura (MA). We examined the relationship between basilar artery (BA) curvature and MA in a population-based cohort of stroke-free participants.
Methods: This cross-sectional study included participants from the MRI substudy of the Northern Manhattan Study.
Lacunar stroke is a marker of cerebral small vessel disease and accounts for up to 25% of ischaemic stroke. In this narrative review, we provide an overview of potential lacunar stroke mechanisms and discuss therapeutic implications based on the underlying mechanism. For this paper, we reviewed the literature from important studies (randomised trials, exploratory comparative studies and case series) on lacunar stroke patients with a focus on more recent studies highlighting mechanisms and stroke prevention strategies in patients with lacunar stroke.
View Article and Find Full Text PDFArticle Synopsis
- A study was conducted to analyze the long-term outcomes, specifically 6-month results, of patients who were hospitalized for COVID-19, particularly focusing on those who experienced neurological complications during their stay.
- Out of 606 patients with neurological issues, 395 survived and were compared to a matched group without such complications; results showed that 91% had at least one abnormal outcome six months later, including difficulties with daily activities, cognition, and mental health.
- Patients with neurological complications had worse functional outcomes, indicating they were less likely to return to normal activities and had greater impairments compared to the control group, highlighting the severe impact of neurological issues following COVID-19 hospitalization.
Background And Purpose: Hospital 30-day readmissions in patients with primary neurological problems are not well characterized. We sought to determine patient characteristics associated with readmission across 3 different inpatient neurology services at New York University Langone Hospital.
Methods: We retrospectively reviewed all 30-day readmissions from the General Neurology, Epilepsy, and Stroke services at NYULH Brooklyn and Manhattan campuses from 2016-2017 and compared them to a random sample of non-readmitted neurology patients.
Objective: To determine the prevalence and associated mortality of well-defined neurologic diagnoses among patients with coronavirus disease 2019 (COVID-19), we prospectively followed hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients and recorded new neurologic disorders and hospital outcomes.
Methods: We conducted a prospective, multicenter, observational study of consecutive hospitalized adults in the New York City metropolitan area with laboratory-confirmed SARS-CoV-2 infection. The prevalence of new neurologic disorders (as diagnosed by a neurologist) was recorded and in-hospital mortality and discharge disposition were compared between patients with COVID-19 with and without neurologic disorders.
Objective: We sought to evaluate early clinical differences between cerebral arteriolosclerosis (pARTE), Alzheimer disease (pAD), and AD with arteriolosclerosis (ADARTE).
Methods: Using National Alzheimer's Coordinating Center neuropathology diagnoses, we defined pARTE (n=21), pAD (n=203), and ADARTE (n=158) groups. We compared demographics, medical history, psychometrics, neuropsychiatric symptoms, and apolipoprotein E (APOE) allele variants across neuropathology groups.
Study Objectives: We sought to evaluate cerebral hemodynamics in obstructive sleep apnea (OSA) and actigraphy-defined short sleep duration using transcranial Doppler ultrasound (TCD) blood flow velocity in a subsample of Hispanics/Latinos without stroke and cardiovascular disease.
Methods: The sample consisted of consecutive participants at the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with overnight home sleep testing and 7 days of wrist actigraphy in the Sueño sleep ancillary study. Ninety-five participants had sleep data and TCD determined cerebral hemodynamics.
Objectives: We sought to describe the relationship between age, sex, and race/ethnicity with transcranial Doppler hemodynamic characteristics from major intracerebral arterial segments in a large elderly population with varying demographics.
Methods: We analyzed 369 stroke-free participants aged 70 years and older from the Einstein Aging Study. Single-gate, nonimaging transcranial Doppler sonography, a noninvasive sonographic technique that assesses real-time cerebrovascular hemodynamics, was used to interrogate 9 cerebral arterial segments.
Background: We sought to determine the association between cigarette smoking and carotid plaque ultrasound morphology in a multiethnic cohort.
Methods: We analyzed 1,743 stroke-free participants (mean age 65.5 ± 8.