Ultrasound Evaluation of Internal Jugular Venous Insufficiency and Its Association with Cognitive Decline
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Clinical Assessments
2.3. Color-Coded Duplex Ultrasonography
2.4. IJV Drainage Determination
2.5. Cognitive Function Assessment
2.6. Statistical Analysis
3. Results
3.1. Baseline Clinical Characteristics of Impaired Cognition and Control Group
3.2. IJV Flow Velocity and Drainage Between Impaired Cognition and Control Group
3.3. Comparison of Neuropsychological Tests Between Impaired IJV Drainage and Control Group
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
IJV | Internal jugular vein. |
AD | Alzheimer’s disease. |
JVR | Jugular venous reflux. |
VM | Valsalva maneuvers. |
MCI | Mild cognitive impairment. |
BMI | Body mass index. |
DM | Diabetes mellitus. |
CKD | Chronic kidney disease. |
TAMV | Time-averaged mean velocity. |
CSA | Cross-sectional area. |
CCA | Common carotid artery. |
ICA | Internal carotid artery. |
VA | Vertebral artery. |
MCA | Middle cerebral artery. |
MMSE | Mini-Mental State Examination. |
MoCA | Montreal Cognitive Assessment. |
CVVLT | Chinese Version of the Verbal Learning Test. |
IQR | Interquartile range. |
OR | Odds ratio. |
CI | Confidence interval. |
PI | Pulsatility index. |
TS | Transverse sinus. |
BFV | Blood flow volume. |
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All | Cognitive Impairment | Normal Cognition | p-Value | |
---|---|---|---|---|
n = 106 | n = 50 | n = 56 | ||
Age (years old) | 71.5 ± 8.0 | 73.4 ± 7.0 | 69.8 ± 8.5 | 0.0503 |
Gender (F/M) | 67/39 | 33/17 | 34/22 | 0.3732 |
Education (years) | 13.1 ± 3.8 | 11.3 ± 4.5 | 14.4 ± 2.9 | 0.0003 * |
BMI (kg/m2) | 24.3 ± 3.2 | 23.9 ± 3.1 | 24.7 ± 3.2 | 0.2195 |
Hypertension (%) | 51 (48%) | 22 (44%) | 29 (52%) | 0.4232 |
DM (%) | 20 (19%) | 12 (24%) | 8 (14%) | 0.2019 |
Dyslipidemia (%) | 42 (40%) | 14 (29%) | 28 (50%) | 0.0208 * |
CKD (%) | 4 (4%) | 1 (2%) | 3 (5%) | 0.3652 |
Thyroid dysfunction(%) | 15 (14%) | 7 (14%) | 8 (14%) | 0.9664 |
History of stroke (%) | 11(10%) | 4 (8%) | 7 (13%) | 0.4482 |
History of MI (%) | 1 (1%) | 0 | 1 (2%) | 0.3424 |
MoCA | 24.3 ± 3.4 | 21.1 ± 2.4 | 26.9 ± 1.4 | <0.0001 * |
MMSE | 27.6 ± 2.1 | 26.2 ± 1.9 | 28.9 ± 1.2 | <0.0001 * |
TAMV, cm/s | Cognitive Impairment (n = 50) No. (%) | Normal Cognition (n = 56) No. (%) | p-Value |
---|---|---|---|
LJ2 < 4 cm/s | 17 (34%) | 14 (25%) | 0.3092 |
LJ3 < 4 cm/s | 17 (34%) | 10 (18%) | 0.0569 |
RJ2 < 4 cm/s | 5 (10%) | 5 (9%) | 0.8342 |
RJ3 < 4 cm/s | 6 (12%) | 1 (2%) | 0.0321 |
LVV < 0.05 cm/s | 11 (22%) | 14 (26%) | 0.6397 |
RVV < 0.05 cm/s | 7 (15%) | 8 (15%) | 0.9425 |
LJ2 and LJ3 < 4 cm/s | 15 (30%) | 8 (14%) | 0.0501 |
RJ2 and RJ3 < 4 cm/s | 4 (8%) | 1 (2%) | 0.1319 |
Impaired outflow * | 17 (34%) | 9 (16%) | 0.0322 |
CSA collapse ** | |||
LJ2 | 18 (36%) | 13 (23%) | 0.1486 |
RJ2 | 10 (20%) | 6 (11%) | 0.1825 |
Impaired IJVD *** | 34 (68%) | 17 (30%) | 0.0001 |
Univariate Analysis | Multivariate Analysis # | |||||
---|---|---|---|---|---|---|
OR | 95% CI | p-Value | OR | 95% CI | p-Value | |
Age | 2.46 | 1.02~5.92 | 0.0445 | 1.07 | 1.00~1.13 | 0.0394 |
Education | 0.79 | 0.70~0.90 | 0.0002 | 0.76 | 0.67~0.88 | 0.0001 |
MCA PI | 12.35 | 1.12~136.5 | 0.0403 | |||
Dyslipidemia | 0.39 | 0.17~0.87 | 0.022 | |||
Impaired IJVD | 2.78 | 1.00~7.71 | 0.0495 | 3.84 | 1.33~11.09 | 0.0130 |
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Yin, J.-H.; Chi, N.-F.; Sheng, W.-Y.; Wang, P.-N.; Sung, Y.-F.; Peng, G.-S.; Hu, H.-H. Ultrasound Evaluation of Internal Jugular Venous Insufficiency and Its Association with Cognitive Decline. Diagnostics 2025, 15, 1427. https://doi.org/10.3390/diagnostics15111427
Yin J-H, Chi N-F, Sheng W-Y, Wang P-N, Sung Y-F, Peng G-S, Hu H-H. Ultrasound Evaluation of Internal Jugular Venous Insufficiency and Its Association with Cognitive Decline. Diagnostics. 2025; 15(11):1427. https://doi.org/10.3390/diagnostics15111427
Chicago/Turabian StyleYin, Jiu-Haw, Nai-Fang Chi, Wen-Yung Sheng, Pei-Ning Wang, Yueh-Feng Sung, Giia-Sheun Peng, and Han-Hwa Hu. 2025. "Ultrasound Evaluation of Internal Jugular Venous Insufficiency and Its Association with Cognitive Decline" Diagnostics 15, no. 11: 1427. https://doi.org/10.3390/diagnostics15111427
APA StyleYin, J.-H., Chi, N.-F., Sheng, W.-Y., Wang, P.-N., Sung, Y.-F., Peng, G.-S., & Hu, H.-H. (2025). Ultrasound Evaluation of Internal Jugular Venous Insufficiency and Its Association with Cognitive Decline. Diagnostics, 15(11), 1427. https://doi.org/10.3390/diagnostics15111427