Anushree Burade, Dhairya A. Lakhani, Richard Dagher, John Anosh, Haris I. Sair, Licia P. Luna
Background and Purpose
Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra pars compacta (SNc) and locus coeruleus (LC). Although initially developed for Parkinson's disease (PD), evidence supports broader utility. This narrative review highlights the diagnostic and prognostic applications of NM-MRI in PD, atypical parkinsonian syndromes, spinocerebellar ataxias (SCA), and Alzheimer's disease (AD), while evaluating methodological heterogeneity, diagnostic performance across diseases, and directions for clinical implementation.
Results
In PD, reduced SNc volume and contrast-to-noise ratio (CNR) correlate with motor symptom severity. Early-stage PD shows lateral SNc signal attenuation progressing ventromedially with disease advancement. NM-MRI sensitivity and specificity range from 70%–92% to 65%–89%, respectively, with higher accuracy at 7T. In progressive supranuclear palsy (PSP), SNc degeneration is more pronounced medially; LC contrast ratio (CR) is elevated compared to PD. In multiple system atrophy (MSA), LC signal attenuation is particularly marked in the parkinsonian subtype (MSA-P). NM-MRI findings in SCA (notably SCA2 and SCA7) vary by genotype; AD is characterized by reduction in the middle and caudal segments of LC, reflecting early tau pathology. NM-MRI LC signal reduction variably correlates with cognitive scores and Braak staging, suggesting potential as a preclinical biomarker.
Conclusion
NM-MRI holds promise for early diagnosis and monitoring of neurodegenerative diseases. While its role in PD is well established, emerging data in PSP, MSA, SCA, and AD suggest wider applicability. Standardization, multimodal imaging integration, and machine learning are critical for clinical translation.
{"title":"Beyond Parkinson's Disease: A Narrative Review of Neuromelanin MRI in Neurodegenerative Diseases","authors":"Anushree Burade, Dhairya A. Lakhani, Richard Dagher, John Anosh, Haris I. Sair, Licia P. Luna","doi":"10.1111/jon.70113","DOIUrl":"10.1111/jon.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra pars compacta (SNc) and locus coeruleus (LC). Although initially developed for Parkinson's disease (PD), evidence supports broader utility. This narrative review highlights the diagnostic and prognostic applications of NM-MRI in PD, atypical parkinsonian syndromes, spinocerebellar ataxias (SCA), and Alzheimer's disease (AD), while evaluating methodological heterogeneity, diagnostic performance across diseases, and directions for clinical implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In PD, reduced SNc volume and contrast-to-noise ratio (CNR) correlate with motor symptom severity. Early-stage PD shows lateral SNc signal attenuation progressing ventromedially with disease advancement. NM-MRI sensitivity and specificity range from 70%–92% to 65%–89%, respectively, with higher accuracy at 7T. In progressive supranuclear palsy (PSP), SNc degeneration is more pronounced medially; LC contrast ratio (CR) is elevated compared to PD. In multiple system atrophy (MSA), LC signal attenuation is particularly marked in the parkinsonian subtype (MSA-P). NM-MRI findings in SCA (notably SCA2 and SCA7) vary by genotype; AD is characterized by reduction in the middle and caudal segments of LC, reflecting early tau pathology. NM-MRI LC signal reduction variably correlates with cognitive scores and Braak staging, suggesting potential as a preclinical biomarker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NM-MRI holds promise for early diagnosis and monitoring of neurodegenerative diseases. While its role in PD is well established, emerging data in PSP, MSA, SCA, and AD suggest wider applicability. Standardization, multimodal imaging integration, and machine learning are critical for clinical translation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Livja Mertiri, Maarten Lequin, Andrea Rossi, Chen Hoffmann, Thierry A. G. M. Huisman
Neurodegeneration with brain iron accumulation (NBIA) refers to a group of rare genetic disorders characterized by abnormal iron deposition in the basal ganglia and brainstem due to impaired iron homeostasis. Disease severity and manifestations vary according to the underlying genetic mutation and age of presentation; however, most subtypes share progressive neurological features such as dystonia, Parkinsonism, spasticity, cognitive decline, and intellectual disability.
In this review, we first outline the physiological role of iron in the central nervous system, emphasizing its importance for neurotransmitter synthesis, myelination, and mitochondrial metabolism, and discuss how disruption of homeostatic mechanisms may lead to ferroptosis and neuronal injury. We then explore the role of neuroimaging in the diagnosis of NBIA, with a focus on MRI as the modality of choice. Finally, we provide an overview of the clinical and imaging features of the major NBIA subtypes, highlighting both shared characteristics and distinctive patterns. Covered NBIA include primary disorders of iron metabolism, such as neuroferritinopathy and aceruloplasminemia, and secondary disorders with disrupted iron regulation, including Pantothenate Kinase-Associated Neurodegeneration, Phospholipase A2 Group VI-Associated Neurodegeneration, Mitochondrial Membrane Protein-Associated Neurodegeneration, Beta-Propeller Protein-Associated Neurodegeneration, Fatty Acid Hydroxylase-Associated Neurodegeneration, Coenzyme A Synthetase Protein-Associated Neurodegeneration, Woodhouse–Sakati syndrome, and Kufor–Rakeb Disease. By integrating genetics, pathophysiology, and imaging, this review aims to improve recognition of NBIA and support comprehensive clinical management.
神经变性伴脑铁积累（Neurodegeneration with brain iron accumulation， NBIA）是指一组罕见的遗传性疾病，其特征是铁稳态受损导致基底节区和脑干的铁沉积异常。疾病的严重程度和表现因潜在的基因突变和发病年龄而异；然而，大多数亚型具有进行性神经学特征，如肌张力障碍、帕金森症、痉挛、认知能力下降和智力残疾。在这篇综述中，我们首先概述了铁在中枢神经系统中的生理作用，强调了它在神经递质合成、髓鞘形成和线粒体代谢中的重要性，并讨论了体内平衡机制的破坏如何导致铁中毒和神经元损伤。然后，我们探讨了神经影像学在NBIA诊断中的作用，重点是MRI作为选择的方式。最后，我们概述了NBIA主要亚型的临床和影像学特征，强调了它们的共同特征和独特模式。涵盖的NBIA包括铁代谢的原发性疾病，如神经铁蛋白病和乙酰纤溶酶血症，以及铁调节紊乱的继发性疾病，包括泛酸激酶相关神经变性、磷脂酶A2组vi相关神经变性、线粒体膜蛋白相关神经变性、β - propeller蛋白相关神经变性、脂肪酸羟化酶相关神经变性、辅酶A合成酶蛋白相关神经变性、Woodhouse-Sakati综合征和Kufor-Rakeb病。通过整合遗传学、病理生理学和影像学，本综述旨在提高对NBIA的认识，并为全面的临床管理提供支持。
{"title":"Neurodegeneration With Brain Iron Accumulation and Ferroptosis Disorders in Children and Adults: An Imaging Review","authors":"Livja Mertiri, Maarten Lequin, Andrea Rossi, Chen Hoffmann, Thierry A. G. M. Huisman","doi":"10.1111/jon.70112","DOIUrl":"10.1111/jon.70112","url":null,"abstract":"<div>\u0000 \u0000 <p>Neurodegeneration with brain iron accumulation (NBIA) refers to a group of rare genetic disorders characterized by abnormal iron deposition in the basal ganglia and brainstem due to impaired iron homeostasis. Disease severity and manifestations vary according to the underlying genetic mutation and age of presentation; however, most subtypes share progressive neurological features such as dystonia, Parkinsonism, spasticity, cognitive decline, and intellectual disability.</p>\u0000 <p>In this review, we first outline the physiological role of iron in the central nervous system, emphasizing its importance for neurotransmitter synthesis, myelination, and mitochondrial metabolism, and discuss how disruption of homeostatic mechanisms may lead to ferroptosis and neuronal injury. We then explore the role of neuroimaging in the diagnosis of NBIA, with a focus on MRI as the modality of choice. Finally, we provide an overview of the clinical and imaging features of the major NBIA subtypes, highlighting both shared characteristics and distinctive patterns. Covered NBIA include primary disorders of iron metabolism, such as neuroferritinopathy and aceruloplasminemia, and secondary disorders with disrupted iron regulation, including Pantothenate Kinase-Associated Neurodegeneration, Phospholipase A2 Group VI-Associated Neurodegeneration, Mitochondrial Membrane Protein-Associated Neurodegeneration, Beta-Propeller Protein-Associated Neurodegeneration, Fatty Acid Hydroxylase-Associated Neurodegeneration, Coenzyme A Synthetase Protein-Associated Neurodegeneration, Woodhouse–Sakati syndrome, and Kufor–Rakeb Disease. By integrating genetics, pathophysiology, and imaging, this review aims to improve recognition of NBIA and support comprehensive clinical management.</p>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josep Puig, Guillem Dolz, Mariano Werner, Pepus Daunis-i-Estadella, Marc Comas-Cufí, Alejandro Tomasello, Eva González, Xabier Manso del Caño, Pedro Vega, Eduardo Murias, Isabel Bravo, Elvira Jiménez, Fernando Aparici-Robles, Juan Manuel Sanchís, Sebastià Remollo, Carlos Castaño, Manuel Moreu, Alfonso López-Frías, Mikel Terceño, Yolanda Silva, Óscar Chirife, Antonio López-Rueda, Javier Martínez-Fernández, José Carlos Méndez, Antonio Sagredo, José Díaz-Pérez, Víctor Cuba, José Carlos Llibre, Yeray Aguilar, Luis SanRoman, Jordi Blasco, ROSSETTI Group
Background and Purpose
Guidelines recommend stent retrievers (SRs) for treating large vessel occlusion (LVO) stroke. We assessed noninferiority of the iNtercept (iVascular) SR with a self-expanding basket on a pusher wire versus contemporary SRs (CSRs) using propensity score (PS) matching analysis.
Methods
We analyzed data from the ROSSETTI multicenter registry of patients with anterior circulation LVO to compare procedural (recanalization rates according to the modified Thrombolysis In Cerebral Infarction (mTICI) score and procedural complications), clinical (modified Rankin Scale at 90 days), and safety (symptomatic intracranial hemorrhage, mortality at 90 days) outcomes of patients treated with iNtercept or CSRs (Solitaire, Trevo, and EmboTrap) as a first-line strategy, with or without balloon-guide catheter (BGC + SR, BCG − SR) after PS matching. Non-inferiority of iNtercept was established if the prespecified lower bound of the 95% confidence interval was over −10%.
Results
A total of 164 and 132 patients treated first-line by iNtercept were matched to 656 and 132 patients treated first-line by CSR + BGC and CSR − BGC, respectively. After matching, successful reperfusion (mTICI2b/3) after first-line strategy was achieved in 53.7% and 54.8% in the iNtercept versus CSR + BGC groups, respectively (absolute difference, −0.1%), and 53.8% and 51.3% in the iNtercept versus CSR − BGC, respectively (2.6%). Final reperfusion rates and favorable 90-day outcomes were similar. iNtercept had fewer sICH, procedural complications, and emboli in a new territory than CSR + BGC, and fewer procedural complications than CSR − BGC.
Conclusions
This multicenter registry with PS matching demonstrated the non-inferiority of iNtercept to approved CSRs for successful reperfusion in LVO acute ischemic stroke.
{"title":"New Stent Retriever Technology Versus Standard Devices for Anterior Large Vessel Thrombectomy: A Multicenter Study","authors":"Josep Puig, Guillem Dolz, Mariano Werner, Pepus Daunis-i-Estadella, Marc Comas-Cufí, Alejandro Tomasello, Eva González, Xabier Manso del Caño, Pedro Vega, Eduardo Murias, Isabel Bravo, Elvira Jiménez, Fernando Aparici-Robles, Juan Manuel Sanchís, Sebastià Remollo, Carlos Castaño, Manuel Moreu, Alfonso López-Frías, Mikel Terceño, Yolanda Silva, Óscar Chirife, Antonio López-Rueda, Javier Martínez-Fernández, José Carlos Méndez, Antonio Sagredo, José Díaz-Pérez, Víctor Cuba, José Carlos Llibre, Yeray Aguilar, Luis SanRoman, Jordi Blasco, ROSSETTI Group","doi":"10.1111/jon.70111","DOIUrl":"https://doi.org/10.1111/jon.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Guidelines recommend stent retrievers (SRs) for treating large vessel occlusion (LVO) stroke. We assessed noninferiority of the iNtercept (iVascular) SR with a self-expanding basket on a pusher wire versus contemporary SRs (CSRs) using propensity score (PS) matching analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the ROSSETTI multicenter registry of patients with anterior circulation LVO to compare procedural (recanalization rates according to the modified Thrombolysis In Cerebral Infarction (mTICI) score and procedural complications), clinical (modified Rankin Scale at 90 days), and safety (symptomatic intracranial hemorrhage, mortality at 90 days) outcomes of patients treated with iNtercept or CSRs (Solitaire, Trevo, and EmboTrap) as a first-line strategy, with or without balloon-guide catheter (BGC + SR, BCG − SR) after PS matching. Non-inferiority of iNtercept was established if the prespecified lower bound of the 95% confidence interval was over −10%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 164 and 132 patients treated first-line by iNtercept were matched to 656 and 132 patients treated first-line by CSR + BGC and CSR − BGC, respectively. After matching, successful reperfusion (mTICI2b/3) after first-line strategy was achieved in 53.7% and 54.8% in the iNtercept versus CSR + BGC groups, respectively (absolute difference, −0.1%), and 53.8% and 51.3% in the iNtercept versus CSR − BGC, respectively (2.6%). Final reperfusion rates and favorable 90-day outcomes were similar. iNtercept had fewer sICH, procedural complications, and emboli in a new territory than CSR + BGC, and fewer procedural complications than CSR − BGC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This multicenter registry with PS matching demonstrated the non-inferiority of iNtercept to approved CSRs for successful reperfusion in LVO acute ischemic stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Colin P. Galvin, Ben Phan, Leo Zekelman, Mark Vangel, Mary Beth Anketell, Erickson Torio, Alexandra J. Golby, Frederic Racicot
Background and Purpose
Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that primarily affects older adults and is typically characterized clinically by a triad of symptoms: gait disturbance, urinary urgency or incontinence, and cognitive decline. The relationship between clinical presentation and iNPH imaging biomarkers remains unclear, as does the ability of these markers to predict outcomes following cerebrospinal fluid diversion. Additionally, the association between fecal incontinence (FI) and iNPH, as well as the relationship between FI and iNPH imaging biomarkers, is poorly understood.
Methods
A retrospective review was conducted on 125 consecutive iNPH patients treated by a single surgeon at Brigham and Women's Hospital between 2015 and 2023. Patients were treated with the placement of a ventriculoperitoneal (VP) shunt. Patient demographics, symptoms, and clinical improvement were recorded at 3 and 12 months post-shunt placement. Imaging biomarkers, including Evans Index (EI), callosal angle (CA), anteroposterior diameter of the lateral ventricle index (ALVI), and disproportionately enlarged subarachnoid space hydrocephalus score, were measured using preoperative imaging.
Results
Of 125 patients (mean age 74.8 years, 71 males), 124 presented with gait disturbance, 113 with urinary dysfunction, and 111 with cognitive decline. FI was present in 24 patients. Patients with preoperative FI had higher EI and ALVI. Patients with improved FI at 3-month follow-up had larger CA. Patients with improved gait at 12-month follow-up had smaller EI and ALVI scores. Patients with preoperative urinary symptoms had a higher EI.
Conclusions
Imaging biomarkers can have both diagnostic utility and predictive potential for outcomes related to specific symptoms following CSF diversion with VP shunts.
{"title":"Imaging Biomarkers in Idiopathic Normal Pressure Hydrocephalus: Associations With Symptoms and 1-Year Treatment Outcomes","authors":"Colin P. Galvin, Ben Phan, Leo Zekelman, Mark Vangel, Mary Beth Anketell, Erickson Torio, Alexandra J. Golby, Frederic Racicot","doi":"10.1111/jon.70109","DOIUrl":"https://doi.org/10.1111/jon.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that primarily affects older adults and is typically characterized clinically by a triad of symptoms: gait disturbance, urinary urgency or incontinence, and cognitive decline. The relationship between clinical presentation and iNPH imaging biomarkers remains unclear, as does the ability of these markers to predict outcomes following cerebrospinal fluid diversion. Additionally, the association between fecal incontinence (FI) and iNPH, as well as the relationship between FI and iNPH imaging biomarkers, is poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted on 125 consecutive iNPH patients treated by a single surgeon at Brigham and Women's Hospital between 2015 and 2023. Patients were treated with the placement of a ventriculoperitoneal (VP) shunt. Patient demographics, symptoms, and clinical improvement were recorded at 3 and 12 months post-shunt placement. Imaging biomarkers, including Evans Index (EI), callosal angle (CA), anteroposterior diameter of the lateral ventricle index (ALVI), and disproportionately enlarged subarachnoid space hydrocephalus score, were measured using preoperative imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 125 patients (mean age 74.8 years, 71 males), 124 presented with gait disturbance, 113 with urinary dysfunction, and 111 with cognitive decline. FI was present in 24 patients. Patients with preoperative FI had higher EI and ALVI. Patients with improved FI at 3-month follow-up had larger CA. Patients with improved gait at 12-month follow-up had smaller EI and ALVI scores. Patients with preoperative urinary symptoms had a higher EI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Imaging biomarkers can have both diagnostic utility and predictive potential for outcomes related to specific symptoms following CSF diversion with VP shunts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lenka Novakova, Igal Rosenstein, Markus Axelsson, Russell Ouellette
Background and Purpose
Synthetic (Sy) MRI is a clinically approved technique providing quantitative MRI measures based on T1-weighted, T2-weighted, and proton density relaxometry. MRI sequences are often acquired after contrast injection with gadolinium (Gd) to assess active lesions in persons with multiple sclerosis (PwMS), affecting relaxation time. We aimed to assess the influence of Gd on the SyMRI-based volumetrics in PwMS.
Methods
We enrolled 106 PwMS and 15 controls who performed pre-/post-contrast brain SyMRI on a 3T scanner. We evaluated mean change in brain parenchymal fraction (BPF), white matter (WM), grey matter (GM), myelin (Myl), non-aqueous component (NAC), excess parenchymal water (EPW), and T1 enhancement (T1E) using paired sample t-test for pre-/post-Gd volumes and independent sample t-test for comparison between groups.
Results
The mean age was 40.9 and 39.9 years with 69% and 87% females in MS and controls, respectively. Compared to native volumetrics, Gd caused a significant observed volume increase (p < 0.001) in BPF 1.05 ± 0.3%, WM 2.8 ± 0.99%, Myl 1.42 ± 0.39%, NAC 1.04 ± 0.23%, and EPW 0.6 ± 0.4% and decrease in GM −3.05 ± 1.34% in MS. Similar change was seen in controls: BPF 0.99 ± 0.21%, WM 2.94 ± 0.93%, Myl 1.35 ± 0.37%, NAC 0.99 ± 0.22%, EPW 0.47 ± 0.29%, and GM −2.89 ± 1.18%. The change in T1E was 0.05 ± 0.12% in MS (p < 0.001) and 0.02 ± 0.25% (p = 0.76) in controls. The number of contrast-enhancing lesions correlated with T1E (r = 0.348, p < 0.003).
Conclusion
There was a consistent pattern of volume changes in PwMS and controls, except for T1E, where the contrast could have affected the results in PwMS. Therefore, combining pre- and post-contrast metrics in longitudinal studies should be interpreted with caution.
{"title":"The Effect of Gadolinium on Synthetic Magnetic Resonance Quantitative Imaging","authors":"Lenka Novakova, Igal Rosenstein, Markus Axelsson, Russell Ouellette","doi":"10.1111/jon.70104","DOIUrl":"10.1111/jon.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Synthetic (Sy) MRI is a clinically approved technique providing quantitative MRI measures based on T<sub>1</sub>-weighted, T<sub>2</sub>-weighted, and proton density relaxometry. MRI sequences are often acquired after contrast injection with gadolinium (Gd) to assess active lesions in persons with multiple sclerosis (PwMS), affecting relaxation time. We aimed to assess the influence of Gd on the SyMRI-based volumetrics in PwMS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 106 PwMS and 15 controls who performed pre-/post-contrast brain SyMRI on a 3T scanner. We evaluated mean change in brain parenchymal fraction (BPF), white matter (WM), grey matter (GM), myelin (Myl), non-aqueous component (NAC), excess parenchymal water (EPW), and T<sub>1</sub> enhancement (T<sub>1</sub>E) using paired sample <i>t</i>-test for pre-/post-Gd volumes and independent sample <i>t</i>-test for comparison between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 40.9 and 39.9 years with 69% and 87% females in MS and controls, respectively. Compared to native volumetrics, Gd caused a significant observed volume increase (<i>p</i> < 0.001) in BPF 1.05 ± 0.3%, WM 2.8 ± 0.99%, Myl 1.42 ± 0.39%, NAC 1.04 ± 0.23%, and EPW 0.6 ± 0.4% and decrease in GM −3.05 ± 1.34% in MS. Similar change was seen in controls: BPF 0.99 ± 0.21%, WM 2.94 ± 0.93%, Myl 1.35 ± 0.37%, NAC 0.99 ± 0.22%, EPW 0.47 ± 0.29%, and GM −2.89 ± 1.18%. The change in T<sub>1</sub>E was 0.05 ± 0.12% in MS (<i>p</i> < 0.001) and 0.02 ± 0.25% (<i>p</i> = 0.76) in controls. The number of contrast-enhancing lesions correlated with T<sub>1</sub>E (<i>r</i> = 0.348, <i>p</i> < 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was a consistent pattern of volume changes in PwMS and controls, except for T<sub>1</sub>E, where the contrast could have affected the results in PwMS. Therefore, combining pre- and post-contrast metrics in longitudinal studies should be interpreted with caution.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12623708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brandon Ojogho, Aidin Abedi, Darrin J. Lee, Xingfeng Shao, Jonathan Russin, Kay Jann, Charles Y. Liu, Danny J. J. Wang
Background and Purpose
Cranioplasty reconstruction after hemicraniectomy restores skull integrity and has been associated with neurological improvement, but the physiological mechanisms underlying recovery remain incompletely understood. This study investigated cerebral blood flow (CBF), arterial transit time (ATT), and blood–brain barrier (BBB) water exchange rate (Kw) as imaging metrics of hemodynamic recovery following cranioplasty.
Methods
Fourteen patients (mean age: 33.4 ± 8.53 years; 2 females, 12 males) who previously underwent hemicraniectomy for traumatic brain injury, ruptured aneurysm, or hemorrhagic stroke were included. All participants underwent diffusion-prepared pseudo-continuous arterial spin labeling (DP-pCASL) Magnetic Resonance Imaging (MRI) at 3 Tesla before and after cranioplasty. Hemodynamic parameters were quantified globally and regionally, with particular focus on the middle cerebral artery perforator (MCA Perf) territory.
Results
Post-surgical imaging revealed significant increases in CBF within the ipsilateral MCA Perf territory compared to pre-surgical values. BBB Kw asymmetry between MCA Perf territories also improved, indicating enhanced perfusion and BBB function in the impacted hemisphere. ATT changes were region-specific, with significant increases in asymmetry observed in the leptomeningeal anterior cerebral artery and posterior cerebral artery territories, but not in the MCA Perf region.
Conclusions
These findings underscore the mechanobiological role of cranioplasty reconstruction in neurological recovery. Advanced hemodynamic imaging with DP-pCASL MRI provides quantitative insight into cerebral perfusion, BBB function, and regional perfusion timing. This approach may guide future research on post-cranioplasty recovery and inform personalized rehabilitation strategies.
{"title":"Cerebral Perfusion and Blood−Brain Barrier Changes After Cranioplasty: A Diffusion-Prepared Arterial Spin Labeling Study","authors":"Brandon Ojogho, Aidin Abedi, Darrin J. Lee, Xingfeng Shao, Jonathan Russin, Kay Jann, Charles Y. Liu, Danny J. J. Wang","doi":"10.1111/jon.70106","DOIUrl":"https://doi.org/10.1111/jon.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Cranioplasty reconstruction after hemicraniectomy restores skull integrity and has been associated with neurological improvement, but the physiological mechanisms underlying recovery remain incompletely understood. This study investigated cerebral blood flow (CBF), arterial transit time (ATT), and blood–brain barrier (BBB) water exchange rate (Kw) as imaging metrics of hemodynamic recovery following cranioplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen patients (mean age: 33.4 ± 8.53 years; 2 females, 12 males) who previously underwent hemicraniectomy for traumatic brain injury, ruptured aneurysm, or hemorrhagic stroke were included. All participants underwent diffusion-prepared pseudo-continuous arterial spin labeling (DP-pCASL) Magnetic Resonance Imaging (MRI) at 3 Tesla before and after cranioplasty. Hemodynamic parameters were quantified globally and regionally, with particular focus on the middle cerebral artery perforator (MCA Perf) territory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-surgical imaging revealed significant increases in CBF within the ipsilateral MCA Perf territory compared to pre-surgical values. BBB Kw asymmetry between MCA Perf territories also improved, indicating enhanced perfusion and BBB function in the impacted hemisphere. ATT changes were region-specific, with significant increases in asymmetry observed in the leptomeningeal anterior cerebral artery and posterior cerebral artery territories, but not in the MCA Perf region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings underscore the mechanobiological role of cranioplasty reconstruction in neurological recovery. Advanced hemodynamic imaging with DP-pCASL MRI provides quantitative insight into cerebral perfusion, BBB function, and regional perfusion timing. This approach may guide future research on post-cranioplasty recovery and inform personalized rehabilitation strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145522050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Hoffmann, Miriam Reichert, Jens Göttler, Michael Helle, Lena Schmitzer, Moritz Hernandez Petzsche, Claus Zimmer, Christine Preibisch, Michael Kallmayer, Kornelia Kreiser, Nico Sollmann, Hans Liebl, Stephan Kaczmarz
Background and Purpose
Individualized diagnostic approaches are crucial in cerebrovascular diseases, such as internal carotid artery stenosis (ICAS). To evaluate individual collateral blood supply, vessel-selective imaging has gained high relevance. However, clinically established digital subtraction angiography (DSA) exposes patients to intervention risks and radiation. Two noninvasive MRI-based alternatives are super-selective pseudo-continuous arterial spin labeling (ss-pCASL, a technique for selective labeling of arterial blood-water) for perfusion territory mapping and four-dimensional vessel-selective angiography (4D-sPACK). We hypothesized that asymptomatic atherosclerosis-induced ICAS and Moyamoya disease result in chronic malperfusion. Therefore, we aimed towards quantitative assessment of collateral blood flow by ss-pCASL.
Methods
In this prospective monocentric study, we acquired data in three subgroups (n = 23): patients with asymptomatic unilateral atherosclerosis-induced ICAS, Moyamoya disease, and age-matched healthy controls (HCs). On the basis of vascular territories from ss-pCASL, we introduced four parameters: volume, territorial shift, overlap with an atlas, and cerebral blood flow (CBF). For patients with atherosclerosis-induced ICAS, ipsi- and contralateral hemispheres were compared (paired t-test), and hemispheric lateralization Δ was calculated subjectwise and compared between patients and HCs (unpaired t-test) (p < 0.05).
Results
We included data from 20 subjects (8 ICAS, 3 Moyamoya, 9 HC). Group-level results showed ICAS-induced shifts with significant lateralization compared to HCs (ΔVolume,ICAS = 18% ± 10%, p < 0.001; ΔShift,ICAS = 4.9% ± 5.8%, p = 0.027; ΔOverlap,ICAS = 0.2 ± 0.3, p = 0.033, ΔCBF,ICAS = 3 ± 3 mL/100 g/min, p = 0.045). Furthermore, collateral blood supply in Moyamoya disease was assessed by 4D-sPACK and showed comparable diagnostic value as DSA.
Conclusion
Perfusion territory mapping by ss-pCASL revealed chronic malperfusion in asymptomatic ICAS that can be objectively quantified, and 4D-sPACK added diagnostic value similar to DSA.
{"title":"Perfusion Territory Shifts in Cerebrovascular Diseases Measured by Super-Selective Arterial Spin Labeling","authors":"Gabriel Hoffmann, Miriam Reichert, Jens Göttler, Michael Helle, Lena Schmitzer, Moritz Hernandez Petzsche, Claus Zimmer, Christine Preibisch, Michael Kallmayer, Kornelia Kreiser, Nico Sollmann, Hans Liebl, Stephan Kaczmarz","doi":"10.1111/jon.70101","DOIUrl":"10.1111/jon.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Individualized diagnostic approaches are crucial in cerebrovascular diseases, such as internal carotid artery stenosis (ICAS). To evaluate individual collateral blood supply, vessel-selective imaging has gained high relevance. However, clinically established digital subtraction angiography (DSA) exposes patients to intervention risks and radiation. Two noninvasive MRI-based alternatives are super-selective pseudo-continuous arterial spin labeling (ss-pCASL, a technique for selective labeling of arterial blood-water) for perfusion territory mapping and four-dimensional vessel-selective angiography (4D-sPACK). We hypothesized that asymptomatic atherosclerosis-induced ICAS and Moyamoya disease result in chronic malperfusion. Therefore, we aimed towards quantitative assessment of collateral blood flow by ss-pCASL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective monocentric study, we acquired data in three subgroups (<i>n</i> = 23): patients with asymptomatic unilateral atherosclerosis-induced ICAS, Moyamoya disease, and age-matched healthy controls (HCs). On the basis of vascular territories from ss-pCASL, we introduced four parameters: volume, territorial shift, overlap with an atlas, and cerebral blood flow (CBF). For patients with atherosclerosis-induced ICAS, ipsi- and contralateral hemispheres were compared (paired <i>t</i>-test), and hemispheric lateralization <i>Δ</i> was calculated subjectwise and compared between patients and HCs (unpaired <i>t</i>-test) (<i>p </i>< 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included data from 20 subjects (8 ICAS, 3 Moyamoya, 9 HC). Group-level results showed ICAS-induced shifts with significant lateralization compared to HCs (<i>Δ</i><sub>Volume,ICAS</sub> = 18% ± 10%, <i>p </i>< 0.001; <i>Δ</i><sub>Shift,ICAS</sub> = 4.9% ± 5.8%, <i>p</i> = 0.027; <i>Δ</i><sub>Overlap,ICAS</sub> = 0.2 ± 0.3, <i>p</i> = 0.033, <i>Δ</i><sub>CBF,ICAS</sub> = 3 ± 3 mL/100 g/min, <i>p</i> = 0.045). Furthermore, collateral blood supply in Moyamoya disease was assessed by 4D-sPACK and showed comparable diagnostic value as DSA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Perfusion territory mapping by ss-pCASL revealed chronic malperfusion in asymptomatic ICAS that can be objectively quantified, and 4D-sPACK added diagnostic value similar to DSA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tereza Kopřivová, Marek Dostál, Tomáš Jůza, Václav Vybíhal, Petra Ovesná, Michal Kozubek, Miloš Keřkovský
Background and Purpose
To evaluate feasibility of multi-b value diffusion magnetic resonance imaging (MRI) and volumetry in differentiating between brain metastases and high-grade gliomas (HGGs) while producing a differentiation tool.
Methods
Preoperative brain MRI consisting of both morphological and multi-b value diffusion sequences of patients with HGGs and brain metastases was prospectively performed. Three-dimensional masks of enhancing and non-enhancing tumor and surrounding edema were semiautomatically segmented. Multiple diffusion parameters were subsequently derived together with volumes of the particular tissues. Histogram analysis of the diffusion parameters was performed, and the parameters’ diagnostic power to differentiate between the subgroups was evaluated by receiver operating characteristic analysis and least absolute shrinkage and selection operator (LASSO) regression method.
Results
A training dataset included 97 consecutive patients (67 HGGs, 30 metastases), whereas 17 patients (9 HGGs and 8 metastases) comprised a validation group. Overall, 66 histogram diffusion parameters and tissue volumes were found to differ significantly between metastasis and HGG subgroups. LASSO regression identified 17 of these as best predictors. A decision tree using four parameters achieved sensitivity of 90% and 87.5% and specificity of 97% and 77.8% for the training and validation subgroups, respectively.
Conclusion
Multi-b diffusion MRI and tumor volumetry may be valuable diagnostic tools for differentiating HGG from brain metastasis.
{"title":"Differentiating Brain Metastasis and High-Grade Glioma Using Multi-b Value Diffusion MRI and Tumor Volumetry","authors":"Tereza Kopřivová, Marek Dostál, Tomáš Jůza, Václav Vybíhal, Petra Ovesná, Michal Kozubek, Miloš Keřkovský","doi":"10.1111/jon.70103","DOIUrl":"10.1111/jon.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>To evaluate feasibility of multi-<i>b</i> value diffusion magnetic resonance imaging (MRI) and volumetry in differentiating between brain metastases and high-grade gliomas (HGGs) while producing a differentiation tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Preoperative brain MRI consisting of both morphological and multi-<i>b</i> value diffusion sequences of patients with HGGs and brain metastases was prospectively performed. Three-dimensional masks of enhancing and non-enhancing tumor and surrounding edema were semiautomatically segmented. Multiple diffusion parameters were subsequently derived together with volumes of the particular tissues. Histogram analysis of the diffusion parameters was performed, and the parameters’ diagnostic power to differentiate between the subgroups was evaluated by receiver operating characteristic analysis and least absolute shrinkage and selection operator (LASSO) regression method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A training dataset included 97 consecutive patients (67 HGGs, 30 metastases), whereas 17 patients (9 HGGs and 8 metastases) comprised a validation group. Overall, 66 histogram diffusion parameters and tissue volumes were found to differ significantly between metastasis and HGG subgroups. LASSO regression identified 17 of these as best predictors. A decision tree using four parameters achieved sensitivity of 90% and 87.5% and specificity of 97% and 77.8% for the training and validation subgroups, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multi-<i>b</i> diffusion MRI and tumor volumetry may be valuable diagnostic tools for differentiating HGG from brain metastasis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gerhard S. Drenthen, Dennis Kool, Amir Far, Jaymin Upadhyay, David E. J. Linden, Raquel van Gool, Celine P. Goijen, Ingemar S. J. Merkies, Walter H. Backes, Catharina G. Faber, Jacobus F. A. Jansen, Janneke G. J. Hoeijmakers
Background and Purpose
Small fiber neuropathy (SFN) is a neuropathic disorder that is associated with chronic pain. While most SFN cases are idiopathic, SFN can also have hereditary causes. For example, rare SCN9A gene mutations can impair the NaV1.7 sodium channel, which leads to dorsal root ganglion neuron hyperexcitability, causing SFN. Although chronic pain may induce cerebral changes, the specific structural brain alterations in SCN9A-associated SFN (SFN-SCN9A) remain insufficiently characterized. Therefore, potential alterations in the structural brain network of idiopathic SFN and SFN-SCN9A were explored.
Methods
Ten SFN-SCN9A patients, 20 idiopathic SFN patients, and 20 controls were included. All participants underwent 3-Tesla diffusion MRI (66 gradient directions, b-value = 1200 s/mm2), and the brain network was quantified using nodal importance, which describes the influence of a group of regions on the whole network.
Results
The nodal importance of pain-associated regions (postcentral gyrus, insular cortex, anterior cingulate cortex, and thalamus) was increased in SFN-SCN9A patients compared to controls (β = 0.43, p = 0.02) and idiopathic SFN patients (β = 0.43, p = 0.02). Moreover, higher self-reported pain was associated with higher nodal importance of pain-associated regions in the SFN-SCN9A group (r = 0.67, p = 0.03), while this effect was not observed in the idiopathic SFN patients (r = −0.22, p = 0.34). As self-reported pain did not differ between the SFN groups, it is likely specific to the SCN9A-mutation and not to differences in pain intensity.
Conclusion
Combined, these results suggest the potential involvement of a distinct structural pathway related to pain processing in SFN-SCN9A.
背景和目的：小纤维神经病（SFN）是一种与慢性疼痛相关的神经性疾病。虽然大多数SFN病例是特发性的，但SFN也可能有遗传原因。如罕见的SCN9A基因突变可损害NaV1.7钠通道，导致背根神经节神经元高兴奋性，引起SFN。尽管慢性疼痛可能会引起大脑的变化，但scn9a相关的SFN （SFN- scn9a）的特异性脑结构改变仍然没有充分的特征。因此，我们探索特发性SFN和SFN- scn9a的脑结构网络的潜在改变。方法：选取SFN- scn9a患者10例，特发性SFN患者20例，对照组20例。所有参与者都进行了3-Tesla扩散MRI(66个梯度方向，b值= 1200 s/mm2)，并使用节点重要性来量化脑网络，节点重要性描述了一组区域对整个网络的影响。结果：与对照组（β = 0.43, p = 0.02）和特发性SFN患者（β = 0.43, p = 0.02）相比，SFN- scn9a患者疼痛相关区域（中央后回、岛叶皮质、前扣带皮层和丘脑）的结重要性增加。此外，在SFN- scn9a组中，较高的自我报告疼痛与较高的疼痛相关区域的淋巴结重要性相关（r = 0.67, p = 0.03），而在特发性SFN患者中没有观察到这种影响（r = -0.22, p = 0.34）。由于自我报告的疼痛在SFN组之间没有差异，这可能是scn9a突变所特有的，而不是疼痛强度的差异。结论：综上所述，这些结果提示SFN-SCN9A可能参与了一个与疼痛加工相关的独特结构通路。
{"title":"Diffusion Tensor Imaging Reveals Altered Centrality of Pain-Related Regions in SCN9A-Associated Small Fiber Neuropathy","authors":"Gerhard S. Drenthen, Dennis Kool, Amir Far, Jaymin Upadhyay, David E. J. Linden, Raquel van Gool, Celine P. Goijen, Ingemar S. J. Merkies, Walter H. Backes, Catharina G. Faber, Jacobus F. A. Jansen, Janneke G. J. Hoeijmakers","doi":"10.1111/jon.70105","DOIUrl":"10.1111/jon.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Small fiber neuropathy (SFN) is a neuropathic disorder that is associated with chronic pain. While most SFN cases are idiopathic, SFN can also have hereditary causes. For example, rare SCN9A gene mutations can impair the Na<sub>V</sub>1.7 sodium channel, which leads to dorsal root ganglion neuron hyperexcitability, causing SFN. Although chronic pain may induce cerebral changes, the specific structural brain alterations in SCN9A-associated SFN (SFN-SCN9A) remain insufficiently characterized. Therefore, potential alterations in the structural brain network of idiopathic SFN and SFN-SCN9A were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten SFN-SCN9A patients, 20 idiopathic SFN patients, and 20 controls were included. All participants underwent 3-Tesla diffusion MRI (66 gradient directions, <i>b</i>-value = 1200 s/mm<sup>2</sup>), and the brain network was quantified using nodal importance, which describes the influence of a group of regions on the whole network.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The nodal importance of pain-associated regions (postcentral gyrus, insular cortex, anterior cingulate cortex, and thalamus) was increased in SFN-SCN9A patients compared to controls (<i>β</i> = 0.43, <i>p</i> = 0.02) and idiopathic SFN patients (<i>β</i> = 0.43, <i>p</i> = 0.02). Moreover, higher self-reported pain was associated with higher nodal importance of pain-associated regions in the SFN-SCN9A group (<i>r</i> = 0.67, <i>p</i> = 0.03), while this effect was not observed in the idiopathic SFN patients (<i>r</i> = −0.22, <i>p</i> = 0.34). As self-reported pain did not differ between the SFN groups, it is likely specific to the SCN9A-mutation and not to differences in pain intensity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined, these results suggest the potential involvement of a distinct structural pathway related to pain processing in SFN-SCN9A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyma Alcicek, Georg Oeltzschner, Doris D. M. Lin, Peter B. Barker
Background and Purpose
In in vivo magnetic resonance spectroscopy (MRS) of the brain, glycine (Gly) is traditionally separated from the overlapping signal of myo-inositol (mI) through the use of intermediate (e.g., 130–140 ms) or long (270–280 ms) echo times (TE). However, no quantitative comparisons have been performed to date comparing the performance of clinically available MRS sequences to differentiate mI and Gly as a function of TE.
Methods
In vivo spectra recorded with two clinically available MRS pulse sequences (single voxel PRESS and semi-LASER 2D-MRSI) with short (35 ms), intermediate (135 ms), and long (280 ms) echo times in a neonate with clinically suspected nonketotic hyperglycinemia were compared to those recorded from phantoms, and spectral simulations.
Results
In vivo spectra recorded at short and intermediate TE spectra showed signals at 3.5 ppm that could arise from either mI or Gly; however, long TE spectra showed an absence of signal in this spectral region, which was consistent with the final clinical diagnosis of hypoxic-ischemic encephalopathy. Phantom data and spectral simulations demonstrated that at intermediate TE, mI has a “pseudo-singlet” appearance that is very similar to that of Gly.
Conclusions
Long echo times are used to best discriminate Gly from mI if specialized sequences and analysis methods are not available. Quantitative spectral analysis methods may also assist in correctly assigning Gly and mI.
{"title":"Distinguishing Myo-Inositol From Glycine in Brain MRS at 3T: A Pitfall Using Intermediate Echo Times","authors":"Seyma Alcicek, Georg Oeltzschner, Doris D. M. Lin, Peter B. Barker","doi":"10.1111/jon.70107","DOIUrl":"10.1111/jon.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>In in vivo magnetic resonance spectroscopy (MRS) of the brain, glycine (Gly) is traditionally separated from the overlapping signal of <i>myo</i>-inositol (mI) through the use of intermediate (e.g., 130–140 ms) or long (270–280 ms) echo times (TE). However, no quantitative comparisons have been performed to date comparing the performance of clinically available MRS sequences to differentiate mI and Gly as a function of TE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In vivo spectra recorded with two clinically available MRS pulse sequences (single voxel PRESS and semi-LASER 2D-MRSI) with short (35 ms), intermediate (135 ms), and long (280 ms) echo times in a neonate with clinically suspected nonketotic hyperglycinemia were compared to those recorded from phantoms, and spectral simulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In vivo spectra recorded at short and intermediate TE spectra showed signals at 3.5 ppm that could arise from either mI or Gly; however, long TE spectra showed an absence of signal in this spectral region, which was consistent with the final clinical diagnosis of hypoxic-ischemic encephalopathy. Phantom data and spectral simulations demonstrated that at intermediate TE, mI has a “pseudo-singlet” appearance that is very similar to that of Gly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long echo times are used to best discriminate Gly from mI if specialized sequences and analysis methods are not available. Quantitative spectral analysis methods may also assist in correctly assigning Gly and mI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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