Gina Rodrigues de Oliveira, Tamires Morett Gama, Lucas Rego Ramos, Marcos Fabio DosSantos
Background and Purpose
Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, hypersensitivity, and cognitive impairments. Alterations in brain functional connectivity have been suggested as possible mechanisms underlying pain amplification in these patients. This study aimed to investigate patterns of brain functional connectivity in patients with FM using resting-state functional magnetic resonance imaging.
Methods
Data were obtained from the public OpenNeuro repository and acquired on a 3 Tesla scanner. The sample consisted of 33 women with a clinical diagnosis of FM (x̅ = 41.73 ± 6.09 years) and 33 age-matched healthy controls (x̅ = 41.52 ± 6.03 years), with no significant differences in age (p = 0.89) or education level (p = 0.81). Images were processed and analyzed using independent component analysis. Between-group comparisons were corrected for multiple comparisons using false discovery rate (FDR) correction (p < 0.05).
Results
Patients with FM showed a significant reduction in functional connectivity within the right sensorimotor network (SMN) compared to controls (p-FDR < 0.05). Moreover, a negative correlation was observed between connectivity in this network and the sensory dimension of pain assessed by the McGill Pain Questionnaire (r = −0.35; p = 0.05).
Conclusion
The reduced functional connectivity within the SMN may represent a neurobiological marker of FM, reflecting dysfunctions in sensorimotor integration and central modulation of pain. These findings support the hypothesis that FM involves functional brain alterations related to pain perception and amplification.
{"title":"Disrupted Sensorimotor Network Integration in Women With Fibromyalgia Revealed by Resting-State Functional MRI","authors":"Gina Rodrigues de Oliveira, Tamires Morett Gama, Lucas Rego Ramos, Marcos Fabio DosSantos","doi":"10.1111/jon.70118","DOIUrl":"10.1111/jon.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, hypersensitivity, and cognitive impairments. Alterations in brain functional connectivity have been suggested as possible mechanisms underlying pain amplification in these patients. This study aimed to investigate patterns of brain functional connectivity in patients with FM using resting-state functional magnetic resonance imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were obtained from the public OpenNeuro repository and acquired on a 3 Tesla scanner. The sample consisted of 33 women with a clinical diagnosis of FM (<i>x̅</i> = 41.73 ± 6.09 years) and 33 age-matched healthy controls (<i>x̅</i> = 41.52 ± 6.03 years), with no significant differences in age (<i>p</i> = 0.89) or education level (<i>p</i> = 0.81). Images were processed and analyzed using independent component analysis. Between-group comparisons were corrected for multiple comparisons using false discovery rate (FDR) correction (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with FM showed a significant reduction in functional connectivity within the right sensorimotor network (SMN) compared to controls (<i>p</i>-FDR < 0.05). Moreover, a negative correlation was observed between connectivity in this network and the sensory dimension of pain assessed by the McGill Pain Questionnaire (<i>r</i> = −0.35; <i>p</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The reduced functional connectivity within the SMN may represent a neurobiological marker of FM, reflecting dysfunctions in sensorimotor integration and central modulation of pain. These findings support the hypothesis that FM involves functional brain alterations related to pain perception and amplification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"36 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944562","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}
Christopher Steward, Vijay Venkatraman, Victoria Mercy Kataike, Peter J. Mitchell, Bruce C. V. Campbell, Patricia M. Desmond, Felix Ng
Background and Purpose
Diffusion-weighted imaging (DWI) is the gold standard for assessing ischemic core in acute stroke but may overestimate irreversible injury due to its assumption of Gaussian diffusion. Diffusion kurtosis imaging (DKI), which accounts for non-Gaussian water diffusion, may provide more accurate tissue characterization. Most prior studies examined DWI and DKI within 24 h or up to 1 month after stroke, but very few have captured both an ultra-early (e.g., 3-h) postreperfusion and a subacute (24–72 h) imaging window in the same population. This study compared DWI and DKI for measuring ischemic core evolution after reperfusion.
Methods
Fifty-two patients with anterior circulation large vessel occlusion stroke underwent endovascular thrombectomy and were imaged with both DWI and DKI at <3 h and again at 24–72 h postreperfusion in a prospective multicenter longitudinal cohort study. Lesion volumes for DWI and DKI were manually segmented to derive a mismatch between DWI and DKI, and reversal between the two time points. Diffusion metrics (apparent diffusion coefficient [ADC] and mean kurtosis [MK]) within regions of interest were also analyzed.
Results
DKI lesion volumes were significantly smaller than DWI at both time points (DWI 11.1 mL vs. DKI 8.5 mL, p = 0.007 at 3 h, and DWI 27.9 mL vs. DKI 19.3 mL, p = 0.002 at 24–72 h), with both increasing significantly over time. DKI(+ve)–DWI(-ve) mismatch regions showed higher ADC and lower MK, indicating less severe injury. The percentage amount of lesion that reversed in relation to the entire infarct was similar for both modalities (DWI: 15.9%, DKI: 12.4%, p > 0.05).
Conclusion
DKI offers additional information to DWI for identifying irreversibly injured tissue in acute stroke, with smaller lesion volumes and further information on tissue microstructure that reversed. These findings suggest DKI may enhance ischemic core assessment and help guide treatment decisions after reperfusion therapy.
背景与目的：弥散加权成像（DWI）是评估急性脑卒中缺血性核心的金标准，但由于其假设为高斯弥散，可能会高估不可逆损伤。扩散峰度成像（DKI），它解释了非高斯水扩散，可以提供更准确的组织表征。大多数先前的研究在卒中后24小时或1个月内检查DWI和DKI，但很少有研究在同一人群中同时捕获超早期（例如，灌注后3小时）和亚急性（24-72小时）成像窗口。本研究比较了DWI和DKI对再灌注后缺血核心演变的测量。方法：52例前循环大血管闭塞性卒中患者行血管内取栓术，并在2个时间点同时行DWI和DKI成像。结果：DKI病变体积在两个时间点均明显小于DWI (3 h时DWI 11.1 mL vs DKI 8.5 mL, p = 0.007； 24-72 h时DWI 27.9 mL vs DKI 19.3 mL, p = 0.002)，且随时间推移两者均显著增加。DKI(+ve)-DWI（-ve）失配区ADC较高，MK较低，说明损伤程度较轻。两种方式的病变逆转百分比与整个梗死区相似（DWI: 15.9%, DKI: 12.4%, p < 0.05）。结论：DKI为DWI识别急性卒中不可逆损伤组织提供了额外的信息，病变体积更小，组织微观结构的进一步信息相反。这些发现表明DKI可以增强缺血核心评估，并有助于指导再灌注治疗后的治疗决策。
{"title":"Diffusion Kurtosis Shows a Smaller Ischemic Core Versus Diffusion-Weighted MR in Early or Subacute Post-Thrombectomy Stroke","authors":"Christopher Steward, Vijay Venkatraman, Victoria Mercy Kataike, Peter J. Mitchell, Bruce C. V. Campbell, Patricia M. Desmond, Felix Ng","doi":"10.1111/jon.70114","DOIUrl":"10.1111/jon.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Diffusion-weighted imaging (DWI) is the gold standard for assessing ischemic core in acute stroke but may overestimate irreversible injury due to its assumption of Gaussian diffusion. Diffusion kurtosis imaging (DKI), which accounts for non-Gaussian water diffusion, may provide more accurate tissue characterization. Most prior studies examined DWI and DKI within 24 h or up to 1 month after stroke, but very few have captured both an ultra-early (e.g., 3-h) postreperfusion and a subacute (24–72 h) imaging window in the same population. This study compared DWI and DKI for measuring ischemic core evolution after reperfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-two patients with anterior circulation large vessel occlusion stroke underwent endovascular thrombectomy and were imaged with both DWI and DKI at <3 h and again at 24–72 h postreperfusion in a prospective multicenter longitudinal cohort study. Lesion volumes for DWI and DKI were manually segmented to derive a mismatch between DWI and DKI, and reversal between the two time points. Diffusion metrics (apparent diffusion coefficient [ADC] and mean kurtosis [MK]) within regions of interest were also analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DKI lesion volumes were significantly smaller than DWI at both time points (DWI 11.1 mL vs. DKI 8.5 mL, <i>p</i> = 0.007 at 3 h, and DWI 27.9 mL vs. DKI 19.3 mL, <i>p</i> = 0.002 at 24–72 h), with both increasing significantly over time. DKI(+ve)–DWI(-ve) mismatch regions showed higher ADC and lower MK, indicating less severe injury. The percentage amount of lesion that reversed in relation to the entire infarct was similar for both modalities (DWI: 15.9%, DKI: 12.4%, <i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DKI offers additional information to DWI for identifying irreversibly injured tissue in acute stroke, with smaller lesion volumes and further information on tissue microstructure that reversed. These findings suggest DKI may enhance ischemic core assessment and help guide treatment decisions after reperfusion therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794045","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}
Sheryl L. Foster, Ramon Landin-Romero, Sarah Lewis, Mayuresh S. Korgaonkar
Background and Purpose
Amygdala dysfunction is implicated in major depressive disorder. Despite wide acknowledgement of its heterogeneity, the amygdala is predominantly considered as a single entity and functional connectivity investigations have reported findings using standard or low spatial resolution functional MRI data. This study compared the capabilities of two high spatial resolution acquisition strategies, the gold standard 2D and a novel 3D, in identifying amygdala functional connectivity to other brain regions at a subregional level.
Methods
Resting state fMRI data were acquired at 3T in 10 healthy controls using both versions of a Gradient-Echo Echo Planar Imaging (GRE-EPI) sequence. Whole brain voxel-wise functional connectivity measures were calculated using the whole amygdala and six subregional seed regions-of-interest; left and right basolateral, centromedial and superficial.
Results
The 3D data identified multiple stronger bilateral connections between both centromedial subregions, most notably to subcortical structures including brainstem and hippocampus, as well as intra-amygdala subregional connections. The 2D data displayed stronger connections to several cortical regions. Whole amygdala and subregional FC results differed.
Conclusions
This study identified underutilized capability in current fMRI acquisition techniques at 3T. 2D GRE-EPI sequences optimized for high spatial resolution with voxel volumes of 15.6 mm3 capably demonstrate functional connectivity patterns of the amygdala at a subregional level, allowing interrogation of heterogeneous amygdala function at a more granular level. The novel 3D acquisition with voxel volumes of 8 mm3 showed promise in outperforming its 2D counterpart in identifying amygdala subregional connections to other subcortical structures that are traditionally difficult to image well.
{"title":"Subregional Amygdala Functional Connectivity at 3T: Comparison of High-Resolution 2D and 3D fMRI Acquisitions","authors":"Sheryl L. Foster, Ramon Landin-Romero, Sarah Lewis, Mayuresh S. Korgaonkar","doi":"10.1111/jon.70110","DOIUrl":"10.1111/jon.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Amygdala dysfunction is implicated in major depressive disorder. Despite wide acknowledgement of its heterogeneity, the amygdala is predominantly considered as a single entity and functional connectivity investigations have reported findings using standard or low spatial resolution functional MRI data. This study compared the capabilities of two high spatial resolution acquisition strategies, the gold standard 2D and a novel 3D, in identifying amygdala functional connectivity to other brain regions at a subregional level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Resting state fMRI data were acquired at 3T in 10 healthy controls using both versions of a Gradient-Echo Echo Planar Imaging (GRE-EPI) sequence. Whole brain voxel-wise functional connectivity measures were calculated using the whole amygdala and six subregional seed regions-of-interest; left and right basolateral, centromedial and superficial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 3D data identified multiple stronger bilateral connections between both centromedial subregions, most notably to subcortical structures including brainstem and hippocampus, as well as intra-amygdala subregional connections. The 2D data displayed stronger connections to several cortical regions. Whole amygdala and subregional FC results differed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified underutilized capability in current fMRI acquisition techniques at 3T. 2D GRE-EPI sequences optimized for high spatial resolution with voxel volumes of 15.6 mm<sup>3</sup> capably demonstrate functional connectivity patterns of the amygdala at a subregional level, allowing interrogation of heterogeneous amygdala function at a more granular level. The novel 3D acquisition with voxel volumes of 8 mm<sup>3</sup> showed promise in outperforming its 2D counterpart in identifying amygdala subregional connections to other subcortical structures that are traditionally difficult to image well.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 6","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768287","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}
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}
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