Yongwoo Kim, Alexander Kim, Josef D. Williams, Charles Withington, Eshetu Tefera, Samrawit Gizaw, Daniel R. Felbaum, Jeffrey C. Mai, Ai-Hsi Liu, Rocco A. Armonda, Jason J. Chang
Background and Purpose
While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.
Methods
In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures. Using a previously reported mathematical model, we estimated ΔP by dividing pulse pressure by PI. We investigated the association between ΔP and mCBFV values and two acute phase complications of SAH—DCI and angiographic vasospasm. Additionally, we explored the association between DCI, vasospasm, and 90-day functional outcome.
Results
Elevated ΔP was associated with DCI (odds ratio [OR] 1.021, 95% confidence interval [CI] 1.004–1.039, p = 0.014) but not vasospasm (OR 1.006, 95% CI 0.991–1.022, p = 0.402). Elevated mCBFV was associated with vasospasm (OR 1.037, 95% CI 1.017–1.057, p < 0.001) but not DCI (OR 0.998, 95% CI 0.979–1.018, p = 0.873). DCI (OR 29.380, 95% CI 2.930–294.615, p = 0.004), rather than vasospasm (OR 0.695, 95% CI 0.120–4.043, p = 0.686), was associated with functional outcome.
Conclusions
Increased ΔP, rather than elevated mCBFV, was associated with DCI. While elevated mCBFV was associated with vasospasm, it was not associated with DCI. Hence, TCD-estimated ΔP may serve as a predictor for the DCI in SAH patients, a condition that impacts long-term outcome.
背景和目的：虽然经颅多普勒（TCD）测量的搏动指数（PI）与神经重症监护的结果有更广泛的关联，但其在动脉瘤性蛛网膜下腔出血（SAH）患者延迟性脑梗死（DCI）监测中的应用并未得到现行临床指南的认可。鉴于动脉压阶差（ΔP）可通过 PI 估算，我们对 TCD 估算的ΔP 的潜在意义进行了研究：在这项针对 186 名 SAH 患者的观察性研究中，我们记录了大脑中动脉的平均脑血流速度（mCBFV）和 PI 值以及相应的血压。我们使用以前报告过的数学模型，通过脉压除以 PI 来估算 ΔP。我们研究了ΔP和mCBFV值与SAH-DCI和血管痉挛两种急性期并发症之间的关联。此外，我们还探讨了DCI、血管痉挛和90天功能预后之间的关联：结果：ΔP 升高与 DCI 相关（几率比 [OR] 1.021，95% 置信区间 [CI] 1.004-1.039，P = 0.014），但与血管痉挛无关（OR 1.006，95% CI 0.991-1.022，P = 0.402）。mCBFV 升高与血管痉挛有关（OR 1.037，95% CI 1.017-1.057，p 结论：mCBFV 升高与血管痉挛无关：与 DCI 相关的是ΔP 升高，而不是 mCBFV 升高。虽然 mCBFV 升高与血管痉挛有关，但与 DCI 无关。因此，TCD估计的ΔP可作为SAH患者DCI的预测指标，这种情况会影响长期预后。
{"title":"Transcranial Doppler Arterial Pressure Gradient Is Associated With Delayed Infarction After Subarachnoid Hemorrhage","authors":"Yongwoo Kim, Alexander Kim, Josef D. Williams, Charles Withington, Eshetu Tefera, Samrawit Gizaw, Daniel R. Felbaum, Jeffrey C. Mai, Ai-Hsi Liu, Rocco A. Armonda, Jason J. Chang","doi":"10.1111/jon.70010","DOIUrl":"10.1111/jon.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (Δ<i>P</i>) can be estimated using PI, we investigated the potential significance of TCD-estimated Δ<i>P</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures. Using a previously reported mathematical model, we estimated Δ<i>P</i> by dividing pulse pressure by PI. We investigated the association between Δ<i>P</i> and mCBFV values and two acute phase complications of SAH—DCI and angiographic vasospasm. Additionally, we explored the association between DCI, vasospasm, and 90-day functional outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Elevated Δ<i>P</i> was associated with DCI (odds ratio [OR] 1.021, 95% confidence interval [CI] 1.004–1.039, <i>p</i> = 0.014) but not vasospasm (OR 1.006, 95% CI 0.991–1.022, <i>p</i> = 0.402). Elevated mCBFV was associated with vasospasm (OR 1.037, 95% CI 1.017–1.057, <i>p</i> < 0.001) but not DCI (OR 0.998, 95% CI 0.979–1.018, <i>p</i> = 0.873). DCI (OR 29.380, 95% CI 2.930–294.615, <i>p</i> = 0.004), rather than vasospasm (OR 0.695, 95% CI 0.120–4.043, <i>p</i> = 0.686), was associated with functional outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Increased Δ<i>P</i>, rather than elevated mCBFV, was associated with DCI. While elevated mCBFV was associated with vasospasm, it was not associated with DCI. Hence, TCD-estimated Δ<i>P</i> may serve as a predictor for the DCI in SAH patients, a condition that impacts long-term outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971272","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}
Josep Puig, Mariano Werner, Guillem Dolz, Alejandro Pascagaza, Pepus Daunis-i-Estadella, Marc Comas-Cufí, Eva González, Jon Fondevila, Pedro Vega, Eduardo Murias, Veredas Romero, Carlos Martínez, Fernando Aparici-Robles, Lluis Morales-Caba, Sebastià Remollo, Isabel Rodríguez-Caamaño, Carlos Pérez-García, Santiago Rosati, Saima Bashir, Isabel Vielba-Gomez, Sonia Aixut, Andrés Julian Paipa, Javier Martínez-Fernández, Yeray Aguilar, Eduardo Fandiño, Giorgio Barbieri, Blanca García-Villalba, Víctor Cuba, Miguel Castaño, Jordi Blasco, ROSSETTI Group
Background and Purpose
The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).
Methods
We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 h [24h-NIHSS] and modified Rankin Scale score at 3 months) were compared. Predictors of the first-pass effect (FPE), defining Modified Treatment In Cerebral Ischemia 2c-3 (mTICI 2c-3) after one pass, were explored.
Results
Of the 4111 patients from the ROSSETTI registry, 243 nonagenarians (68.7% female) were included in the analysis. The distribution of endovascular techniques was 101-group (61.4%), 111-group (15.6%), and 011-group (23%). The 101-group and 111-group had significantly shorter procedural times than the 011-group. The 111-group had a higher FPE rate, a lower number of passes, and a higher rate of final mTICI ≥2c than the other groups. The 24h-NIHSS score was significantly lower in the 111-group. In multivariate analysis, the only independent predictor for FPE was the BGC+DAC+SR endovascular technique (odds ratio 2.74 [confidence interval 1.16–6.47]; p = 0.021).
Conclusions
The addition of a DAC to a BGC increases the likelihood of FPE in nonagenarians with anterior circulation LVO SR-based thrombectomy for acute stroke.
{"title":"Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians","authors":"Josep Puig, Mariano Werner, Guillem Dolz, Alejandro Pascagaza, Pepus Daunis-i-Estadella, Marc Comas-Cufí, Eva González, Jon Fondevila, Pedro Vega, Eduardo Murias, Veredas Romero, Carlos Martínez, Fernando Aparici-Robles, Lluis Morales-Caba, Sebastià Remollo, Isabel Rodríguez-Caamaño, Carlos Pérez-García, Santiago Rosati, Saima Bashir, Isabel Vielba-Gomez, Sonia Aixut, Andrés Julian Paipa, Javier Martínez-Fernández, Yeray Aguilar, Eduardo Fandiño, Giorgio Barbieri, Blanca García-Villalba, Víctor Cuba, Miguel Castaño, Jordi Blasco, ROSSETTI Group","doi":"10.1111/jon.70012","DOIUrl":"10.1111/jon.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group). Demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale score at 24 h [24h-NIHSS] and modified Rankin Scale score at 3 months) were compared. Predictors of the first-pass effect (FPE), defining Modified Treatment In Cerebral Ischemia 2c-3 (mTICI 2c-3) after one pass, were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4111 patients from the ROSSETTI registry, 243 nonagenarians (68.7% female) were included in the analysis. The distribution of endovascular techniques was 101-group (61.4%), 111-group (15.6%), and 011-group (23%). The 101-group and 111-group had significantly shorter procedural times than the 011-group. The 111-group had a higher FPE rate, a lower number of passes, and a higher rate of final mTICI ≥2c than the other groups. The 24h-NIHSS score was significantly lower in the 111-group. In multivariate analysis, the only independent predictor for FPE was the BGC+DAC+SR endovascular technique (odds ratio 2.74 [confidence interval 1.16–6.47]; <i>p</i> = 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The addition of a DAC to a BGC increases the likelihood of FPE in nonagenarians with anterior circulation LVO SR-based thrombectomy for acute stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971240","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}
We investigated the relationship between serotonergic and dopaminergic specific binding transporter ratios (SBRs) over 4 years in Parkinson's disease (PD) patients. We assessed serotonergic innervation's potential compensatory role for dopaminergic denervation, association with PD symptoms, and involvement in the development of levodopa-induced dyskinesia (LID).
Methods
SBRs of the midbrain and striatum were evaluated from [I-123] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane SPECT images at baseline and after 4 years. Correlations between SBRs and PD symptoms were analyzed, alongside interval changes.
Results
Study included 177 PD patients (110 males, 67 females; mean age 61.0 ± 9.0 years). Significant worsening was observed in Hoehn and Yahr staging and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II and III scores over 4 years (p < 0.05, p < 0.001, and p < 0.001, respectively). SBRs of the caudate, putamen, and midbrain declined significantly (p < 0.001). Midbrain and striatal SBRs correlated significantly at both baseline and 4-year follow-up (p < 0.0001). Striatal SBRs correlated significantly with MDS-UPDRS II and III scores at both time points, while midbrain SBRs correlated with changes in MDS-UPDRS III scores over the 4 years (p < 0.01). Putamen and midbrain SBRs at 4 years were significantly lower in patients who developed LID compared to those who did not (p < 0.05).
Conclusion
The study demonstrates correlations between midbrain and putamen SBRs and MDS-UPDRS scores over 4 years in PD patients. Midbrain serotonin dysfunction may contribute to the development of LID.
{"title":"Longitudinal Serotonergic and Dopaminergic Binding: Impact on Parkinson's Disease Progression and Levodopa Dyskinesia","authors":"Eun Hye Jeong, Jae Yong Lee, Yoo Sung Song","doi":"10.1111/jon.70014","DOIUrl":"10.1111/jon.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>We investigated the relationship between serotonergic and dopaminergic specific binding transporter ratios (SBRs) over 4 years in Parkinson's disease (PD) patients. We assessed serotonergic innervation's potential compensatory role for dopaminergic denervation, association with PD symptoms, and involvement in the development of levodopa-induced dyskinesia (LID).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>SBRs of the midbrain and striatum were evaluated from [I-123] <i>N</i>-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane SPECT images at baseline and after 4 years. Correlations between SBRs and PD symptoms were analyzed, alongside interval changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Study included 177 PD patients (110 males, 67 females; mean age 61.0 ± 9.0 years). Significant worsening was observed in Hoehn and Yahr staging and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II and III scores over 4 years (<i>p</i> < 0.05, <i>p</i> < 0.001, and <i>p</i> < 0.001, respectively). SBRs of the caudate, putamen, and midbrain declined significantly (<i>p</i> < 0.001). Midbrain and striatal SBRs correlated significantly at both baseline and 4-year follow-up (<i>p</i> < 0.0001). Striatal SBRs correlated significantly with MDS-UPDRS II and III scores at both time points, while midbrain SBRs correlated with changes in MDS-UPDRS III scores over the 4 years (<i>p</i> < 0.01). Putamen and midbrain SBRs at 4 years were significantly lower in patients who developed LID compared to those who did not (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study demonstrates correlations between midbrain and putamen SBRs and MDS-UPDRS scores over 4 years in PD patients. Midbrain serotonin dysfunction may contribute to the development of LID.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971248","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}
Abir Troudi Habibi, Ines Ben Alaya, Fatima Tensaouti, Eloïse Baudou, Germain Arribarat, Lisa Pollidoro, Patrice Péran, Yves Chaix, Salam Labidi, Anne Laprie
Background and Purpose
Working memory, a primary cognitive domain, is often impaired in pediatric brain tumor survivors, affecting their attention and processing speed. This study investigated the long-term effects of treatments, including surgery, radiotherapy (RT), and chemotherapy (CT), on working memory tracts in children with posterior fossa tumors (PFTs) using resting-state functional MRI (rs-fMRI) and diffusion MRI tractography.
Methods
This study included 16 medulloblastoma (MB) survivors treated with postoperative RT and CT, 14 pilocytic astrocytoma (PA) survivors treated with surgery alone, and 16 healthy controls from the Imaging Memory after Pediatric Cancer in children, adolescents, and young adults study (NCT04324450). Working memory tracts were identified by combining seed masks from rs-fMRI maps and whole-brain tractography from diffusion MRI. Connectivity alterations were assessed qualitatively and quantitatively, alongside neuropsychological evaluations and correlations with behavioral outcomes and mean supratentorial dose.
Results
Compared to controls, MB survivors exhibited significant impairments in the working memory network, including reductions in tract volume (TV), fiber density, fiber cross-section (FC), mean streamline length (MLS), and fractional anisotropy (FA) (all p = 0.04). Lower working memory scores were correlated with reduced TV and FA in MB survivors. Higher mean supratentorial doses were associated with lower TV, FC, and FA values across multiple tracts, particularly in the arcuate and superior longitudinal fasciculi.
Conclusions
Tractography-derived features highlighted white matter damage as a biomarker of treatment-related neurotoxicity in PFTs survivors. These findings underscore the detrimental impact of RT and CT on working memory networks and emphasize the importance of preserving cognitive function during treatment planning.
{"title":"Impact of Pediatric Posterior Fossa Tumor Treatments on Working Memory Tracts Using Resting-State fMRI and Tractography","authors":"Abir Troudi Habibi, Ines Ben Alaya, Fatima Tensaouti, Eloïse Baudou, Germain Arribarat, Lisa Pollidoro, Patrice Péran, Yves Chaix, Salam Labidi, Anne Laprie","doi":"10.1111/jon.70007","DOIUrl":"10.1111/jon.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Working memory, a primary cognitive domain, is often impaired in pediatric brain tumor survivors, affecting their attention and processing speed. This study investigated the long-term effects of treatments, including surgery, radiotherapy (RT), and chemotherapy (CT), on working memory tracts in children with posterior fossa tumors (PFTs) using resting-state functional MRI (rs-fMRI) and diffusion MRI tractography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 16 medulloblastoma (MB) survivors treated with postoperative RT and CT, 14 pilocytic astrocytoma (PA) survivors treated with surgery alone, and 16 healthy controls from the Imaging Memory after Pediatric Cancer in children, adolescents, and young adults study (NCT04324450). Working memory tracts were identified by combining seed masks from rs-fMRI maps and whole-brain tractography from diffusion MRI. Connectivity alterations were assessed qualitatively and quantitatively, alongside neuropsychological evaluations and correlations with behavioral outcomes and mean supratentorial dose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to controls, MB survivors exhibited significant impairments in the working memory network, including reductions in tract volume (TV), fiber density, fiber cross-section (FC), mean streamline length (MLS), and fractional anisotropy (FA) (all <i>p</i> = 0.04). Lower working memory scores were correlated with reduced TV and FA in MB survivors. Higher mean supratentorial doses were associated with lower TV, FC, and FA values across multiple tracts, particularly in the arcuate and superior longitudinal fasciculi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tractography-derived features highlighted white matter damage as a biomarker of treatment-related neurotoxicity in PFTs survivors. These findings underscore the detrimental impact of RT and CT on working memory networks and emphasize the importance of preserving cognitive function during treatment planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950219","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}
Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicated the involvement of nonauditory brain structures, including the limbic system. We aimed to compare the volumes of specific brain structures between patients with tinnitus and controls.
Methods
Voxel-based morphometry and subfield volumetry were applied to analyze the brain structures of 53 patients with tinnitus and 52 age- and sex-matched controls. The volumes of the amygdala, hippocampus, and thalamus were measured and compared between the groups.
Results
Patients with tinnitus had larger volumes in the whole amygdala, basal nucleus, right lateral nucleus, and left paralaminar nucleus compared with controls. In addition, the subiculum head, left fimbria, and left presubiculum head in the hippocampus were larger in patients with tinnitus. No differences were found in the total thalamic volume or thalamic subnuclei between groups. The gray matter volumes in the thalamus, amygdala, and hippocampus were significantly high in the tinnitus group. The cortical thicknesses of both of the marginal branches of the cingulate sulcus, the left superior parietal lobule, and the left subparietal sulcus were also high in the tinnitus group.
Conclusions
These findings indicate the involvement of the limbic system in tinnitus, and enhance our understanding of the condition. The subfield volumetry technique used in this study may aid in identifying the structural differences associated with specific neurological and psychiatric conditions.
{"title":"Voxel-Based Morphometry and Subfield Volumetry Analysis Reveal Limbic System Involvement in Tinnitus","authors":"Sekwang Lee, Sung-Bom Pyun, Youngbo Sim, Sangwon Um, Woo-Suk Tae, Eui-Cheol Nam","doi":"10.1111/jon.70008","DOIUrl":"10.1111/jon.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Tinnitus is a condition in which individuals perceive sounds, such as ringing or buzzing, without any external source. Although the exact cause is not fully understood, recent studies have indicated the involvement of nonauditory brain structures, including the limbic system. We aimed to compare the volumes of specific brain structures between patients with tinnitus and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Voxel-based morphometry and subfield volumetry were applied to analyze the brain structures of 53 patients with tinnitus and 52 age- and sex-matched controls. The volumes of the amygdala, hippocampus, and thalamus were measured and compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with tinnitus had larger volumes in the whole amygdala, basal nucleus, right lateral nucleus, and left paralaminar nucleus compared with controls. In addition, the subiculum head, left fimbria, and left presubiculum head in the hippocampus were larger in patients with tinnitus. No differences were found in the total thalamic volume or thalamic subnuclei between groups. The gray matter volumes in the thalamus, amygdala, and hippocampus were significantly high in the tinnitus group. The cortical thicknesses of both of the marginal branches of the cingulate sulcus, the left superior parietal lobule, and the left subparietal sulcus were also high in the tinnitus group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate the involvement of the limbic system in tinnitus, and enhance our understanding of the condition. The subfield volumetry technique used in this study may aid in identifying the structural differences associated with specific neurological and psychiatric conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950225","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}
Maggie Barghash, Hamza Adel Salim, Janet Mei, Mohamed Tantawi, Awab K. Elnaeem, Heitor Cabral Frade, Khalid Kabeel, Dhairya A. Lakhani, Manisha Koneru, Argye E. Hillis, Raf Llinas, Hanzhang Lu, Rich Leigh, Mona Bahouth, Victor C. Urrutia, Elisabeth B. Marsh, Risheng Xu, Judy Huang, Max Wintermark, Kambiz Nael, Gregory W. Albers, Paul Stracke, Tobias D. Faizy, Jeremy J. Heit, Vivek Yedavalli
Introduction
The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels. In this narrative review, we will highlight the different parameters and modalities used to assess the VOP in acute ischemia.
VO Assessment With Different Modalities
CT parameters include cortical vein opacification score, interhemispheric difference of composite scores of the draining veins classifications on single-phase CT angiography (CTA), as well as the extent and velocity of optimal cortical venous filling on multiphase CTA. Differences in contrast administration and acquisition time render the single-phase CTA parameters less reliable. Perfusion parameters are semiautomated, thus offering greater reproducibility. These include time to peak and prolonged venous transit. Finally, the venous transit time is an MRI parameter.
Associations and Prognostic Implications
VOP parameters’ significance lies in their potential to predict tissue fate and, subsequently, clinical outcomes. Recent studies indicate that favorable VOP is independently associated with slower rates of infarct edema progression, smaller infarct volumes, and higher rates of functional independence after 90 days. Moreover, it is considered a predictor of recanalization success and the first-pass effect during mechanical thrombectomy. Conversely, an unfavorable VOP predicts futile recanalization and indicates a higher risk of reperfusion hemorrhage. Our aim is to explore these prognostic implications and their relevance in determining the utility of intracranial intervention.
{"title":"Role and Prognostic Implications of Venous Outflow Assessment in Acute Ischemic Stroke","authors":"Maggie Barghash, Hamza Adel Salim, Janet Mei, Mohamed Tantawi, Awab K. Elnaeem, Heitor Cabral Frade, Khalid Kabeel, Dhairya A. Lakhani, Manisha Koneru, Argye E. Hillis, Raf Llinas, Hanzhang Lu, Rich Leigh, Mona Bahouth, Victor C. Urrutia, Elisabeth B. Marsh, Risheng Xu, Judy Huang, Max Wintermark, Kambiz Nael, Gregory W. Albers, Paul Stracke, Tobias D. Faizy, Jeremy J. Heit, Vivek Yedavalli","doi":"10.1111/jon.13256","DOIUrl":"10.1111/jon.13256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels. In this narrative review, we will highlight the different parameters and modalities used to assess the VOP in acute ischemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> VO Assessment With Different Modalities</h3>\u0000 \u0000 <p>CT parameters include cortical vein opacification score, interhemispheric difference of composite scores of the draining veins classifications on single-phase CT angiography (CTA), as well as the extent and velocity of optimal cortical venous filling on multiphase CTA. Differences in contrast administration and acquisition time render the single-phase CTA parameters less reliable. Perfusion parameters are semiautomated, thus offering greater reproducibility. These include time to peak and prolonged venous transit. Finally, the venous transit time is an MRI parameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Associations and Prognostic Implications</h3>\u0000 \u0000 <p>VOP parameters’ significance lies in their potential to predict tissue fate and, subsequently, clinical outcomes. Recent studies indicate that favorable VOP is independently associated with slower rates of infarct edema progression, smaller infarct volumes, and higher rates of functional independence after 90 days. Moreover, it is considered a predictor of recanalization success and the first-pass effect during mechanical thrombectomy. Conversely, an unfavorable VOP predicts futile recanalization and indicates a higher risk of reperfusion hemorrhage. Our aim is to explore these prognostic implications and their relevance in determining the utility of intracranial intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950221","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}
Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white matter damage in patients with isolated rapid eye movement sleep behavior disorder (RBD) using PSMD.
Methods
We enrolled patients with newly diagnosed isolated RBD confirmed by polysomnography and age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was conducted using a 3-Tesla MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the Functional Magnetic Resonance Imaging of the Brain Software Library program. We compared the incidence of PSMD between patients with RBD and healthy controls and performed a correlation analysis between PSMD and clinical factors in patients with RBD.
Results
Thirty patients with isolated RBD and 41 healthy controls were enrolled. The PSMD was significantly higher in patients with RBD than that in the healthy controls (3.078 vs. 2.746 × 10−4 mm2/s, p = 0.001). In addition, PSMD positively correlated with age in patients with RBD (r = 0.477, p = 0.007). However, PSMD was not associated with other clinical or polysomnographic factors.
Conclusion
Patients with isolated RBD had a higher PSMD than healthy controls, indicating the evidence of white matter damage in patients with RBD. This finding highlights the potential of PSMD as a marker for detecting white matter damage, which may be related to small vessel diseases, in patients with sleep disorders.
背景与目的：骨胳化平均弥漫性峰宽（PSMD）是一种新的白质损伤指标，可能与小血管疾病有关。本研究旨在利用PSMD研究孤立性快速眼动睡眠行为障碍（RBD）患者白质损伤的存在。方法：我们招募了经多导睡眠图证实的新诊断的孤立性RBD患者和年龄和性别匹配的健康对照。采用3特斯拉MRI扫描仪进行弥散张量成像（DTI）。使用脑功能磁共振成像软件库程序，我们测量了基于DTI的PSMD，包括预处理、骨架化、自定义掩膜的应用和直方图分析。我们比较了RBD患者与健康对照者的PSMD发病率，并对RBD患者PSMD与临床因素之间的相关性进行了分析。结果：30例孤立性RBD患者和41名健康对照者入组。RBD患者的PSMD显著高于健康对照组（3.078 vs 2.746 × 10-4 mm2/s, p = 0.001）。RBD患者PSMD与年龄呈正相关（r = 0.477, p = 0.007）。然而，PSMD与其他临床或多导睡眠图因素无关。结论：孤立性RBD患者的PSMD高于健康对照组，表明RBD患者存在白质损伤的证据。这一发现强调了PSMD作为检测白质损伤的标记物的潜力，白质损伤可能与睡眠障碍患者的小血管疾病有关。
{"title":"Brain MRI Detection of an Abnormal Peak Width of Skeletonized Mean Diffusivity in REM Sleep Behavior Disorder","authors":"Dong Ah Lee, Ho-Joon Lee, Kang Min Park","doi":"10.1111/jon.70009","DOIUrl":"10.1111/jon.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter damage, which may be related to small vessel disease. This study aimed to investigate the presence of white matter damage in patients with isolated rapid eye movement sleep behavior disorder (RBD) using PSMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled patients with newly diagnosed isolated RBD confirmed by polysomnography and age- and sex-matched healthy controls. Diffusion tensor imaging (DTI) was conducted using a 3-Tesla MRI scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the Functional Magnetic Resonance Imaging of the Brain Software Library program. We compared the incidence of PSMD between patients with RBD and healthy controls and performed a correlation analysis between PSMD and clinical factors in patients with RBD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty patients with isolated RBD and 41 healthy controls were enrolled. The PSMD was significantly higher in patients with RBD than that in the healthy controls (3.078 vs. 2.746 × 10<sup>−4</sup> mm<sup>2</sup>/s, <i>p</i> = 0.001). In addition, PSMD positively correlated with age in patients with RBD (<i>r</i> = 0.477, <i>p</i> = 0.007). However, PSMD was not associated with other clinical or polysomnographic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with isolated RBD had a higher PSMD than healthy controls, indicating the evidence of white matter damage in patients with RBD. This finding highlights the potential of PSMD as a marker for detecting white matter damage, which may be related to small vessel diseases, in patients with sleep disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950175","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}
Trenesha L. Hill, Xiaoxu Na, Jayne Bellando, Charles M. Glasier, Xiawei Ou
Background and Purpose
Anxiety during pregnancy is common, and exposure to heightened anxiety during pregnancy may influence children's brain development and functioning. However, it is unclear if exposure to low levels of anxiety in utero would also impact the developing brain. The current prospective and longitudinal study included 40 healthy pregnant women without pregnancy complications or previous diagnosis of anxiety disorders.
Methods
Pregnant women's anxiety symptoms were measured at 12, 24, and 36 weeks of gestation. Their healthy, full-term offspring underwent a brain MRI scan without sedation, including resting-state functional MRI, at 2 weeks postnatal age. The associations between neonatal brain cortical functional connectivity originating from the amygdala and maternal prenatal anxiety symptom scores were examined using correlational analyses.
Results
Significant correlations were identified after controlling for child sex, postmenstrual age at MRI, and mother's depression symptom scores. Higher maternal anxiety during pregnancy was related to alterations in offspring's functional connectivity between the amygdala and other brain regions involved in fear learning. Specifically, higher maternal prenatal anxiety during the first trimester of pregnancy was associated with lower connectivity between the amygdala and fusiform gyrus and higher connectivity between the amygdala and thalamus. Higher maternal prenatal anxiety during the third trimester was also associated with lower connectivity between the amygdala and fusiform gyrus.
Conclusions
The findings from this study indicate that exposure to low levels of anxiety in utero may also impact offspring brain development and functioning, particularly brain regions that are important for threat detection.
{"title":"Functional Connectivity to the Amygdala in the Neonate Is Impacted by the Maternal Anxiety Level During Pregnancy","authors":"Trenesha L. Hill, Xiaoxu Na, Jayne Bellando, Charles M. Glasier, Xiawei Ou","doi":"10.1111/jon.70004","DOIUrl":"10.1111/jon.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Anxiety during pregnancy is common, and exposure to heightened anxiety during pregnancy may influence children's brain development and functioning. However, it is unclear if exposure to low levels of anxiety in utero would also impact the developing brain. The current prospective and longitudinal study included 40 healthy pregnant women without pregnancy complications or previous diagnosis of anxiety disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pregnant women's anxiety symptoms were measured at 12, 24, and 36 weeks of gestation. Their healthy, full-term offspring underwent a brain MRI scan without sedation, including resting-state functional MRI, at 2 weeks postnatal age. The associations between neonatal brain cortical functional connectivity originating from the amygdala and maternal prenatal anxiety symptom scores were examined using correlational analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant correlations were identified after controlling for child sex, postmenstrual age at MRI, and mother's depression symptom scores. Higher maternal anxiety during pregnancy was related to alterations in offspring's functional connectivity between the amygdala and other brain regions involved in fear learning. Specifically, higher maternal prenatal anxiety during the first trimester of pregnancy was associated with lower connectivity between the amygdala and fusiform gyrus and higher connectivity between the amygdala and thalamus. Higher maternal prenatal anxiety during the third trimester was also associated with lower connectivity between the amygdala and fusiform gyrus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings from this study indicate that exposure to low levels of anxiety in utero may also impact offspring brain development and functioning, particularly brain regions that are important for threat detection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931966","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}
Pedro Navia, Andrés Javier Barrios, Cristina Utrilla, Blanca Fuentes, Andrés Fernández-Prieto, Alberto Álvarez-Muelas, Remedios Frutos, Begoña Marín, Arantxa Royo, Pilar García-Raya, Amelia Fernández-Zubillaga, Elena de Celis, Josep Puig, Marc Comas-Cufí, Luis-Alfonso Arráez-Aybar, Gonzalo Garzón
Background and Purpose
Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with M2 segment occlusion of the middle cerebral artery (MCA) is debatable. This study assessed the efficacy, safety, and functional outcomes of EVT in M2 occlusion patients, examining differences in outcomes based on the dominance of the occluded segment (DomM2 vs. Non-DomM2).
Methods
A prospective cohort of 108 patients with AIS resulting from M2 segment occlusion of the MCA who underwent EVT was analyzed. We compared demographic, clinical, angiographic, and clinical outcome data (National Institutes of Health Stroke Scale [NIHSS] score at 24 h and modified Rankin Scale [mRS] score at 3 months) between patients with or without DomM2. The primary endpoint was the first-pass effect (FPE), defined as achieving modified Thrombolysis in Cerebral Infarction 2c–3 after one pass. We examined the symptomatic hemorrhagic transformation, 3-month functional outcomes, and mortality rates.
Results
Seventy-five patients (69.44%) had DomM2. FPE rates (48.48% for DomM2; 42.66% for Non-DomM2, p = 0.521), final successful recanalization rate, and functional outcomes were comparable between subgroups. Direct aspiration yielded a higher FPE rate (56.25%). FPE was associated with lower NIHSS scores at discharge (median, 2 [interquartile range 0–4] vs. 5 [1–10]; p < 0.001) and higher 3-month functional independence (83.33% vs. 60.34%; p < 0.001). Direct aspiration independently predicted FPE, with a 75% likelihood compared to stent retriever (p = 0.007).
Conclusions
EVT is a safe and effective treatment for acute M2 occlusion regardless of the dominance of the M2 segment. Direct aspiration used as a frontline technique increases the likelihood of FPE.
{"title":"Middle Cerebral Artery M2 Occlusions: Impact of Segment Dominance and Benefit of Direct Aspiration for the First-Pass Effect","authors":"Pedro Navia, Andrés Javier Barrios, Cristina Utrilla, Blanca Fuentes, Andrés Fernández-Prieto, Alberto Álvarez-Muelas, Remedios Frutos, Begoña Marín, Arantxa Royo, Pilar García-Raya, Amelia Fernández-Zubillaga, Elena de Celis, Josep Puig, Marc Comas-Cufí, Luis-Alfonso Arráez-Aybar, Gonzalo Garzón","doi":"10.1111/jon.70001","DOIUrl":"10.1111/jon.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) with M2 segment occlusion of the middle cerebral artery (MCA) is debatable. This study assessed the efficacy, safety, and functional outcomes of EVT in M2 occlusion patients, examining differences in outcomes based on the dominance of the occluded segment (DomM2 vs. Non-DomM2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort of 108 patients with AIS resulting from M2 segment occlusion of the MCA who underwent EVT was analyzed. We compared demographic, clinical, angiographic, and clinical outcome data (National Institutes of Health Stroke Scale [NIHSS] score at 24 h and modified Rankin Scale [mRS] score at 3 months) between patients with or without DomM2. The primary endpoint was the first-pass effect (FPE), defined as achieving modified Thrombolysis in Cerebral Infarction 2c–3 after one pass. We examined the symptomatic hemorrhagic transformation, 3-month functional outcomes, and mortality rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-five patients (69.44%) had DomM2. FPE rates (48.48% for DomM2; 42.66% for Non-DomM2, <i>p</i> = 0.521), final successful recanalization rate, and functional outcomes were comparable between subgroups. Direct aspiration yielded a higher FPE rate (56.25%). FPE was associated with lower NIHSS scores at discharge (median, 2 [interquartile range 0–4] vs. 5 [1–10]; <i>p</i> < 0.001) and higher 3-month functional independence (83.33% vs. 60.34%; <i>p</i> < 0.001). Direct aspiration independently predicted FPE, with a 75% likelihood compared to stent retriever (<i>p</i> = 0.007).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>EVT is a safe and effective treatment for acute M2 occlusion regardless of the dominance of the M2 segment. Direct aspiration used as a frontline technique increases the likelihood of FPE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931981","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}
Pragalv Karki, Matthew C. Murphy, Sandeep Ganji, Jeffrey L. Gunter, Jonathan Graff-Radford, David T. Jones, Hugo Botha, Jeremy K. Cutsforth-Gregory, Benjamin D. Elder, Clifford R. Jack Jr., John Huston III, Petrice M. Cogswell
Background and Purpose
In idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cerebral aqueduct. This approach is limited by the evaluation of a single location and does not account for respiration effects on flow. In this study, we quantified the cardiac and respiratory contributions to CSF movement at multiple intracranial locations using a real-time 2D PC-MRI and evaluated the diagnostic value of CSF dynamics biomarkers in classifying iNPH patients.
Methods
This study included 37 participants: 16 iNPH, 10 Alzheimer's disease (AD), and 11 cognitively unimpaired (CU) controls. Anatomical and real-time (non-gated) PC images were acquired in a 3T Philips scanner. CSF flow was assessed at the foramen magnum, fourth ventricle, Sylvian fissure, lateral ventricle, and cerebral aqueduct. We calculated three CSF dynamics biomarkers: mean velocity amplitude, cardiac signal power, and respiratory signal power. Biomarkers from each location were evaluated for classifying iNPH versus AD and CU using support vector machine (SVM). A p-value of 0.05 or less was considered statistically significant.
Results
The velocity amplitude and cardiac signal power were significantly reduced in iNPH compared to CU (p < 0.005) and AD (p < 0.05) at the lateral ventricle. The SVM model using biomarkers from the lateral ventricle performed significantly better at classifying iNPH than the other locations in terms of accuracy (p < 0.005) and diagnostic odds ratio (p < 0.05).
Conclusion
Evaluation of CSF movement beyond the cerebral aqueduct may aid in identifying patients with and understanding the pathophysiology of iNPH.
{"title":"Real-Time 2D Phase-Contrast MRI to Assess Cardiac- and Respiratory-Driven CSF Movement in Normal Pressure Hydrocephalus","authors":"Pragalv Karki, Matthew C. Murphy, Sandeep Ganji, Jeffrey L. Gunter, Jonathan Graff-Radford, David T. Jones, Hugo Botha, Jeremy K. Cutsforth-Gregory, Benjamin D. Elder, Clifford R. Jack Jr., John Huston III, Petrice M. Cogswell","doi":"10.1111/jon.70000","DOIUrl":"10.1111/jon.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>In idiopathic normal pressure hydrocephalus (iNPH) patients, cerebrospinal fluid (CSF) flow is typically evaluated with a cardiac-gated two-dimensional (2D) phase-contrast (PC) MRI through the cerebral aqueduct. This approach is limited by the evaluation of a single location and does not account for respiration effects on flow. In this study, we quantified the cardiac and respiratory contributions to CSF movement at multiple intracranial locations using a real-time 2D PC-MRI and evaluated the diagnostic value of CSF dynamics biomarkers in classifying iNPH patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 37 participants: 16 iNPH, 10 Alzheimer's disease (AD), and 11 cognitively unimpaired (CU) controls. Anatomical and real-time (non-gated) PC images were acquired in a 3T Philips scanner. CSF flow was assessed at the foramen magnum, fourth ventricle, Sylvian fissure, lateral ventricle, and cerebral aqueduct. We calculated three CSF dynamics biomarkers: mean velocity amplitude, cardiac signal power, and respiratory signal power. Biomarkers from each location were evaluated for classifying iNPH versus AD and CU using support vector machine (SVM). A <i>p</i>-value of 0.05 or less was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The velocity amplitude and cardiac signal power were significantly reduced in iNPH compared to CU (<i>p</i> < 0.005) and AD (<i>p</i> < 0.05) at the lateral ventricle. The SVM model using biomarkers from the lateral ventricle performed significantly better at classifying iNPH than the other locations in terms of accuracy (<i>p</i> < 0.005) and diagnostic odds ratio (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Evaluation of CSF movement beyond the cerebral aqueduct may aid in identifying patients with and understanding the pathophysiology of iNPH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11686571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906561","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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