Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder prevalent among adolescents and exhibits notable sex dimorphism. Despite an increasing body of research, the impact of sex on ADHD remains underexplored. This study aimed to examine sex differences in white matter organization in children with ADHD using magnetic resonance (MR) diffusion data analyzed with fixel-based analysis (FBA), a novel technique that enables detailed assessment of both microstructural and macrostructural properties of white matter.
Methods
Fifty-five children with ADHD and 37 age-matched typically developing controls underwent MR diffusion. FBA was used to assess white matter structure. Group comparisons examined sex differences within and between groups, and correlation analyses were conducted between white matter features and clinical symptoms in the ADHD group.
Results
The results demonstrated that no significant sex differences were identified among healthy controls. However, within the ADHD group, the fiber cross-section (FC) metric revealed significant white matter alterations in several tracts, including the arcuate fasciculus, corpus callosum (CC), cingulum (CG), superior longitudinal fascicle, striato-fronto-orbital (ST_FO), and striato-precentral. In addition, the fiber density and cross-section metrics showed comparable abnormalities in the CC, CG, and ST_FO. Females with ADHD showed stronger correlations between FC metrics in bundles of white matter and clinical symptoms.
Conclusions
This study is the first to demonstrate sex differences in ADHD white matter bundles using FBA, contributing to a deeper understanding of the pathological mechanisms of ADHD and offering new insights for its diagnosis and treatment.
{"title":"Sex Differences in White Matter Structure in Attention Deficit Hyperactivity Disorder: MR Diffusion Fixel-Based Analysis","authors":"Yan Yu, Jiancheng Fu, Meihao Wang, Ronghui Zhou, Chenhao Shan, Xinye Sun, Yuanjing Feng","doi":"10.1111/jon.70072","DOIUrl":"https://doi.org/10.1111/jon.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder prevalent among adolescents and exhibits notable sex dimorphism. Despite an increasing body of research, the impact of sex on ADHD remains underexplored. This study aimed to examine sex differences in white matter organization in children with ADHD using magnetic resonance (MR) diffusion data analyzed with fixel-based analysis (FBA), a novel technique that enables detailed assessment of both microstructural and macrostructural properties of white matter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-five children with ADHD and 37 age-matched typically developing controls underwent MR diffusion. FBA was used to assess white matter structure. Group comparisons examined sex differences within and between groups, and correlation analyses were conducted between white matter features and clinical symptoms in the ADHD group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results demonstrated that no significant sex differences were identified among healthy controls. However, within the ADHD group, the fiber cross-section (FC) metric revealed significant white matter alterations in several tracts, including the arcuate fasciculus, corpus callosum (CC), cingulum (CG), superior longitudinal fascicle, striato-fronto-orbital (ST_FO), and striato-precentral. In addition, the fiber density and cross-section metrics showed comparable abnormalities in the CC, CG, and ST_FO. Females with ADHD showed stronger correlations between FC metrics in bundles of white matter and clinical symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to demonstrate sex differences in ADHD white matter bundles using FBA, contributing to a deeper understanding of the pathological mechanisms of ADHD and offering new insights for its diagnosis and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751291","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}
Rami Fakih, Ibrahim A. Bhatti, Rehan Ahmed, Xiaoyu Ma, Syed A. Gillani, Farhan Siddiq, Camilo R. Gomez, Adnan I. Qureshi
Background and Purpose
The impact of endovascular therapy (EVT) on outcomes in World Federation of Neurological Societies (WFNS) grade ≥ 4 aneurysmal subarachnoid hemorrhage (aSAH) remains unclear.
Methods
We conducted a retrospective cohort study of 80 patients with WFNS grade ≥ 4 aSAH and secondary vasospasm treated between 2010 and 2023. EVT included intra-arterial vasodilators and/or balloon angioplasty. The primary outcome was favorable functional status at 90 days (modified Rankin Scale 0–3). Multivariable logistic regression was used to assess associations between EVT and outcomes, adjusting for age, sex, and time-to-aneurysm securement.
Results
EVT was performed in 77.5% of patients (n = 62). Favorable outcomes occurred in occurred in 42.5% of all patients (n = 34), and were significantly more frequent in the EVT group (48.4% versus 22.2%; p = 0.038). EVT was independently associated with greater odds of favorable outcome (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.12–8.85; p = 0.030) and reduced mortality (aOR 0.24, 95% CI 0.07–0.82; p = 0.023). Early aneurysm treatment (≤ 12 h) also independently predicted favorable outcomes (aOR 2.38, p = 0.044) and lower mortality (aOR 0.42, p = 0.045).
Conclusions
Among patients with poor-grade aSAH and vasospasm, EVT was independently associated with improved functional outcomes and survival. These findings challenge historical nihilism and support timely, aggressive endovascular intervention as a critical component of care in this high-risk population.
背景与目的血管内治疗（EVT）对世界神经学会联合会（WFNS）分级≥4级动脉瘤性蛛网膜下腔出血（aSAH）预后的影响尚不清楚。方法对2010年至2023年间80例WFNS分级≥4级aSAH伴继发性血管痉挛患者进行回顾性队列研究。EVT包括动脉内血管扩张和/或球囊血管成形术。主要终点为90天的良好功能状态（修正Rankin量表0-3）。采用多变量逻辑回归评估EVT与预后之间的关系，调整年龄、性别和动脉瘤固定时间。结果62例（77.5%）患者行EVT。42.5%的患者（n = 34）出现了良好结果，EVT组出现良好结果的频率更高(48.4% vs 22.2%；P = 0.038)。EVT与更大的有利结局几率独立相关(调整优势比[aOR] 3.15, 95%可信区间[CI] 1.12-8.85；p = 0.030)和降低死亡率(aOR 0.24, 95% CI 0.07-0.82；P = 0.023)。动脉瘤早期治疗（≤12 h）也独立预测了良好的预后（aOR 2.38, p = 0.044）和较低的死亡率（aOR 0.42, p = 0.045）。结论：在低度aSAH和血管痉挛患者中，EVT与改善功能结局和生存率独立相关。这些发现挑战了历史虚无主义，并支持及时、积极的血管内干预作为高危人群护理的关键组成部分。
{"title":"Endovascular Therapy Outcomes for Cerebral Vasospasm in Poor-Grade Aneurysmal Subarachnoid Hemorrhage","authors":"Rami Fakih, Ibrahim A. Bhatti, Rehan Ahmed, Xiaoyu Ma, Syed A. Gillani, Farhan Siddiq, Camilo R. Gomez, Adnan I. Qureshi","doi":"10.1111/jon.70066","DOIUrl":"https://doi.org/10.1111/jon.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The impact of endovascular therapy (EVT) on outcomes in World Federation of Neurological Societies (WFNS) grade ≥ 4 aneurysmal subarachnoid hemorrhage (aSAH) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study of 80 patients with WFNS grade ≥ 4 aSAH and secondary vasospasm treated between 2010 and 2023. EVT included intra-arterial vasodilators and/or balloon angioplasty. The primary outcome was favorable functional status at 90 days (modified Rankin Scale 0–3). Multivariable logistic regression was used to assess associations between EVT and outcomes, adjusting for age, sex, and time-to-aneurysm securement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EVT was performed in 77.5% of patients (n = 62). Favorable outcomes occurred in occurred in 42.5% of all patients (n = 34), and were significantly more frequent in the EVT group (48.4% versus 22.2%; p = 0.038). EVT was independently associated with greater odds of favorable outcome (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.12–8.85; p = 0.030) and reduced mortality (aOR 0.24, 95% CI 0.07–0.82; p = 0.023). Early aneurysm treatment (≤ 12 h) also independently predicted favorable outcomes (aOR 2.38, p = 0.044) and lower mortality (aOR 0.42, p = 0.045).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among patients with poor-grade aSAH and vasospasm, EVT was independently associated with improved functional outcomes and survival. These findings challenge historical nihilism and support timely, aggressive endovascular intervention as a critical component of care in this high-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740537","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}
Syeda Maria Muzammil, Yasaman Pirahanchi, Ammar Tarabichi, Joseph C. Masdeu
Neurologists have a unique ability to interpret neuroimaging in conjunction with clinical context and disease pathology, making their role vital in accurate interpretation. Neuroimaging education is essential for enhancing these skills, typically provided through neurology residency programs and specialized neuroimaging fellowships. Neuroimaging training experience in neurology residency programs can be quite variable. Neurology residents typically gain substantial exposure to neuroimaging techniques through the sheer volume of cases they encounter during training, often under direct guidance of subspeciality neurologists. However, curriculum implementation and proper documentation of training often lacks consistency, and opportunities for advanced neuroimaging training are limited. The number of fellowship-trained neuroimaging specialists is insufficient to meet the growing demand for neuroimaging expertise. Credentialing and certification issues related to neuroimaging training for neurologists hinder the integration of qualified neurologists into the neuroimaging field. The need for additional years of specialized training, financial burden associated with maintaining certification, opposition by radiological societies, complexities of reimbursement which vary by insurer, region, and hospital policies are some of the challenges. This article explores these issues and suggests that solutions may include the establishment of more accredited neuroimaging fellowship programs or an increase in the neuroimaging component of subspecialty training, as well as addressing credentialing and hospital privileging issues.
{"title":"Neuroimaging Training Programs, Certification Pathways, and Credentialing Issues","authors":"Syeda Maria Muzammil, Yasaman Pirahanchi, Ammar Tarabichi, Joseph C. Masdeu","doi":"10.1111/jon.70049","DOIUrl":"https://doi.org/10.1111/jon.70049","url":null,"abstract":"<div>\u0000 \u0000 <p>Neurologists have a unique ability to interpret neuroimaging in conjunction with clinical context and disease pathology, making their role vital in accurate interpretation. Neuroimaging education is essential for enhancing these skills, typically provided through neurology residency programs and specialized neuroimaging fellowships. Neuroimaging training experience in neurology residency programs can be quite variable. Neurology residents typically gain substantial exposure to neuroimaging techniques through the sheer volume of cases they encounter during training, often under direct guidance of subspeciality neurologists. However, curriculum implementation and proper documentation of training often lacks consistency, and opportunities for advanced neuroimaging training are limited. The number of fellowship-trained neuroimaging specialists is insufficient to meet the growing demand for neuroimaging expertise. Credentialing and certification issues related to neuroimaging training for neurologists hinder the integration of qualified neurologists into the neuroimaging field. The need for additional years of specialized training, financial burden associated with maintaining certification, opposition by radiological societies, complexities of reimbursement which vary by insurer, region, and hospital policies are some of the challenges. This article explores these issues and suggests that solutions may include the establishment of more accredited neuroimaging fellowship programs or an increase in the neuroimaging component of subspecialty training, as well as addressing credentialing and hospital privileging issues.</p>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740536","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}
Julia Pfirrmann, Anne Adlung, Ingo Hermann, Claudia E. Weber, Anne Ebert, Frank G. Zöllner, Achim Gass, Philipp Eisele
Background and Purpose
Quantitative MRI provides insights into (patho-) physiological processes of the brain macro- and microstructure. In this study, we applied a multimodal MRI approach to determine quantitative values of the brain in healthy young adults.
Methods
3 T MRI including sodium MRI (4.0 mm nominal isotropic resolution), 3D T1-weighted magnetization-prepared rapid acquisition gradient-echo (spatial resolution = 0.9 mm × 0.9 mm × 0.9 mm), T2-fluid attenuated inversion recovery (spatial resolution = 0.4 mm × 0.4 mm × 5.0 mm), diffusion-weighted imaging (spatial resolution = 1.0 mm × 1.0 mm × 4.0 mm), PD/T2 (spatial resolution = 1.0 mm × 1.0 mm × 2.0 mm), and MR fingerprinting including T1 and T2* relaxation times (spatial resolution = 1 mm × 1 mm × 2 mm) was performed on 40 healthy young adults (28 women, mean age: 24.55 years).
Results
Mean values for the gray matter were as follows—apparent diffusion coefficient (ADC): 0.95 ± 0.03 × 10−3 mm2/s, total sodium concentration (TSC): 41.99 ± 2.35 mM, T1: 1338.04 ± 46.29 ms, T2*: 63.39 ± 2.94 ms. For the white matter, mean values were as follows—ADC: 0.79 ± 0.02 × 10−3 mm2/s, TSC: 36.08 ± 5.62 mM, T1: 968.47 ± 48.35 ms, T2*: 53.62 ± 8.06 ms, and for the deep gray matter, mean values were as follows—ADC: 0.85 ± 0.04 × 10−3 mm2/s, TSC: 38.23 ± 2.91 mM, T1: 1087.24 ± 39.77 ms, T2*: 54.53 ± 7.15.
Conclusion
Our multimodal, quantitative MRI atlas of the human brain in healthy young adults provides meaningful in vivo insights into the brain microstructure and can be used for reference in future studies.
背景与目的定量MRI提供了对大脑宏观和微观结构（病理）生理过程的深入了解。在这项研究中，我们应用多模态MRI方法来确定健康年轻人大脑的定量值。方法3 T MRI包括钠核磁共振（4.0 mm名义各向同性分辨率）、三维t1加权磁化制备快速采集梯度回波（空间分辨率= 0.9 mm × 0.9 mm × 0.9 mm）、T2流体衰减反演恢复（空间分辨率= 0.4 mm × 0.4 mm × 5.0 mm）、弥散加权成像（空间分辨率= 1.0 mm × 1.0 mm × 4.0 mm）、PD/T2（空间分辨率= 1.0 mm × 1.0 mm × 2.0 mm）、对40例健康青年（女性28例，平均年龄24.55岁）进行T1和T2*弛豫时间（空间分辨率= 1 mm × 1 mm × 2 mm） MR指纹识别。结果脑灰质表观扩散系数（ADC）平均值：0.95±0.03 × 10−3 mm2/s，总钠浓度（TSC）： 41.99±2.35 mM, T1: 1338.04±46.29 ms, T2*: 63.39±2.94 ms。白质平均值为：adc: 0.79±0.02 × 10−3 mm2/s, TSC: 36.08±5.62 mM, T1: 968.47±48.35 ms, T2*: 53.62±8.06 ms；深灰质平均值为：adc: 0.85±0.04 × 10−3 mm2/s, TSC: 38.23±2.91 mM, T1: 1087.24±39.77 ms, T2*: 54.53±7.15。结论我们的多模态、定量的健康年轻人大脑MRI图谱提供了对大脑微观结构有意义的活体洞察，可为未来的研究提供参考。
{"title":"Multimodal Quantitative MRI Atlas of the Human Brain in Healthy Young Adults","authors":"Julia Pfirrmann, Anne Adlung, Ingo Hermann, Claudia E. Weber, Anne Ebert, Frank G. Zöllner, Achim Gass, Philipp Eisele","doi":"10.1111/jon.70074","DOIUrl":"https://doi.org/10.1111/jon.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Quantitative MRI provides insights into (patho-) physiological processes of the brain macro- and microstructure. In this study, we applied a multimodal MRI approach to determine quantitative values of the brain in healthy young adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>3 T MRI including sodium MRI (4.0 mm nominal isotropic resolution), 3D T1-weighted magnetization-prepared rapid acquisition gradient-echo (spatial resolution = 0.9 mm × 0.9 mm × 0.9 mm), T2-fluid attenuated inversion recovery (spatial resolution = 0.4 mm × 0.4 mm × 5.0 mm), diffusion-weighted imaging (spatial resolution = 1.0 mm × 1.0 mm × 4.0 mm), PD/T2 (spatial resolution = 1.0 mm × 1.0 mm × 2.0 mm), and MR fingerprinting including T1 and T2* relaxation times (spatial resolution = 1 mm × 1 mm × 2 mm) was performed on 40 healthy young adults (28 women, mean age: 24.55 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean values for the gray matter were as follows—apparent diffusion coefficient (ADC): 0.95 ± 0.03 × 10<sup>−3</sup> mm<sup>2</sup>/s, total sodium concentration (TSC): 41.99 ± 2.35 mM, T1: 1338.04 ± 46.29 ms, T2*: 63.39 ± 2.94 ms. For the white matter, mean values were as follows—ADC: 0.79 ± 0.02 × 10<sup>−3</sup> mm<sup>2</sup>/s, TSC: 36.08 ± 5.62 mM, T1: 968.47 ± 48.35 ms, T2*: 53.62 ± 8.06 ms, and for the deep gray matter, mean values were as follows—ADC: 0.85 ± 0.04 × 10<sup>−3</sup> mm<sup>2</sup>/s, TSC: 38.23 ± 2.91 mM, T1: 1087.24 ± 39.77 ms, T2*: 54.53 ± 7.15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our multimodal, quantitative MRI atlas of the human brain in healthy young adults provides meaningful in vivo insights into the brain microstructure and can be used for reference in future studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705613","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}
José Carlos Méndez, Pedro Vega, Alfonso Lopez-Frías, Teresa Díaz, Josep Puig, Eduardo Murias, Jordi Blasco, Carlos Pérez-García, Víctor Maestro, Manuel Moreu, Marc Comas-Cufí, Antonio Cruz-Culebras, María Antonia Prieto, Isabel Bermúdez-Coronel, Javier Blázquez, Jaime Masjuán
Background and Purpose
Mechanical thrombectomy (MT) is increasingly performed for distal medium vessel occlusions (DMVOs) of the anterior circulation in acute stroke patients. Although trials have not shown superiority over usual care, selected patients may still benefit from MT. The ideal endovascular technique is debated. We aimed to determine the safety and efficacy of double stent retriever MT (DSR-MT) for DMVOs.
Methods
We retrospective analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute primary DMVOs treated with DSR-MT at four comprehensive stroke centers. Reperfusion was defined by the extended Thrombolysis In Cerebral Infarction (eTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.
Results
We included 32 patients (median age, 78 years, interquartile range [IQR] 71–82; 16 [50%] female), of whom 26 (81.2%) had primary occlusion of the M2 segment of the middle cerebral artery and six (18.8%) had occlusion of M3. Clinical severity was moderate (median, NIHSS 13; IQR 10–15) in 24 patients (75%). First-pass effect (eTICI 2c/3) was achieved in 20 patients (62.5%). Final eTICI 2b/2c/3 was achieved in 30 patients (93.7%) and final eTICI 2c/3 in 25 (78.1%). Symptomatic intracranial hemorrhage developed in one patient (3.1%). Median NIHSS was 6 at 24 h (IQR 3–12) and 4 at discharge (IQR 1–9). At 90 days, 22 (73.3%) patients were functionally independent (mRS 0–2).
Conclusions
This preliminary study found good efficacy and safety of DSR-MT for DMVOs in patients with M2 and M3 occlusions.
{"title":"Double Stent Retriever Mechanical Thrombectomy for Distal Medium Vessel Clots in the Middle Cerebral Artery: Initial Experience","authors":"José Carlos Méndez, Pedro Vega, Alfonso Lopez-Frías, Teresa Díaz, Josep Puig, Eduardo Murias, Jordi Blasco, Carlos Pérez-García, Víctor Maestro, Manuel Moreu, Marc Comas-Cufí, Antonio Cruz-Culebras, María Antonia Prieto, Isabel Bermúdez-Coronel, Javier Blázquez, Jaime Masjuán","doi":"10.1111/jon.70064","DOIUrl":"https://doi.org/10.1111/jon.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Mechanical thrombectomy (MT) is increasingly performed for distal medium vessel occlusions (DMVOs) of the anterior circulation in acute stroke patients. Although trials have not shown superiority over usual care, selected patients may still benefit from MT. The ideal endovascular technique is debated. We aimed to determine the safety and efficacy of double stent retriever MT (DSR-MT) for DMVOs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospective analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute primary DMVOs treated with DSR-MT at four comprehensive stroke centers. Reperfusion was defined by the extended Thrombolysis In Cerebral Infarction (eTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 32 patients (median age, 78 years, interquartile range [IQR] 71–82; 16 [50%] female), of whom 26 (81.2%) had primary occlusion of the M2 segment of the middle cerebral artery and six (18.8%) had occlusion of M3. Clinical severity was moderate (median, NIHSS 13; IQR 10–15) in 24 patients (75%). First-pass effect (eTICI 2c/3) was achieved in 20 patients (62.5%). Final eTICI 2b/2c/3 was achieved in 30 patients (93.7%) and final eTICI 2c/3 in 25 (78.1%). Symptomatic intracranial hemorrhage developed in one patient (3.1%). Median NIHSS was 6 at 24 h (IQR 3–12) and 4 at discharge (IQR 1–9). At 90 days, 22 (73.3%) patients were functionally independent (mRS 0–2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This preliminary study found good efficacy and safety of DSR-MT for DMVOs in patients with M2 and M3 occlusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666213","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}
Korhan Buyukturkoglu, Lin Lu, Levi Davis, Renan E. Orellana, Charles C. White, Rongyi Sun, Sinem Ozcelik, Nina M. Isenstein, Kaho B. Onomichi, Rifat Iqbal, Binsheng Zhao, Yaakov Stern, Burcu Zeydan, Orhun H. Kantarci, Claire S. Riley, Philip L. De Jager
Background and Purpose
Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.
Methods
A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (N = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (N = 63). Their associations with PASAT in a second MS cohort (N = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes.
Results
Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] < 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes.
Conclusion
RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.
{"title":"A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis","authors":"Korhan Buyukturkoglu, Lin Lu, Levi Davis, Renan E. Orellana, Charles C. White, Rongyi Sun, Sinem Ozcelik, Nina M. Isenstein, Kaho B. Onomichi, Rifat Iqbal, Binsheng Zhao, Yaakov Stern, Burcu Zeydan, Orhun H. Kantarci, Claire S. Riley, Philip L. De Jager","doi":"10.1111/jon.70069","DOIUrl":"https://doi.org/10.1111/jon.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (<i>N</i> = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (<i>N</i> = 63). Their associations with PASAT in a second MS cohort (<i>N</i> = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] < 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666214","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}
Jeremy Rubin, Quy Cao, Yu Sakai, Nathan Arnett, Huy Q. Phi, Andrew C. Hu, Brett L. Cucchiara, Daniel Bos, Luca Saba, Elias Johannson, Jarcy Zee, Jae W. Song
Background and Purpose
Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear.
Methods
Calcific carotid plaques were identified on neck computed tomography angiographies (CTAs) from patients meeting criteria for embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D-Slicer to quantify features, including volume and attenuation (Hounsfield Units [HU]). IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (>924HU) and volume (>30 millimeter [mm]3) as high versus low on the basis of median values.
Results
From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors, and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, p = 0.002). A significant interaction between calcification volume and attenuation emerged (p = 0.042). Among plaques with low plaque calcification volumes, plaques with low-attenuation (<924HU) calcifications showed 5.53 times higher IPHvols than plaques with high-attenuation calcifications (p = 0.003). Among plaques with high-attenuation calcifications, plaques with high volumes of these calcifications showed 4.40 times higher IPHvols compared to low-volumes of high-attenuation calcifications (p = 0.011).
Conclusions
Plaque calcification attenuation characteristics are associated with IPHvols. Understanding calcification patterns that correlate with IPH could enable clinicians to infer plaque instability from readily visible calcifications on CTA.
{"title":"Association of Carotid Plaque Calcification Attenuation With Intraplaque Hemorrhage Volume: 3D-Segmentation Analysis","authors":"Jeremy Rubin, Quy Cao, Yu Sakai, Nathan Arnett, Huy Q. Phi, Andrew C. Hu, Brett L. Cucchiara, Daniel Bos, Luca Saba, Elias Johannson, Jarcy Zee, Jae W. Song","doi":"10.1111/jon.70071","DOIUrl":"https://doi.org/10.1111/jon.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Calcific carotid plaques were identified on neck computed tomography angiographies (CTAs) from patients meeting criteria for embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D-Slicer to quantify features, including volume and attenuation (Hounsfield Units [HU]). IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (>924HU) and volume (>30 millimeter [mm]<sup>3</sup>) as high versus low on the basis of median values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors, and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, <i>p</i> = 0.002). A significant interaction between calcification volume and attenuation emerged (<i>p</i> = 0.042). Among plaques with low plaque calcification volumes, plaques with low-attenuation (<924HU) calcifications showed 5.53 times higher IPHvols than plaques with high-attenuation calcifications (<i>p</i> = 0.003). Among plaques with high-attenuation calcifications, plaques with high volumes of these calcifications showed 4.40 times higher IPHvols compared to low-volumes of high-attenuation calcifications (<i>p</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plaque calcification attenuation characteristics are associated with IPHvols. Understanding calcification patterns that correlate with IPH could enable clinicians to infer plaque instability from readily visible calcifications on CTA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615056","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}
Bhaswati Roy, Xingfeng Shao, Kamlesh J. Jobanputra, Gregg C. Fonarow, Danny J. J. Wang, Mary Woo, Rajesh Kumar
Background and Purpose
Heart failure (HF) patients show brain tissue injury in sites that mediate autonomic, cognitive, and mood dysfunctions that are linked with increased morbidity and mortality. The pathological mechanisms that may contribute to brain tissue injury in HF are unclear, but may include blood brain barrier (BBB) dysfunction.
Methods
We performed diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) in 27 HF and 59 controls to examine BBB, using a 3.0-Tesla MRI scanner, and assessed anxiety, depressive symptoms, and cognition. Using DW-pCASL data, arterial transit time (ATT, an index of large artery integrity) and water exchange rates across the BBB (Kw, an index of BBB function) maps were generated, normalized, smoothed, and compared between HF and controls, and correlated with cognition and mood.
Results
Significantly increased mood deficits and reduced cognition appeared in HF over controls. Multiple brain areas, which are involved in mediating cognition and mood, showed altered Kw and ATT values in HF over controls. Increased Kw emerged in the insula, hippocampus, and cerebellum. ATT values decreased in the prefrontal cortices, cingulate, and cerebellum, and increased in a few sites in HF patients. Kw values from regions that are involved in mood and cognition functions showed significant associations with anxiety, depression, and cognition.
Conclusions
HF patients show impaired BBB function and altered large artery integrity. BBB alterations may introduce neural damage to autonomic, mood, and cognitive regulatory areas, contributing to abnormal functions found in HF. The findings suggest a need to repair BBB function to rescue brain tissue and functions in this condition.
{"title":"Blood-Brain Barrier Dysfunction in Adults With Heart Failure","authors":"Bhaswati Roy, Xingfeng Shao, Kamlesh J. Jobanputra, Gregg C. Fonarow, Danny J. J. Wang, Mary Woo, Rajesh Kumar","doi":"10.1111/jon.70068","DOIUrl":"https://doi.org/10.1111/jon.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Heart failure (HF) patients show brain tissue injury in sites that mediate autonomic, cognitive, and mood dysfunctions that are linked with increased morbidity and mortality. The pathological mechanisms that may contribute to brain tissue injury in HF are unclear, but may include blood brain barrier (BBB) dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) in 27 HF and 59 controls to examine BBB, using a 3.0-Tesla MRI scanner, and assessed anxiety, depressive symptoms, and cognition. Using DW-pCASL data, arterial transit time (ATT, an index of large artery integrity) and water exchange rates across the BBB (Kw, an index of BBB function) maps were generated, normalized, smoothed, and compared between HF and controls, and correlated with cognition and mood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significantly increased mood deficits and reduced cognition appeared in HF over controls. Multiple brain areas, which are involved in mediating cognition and mood, showed altered Kw and ATT values in HF over controls. Increased Kw emerged in the insula, hippocampus, and cerebellum. ATT values decreased in the prefrontal cortices, cingulate, and cerebellum, and increased in a few sites in HF patients. Kw values from regions that are involved in mood and cognition functions showed significant associations with anxiety, depression, and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HF patients show impaired BBB function and altered large artery integrity. BBB alterations may introduce neural damage to autonomic, mood, and cognitive regulatory areas, contributing to abnormal functions found in HF. The findings suggest a need to repair BBB function to rescue brain tissue and functions in this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550968","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}
Doudou Cao, Litong Ni, Qi Qi, Lan Zhou, Wei Zhang, Yi Wang, Li Zhu, Guolin Ma, Fan Zhang, Shijun Li
Background and Purpose
The middle longitudinal fascicle (MdLF), a recently characterized white matter tract within the ventral language network, remains understudied in autism spectrum disorder (ASD). We hypothesized that altered microstructural development of the MdLF contributes to language impairment in children with ASD.
Methods
Free water corrected diffusion magnetic resonance imaging (MRI) tractography was employed to reconstruct the MdLF in 57 children with ASD (5.79±0.99 years) and 37 matched typically developing (TD) controls (5.99±1.38 years), aged 4–9 years. Language impairment was assessed using the Autism Behavior Checklist language subscale. General linear models and partial correlations (covarying age) were applied to investigate age-related differences of diffusion metrics and the correlation of diffusion metrics with language impairment in ASD.
Results
Significant age-by-group interactions emerged for bilateral MdLF fractional anisotropy tissue (FAt) (TD: left/right β = 0.614/0.511, p < 0.01; ASD: p > 0.05) and axial diffusivity tissue (ADt) (ASD: left/right β = −0.458/−0.348, p < 0.05; TD: p > 0.05). In ASD, FAt (r = −0.441, p < 0.001) and ADt (r = −0.28, p = 0.037) were negatively correlated with language impairment, while radial diffusivity tissue showed a positive correlation (r = 0.355, p = 0.007) in the right MdLF. There were no significant between-group differences found in diffusion metrics.
Conclusions
The MdLF exhibits aberrant developmental trajectories in preschool children with ASD, and its microstructural integrity is linked to language impairment. These findings underscore the MdLF's role in ASD-related language deficits and highlight the importance of early neurodevelopmental assessment.
背景与目的中纵束（MdLF）是最近在腹侧语言网络中发现的一个白质束，在自闭症谱系障碍（ASD）中的研究尚不充分。我们假设MdLF的微观结构发育改变有助于ASD儿童的语言障碍。方法对57例（5.79±0.99岁）和37例（5.99±1.38岁）4 ~ 9岁的正常发育（TD）儿童（5.99±1.38岁）采用游离水校正弥散性磁共振（MRI）束道成像重建MdLF。使用自闭症行为检查表语言子量表评估语言障碍。采用一般线性模型和部分相关模型（共变年龄）研究ASD中扩散指标的年龄相关差异以及扩散指标与语言障碍的相关性。结果双侧MdLF分数各向异性组织（FAt）出现显著的年龄组相互作用(TD：左/右β = 0.614/0.511, p <；0.01;ASD: p >；0.05)和轴向扩散性组织（ADt） (ASD：左/右β =−0.458/−0.348,p <；0.05;TD: p >；0.05)。在ASD中，FAt (r = - 0.441, p <；0.001)和ADt （r = - 0.28, p = 0.037）与语言障碍呈负相关，而右侧MdLF的径向扩散率组织呈正相关（r = 0.355, p = 0.007）。扩散指标组间无显著差异。结论学龄前ASD患儿的MdLF表现出异常的发育轨迹，其微观结构完整性与语言障碍有关。这些发现强调了MdLF在自闭症相关语言缺陷中的作用，并强调了早期神经发育评估的重要性。
{"title":"Middle Longitudinal Fascicle Maldevelopment on Free Water Corrected MR Diffusion Underlies Language Impairment in Autism","authors":"Doudou Cao, Litong Ni, Qi Qi, Lan Zhou, Wei Zhang, Yi Wang, Li Zhu, Guolin Ma, Fan Zhang, Shijun Li","doi":"10.1111/jon.70067","DOIUrl":"https://doi.org/10.1111/jon.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The middle longitudinal fascicle (MdLF), a recently characterized white matter tract within the ventral language network, remains understudied in autism spectrum disorder (ASD). We hypothesized that altered microstructural development of the MdLF contributes to language impairment in children with ASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Free water corrected diffusion magnetic resonance imaging (MRI) tractography was employed to reconstruct the MdLF in 57 children with ASD (5.79±0.99 years) and 37 matched typically developing (TD) controls (5.99±1.38 years), aged 4–9 years. Language impairment was assessed using the Autism Behavior Checklist language subscale. General linear models and partial correlations (covarying age) were applied to investigate age-related differences of diffusion metrics and the correlation of diffusion metrics with language impairment in ASD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant age-by-group interactions emerged for bilateral MdLF fractional anisotropy tissue (FA<sub>t</sub>) (TD: left/right β = 0.614/0.511, <i>p</i> < 0.01; ASD: <i>p</i> > 0.05) and axial diffusivity tissue (AD<sub>t</sub>) (ASD: left/right β = −0.458/−0.348, <i>p</i> < 0.05; TD: <i>p</i> > 0.05). In ASD, FA<sub>t</sub> (<i>r</i> = −0.441, <i>p</i> < 0.001) and AD<sub>t</sub> (<i>r</i> = −0.28, <i>p</i> = 0.037) were negatively correlated with language impairment, while radial diffusivity tissue showed a positive correlation (<i>r</i> = 0.355, <i>p</i> = 0.007) in the right MdLF. There were no significant between-group differences found in diffusion metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MdLF exhibits aberrant developmental trajectories in preschool children with ASD, and its microstructural integrity is linked to language impairment. These findings underscore the MdLF's role in ASD-related language deficits and highlight the importance of early neurodevelopmental assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551010","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, Andres Fernandez-Prieto, Alberto Alvarez-Muelas, Ángel Calleja, Joaquin Ortega, Carlos Domínguez, Antonio Sagredo, Amado Rodríguez-Benítez, Juan García-Villanego, Alberto Martínez-Calvo, Daniel Cubillo-Prieto, Carmen de la Rosa, Antonio Mosqueira, Rebeca Bermejo-Garcés, Juan Chaviano, Isabel Bermúdez-Coronel, Carlos Pérez-García, Carlos Manuel Rodriguez-Paz, Carlos Hidalgo-Barranco, Javier Maynar, Jose Luis Caniego, Juan David Molina-Nuevo, Víctor Maestro, Juan Manuel Sanchís-García, Oscar Balboa, Mario Martínez-Galdamez, Eñaut Garmendia, Marc Comas-Cufí, Josep Puig, Joaquín Zamarro
Background and Purpose
The effectiveness of a large-bore aspiration catheter for contact aspiration (CA) thrombectomy is compared to the combined use of an aspiration catheter and a stent retriever (CA+SR) for large vessel occlusion (LVO). We assessed the efficacy and safety of CA alone versus CA+SR as first-line treatment for middle cerebral artery (MCA) LVO in daily practice.
Methods
We retrospectively analyzed data from the SARA-3 registry of patients with MCA occlusion (M1 and M2 segments), dividing them into two groups: first-line CA alone and combined CA+SR. Demographic, clinical, angiographic, and clinical outcomes (National Institute of Health Stroke Scale score at 24 h and modified Rankin Scale [mRS] score at 3 months) were compared.
Results
Of 551 patients, 348 (63.8%) received CA alone and 203 (36.8%) received CA+SR. The groin-to-reperfusion time was significantly shorter in the CA-alone group than in the combined CA+SR group (median, 26 vs. 40 min, p < 0.001). The CA group demonstrated higher first-pass modified Thrombolysis In Cerebral Infarction (mTICI) 3 recanalization rates (47% vs. 37%; adjusted odds ratio [OR] 1.5 [confidence interval 1–2.1], p = 0.042), a higher final mTICI 3 rate (65% vs. 56%; OR 1.5 [1–2.2], p = 0.037), and fewer new territory embolisms (0.9% vs. 3.9%; OR 0.2 [0–0.8], p = 0.028) compared to the CA+SR group. The CA-alone group had better functional outcomes at 3 months (mRS ≤ 2, 77% vs. 63%; OR 1.9 [1.3–3], p = 0.003).
Conclusions
CA alone outperformed CA+SR as a first-line treatment for MCA LVO, yielding higher first-pass and final recanalization rates, lower new territory embolism risk, shorter procedure times, and better functional outcomes at 3 months.
背景与目的比较了大口径吸血导管用于接触吸血（CA）取栓的有效性，并将其与大血管闭塞（LVO）联合使用吸血导管和支架回收器（CA+SR）进行了比较。我们在日常实践中评估了单独CA与CA+SR作为大脑中动脉（MCA） LVO一线治疗的有效性和安全性。方法回顾性分析SARA-3登记的MCA闭塞（M1和M2段）患者的资料，将其分为两组：一线CA单独组和CA+SR联合组。比较人口学、临床、血管造影和临床结果（24小时时美国国立卫生研究院卒中量表评分和3个月时改良Rankin量表[mRS]评分）。结果551例患者中，单纯CA治疗348例（63.8%），CA+SR治疗203例（36.8%）。CA单独组腹股沟到再灌注时间明显短于CA+SR联合组(中位数，26 vs 40 min, p <；0.001)。CA组表现出更高的首过改良脑梗死溶栓（mTICI） 3再通率(47% vs 37%；校正优势比[OR] 1.5[置信区间1-2.1],p = 0.042)，最终mTICI 3率较高(65%对56%；OR为1.5 [1-2.2],p = 0.037)，新区域栓塞较少(0.9% vs. 3.9%；OR 0.2 [0-0.8], p = 0.028)，与CA+SR组比较。单独ca组在3个月时功能预后更好(mRS≤2,77% vs. 63%；OR 1.9 [1.3-3], p = 0.003)。结论单独CA优于CA+SR作为MCA LVO的一线治疗，在3个月时具有更高的首次通过率和最终再通率，更低的新区域栓塞风险，更短的手术时间和更好的功能结果。
{"title":"Contact Aspiration Alone or Combined With Stent Retriever Thrombectomy for Middle Cerebral Artery Large Vessel Occlusion","authors":"Pedro Navia, Andres Fernandez-Prieto, Alberto Alvarez-Muelas, Ángel Calleja, Joaquin Ortega, Carlos Domínguez, Antonio Sagredo, Amado Rodríguez-Benítez, Juan García-Villanego, Alberto Martínez-Calvo, Daniel Cubillo-Prieto, Carmen de la Rosa, Antonio Mosqueira, Rebeca Bermejo-Garcés, Juan Chaviano, Isabel Bermúdez-Coronel, Carlos Pérez-García, Carlos Manuel Rodriguez-Paz, Carlos Hidalgo-Barranco, Javier Maynar, Jose Luis Caniego, Juan David Molina-Nuevo, Víctor Maestro, Juan Manuel Sanchís-García, Oscar Balboa, Mario Martínez-Galdamez, Eñaut Garmendia, Marc Comas-Cufí, Josep Puig, Joaquín Zamarro","doi":"10.1111/jon.70065","DOIUrl":"https://doi.org/10.1111/jon.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>The effectiveness of a large-bore aspiration catheter for contact aspiration (CA) thrombectomy is compared to the combined use of an aspiration catheter and a stent retriever (CA+SR) for large vessel occlusion (LVO). We assessed the efficacy and safety of CA alone versus CA+SR as first-line treatment for middle cerebral artery (MCA) LVO in daily practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from the SARA-3 registry of patients with MCA occlusion (M1 and M2 segments), dividing them into two groups: first-line CA alone and combined CA+SR. Demographic, clinical, angiographic, and clinical outcomes (National Institute of Health Stroke Scale score at 24 h and modified Rankin Scale [mRS] score at 3 months) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 551 patients, 348 (63.8%) received CA alone and 203 (36.8%) received CA+SR. The groin-to-reperfusion time was significantly shorter in the CA-alone group than in the combined CA+SR group (median, 26 vs. 40 min, <i>p</i> < 0.001). The CA group demonstrated higher first-pass modified Thrombolysis In Cerebral Infarction (mTICI) 3 recanalization rates (47% vs. 37%; adjusted odds ratio [OR] 1.5 [confidence interval 1–2.1], <i>p</i> = 0.042), a higher final mTICI 3 rate (65% vs. 56%; OR 1.5 [1–2.2], <i>p</i> = 0.037), and fewer new territory embolisms (0.9% vs. 3.9%; OR 0.2 [0–0.8], <i>p</i> = 0.028) compared to the CA+SR group. The CA-alone group had better functional outcomes at 3 months (mRS ≤ 2, 77% vs. 63%; OR 1.9 [1.3–3], <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CA alone outperformed CA+SR as a first-line treatment for MCA LVO, yielding higher first-pass and final recanalization rates, lower new territory embolism risk, shorter procedure times, and better functional outcomes at 3 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144536927","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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