Neuroimage-Clinical最新文献

{"title":"Fully automated pipeline for the fiber tractography of the anterior optic pathway in patients with sellar and parasellar tumors and analysis of the microstructural alterations","authors":"Laura Ludovica Gramegna ,&nbsp;Matteo Zoli ,&nbsp;Giovanni Sighinolfi ,&nbsp;Alessandro Carrozzi ,&nbsp;Gianfranco Vornetti ,&nbsp;Elena Cantoni ,&nbsp;Federica Guaraldi ,&nbsp;Sofia Asioli ,&nbsp;Caterina Tonon ,&nbsp;David Neil Manners ,&nbsp;Diego Mazzatenta ,&nbsp;Raffaele Lodi","doi":"10.1016/j.nicl.2025.103827","DOIUrl":"10.1016/j.nicl.2025.103827","url":null,"abstract":"<div><div>Compared to conventional morphological MR imaging, diffusion tractography may improve the visualization of the anterior optic pathway (AOP), thus enhancing the understanding of its anatomical relationship with surrounding sellar/parasellar tumors (SPTs).</div><div>We aimed to develop a diffusion tractography pipeline for automatic and reliable reconstruction of the AOP and to investigate its microstructural alterations in SPT patients.</div><div>A multishell diffusion protocol (b-values = 0,300,1000,2000 s/mm²; 64 maximum gradient directions; 2-mm isotropic voxel) on a 3T scanner, followed by a fully automated pipeline developed in-house to perform the probabilistic tractography, based on multishell-multitissue constrained spherical deconvolution modeling of the signal, was performed. It was first tested retrospectively in 10 healthy controls, then prospectively applied in 25 additional healthy controls and 35 SPTs patients. Microstructural parameters were compared between patients and controls using an along-tract approach.</div><div>The study included 70 subjects: 35 healthy controls (18 females, mean age 50.7 ± 14.3 years) and 35 patients with SPTs displacing the optic chiasm (18 females; mean age 53.7 ± 16.4 years). The AOP reconstruction was successfully performed in all normal controls and patients. A correct correspondence with surgical inspection was identified in 84.7 % of patients who underwent surgery. Patients had significantly lower mean diffusivity (MD) values at the level of the chiasm (p &lt; 0.01), that correlated with supero-inferior chiasmatic displacement (R = -0.49, p = 0.01).</div><div>A novel, fully automated diffusion tractography pipeline for the AOP was developed and validated in patients with sellar/parasellar tumors. Reduced MD values at the chiasm level may indicate compression or gliosis in case of displacement.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"47 ","pages":"Article 103827"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Quantitative susceptibility mapping in multiple sclerosis: A systematic review and meta-analysis” [Neuroimage: Clin. 42 (2024) 103598]","authors":"Cui Ci Voon ,&nbsp;Tun Wiltgen ,&nbsp;Benedikt Wiestler ,&nbsp;Sarah Schlaeger ,&nbsp;Mark Mühlau","doi":"10.1016/j.nicl.2024.103693","DOIUrl":"10.1016/j.nicl.2024.103693","url":null,"abstract":"","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103693"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Striato-cortical connectivity patterns predict clinical profiles in Huntington’s disease","authors":"Audrey E. De Paepe ,&nbsp;Vasiliki Bikou ,&nbsp;Eylül Turan ,&nbsp;Alexis Pérez-Bellido ,&nbsp;Clara Garcia-Gorro ,&nbsp;Nadia Rodriguez-Dechicha ,&nbsp;Irene Vaquer ,&nbsp;Matilde Calopa ,&nbsp;Ruth de Diego-Balaguer ,&nbsp;Estela Camara","doi":"10.1016/j.nicl.2025.103788","DOIUrl":"10.1016/j.nicl.2025.103788","url":null,"abstract":"<div><h3>Background</h3><div>Huntington’s disease is an inherited neurodegenerative disorder affecting striato-cortical circuits, with significant heterogeneity in the severity and progression of symptoms and neurodegenerative patterns.</div></div><div><h3>Objectives</h3><div>To identify how distinct functional striato-cortical connectivity signatures may predict clinical profiles in Huntington’s disease.</div></div><div><h3>Methods</h3><div>Thirty-eight Huntington’s disease gene expansion carriers underwent cross-sectional motor, cognitive, and behavioral assessments and multimodal MRI. Principal component analysis was employed to characterize Huntington’s disease clinical profiles. Next, seed-based whole-brain functional connectivity maps were derived for three basal ganglia seeds (caudate nucleus, putamen, nucleus accumbens) to delineate cortico-striatal connections. Multiple linear regressions assessed relationships between resulting clinical profiles and seed-based resting-state functional connectivity maps. Finally, basal ganglia gray matter volumes were examined in relation to clinical profiles and connectivity.</div></div><div><h3>Results</h3><div>Principal component analysis identified two main clinical profiles in Huntington’s disease: motor-cognitive and behavioral. Multiple linear regression models revealed distinct functional neural signatures associated with each profile. Motor-cognitive symptoms related with a divergent connectivity pattern, specifically decreased connectivity between the caudate and putamen with executive and premotor areas, in contrast to increased connectivity between the ventral nucleus accumbens and executive network regions. Meanwhile, the behavioral profile was linked to decreased connectivity in limbic networks. Basal ganglia atrophy was associated with increased nucleus accumbens-cortical connectivity as well as motor-cognitive symptom severity.</div></div><div><h3>Conclusions</h3><div>Distinct Huntington’s disease clinical profiles can be characterized by predominantly motor-cognitive or behavioral disturbances, each related with unique functional and structural brain signatures. This substantiates that striato-cortical circuits exhibit functional interaction and potential reorganization.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103788"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial volume effect correction impairs the diagnostic utility of [18F]-THK-5351 PET in nonfluent-agrammatic variant primary progressive aphasia","authors":"Patrick J. Sommer ,&nbsp;Sebastian Schuster ,&nbsp;Oliver Goldhardt ,&nbsp;Nobuyuki Okamura ,&nbsp;Felix Mueller-Sarnowski ,&nbsp;Maximilian Scheifele ,&nbsp;Florian Eckenweber ,&nbsp;Annika Kreuzer ,&nbsp;Maria Griessl ,&nbsp;Peter Bartenstein ,&nbsp;Thomas Wegehaupt ,&nbsp;Lucas Wolski ,&nbsp;Josef Priller ,&nbsp;Axel Rominger ,&nbsp;Leonie Beyer ,&nbsp;Timo Grimmer ,&nbsp;Matthias Brendel","doi":"10.1016/j.nicl.2025.103789","DOIUrl":"10.1016/j.nicl.2025.103789","url":null,"abstract":"<div><h3>Objectives</h3><div>Partial volume effects in positron emission tomography occur frequently in neurodegenerative diseases due to increasing cortical atrophy during the disease course, and fronto-temporal dementia is often characterized by severe atrophy. The aim of this study was to challenge partial volume effect correction (PVEC) in patients with nonfluent-agrammatic variant primary progressive aphasia (nfv-PPA) imaged with [¹⁸F]-THK-5351 PET a marker of reactive neuroinflammatory astrogliosis as well as tau-binding.</div></div><div><h3>Methods</h3><div>Patients with nfv-PPA (n = 20) were imaged with [¹⁸F]-THK-5351 PET accompanied by structural magnetic resonance tomography imaging (MRI). Region specific cortical grey matter volumes and standard uptake value ratios (SUVr) of the Hammers atlas were compared with eight healthy control (HC) (n = 8) data before and after performing region-based voxel-wise PVEC. We evaluated regional coefficients of variance (CoV) and the number of regions with significant [¹⁸F]-THK-5351 PET signal differences between nfv-PPA and controls before and after PVEC. Additionally, a blinded visual read was performed by three nuclear medicine physicians (consensus) before and after PVEC.</div></div><div><h3>Results</h3><div>Prior to PVEC, [¹⁸F]-THK-5351 tracer uptake was significantly higher in the bilateral frontal cortex of patients with nfv-PPA when compared to HC (left &gt; right), despite significant grey matter atrophy in the same brain regions in patients with nfv-PPA. SUVr differences between nfv-PPA and HC were further increased by PVEC in frontal brain regions, but group level variance increased in parallel and reduced the number of significant differences between SUVr of nfv-PPA and HC (uncorrected: 10 significant regions, CoV[nfv-PPA]: 20.8 % ± 4.7 %, CoV[HC]: 7.9 % ± 2.4 %/PVEC: 3 significant regions, CoV[nfv-PPA]: 28.4 % ± 8.9 %, CoV[HC]: 9.8 % ± 2.5 %). Sensitivity/specificity of the visual read for detection of nfv-PPA was 0.85/1.00 without PVEC and 0.85/0.75 with PVEC.</div></div><div><h3>Conclusions</h3><div>[¹⁸F]-THK-5351 PET facilitates detection of pathological alterations in patients with nfvPPA with severe atrophy. PVEC increases quantitative SUVr differences between patients with nfv-PPA and HC but introduces a parallel increase of variance at the group level. Visual assessment of [¹⁸F]-THK-5351 images in patients with nfv-PPA is impaired by PVEC due to loss of specificity and does not support the use of PVEC even in patients with severe atrophy.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103789"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of structural-functional coupling abnormalities using multimodal brain networks in Alzheimer’s disease: A comparison of three computational models","authors":"Yinping Lu ,&nbsp;Luyao Wang ,&nbsp;Toshiya Murai ,&nbsp;Jinglong Wu ,&nbsp;Dong Liang ,&nbsp;Zhilin Zhang","doi":"10.1016/j.nicl.2025.103764","DOIUrl":"10.1016/j.nicl.2025.103764","url":null,"abstract":"<div><div>Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by the disconnection of white matter fibers and disrupted functional connectivity of gray matter; however, the pathological mechanisms linking structural and functional changes remain unclear. This study aimed to explore the interaction between the structural and functional brain network in AD using advanced structural–functional coupling (S-F coupling) models to assess whether these changes correlate with cognitive function, Aβ deposition levels, and gene expression. In this study, we utilized multimodal magnetic resonance imaging data from 41 individuals with AD, 112 individuals with mild cognitive impairment, and 102 healthy controls to explore these mechanisms. We applied different computational models to examine the changes in the S-F coupling associated with AD. Our results showed that the communication and graph harmonic models demonstrated greater heterogeneity and were more sensitive than the statistical models in detecting AD-related pathological changes. In addition, S-F coupling increases with AD progression at the global, subnetwork, and regional node levels, especially in the medial prefrontal and anterior cingulate cortices. The S-F coupling of these regions also partially mediated cognitive decline and Aβ deposition. Furthermore, gene enrichment analysis revealed that changes in S-F coupling were strongly associated with the regulation of cellular catabolic processes. This study advances our understanding of the interaction between structural and functional connectivity and highlights the importance of S-F coupling in elucidating the neural mechanisms underlying cognitive decline in AD.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103764"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging and kinematic biomarkers of post-stroke upper limb motor impairment.","authors":"Joyce L Chen, Timothy K Lam, Melanie C Baniña, Daniele Piscitelli, Mindy F Levin","doi":"10.1016/j.nicl.2025.103854","DOIUrl":"10.1016/j.nicl.2025.103854","url":null,"abstract":"<p><p>Structural and functional biomarkers derived from magnetic resonance imaging explain some variance in post-stroke motor impairment. The understanding of the nature of impairment and the discrimination between true behavioural motor recovery/restitution and motor compensation may be improved by the addition of kinematic information. The aim of the study was to determine the influence of neuroimaging combined with kinematic biomarkers in explaining the variance in motor impairment of the upper limb. People living with late sub-acute to chronic stroke (n = 25) underwent the Fugl Meyer Assessment - Upper Limb (FMA-UL), magnetic resonance imaging, and completed a reaching task where upper limb and trunk kinematics were recorded. Regression analyses were performed to determine the amount of variability in FMA-UL explained by the following biomarkers: the amount of corticospinal tract impacted by the stroke lesion (CST involvement), interhemispheric and ipsilesional resting state connectivity, and the Trunk-based Index of Performance (IPt) that measures skilled reaching ability while accounting for trunk compensation. CST involvement, interhemispheric connectivity, and the IPt, together explained ∼49 % of the variance in the FMA-UL (F(3,21) = 8.694, p = 0.001, R²_adj = 0.49). The IPt explained an additional 14 % of the variance in the FMA-UL compared to CST involvement alone (p = 0.02). The IPt is a relevant kinematic biomarker of post-stroke upper limb motor impairment. Our findings suggest the importance of using multiple categories of biomarkers to better understand the level of post-stroke motor impairment.</p>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"48 ","pages":"103854"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes of resting-state networks in Parkinson‘s disease","authors":"Matthias Sure ,&nbsp;Rasha Hyder ,&nbsp;Levent Kandemir ,&nbsp;Jan Vesper ,&nbsp;Alfons Schnitzler ,&nbsp;Esther Florin","doi":"10.1016/j.nicl.2025.103833","DOIUrl":"10.1016/j.nicl.2025.103833","url":null,"abstract":"<div><div>Deep brain stimulation (DBS), but also the sole implantation of the electrodes and dopaminergic medication, can reduce symptoms in Parkinson’s disease (PD) patients. Furthermore, an effect on network activity is known for all three options separately. However, long-term effects have rarely been investigated. Therefore, in the present study, we focus on the long-term impact of dopaminergic medication on whole-brain network activity following DBS electrode implantation.</div><div>Therefore, we extracted resting state networks (RSNs) of 20 PD patients (4 females, (59.00 ± 9.72 years) from magnetoencephalography data. We recorded 30 min of resting-state activity two days before and one year after implantation of the electrodes with and without dopaminergic medication, but DBS was turned off. RSNs were obtained based on the phase-amplitude coupling between a low-frequency phase and a high gamma amplitude and examined for differences between conditions (i.e., pre- vs. post-surgery).</div><div>We identified three RSNs across all conditions: sensory-motor, visual, and frontal. Each RSN was selectively altered due to a year of disease progression – while patients being treated with dopaminergic medication and DBS. In line with previous literature, we focus on longitudinal changes in RSNs over time after electrode implantation, acknowledging that chronic DBS treatment and other factors may confound the interpretation of these changes. In addition, the alterations found were RSN specific, as dopaminergic medication showed a greater impact on the frontal RSN, and the longitudinal factor expressed by the disease progression was more severe in alterations in the SMN and the visual RSN.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"47 ","pages":"Article 103833"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics feature similarity: A novel approach for characterizing brain network changes in patients with behavioral variant frontotemporal dementia","authors":"Salvatore Nigro ,&nbsp;Marco Filardi ,&nbsp;Benedetta Tafuri ,&nbsp;Roberto De Blasi ,&nbsp;Maria Teresa Dell’Abate ,&nbsp;Alessia Giugno ,&nbsp;Valentina Gnoni ,&nbsp;Giammarco Milella ,&nbsp;Daniele Urso ,&nbsp;Chiara Zecca ,&nbsp;Stefano Zoccolella ,&nbsp;Giancarlo Logroscino","doi":"10.1016/j.nicl.2025.103780","DOIUrl":"10.1016/j.nicl.2025.103780","url":null,"abstract":"<div><h3>Introduction</h3><div>Network modeling is increasingly used to study brain alterations in neurological disorders. In this study, we apply a novel modeling approach based on the similarity of regional radiomics feature to characterize gray matter network changes in patients with behavioral variant frontotemporal dementia (bvFTD) using MRI data.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we assessed structural 3 T MRI data from twenty patients with bvFTD and 20 cognitively normal controls. Radiomics features were extracted from T1-weighted MRI based on cortical and subcortical brain segmentation. Similarity in radiomics features between brain regions was used to construct intra-individual structural gray matter networks. Regional mean connectivity strength (RMCS) and region-to-region radiomics similarity were compared between bvFTD patients and controls. Finally, associations between network measures, clinical data, and biological features were explored in bvFTD patients.</div></div><div><h3>Results</h3><div>Relative to controls, patients with bvFTD showed higher RMCS values in the superior frontal gyrus, right inferior temporal gyrus and right inferior parietal gyrus (FDR-corrected p &lt; 0.05). Patients with bvFTD also showed several edges of increased radiomics similarity in key components of the frontal, temporal, parietal and thalamic pathways compared to controls (FDR-corrected p &lt; 0.05). Network measures in frontotemporal circuits were associated with Mini-Mental State Examination scores and cerebrospinal fluid total-tau protein levels (Spearman r &gt; |0.7|, p &lt; 0.005).</div></div><div><h3>Conclusions</h3><div>Our study provides new insights into frontotemporal network changes associated with bvFTD, highlighting specific associations between network measures and clinical/biological features. Radiomics feature similarity analysis could represent a useful approach for characterizing brain changes in patients with frontotemporal dementia.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103780"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial direct current stimulation over the temporal-parietal junction yields no lexical-semantic effects in logopenic primary progressive aphasia: a double-blind sham-controlled study","authors":"Marc Teichmann ,&nbsp;Clara Sanches ,&nbsp;Angelina Bourbon ,&nbsp;Dennis Q. Truong ,&nbsp;Marom Bikson ,&nbsp;Antoni Valero-Cabré","doi":"10.1016/j.nicl.2025.103798","DOIUrl":"10.1016/j.nicl.2025.103798","url":null,"abstract":"<div><div>Transcranial direct current stimulation (tDCS) has generated some promising outcomes in primary progressive aphasia (PPA). The logopenic variant (lv-PPA), one of the most frequent PPA phenotypes, erodes the temporal-parietal junction (TPJ) generating impaired lexical processing, rapidly extending to semantic deficits. Positive tDCS effects have been reported in several small-cohort studies but there is need for rigorous sham-controlled double-blind investigations to substantiate, or not, beneficial effects.</div><div>We used a sham-controlled double-blind counter-balanced crossover design with 12 clinically and imaging-characterized lv-PPA patients applying, according to the principle of interhemispheric rivalry, anodal and cathodal tDCS over the left and right TPJ, respectively, as compared to sham. A letter fluency (lexical access), a picture-naming (lexical/semantic access), and a semantic-matching task (semantic access) were applied before and after tDCS. Computational modeling was used to characterize predicted cortical tDCS current distribution.</div><div>Comparisons of post/pre-tDCS results did not show language improvement in any task. Finite element models showed impact for both tDCS modalities on the TPJ, but with lower radial field-strength when atrophy was implemented in the model. Correlation analyses on individual data, uncorrected for multiples comparisons, suggested that lesser aphasia severity and shorter disease duration are associated with more efficient tDCS effects.</div><div>Our results showing the absence of significant tDCS outcomes in lv-PPA mitigate previous reports of positive tDCS effects with similar or smaller patient sample sizes, and they demonstrate the need for exploring factors influencing stimulation effects. Findings from computational modelling combined with our uncorrected correlation results suggest that tDCS use might be most appropriate in PPA patients having slight atrophy and aphasia severity. Future studies on larger patient populations are required for robust proof-of-concept regarding therapy use of tDCS in PPA.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103798"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT perfusion lesions are present in most MRI confirmed lacunar strokes","authors":"James O. Thomas ,&nbsp;Milanka Visser ,&nbsp;Carlos Garcia-Esperon ,&nbsp;Neil J. Spratt ,&nbsp;Dennis Cordato ,&nbsp;Cecilia Cappelen-Smith ,&nbsp;Longting Lin ,&nbsp;Mark W. Parsons","doi":"10.1016/j.nicl.2025.103903","DOIUrl":"10.1016/j.nicl.2025.103903","url":null,"abstract":"<div><div>Lacunar stroke remains diagnostically challenging in acute settings due to limited sensitivity of routine imaging. While CT perfusion (CTP) is widely used for evaluating stroke, its role in the identification of subcortical lacunar infarcts is less clear. Current core/penumbra algorithms used for CTP interpretation intentionally suppress small subcortical lesions rendering them unsuitable for lacunar stroke diagnosis. This retrospective, multicentre study evaluates the frequency of perfusion abnormalities in retrospectively confirmed lacunar stroke cases and characterizes clinical and radiological differences between cases with and without perfusion abnormalities.</div><div>We reviewed consecutive patients presenting to two comprehensive stroke centres between 2018 and 2022, who underwent acute multimodal CT and had a final diagnosis of acute lacunar stroke confirmed by diffusion-weighted MRI. Patients were included if no perfusion lesion was identified on algorithmic core/penumbra maps. CTP parameter maps were reviewed for the presence of focal perfusion abnormalities by stroke neurologists aware of the clinical scenario but blinded to MRI findings, followed by a second review with DWI co-registration to identify additional subtle perfusion abnormalities.</div><div>Of the 183 patients meeting inclusion criteria, 107 (58 %) demonstrated obvious perfusion abnormalities on blinded CTP review, an additional 36 (20 %) were found to have subtle lesions identified retrospectively with DWI guidance, resulting in an overall frequency of 78 %. Cases with no perfusion abnormality (22 %) had significantly smaller infarct volumes (median 0.7 ml vs 1.8 ml, p &lt; 0.001), lower baseline NIHSS scores (median 2 vs 4, p = 0.005), and longer time from onset to imaging (median 8.4 h vs 4.5 h, p = 0.033).</div><div>Despite negative algorithmic CTP maps being negative, in DWI proven lacunar stroke, focal perfusion abnormalities are in fact present in most cases. CTP-negative cases appear to represent a distinct subgroup with smaller infarcts and milder deficits. These results highlight the influence of infarct volume and scan timing on lesion visibility and suggest that with advanced processing or machine learning assisted interpretation, CTP could play a greater role in the acute assessment of lacunar stroke.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"48 ","pages":"Article 103903"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}