Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103754
Catharina Zich , Nick S. Ward , Nina Forss , Sven Bestmann , Andrew J. Quinn , Eeva Karhunen , Kristina Laaksonen
Improving outcomes after stroke depends on understanding both the causes of initial function/impairment and the mechanisms of recovery. Recovery in patients with initially low function/high impairment is variable, suggesting the factors relating to initial function/impairment are different to the factors important for subsequent recovery. Here we aimed to determine the contribution of altered brain structure and function to initial severity and subsequent recovery of the upper limb post-stroke.
The Nine-Hole Peg Test was recorded in week 1 and one-month post-stroke and used to divide 36 stroke patients (18 females, age: M = 66.56 years) into those with high/low initial function and high/low subsequent recovery. We determined differences in week 1 brain structure (Magnetic Resonance Imaging) and function (Magnetoencephalography, tactile stimulation) between high/low patients for both initial function and subsequent recovery. Lastly, we examined the relative contribution of changes in brain structure and function to recovery in patients with low levels of initial function.
Low initial function and low subsequent recovery are related to lower sensorimotor β power and greater lesion-induced disconnection of contralateral [ipsilesional] white-matter motor projection connections. Moreover, differences in intra-hemispheric connectivity (structural and functional) are unique to initial motor function, while differences in inter-hemispheric connectivity (structural and functional) are unique to subsequent motor recovery.
Function-related and recovery-related differences in brain function and structure after stroke are related, yet not identical. Separating out the factors that contribute to each process is key to identifying potential therapeutic targets for improving outcomes.
{"title":"Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery","authors":"Catharina Zich , Nick S. Ward , Nina Forss , Sven Bestmann , Andrew J. Quinn , Eeva Karhunen , Kristina Laaksonen","doi":"10.1016/j.nicl.2025.103754","DOIUrl":"10.1016/j.nicl.2025.103754","url":null,"abstract":"<div><div>Improving outcomes after stroke depends on understanding both the causes of initial function/impairment and the mechanisms of recovery. Recovery in patients with initially low function/high impairment is variable, suggesting the factors relating to initial function/impairment are different to the factors important for subsequent recovery. Here we aimed to determine the contribution of altered brain structure and function to initial severity and subsequent recovery of the upper limb post-stroke.</div><div>The Nine-Hole Peg Test was recorded in week 1 and one-month post-stroke and used to divide 36 stroke patients (18 females, age: M = 66.56 years) into those with high/low initial function and high/low subsequent recovery. We determined differences in week 1 brain structure (Magnetic Resonance Imaging) and function (Magnetoencephalography, tactile stimulation) between high/low patients for both initial function and subsequent recovery. Lastly, we examined the relative contribution of changes in brain structure and function to recovery in patients with low levels of initial function.</div><div>Low initial function and low subsequent recovery are related to lower sensorimotor β power and greater lesion-induced disconnection of contralateral [ipsilesional] white-matter motor projection connections. Moreover, differences in intra-hemispheric connectivity (structural and functional) are unique to initial motor function, while differences in inter-hemispheric connectivity (structural and functional) are unique to subsequent motor recovery.</div><div>Function-related and recovery-related differences in brain function and structure after stroke are related, yet not identical. Separating out the factors that contribute to each process is key to identifying potential therapeutic targets for improving outcomes.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103754"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444917","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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103798
Marc Teichmann , Clara Sanches , Angelina Bourbon , Dennis Q. Truong , Marom Bikson , Antoni Valero-Cabré
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.
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.
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.
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.
{"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 , Clara Sanches , Angelina Bourbon , Dennis Q. Truong , Marom Bikson , 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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103796
Frauke Beyer , Lukas Kleine , Andrea Zülke , Melanie Luppa , Toralf Mildner , Jochen Gensichen , Thomas Frese , David Czock , Birgitt Wiese , Hans-Helmut König , Hanna Kaduszkiewicz , Wolfgang Hoffmann , Jochen René Thyrian , Arno Villringer , Steffi Riedel-Heller , A.Veronica Witte
<div><h3>Background</h3><div>Multimodal lifestyle interventions might help to maintain healthy cognition in older age and to delay onset of dementia. Here, we studied the effects of a multi-modal lifestyle-based intervention, based on the FINGER trial, on magnetic resonance imaging (MRI) markers of hippocampal-limbic atrophy and cerebral small vessel disease in older adults at increased risk for dementia in Germany.</div></div><div><h3>Methods</h3><div>Leipzig participants of the multicenter AgeWell.de randomized controlled trial underwent neuroimaging before and after a two year intervention at 3 Tesla MRI. We extracted hippocampal volume and entorhinal cortex thickness (ECT), free water fraction (FW), peak width of skeletonized mean diffusivity (PSMD), white matter hyperintensity volume and mean gray matter cerebral blood flow and assessed the effect of the intervention on these imaging markers using linear mixed models. We also tested the effect of the intervention on the hippocampus-dependent Mnemonic Similarity Test and fixel-based white matter microstructure.</div></div><div><h3>Results</h3><div>56 individuals (mean (sd) age: 68.8 (4.2) years, 26 females, 24/32 intervention/control group) were included at baseline and 41 returned after an average of 28 months for the second assessment. ECT and FW exhibited stronger decline in the intervention compared to the control group in preregistered models but not when adjusted for baseline differences. All other markers progressed similarly across groups, however sample size was smaller than expected. In exploratory analyses, cerebral blood flow increased more in the intervention group and this change was associated with decreases in systolic blood pressure.</div></div><div><h3>Conclusions</h3><div>In this group of older adults at risk for dementia, we find no conclusive evidence whether a multi-modal lifestyle intervention improves brain imaging markers of neurodegeneration and small vessel disease. Preliminary evidence suggested an association of the intervention, increased cerebral blood flow and systolic blood pressure reductions.</div><div>Abbreviations: ECT, entorhinal cortex thickness; FW, free water fraction; WHO, world health organization; AD, Alzheimer’s disease; VCI, vascular cognitive impairment; FINGER, Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability; MTL, medial temporal lobe; MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay diet; cSVD, cerebral small vessel disease; WMH, white matter hyperintensities of presumed vascular origin; PSMD, peak width of the mean diffusivity distribution; WW-FINGERS, world wide FINGER studies; CAIDE, Cardiovascular Risk Factors, Aging, and Incidence of Dementia; GPP, general practitioner praxis; MRI, magnetic resonance imaging; MST, Mnemonic Similarity Test; TE, echo time; TR, repetition time; FA, flip angle; FOV, field of view; GRAPPA, GeneRalized Autocalibrating Partial Parallel Acquisition; CMRR, Center
{"title":"Exploring the effect of multi-modal intervention against cognitive decline on atrophy and small vessel disease imaging markers in the AgeWell.de imaging study","authors":"Frauke Beyer , Lukas Kleine , Andrea Zülke , Melanie Luppa , Toralf Mildner , Jochen Gensichen , Thomas Frese , David Czock , Birgitt Wiese , Hans-Helmut König , Hanna Kaduszkiewicz , Wolfgang Hoffmann , Jochen René Thyrian , Arno Villringer , Steffi Riedel-Heller , A.Veronica Witte","doi":"10.1016/j.nicl.2025.103796","DOIUrl":"10.1016/j.nicl.2025.103796","url":null,"abstract":"<div><h3>Background</h3><div>Multimodal lifestyle interventions might help to maintain healthy cognition in older age and to delay onset of dementia. Here, we studied the effects of a multi-modal lifestyle-based intervention, based on the FINGER trial, on magnetic resonance imaging (MRI) markers of hippocampal-limbic atrophy and cerebral small vessel disease in older adults at increased risk for dementia in Germany.</div></div><div><h3>Methods</h3><div>Leipzig participants of the multicenter AgeWell.de randomized controlled trial underwent neuroimaging before and after a two year intervention at 3 Tesla MRI. We extracted hippocampal volume and entorhinal cortex thickness (ECT), free water fraction (FW), peak width of skeletonized mean diffusivity (PSMD), white matter hyperintensity volume and mean gray matter cerebral blood flow and assessed the effect of the intervention on these imaging markers using linear mixed models. We also tested the effect of the intervention on the hippocampus-dependent Mnemonic Similarity Test and fixel-based white matter microstructure.</div></div><div><h3>Results</h3><div>56 individuals (mean (sd) age: 68.8 (4.2) years, 26 females, 24/32 intervention/control group) were included at baseline and 41 returned after an average of 28 months for the second assessment. ECT and FW exhibited stronger decline in the intervention compared to the control group in preregistered models but not when adjusted for baseline differences. All other markers progressed similarly across groups, however sample size was smaller than expected. In exploratory analyses, cerebral blood flow increased more in the intervention group and this change was associated with decreases in systolic blood pressure.</div></div><div><h3>Conclusions</h3><div>In this group of older adults at risk for dementia, we find no conclusive evidence whether a multi-modal lifestyle intervention improves brain imaging markers of neurodegeneration and small vessel disease. Preliminary evidence suggested an association of the intervention, increased cerebral blood flow and systolic blood pressure reductions.</div><div>Abbreviations: ECT, entorhinal cortex thickness; FW, free water fraction; WHO, world health organization; AD, Alzheimer’s disease; VCI, vascular cognitive impairment; FINGER, Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability; MTL, medial temporal lobe; MIND, Mediterranean-DASH Intervention for Neurodegenerative Delay diet; cSVD, cerebral small vessel disease; WMH, white matter hyperintensities of presumed vascular origin; PSMD, peak width of the mean diffusivity distribution; WW-FINGERS, world wide FINGER studies; CAIDE, Cardiovascular Risk Factors, Aging, and Incidence of Dementia; GPP, general practitioner praxis; MRI, magnetic resonance imaging; MST, Mnemonic Similarity Test; TE, echo time; TR, repetition time; FA, flip angle; FOV, field of view; GRAPPA, GeneRalized Autocalibrating Partial Parallel Acquisition; CMRR, Center","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103796"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946816","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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103827
Laura Ludovica Gramegna , Matteo Zoli , Giovanni Sighinolfi , Alessandro Carrozzi , Gianfranco Vornetti , Elena Cantoni , Federica Guaraldi , Sofia Asioli , Caterina Tonon , David Neil Manners , Diego Mazzatenta , Raffaele Lodi
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).
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.
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.
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 < 0.01), that correlated with supero-inferior chiasmatic displacement (R = -0.49, p = 0.01).
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.
与传统形态学MR成像相比，弥散束造影可以改善前视神经通路（AOP）的可视化，从而增强对其与周围鞍区/鞍旁肿瘤（SPTs）的解剖关系的理解。我们的目标是开发一种用于自动可靠重建AOP的扩散束造影管道，并研究SPT患者AOP的显微结构改变。多壳扩散协议(b值= 0,300,1000,2000 s/mm2；64个最大梯度方向；2毫米各向同性体素)在3T扫描仪上进行，然后使用内部开发的全自动管道进行概率轨迹成像，基于信号的多壳-多组织约束球面反褶积建模。首先在10名健康对照中进行回顾性测试，然后在另外25名健康对照和35名spt患者中进行前瞻性测试。采用沿道入路比较患者和对照组的显微结构参数。本研究纳入70名受试者：35名健康对照者（18名女性，平均年龄50.7±14.3岁）和35名SPTs移位视交叉患者(18名女性；平均年龄53.7±16.4岁)。所有正常对照和患者的AOP重建均成功。在接受手术的患者中，84.7%的患者与手术检查正确对应。患者在交叉水平的平均弥漫性（MD）值显著降低(p <；0.01)，与上下交叉位移相关（R = -0.49, p = 0.01）。在鞍区/鞍旁肿瘤患者中开发并验证了一种新的全自动弥漫性动脉导管。交叉处MD值降低可能表明移位时压迫或神经胶质瘤。
{"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 , Matteo Zoli , Giovanni Sighinolfi , Alessandro Carrozzi , Gianfranco Vornetti , Elena Cantoni , Federica Guaraldi , Sofia Asioli , Caterina Tonon , David Neil Manners , Diego Mazzatenta , 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/mm<sup>2</sup>; 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 < 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}
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.
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).
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.
{"title":"Longitudinal changes of resting-state networks in Parkinson‘s disease","authors":"Matthias Sure , Rasha Hyder , Levent Kandemir , Jan Vesper , Alfons Schnitzler , 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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103903
James O. Thomas , Milanka Visser , Carlos Garcia-Esperon , Neil J. Spratt , Dennis Cordato , Cecilia Cappelen-Smith , Longting Lin , Mark W. Parsons
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.
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.
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 < 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).
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.
由于常规成像的敏感性有限，腔隙性卒中在急性环境中仍然具有诊断挑战性。虽然CT灌注（CTP）被广泛用于评估脑卒中，但其在识别皮层下腔隙性梗死中的作用尚不清楚。目前用于CTP解释的核心/半阴影算法有意抑制皮质下小病变，使其不适合腔隙性卒中诊断。这项回顾性的多中心研究评估了回顾性证实的腔隙性卒中病例中灌注异常的频率，并描述了有灌注异常和无灌注异常病例之间的临床和影像学差异。我们回顾了2018年至2022年期间在两个综合卒中中心连续就诊的患者，这些患者接受了急性多模态CT检查，最终诊断为急性腔隙性卒中，并通过弥散加权MRI确诊。如果在算法核心/半影图上没有发现灌注病变，则纳入患者。脑卒中神经科医师了解临床情况，但不知道MRI结果，对CTP参数图进行复查，以确定局灶性灌注异常的存在，随后进行第二次复查，并与DWI共同登记，以确定其他细微的灌注异常。在183例符合纳入标准的患者中，107例（58%）在盲法CTP检查中表现出明显的灌注异常，另外36例（20%）在DWI指导下发现有轻微病变，总频率为78%。无灌注异常的病例（22%）梗死体积明显较小(中位0.7 ml vs 1.8 ml, p
{"title":"CT perfusion lesions are present in most MRI confirmed lacunar strokes","authors":"James O. Thomas , Milanka Visser , Carlos Garcia-Esperon , Neil J. Spratt , Dennis Cordato , Cecilia Cappelen-Smith , Longting Lin , 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 < 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}
Pub Date : 2025-01-01Epub Date: 2025-07-28DOI: 10.1016/j.nicl.2025.103854
Joyce L Chen, Timothy K Lam, Melanie C Baniña, Daniele Piscitelli, Mindy F Levin
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, R2adj = 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.
{"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, R<sup>2</sup><sub>adj</sub> = 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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2024.103675
Changjun Teng , Wei Zhang , Da Zhang , Xiaomeng Shi , Xin Wu , Huifen Qiao , Ning Zhang , Xiao Hu , Chengbin Guan
{"title":"Corrigendum to “Association between clinical features and decreased degree centrality and variability in dynamic functional connectivity in the obsessive-compulsive disorder” [Neuroimage: Clinical 44 (2024) 1–9/103665]","authors":"Changjun Teng , Wei Zhang , Da Zhang , Xiaomeng Shi , Xin Wu , Huifen Qiao , Ning Zhang , Xiao Hu , Chengbin Guan","doi":"10.1016/j.nicl.2024.103675","DOIUrl":"10.1016/j.nicl.2024.103675","url":null,"abstract":"","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103675"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332387","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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103739
Ruikun Yang , Junxia Chen , Suping Yue , Yue Yu , Jiamin Fan , Yuling Luo , Hui He , Mingjun Duan , Sisi Jiang , Dezhong Yao , Cheng Luo
Backgrounds/Objective
Deep brain stimulation (DBS) has proved the viability of alleviating depression symptoms by stimulating deep reward-related nuclei. This study aims to investigate the abnormal connectivity profiles among superficial, intermediate, and deep brain regions within the reward circuit in major depressive disorder (MDD) and therefore provides references for identifying potential superficial cortical targets for non-invasive neuromodulation.
Methods
Resting-state functional magnetic resonance imaging data were collected from a cohort of depression patients (N = 52) and demographically matched healthy controls (N = 60). Utilizing existing DBS targets as seeds, we conducted step-wise functional connectivity (sFC) analyses to delineate hierarchical pathways linking to cerebral cortices. Subsequently, the mediation effects of cortical regions on the interaction within reward-related circuits were further explored by constructing mediation models.
Results
In both cohorts, sFC analysis revealed two reward-related pathways from the deepest DBS targets to intermediate regions including the thalamus, insula, and anterior cingulate cortex (ACC), then to the superficial cortical cortex including medial frontal cortex, posterior default mode network (pDMN), and right dorsolateral prefrontal cortex (DLPFC). Patients exhibited reduced sFC in bilateral thalamus and medial frontal cortex in short and long steps respectively compared to healthy controls. We also discovered the disappearance of the mediation effects of superficial cortical regions on the interaction between DBS targets and intermediate regions in reward-related pathways in patients with MDD.
Conclusion
Our findings support abnormal hierarchical connectivity and mediation effects in reward-related brain regions at different depth levels in MDD, which might elucidate the underlying pathophysiological mechanisms and inspire novel targets for non-invasive interventions.
{"title":"Disturbed hierarchy and mediation in reward-related circuits in depression","authors":"Ruikun Yang , Junxia Chen , Suping Yue , Yue Yu , Jiamin Fan , Yuling Luo , Hui He , Mingjun Duan , Sisi Jiang , Dezhong Yao , Cheng Luo","doi":"10.1016/j.nicl.2025.103739","DOIUrl":"10.1016/j.nicl.2025.103739","url":null,"abstract":"<div><h3>Backgrounds/Objective</h3><div>Deep brain stimulation (DBS) has proved the viability of alleviating depression symptoms by stimulating deep reward-related nuclei. This study aims to investigate the abnormal connectivity profiles among superficial, intermediate, and deep brain regions within the reward circuit in major depressive disorder (MDD) and therefore provides references for identifying potential superficial cortical targets for non-invasive neuromodulation.</div></div><div><h3>Methods</h3><div>Resting-state functional magnetic resonance imaging data were collected from a cohort of depression patients (N = 52) and demographically matched healthy controls (N = 60). Utilizing existing DBS targets as seeds, we conducted step-wise functional connectivity (sFC) analyses to delineate hierarchical pathways linking to cerebral cortices. Subsequently, the mediation effects of cortical regions on the interaction within reward-related circuits were further explored by constructing mediation models.</div></div><div><h3>Results</h3><div>In both cohorts, sFC analysis revealed two reward-related pathways from the deepest DBS targets to intermediate regions including the thalamus, insula, and anterior cingulate cortex (ACC), then to the superficial cortical cortex including medial frontal cortex, posterior default mode network (pDMN), and right dorsolateral prefrontal cortex (DLPFC). Patients exhibited reduced sFC in bilateral thalamus and medial frontal cortex in short and long steps respectively compared to healthy controls. We also discovered the disappearance of the mediation effects of superficial cortical regions on the interaction between DBS targets and intermediate regions in reward-related pathways in patients with MDD.</div></div><div><h3>Conclusion</h3><div>Our findings support abnormal hierarchical connectivity and mediation effects in reward-related brain regions at different depth levels in MDD, which might elucidate the underlying pathophysiological mechanisms and inspire novel targets for non-invasive interventions.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103739"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048585","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}
Pub Date : 2025-01-01DOI: 10.1016/j.nicl.2025.103782
M. Boumeester , E. Blom , T. Boerma , F. Lammertink , M.P. van den Heuvel , J. Dudink , M.J.N.L. Benders , E. Roze
Between 22 and 45 % of children born preterm experience difficulties with expressive and receptive language when they reach school age. Little is currently known about the neural mechanisms behind their linguistic performance. This study investigates the brain areas and white matter connections that form the structural language network in extremely preterm-born children who have reached school age. Structural brain connectivity was quantified using diffusion-weighted imaging (DWI) and tractography in n = 58 (62 % female) extremely preterm-born children aged 8–12 years. Language outcomes were assessed using the CELF-4-NL Recalling Sentences subtest. Language scores were below average in n = 13 (22 %) children. Language outcomes related significantly to a subnetwork of 16 brain regions (p = 0.012). The network comprised brain regions from the left hemisphere including the pars orbitalis, middle and superior frontal gyrus, frontal pole, pre- and postcentral gyrus, superior temporal gyrus, insula, caudate nucleus, thalamus, and putamen. In the right hemisphere, the anterior cingulate was part of the network. These findings suggest that extremely preterm children rely mostly on their left hemisphere during language processing, which is similar to typically developing children. However, they seem to use compensatory neural pathways that include brain areas right next to the areas typically involved in language processing. These areas include the pars orbitalis (adjacent to Broca’s area) and the putamen and caudate nucleus (adjacent to the limbic system). It is important to note that language difficulties were not necessarily related to brain injury around birth.
{"title":"Structural brain network in relation to language in school-aged extremely preterm children: A diffusion tensor imaging study","authors":"M. Boumeester , E. Blom , T. Boerma , F. Lammertink , M.P. van den Heuvel , J. Dudink , M.J.N.L. Benders , E. Roze","doi":"10.1016/j.nicl.2025.103782","DOIUrl":"10.1016/j.nicl.2025.103782","url":null,"abstract":"<div><div>Between 22 and 45 % of children born preterm experience difficulties with expressive and receptive language when they reach school age. Little is currently known about the neural mechanisms behind their linguistic performance. This study investigates the brain areas and white matter connections that form the structural language network in extremely preterm-born children who have reached school age. Structural brain connectivity was quantified using diffusion-weighted imaging (DWI) and tractography in <em>n</em> = 58 (62 % female) extremely preterm-born children aged 8–12 years. Language outcomes were assessed using the CELF-4-NL Recalling Sentences subtest. Language scores were below average in <em>n</em> = 13 (22 %) children. Language outcomes related significantly to a subnetwork of 16 brain regions (<em>p</em> = 0.012). The network comprised brain regions from the left hemisphere including the pars orbitalis, middle and superior frontal gyrus, frontal pole, pre- and postcentral gyrus, superior temporal gyrus, insula, caudate nucleus, thalamus, and putamen. In the right hemisphere, the anterior cingulate was part of the network. These findings suggest that extremely preterm children rely mostly on their left hemisphere during language processing, which is similar to typically developing children. However, they seem to use compensatory neural pathways that include brain areas right next to the areas typically involved in language processing. These areas include the pars orbitalis (adjacent to Broca’s area) and the putamen and caudate nucleus (adjacent to the limbic system). It is important to note that language difficulties were not necessarily related to brain injury around birth.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103782"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860528","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}
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