Comparative study on radiological features between serum aquaporin 4 antibody positive and negative neuromyelitis optica spectrum disorder / 中华放射学杂志

Objective:To investigate the clinical and imaging differences between serum aquaporin 4 (AQP4) antibody positive and negative patients with neuromyelitis optica spectrum disorder (NMOSD).Methods:The clinical data and radiologic findings of 89 NMOSD patients diagnosed at Beijing Tiantan Hospital, Capital Medical University from January 2018 to June 2022 were retrospectively analyzed. There were 17 male cases and 72 female cases, aged 18-74 years. According to the results of serum AQP4 antibody test, the patients were divided into AQP4 antibody positive group and AQP4 antibody negative group, and the differences in clinical data, lesion distribution, lesion characteristics, and brain area volume between the 2 groups were compared using independent sample t-test and χ 2 test, and the correlation between brain area volume and expanded disability status scale (EDSS) scores was further investigated using Spearman correlation analysis. Results:There were 68 cases in the AQP4 antibody positive group and 21 cases in the AQP4 antibody negative group. Patients in both groups were predominantly female, but the percentage of females in the AQP4 antibody-positive group (86.8%, 59/68) was higher than that in the AQP4 antibody-negative group (61.9%, 13/21), with a statistically significant difference (χ 2=4.91, P=0.027). The incidence of optic neuritis in AQP4 antibody negative group (66.7%, 14/21) was higher than that in antibody positive group (41.2%, 28/68), with a statistically significant difference (χ 2=4.18, P=0.041). In the distribution of intracranial lesions on MRI, the probability of lesions involving the brain stem in AQP4 antibody negative group (47.6%, 10/21) was higher than that in AQP4 antibody positive group (23.5%, 16/68), the difference had statistically significance (χ 2=4.50, P=0.034). The volumes of whole brain white matter, right amygdala, right accumbens-area and right ventral diencephalon in AQP4 antibody positive group were lower than those in AQP4 antibody negative group ( P<0.05), and the volumes of the right accumbens-area were negatively correlated with the EDSS scores in AQP4 antibody positive group ( r=-0.628, P=0.009). Conclusion:There are differences in clinical and imaging manifestations between AQP4 antibody positive and AQP4 antibody negative patients, which provides more basis for clinical in-depth understanding of NMOSD.

Valor pronóstico del glutamato en el líquido cefalorraquídeo en esclerosis múltiple / Prognostic value of cerebrospinal fluid glutamate in multiple sclerosis

Resumen El objetivo del trabajo fue evaluar la asociación entre el nivel de glutamato en el líquido cefalorraquídeo (LCR) al inicio de la enfermedad y la progresión de la enfermedad durante el seguimiento en una cohorte de pacientes con esclerosis múltiple (EM). Se determinaron niveles de glutamato (Glu) en LCR al inicio de la enfermedad. Se realizó una resonancia basal y durante el seguimiento cada 12 meses con el objeto de determinar el porcentaje de cambio de volumen cerebral (PCVC), grosor cortical (GC) y volumen le sional cerebral en secuencia T2 (VLT2). Los predictores primarios de interés fueron los niveles basales de Glu en LCR, PCVC Y GC, así como la progresión clínica de la enfermedad [medida por Expanded Disability Status Scale (EDSS) y tasa anual de recaídas]. Un total de 26 pacientes fueron incluidos. La concentración media de Glu fue de 5.3 ± 0.4 μM/l. Se encontró una asociación significativa entre concentraciones basales elevadas de Glu y la progresión del EDSS (b = 1.06, IC 95% 0.47-1.66, p = 0.003), así como también el PCVC (b = -0.71, IC 95% -0.56-1.38, p = 0.002) y CG (b = -0.15, IC 95% -0.06-0.33, p = 0.01). No se encontró asociación entre los niveles de Glu y la tasa anual de recaídas como tampoco el VLT2 (b = 0.08, IC 95% -0.11-0.43, p = 0.11 y b = 195, IC -39-330, p = 0.22, respectivamente). Los niveles aumentados de Glu se asociaron con un mayor cambio en el PCVC y progresión del EDSS durante el seguimiento.

Abstract. The objective of this study was to evaluate the association between glutamate (Glu) levels in cerebrospinal fluid (CSF) at disease onset and disease progression during follow up in a cohort of multiple sclerosis (MS) patients. Glu level was measured at disease onset (first relapse). MRI was obtained at baseline and follow-up (every 12 months) to determine the percent of brain volume change (PBVC), cortical thickness (CT), and T2 lesion volume (T2LV). The primary predictors of interest were baseline CSF Glu levels, PBVC and CT, as well as clinical disease progression [measured by Expanded Disability Status Scale (EDSS) and annualized relapse rate] during follow-up. A total of 26 MS patients were included. Mean concentration of Glu in CSF at diagnosis was 5.3 ± 0.4 μM/l. A significant association was observed between higher baseline levels of Glu and an increase in EDSS during follow up (b = 1.06, 95%CI 0.47-1.66, p = 0.003) as well as PBVC (b = -0.71 95%CI -0.56-1.38, p = 0.002) and CT (b = -0.15, 95%CI -0.06-0.33, p = 0.01). We did not observe an association between baseline Glu levels and relapse rate or T2LV during follow-up (b = 0.08, 95%CI -0.11-0.43, p = 0.11 and b = 195, 95%CI -39-330, p = 0.22, respectively). Higher Glu concentrations at disease onset were associated with an increase in PBVC and EDSS progression during follow-up in MS patients.

MR three-dimension brain volume imaging enhanced scanning in diagnosis of internal auditory canal lesions / 中国介入影像与治疗学

Objective: To investigate the value of MR three-dimension brain volume imaging (3D-BRAVO) enhanced scanning in diagnosis of internal auditory canal lesion. Methods: Eighty-one patients with internal auditory canal disease (totally 116 lesions) underwent 3D-BRAVO enhanced and conventional enhanced MR scanning. The sensitivity of methods was compared. Results: Conventional MR enhanced scanning found 86 lesions, the diagnostic sensitivity was 71.55% (83/116), and the misdiagnose rate was 28.45% (33/116). All 116 lesions were detected with 3D-BRAVO enhanced scanning, and the diagnostic sensitivity was 100% (116/116). The diagnostic sensitivity of 3D-BRAVO scanning was higher than that of conventional enhanced scanning (Z=-3.74, P<0.001). Conclusion: 3D-BRAVO enhanced scanning can sensitively detect lesions in the internal auditory canal area and provide imaging evidences for clinical diagnosis and treatment of these lesions.

The Clock Is Ticking – Brain Atrophy in Case of Acute Trauma? / 대한신경손상학회지

OBJECTIVE: Brain atrophy and brain herniation are gaining a lot of attention separately, but a limited amount of studies connected them together, and because of this, we are going to review and examine the subject in the current meta-analysis. METHODS: The authors collected data reporting brain atrophy of alcoholic and schizophrenic cause, as well as data on control patients, all of which was published on MEDLINE between 1996 and 2018. The included 11 articles were processed with a statistical program. RESULTS: We found that the pericerebral space is unequal among the groups, while the intracranial volume is strongly correlated to the biggest foramen of the body. The effect of this inequality, however, is expressed in emergency cases, where the patients with brain atrophy will have more time before the final stage of brain herniation CONCLUSION: The current study raises a controversial issue that requires careful investigation and high attention from the health care personnel.

Volume quantification of normal brain tissues based on the magnetic resonance T1 images / 解剖学报

Objective: By manual and automatic segmentation, the total volume, cerebrospinal fluid volume and white matter volume of normal human brain were obtained, and the differences between different genders and the patterns of changes with age were analyzed. At the same time, we give the software and parameters that can get better result. Methods: The rough brain mask was obtained by software automatic segmentation and it would be refined manually. Then the brain masks would be divided into gray matter, white matter and cerebrospinal fluid by FSL-FAST, and finally statistical analysis was performed with SPSS 25.0 software. Results: The total brain volume of normal Chinese adults was about 1263.24 ml, and the total brain volume of males (1313.84 ml) was lager than the total volume of female brain (1173.11 ml). The difference was statistically significant. There were significant differences in total volume, gray matter, white matter and cerebrospinal fluid volume among different age groups. And there was no correlation between the age and the ratio of gray matter white matter. The total brain volume, gray matter, and white matter volume of males were larger than those of females, and as the age increases, the decline trend of these three sets of data is similar. The changes of total brain volume, gray matter volume and white matter volume with age were also similar in females. They reached their maximum at about 50 years of age, and then the volume gradually decreased. Conclusion: The study on the changes of brain volume and the volume of gray matter, white matter and cerebrospinal fluid with age in different sexes can be used as a basis for identifying the changes of brain volume caused by diseases or the age.

Comparison of BRAVO Sequence and TRICKS Sequence on Cerebral Venous Sinus Thrombosis / 昆明医科大学学报

Objective To compare the advantages and disadvantages of 3D BRAVO and TRICKS for detecting cerebral venous sinus thrombosis (CVST) and to explore the MR scanning methods on CVST.Methods A retrospective analysis was conducted on 40 patients who were diagnosed with CVST in the Fourth Affiliated Hospital of Kunming Medical University from January 2011 to June,2014.All the patients underwent TRICKS scan and 3D BRAVO examination and were classified into 3 groups based on dural venous sinuses,deep cerebral vein and superficial cerebral vein.Detection rates of TRICKS and BRAVO were evaluated and the results were analyzed.Result Detection rates of dural venous sinuses by TRICKS and BRAVO were 98.0％ and 100％ respectively.Detection rates of deep cerebral vein were 92.9％ and 100％ respectively.No significant difference was found (P＞0.05).Detection rates of superficial cerebral vein were 66.7％ and 100％ respectively.Significant difference was found between the two (P＜0.05) Conclusion BRAVO technology can clearly demonstrate the details of CVST,especially in superficial cerebral vein.With the combination use of TRICKS sequences,it will be of higher diagnostic value.

Combined use of MRI and 1 H proton magnetic resonance spectroscopy on the detection of brain metabolites and different brain areas of volume in small for gestational age / 中国小儿急救医学

Objective By 1 H magnetic resonance spectroscopy( 1 H MRS) ,small for gestational age (SGA)and appropriate for gestational age(AGA) as the detection of brain metabolites and MRI plus soft-ware measurement in different brain areas of volume,investigate its cerebral metabolites and the changes of brain in different parts of the volume and significance. Methods Select 88 patients eligible infants, SGA group of 27 cases and AGA group of 21 cases of premature infants;SGA group of 22 cases and AGA group of 18 cases of term infants. Preterm infants with a gestational age of 32 to 36 weeks,term infants with a gesta-tional age of 37 to 41 weeks. Check time between 4 to 7 days old. Calculation of cerebrum volume,cerebellar volume and cerebrospinal fluid volume and intracranial volume,N-acetylaspartic acid(NAA),as 1H MRS area of metabolites measured right frontal choline compounds( Cho) and creatine compounds( Cr) wave,calcu-lation of Cho/Cr and NAA/Cho ratio of NAA/Cr. Results NAA/Cr,the cerebrum volume and intracranial volume of SGA in premature infants group,term infants group and mixed group were 0. 627 ± 0. 183,(2. 831 ±0. 199) ×105 mm3,(3. 178 ±0. 209) ×105 mm3;0. 706 ±0. 139,(3. 056 ±0. 217) ×105 mm3,(3. 411 ± 0. 212 ×105 mm3;0. 708 ± 0. 171,(2. 932 ± 0. 234) × 105 mm3,(3. 282 ± 0. 239) × 105 mm3,respective-ly. NAA/Cr,the cerebrum volume and intracranial volume of AGA in premature infants group,term infants group and mixed group were 0. 734 ± 0. 101,(2. 987 ± 0. 111) × 105 mm3,(3. 347 ± 0. 137) × 105 mm3;0. 805 ± 0. 106, ( 3. 228 ± 0. 284 ) × 105 mm3 , ( 3. 588 ± 0. 306 ) × 105 mm3; 0. 721 ± 0. 119, ( 3. 098 ± 0.240) ×105 mm3,(3.458 ±0.258) ×105 mm3,respectively. The data of SGA group were all lower than those in AGA group,which had significant difference(P0. 05,respectively). In the premature infants groups,the NAA/Cho of SGA group(0. 401 ± 0. 737) was lower than in the AGA group(0. 506 ± 0. 116), which had significant difference(P=0. 000). In the term infants groups,the NAA/Cho of SGA group(0. 483 ±0. 605) was lower than in the AGA group(0. 472 ± 0. 987),which had no significant difference(P =0. 653). In the AGA groups,NAA/Cr,NAA/Cho,cerebellar volume and cerebrospinal fluid volume of pre-mature infants group and term infants group had no significant difference ( P>0. 05 ) . Both of the cerebellar volume and cerebrospinal fluid volume between the premature infants AGA group and premature infants AGA group had no significant difference(P>0. 05). Conclusion Neurons in the brain,the cerebrum volume,the cranial cavity volume and NAA/Cr of SGA was significantly lower than those of AGA,but Cho/Cr,cerebel-lar volume and cerebrospinal fluid volume of SGA and AGA had no significant difference. NAA/Cr in the brain and the cerebrum volume of SGA may be associated with low volume of small nerve mental retarda-tion,worthy of further study.

The Accompanying Changes in Brain Structure of a Remitted Depression Patient with the Bupropion Treatment

The impacts from the bupropion on the brain structures have seldom been mentioned in the literature. The bupropion is a kind of antidepressant with dual action in the norepinephrine and dopamine receptors. Here we have a case to share about the bupropion-related effects in the brain structure.

Uso de volumetría y carga lesional en el seguimiento de pacientes con esclerosis múltiple: experiencia local y revisión de la literatura / Use of lesion volumes and loads for monitoring patients with multiple sclerosis: local experience and literature review

Multiple sclerosis (MS) is a common demyelinating disease that involves the central nervous system causing focal lesions in the brain and spinal cord causing diverse neurological development deficits, many of them severe and irreversible, affecting and invaliding a large percentage of young productive-aged patients. MRI exams have improved diagnostic capability compared to computed tomography, but in this decade the development of new magnets, coils and software have allowed the development of quantitative neuroradiology which achieves the evaluation of parameters such as total brain volume, of each of its structures, as well as semi-automated or automated counting of the lesion load, allowing better monitoring of each individual patient in relation to a particular event such as a new neurological deficit in an outbreak of the disease, a previously undetected cognitive impairment or in related to a given treatment. We will show our local experience using the FreeSurfer software in our habitual practice, as well as other post-processing software, this being the first experience of its use in multiple sclerosis published in our country.

La esclerosis múltiple (EM) es una frecuente enfermedad desmielinizante que afecta el sistema nervioso central produciendo lesiones focales a nivel cerebral y medular que condicionan diversos déficit neurológicos evolutivos, muchos de ellos severos e irreversibles, afectando e invalidando un gran porcentaje de pacientes jóvenes en edad productiva. El estudio con resonancia magnética mejoró la capacidad diagnóstica respecto a la tomografía computada, pero en esta década el desarrollo de nuevos magnetos, bobinas y software han permitido desarrollar la neurorradiología cuantitativa que logra evaluar parámetros como el volumen cerebral global, de cada una de sus estructuras así como el recuento semi o automatizado de la carga lesional, lo que permite el mejor seguimiento de cada paciente individual en relación a un evento determinado como un nuevo déficit neurológico dentro de un brote de la enfermedad, un deterioro cognitivo no detectado previamente o en relación a un tratamiento determinado. Mostraremos nuestra experiencia local utilizando el software freesurfer en nuestra práctica habitual, así como otro software de postproceso, siendo la primera experiencia de su uso en esclerosis múltiple publicada en nuestro país.

A pilot study of voxel-based morphometry on brain structures related to emotional enhancement effect of memory / 中华行为医学与脑科学杂志

Objective The brain volume and behavioral performance of emotional memory were measured by combining voxel-hased morphometry (VBM) and behavior to explore the morphological characters of brain regions related to the emotional enhancement effect of memory.Methods A total of 32 healthy young subjects participated in the study.The experimental processes included MR scan and behavioral performance of emotional memory the latter of which involved two phases-encoding and retrieval.Behavioral performance was recorded and the whole-brain 3D MRI data were acquired via 3.0T MR.3D MRI data were segmented by VBM5,and the wholebrain volumes of gray matter,white matter and CSF were produced.SPM5 and SPSS13.0 were used for statistical analysis of the 3D MRI data and behavioral data,respectively.Results Retrieval accuracy of the emotional pictures was higher than that of the neutral pictures ( t =5.08,P＜0.001 ),the emotional enhancement effect was significant ( Δ Pr =0.12 ± 0.01 ).Brain regions related to emotional enhancement effect included bilateral amygdala,dorsolateral prefrontal cortex,middle frontal gyrus,dorsomedial prefrontal cortex,fusiform gyms,right parahippocampus,left orbitofrontal cortex and middle cingulate gyms.Volume ratio of bilateral amygdala were related to emotion enhancement effect evidently (left:r=0.564,P＜0.01 ; right:r=0.541,P＜0.01 ).Conclusion This study morphologically confirms that brain regions,such as amygdale and prefrontal cortex,are critical structures for the enhancement of emotional memory,and further extends the findings of previous functional imaging studies.

Imaging changes of brain structure in post-traumatic stress disorders: Recent progress / 第二军医大学学报

The brain structural imaging changes in patients with post-traumatic stress disorders (PTSD) and the related research progress are reviewed. It is elucidated that the volume decrease and the density reductions of gray and white matters in PTSD patients are mainly manifested as the imaging changes of the hippocampus, callus, and anterior cingulate cortex (ACC). The imaging change of callus is characteristic in PTSD patients. The image structure analyses of the white matter and gray matter are the current frontiers and strategic trends of PTSD-related research. Meanwhile, it is pointed out that the relationship between PTSD and brain structure imaging is a problem needs to be urgently solved.

Peso de nacimiento y posterior estado nutricional, desarrollo cognitivo y actividad ocupacional: una revisión crítica / Birth weight and later nutritional status, cognitive development and job status: a critical review

El impacto del estado nutricional prenatal, especialmente lo concerniente al peso de nacimiento (PN) y sus efectos tanto en el corto, mediano o largo plazo, sobre el estado nutricional y el desarrollo cognitivo del niño y, sobre la ocupación desempeñada en la vida adulta, ha sido una problemática de interés para diversos investigadores; al respecto, algunos autores encuentran una asociación positiva y significativa entre estas variables, mientras que otros no encuentran ninguna relación. Es así como se ha descrito que niños con PN insuficiente, bajo o, extremadamente bajo, además del deterioro temprano del estado nutricional, presentarían en el corto plazo, un mayor riesgo de daño en la maduración cerebral, retraso del desarrollo cognitivo y menores circunferencias craneanas, lo que implicaría menor volumen encefálico y bajo rendimiento intelectual. En el corto y mediano plazo, esta situación perjudicaría el proceso enseñanza-aprendizaje en la etapa escolar, mientras que en el largo plazo, esto condicionaría la ocupación a desempeñar en la vida adulta. Actualmente, el cuerpo de conocimientos pone de manifiesto que los hallazgos relativos a estas asociaciones no son concluyentes, existiendo gran controversia en estas materias. Este artículo de revisión tiene el propósito de analizar la evidencia existente hasta este momento, con el objeto de incentivar la investigación en estos aspectos que son de gran relevancia para el desarrollo del niño y su vida futura.

The impact of prenatal nutritional status, assessed through birth weight (BW) and their effects in the short, medium and long-term on nutritional status, cognitive development and job status in the adult life, has been a problem of interest for several researchers; as regards, some of these report a positive and significant association between these variables and others do not find any relation. Children with insufficient, low or very low BW despite the early more deteriorate nutritional status should present higher risk for brain maturation, failure cognitive development and lowered head circumference which implies both lowered brain volume and intellectual development. In the short and medium-term, this situation damages the learning process at school-age, while in the long-term this might condition the quality of jobs. At present, the body of knowledge pinpoints that findings related to these associations is not conclusive verifying a great controversy in these matters. This review article has the purpose of analyzing the current evidence, in order to stimulate research about to these aspects which are relevant for child development and their future life.

Changes in Total Cerebral Blood Flow with Aging, Parenchymal Volume Changes, and Vascular Abnormalities: a Two-dimensional Phase-Contrast MRI Study

PURPOSE: To evaluate changes in total cerebral blood flow (tCBF) with aging, parenchymal volume changes and vascular abnormalities, using 2 dimensional (D) phase-contrast magnetic resonance imaging (PC MRI). MATERIALS AND METHODS: Routine brain MRI including T2 weighted image, time-of-flight (TOF) MR Angiography (MRA) and 2D PC MRI were performed in 73 individuals, including 12 volunteers. Normal subjects (12 volunteers, and 21 individuals with normal MRI and normal MRA) were classified into groups according to age (18 -29, 30 -49 and 50 -66 years). For the group with abnormalities in brain MRIs, cerebral parenchymal volume changes were scored according to the T2 weighted images, and atherosclerotic changes were scored according to the MRA findings. Abnormal groups were classified into 4 groups: (i) mild reduction in volume, (ii) marked reduction in volume by parenchymal volume and atherosclerotic changes, and (iii) increased volume and (iv) Moya-moya disease. Volumetric flow was measured at the internal carotid artery (ICA) and vertebral artery bilaterally using the velocity-flow diagrams from PC MRI, and combined 4 vessel flows and tCBF were compared among all the groups. RESULTS: The age-specific distribution of tCBFs in normal subjects were as follows: 12.0 +/- 2.1 ml/sec in 18 -29 years group, 11.8 +/- 1.9 ml/sec in 30 -49 years group, 10.9 +/-2.2 ml/sec in 50 -66 years group. The distribution of tCBFs in the different subsets of the abnormal population were as follows: 9.5 +/-2.5 ml/sec in the group with mild reduction in volume, 7.6 +/-2.0 ml/sec in the group with marked reduction in volume, and 7.3 +/-1.2 ml/sec and 7.0 +/- 1.1 ml/sec in the increased parenchymal volume and Moya-moya disease groups respectively. CONCLUSION: Total cerebral blood flow decreases with increasing age with a concomitant reduction in parenchymal volumes and increasing atherosclerotic changes. It is also reduced in the presence of increased parenchymal volume and Moya-moya disease. 2D PC MRI can be used as a tool to evaluate tCBF with aging and in the presence of various conditions that can affect parenchymal volume and cerebral vasculature.