Neuroimaging for Early Diagnosis of Alzheimer's Disease: a Review.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disease that primarily affects people above the age of 60 all around the world. As of now, the cause is unknown and there is no effective cure. The pathological changes of AD have occurred many years before the onset of the disease, and current treatment techniques can only delay the progression of the disease. Because disease-modifying therapies may be most beneficial in the early stages of AD, the clinical significance of an early diagnosis is emphasized. So far, a variety of imaging technologies and related biomarkers have been used to identify and monitor AD, but there are many imaging technologies; finding the most effective imaging technology can assist medical personnel in interpreting the early stages of AD and can also improve patient treatment opportunities. This is, therefore, the main purpose and back-ground of this study. METHODS: PubMed and other repositories were used in this study to conduct a literature search with various keywords, and relevant articles were reviewed. In this review, different neuroimaging techniques are reviewed which are considered advanced tools to help establish the diagnosis, and in addition, the diagnostic utility, advantages, and limitations of contemporary AD imaging techniques are discussed. RESULTS: The results of the literature review and synthesis show that the prevalence of several in vivo biomarkers helps distinguish affected individuals from healthy controls in the early stages of the disease. Additionally, each current imaging method has its advantages and disadvantages, so no single imaging method is the best diagnostic modality. CONCLUSIONS: This article also reviews and draws conclusions on better ways to use the imaging techniques to improve the likelihood of an early diagnosis of AD. It is suggested that future research could focus on expanding the use of imaging technologies and on identifying novel biomarkers manifesting the earliest stages of AD pathology.

Grey matter alterations in generalized anxiety disorder: A voxel-wise meta-analysis of voxel-based morphometry studies.

OBJECTIVE: Grey matter, a crucial component of the brain, has been found altered in generalized anxiety disorder (GAD) of several voxel-based morphometry studies. The conclusive and consistent grey matter alterations in GAD have not been confirmed. METHOD: Eleven voxel-based morphometry studies of GAD patients were included in the current systematic review and meta-analysis. The linear model of anxiety severity scores was applied to explore the relationship of grey matter alterations and anxiety severity. The subgroup analysis of adult GAD and adolescent GAD was also performed. RESULTS: Significantly modest grey matter alterations in the left superior temporal gyrus of patients with GAD were found. The anxiety severity score was significantly correlated with grey matter alterations in the right insula, lenticular nucleus, putamen and striatum. The subgroup analysis of adult GAD and adolescent GAD all failed to show significant grey matter alterations. However, in the adult GAD subgroup, anxiety severity score was significantly correlated with grey matter alterations in the right insula. CONCLUSION: GAD might have the modest grey matter alterations in the left superior temporal gyrus. Anxiety severity might be related to the grey matter alterations in the limbic regions, such as the right insula, lenticular nucleus, putamen and striatum. This kind of correlation might be related to the effects of adult GAD. Future studies with adequate sample sizes and sophisticated GAD categories will be needed.

Monorail snare technique for retrieval of stretched coil.

Coil stretching is a recognized complication during cerebral aneurysm embolization.1, 3- 5 For over a decade, the microsnare has proven effective in retrieving migrated coils.1- 5 Fiorella et al. unveiled the "Monorail Snare Technique" in 2005, offering a specialized approach to stretched coil recovery.1 However, to gain a complete understanding of this technique, more than just textual descriptions are necessary; a thorough, practical demonstration is essential. In our technical video (video 1), we illustrated an episode of coil stretching during aneurysm embolization, where the "Monorail Snare Technique" was successfully employed to retrieve a stretched coil. Our video emphasizes the meticulous preparation and modification of the microsnare, showcasing enhanced steps to mitigate the potential blood backflow triggered by the exclusive use of one-arm hemostasis valve during the "Monorail Snare Technique."1, 5 This pivotal adjustment substantially lowers the threat of thromboembolic events. We highlighted essential precautions to ensure the procedure's safety and efficacy.4, 5.

Coil embolization of distal vascular lesion using a 1.5 Fr Marathon microcatheter and 'free-running' technique.

In distal vascular lesions, such as the distal anterior inferior cerebellar artery or posterior inferior cerebellar artery (PICA) dissecting aneurysm, and dural arteriovenous fistula (dAVF) and arteriovenous malformation (AVM), super-selective catheterization and embolization using liquid agents, such as NBCA or Onyx liquid embolic system, is the preferred treatment.1 2 We used a flow-directed 1.5 Fr Marathon microcatheter (Medtronic, Minneapolis, MN, USA) for embolization because commonly used detachable coil-compatible microcatheters can be too short or rigid for superselection.3-6 We designed an in vitro coil compatibility test for the Marathon microcatheter and developed a 'free-running' technique (video 1). Using this technique, we trapped the distal PICA dissecting aneurysm and embolized the fistula points of dAVF precisely and safely without affecting adjacent normal structures, which can occur when applying liquid embolizing agents.1-3 After reviewing the case, we determined that this technique can also potentially be applied for implementing the pressure cooker technique7 and combining the management of AVM.4neurintsurg;jnis-2023-020893v1/V1F1V1Video 1Free-running technique via 1.5 Fr Marathon microcatheter.

Transvenous embolization of a direct carotid-cavernous fistula through the pterygoid plexus approach.

We present a transvenous embolization technique for a direct carotid-cavernous fistula through the pterygoid plexus to the cavernous sinus which only 2 cases have been previously reported in the English literature. This method is appropriate when transarterial techniques or other attempts at transvenous access have failed due to vessel tortuosity, hypoplasia, stenosis, or occlusion. A middle-aged female patient presented with progressive left exophthalmos with conjunctiva chemosis and bruit after sustaining a falling injury. Digital subtraction angiography revealed Barrow type A carotid-cavernous fistula. The drainage route passed through a distal thrombosed superior ophthalmic vein that ended deep in the orbit. No other patent venous sinuses connected to the cavernous sinus, except for a small tract of pterygoid plexus. After failure of transarterial approach and other methods of transvenous access, we attempted to superselectly access to the cavernous sinus by applying transpterygoid technique with embolization using detachable coils. The transpterygoid venous approach to accessing the cavernous sinus represents an alternative approach when other techniques fail.

Reactive Oxygen Species and Inflammatory Responses of Macrophages to Substrates with Physiological Stiffness.

Macrophages play essential roles in innate immunity and their functions can be activated by different signals at pathological sites. Concerning changes in the rigidity of the microenvironment as a disease progresses, the influence of stiffened substrates on macrophage physiology remains elusive. In this study, to evaluate the effect of stiffened substrates on macrophages, we used J774A.1 cells as the macrophage model to investigate its mechanoinflammation responses using engineered polymeric substrates with various physiological rigidities (approximately 0.6 to 100 kPa). Under lipopolysaccharide (LPS) and adenosine triphosphate (ATP) stress, approximately 4-fold higher cytoplasmic reactive oxygen species (ROS) were triggered in cells on the softer substrate, compared with cells on the stiff substrates. The enhanced ROS response was found to be regulated mainly by NADPH oxidase. Moreover, mitochondrial ROS (mtROS), a crucial intracellular ROS source, are produced in response to substrate rigidity. The results showed higher mtROS production when cells were grown on a soft substrate with LPS/ATP stimuli, and the mechano-mtROS alteration was eliminated by Rho kinase inhibitor Y-27632. We suggest that substrate rigidity can coincide with LPS/ATP in regulating the ROS generation of macrophages. As a result of the pivotal role of ROS in regulating inflammation, increased NLRP-3 inflammasome formation and higher NO secretion (an approximately 300% increase) were observed with macrophages grown on soft substrates. Although no substantial genomic distinction was identified in our experiments, based on the phenotypic and functional results, softer substrates prime macrophages toward the proinflammatory (M1)-like phenotype. In summary, this study demonstrated the mechanosensitive inflammatory response of macrophages and the alteration of ROS, as secondary inflammation signals, may contribute to the functional status of macrophages. These findings not only provide an alternative interpretation of the functional transitions of macrophages influenced by substrate rigidity but may also support the manipulation of the inflammatory responses of macrophages via physical microenvironment modifications.

Evaluation of plant seed DNA and botanical evidence for potential forensic applications.

Seeds, the reproductive organs of plants, are common as trace evidence from crime scenes. Seed evidence could be grouped into several categories based on the types of crimes they are associated with, including child abuse, homicides and drugs. Most commonly, seeds are examined microscopically and identified to the plant species level to show a linkage between persons and places. More recently, forensic researchers have evaluated the potential for extracting and typing DNA from seeds to further individualize the samples. As a model system, tomato seeds were examined microscopically after different cooking treatments and assessed for the potential to DNA type seeds for variety identification. A sufficient quantity and quality of DNA were recovered from uncooked, digested and undigested tomato seeds for amplified fragment length polymorphism (AFLP) analysis; however, any form of cooking destroyed the seed DNA. A simple microscopic analysis was able to distinguish between a cooked tomato seed versus an uncooked seed. This article is intended to provide an overview of case examples and current techniques for the forensic examination of seeds as plant-derived evidence.

An evaluation of tactile symbols in public environment for the visually impaired.

This study evaluated the identification performance of a set of tactile symbols used in public environments for the visually impaired. A questionnaire survey was carried out to investigate the public environment needs from 60 visually impaired associations. A two-stage experiment with a matching test was then conducted to explore the identification efficiency of graphic tactile public information symbols. Eighty-one students were recruited as participants from a school for the visually impaired. The survey results show that fourteen public buildings were frequently visited and ten architectural elements were mostly needed by the visually impaired. The experimental results showed the correct response of graphic symbols tested in both two-stage experiments could meet the identification criterion of 90% and even better except for the escalator/elevator with 87.0% in the second stage. Relevant confusion among the graphic symbols tested was found. Some suggestions were made in the study.

The acute effect of exposure to noise on cardiovascular parameters in young adults.

OBJECTIVE: In this study, an experiment was conducted to examine whether noise exposure produced acute changes in cardiovascular responses, and whether these responses differed based on psycho-acoustic parameters to noises of low to high intensity. METHODS: Thirty healthy subjects were enrolled. Three industrial noises were binaurally presented with a supra-aural earphone. The sound levels of noise were <55, 75, and 90 dB. Each noise was continued for 20 min and the electrocardiogram was simultaneously recorded. RESULTS: The results showed a statistically significant increase in systolic blood pressure (SBP) at the 90 dB sound level. The study estimated a blood pressure increase of 0.85 mmHg/10 dB and 0.71 mmHg/10 dB in SBP and diastolic blood pressure (DBP), respectively. These results suggest that exposure to noise, particularly high-frequency noise, negatively impacts blood pressure. The tonality and fluctuation strength of noise especially impacts systolic blood pressure. CONCLUSIONS: The psycho-acoustic parameters of noise should be considered when evaluating the impact of noise exposure.

Assessment of a simple obstacle detection device for the visually impaired.

A simple obstacle detection device, based upon an automobile parking sensor, was assessed as a mobility aid for the visually impaired. A questionnaire survey for mobility needs was performed at the start of this study. After the detector was developed, five blindfolded sighted and 15 visually impaired participants were invited to conduct travel experiments under three test conditions: (1) using a white cane only, (2) using the obstacle detector only and (3) using both devices. A post-experiment interview regarding the usefulness of the obstacle detector for the visually impaired participants was performed. The results showed that the obstacle detector could augment mobility performance with the white cane. The obstacle detection device should be used in conjunction with the white cane to achieve the best mobility speed and body protection.

DNA analysis of digested tomato seeds in stomach contents.

Examination of stomach contents is one of the important steps in medical legal autopsy. Vegetative materials such as stems, roots, and seeds in stomach contents can be valuable evidence for providing investigative leads in death investigation. Currently, the identification of plant materials relies on microscopic and morphologic examination. We have found that many seeds are often protected from acid degradation during stomach digestion by their tough exterior seed coat. Tomato seeds were selected as a model system to assess DNA analysis and plant variety marker identification. The DNA-amplified fragment length polymorphism method was performed to determine if the DNA obtained from single seeds could be used for PCR analysis. From the amplified fragment length polymorphism results, some candidate markers for individualizing seeds from morphologically distinct tomatoes were identified. These data on DNA analysis of tomato seeds indicate amplified fragment length polymorphism is a viable procedure for the individualization of seeds from stomach contents in forensic investigations.

DNA analysis of ingested tomato and pepper seeds.

Ingested food is one of the important types of forensic evidence obtained during a medicolegal autopsy. Many materials containing seeds pass through the human digestive system and are still recognizable; thus, they can be valuable for providing investigative leads. Currently, the identification of seeds relies on microscopic and morphologic examination. However this method sometimes can be problematic. For example, the microscopic appearance of the ingested tomato and pepper seeds is very similar; thus, it is not always easy to distinguish these seeds by comparing their physical characteristics. Tomato and pepper seeds were selected as a model system to assess the value of performing DNA analysis as an alternate and/or complimentary means of seed identification. Results of blind testing indicate that the deoxyribonucleic acid-amplified fragment length polymorphism (DNA-AFLP) results were able to discriminate between pepper and tomato seed samples after they passed through the digestive system.

Forensic botany: using plant evidence to aid in forensic death investigation.

Forensic botany is still an under-utilized resource in forensic casework, although it has been used on occasion. It is an area of specialty science that could include traditional botanical classification of species, DNA, or materials evidence (trace and transfer evidence), crime mapping or geo-sourcing, all dependent on the specific case application under consideration. Critical to the evaluation of plant evidence is careful collection, documentation, and preservation for later scientific analysis. This article reviews proper procedures and recent cases where botanical evidence played a role in establishing either manner or time of death. Plant evidence can be useful for determining if a death was due to an accident, suicide, or homicide, or what time of year burial may have taken place. In addition, plant evidence can be used to determine if a crime scene is a primary or secondary scene and to locate missing bodies.

A three-dimensional mathematical model for predicting spinal joint force distribution during manual liftings.

OBJECTIVE: A three-dimensional dynamic mathematical model was developed to discover what loads are imposed on the lumbar structures by performance of asymmetric manual liftings. DESIGN: An external model was used to estimate the intersegmental resultant forces and moments at the L(5)/S(1) joint in this dynamic biomechanical model. Using an optimization algorithm, an internal model then distributed the intersegmental resultants to forces of muscle, disc, facet joints, and ligaments. BACKGROUND: To study the relation between large loads and low-back disorders, many biomechanical models have been developed. Most of the models were two-dimensional models discussed with symmetric activities. Some three-dimensional biomechanical models were static models or only included limited elements of the disc and muscles in the model. METHODS: A healthy young male subject was asked to perform asymmetric lift with bent knees. Dynamic data of body motion and ground reaction forces were monitored, and the EMG of six muscles were recorded simultaneously. A Newtonian equation was used to calculate the joint intersegmental resultant forces and moments. In the internal model, three components of the disc force, eight muscle forces, two ligament forces and two facet joint forces were computed. RESULTS: The correlation between the reaction moments from the upper and lower models of the external part were generally above 0.94, and the root mean square differences were below 19 Nm. In this internal model, the maximal disc compression was close to the data showed on the literature, and the estimation of muscle forces corresponded to the EMG activities. CONCLUSIONS: A three-dimensional biomechanical model has been developed and evaluated to estimate the spinal joint force distribution during asymmetric manual lifting activities.