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Background: Eclampsia is a serious pregnancy complication and is associated with cerebral edema and infarctions. However, the underlying pathophysiology of eclampsia remains poorly explored., Objective: This study aimed to assess the pathophysiology of eclampsia using specialized magnetic resonance imaging to measure diffusion, perfusion, and vasospasm., Study Design: This was a cross-sectional study recruiting consecutive pregnant women between April 2018 and November 2021 at Tygerberg Hospital, Cape Town, South Africa. Women with eclampsia, preeclampsia, and normotensive pregnancies who underwent magnetic resonance imaging after birth were recruited. The main outcome measures were cerebral infarcts, edema, and perfusion using intravoxel incoherent motion imaging and vasospasm using magnetic resonance imaging angiography. The imaging protocol was established before inclusion., Results: Here, 49 women with eclampsia, 20 women with preeclampsia, and 10 normotensive women were included. Cerebral infarcts were identified in 34% of women with eclampsia and 5% of women with preeclampsia (risk difference, 0.29; 95% confidence interval, 0.06-0.52; P=.012). However, no cerebral infarct was identified in normotensive controls. Women with eclampsia were more likely to have vasogenic cerebral edema than women with preeclampsia (80% vs 20%, respectively; risk difference, 0.60; 95% confidence interval, 0.34-0.85; P<.001) and normotensive women (risk difference, 0.80; 95% confidence interval, 0.47-1.00; P<.001). Diffusion was increased in women with eclampsia in the parieto-occipital white matter (mean difference, 0.02 × 10 -3 mm 2 /s; 95% confidence interval, 0.00-0.05; P=.045) and caudate nucleus (mean difference, 0.02 × 10 -3 mm 2 /s; 95% confidence interval, 0.00-0.04; P=.033) compared with women with preeclampsia. In addition, diffusion was increased in women with eclampsia in the frontal white matter (mean difference, 0.07 × 10 -3 mm 2 /s; 95% confidence interval, 0.02-0.12; P=.012), parieto-occipital white matter (mean difference, 0.05 × 10 -3 mm 2 /s; 95% confidence interval, 0.02-0.07; P=.03), and caudate nucleus (mean difference, 0.04 × 10 -3 mm 2 /s; 95% confidence interval, 0.00-0.07; P=.028) compared with normotensive women. Perfusion was decreased in edematous regions. Hypoperfusion was present in the caudate nucleus in eclampsia (mean difference, -0.17 × 10 -3 mm 2 /s; 95% confidence interval, -0.27 to -0.06; P=.003) compared with preeclampsia. There was no sign of hyperperfusion. Vasospasm was present in 18% of women with eclampsia and 6% of women with preeclampsia. However, no vasospasm was present in the controls., Conclusion: Eclampsia was associated with cerebral infarcts, vasogenic cerebral edema, vasospasm, and decreased perfusion, which are not usually evident on standard clinical imaging. This finding may explain why some patients have cerebral symptoms and signs despite having normal conventional imaging., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Premenstrual dysphoric disorder (PMDD) is a depressive disorder triggered by fluctuations of progesterone and estradiol during the luteal phase of the menstrual cycle. Selective progesterone receptor modulation (SPRM), while exerting an antagonistic effect on progesterone and maintaining estradiol on moderate levels, has shown beneficial effects on the mental symptoms of PMDD. Progesterone is also known for its neuroprotective effects, while synthetic progestins have been suggested to promote myelination. However, the impact of SPRM treatment on white matter microstructure is unexplored., Methods: Diffusion tensor imaging was employed to collect data on white matter integrity in patients with PMDD, before and after treatment with ulipristal acetate (an SPRM) or placebo, as part of a double-blind randomized controlled-trial. Tract based spatial statistics were performed to investigate SPRM treatment vs. placebo longitudinal effects on fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD), on the whole white matter skeleton., Results: Voxel-wise analyses indicated no change over time in any white matter microstructure metrics in individuals treated with SPRM versus placebo. Improvement in PMDD symptoms did not correlate with changes in white matter microstructure. In secondary, exploratory, cross-sectional comparisons during treatment, the SPRM group displayed lower FA and higher MD, RD, and AD than the placebo group in several tracts., Conclusion: The main findings suggest that SPRM treatment did not impact white matter microstructure compared with placebo. However, secondary exploratory analyses yielded between-group differences after treatment, which call for further investigation on the tracts potentially impacted by progesterone antagonism., Clinical Trial Registration: EUDRA-CT 2016-001719-19; "Selective progesterone receptor modulators for treatment of premenstrual dysphoric disorder. A randomized, double-blind, placebo-controlled study."; https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-001719-19/SE., Competing Interests: Declaration of competing interest EC receives funds from the Swedish Research Council (2015–00495), EU FP7-People-Cofund (INCA 600398) and SciLifeLab. The study drugs were provided by Gedeon Richter, but no further financial or design- related involvement was foreseen. R. Lanzenberger received investigator-initiated research funding from Siemens Healthcare regarding clinical research using PET/MR. He is a shareholder of the start-up company BM Health GmbH since 2019. The rest of the authors report no further financial interest or conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Sediments contaminated with hazardous metals pose risks to humans and wildlife, yet viable management options are scarce. In a series of laboratory experiments, we characterized Polonite® - an activated calcium-silicate - as a novel sorbent for thin-layer capping of metal-contaminated sediments. We tested a fine-grained by-product from the Polonite production as a cheap and sustainable sorbent. First, Polonite was reacted with solutions of Cu, Pb, and Zn, and the surface chemistry of the Polonite was examined using, e.g., scanning electron microscopy to investigate metal sorption mechanisms. Batch experiments were conducted by adding Polonite to industrially contaminated harbor sediment to determine sorption kinetics and isotherms. Importantly, we measured if the Polonite could reduce metal bioavailability to sediment fauna by performing digestive fluid extraction (DFE). Finally, a cap placement technique was studied by applying a Polonite slurry in sedimentation columns. The results showed rapid metal sorption to Polonite via several mechanisms, including hydroxide and carbonate precipitation, and complexation with metal oxides on the Polonite surface. Isotherm data revealed that the sediment uptake capacity (K f ) for Cu, Pb, and Zn increased by a factor of 25, 21, and 14, respectively, after addition of 5% Polonite. The bioavailability of Cu, Pb, and Zn was reduced by 70%, 65%, and 54%, respectively, after a 25% Polonite addition. In conclusion, we propose that sediment treatment with low doses of the Polonite by-product can be a cheap, sustainable, and effective remediation method compared to other more intrusive methods such as dredging or conventional isolation capping., Competing Interests: Declaration of competing interest We have no conflicts of interests to disclose. The funding sources did not have any participation in the research., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Impaired cognitive ability is one of the most frequently reported neuropsychiatric symptoms in the post-COVID phase among patients. It is unclear whether this condition is related to structural or functional brain changes., Purpose: In this study, we present a multimodal magnetic resonance imaging study of 36 post-COVID patients and 36 individually matched controls who had a mild form of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection from March 2020 to February 2022. This study aimed to investigate structural and functional brain alterations and their correlation with post-COVID symptoms and neurocognitive functions., Materials and Methods: The study protocol comprised an assessment of physical fatigue [Fatigue Severity Scale (FSS)], mental fatigue (Mental Fatigue Scale (MFS)], depression [Montgomery Asberg Depression Rating Scale (MADRS)], anxiety [Hospital Anxiety and Depression Scale (HAD)], post-COVID Symptoms Severity Score, and neurocognitive status [Repeatable Battery for the Assessment of Neuropsychological Status Update (RBANS)]. The magnetic resonance imaging protocol included morphological sequences, arterial spin labeling (ASL) and dynamic susceptibility contrast-enhanced (DSC) perfusion, diffusion tensor imaging (DTI), and resting-state functional magnetic resonance imaging (fMRI) sequences. Using these protocols, the assessments of macrostructural abnormalities, perfusion, gray matter density, white matter integrity, and brain connectivity were performed., Results: Post-COVID patients had higher levels of physical fatigue, mental fatigue, depression, and anxiety than controls and showed cognitive impairment in all the RBANS domains except in Visuospatial/Construction. The subjective mental fatigue correlated with objective impaired cognitive ability in the RBANS test, particularly in the Attention domain. There were no differences between patients and controls regarding macrostructural abnormalities, regional volumes, regional perfusion metrics, gray matter density, or DTI parameters. We observed a significant positive correlation between RBANS Total Scale Index score and gray matter volume in the right superior/middle-temporal gyrus ( p < 0.05) and a significant negative correlation between the white matter integrity and post-COVID symptoms ( p < 0.05) in the same area. The connectivity differences were observed between patients and controls in a few regions, including the right middle frontal gyrus, an important area of convergence of the dorsal and ventral attention networks. We also noted a positive correlation between post-COVID symptoms and increased connectivity in the right temporoparietal junction, which is part of the ventral attention system., Conclusion: In non-hospitalized subjects with post-COVID, we did not find any structural brain changes or changes in perfusion, compared to controls. However, we noted differences in connectivity within an important area for attention processes, which may be associated with post-COVID brain fog., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fineschi, Fahlström, Fällmar, Haller and Wikström.)

Background: Hemodynamic changes are seen in the feeding arteries of arteriovenous malformations (AVMs). Phase-contrast MRI (PC-MRI) enables the acquisition of hemodynamic information from blood vessels. There is insufficient knowledge on which flow or velocity parameter best discriminates AVMs from healthy subjects., Purpose: To evaluate PC-MRI-measured flow and velocity in feeding arteries of AVMs before and, when possible, also after treatment and to compare these measurements to corresponding measurements in healthy controls., Materials and Methods: Highest flow (HF), lowest flow (LF), mean flow (MF), peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean velocity (MV) were measured in feeding arteries in patients with intracranial AVMs using 2D PC-MRI at 3 T. Measurements were compared to previously reported values in healthy individuals. Values in patients above the 95th percentile in the healthy cohort were categorized as pathological. Nidus volume was measured using 3D time-of-flight MR angiography., Results: Ten patients with diagnosed AVMs were examined with PC-MRI. Among these, three patients also underwent follow-up PC-MRI after treatment. Pathological velocities (PSV, EDV, and MV) were seen in all five subjects with a nidus larger or equal to 5.7 cm 3 , whereas pathological flow values were not seen in all, that is, pathologic HF in three, pathologic LF in two, and pathologic MF in two. After treatment, there was a decrease in flow and velocity (all measured parameters). After treatment, velocities (PSV, EDV, and MV) were no longer abnormal compared to healthy controls., Conclusion: Patients with a large AVM nidus show pathological velocities, but less consistent flow increases. Following treatment, velocities normalize., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)