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Excessive alcohol consumption remains a global public health crisis, with millions suffering from alcohol use disorder (AUD, or simply "alcoholism"), leading to significantly reduced life expectancy. This review examines the interplay between habitual and goal-directed behaviors and the associated neurobiological changes induced by chronic alcohol exposure. Contrary to a strict habit-goal dichotomy, our meta-analysis of the published animal experiments combined with a review of human studies reveals a nuanced transition between these behavioral control systems, emphasizing the need for refined terminology to capture the probabilistic nature of decision biases in individuals with a history of chronic alcohol exposure. Furthermore, we distinguish habitual responding from compulsivity, viewing them as separate entities with diverse roles throughout the stages of the addiction cycle. By addressing species-specific differences and translational challenges in habit research, we provide insights to enhance future investigations and inform strategies for combatting AUD., (© 2024. The Author(s).)

Rationale: Compared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cue-reactivity., Objectives: In this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cue-reactivity with a hybrid imaging task., Methods: Out of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task ("Simon-task") and an alcohol cue-reactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses., Results: The four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions., Conclusions: Our findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity.

Background and Purpose: The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke., Materials and Methods: In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2)., Results: Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; P < .05). Both collateralization grade (OR, 1.00; P > .05) and time delay to peak enhancement (OR, 0.90; P > .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664-1.011; P = .330-.953) or at 90 days (OR, 0.779-1.016; P = .130-.845)., Conclusions: A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke., (© 2016 by American Journal of Neuroradiology.)

Background and Purpose: Collateral blood flow is an important prognostic marker in the acute stroke situation but approaches for assessment vary widely. Our aim was to compare strategies of collateral blood flow assessment in dynamic and conventional CTA in their ability to predict the follow-up infarction volume., Materials and Methods: We retrospectively included all patients with an M1 occlusion from an existing cohort of 1912 consecutive patients who underwent initial multimodal stroke CT and follow-up MR imaging or nonenhanced CT. Collateralization was assessed in both conventional CT angiography and dynamic CT angiography by using 3 different collateral grading scores and segmentation of the volume of hypoattenuation. Arterial, arteriovenous, and venous phases were reconstructed for dynamic CT angiography, and all collateral scores and the volume of hypoattenuation were individually assessed for all phases. Different grading systems were compared by using the Bayesian information criterion calculated for multivariate regression analyses (Bayesian information criterion difference = 2-6, "positive"; Bayesian information criterion difference = 6-10, "strong"; Bayesian information criterion difference = >10, "very strong")., Results: One hundred thirty-six patients (mean age, 70.4 years; male sex, 41.2%) were included. In the multivariate analysis, models containing the volume of hypoattenuation showed a significantly better model fit than models containing any of the 3 collateral grading scores in conventional CT angiography (Bayesian information criterion difference = >10) and dynamic CT angiography (Bayesian information criterion difference = >10). All grading systems showed the best model fit in the arteriovenous phase. For the volume of hypoattenuation, model fit was significantly higher for models containing the volume of hypoattenuation as assessed in the arteriovenous phase of dynamic CT angiography compared with the venous phase (Bayesian information criterion difference = 6.2) and the arterial phase of dynamic CT angiography (Bayesian information criterion difference = >10) and in comparison with conventional CT angiography (Bayesian information criterion difference = >10)., Conclusions: The use of dynamic CT angiography within the arteriovenous phase by using quantification of the volume of hypoattenuation is the superior technique for assessment of collateralization among the tested approaches., (© 2015 by American Journal of Neuroradiology.)

Purpose: To evaluate the additional effect of higher frequent linear probes than 12.5 MHz in color Doppler sonography and free hand sonoelastography of benign and malignant breast masses and to compare different color encodings in sonoelastography., Materials and Methods: From December 2012 to March 2013, 37 patients with benign or malignant breast masses were prospectively included in this study. All solid masses have been histologically proven. Two readers assessed sonoelastographic findings at 12.5 MHz vs. 17 MHz according to the tsukuba elasticity score and additionally different color encodings were compared. Results of Doppler sonography using a score of 0, 1 or 2, depending on the degree of perfusion, also were assessed at 12.5 MHz vs. 17 MHz., Results: Among the 37 examined breast masses there were 10 cysts, 16 fibroadenomas and 11 carcinomas. Median participant age was 49.0 years. Use of color Doppler sonography enabled to distinguish cysts from solid breast masses (p < 0.001), without an improvement at 17 MHz. Additional sonoelastography significantly improved the specificity in solid breast masses (p < 0.001). No changes could be seen using different colors in sonoelastography., Conclusion: Combination of color Doppler sonography and sonoelastography can increase the accuracy in distinguishing benign from malignant breast masses. The use of linear probes with a higher frequency than 12.5 MHz does not show any benefit, neither in color Doppler sonography nor in sonoelastography.

Computed tomography angiography (CTA) of the aorta is an accepted standard diagnostic procedure for preoperative evaluation and planning of endovascular treatment of abdominal aortic aneurysms (endovascular aortic repair EVAR). The CTA method delivers all relevant anatomical and morphological information on the underlying pathology of the aorta and pelvic axes. Various software solutions are available for multiplanar reconstruction of the CT data for exact measurement of the access routes and landing zones and are essential components of individualized operation planning. The synthesis of all CT-based information allows a safe and exactly targeted release of the stent graft in the aorta. Furthermore, the periprocedural radiation dose can be reduced by a precise preoperative planning of the positions to be irradiated during implantation.

Objectives: To study the feasibility of an optimized multiphase renal-CT-angiography (MP-CTA) protocol in patients with history of renal transplantation compared with Doppler-ultrasound (DUS)., Methods: 36 Patients underwent both DUS and time-resolved, MP-CTA (12 phases), with a mean contrast-volume of 34.4±5.1 ml. Quality of MP-CTA was assessed quantitatively (vascular attenuation) and qualitatively (grades 1-4, 1=best). For the assessment of clinical value of MP-CTA, cases were grouped into normal, macrovascular (arterial/venous) and microvascular complications (parenchymal perfusion defect). DUS served as the standard of reference., Results: Using the best of 12 phases in each patient, optimal attenuation was 353±111 HU, 337±98 HU and 164±51 HU in the iliac arteries, renal arteries, and renal veins, respectively. Mean image quality was 1.1±0.3 (n=36) and 2.1±0.6 (n=30) for the transplant renal arteries and veins, respectively. Six renal veins were non-diagnostic in MP-CTA. In 36 patients, MP-CTA showed 13 vascular complications and 10 parenchymal perfusion defects. DUS was not assessable in eight patients. Overall, MP-CTA showed 15 cases with pathology (42%) not identifiable with DUS. The mean effective radiation dose of the MP-CTA protocol was 13.5±5.2 mSv., Conclusion: MP-CTA can be sufficiently performed with reduced contrast volume at reasonable radiation dose in renal transplant patients, providing substantially higher diagnostic yield than DUS., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Carotid duplex ultrasound is the standard of care for the initial diagnosis of carotid artery bifurcation diseases. But in difficult examinations, carotid abnormalities are commonly encountered and may represent a diagnostic challenge in patients with clinical symptoms as well as in the follow up after carotid endarterectomy or carotid artery stenting. Contrast enhanced ultrasound (CEUS) with low mechanical index (low MI) is a promising new method in the diagnosis and follow up of pathological carotid diseases. Unlike most contrast agents used for magnetic resonance imaging or computed tomography, the microbubbles used in CEUS with SonoVue(®) remain within the vascular space and hence can be used to study vascular disease. In addition to improving current carotid structural scans, CEUS has potential to improve or add extra information on carotid arterial diseases. This review describes the current carotid duplex ultrasound examination and compares the pathological findings with CEUS., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

With the introduction of second generation ultrasound contrast agents, contrast-enhanced ultrasound (CEUS) has become available as an adjunct to the conventional FAST (focused assessment with sonography in trauma) protocol and B-mode sonography of the abdomen after blunt force abdominal trauma. Results from several controlled studies indicate excellent diagnostic accuracy of CEUS for the exclusion of clinically relevant parenchymal injuries after blunt force abdominal trauma. Particularly in younger, hemodynamically stable patients this technique could contribute to a reliable exclusion of parenchymal injuries without the use of ionizing radiation. This report provides details on the technical performance of CEUS, shows examples of typical CEUS findings after blunt abdominal trauma and summarizes the current clinical evidence regarding the use of CEUS after blunt abdominal trauma.

Purpose: To evaluate neovascularisation within carotid atherosclerotic plaques with contrast enhanced ultrasound., Methods: We used contrast-enhanced ultrasound to examine 33 patients with carotid atherosclerotic plaques. Plaque size and echogenicity were analyzed and we correlated neovascularization within the plaques., Results: There were 41 atherosclerotic plaques, 27 plaques enhanced after the injection of a contrast agent. Among the group of enhancing plaques we found 8 soft- and 19 mixed plaques. The overall thickness ranging in enhanced plaques was from 1.8 to 4.6 mm. In all cases the contrast uptake in the plaques was later than in the carotid artery. Among the 14 unenhanced atherosclerotic plaques, 4 plaques presented as hard plaques, three calcified plaques, two soft plaques and five presented as mixed plaques. The overall thickness ranging in unenhanced plaques was from 1.7 to 6 mm., Conclusion: Contrast-enhanced ultrasound allows the non invasive, dynamic evaluation of neovascularisation within carotid plaques.

Purpose: To evaluate whether the image fusion with contrast enhanced ultrasound (CEUS) and CT affects the diagnosis of endoleaks in unclear cases., Methods and Materials: 35 patients with follow-up examinations after endovascular aneurysm repair (EVAR) were included in this retrospective study. Mean patient age was 73 years (range 54-83 y). B-scan, colour doppler and CEUS (1.2 ml SonoVue®, Bracco Imaging Germany) were performed in all patients by an experienced examiner using two different high-end ultrasound system (Siemens ACUSON S2000™, Siemens Healthcare, Erlangen, Germany or Logic E9, GE Healthcare, Milwaukee,WI, USA) with a multifrequency curved array transducer. The examiner was initially blinded to the CT results. Additional image fusion with CT-angiography (CTA) was then performed. The ultrasound examinations were later read by two blinded unbiased investigators with more than five years of clinical ultrasound in consensus., Results: All patients were examined using all diagnostic ultrasound tools of the study. The results show that image fusion is easy and convenient to perform. Conventional ultrasound examination with B-scan and colour Doppler examination detected one Type I and one Type II endoleak, contrast enhanced ultrasound detected one Type I and three Type II endoleaks after EVAR whereas CTA depicted one Type I and two Type II endoleaks. Ultrasound image fusion with CT-angiography confirmed one Type I and three Type II endoleaks., Conclusion: In comparison to conventional ultrasound and CTA the use of CEUS improved the visualization and classification of endoleaks. CEUS shows even small blood flow which can be depicted due to the real time imaging of endoleaks. In unclear cases additional ultrasound image fusion with CEUS and CT angiography improves the visualisation of small endoleaks and this may cause a change in the follow-up interval. CEUS is a good alternative to CT in the detection and follow-up of endoleaks, especially in patients with contraindications to CT contrast agents due to allergies or renal failure, enabling reduced additional costs and exposure to radiation.

Purpose: To evaluate the benefit of CEUS (contrast enhanced ultrasound) regarding depiction of ischaemic lesions and AVFs (arterio venous fistula) in renal transplants compared to standard ultrasound (US) (grey-scale and color Doppler)., Materials and Methods: In this study 22 patients suspected of having acute vascular complication after renal transplantation were investigated using standard ultrasound (grey-scale US and color Doppler US) and CEUS, respectively. Validity of the respective US-techniques regarding depiction of ischaemic lesions and AVF was compared. Dynamic CTA (computed tomography angiography) served as the standard of reference., Results: In 10 renal transplants arterial embolism associated with kidney infarctions were observed. Very good correlation to dynamic CTA was yielded using CEUS, whereas grey scale US and color Doppler US was limited in the accurate depiction of renal infarctions. Additionally CEUS was superior in displaying arteriovenous fistulas compared to standard US., Conclusion: CEUS as a fast and bedside available imaging modality not associated with dose exposure or renal toxicity facilitates improved detection of ischaemic lesions and AVFs compared to standard US and thus should be considered for short term follow up of renal transplants.

Purpose: The aim of the study was to evaluate whether contrast enhanced ultrasound (CEUS) can improve the visualization of in-stent restenosis after carotid stenting of the internal carotid artery (ICA) in comparison to color-coded duplex sonography (CCDS) and power Doppler., Material and Methods: The study included the follow up of thirty patients after carotid artery stenting (CAS). Intrastenotic flow detection and lengths of in-stent restenosis were the main criteria. A high-end ultrasound machine (Siemens, ACUSON, Sequoia or S2000) with a multi-frequency linear 9 MHz or 15 MHz transducer was used to carry out contrast-enhanced ultrasound with SonoVue. In cases of treatment of a high degree in-stent stenosis intra-arterial digital subtraction angiography (DSA) was used., Results: All patients were examined using all diagnostic ultrasound tools of the study. In five patients (17%) an in-stent restenosis of the internal carotid artery (ICA) was found. Two patients need a reintervention. The results show that the contrast enhanced ultrasound could improve the diagnostic assessment capabilities in comparison to CCDS and power Doppler for patients with in-stent restenosis after carotid stenting of the ICA., Conclusion: Contrast enhanced ultrasound is a reliable method for the evaluation of in-stent restenosis after carotid stenting of the ICA. CEUS provides a reduction in intrastenotic flow artefacts, resulting in better visualisation and detection of the complete length of the stenosis in comparison with CCDS and power Doppler. In order to elucidate hemodynamic changes, additional Doppler examinations are still necessary.

Endoleaks following endovascular aneurysm repair (EVAR) are common and present a diagnostic challenge in the follow-up after EVAR. Contrast-enhanced ultrasound (CEUS) is a promising new method for the diagnosis and follow-up of endoleaks. CEUS with SonoVue allows a rapid and non-invasive diagnosis in the follow-up after EVAR. The sensitivity and specificity of conventional ultrasound compared to the multislice CT angiography is estimated to be 33-63% and 63-93%, respectively. These values can be increased through the use of CEUS in up to 98-100% (sensitivity) and 82-93% (specificity). This article describes the etiology, classification and importance of different types of endoleaks. The value of CEUS in this clinical scenario will be discussed.

Lists of differentially expressed genes in a disease have become increasingly more comprehensive with improvements on all technical levels. Despite statistical cutoffs of 99% or 95% confidence intervals, the number of genes can rise to several hundreds or even thousands, which is barely amenable to a researcher's understanding. This report describes some ways of processing those data by mathematical algorithms. Gene lists obtained from 53 microarrays (two brain regions (amygdala and caudate putamen), three rat strains drinking alcohol or being abstinent) have been used. They resulted from analyses on Affymetrix chips and encompassed approximately 6 000 genes that passed our quality filters. They have been subjected to four mathematical ways of processing: (a) basic statistics, (b) principal component analysis, (c) hierarchical clustering, and (d) introduction into Bayesian networks. It turns out, by using the p-values or the log-ratios, that they best subdivide into brain areas, followed by a fairly good discrimination into the rat strains and the least good discrimination into alcohol-drinking vs. abstinent. Nevertheless, despite the fact that the relation to alcohol-drinking was the weakest signal, attempts have been made to integrate the genes related to alcohol-drinking into Bayesian networks to learn more about their inter-relationships. The study shows, that the tools employed here are extremely useful for (a) quality control of datasets, (b) for constructing interactive (molecular) networks, but (c) have limitations in integration of larger numbers into the networks. The study also shows that it is often pivotal to balance out the number of experimental conditions with the number of animals.

Purpose: To determine the value of MR enteroclysis (MRE) in the localization and characterization of primary carcinoid tumors of the small bowel and to describe typical imaging features., Material and Methods: Twenty patients with suspicion of primary small bowel carcinoid tumors (pCT) were recruited to undergo MRE following nasojejunal intubation and small bowel filling with 2.5 l of 0.5% methylcellulose solution under MR fluoroscopic guidance. MRE was performed on a 1.5 T MR scanner including T2w SSFSE, SSFP and contrast enhanced T1w GRE sequences with fat saturation. Fifteen patients, who subsequently had surgery for resection of their pCT, were retrospectively included in the study. All MRE were analyzed as for the presence, location, number, size, multiplicity and morphologic appearance of the pCT by two board certified radiologists in consensus. The conspicuity of the tumors was rated for each sequence type separately, according to a 4-point rating scale. Signal intensity measurements were performed in tumor and muscle. The presence of desmoplastic reaction, vascular involvement and lymph node metastases was also analyzed., Results: pCT were correctly identified and localized in 14/15 patients. Due to their hyperenhancement tumors was best detected on contrast-enhanced T1w fat saturated GRE sequences. SSFSE was clearly inferior with the tumors being either hyperintense or isointense to muscle. pCT appeared as nodular intraluminal masses in 40% of the cases, as focal wall thickening in 33.3% and in 20% with both. Mean size was 25 (7-46 mm) with a tendency to smaller size for ileal tumors. MRE failed to depict superficial micronodular peritoneal spread in one patient. Desmoplastic reaction was observed in 73.3% of the cases with mesenteric masses exhibiting lower signal than the pCT due to fibrotic changes., Conclusion: MRE is a valuable method for the detection and localization of primary carcinoid tumors, provided that appropriate bowel distension is achieved. Various characteristic morphologic features could be identified which may contribute to characterize pCT and their loco-regional metastases.

Purpose: To evaluate the diagnostic results of different ultrasound techniques: B-scan, color-coded Doppler sonography (CCDS) and contrast-enhanced ultrasound in the diagnosis of abdominal aortic dissection in comparison to multislice computed tomography (MS-CT)., Materials and Methods: Between March 2006 and December 2008, 35 patients (28 males, 7 females) with a mean age of 58 years (range 37-87 years) with abdominal aortic dissection and 15 patients (11 males, 4 females) with a mean age of 53 years (range 42-78 years) without abdominal aortic dissection as a control group were examined with B-scan, CCDS and contrast-enhanced ultrasound (CEUS) after injection of 1.0-1.2 cc of SonoVue (Bracco, Italy). The examinations were performed using a Sequoia 512 (Siemens/Acuson, Mountain View) system with CPS software. Standardized MS-CTA using a 16 or 64 row scanner (Somatom Sensation 16 or 64, Siemens Medical Systems, Forchheim, Germany) served as the reference standard., Results: The sensitivity of B-scan and CCDS for detecting abdominal aortic dissections were both 23/35 (68%); for contrast-enhanced ultrasound it was 34/35 (97%). Dissection membrane, differentiation of true and false lumen and flow direction within the true and false lumen were better detected by CEUS than by CCDS. The lack of angle dependence of the US probe and lack of flow and pulsations artifacts in CEUS made the examination procedure easier. All findings were confirmed by MS-CT., Conclusion: With contrast-enhanced ultrasound, diagnostic accuracy sensitivity and specificity for the diagnosis of abdominal aortic dissections is improved as compared to B-scan and CCDS. Dissection membrane and flow within the true and false lumen are clearly differentiated by CEUS. Thus CEUS is a promising alternative for patients whose condition does not allow an examination by CTA.

Several studies in different in vitro and in vivo models have demonstrated neuroprotective effects of nicotinic receptor agonists and indirect trophic actions of nicotine on brain are suggested from observations describing nicotine as a cognitive enhancer by increasing vigilance and improving learning and memory. While an increasing number of studies have given evidence of neuroprotective and neurotrophic effects of nicotine treatment, the molecular mechanism mediating the neurotrophic effects of nicotine are not fully understood. Previously in an analysis of several neurotrophic factors as possible mediators of nicotine-induced neuroprotection and/or neurotrophic effects we could reveal that an acute intermittent nicotine treatment increases fibroblast growth factor-2 mRNA and protein in several brain regions of rat brain. Even if other studies have demonstrated in different paradigms that nicotine administration modulates expression level of a variety of genes, there is still a lack of indication which candidate genes, involved in neuroprotective responses are modulated by nicotine. In the present work we have used a microarray assay to further find and characterize new genes responsive to acute intermittent nicotine treatment and linked to neuroprotection. Therefore, we used Rat Genome U34A Affymetrix GeneChip arrays containing about 8800 probe sets to characterize transcriptional responses in the rat parietal cortex after acute intermittent nicotine treatment. We focused our attention to expression of transcription factors and several of them were up- or down-regulated by nicotine, among these Nr4a1 (Nurr77), Egr-1 and Egr-2. In situ hybridization was used to corroborate the microarray data and to reveal further spatial and temporal patterns of these nicotine induced genes. Taken together the present results identified several novel candidate genes modified by acute intermittent nicotine exposure and as such potentially involved in neuroprotective-neurotrophic actions.