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Purpose: We examined the effects of increasing hypoxia severity on oxygenation kinetics in the vastus lateralis muscle during repeated treadmill sprints, using statistical parametric mapping (SPM). Methods: Ten physically active males completed 8 sprints of 5 seconds each (recovery = 25 s) on a motorized sprint treadmill in normoxia (sea level; inspired oxygen fraction = 0.21), moderate hypoxia (inspired oxygen fraction = 0.17), and severe hypoxia (SH; inspired oxygen fraction = 0.13). Continuous assessment of tissue saturation index (TSI) in the vastus lateralis muscle was conducted using near-infrared spectroscopy. Subsequently, TSI data were averaged for the sprint–recovery cycle of all sprints and compared between conditions. Results: The SPM analysis revealed no discernible difference in TSI signal amplitude between conditions during the actual 5-second sprint phase. However, during the latter portion of the 25-second recovery phase, TSI values were lower in SH compared with both sea level (from 22 to 30 s; P =.003) and moderate hypoxia (from 16 to 30 s; P =.001). The mean distance covered at sea level (22.9 [1.0] m) was greater than for both moderate hypoxia (22.5 [1.2] m; P =.045) and SH (22.3 [1.4] m; P =.043). Conclusions: The application of SPM demonstrated that only SH reduced muscle oxygenation levels during the late portion of the passive (recovery) phase and not the active (sprint) phase during repeated treadmill sprints. These findings underscore the usefulness of SPM for assessing muscle oxygenation differences due to hypoxic exposure and the importance of the duration of the between-sprints recovery period. [ABSTRACT FROM AUTHOR]

A muscle's architecture, defined as the geometric arrangement of its fibers with respect to its mechanical line of action, impacts its abilities to produce force and shorten or lengthen under load. Ultrasound and other noninvasive imaging methods have contributed significantly to our understanding of these structure–function relationships. The goal of this work was to develop a MATLAB toolbox for tracking and mathematically representing muscle architecture at the fascicle scale, based on brightness-mode ultrasound imaging data. The MuscleUS_Toolbox allows user-performed segmentation of a region of interest and automated modeling of local fascicle orientation; calculation of streamlines between aponeuroses of origin and insertion; and quantification of fascicle length, pennation angle, and curvature. A method is described for optimizing the fascicle orientation modeling process, and the capabilities of the toolbox for quantifying and visualizing fascicle architecture are illustrated in the human tibialis anterior muscle. The toolbox is freely available. [ABSTRACT FROM AUTHOR]

Background: Mind--body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with fibromyalgia syndrome (FMS), and reduce perceived pain in some cases. However, responses to these treatments are highly variable, the mechanisms underpinning them remain unclear, and reliable predictors of treatment response are lacking. We employed resting-state blood oxygen level-dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind--body treatment that may relate to and predict pain relief. Methods: We recruited patients with FMS who underwent either mindfulnessbased stress reduction (MBSR; n = 18) or a psychoeducational program (FibroQoL; n = 22) and a treatment-as-usual FMS group (TAU; n = 18). We collected rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioral changes and FC changes in the salience network (SN) and sensorimotor network (SMN) and performed regression analyses to identify predictors for treatment response. Results: The MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, the FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. The FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice were positively associated with clinical improvement (small to medium effect size). Conclusions: Different mind--body treatments are underpinned by discrete brain networks. Measures of the functional interplay between SN and SMN have the potential as predictors of mind--body treatment response in patients with FMS. [ABSTRACT FROM AUTHOR]

Background: The Multidisciplinary Tumor Board (MTB) is a collaborative platform involving specialists in oncology, surgery, radiology, pathology, and radiotherapy, and aims to optimize diagnostics and treatments. Despite MTB's widespread benefits, limited literature addresses its application in pediatric neuro-oncology. After a literature revision on pediatric neuro-oncology MTB, our study describes our institute's pediatric neuro-oncology MTB, focuses on evaluating its impact and the neuroradiologist's role in patient-centric approaches, considering recent genetic insights into pediatric brain tumors. Materials and methods: Literature Review concerning pediatric neuro-oncology MTB from January 2002 to June 2024. Clinical Data: retrospective study of all patient files presented in the pediatric neuro-oncology MTB (pnMTB) between 2019 and 2022. Statistical analysis was mainly carried out by directly comparing the absolute or relative values of the respective parameters examined; qualitative variables compared mainly with the chi-square test, quantitative variables mainly with the t-test. Results: Literature Review: 7 papers encompass a multidisciplinary approach for the pediatric CNS tumors. Clinical data: A total of 236 discussions were analyzed representing 107 patients. Median age was 14,3 years (range: 6 months – 17 years). The requests for case evaluations primarily came from the pediatric oncologists (83%) and neurosurgeons (14.8%), and they were mainly addressed to the neuroradiologists (70.3%). Proposals during pnMTB mainly involved imaging follow-up (47.8%) and management with chemotherapy (34.7%). Changes in patient treatment (CPT) occurred in 115 cases, and pediatric neuroradiologist intervention contributed to 72.4% of these changes. Conclusion: Thanks to their multidisciplinarity, high number of cases discussed, and usual respect for their proposals, the pnMTB has made it possible to improve the coordination among specialties involved in patient management, to apply the recent protocols, and to exchange knowledge among teams managing pediatric CNS tumors. [ABSTRACT FROM AUTHOR]

Background: Stable mild cognitive impairment (sMCI) and progressive mild cognitive impairment (pMCI) represent two distinct subtypes of mild cognitive impairment (MCI). Early and effective diagnosis and accurate differentiation between sMCI and pMCI are crucial for administering targeted early intervention and preventing cognitive decline. This study investigated the intrinsic dysconnectivity patterns in sMCI and pMCI based on degree centrality (DC) and effective connectivity (EC) analyses, with the goal of uncovering shared and distinct neuroimaging mechanisms between subtypes. Methods: Resting-state functional magnetic resonance imaging combined with DC analysis was used to explore the functional connectivity density in 42 patients with sMCI, 31 patients with pMCI, and 82 healthy control (HC) participants. Granger causality analysis was used to assess changes in EC based on the significant clusters found in DC. Furthermore, correlation analysis was conducted to examine the associations between altered DC/EC values and cognitive function. Receiver operating characteristic curve analysis was performed to determine the accuracy of abnormal DC and EC values in distinguishing sMCI from pMCI. Results: Compared with the HC group, both pMCI and sMCI groups exhibited increased DC in the left inferior temporal gyrus (ITG), left posterior cerebellum lobe (CPL), and right cerebellum anterior lobe (CAL), along with decreased DC in the left medial frontal gyrus. Moreover, the sMCI group displayed reduced EC from the right CAL to bilateral CPL, left superior temporal gyrus, and bilateral caudate compared with HC. pMCI demonstrated elevated EC from the right CAL to left ITG, which was linked to episodic memory and executive function. Notably, the EC from the right CAL to the right ITG effectively distinguished sMCI from pMCI, with sensitivity, specificity, and accuracy of 0.5806, 0.9512, and 0.828, respectively. Conclusion: This study uncovered shared and distinct alterations in DC and EC between sMCI and pMCI, highlighting their involvement in cognitive function. Of particular significance are the unidirectional EC disruptions from the cerebellum to the temporal lobe, which serve as a discriminating factor between sMCI and pMCI and provide a new perspective for understanding the temporal-cerebellum. These findings offer novel insights into the neural circuit mechanisms involving the temporal-cerebellum connection in MCI. [ABSTRACT FROM AUTHOR]

Background: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure. Whilst lumbar puncture (LP) is necessary for the diagnosis of IIH, its therapeutic effect remains unclear. Our aim was to evaluate the therapeutic effect of a single LP in people with IIH (pwIIH). Methods: In this prospective observational study, we analysed short-term neurological and ophthalmological outcomes in pwIIH before, one (D1) and seven days (D7) after the LP. The primary outcome was the change in papilledema degree from baseline. Secondary outcomes included visual outcomes, morphological changes in optical coherence tomography (peripapillary retinal nerve fibre layer [pRNFL] thickness and ganglion cell layer [GCL] volume) and transbulbar sonography (arachnoid optic nerve sheath diameter [AONSD]), and headache outcomes (peak and median headache severity and burden related to headache). Results: We included 30 pwIIH (mean age 32.8 years [SD 8.4], 93.3% female, median cerebrospinal fluid [CSF] opening pressure 33.0 cmCSF [IQR 26.9–35.3], median body mass index (BMI) 34.8 kg/m2 [IQR 30.9–40.9]). The median papilledema grading at baseline was 2 (Friedman DI (1999) Pseudotumor cerebri. Neurosurg Clin N Am 10(4):609–621 viii); (Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ (2019) The expanding burden of idiopathic intracranial hypertension. Eye Lond Engl 33(3):478–485); (Ab D, Gt L, Nj V, Sl G, Ml M, Nj N et al. (2007) Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension (pseudotumor cerebri). Am J Ophthalmol [Internet]. Apr [cited 2024 Jun 2];143(4). https://pubmed.ncbi.nlm.nih.gov/17386271/) and was significantly reduced at D7 (2 [1–2], p = 0.011). Median pRNFL thickness had decreased significantly at D7 (-9 μm [-62.5, -1.3], p = 0.035), with pRNFL thickness at baseline being associated with the pRNFL change (F(1,11) = 18.79, p = 0.001). Mean AONSD had decreased significantly at both D1 (-0.74 mm [0.14], p < 0.001) and D7 (-0.65 mm [0.17], p = 0.01), with AONSD at baseline being associated with the change in AONSD at both time points (D1: β= -0.89, 95% CI -1.37, -0.42, p = 0.002; D7: β= -0.85, 95% CI -1.42, -0.28, p = 0.007). Peak headache severity was slightly lower at D7 (-1/10 [-3, 0], p = 0.026), whereas median headache severity and headache burden remained unchanged. Conclusions: This short-term follow-up study in pwIIH undergoing a single LP suggests a moderate effect on ophthalmological but not headache outcomes. The usefulness of LP as a therapeutic measure in IIH remains controversial and should likely be reserved for patients with limited treatment options, e.g., in pregnancy or intolerability to medication. [ABSTRACT FROM AUTHOR]

Craniosynostoses (CRS) are caused by the premature fusion of one or more cranial sutures, with isolated nonsyndromic CRS accounting for most of the clinical manifestations. Such premature suture fusion impacts both skull and brain morphology and involves regions far beyond the immediate area of fusion. The combined use of different neuroimaging tools allows for an accurate depiction of the most prominent clinical–radiological features in nonsyndromic CRS but can also contribute to a deeper investigation of more subtle alterations in the underlying nervous tissue organization that may impact normal brain development. This review paper aims to provide a comprehensive framework for a better understanding of the present and future potential applications of neuroimaging techniques for evaluating nonsyndromic CRS, highlighting strategies for optimizing their use in clinical practice and offering an overview of the most relevant technological advancements in terms of diagnostic performance, radiation exposure, and cost-effectiveness. [ABSTRACT FROM AUTHOR]

A core assumption in the current neurosemantic research is that meanings of concrete words (object nouns, action verbs) are at least partially grounded in modality-specific representations implemented by perceptual and motor cortices. Nevertheless, increasing evidence from the multisensory research suggests that extensive portions of what are traditionally considered modality-specific cortices are in fact supramodal in nature – that is, they can process specific information in multiple sensory modalities and in both normal and sensory-deprived individuals. My central argument in this paper is that the amount of data collected within the supramodal paradigm, although certainly not conclusive, is already robust enough to foster reflections about the role of modality-specificity in the semantic brain and to prompt considerations about the possibility of promoting a property-specific and modality-invariant turn in neurosemantics. [ABSTRACT FROM AUTHOR]

Background and purpose: Traumatic brain injury (TBI) is a major source of health loss and disability worldwide. Accurate and timely diagnosis of TBI is critical for appropriate treatment and management of the condition. Neuroimaging plays a crucial role in the diagnosis and characterization of TBI. Computed tomography (CT) is the first-line diagnostic imaging modality typically utilized in patients with suspected acute mild, moderate and severe TBI. Radiology reports play a crucial role in the diagnostic process, providing critical information about the location and extent of brain injury, as well as factors that could prevent secondary injury. However, the complexity and variability of radiology reports can make it challenging for healthcare providers to extract the necessary information for diagnosis and treatment planning. Methods/results/conclusion: In this article, we report the efforts of an international group of TBI imaging experts to develop a clinical radiology report template for CT scans obtained in patients suspected of TBI and consisting of fourteen different subdivisions (CT technique, mechanism of injury or clinical history, presence of scalp injuries, fractures, potential vascular injuries, potential injuries involving the extra-axial spaces, brain parenchymal injuries, potential injuries involving the cerebrospinal fluid spaces and the ventricular system, mass effect, secondary injuries, prior or coexisting pathology). [ABSTRACT FROM AUTHOR]

Purpose: How to measure brain globotriaosylceramide (Gb3) accumulation in Fabry Disease (FD) patients in-vivo is still an open challenge. The objective of this study is to provide a quantitative, non-invasive demonstration of this phenomenon using quantitative MRI (qMRI). Methods: In this retrospective, monocentric cross-sectional study conducted from November 2015 to July 2018, FD patients and healthy controls (HC) underwent an MRI scan with a relaxometry protocol to compute longitudinal relaxation rate (R1) maps to evaluate gray (GM) and white matter (WM) lipid accumulation. In a subgroup of 22 FD patients, clinical (FAbry STabilization indEX -FASTEX- score) and biochemical (residual α-galactosidase activity) variables were correlated with MRI data. Quantitative maps were analyzed at both global ("bulk" analysis) and regional ("voxel-wise" analysis) levels. Results: Data were obtained from 42 FD patients (mean age = 42.4 ± 12.9, M/F = 16/26) and 49 HC (mean age = 42.3 ± 16.3, M/F = 28/21). Compared to HC, FD patients showed a widespread increase in R1 values encompassing both GM (pFWE = 0.02) and WM (pFWE = 0.02) structures. While no correlations were found between increased R1 values and FASTEX score, a significant negative correlation emerged between residual enzymatic activity levels and R1 values in GM (r = -0.57, p = 0.008) and WM (r = -0.49, p = 0.03). Conclusions: We demonstrated the feasibility and clinical relevance of non-invasively assessing cerebral Gb3 accumulation in FD using MRI. R1 mapping might be used as an in-vivo quantitative neuroimaging biomarker in FD patients. [ABSTRACT FROM AUTHOR]

The differential diagnosis of supratentorial brain tumours in children can be challenging, especially considering the recent changes to the WHO classification of CNS tumours published in 2021. Many new tumour types have been proposed which frequently present in children and young adults and their imaging features are currently being described by the neuroradiology community. The purpose of this article is to provide guidance to residents and fellows new to the field of paediatric neuroradiology on how to evaluate an MRI of a patient with a newly diagnosed supratentorial tumour. Six different approaches are discussed including: 1. Tumour types, briefly discussing the main changes to the recent WHO classification of CNS tumours, 2. Patient age and its influence on incidence rates of specific tumour types, 3. Growth patterns, 4. Tumour location and how defining the correct location helps in narrowing down the differential diagnoses and 5. Imaging features of the tumour on DWI, SWI, FLAIR and post contrast sequences. [ABSTRACT FROM AUTHOR]

During neuroradiological interventions such as treating intracranial aneurysms, neuroradiologists have to navigate a catheter in the 3D anatomy while watching a 2D projection of the vessels. To train this visuospatial ability, we present a virtual reality application where the user has to identify anatomically relevant positions on the Circle of Willis based on a 2D projection image. This image is generated based on a 3D model using a Fresnel shader. To increase motivation, which is an important aspect of training, we included several game elements. We qualitatively evaluated our application with two neuroradiologists. Although they rated our implementation of the task as difficult due to the small image section, both participants emphasized the importance of this training. Even small changes that have been suggested can adjust the difficulty, leading to an appropriate training that could be integrated into the curriculum. The results also indicate that the included game elements are motivating and that the application in general has a high usability. The proposed immersive virtual reality application provides training for visuospatial ability in a concrete medical context. Due to gamification, fun, and motivation are increased, which are two important factors of training affecting the frequency of use and outcome. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Persistent auditory verbal hallucinations (pAVHs) and olfactory identification impairment are common in schizophrenia (SCZ), but the neuroimaging mechanisms underlying both pAVHs and olfactory identification impairment are unclear. This study aimed to investigate whether pAVHs and olfactory identification impairment in SCZ patients are associated with changes in cortical thickness. Study Design In this study, cortical thickness was investigated in 78 SCZ patients with pAVHs (pAVH group), 58 SCZ patients without AVHs (non-AVH group), and 83 healthy controls (HC group) using 3T magnetic resonance imaging. The severity of pAVHs was assessed by the Auditory Hallucination Rating Scale. Olfactory identification deficits were assessed using the Odor Stick Identification Test for Japanese (OSIT-J). In addition, the relationship between the severity of pAVHs and olfactory identification disorder and cortical thickness abnormalities was determined. Study Results Significant reductions in cortical thickness were observed in the right medial orbital sulcus (olfactory sulcus) and right orbital sulcus (H-shaped sulcus) in the pAVH group compared to both the non-AVH and HC groups (P  < .003, Bonferroni correction). Furthermore, the severity of pAVHs was found to be negatively correlated with the reduction in cortical thickness in the olfactory sulcus and H-shaped sulcus. Additionally, a decrease in cortical thickness in the olfactory sulcus showed a positive correlation with the OSIT-J scores (P  < .05, false discovery rate correction). Conclusions Cortical thickness abnormalities in the olfactory sulcus may be a common neuroimaging mechanism for pAVHs and olfactory identification deficits in SCZ patients. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have highlighted cognitive benefits in lifelong bilinguals during aging, manifesting as superior performance on cognitive tasks compared to monolingual counterparts. Yet, the cognitive impacts of acquiring a new language in older adulthood remain unexplored. In this study, we assessed both behavioral and fMRI responses during a Stroop task in older adults, preand post language-learning intervention. Methods: A group of 41 participants (age:60-80) from a predominantly monolingual environment underwent a four-month online language course, selecting a new language of their preference. This intervention mandated engagement for 90 minutes a day, five days a week. Daily tracking was employed to monitor progress and retention. All participants completed a color-word Stroop task inside the scanner before and after the language instruction period. Results: We found that performance on the Stroop task, as evidenced by accuracy and reaction time, improved following the language learning intervention. With the neuroimaging data, we observed significant differences in activity between congruent and incongruent trials in key regions in the prefrontal and parietal cortex. These results are consistent with previous reports using the Stroop paradigm. We also found that the amount of time participants spent with the language learning program was related to differential activity in these brain areas. Specifically, we found that people who spent more time with the language learning program showed a greater increase in differential activity between congruent and incongruent trials after the intervention relative to before. Discussion: Future research is needed to determine the optimal parameters for language learning as an effective cognitive intervention for aging populations. We propose that with sufficient engagement, language learning can enhance specific domains of cognition such as the executive functions. These results extend the understanding of cognitive reserve and its augmentation through targeted interventions, setting a foundation for future investigations. [ABSTRACT FROM AUTHOR]

Homocysteine (Hcy) is a cardiovascular risk factor implicated in cognitive impairment and cerebrovascular disease but has also been associated with Alzheimer's disease. In 160 healthy older adults (mean age = 69.66 ± 9.95 years), we sought to investigate the association of cortical brain volume with white matter hyperintensity (WMH) burden and a previously identified Hcy-related multivariate network pattern showing reductions in subcortical gray matter (SGM) volumes of hippocampus and nucleus accumbens with relative preservation of basal ganglia. We additionally evaluated the potential role of these brain imaging markers as a series of mediators in a vascular brain pathway leading to age-related cognitive dysfunction in healthy aging. We found reductions in parietal lobar gray matter associated with the Hcy-SGM pattern, which was further associated with WMH burden. Mediation analyses revealed that slowed processing speed related to aging, but not executive functioning or memory, was mediated sequentially through increased WMH lesion volume, greater Hcy-SGM pattern expression, and then smaller parietal lobe volume. Together, these findings suggest that volume reductions in parietal gray matter associated with a pattern of Hcy-related SGM volume differences may be indicative of slowed processing speed in cognitive aging, potentially linking cardiovascular risk to an important aspect of cognitive dysfunction in healthy aging. [ABSTRACT FROM AUTHOR]

Introduction: Emerging evidence suggests a connection between vulnerability to infections and Alzheimer's disease (AD). The nectin cell adhesion molecule 2 (NECTIN2) gene coding for a membrane component of adherens junctions is involved in response to infections, and its single nucleotide polymorphism (SNP) rs6859 was significantly associated with AD risk in several human cohorts. It is unclear, however, how exactly rs6859 influences the development of AD pathology. The aggregation of hyperphosphorylated tau protein (pTau) is a key pathological feature of neurodegeneration in AD, which may be induced by infections, among other factors, and potentially influenced by genes involved in both AD and vulnerability to infections, such as NECTIN2. Materials and methods: We conducted a causal mediation analysis (CMA) on a sample of 708 participants in the Alzheimer's disease Neuroimaging Initiative (ADNI). The relationship between rs6859 and Alzheimer's disease (AD), with AD (yes/no) as the outcome and pTau-181 levels in the cerebrospinal fluid (CSF) acting as a mediator in this association, was assessed. Adjusted estimates from the probit and linear regression models were used in the CMA model, where an additive model considered an increase in dosage of the rs6859 A allele (AD risk factor). Results: The increase in dose of allele A of the SNP rs6859 resulted in about 0.144 increase per standard deviation (SD) of pTau-181 (95% CI: 0.041, 0.248, p < 0.01). When included together in the probit model, the change in A allele dose and each standard deviation change in pTau-181 predicted 6.84% and 9.79% higher probabilities for AD, respectively. In the CMA, the proportion of the average mediated effect was 17.05% and was higher for the risk allele homozygotes (AA), at 19.40% (95% CI: 6.20%, 43.00%, p < 0.01). The sensitivity analysis confirmed the evidence of a robust mediation effect. Conclusion: This study reported a new potential causal relationship between pTau-181 and AD. We found that the association between rs6859 in the NECTIN2 gene and AD is partly mediated by pTau-181 levels in CSF. The rest of this association may be mediated by other factors. Our finding sheds light on the complex interplay between genetic susceptibility, protein aggregation, and neurodegeneration in AD. Further research, using other biomarkers, is needed to uncover the remaining mechanisms of the association between the NECTIN2 gene and AD. [ABSTRACT FROM AUTHOR]

Demand for emergency neuroimaging is increasing. Even magnetic resonance imaging (MRI) is often performed outside office hours, sometimes revealing more uncommon entities like brain tumors. The scientific literature studying artificial intelligence (AI) methods for classifying brain tumors on imaging is growing, but knowledge about the radiologist's performance on this task is surprisingly scarce. Our study aimed to tentatively fill this knowledge gap. We hypothesized that the radiologist could classify intra-axial brain tumors at the emergency department with clinically acceptable accuracy. We retrospectively examined emergency brain MRI reports from 2013 to 2021, the inclusion criteria being (1) emergency brain MRI, (2) no previously known intra-axial brain tumor, and (3) suspicion of an intra-axial brain tumor on emergency MRI report. The tumor type suggestion and the final clinical diagnosis were pooled into groups: (1) glial tumors, (2) metastasis, (3) lymphoma, and (4) other tumors. The final study sample included 150 patients, of which 108 had histopathological tumor type confirmation. Among the patients with histopathological tumor type confirmation, the accuracy of the MRI reports in classifying the tumor type was 0.86 for gliomas against other tumor types, 0.89 for metastases, and 0.99 for lymphomas. We found the result encouraging, given the prolific need for emergency imaging. [ABSTRACT FROM AUTHOR]

Background: Wilson's disease is an inherited disease characterized by impaired copper metabolism that causes damage to many organs, including the brain. Patients having neurological involvement usually present with varied neuropsychiatric symptoms. Magnetic resonance imaging (MRI) Brain plays an indispensable role in identifying the structural involvement in these patients, aiding in early accurate diagnosis and timely management. Typically, basal ganglia, thalami and brainstem are involved, with bright claustrum sign, face of giant panda sign and miniature panda signs on MRI. Conclusions: Having knowledge about the commonly encountered and known MRI brain findings in Wilson's disease are essential in aiding accurate diagnosis and initiating early management. However, identifying the Atypical MRI brain characteristics is all the more imperative and should be considered in patients with prolonged or severe disease or in patients with rapid clinical progression and in patients showing poor response to treatment. [ABSTRACT FROM AUTHOR]

Bilateral edematous optic disc swelling from papilledema is caused by elevated intracranial pressure (ICP). Idiopathic intracranial hypertension (IIH), a clinical syndrome with elevated ICP of unclear etiology, is a frequent cause of this condition. IIH typically affects obese middle-aged females. Papilledema usually has a fairly symmetrical bilateral pattern. Unilateral papilledema is a rare disorder that must be detected early to avoid optic nerve damage. However, the etiology of unilateral papilledema remains unclear. Based on bilateral optic nerve sheath diameter measurements, we aimed to find an explanation for the unilaterality in this rare case. [ABSTRACT FROM AUTHOR]

Background: We used a polygenic score for externalizing behavior (extPGS) and structural MRI to examine potential pathways from genetic liability to conduct problems via the brain across the adolescent transition. Methods: Three annual assessments of child conduct problems, attention‐deficit/hyperactivity problems, and internalizing problems were conducted across across 9–13 years of age among 4,475 children of European ancestry in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Results: The extPGS predicted conduct problems in each wave (R2 = 2.0%–2.9%). Bifactor models revealed that the extPRS predicted variance specific to conduct problems (R2 = 1.7%–2.1%), but also variance that conduct problems shared with other measured problems (R2 =.8%–1.4%). Longitudinally, extPGS predicted levels of specific conduct problems (R2 = 2.0%), but not their slope of change across age. The extPGS was associated with total gray matter volume (TGMV; R2 =.4%) and lower TGMV predicted both specific conduct problems (R2 = 1.7%–2.1%) and the variance common to all problems in each wave (R2 = 1.6%–3.1%). A modest proportion of the polygenic liability specific to conduct problems in each wave was statistically mediated by TGMV. Conclusions: Across the adolescent transition, the extPGS predicted both variance specific to conduct problems and variance shared by all measured problems. The extPGS also was associated with TGMV, which robustly predicted conduct problems. Statistical mediation analyses suggested the hypothesis that polygenic variation influences individual differences in brain development that are related to the likelihood of conduct problems during the adolescent transition, justifying new research to test this causal hypothesis. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the multisystem factors contributing to redundant neurovascular orders in the ED. Methods: This was an IRB-approved, retrospective study, performed at a single institution examining a 5-year history of redundant CTA/MRA head and neck (HN) exams performed in the ED for patients with no documented clinical change in mental status/neurological exam necessitating additional imaging. Factors contributing to redundant ordering including provider experience, synchronous order placement, and radiologist recommendations were examined. Additionally, the impact of duplicative imaging in terms of medical cost and ED length of stay was evaluated. Results: 250 patients met inclusion criteria with both CTA/MRA of the HN performed during a single ED encounter (total 500 exams). 190 (76%) redundant exams were not recommended by a radiologist and contributed to an added ED length of stay of 3.6 h on average. Provider experience was not a significant contributing factor. 60 (24%) of redundant exams were recommended by a radiologist and were most frequently CTAs needed to clarify an area of artifact/high-grade stenosis/occlusion on a primary MRA exam. Conclusion: Evaluation of contributing factors to redundant CTA/MRA HN exams ordering has highlighted multiple associated factors including provider experience, recommendations by radiologists for clarification of MRA findings, as well as systems processes related to synchronous CTA/MRA order placement. [ABSTRACT FROM AUTHOR]

Purpose: Malignant intracranial germ cell tumors (GCTs) are rare diseases in Western countries. They arise in midline structures and diagnosis is often delayed. We evaluated imaging characteristics and early tumor signs of suprasellar and bifocal GCT on MRI. Methods: Patients with the diagnosis of a germinoma or non-germinomatous GCT (NGGCT) who received non-contrast sagittal T1WI on MRI pre-therapy were included. Loss of the posterior pituitary bright spot (PPBS), the expansion and size of the tumor, and the expansion and infiltration of surrounding structures were evaluated. Group comparison for histologies and localizations was performed. Results: A total of 102 GCT patients (median age at diagnosis 12.3 years, range 4.4–33.8; 57 males; 67 in suprasellar localization) were enrolled in the study. In the suprasellar cohort, NGGCTs (n = 20) were noticeably larger than germinomas (n = 47; p <.001). Each tumor showed involvement of the posterior lobe or pituitary stalk. A PPBS loss (total n = 98) was observed for each localization and entity in more than 90% and was related to diabetes insipidus. Osseous infiltration was observed exclusively in suprasellar GCT (significantly more frequent in NGGCT; p =.004). Time between the first MRI and therapy start was significantly longer in the suprasellar cohort (p =.005), with an even greater delay in germinoma compared to NGGCT (p =.002). The longest interval to treatment had circumscribed suprasellar germinomas (median 312 days). Conclusion: A loss of the PPBS is a hint of tumor origin revealing small tumors in the neurohypophysis. Using this sign in children with diabetes insipidus avoids a delay in diagnosis. [ABSTRACT FROM AUTHOR]

We compared different LLMs, notably chatGPT, GPT4, and Google Bard and we tested whether their performance differs in subspeciality domains, in executing examinations from four different courses of the European Society of Neuroradiology (ESNR) notably anatomy/embryology, neuro-oncology, head and neck and pediatrics. Written exams of ESNR were used as input data, related to anatomy/embryology (30 questions), neuro-oncology (50 questions), head and neck (50 questions), and pediatrics (50 questions). All exams together, and each exam separately were introduced to the three LLMs: chatGPT 3.5, GPT4, and Google Bard. Statistical analyses included a group-wise Friedman test followed by a pair-wise Wilcoxon test with multiple comparison corrections. Overall, there was a significant difference between the 3 LLMs (p < 0.0001), with GPT4 having the highest accuracy (70%), followed by chatGPT 3.5 (54%) and Google Bard (36%). The pair-wise comparison showed significant differences between chatGPT vs GPT 4 (p < 0.0001), chatGPT vs Bard (p < 0. 0023), and GPT4 vs Bard (p < 0.0001). Analyses per subspecialty showed the highest difference between the best LLM (GPT4, 70%) versus the worst LLM (Google Bard, 24%) in the head and neck exam, while the difference was least pronounced in neuro-oncology (GPT4, 62% vs Google Bard, 48%). We observed significant differences in the performance of the three different LLMs in the running of official exams organized by ESNR. Overall GPT 4 performed best, and Google Bard performed worst. This difference varied depending on subspeciality and was most pronounced in head and neck subspeciality. [ABSTRACT FROM AUTHOR]

Introduction: Diffusion tensor imaging (DTI) is a valuable non-invasive imaging modality for mapping white matter tracts and assessing microstructural integrity, and can be used as a "biomarker" in diagnosis, differentiation, and therapeutic monitoring. Although it has gained clinical importance as a marker of neuropathology, limitations in its interpretation underscore the need for caution. Methods: This review provides an overview of the principles and clinical applicability of DTI. We focus on major white matter fiber bundles, detailing their normal anatomy and pathological DTI patterns, with emphasis on tracts routinely requested in our neurosurgical department in the preoperative context (uncinate fasciculus, arcuate fasciculus, pyramidal pathway, optic radiation, and dentatorubrothalamic tract). Results: We guide neuroradiologists and neurosurgeons in defining volumes of interest for mapping individual tracts and demonstrating their 3D reconstructions. The intricate trajectories of white matter tracts pose a challenge for accurate fiber orientation recording, with each bundle exhibiting specific characteristics. Tracts adjacent to brain lesions are categorized as displaced, edematous, infiltrated, or disrupted, illustrated with clinical cases of brain neoplasms. To improve structured reporting, we propose a checklist of topics for inclusion in imaging evaluations and MRI reports. Conclusion: DTI is emerging as a powerful tool for assessing microstructural changes in brain disorders, despite some challenges in standardization and interpretation. This review serves an educational purpose by providing guidance for fiber monitoring and interpretation of pathological patterns observed in clinical cases, highlighting the importance and potential pitfalls of DTI in neuroradiology and surgical planning. [ABSTRACT FROM AUTHOR]

Background Congenital cytomegalovirus (cCMV) is the most common infectious cause of neurodevelopmental deficits in US children. To inform patient management, it is important to define whether central nervous system (CNS) manifestations are present at birth. This study characterized neuroimaging findings in infants with cCMV identified by a universal screening study in Minnesota during February 2016–December 2022. Methods Newborns with cCMV infection (confirmed by urine CMV polymerase chain reaction [PCR] testing, obtained following a positive screening saliva and/or dried blood spot result) underwent a diagnostic evaluation that included a cranial ultrasound (cUS) exam, laboratory studies, ophthalmological, and audiological evaluation. Neuroimaging findings and cCMV disease classification were interpreted based on international consensus guidelines. Results Among 87 newborns with confirmed cCMV, 76 underwent cUS. Of these, 53/76 (70%) had normal examinations, while 23/76 (30%) exhibited cUS findings: for 5 infants, these were clearly cCMV disease-defining, while for 18 infants, there were findings of uncertain significance. Magnetic resonance imaging (MRI) results (n  = 10 infants) aligned with cUS cCMV disease-defining findings in 2 infants, while cCMV-specific abnormalities were noted by MRI in 2 of 6 infants with nondiagnostic/incidental cUS findings. Of 9 infants who had both cUS and MRI examination, the average time interval between studies was 220 days (range, 2–1061). Excluding infants with cCMV CNS disease-defining cUS abnormalities, incidental findings were observed more commonly in infants with clinical/laboratory features described in cCMV disease classification guidelines (9/13) than in newborns with completely asymptomatic infections (9/58; P  < .0001). Conclusions Among infants with cCMV identified in a universal screening study, the majority had a normal cUS. CNS disease-defining abnormalities were present in 7%, while 24% had findings of uncertain significance. We propose that many cUS findings are incidental, and not diagnostic of symptomatic cCMV infection. Although these findings may not be sufficient to define the presence of symptomatic cCMV disease involving the CNS, in our study they were more commonly observed in infants with other clinical and/or laboratory findings associated with symptomatic cCMV infection. [ABSTRACT FROM AUTHOR]

Background: Although the World Health Organization recommends visible and clear warning labels about the risks of alcohol consumption on containers and advertising, many of the currently used labels are too small to be visible. This study investigated the brain activity (using fMRI) and alcohol consumption intentions of French young men exposed to two warning formats displayed on alcoholic beverage advertisements: a small Text‐only Alcohol Warning (TAW) currently used in many countries, and a larger text‐and‐picture alcohol warning (PAW). Methods: Seventy‐four eligible 18–25‐year‐old male drinkers completed a face‐to‐face individual visit with a physician expert in addiction medicine. This was followed by the fMRI session during which they viewed 288 stimuli [96 alcohol advertisements with TAWs, the same 96 advertisements with PAWs, and 96 water advertisements (controls)] for 3 s each. If the advertisement made participants want ("yes")/do not want ("no") to consume the product, they pressed the corresponding button (self‐report responses). The number of "yes" responses was compared between advertisement types with a paired sample t‐test. Whole‐brain and region‐of‐interest (ROI) analyses of the fMRI data were performed. Results: Whole‐brain BOLD fMRI highlighted contrasting effects of PAWs and TAWs. Compared with TAWs, PAWs elicited more activation in the precuneus, angular gyrus, occipital, frontal and temporal areas, and less activation in the nucleus accumbens, ventral tegmental areas, and putamen areas (regions of the reward circuit). The ROI analysis confirmed less activation in the reward circuit (left and right ventral tegmental areas, left and right nucleus accumbens) when viewing PAWs than TAWs. Analysis of the self‐report responses indicated that the desire to consume the advertised alcohol product was lower when PAWs were viewed (compared with TAWs) (T = 8.18, p < 10−11). Conclusions: This is the first fMRI study to assess the effect of different alcohol warning formats. Our findings show that compared with TAWs, stronger PAWs in advertisements elicited less activity in key regions of the reward system. This suggests that the effects may influence the desire to consume alcohol products (self‐report response analysis). These results could help policymakers who are interested in developing more effective labeling measures that target young people. [ABSTRACT FROM AUTHOR]

The incidence of brain death/death by neurologic criteria (BD/DNC) among all hospital deaths in the US is approximately 2.06% or 15,000-20,000 cases annually. This article reviews the latest guidelines for adult and pediatric BD/DNC. Although there have not been many changes to the guidelines over the years, BD/DNC guideline updates maintain consistency in determining BD/DNC. [ABSTRACT FROM AUTHOR]

Objectives Early diagnosis of Alzheimer's disease (AD) using brain scans and other biomarker tests will be essential to increasing the benefits of emerging disease-modifying therapies, but AD biomarkers may have unintended negative consequences on stigma. We examined how a brain scan result affects AD diagnosis confidence and AD stigma. Methods The study used a vignette-based experiment with a 2 × 2 × 3 factorial design of main effects: a brain scan result as positive or negative, treatment availability and symptom stage. We sampled 1,283 adults ages 65 and older between June 11and July 3, 2019. Participants (1) rated their confidence in an AD diagnosis in each of four medical evaluations that varied in number and type of diagnostic tools and (2) read a vignette about a fictional patient with varied characteristics before completing the Modified Family Stigma in Alzheimer's Disease Scale (FS-ADS). We examined mean diagnosis confidence by medical evaluation type. We conducted between-group comparisons of diagnosis confidence and FS-ADS scores in the positive versus negative brain scan result conditions and, in the positive condition, by symptom stage and treatment availability. Results A positive versus negative test result corresponds with higher confidence in an AD diagnosis independent of medical evaluation type (all p  < .001). A positive result correlates with stronger reactions on 6 of 7 FS-ADS domains (all p  < .001). Discussion A positive biomarker result heightens AD diagnosis confidence but also correlates with more AD stigma. Our findings inform strategies to promote early diagnosis and clinical discussions with individuals undergoing AD biomarker testing. [ABSTRACT FROM AUTHOR]

Objectives Numerous theories exist regarding age differences in risk preference and related constructs, yet many of them offer conflicting predictions and fail to consider convergence between measurement modalities or constructs. To pave the way for conceptual clarification and theoretical refinement, in this preregistered study we aimed to comprehensively examine age effects on risk preference, impulsivity, and self-control using different measurement modalities, and to assess their convergence. Methods We collected a large battery of self-report, informant report, behavioral, hormone, and neuroimaging measures from a cross-sectional sample of 148 (55% female) healthy human participants between 16 and 81 years (mean age = 46 years, standard deviation [ SD ] = 19). We used an extended sample of 182 participants (54% female, mean age = 46 years, SD  = 19) for robustness checks concerning the results from self-reports, informant reports, and behavioral measures. For our main analysis, we performed specification curve analyses to visualize and estimate the convergence between the different modalities and constructs. Results Our multiverse analysis approach revealed convergent results for risk preference, impulsivity, and self-control from self- and informant reports, suggesting a negative effect of age. For behavioral, hormonal, and neuroimaging outcomes, age effects were mostly absent. Discussion Our findings call for conceptual clarification and improved operationalization to capture the putative mechanisms underlying age-related differences in risk preference and related constructs. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) remains a significant global problem with an increasing socioeconomic impact. Increasing knowledge of the pathophysiology of TBI has led to a systematic multidisciplinary approach towards management aiming to protect the brain from secondary injury. Early management starting from the scene of injury, to intensive care and surgical settings is paramount to achieve this purpose. TBI includes a large spectrum of diseases, therefore identifying the correct pathology on imaging is fundamental to define the appropriate next steps of management. Computed tomography (CT) imaging to date remains the gold standard for initial radiological assessment. Intracranial and cerebral perfusion pressure targeted therapies are still the minimum requirement in most of modern intensive care units worldwide. Decompressive craniectomy is a fundamental technique to control medically refractory intracranial hypertension and reduce mortality; however, its burden in terms of outcomes remains a controversial topic requiring further debate. There is emerging evidence that TBI is a chronic illness, with increased incidence of cognitive and behavioural deficits, neurodegenerative disease such as seizures and epilepsy, and an increased mortality that extends well beyond the initial TBI stage. Ongoing research into novel biomarkers, the application of artificial intelligence (AI) and an increasing global effort may yield future therapeutic strategies to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: The study of central nervous system (CNS) tumors is particularly relevant in the pediatric population because of their relatively high frequency in this demographic and the significant impact on disease- and treatment-related morbidity and mortality. While both morphological and non-morphological magnetic resonance imaging techniques can give important information concerning tumor characterization, grading, and patient prognosis, increasing evidence in recent years has highlighted the need for personalized treatment and the development of quantitative imaging parameters that can predict the nature of the lesion and its possible evolution. For this purpose, radiomics and the use of artificial intelligence software, aimed at obtaining valuable data from images beyond mere visual observation, are gaining increasing importance. This brief review illustrates the current state of the art of this new imaging approach and its contributions to understanding CNS tumors in children. Data sources: We searched the PubMed, Scopus, and Web of Science databases using the following key search terms: ("radiomics" AND/OR "artificial intelligence") AND ("pediatric AND brain tumors"). Basic and clinical research literature related to the above key research terms, i.e., studies assessing the key factors, challenges, or problems of using radiomics and artificial intelligence in pediatric brain tumors management, was collected. Results: A total of 63 articles were included. The included ones were published between 2008 and 2024. Central nervous tumors are crucial in pediatrics due to their high frequency and impact on disease and treatment. MRI serves as the cornerstone of neuroimaging, providing cellular, vascular, and functional information in addition to morphological features for brain malignancies. Radiomics can provide a quantitative approach to medical imaging analysis, aimed at increasing the information obtainable from the pixels/voxel grey-level values and their interrelationships. The "radiomic workflow" involves a series of iterative steps for reproducible and consistent extraction of imaging data. These steps include image acquisition for tumor segmentation, feature extraction, and feature selection. Finally, the selected features, via training predictive model (CNN), are used to test the final model. Conclusions: In the field of personalized medicine, the application of radiomics and artificial intelligence (AI) algorithms brings up new and significant possibilities. Neuroimaging yields enormous amounts of data that are significantly more than what can be gained from visual studies that radiologists can undertake on their own. Thus, new partnerships with other specialized experts, such as big data analysts and AI specialists, are desperately needed. We believe that radiomics and AI algorithms have the potential to move beyond their restricted use in research to clinical applications in the diagnosis, treatment, and follow-up of pediatric patients with brain tumors, despite the limitations set out. [ABSTRACT FROM AUTHOR]

Background: Percutaneous cement discoplasty (PCD) is a minimally invasive procedure. We aim to explore the efficacy and indication(s) of PCD in patients with degenerative disc disease (DDD). Methods: The search was conducted across Ovid MEDLINE, Ovid Embase, and PubMed. Data on study design, patient demographics, pre- and post-procedure Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores, and complications were extracted. Inclusion criteria focused on adult patients with degenerative spinal diseases treated with cement discoplasty. The overall effect size was evaluated using a forest plot, and heterogeneity was assessed using the I2 statistic and chi-squared test. Results: The search strategy yielded six studies, which included 336 patients (73.8% female, 26.2% male) with a mean average age of 74.6 years. VAS scores were reported in all studies, showing a significant difference between pre- and post-PCD pain scores (Weighted Mean Difference [WMD]: -3.45; 95% CI: -3.83, -3.08; I2 = 15%; P <.001). ODI scores were reported in 83% of studies, with a significant difference between pre- and post-PCD scores (WMD: -22.22; 95% CI: -25.54, -18.89; I2 = 61%; p <.001). Complications reported included infections, thrombophlebitis, vertebral fractures, disc extrusion, and the need for further operations. Conclusions: The analysis showed clinically significant improvements in pain and functional disability based on VAS and ODI scores. However, due to methodological limitations and a high risk of bias, the validity and generalizability of the findings are uncertain. Despite these issues, the results provide preliminary insights into PCD's potential efficacy and can guide future research to address current limitations. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion The aim of this study is to quantify the association of temporary epilation following interventional neuroradiology (INR) procedures and compare the peak skin dose (Dskin,max) threshold to published values.Gold Coast University Hospital (GCUH) is a major centre for INR with over 500 primarily interventional procedures performed every year. Dskin,max is calculated when the reference air kerma (Ka,r) exceeds 3 Gy. If the Dskin,max exceeds 3 Gy, the patient is followed up for any skin effects. An audit was undertaken of these results over a 2‐year period.From January 2020 to December 2021, 140 patients who underwent INR procedures had a Ka,r > 3 Gy, 66 resulted in a calculated Dskin,max >3 Gy, and 45 were successfully followed up. Twenty patients (44%) reported no skin effects and 25 (56%) reported skin effects, which were almost exclusively epilation. The mean (range) Dskin,max for patients with no reported skin effects and those with observed skin effects was 4.6 Gy (3.0–11.1 Gy) and 4.2 Gy (3.0–7.0 Gy), respectively.These results demonstrate that temporary epilation was observed in 56% of patients, in a cohort of 45 patients who underwent an INR procedure with calculated Dskin,max >3 Gy and successful follow‐up. The results support evidence in the literature that suggests the approximate threshold for temporary epilation reported by the International Commission on Radiological Protection (ICRP) may be too high for incidence of this effect, specifically on the scalp, when Dskin,max is calculated from Ka,r (using commonly used corrections and assumptions in the calculation). [ABSTRACT FROM AUTHOR]

Background: In the perioperative setting, the most accurate way to continuously measure arterial blood pressure (ABP) is using an arterial catheter. Surrogate methods such as finger cuff have been developed to allow non-invasive measurements and are increasingly used, but need further evaluation. The aim of this study is to evaluate the accuracy and clinical concordance between two devices for the measurement of ABP during neuroradiological procedure. Methods: This is a prospective, monocentric, observational study. All consecutive patients undergoing a neuroradiological procedure were eligible. Patients who needed arterial catheter for blood pressure measurement were included. During neuroradiological procedure, ABP (systolic, mean and diatolic blood pressure) was measured with two different technologies: radial artery catheter and Nexfin. Bland-Altman and error grid analyses were performed to evaluate the accuracy and clinical concordance between devices. Results: From March 2022 to November 2022, we included 50 patients, mostly ASA 3 (60%) and required a cerebral embolization (94%) under general anaesthesia (96%). Error grid analysis showed that 99% of non-invasive ABP measures obtained with the Nexfin were located in the risk zone A or B. However, 65.7% of hypertension events and 41% of hypotensive events were respectively not detected by Nexfin. Compared to the artery catheter, a significant relationship was found for SAP (r2 = 0.78) and MAP (r2 = 0.80) with the Nexfin (p < 0.001). Bias and limits of agreement (LOA) were respectively 9.6 mmHg (− 15.6 to 34.8 mmHg) and − 0.8 mmHg (− 17.2 to 15.6 mmHg), for SAP and MAP. Conclusions: Nexfin is not strictly interchangeable with artery catheter for ABP measuring. Further studies are needed to define its clinical use during neuroradiological procedure. Trial registration: Clinicaltrials.gov, registration number: NCT05283824. [ABSTRACT FROM AUTHOR]

Background: Women carrying the APOE4 allele are at greater risk of developing Alzheimer's disease (AD) from ages 65-75 years compared to men. To better understand the elevated risk conferred by APOE4 carrier status among midlife women, we investigated the separate and interactive associations of endogenous estrogens, plasma AD biomarkers, and APOE4 carrier status on regional brain volumes in a sample of late midlife postmenopausal women. Methods: Participants were enrolled in MsBrain, a cohort study of postmenopausal women (n = 171, mean age = 59.4 years, mean MoCA score = 26.9; race = 83.2% white, APOE4 carriers = 40). Serum estrone (E1) and estradiol (E2) levels were assessed using liquid chromatography-tandem mass spectrometry. APOE genotype was determined using TaqMan SNP genotyping assays. Plasma AD biomarkers were measured using single molecule array technology. Cortical volume was measured and segmented by FreeSurfer software using individual T1w MPRAGE images. Multiple linear regression models were conducted to determine whether separate and interactive associations between endogenous estrogen levels, plasma AD biomarkers (Aβ42/Aβ40, Aβ42/p-tau181), and APOE4 carrier status predict regional brain volume (21 regions per hemisphere, selected a priori); and, whether significant interactive associations between estrogens and AD biomarkers on brain volume differed by APOE4 carrier status. Results: There was no main effect of APOE4 carrier status on regional brain volumes, endogenous estrogen levels, or plasma AD biomarkers. Estrogens did not associate with regional brain volumes, except for positive associations with left caudal middle frontal gyrus and fusiform volumes. The interactive association of estrogens and APOE4 carrier status on brain volume was not significant for any region. The interactive association of estrogens and plasma AD biomarkers predicted brain volume of several regions. Higher E1 and E2 were more strongly associated with greater regional brain volumes among women with a poorer AD biomarker profile (lower Aβ42/40, lower Aβ42/p-tau181 ratios). In APOE4- stratified analyses, these interactions were driven by non-APOE4 carriers. Conclusion: We demonstrate that the brain volumes of postmenopausal women with poorer AD biomarker profiles benefit most from higher endogenous estrogen levels. These findings are driven by non-APOE4 carriers, suggesting that APOE4 carriers may be insensitive to the favorable effects of estrogens on brain volume in the postmenopause. [ABSTRACT FROM AUTHOR]

Background: Vascular cognitive impairment (VCI) manifests in memory impairment, mental slowness, executive dysfunction, behavioral changes, and visuospatial abnormalities, significantly compromising the quality of daily life for patients and causing inconvenience to caregivers. Neuroimaging serves as a crucial approach to evaluating the extent, location, and type of vascular lesions in patients suspected of VCI. Nevertheless, there is still a lack of comprehensive bibliometric analysis to discern the research status and emerging trends concerning VCI neuroimaging. Objective: This study endeavors to explore the collaboration relationships of authors, countries, and institutions, as well as the research hotspots and frontiers of VCI neuroimaging by conducting a bibliometric analysis. Methods: We performed a comprehensive retrieval within the Core Collection of Web of Science, spanning from 2000 to 2023. After screening the included literature, CiteSpace and VOSviewer were utilized for a visualized analysis aimed at identifying the most prolific author, institution, and journal, as well as extracting valuable information from the analysis of references. Results: A total of 1,024 publications were included in this study, comprising 919 articles and 105 reviews. Through the analysis of keywords and references, the research hotspots involve the relationship between neuroimaging of cerebral small vessel disease (CSVD) and VCI, the diagnosis of VCI, and neuroimaging methods pertinent to VCI. Moreover, potential future research directions encompass CSVD, functional and structural connectivity, neuroimaging biomarkers, and lacunar stroke. Conclusion: The research in VCI neuroimaging is constantly developing, and we hope to provide insights and references for future studies by delving into the research hotspots and frontiers within this field. [ABSTRACT FROM AUTHOR]

Background and Objectives: Integrating large language models (LLMs) such as GPT-4 Turbo into diagnostic imaging faces a significant challenge, with current misdiagnosis rates ranging from 30–50%. This study evaluates how prompt engineering and confidence thresholds can improve diagnostic accuracy in neuroradiology. Methods: We analyze 751 neuroradiology cases from the American Journal of Neuroradiology using GPT-4 Turbo with customized prompts to improve diagnostic precision. Results: Initially, GPT-4 Turbo achieved a baseline diagnostic accuracy of 55.1%. By reformatting responses to list five diagnostic candidates and applying a 90% confidence threshold, the highest precision of the diagnosis increased to 72.9%, with the candidate list providing the correct diagnosis at 85.9%, reducing the misdiagnosis rate to 14.1%. However, this threshold reduced the number of cases that responded. Conclusions: Strategic prompt engineering and high confidence thresholds significantly reduce misdiagnoses and improve the precision of the LLM diagnostic in neuroradiology. More research is needed to optimize these approaches for broader clinical implementation, balancing accuracy and utility. [ABSTRACT FROM AUTHOR]

Introduction: Aneurysmal wall enhancement (AWE) of non-ruptured sacular intracranial aneurysms (IA) after endovascular treatment (ET) is a frequently observed imaging finding using AWE-sequences in brain magnetic resonance imaging (MRI). So far, its value remains unclear. We aimed to investigate the effect of AWE on aneurysm reperfusion rates in a longitudinal cohort. Methods: This is a retrospective MRI study over the timespan of up to 5 years, assessing the correlation of increased AWE of non-ruptured IAs and events of aneurysm reperfusion and retreatment, PHASES Score and grade of AWE. T1 SPACE fat saturation (FS) and T1 SE FS blood suppression sequences after contrast administration were used for visual interpretation of increased AWE. The IAs' sizes were assessed via the biggest diameter. The grade of enhancement was defined in a grading system from grade 1 to grade 3. Results: 127 consecutive non ruptured IA-patients (58.9 ± 9.0 years, 94 female, 33 male) who underwent elective aneurysm occlusion were included. AWE was observed in 40.2% of patients (51/127) after ET, 6 patients already showed AWE before treatment. In large IAs (which were defined as a single maximum diameter of over 7.5 mm), AWE was significantly associated with aneurysm reperfusion in contrast to large aneurysm without AWE). All grades of AWE were significantly associated with reperfusion. Conclusions: Our data suggests that in patients with initially large IAs, AWE is correlated with aneurysm reperfusion. [ABSTRACT FROM AUTHOR]

The article focuses on a rare case of cerebral sparganosis in a young child, a parasitic disease caused by the Spirometra tapeworm. Topics include the child's presentation with focal seizures and intracranial lesions, diagnostic challenges given the resemblance to tuberculoma, and the diagnostic process involving MRI and eosinophilia.

Background: Patients displaying clinical features of behavioural variant of frontotemporal dementia (bvFTD) but lacking both neuroimaging abnormalities and clinical progression are considered to represent the phenocopy syndrome of bvFTD (phFTD). Extensive clinical overlap between early phase bvFTD and phFTD hampers diagnostic distinction. We aimed to assess the diagnostic value of clinician‐rated, self‐reported and caregiver‐reported symptoms for clinical distinction between phFTD and bvFTD. Methods: There were 33 phFTD and 95 probable bvFTD patients included in the study (total N = 128). Clinician‐rated, self‐reported tests and caregiver‐reported symptoms were compared between phFTD and bvFTD on social cognition, behaviour, mood and activities of daily living (ADL). Scores were compared between groups, followed by multiple logistic regression analysis, adjusted for age and sex. Receiver operating characteristic curves were plotted to assess diagnostic value. Results: Using clinician‐rated and self‐reported tests, phFTD patients performed better on facial emotion recognition and reported more depressive symptoms. Caregiver‐reported behavioural symptoms indicated higher behavioural and ADL impairment in phFTD compared to bvFTD. Facial emotion recognition provided highest diagnostic accuracy for distinction of phFTD from bvFTD (area under the curve (AUC) 0.813 95% CI 0.735–0.892, P < 0.001, sensitivity 81%, specificity 74%) followed by depressive symptoms (AUC 0.769 95% 0.674–0.864, P < 0.001 sensitivity 81%, specificity of 63%). Conclusion: Social cognition tests are most suitable for distinction of phFTD from bvFTD. Caregiver‐reported questionnaires and phFTD diagnosis seemed inversely correlated, showing more symptoms in phFTD. Further research is needed on phFTD aetiology and in caregivers taking into account disease burden to assess what explains this discrepancy between clinician‐rated and caregiver‐based tools. [ABSTRACT FROM AUTHOR]

The "brain-cognition-behavior" process is an important pathological pathway in children with attention-deficit/hyperactivity disorder (ADHD). Symptom guided multimodal neuroimaging fusion can capture behaviorally relevant and intrinsically linked structural and functional features, which can help to construct a systematic model of the pathology. Analyzing the multimodal neuroimage fusion pattern and exploring how these brain features affect executive function (EF) and leads to behavioral impairment is the focus of this study. Based on gray matter volume (GMV) and fractional amplitude of low frequency fluctuation (fALFF) for 152 ADHD and 102 healthy controls (HC), the total symptom score (TO) was set as a reference to identify co-varying components. Based on the correlation between the identified co-varying components and EF, further mediation analysis was used to explore the relationship between brain image features, EF and clinical symptoms. This study found that the abnormalities of GMV and fALFF in ADHD are mainly located in the default mode network (DMN) and prefrontal-striatal-cerebellar circuits, respectively. GMV in ADHD influences the TO through Metacognition Index, while fALFF in HC mediates the TO through behavior regulation index (BRI). Further analysis revealed that GMV in HC influences fALFF, which further modulates BRI and subsequently affects hyperactivity-impulsivity score. To conclude, structural brain abnormalities in the DMN in ADHD may affect local brain function in the prefrontal-striatal-cerebellar circuit, making it difficult to regulate EF in terms of inhibit, shift, and emotional control, and ultimately leading to hyperactive-impulsive behavior. [ABSTRACT FROM AUTHOR]

Objective: The development of novel treatments for anorexia nervosa (AN) requires a detailed understanding of the biological underpinnings of specific, commonly occurring symptoms, including compulsive exercise. There is considerable bio‐behavioral overlap between AN and obsessive‐compulsive disorder (OCD), therefore it is plausible that similar mechanisms underlie compulsive behavior in both populations. While the association between these conditions is widely acknowledged, defining the shared mechanisms for compulsive behavior in AN and OCD requires a novel approach. Methods: We present an argument that a better understanding of the neurobiological mechanisms that underpin compulsive exercise in AN can be achieved in two critical ways. First, by applying a framework of the neuronal control of OCD to exercise behavior in AN, and second, by taking better advantage of the activity‐based anorexia (ABA) rodent model to directly test this framework in the context of feeding pathology. Results: A cross‐disciplinary approach that spans preclinical, neuroimaging, and clinical research as well as compulsive neurocircuitry and behavior can advance our understanding of when, why, and how compulsive exercise develops in the context of AN and provide targets for novel treatment strategies. Discussion: In this article, we (i) link the expression of compulsive behavior in AN and OCD via a transition between goal‐directed and habitual behavior, (ii) present disrupted cortico‐striatal circuitry as a key substrate for the development of compulsive behavior in both conditions, and (iii) highlight the utility of the ABA rodent model to better understand the mechanisms of compulsive behavior relevant to AN. Public Significance: Individuals with AN who exercise compulsively are at risk of worse health outcomes and have poorer responses to standard treatments. However, when, why, and how compulsive exercise develops in AN remains inadequately understood. Identifying whether the neural circuitry underlying compulsive behavior in OCD also controls hyperactivity in the activity‐based anorexia model will aid in the development of novel eating disorder treatment strategies for this high‐risk population. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that often persists into adulthood. Underlying alterations in brain connectivity have been identified but some relevant connections, such as the middle, superior, and inferior cerebellar peduncles (MCP, SCP, and ICP, respectively), have remained largely unexplored; thus, we sought to investigate whether the cerebellar peduncles contribute to ADHD pathophysiology among adults. Methods: We applied diffusion-weighted spherical deconvolution tractography to dissect the cerebellar peduncles of male adults with ADHD (including those who did or did not respond to methylphenidate, based on at least 30% symptom improvement at 2 months) and controls. We investigated differences in tract metrics between controls and the whole ADHD sample and between controls and treatment-response groups using sensitivity analyses. Finally, we analyzed the association between the tract metrics and cliniconeuropsychological profiles. Results: We included 60 participants with ADHD (including 42 treatment responders and 18 nonresponders) and 20 control participants. In the whole ADHD sample, MCP fractional anisotropy (FA; t 78 = 3.24, p = 0.002) and hindrance modulated orientational anisotropy (HMOA; t 78 = 3.01, p = 0.004) were reduced, and radial diffusivity (RD) in the right ICP was increased (t 78 = −2.84, p = 0.006), compared with controls. Although case–control differences in MCP FA and HMOA, which reflect white-matter microstructural organization, were driven by both treatment response groups, only responders significantly differed from controls in right ICP RD, which relates to myelination (t 60 = 3.14, p = 0.003). Hindrance modulated orientational anisotropy of the MCP was significantly positively associated with hyperactivity measures. Limitations: This study included only male adults with ADHD. Further research needs to investigate potential sex- and development-related differences. Conclusion: These results support the role of the cerebellar networks, especially of the MCP, in adult ADHD pathophysiology and should encourage further investigation. Clinical trial registration: NCT 03709940 [ABSTRACT FROM AUTHOR]

Purpose: Despite common clinical complaints about memory for conversation after traumatic brain injury (TBI), the nature and severity of this deficit are unknown. In this research note, we report feasibility and preliminary data from a new conversation memory study protocol. Method: Participants in this feasibility study were 10 pairs, each including an adult with chronic, moderate-to-severe TBI and their chosen familiar conversation partner. The experiment began with a naturalistic conversation between participants with TBI and their conversation partners. After a filled delay, participants next completed verbal recall for the conversation, which we transcribed and coded for their accuracy relative to the original conversation. Participants also read chosen statements from their original conversation and predicted what each partner would remember in a week. One week later, participants completed a posttest about who said each of the chosen statements, allowing direct comparison to their predictions. Results: We successfully collected conversation memory data from all 10 pairs, suggesting that this protocol is feasible for future study. In this preliminary sample, people with TBI and their conversation partners did not differ in the accuracy of their recall for the conversation about 20 min after it occurred. When asked to predict their partner’s delayed memory, conversation partners were less accurate than participants with TBI because they underestimated how much their partners with TBI would remember. Conclusion: Measuring memory for conversation in TBI is feasible and may advance the characterization of cognitive-communication impairment in TBI, and its heterogeneity, in everyday contexts. [ABSTRACT FROM AUTHOR]

Purpose: We examined the neurocognitive bases of lexical morphology in children of varied reading abilities to understand the role of meaning-based skills in learning to read with dyslexia. Method: Children completed auditory morphological and phonological awareness tasks during functional near-infrared spectroscopy neuroimaging. We first examined the relation between lexical morphology and phonological processes in typically developing readers (Study 1, N = 66, Mage = 8.39), followed by a more focal inquiry into lexical morphology processes in dyslexia (Study 2, N = 50, Mage = 8.62). Results: Typical readers exhibited stronger engagement of language neurocircuitry during the morphology task relative to the phonology task, suggesting that morphological analyses involve synthesizing multiple components of sublexical processing. This effect was stronger for more analytically complex derivational affixes (like + ly) than more semantically transparent free base morphemes (snow + man). In contrast, children with dyslexia exhibited stronger activation during the free base condition relative to derivational affix condition. Taken together, the findings suggest that although children with dyslexia may struggle with derivational morphology, they may also use free base morphemes’ semantic information to boost word recognition. Conclusion: This study informs literacy theories by identifying an interaction between reading ability, word structure, and how the developing brain learns to recognize words in speech and print. [ABSTRACT FROM AUTHOR]