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Background: this systematic review aims to evaluate the concordance between preoperative synovial fluid culture and intraoperative tissue cultures in patients with periprosthetic joint infection (PJI) undergoing total hip (THA) or knee arthroplasty (TKA) revision surgery. Methods: this review was conducted in accordance with the preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies (PRISMA-DTA) statement. Cochrane, Embase, PubMed, and Web of Science databases were searched to identify studies involving patients who had THA or TKA revision surgery for PJI and for whom preoperative synovial fluid culture and intraoperative tissue cultures were performed. Studies were only included if the diagnosis of PJI was based on the EBJIS (the European Bone and Joint Infection Society) or MSIS (Musculoskeletal Infection Society) criteria. Risk of bias was assessed using an amended version of Joanna Briggs Institute's (JBI) critical appraisal checklist for case series. Results: seven studies were included in this review comprising 1677 patients. All studies had a retrospective study design and five studies explored patients undergoing revision surgery of THA or TKA. Concordance rates varied between 52 % and 79 %, but different authors defined and calculated concordance differently. Six studies were judged as having an unclear to high risk of bias and one study as having a low risk of bias. Conclusions: the included studies showed a wide range of concordance rates between preoperative synovial fluid culture and intraoperative tissue cultures and the majority of studies had a high risk of bias. Higher-quality studies are warranted to obtain a more accurate estimate of this concordance rate. We recommend continuing the use of a system such as the EBJIS definition or MSIS criteria when diagnosing PJI.

Early detection of bacterial transmission and outbreaks in hospitals is important because nosocomial infections can result in health complications and longer hospitalization. Current practice to detect outbreaks uses genotyping methods amplified fragment length polymorphism (AFLP) and whole genome sequencing (WGS), which are not suitable methods for real-time transmission screening of both susceptible and resistant bacteria. The aim was to assess the typing technique Fourier transform infrared (FTIR) spectroscopy as real-time screening method to discriminate large amounts of susceptible and resistant bacteria at strain level when there is no evident outbreak in comparison with the WGS reference. Isolates of past hospital outbreak strains of Acinetobacter baumannii/calcoaceticus complex (n = 25), Escherichia coli (n = 31), Enterococcus faecium (n = 22), Staphylococcus aureus (n = 37) and Pseudomonas aeruginosa (n = 30) were used for validation of FTIR. Subsequently, Enterococcus faecalis (n = 106) and Enterococcus faecium (n = 104) isolates from weekly routine screening samples when no potential outbreak was present were analysed. FTIR showed reproducibility and congruence of cluster composition with WGS for A. baumannii/calcoaceticus complex and E. faecium outbreak isolates. The FTIR results of E. faecalis and E. faecium isolates from routine samples showed reproducibility, but the congruence of cluster composition with WGS was low. For A. baumannii/calcoaceticus complex and E. faecium outbreak isolates, FTIR appears to be a discriminatory typing tool. However, our study shows the discriminatory power is too low to screen real-time for transmission of E. faecium and E. faecalis at patient wards based on isolates acquired in routine surveillance cultures when there is no clear suspicion of an ongoing outbreak.

Background Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa (VIM-PA) can cause nosocomial infections and may be responsible for increased mortality. Multidrug resistance in VIM-PA complicates treatment. We aimed to assess the contribution of VIM-PA to mortality in patients in a large tertiary care hospital in the Netherlands. Methods A focus group of five members created a scheme to define related mortality based on clinical and diagnostic findings. Contribution to mortality was categorized as “definitely”, “probably”, “possibly”, or “not” related to infection with VIM-PA, or as “unknown”. Patients were included when infected with or carrier of VIM-PA between January 2008 and January 2016. Patient-related data and specific data on VIM-PA cultures were retrieved from the electronic laboratory information system. For patients who died in our hospital, medical records were independently reviewed and thereafter discussed by three physicians. Results A total of 198 patients with any positive culture with VIM-PA were identified, of whom 95 (48.0%) died. Sixty-seven patients died in our hospital and could be included in the analysis. The death of 15 patients (22.4%) was judged by all reviewers to be definitely related to infection with VIM-PA. In 17 additional patients (25.4%), death was probably or possibly related to an infection with VIM-PA. The level of agreement was 65.7% after the first evaluation, and 98.5% after one session of discussion. Conclusion Using our assessment tool, infections with VIM-PA were shown to have an important influence on mortality in our complex and severely ill patients. The tool may be used for other (resistant) bacteria as well but this needs further exploration. Electronic supplementary material The online version of this article (10.1186/s13756-019-0556-9) contains supplementary material, which is available to authorized users.

MRI studies (e.g. using diffusion tensor imaging) revealed that injury to white matter tracts, as observed in for instance perinatal white matter injury and multiple sclerosis, leads to compromised microstructure of myelinated axonal tracts. Alterations in white matter microstructure are also present in a wide range of neurological disorders including autism-spectrum disorders, schizophrenia and ADHD. Whereas currently myelin quantity measures are often used in translational animal models of white matter disease, it can be an important valuable addition to study the microstructural organization of myelination patterns in greater detail. Here, we describe methods to extensively study the microstructure of cortical myelination by immunostaining for myelin. To validate these methods, we carefully analyzed the organization of myelinated axons running from the external capsule towards the outer layers of the cortex in three rodent models of neonatal brain injury and in an adult stroke model, that have all been associated with myelination impairments. This unique, relatively easy and sensitive methodology can be applied to study subtle differences in myelination patterns in animal models in which aberrations in myelination integrity are suspected. Importantly, the described methods can be applied to determine efficacy of novel experimental treatments on microstructural organization of cortical myelination.

Functional outcome after stroke depends on the local site of ischemic injury and on remote effects within connected networks, frequently extending into the contralesional hemisphere. However, the pattern of large-scale contralesional network remodeling remains largely unresolved. In this study, we applied diffusion-based tractography and graph-based network analysis to measure structural connectivity in the contralesional hemisphere chronically after experimental stroke in rats. We used the minimum spanning tree method, which accounts for variations in network density, for unbiased characterization of network backbones that form the strongest connections in a network. Ultrahigh-resolution diffusion MRI scans of eight post-mortem rat brains collected 70 days after right-sided stroke were compared against scans from 10 control brains. Structural network backbones of the left (contralesional) hemisphere, derived from 42 atlas-based anatomical regions, were found to be relatively stable across stroke and control animals. However, several sensorimotor regions showed increased connection strength after stroke. Sensorimotor function correlated with specific contralesional sensorimotor network backbone measures of global integration and efficiency. Our findings point toward post-stroke adaptive reorganization of the contralesional sensorimotor network with recruitment of distinct sensorimotor regions, possibly through strengthening of connections, which may contribute to functional recovery.

Glucocorticoid treatment increases the risk of opportunistic infection. Infections that can arise during glucocorticoid use, and for which preventative measures can be taken, include reactivation of latent tuberculosis and hepatitis B, pneumococcal and Pneumocystis jiroveci pneumonia, influenza, herpes zoster and Strongyloides stercoralis hyperinfection syndrome. The risk of such infections depends upon the duration of glucocorticoid use and dosage, as well as comorbidity and comedication. It is important to enquire about vaccinations, travel, exposure and previous infections when taking a case history. Possible infectious complications should be considered in patients who are receiving high-dose glucocorticoids treatment amounting to more than 420 mg PED per 4 weeks. Preventative measures are not usually required in patients who receive a short high-dosed treatment (30 mg PED in 7 days) or prednisolone at a dosage of15 mg/day.

Focal epilepsy has recently been associated with remote white matter damage, including reduced white matter volume. Longitudinal assessment of these white matter changes, in relation to functional mechanisms and consequences, may be ideally done by in vivo neuroimaging in well-controlled experimental animal models. We assessed whether advanced machine learning algorithm models could accurately detect volumetric changes in white matter from multiparametric MR images, longitudinally collected in a neocortical focal epilepsy rat model. We measured classification accuracy in two supervised segmentation models: i.e. the generalized linear model and the nonlinear random forest model-by comparing computed white matter probabilities with actual neuroanatomically identified white matter. We found excellent overall discriminatory power for both models. However, the random forest model demonstrated a superior goodness-of-fit calibration plot that was close to the ideal calibration line. Based on this model, we measured that total white matter volume increased in young adult control and epileptic rats over a period of 10 weeks, but the average white matter volume was significantly lower in the focal epilepsy group. Changes in gray matter volume were not significantly different between control and epileptic rats. Our results (1) indicate that recurrent spontaneous seizures have an adverse effect on global white matter growth and (2) show that individual whole brain white matter volume can be accurately determined using a combination of multiparametric MRI and supervised segmentation models, offering a powerful tool to assess white matter volume changes in preclinical studies of neurological disease.

Contains fulltext : 171457.pdf (Publisher’s version ) (Open Access) Immunization of volunteers under chloroquine prophylaxis by bites of Plasmodium falciparum sporozoite (PfSPZ)-infected mosquitoes induces > 90% protection against controlled human malaria infection (CHMI). We studied intradermal immunization with cryopreserved, infectious PfSPZ in volunteers taking chloroquine (PfSPZ chemoprophylaxis vaccine [CVac]). Vaccine groups 1 and 3 received 3x monthly immunizations with 7.5 x 10(4) PfSPZ. Control groups 2 and 4 received normal saline. Groups 1 and 2 underwent CHMI (#1) by mosquito bite 60 days after the third immunization. Groups 3 and 4 were boosted 168 days after the third immunization and underwent CHMI (#2) 137 days later. Vaccinees (11/20, 55%) and controls (6/10, 60%) had the same percentage of mild to moderate solicited adverse events. After CHMI #1, 8/10 vaccinees (group 1) and 5/5 controls (group 2) became parasitemic by microscopy; the two negatives were positive by quantitative real-time polymerase chain reaction (qPCR). After CHMI #2, all vaccinees in group 3 and controls in group 4 were parasitemic by qPCR. Vaccinees showed weak antibody and no detectable cellular immune responses. Intradermal immunization with up to 3 x 10(5) PfSPZ-CVac was safe, but induced only minimal immune responses and no sterile protection against Pf CHMI.

Spontaneous fluctuations in the blood oxygenation level-dependent (BOLD) MRI signal during the resting state are increasingly being studied in healthy and diseased brain in humans and animal models. Yet, the relationship between functional brain status and the characteristics of spontaneous BOLD fluctuations remains poorly understood. In order to obtain more insights into this relationship and, in particular, the effects of anesthesia thereupon, we investigated the spatial and temporal correlations of spontaneous BOLD fluctuations in somatosensory and motor regions of rat brain at different inhalation levels of the frequently applied anesthetic isoflurane. We found that the temporal scaling, characterized by the Hurst exponent (H), showed persistent behavior (H > 0.5) at 0.5-1.0% isoflurane. Furthermore, low-pass-filtered spontaneous BOLD oscillations were correlated significantly in bilateral somatosensory and bilateral motor cortices, reflective of interhemispheric functional connectivity. Under 2.9% isoflurane anesthesia, the temporal scaling characteristics approached those of Gaussian white noise (H = 0.5), the relative amplitude of BOLD low-frequency fluctuations declined, and cross-correlations of these oscillations between functionally connected regions decreased significantly. Loss of interhemispheric functional connectivity at 2.9% isoflurane anesthesia was stronger between bilateral motor regions than between bilateral somatosensory regions, which points to distinct effects of anesthesia on differentially organized neuronal networks. Although we cannot completely rule out a possible contribution from hemodynamic signals with a non-neuronal origin, our results emphasize that spatiotemporal characteristics of spontaneous BOLD fluctuations are related to the brain's specific functional status and network organization, and demonstrate that these are largely preserved under light to mild anesthesia with isoflurane. Copyright (C) 2010 John Wiley & Sons, Ltd.

Background and Purpose— The use of lithium as a neuroprotective agent has been demonstrated using various models in which improvements in infarct size, DNA damage, and neurological function were reported. We further investigated neurohemodynamic aspects of the treatment-associated recovery by assessing the therapeutic efficacy of delayed chronic lithium treatment using functional MRI. Methods— Ipsilesional functional MRI activations in the somatosensory cortex, acquired 2 weeks after the 90-minute transient middle cerebral artery occlusion, were compared between lithium- and saline-treated rats. Specifically, MRI signal changes based on blood oxygenation level dependence and functional cerebral blood volume responses were examined using electrical stimulation of forelimbs. Additional immunohistochemical assays were performed. Results— The ratio of ipsilesional to contralesional blood oxygenation level dependence response magnitudes significantly improved with lithium treatments. In contrast, the increase of the functional cerebral blood volume response magnitude ratio was not statistically significant. Nonetheless, the lithium treatment induced significant enhancements of total functional MRI activation (defined as a product of activation volume and response magnitude) for both blood oxygenation level dependence and functional cerebral blood volume methods. Increased cerebral blood volume in periinfarct tissues suggests a possible stroke-induced vascular transformation in both saline- and lithium-treated rats; however, other MRI-derived vascular parameters (vascular size index and microvascular volume) and immunohistochemical staining (CD31, glia fibrillary-associated protein, and matrix metalloproteinase-9) may imply that the neoformation of vasculature was differently affected by the lithium treatment. Conclusions— The delayed chronic lithium treatment enhanced the blood oxygenation level dependence functional MRI response magnitude in the absence of neurological improvement and influenced vascular formation in poststroke animal models.

Hemispherectomy is often followed by remarkable recovery of cognitive and motor functions. This reflects plastic capacities of the remaining hemisphere, involving large-scale structural and functional adaptations. Better understanding of these adaptations may (1) provide new insights in the neuronal configuration and rewiring that underlies sensorimotor outcome restoration, and (2) guide development of rehabilitation strategies to enhance recovery after hemispheric lesioning. We assessed brain structure and function in a hemispherectomy model. With MRI we mapped changes in white matter structural integrity and gray matter functional connectivity in eight hemispherectomized rats, compared with 12 controls. Behavioral testing involved sensorimotor performance scoring. Diffusion tensor imaging and resting-state functional magnetic resonance imaging were acquired 7 and 49 days post surgery. Hemispherectomy caused significant sensorimotor deficits that largely recovered within 2 weeks. During the recovery period, fractional anisotropy was maintained and white matter volume and axial diffusivity increased in the contralateral cerebral peduncle, suggestive of preserved or improved white matter integrity despite overall reduced white matter volume. This was accompanied by functional adaptations in the contralateral sensorimotor network. The observed white matter modifications and reorganization of functional network regions may provide handles for rehabilitation strategies improving functional recovery following large lesions.

A 23-year-old healthy male volunteer took part in a clinical trial in which the volunteer took chloroquine chemoprophylaxis and received three intradermal doses at four-week intervals of aseptic, purified Plasmodium falciparum sporozoites to induce protective immunity against malaria. Fifty-nine days after the last administration of sporozoites and 32 days after the last dose of chloroquine the volunteer underwent controlled human malaria infection (CHMI) by the bites of five P. falciparum-infected mosquitoes. Eleven days post-CHMI a thick blood smear was positive (6 P. falciparum/μL blood) and treatment was initiated with atovaquone/proguanil (Malarone®). On the second day of treatment, day 12 post-CHMI, troponin T, a marker for cardiac tissue damage, began to rise above normal, and reached a maximum of 1,115 ng/L (upper range of normal = 14 ng/L) on day 16 post-CHMI. The volunteer had one ~20 minute episode of retrosternal chest pain and heavy feeling in his left arm on day 14 post-CHMI. ECG at the time revealed minor repolarization disturbances, and cardiac MRI demonstrated focal areas of subepicardial and midwall delayed enhancement of the left ventricle with some oedema and hypokinesia. A diagnosis of myocarditis was made. Troponin T levels were normal within 16 days and the volunteer recovered without clinical sequelae. Follow-up cardiac MRI at almost five months showed normal function of both ventricles and disappearance of oedema. Delayed enhancement of subepicardial and midwall regions decreased, but was still present. With the exception of a throat swab that was positive for rhinovirus on day 14 post-CHMI, no other tests for potential aetiologies of the myocarditis were positive. A number of possible aetiological factors may explain or have contributed to this case of myocarditis including, i) P. falciparum infection, ii) rhinovirus infection, iii) unidentified pathogens, iv) hyper-immunization (the volunteer received six travel vaccines between the last immunization and the CHMI), v) atovaquone/proguanil treatment, or vi) a combination of these factors. Definitive aetiology and pathophysiological mechanism for the myocarditis have not been established.

In some recent studies, diffusion weighted functional MRI has been proposed to provide contrast immune to vascular changes. Increases in relative signal change during neuronal activation observed under increasing diffusion weighting support the possible diffusion based origin of this contrast. A recent diffusion tensor imaging (DTI) study has also reported the use of Fractional Anisotropy (FA) to track activation in white matter. In this study we aimed to establish if relatively high diffusion weighting (b = 1200 and 1800 s/mm2) eliminates the strong vascular influences brought about by 100% O2 and carbogen (95%O2 + 5% CO2) induced vascular challenges in gray matter (GM) and white matter (WM) of rat brain. We also aimed to characterize the influences of these vascular changes on FA, both in GM and in WM. Our study endorses previous reports that even relatively heavily diffusion weighted data can be significantly influenced by hemodynamic changes. However, this was not only observed in GM, but also in WM. Moreover, our study demonstrates that the estimator used to calculate the relative changes should be carefully chosen in order to avoid biases at low signal-to-noise ratios (SNRs) which accompany increasing diffusion weighting. With the use of robust estimators, we found no increases in relative change with increasing b-value during both vascular challenges. Our data also demonstrate that FA can be significantly influenced by hemodynamics, both in GM and in WM. The observed influence of diffusion weighting direction on relative signal change in GM was shown to be associated with structural differences among various regions. If diffusion based functional contrasts immune to hemodynamics do exist, our results highlight the difficulty in discerning those diffusion changes from accompanying vascular changes.

The potential of the adult brain to reorganize after ischemic injury is critical for functional recovery and provides a significant target for therapeutic strategies to promote brain repair. Despite the accumulating evidence of brain plasticity, the interaction and significance of morphological and physiological modifications in post-stroke brain tissue remain mostly unclear. Neuroimaging techniques such as functional MRI (fMRI) and diffusion tensor imaging (DTI) enable in vivo assessment of the spatial and temporal pattern of functional and structural changes inside and outside ischemic lesion areas. This can contribute to the elucidation of critical aspects in post-stroke brain remodeling. Task/stimulus-related fMRI, resting-state fMRI, or pharmacological MRI enables direct or indirect measurement of neuronal activation, functional connectivity, or neurotransmitter system responses, respectively. DTI allows estimation of the structural integrity and connectivity of white matter tracts. Together, these MRI methods provide an unprecedented means to (a) measure longitudinal changes in tissue structure and function close by and remote from ischemic lesion areas, (b) evaluate the organizational profile of neural networks after stroke, and (c) identify degenerative and restorative processes that affect post-stroke functional outcome. Besides, the availability of MRI in clinical institutions as well as research laboratories provides an optimal basis for translational research on stroke recovery. This review gives an overview of the current status and perspectives of fMRI and DTI applications to study brain reorganization in experimental stroke models.

Reinstatement of perilesional activation and connectivity may underlie functional recovery after stroke. To measure activation responsiveness in perilesional cortex in relation to white matter integrity, we performed functional functional magnetic resonance imaging during stimulation of the contralesional cortex, together with diffusion tensor imaging, 3 and 28 days after stroke in rats. Despite disturbed sensorimotor function and abnormal callosal appearance at day 3, activation amplitudes were preserved in the perilesional sensorimotor cortex, although time-to-peak was significantly delayed. This indicates that in spite of dysfunction, perilesional cortical tissue can be activated subacutely after stroke, while delay of the hemodynamic activation response suggests impaired neurovascular coupling.

Spontaneous fluctuations in the blood oxygenation level-dependent (BOLD) MRI signal during the resting state are increasingly being studied in healthy and diseased brain in humans and animal models. Yet, the relationship between functional brain status and the characteristics of spontaneous BOLD fluctuations remains poorly understood. In order to obtain more insights into this relationship and, in particular, the effects of anesthesia thereupon, we investigated the spatial and temporal correlations of spontaneous BOLD fluctuations in somatosensory and motor regions of rat brain at different inhalation levels of the frequently applied anesthetic isoflurane. We found that the temporal scaling, characterized by the Hurst exponent (H), showed persistent behavior (H 0.5) at 0.5-1.0% isoflurane. Furthermore, low-pass-filtered spontaneous BOLD oscillations were correlated significantly in bilateral somatosensory and bilateral motor cortices, reflective of interhemispheric functional connectivity. Under 2.9% isoflurane anesthesia, the temporal scaling characteristics approached those of Gaussian white noise (H = 0.5), the relative amplitude of BOLD low-frequency fluctuations declined, and cross-correlations of these oscillations between functionally connected regions decreased significantly. Loss of interhemispheric functional connectivity at 2.9% isoflurane anesthesia was stronger between bilateral motor regions than between bilateral somatosensory regions, which points to distinct effects of anesthesia on differentially organized neuronal networks. Although we cannot completely rule out a possible contribution from hemodynamic signals with a non-neuronal origin, our results emphasize that spatiotemporal characteristics of spontaneous BOLD fluctuations are related to the brain's specific functional status and network organization, and demonstrate that these are largely preserved under light to mild anesthesia with isoflurane.

Accumulating experimental and clinical data suggest that albumin may be neuroprotective for stroke. Here, we use functional magnetic resonance imaging (fMRI) to evaluate the therapeutic efficacy of albumin and its effects on the recovery of stimuli-induced cerebral hemodynamics. For this purpose, fMRI activity in the ipsilesional somatosensory (SS) cortex was assessed using a well established rat model of transient 90 min focal ischemia and electrical forelimb stimulation. Rats were treated with either saline or albumin via intracerebroventricular injections at 12 h poststroke onset. Despite this delayed treatment time, when compared to the saline-treated rats ( n = 7), there were significant enhancements of the fMRI activation in the albumin-treated rats ( n = 6) for both blood oxygenation level dependence (BOLD) and functional cerebral blood volume (fCBV) responses. Interestingly, the temporal characteristics of the ipsilesional SS BOLD responses in the albumin-treated rats appeared considerably altered compared to those of contralesional responses while such temporal alterations were not pronounced for the fCBV responses. These characteristic fMRI temporal profiles of the albumin-treated brains may be due to altered neuronal responses rather than altered integrity of neurovascular coupling, which implies an unusually fast habituation of neuronal responses in the lesional SS cortex. The correlation between various MRI-derived structural parameters and the fMRI response magnitude was also characteristic for albumin and control groups. Taken together, these data suggest that restoration of fMRI response magnitudes, temporal profiles, and correlations with structure may reveal the extent and specific traits of albumin treatment associated stroke recovery.

Brain responses to external stimuli after permanent and transient ischemic insults have been documented using cerebral blood volume weighted (CBVw) functional magnetic resonance imaging (fMRI) in correlation with tissue damage and neurological recovery. Here, we extend our previous studies of stroke recovery in rat models of focal cerebral ischemia by comparing blood oxygen level-dependent (BOLD) and cerebral blood volume (CBV) changes. Responses to forepaw stimulation were measured in normal rats ( n = 5) and stroke rats subjected to 2 h of middle cerebral artery occlusion ( n = 6). Functional magnetic resonance imaging was performed 2 weeks after stroke to evaluate the recovery process. After stroke, animals showed variable degrees of fMRI activation in ipsilesional cortex, the extent of which did not correlate with structural damages as measured using apparent diffusion coefficient, fractional anisotropy, blood volume, and vessel size index. While the contralesional cortex showed good overlap between BOLD and CBV-activated regions, the ipsilesional cortex showed low covariance between significantly activated voxels by BOLD and CBVw techniques. In particular, the relative activation during contralateral stimuli in the ipsilesional somatosensory cortex was significantly higher for CBVw responses than BOLD, which might be due to stroke-related alterations in fMRI hemodynamic coupling. Aberrant subcortical activations were also observed. When unaffected forelimbs were stimulated, strong bilateral responses were observed. However, little thalamic responses accompanied stimulation of affected forelimbs despite significant activation in the ipsilesional somatosensory cortex. These results suggest that stroke affects not only local hemodynamics and coupling but also other factors including neural connectivity.

An important function of lithium as a neuroprotective agent has been documented previously. Significant reduction in infarct size and DNA damages with the corresponding improvement of neurological scores were reported as results of post stroke lithium administration. In the current study, therapeutic efficacy of chronic lithium treatment was assessed by various MRI-derived parameters (i.e., apparent diffusion coefficient (ADC), fractional anisotropy (FA), and vessel size index (VSI)) and quantified with fMRI activity using electrical stimulation of rat forelimbs. The fMRI responses were examined by measuring the local hemodynamic MRI signal intensity based on blood oxygenation level dependence (BOLD) and cerebral blood volume weighted (CBVw) responses. The ipsilesional fMRI activations in the somatosensory (SS) cortex of lithium-treated (n=6) and saline-treated rats (n=6) two weeks after middle cerebral artery occlusion (MCAO) were compared. ADC and FA values of local brain tissues were significantly correlated with the magnitude of fMRI responses for the lithium-treated rats while no such correlations were seen in the saline controls. The ipsilesional/contralesional BOLD signal intensity response ratios of lithium-treated rats were larger than those of saline-treated control rats. In contrast, the CBVw response ratios were similar between two groups. These results demonstrated that the lithium-treatment of post-stroke animal models positively enhanced BOLD fMRI response in the lesion hemisphere. Overall activation volume and magnitude were larger for saline-treated rats than the lithium-treated group in both contra and ipsilesional somatosensory cortices. However, for both BOLD and CBVw responses, the mean activated volume ratio (ipsilesional/contralesional) was higher for lithium-treated rats than controls. The CBVw activation signal magnitude ratios (Figure 1 upper panel) were significantly higher than BOLD ratios for the control animals; however, similar for the lithium-treated rats. As shown in Figure 1 (bottom panel), functional status index (FSI) which represents the mean ratio between BOLD and CBVw ipsi/contralesional activation signal intensity ratio for the individual somatosensory cortex was significantly higher for lithium-treated rats than the control group. From the acquired ADC maps, ex vacuo dilation of the ipsilesional lateral ventricles was identified for most of rats while other structural damages (e.g., FA) were also evident at this late stage (2 weeks) of recovery. Among the acquired structural parameters, ADC and FA were significantly correlated with CBVw fMRI activation magnitude (i.e., area under the curve) for the lithium-treated rats while no such correlations were found for the saline controls. When compared to the contralesional values, the ipsilesional mean VSI ratio (ipsi/contra) was larger for the lithium-treated rats; however, the micro vascular volume (i.e., Delta-R2) ratio (ipsi/contra) was larger for control rats. These results imply that possible vascular transformation affects fMRI characteristics.