Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Randomized Controlled Trial
Functional Near-Infrared Spectroscopy to Assess Central Pain Responses in a Nonpharmacologic Treatment Trial of Osteoarthritis.
Knee osteoarthritis (OA) is a common source of pain in older adults. Although OA-induced pain can be relieved with analgesics and anti-inflammatory drugs, the current opioid epidemic is fostering the exploration of nonpharmacologic strategies for pain mitigation. Amongs these, transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM) hold potential for pain-relief efficacy due to their neuromodulatory effects of the central nervous system, which is known to play a fundamental role in pain perception and processing. ⋯ In conclusion, fNIRS can be effectively used to investigate neural mechanisms of pain at the cortical level in association with nonpharmacological, self-administered treatments.
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Virtual reality (VR) is a promising tool for distraction analgesia. This study aims to compare brain perfusion patterns while patients were undergoing burn wound care in two conditions-VR distraction and control (NoVR). ⋯ Relative decrease in cerebellar perfusion based on stringent statistical threshold in the VR environment combined with improved subjective pain experience supports the hypotheses on the role of cerebellum in perception of noxious stimuli.
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Extracranial carotid artery stenosis (ECAS) due to the presence of atherosclerotic plaque is a well-known risk factor for stroke. Several structural imaging studies have investigated the effect of ECAS on the brain, focusing on structural damage (in particular cerebral small vessel disease) and on the rearrangement of the cerebral circulation. For example, it is known from the literature an association between carotid stenosis and cerebral small vessel disease, and it is also noted that a series of compensatory mechanisms are activated by the cerebrovascular system in order to overcome the cerebral hypoperfusion that is induced by the ECAS. ⋯ Although these studies have been performed on small cohorts of patients without standardized protocols, it is plausible that in the future, such studies will help find early stage markers of cognitive impairment. This could permit an extension of indications for revascularization for the treatment of cognitive impairment in selected patients. The aim of this narrative review is to discuss the current knowledge on the effects of ECAS on brain and cognition by analyzing the main evidence from animal and clinical studies, with a special focus on rs-fc MR studies.
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Transient global amnesia (TGA) is a rare clinical entity with a sudden onset of anterograde amnesia that recovers within 24 hours. The underlying pathophysiology is uncertain. Imaging studies are controversial, but diffusion-weighted images often show small diffusion-restricted lesions in the hippocampus, which may suggest ischemic damage. Thus, we conducted the first clinical study using neurite orientation dispersion and density imaging (NODDI) and arterial spin labeling (ASL) to examine whether the microstructure and perfusion status of the hippocampus are influenced by the presence of diffusion-restricted lesions. ⋯ The first NODDI and ASL study in patients after TGA demonstrated no obvious microstructural or perfusion abnormalities in the hippocampus with typical DWI-positive lesions, which may indicate that TGA does not cause destructive damage or involve baseline microstructure or perfusion abnormalities in the hippocampus in relation to diffusion-restricted lesions.
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Despite increasing demand for fluoroscopy-guided lumbar puncture (FG-LP), there is limited quantitative and epidemiological data on patients undergoing this procedure. Additionally, data are scarce on the correlation of iliac crest landmarks to the actual anatomical lumbar level (intercristal line). The aim of this study is to determine if (1) body mass index (BMI) correlates with skin to spinal canal distance (SCD) and (2) the iliac crest landmark correlates with the presumed anatomical landmark on cross-sectional imaging. ⋯ There was direct, positive linear correlation between BMI and SCD at clinically relevant lumbar disc levels. Furthermore, there is considerable anatomical variance in the intervertebral space that aligns with the superior aspect of the iliac crest.