Journal of neuroimaging : official journal of the American Society of Neuroimaging
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MRI enables detailed in vivo depiction of multiple sclerosis (MS) pathology. Localized areas of MS damage, commonly referred to as lesions, or plaques, have been a focus of clinical and research MRI studies for over four decades. A nonplaque MRI abnormality which is present in at least 25% of MS patients but has received far less attention is diffusely abnormal white matter (DAWM). ⋯ Given the prevalence and potential clinical impact of DAWM, the number of imaging studies focusing on DAWM is insufficient. Characterization of DAWM significance and microstructure would benefit from larger longitudinal and additional quantitative imaging efforts. Revisiting data from previous studies that included proton density and T2 imaging would enable retrospective DAWM identification and analysis.
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To explore the application value and clinical significance of transcranial Doppler(TCD)in assessing leptomeningeal collateral flow (LMF) status in patients with unilateral middle cerebral artery (MCA) occlusion. ⋯ TCD can assess LMF status by detecting the changes of flow velocity of intracranial vessels. CBFV of ACA and PCA in patients with MCA occlusion is significantly correlated with LMF status by DSA. Assessing LMF status, CBFViACA, CBFViACA/CBFVcACA, and CBFViACA/CBFViMCA has the great diagnostic value, which is of great significance in guiding MCA occlusion patients to choose individualized treatment.
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This study aims todetermine the sensitivity of superficial white matter (SWM) integrity as a metric to distinguish early multiple sclerosis (MS) patients from healthy controls (HC). ⋯ Our results reveal a non-random pattern of SWM abnormalities at early stages of MS even before pronounced structural and functional alterations emerge.
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Diffusion tensor imaging (DTI) allows the quantification of water diffusivity within the cerebral cortex. Alterations in cortical mean diffusivity (MD) have been suggested to reflect microstructural damage. Interestingly, microstructural changes can be detected in the absence of macrostructural alterations such as cortical thinning or gray matter volume loss. ⋯ Importantly, microstructural damage significantly correlated with cognitive performance and biomarker measures, suggesting a potential role for its use in clinical trials as a sensitive imaging marker of neurodegeneration. Given that DTI is a widely available imaging modality, these encouraging results motivate further research using this novel neuroimaging metric in other clinical contexts. Overall, this technique has shed light into the key role of early cortical degeneration in many diseases where cortical involvement was previously thought to have limited clinical and biological significance.
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People with human immunodeficiency virus (HIV; PWH) present a complex array of immunologic and medical disorders that impact brain structure and metabolism, complicating the interpretation of neuroimaging. This pilot study of well-characterized multi-morbid PWH examined how medical and immunologic factors predicted brain characteristics on proton MR spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI). ⋯ 1H-MRS neurometabolites were most often predicted by immunologic factors sensitive to temporal variation, whereas DWI metrics were more often related to longer-term disease state. In multi-morbid cART-era populations, selection and interpretation of neuroimaging modalities should account for complex temporal and pathogenetic influences of immunologic abnormality, disease state, and aging.