MRA morphologic study of the vertebrobasilar artery system in patients with primary hemifacial spasm.

Morphological characteristics of the vertebrobasilar artery system in patients with hemifacial spasm and measurement of bending length for evaluation of tortuosity

To investigate the risk of cardiovascular disease by measuring carotid intima-media thickness (CIMT) and to evaluate the diameters and blood flow volume of vertebral arteries using Doppler ultrasound and the possible contribution of hyperandrogenemia that exists in these patients. We prospectively studied 64 Caucasian women aged 18-35 years (31 with polycystic ovary syndrome [PCOS] and 33 healthy controls). Patients were classified according to body mass index into obese (BMI > 27 kg/m(2) ). All subjects were examined with ultrasound to measure CIMT and blood flow volume and diameters of vertebral arteries. A significant difference between the two groups in CIMT (0.51 ± 0.08 vs 0.39 ± 0.02 mm, P < 0.001) and diameters of vertebral arteries (right, 3.03 ± 0.37 vs 3.44 ± 0.68 mm and left, 2.94 ± 0.34 vs 3.33 ± 0.63 mm, P < 0.05) were found, respectively. Right-left and total flow volumes of the vertebral arteries (VA) were significantly lower in the PCOS group than in the control group (P ≤ 0.001). Compared to the control group, diameters of right and left VA decreased (P < 0.05). The results of this study suggest that hyperandrogenemia in obese PCOS patients affects carotid and vertebro-basilar system arteries wall thickness. Pre-atherosclerotic vascular impairment with androgen excess should determine early examination of vertebro-basilar system with ultrasound. All patients with PCOS must be routinely examined using color Doppler ultrasound to measure CIMT carotid and vertebro-basilar arteries, and diameters and blood flow volume of vertebral arteries.

The aim of this study is the evaluation of the vertebrobasilar artery system in patients with Behçet's and Neuro-Behçet's disease. For this aim; 20 adults with clinically diagnosed Behcet's disease, 20 adults with Neuro-Behçet's disease, and 19 age- and gender-matched controls were examined by magnetic resonance angiography (MRA). During MRA, diameters of left vertebral artery (LVA), right vertebral artery (RVA), basilar artery (BA), and proximal segment (P1) of posterior cerebral artery between origin and junction with the posterior communicating artery were measured. In all groups, LVA was dominant than RVA (P < 0.05). The diameters of BA and right P1 of Neuro-Behçet's disease were larger than the other groups (P < 0.05). In addition, the diameters of left P1 of Neuro-Behçet's disease were larger but not statistically significant. There is no difference between the groups in terms of gender. Behçet's disease can affect vascular structures; therefore vertebrobasilar artery system should be examined in patients with Behçet's and Neuro-Behçet's disease.

BackgroundAtherosclerotic plaques are often present in regions of arteries with complicated flow patterns. Vascular morphology plays important role in hemodynamics. In this study, we investigated the relationship between the geometry of the vertebrobasilar artery system and presence of basilar artery (BA) plaque.MethodsWe enrolled 290 patients with posterior circulation ischemic stroke. We distinguished four configurations of the vertebrobasilar artery: Walking, Tuning Fork, Lambda, and No Confluence. Patients were divided into multi-bending (≥ 3 bends) and oligo-bending (< 3 bends) VA groups. The diameter of the vertebral artery (VA) and the number of bends in the intracranial VA segment were assessed using three-dimensional time-of-flight magnetic resonance angiography. High-resolution magnetic resonance imaging was used to evaluate BA plaques. Logistic regression models were used to determine the relationship between the geometry type and BA plaque prevalence.ResultsAfter adjusting for sex, age, body mass index ≥ 28, hypertension, and diabetes mellitus, the Walking, Lambda, and No Confluence geometries were associated with the presence of BA plaque (all p < 0.05). Patients with multi-bending VAs in both the Walking (20/28, 71.43% vs. 6/21, 28.57%, p = 0.003) and Lambda group (19/47, 40.43% vs. 21/97, 21.65%, p = 0.018) had more plaques compared to patients with oligo-bending VAs in these groups. In the Lambda group, the difference in diameter of bilateral VAs was larger in patients with BA plaques than that in patients without BA plaques (1.4 mm [IQR: 0.9–1.6 mm] vs. 0.9 mm [IQR: 0.6–1.3 mm], p < 0.001).ConclusionsThe Walking, Lambda, and No Confluence geometry, ≥ 3 bends in the VAs, and a large diameter difference between bilateral VAs are associated with the presence of BA plaque.

BackgroundFrontal lobe injury (FLI) is related to cognitive control impairments, but the influences of FLI on the internal subprocesses of cognitive control remain unclear.AimsWe sought to identify specific biomarkers for...

To determine if extracranial venous structural and flow abnormalities exist in patients with multiple sclerosis (MS). Magnetic resonance imaging was used to assess the anatomy and function of major veins in the neck in 138 MS patients and 67 healthy controls (HC). Time-of-flight MR angiography (MRA) was used to assess stenosis while 2-dimensional phase-contrast flow quantification was used to assess flow at the C2/C3 and C5/C6 levels. Venous flow was normalized to the total arterial flow. The MS patients were divided into stenotic (ST) and nonstenotic (NST) groups based on MRA assessment, and each group was compared to the HC group in anatomy and flow. The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (P < .001). In the MS group, 72 (52%) were classified as ST while 66 (48%) were NST. In the HC group, 11 (23%) were ST while 37 (77%) were NST. The ST-MS group had lower IJV flow than both HC and NST-MS groups. After categorizing the MS population into two groups based upon anatomical stenosis, as determined from an absolute quantification of IJV cross section, clear differences in IJV flow between the ST-MS and HC samples became evident. Despite the unknown etiology of MS, abnormal venous flow was noted in a distinct group of MS patients compared to HC.

Objective To explore the relationship of vertebral artery hypoplasia (VAH) with acute posterior circulation cerebral infarction (APCCI). Methods One hundred and eighty-nine consecutive patients diagnosed as having acute cerebral infarction admitted to our hospital from March 2015 to March 2016 were enrolled in our study; retrospective analysis was performed on their clinical and radiographic data to compare the general clinical characteristics of patients with posterior circulation infarction (PCI) and anterior circulation infarction (ACI). VAH was conformed by cranial magnetic resonance angiography (MRA), vertebral artery ultrasound or cranial MRA+vertebral artery Ultrasound. The infarction lesions in VAH patients with APCCI were typed; the correlation between vertebral artery diameter’s differences and National Institute of Health stroke scale (NIHSS) scores in VAH patients with APCCI was illuminated. Results In 189 consecutive patients with acute cerebral infarction, 32 (16.93%) were with VAH; after exclusion of 8 with infarction in both anterior and posterior circulation, 90 (49.72%) were in PCI group while 91(50.28%) in the ACI group. Univariate analysis showed that statistical differences were noted between the two groups in triglyceride (TG) and VAH levels (P<0.05). In 23 patients with APCCI with VAH, brain stem infarction consisted of 9 patients (5 VAHs were ipsilateral to the infarction, 3 VAHs contralateral and one bi-VAH), cerebellum infarction consisted of one patient (ipsilateral side), thalamus infarction 10 patients (4 VAHs were ipsilateral to the infarction, and 6 VAHs contralateral), occipital lobe infarction 2 patients (one ipsilateral and one contralateral) and cerebellum with thalamus infarction one patient (the side of VAH was ipsilateral to the cerebellum and contralateral to the thalamus). After excluding one patient with bi-VAH, in 22 patients with APCCI combined with VAH, significantly positive correlation between vertebral artery diameter’s differences and NIHSS scores was noted (r=0.560, P=0.000). Conclusions It might be the best assessment standard of VAH measured by combination of transcranial MRA and vertebral ultrasound. TG and VAH may be risk factors of APCCI, and VAH could be one independent risk factor of APCCI. The side of VAH is usually ipsilateral to the brain stem and cerebellum infarction, while contralateral to the thalamus infarction in APCCI patients with VAH. Also, vertebral artery diameter’s differences are positively correlated with NIHSS scores. Key words: Vertebral artery hypoplasia; Cerebral infarction; Posterior circulation

To use structural magnetic resonance imaging (3D-MRI) to evaluate the abnormal development of the cerebral cortex in infants with global developmental delay (GDD). The GDD group includes 67 infants aged between 112 and 699 days with global developmental delay and who underwent T1-weighted MRI scans in Shanxi Children's Hospital from December 2019 to March 2022. The healthy control (HC) group includes 135 normal developing infants aged between 88 and 725 days in Shanxi Children's Hospital from September 2020 to August 2021. Whole-brain T1-weighted MRI scans were carried out with a 3.0-T magnetic resonance scanner, which was later processed using InfantSurfer to perform MR image processing and cortical surface reconstruction. Two morphological features of the cortical surface of the 68 brain regions were computed, i.e., the cortical thickness (CT) and cortical surface area (SA), and compared between the GDD and HC groups. With regard to the CT, the HC group showed a rapid decrease at first and then a slow increase after birth, and the CT of the GDD group decreased slowly and then became relatively stable. The GDD group showed bilaterally higher hemispherical average CT than those in the HC group. In detail, for the left hemisphere, except in the entorhinal and temporal poles in which the average CT values of the two brain regions were lower than those of the HC group, the CT of the 26 brain regions in the GDD group was higher than those of the HC group (p < 0.05). For the right hemisphere, the CT of the entorhinal in the GDD group was lower than that in the HC group. Otherwise, the CT of the remaining 28 brain regions was higher than those in the HC group (p < 0.05). With regard to the SA, both groups showed a rapid increase after birth till 23 months and remained quite stable afterward. The GDD group shows lower SA bilaterally than that in the HC group. In detail, SA in the GDD group was lower in most cortical regions of both hemispheres than in the HC group (p < 0.05), except for the right temporal pole and entorhinal. When testing for brain asymmetry, we found that the HC group showed obvious asymmetry of CT and SA, while only a few cortical regions in the GDD group showed asymmetry.

Structural neuroimaging changes associated with subjective cognitive decline from a clinical sample

BackgroundIt is difficult to make a precise diagnosis to distinguish patients with Major Depressive Disorder (MDD) from patients with Bipolar Depressive Disorder (current depressive episode, BD). This study will explore the difference in time perception between MDD and BD using a temporal bisection task.MethodsIn this temporal bisection task, 30 MDD patients, 30 BD patients, and 30 healthy controls (HC) had to categorize a signal duration, between 400 and 1600 milliseconds (ms), as either short or long. A repeated measurement analysis of variance with 3 (subject type) × 7 (time interval) was performed on the long response ratio with Bonferroni correction for multiple comparisons. Origin software was used to calculate the subjective bisection point (BP), difference limen (DL), and Weber ratio (WR). The Hamilton Depression Rating Scale for depression-17 was used to assess depressive symptoms in the patients.ResultsThe data showed that the interaction effect between subject type and duration was significant (F(6,498) = 4.656, p <0.001, η2p = 0.101). At 400 ms, and the long response of the MDD group was greater than HC group (p<0.017, Bonferroni-corrected). At 1200, 1400 and 1600 ms, the long response of BD group is smaller than HC group, (p<0.017, Bonferroni-corrected). The one-way ANOVA revealed significant difference among the HC, MDD and BD groups in the BP values WR values, F(2, 81) = 3.462, p = 0.036 vs. F(2, 81) = 3.311, p = 0.042. Post-hoc tests showed that the value of BP in the MDD group was less than BD group (p = 0.027) and the value of BP in the MDD group was less than HC group (p = 0.027), while there was not significant difference of BP values between BD group and HC group. The WR values in MDD group larger than the HC group (p = 0.022).LimitationsSeverity of depression not divided and analyzed according to the Hamilton Depression Rating Scale score.ConclusionThe time perception of the MDD and BD groups was different from that of the HC group, they overestimated short time periods. Compared with the BD group, the MDD group had a smaller time bisector, and these patients felt that time passed more slowly. The time sensitivity of MDD group and BD group were less than the HC group. However, there was no statistical difference in time sensitivity between the MDD and BD groups.

BackgroundThe molecular mechanisms of hepatic fibrosis (HF), closely related to autophagy, remain unclear. This study aimed to investigate autophagy characteristics in HF.MethodsGene expression profiles (GSE6764, GSE49541 and GSE84044) were downloaded, normalized, and merged. Autophagy-related differentially expressed genes (ARDEGs) were determined using the limma R package and the Wilcoxon rank sum test and then analyzed by GO, KEGG, GSEA and GSVA. The infiltration of immune cells, molecular subtypes and immune types of healthy control (HC) and HF were analyzed. Machine learning was carried out with two methods, by which, core genes were obtained. Models of liver fibrosis in vivo and in vitro were constructed to verify the expression of core genes and corresponding immune cells.ResultsA total of 69 ARDEGs were identified. Series functional cluster analysis showed that ARDEGs were significantly enriched in autophagy and immunity. Activated CD4 T cells, CD56bright natural killer cells, CD56dim natural killer cells, eosinophils, macrophages, mast cells, neutrophils, and type 17 T helper (Th17) cells showed significant differences in infiltration between HC and HF groups. Among ARDEGs, three core genes were identified, that were ATG5, RB1CC1, and PARK2. Considerable changes in the infiltration of immune cells were observed at different expression levels of the three core genes, among which the expression of RB1CC1 was significantly associated with the infiltration of macrophage, Th17 cell, natural killer cell and CD56dim natural killer cell. In the mouse liver fibrosis experiment, ATG5, RB1CC1, and PARK2 were at higher levels in HF group than those in HC group. Compared with HC group, HF group showed low positive area in F4/80, IL-17 and CD56, indicating decreased expression of macrophage, Th17 cell, natural killer cell and CD56dim natural killer cell. Meanwhile, knocking down RB1CC1 was found to inhibit the activation of hepatic stellate cells and alleviate liver fibrosis.ConclusionATG5, RB1CC1, and PARK2 are promising autophagy-related therapeutic biomarkers for HF. This is the first study to identify RB1CC1 in HF, which may promote the progression of liver fibrosis by regulating macrophage, Th17 cell, natural killer cell and CD56dim natural killer cell.

Dysfunctional processing of auditory sensory gating has generally been found in schizophrenic patients and ultra-high-risk (UHR) individuals. The aim of the study was to investigate the differences of functional interaction between brain regions and performance during the P50 sensory gating in UHR group compared with those in first-episode schizophrenia patients (FESZ) and healthy controls (HC) groups. The study included 128-channel scalp Electroencephalogram (EEG) recordings during the P50 auditory paradigm for 35 unmedicated FESZ, 30 drug-free UHR, and 40 HC. Cortical sources of scalp electrical activity were recomputed using exact low-resolution electromagnetic tomography (eLORETA), and functional brain networks were built at the source level and compared between the groups (FESZ, UHR, HC). A classifier using decision tree was designed for differentiating the three groups, which uses demographic characteristics, MATRICS Consensus Cognitive Battery parameters, behavioral features in P50 paradigm, and the measures of functional brain networks based on graph theory during P50 sensory gating. The results showed that very few brain connectivities were significantly different between FESZ and UHR groups during P50 sensory gating, and that a large number of brain connectivities were significantly different between FESZ and HC groups and between UHR and HC groups. Furthermore, the FESZ group had a stronger connection in the right superior frontal gyrus and right insula than the HC group. And the UHR group had an enhanced connection in the paracentral lobule and the middle temporal gyrus compared with the HC group. Moreover, comparison of classification analysis results showed that brain network metrics during P50 sensory gating can improve the accuracy of the classification for FESZ, UHR and HC groups. Our findings provide insight into the mechanisms of P50 suppression in schizophrenia and could potentially improve the performance of early identification and diagnosis of schizophrenia for the earliest intervention.

Patients with posterior circulation infarction underwent CT angiography and magnetic resonance angiography. Intracranial and extracranial vasculopathy was evaluated according to age group and location of stroke. Patients aged > 60 years and < 60 years had similar rates of vertebral artery dominance and vertebrobasilar artery developmental or origin anomalies. Vertebrobasilar artery stenosis or occlusion and tortuosity occurred more frequently in patients aged > 60 years than < 60 years. The rates of vertebrobasilar artery anomalies and tortuosity were high in patients with posterior circulation infarction. Vertebrobasilar artery tortuosity occurred more frequently in patients aged > 60 years, whereas vertebrobasilar artery developmental anomalies occurred with similar frequency in patients aged < 60 years and > 60 years. Patients with infarction of the brainstem or cerebellum were more likely to have vertebral artery stenosis or occlusion, basilar artery stenosis or occlusion, vertebral artery dominance or tortuosity, and basilar artery tortuosity, and patients with infarction of the thalamus, medial temporal, or occipital lobes were more likely to have stenosis or occlusion of the vertebral or basilar arteries. Vertebrobasilar artery tortuosity, vertebral artery dominance (hypoplasia), and congenital variations of the vertebrobasilar system may lead to posterior circulation infarction at different locations in different age groups.

Although the four-class system of classifying premature ejaculation (PE), including lifelong PE (LPE), acquired PE (APE), natural variable PE (NPE), and subjective PE (SPE), has existed for many years, objective classification standards in clinical practice are lacking. In this study, we sought to investigate the use of electrophysiologic parameters to assist in the classification of PE, thereby guiding subsequent treatment. From July 2023 to April 2024, 187 study participants were enrolled. For each participant, the biological sensory threshold (BST), penile sympathetic skin response (PSSR), and dorsal nerve somatosensory evoked potential (DNSEP) were recorded. The differences in the PSSR latencies (PL) and DNSEP latencies (DL), the PSSR amplitudes (PA) and DNSEP amplitudes (DA), and the BST were compared among the LPE, APE, SPE, NPE, and healthy control (HC) groups. The participants were divided into the LPE (46 cases), APE (53 cases), SPE (20 cases), NPE (33 cases), and HC (35 cases) groups. The results showed shorter latencies of the PSSR (PL) and DNSEP (DL), larger amplitudes of the PSSR (PA) and DNSEP (DL), and smaller BST in the LPE group than in the NPE, SPE, APE, and HC groups (P < .05). In addition, the larger PA and shorter PL in the APE group than in the NPE and HC groups (P < .05). However, the electrophysiological parameters were not significantly different among the NPE, SPE, and HC groups (P > .05). In addition, PL <1262.0milliseconds and DL <41.85 milliseconds were strong predictors of LPE, 1262.0milliseconds < PL <1430.0milliseconds was a predictor of APE, and PL >1430.0milliseconds suggested possible SPE or NPE. Analysis of the electrophysiological parameters of PE may be helpful for classification and treatment. No previous study, to our knowledge, has analyzed the electrophysiological parameters of the four types of PE. The main limitation is the small sample size. APE is characterized by increased sympathetic excitability, whereas LPE is characterized by increased penile sensitivity and increased sympathetic excitability. However, penile sensitivity and sympathetic excitability in SPE and NPE patients may not differ significantly from normal.

To explore the profile of changes of memory monitoring in patients with mild cognitive impairment (MCI). Rey- auditory verbal learning test (AVLT) and feeling-of-knowing (FOK) test in episodic memory (EM) and semantic memory (SM) were conducted on 30 MCI patients, 17 males and 13 females, aged (66 +/- 9), and 30 age, education level, word fluency test, and digit span-matched healthy persons as healthy control (HC) group. The EM impairment of the MCI group was (13.7 +/- 2.8), significantly higher than that of the HC group [(8.1 +/- 2.0), P < 0.01], but the SM impairment of the MCI group was (5.4 +/- 1.4), not significantly different from that of the HC group [(5.0 +/- 1.4), P > 0.05]. The EM-FOK of the MCI patients with correct judgment and false recognition was (41.8 +/- 13.2)%, significantly higher than that of the HC group [(28.1 +/- 11.6)%, P < 0.01], however, the SM-FOK levels of the MCI patients with different judgment and recognition were all not significantly different from those of the HC group (all P > 0.05). The MCI patients overestimate their memory performance on episodic FOK, but their SM monitoring is not impaired. The deficit of memory monitoring in MCI may be the foundation of subjective memory complaints and is useful for diagnosis of MCI. EM and SM monitoring may depend on different neural mechanisms.