The aim of this work was to investigate the effect of an air layer of different thicknesses on the design of high-permittivity materials (HPM) helmets for ultrahigh field (UHF) magnetic resonance imaging (MRI). We used a recently proposed analytical formulation of scattering from layered spheres to model an MRI experiment with a variable air layer between a homogenous human head and an HPM helmet. Such model expresses the fields as a superposition of progressive and regressive traveling waves by exploiting the theory of inhomogeneous transmission. Analytical results were compared with numerical simulations, in terms of changes in the radiofrequency (RF) magnetic induction field employing a surface and volume coil, to validate the proposed method. The presence of an air layer, due to differences in head size, results in a slight variation in the optimal permittivity value required to optimize the performance of the helmet, with a maximum relative variation of no more than 12%. This can be explained by the invariance of the impedance at the outer air-HPM interface, due to the high conductivity typical of biological tissues. In both cases, a clear increase in the magnetic induction field is observed, suggesting that the HPM design is robust to the introduction of a small dielectric insulating layer. Also, good agreement was found between the analytical and numerical results suggesting that the model could be employed to optimize the HPM also in real experiments, particularly when canonical geometries, such as cylindrical or spherical shapes, are employed to design the helmet.

The Individual Brain Charting project focuses on collecting functional Magnetic Resonance Imaging data across a large set of cognitive tasks from a fixed cohort of participants, within a standardized environment. This approach seeks to obtain refined cognitive phenotyping of individual brains, uncovering details of their functional organization. We present an extension to the dataset, integrating data from eleven participants obtained at 3T, from a fixed environment to minimize inter-site and inter-subject variability. This release further enriches the cumulative coverage of psychological domains, while introducing new concepts. It includes tasks on mathematical processing, spatial navigation, emotion recognition and memory, proactive control, oddball detection, reward processing, reaction time, biological motion perception, gambling, scene processing and working memory. In total, 18 tasks with 180 contrasts were added, and 54 cognitive components were included in the description of the ensuing contrasts. As the dataset becomes larger, the collection of the corresponding topographies becomes more comprehensive, leading to enhanced brain-atlasing frameworks. Aligned with open-access and data-sharing standards, this dataset emphasizes transparency and collaborative research.

In pediatric abusive head trauma (AHT), retinal hemorrhages are a key diagnostic feature. Detection by fundoscopy may be delayed or limited, whereas magnetic resonance imaging (MRI) enables non-invasive, objective assessment on routine brain sequences. To evaluate the diagnostic utility of different MRI sequences-particularly susceptibility-weighted imaging (SWI), T2*-weighted (T2*w), and morphological sequences-in detecting retinal hemorrhages in AHT. In this retrospective multicenter study (2006-2015), 57 well-documented AHT cases from three German institutions were analyzed. A subgroup consisted of "confession cases." MRI scans were reviewed for retinal hemorrhages across SWI, T2*w, T1-weighted, T2-weighted (T2w), and fluid-attenuated inversion recovery (FLAIR) sequences by blinded expert readers. Fundoscopy results served as the gold standard. Sensitivities were calculated for each sequence, and "confession" versus "non-confession" cases were compared. Fundoscopy detected retinal hemorrhages in 44 of 56 evaluable cases (78.6%). MRI identified retinal hemorrhages most frequently on gradient recalled echo sequences, with SWI showing higher sensitivity compared to T2*w (76.9% vs. 47.8%). T2w imaging showed markedly lower sensitivity (30.3%) but detected retinal hemorrhages on one eye missed on T2*w imaging in two cases. In three cases, MRI detected retinal hemorrhages not reported on fundoscopy. No statistically significant differences were found between "confession" and "non-confession" cases across all parameters considered (P>0.05). MRI-particularly SWI and, to a lesser extent, T2*w imaging-may offer a useful tool of detecting retinal hemorrhages in AHT when fundoscopy is limited. T2w imaging may provide complementary information in selected cases.

Surgical treatment of high anal fistulas is challenging and associated with a relatively high rate of complications and failure. Stem cell therapy has shown promising results for fistulas associated with Crohn's disease but remains less studied in cryptoglandular fistulas. This clinical trial is being performed to evaluate the outcome of treating complex cryptoglandular perianal fistulas (PAFs) using minimal surgical debridement combined with either non-cultured (autologous) or cultured (allogeneic) adipose-derived regenerative cells (ADRCs). The primary outcome is the clinical healing rate after 12months. Secondary outcomes include functional outcomes regarding quality of life and anal continence (measured by the 36-Item Short Form Health Survey [SF-36] and the Wexner Fecal Incontinence Score), risk factors for fistula recurrence, radiological healing assessed by magnetic resonance imaging, and comparison of autologous versus allogeneic ADRCs with respect to cell characterization, immune responses, and efficacy. This is a double-blinded, randomized interventional non-inferiority, phase I-II clinical trial using two approved investigational medicinal products. The study will be conducted at the surgical department, Odense University Hospital OUH, in Odense, Denmark. Inclusion criterion is an adult patient (≥ 18years) with complex PAF (high transsphincteric or suprasphincteric), involving more than 30% of the anal sphincter. Key exclusion criteria are ongoing suppuration, simple anal fistula, ano- or rectovaginal fistula, inflammatory bowel disease, body mass index (BMI) of < 18.5kg/m2, known allergy to penicillin or streptomycin, pregnancy, and verified syphilis, human immunodeficiency virus (HIV), or hepatitis on screening test. The primary investigator (PI) is responsible for participants' recruitment. Eligible patients will undergo 1-day surgery, including debridement of the fistula tract and closure of the internal orifice, liposuction from the anterior abdominal wall, injection of 30-40mL of autologous microfat around the fistula tract, and injection of 30 million stem cells (either autologous ADRCs or allogeneic ADRC001) according to randomization (1:1 allocation ratio). Patients who receive treatment will attend follow-up visits at 3, 6, and 12months postoperatively. Serious adverse events will be reported including large abscess formation, wound dehiscence causing fecal incontinence, sepsis, major bleeding, and serious allergic reactions. The trial has been approved by the European Medicines Agency EMA and is monitored by the Good Clinical Practice (GCP) Unit at OUH. A total of 75 patients will be included. Recruitment began in October 2024, with a planned duration of 3years. The trial intervention is designed as a minimally invasive treatment with the potential to shorten and ease recovery, enable a quicker return to daily activities and work, and avoid sphincter damage, thereby preserving function. The trial is expected to provide evidence on whether allogeneic ADRCs combined with microfat are a viable alternative to autologous ADRCs with microfat for the treatment of PAF. Clinical Trials Information System (CTIS) EU CT 2022-502659-73-01. Registered on 18 November 2023. org NCT06303752. Registered on 25 February 2024.

Leukemic infiltration of the optic nerves is an uncommon yet clinically significant manifestation of central nervous system (CNS) involvement in acute lymphoblastic leukemia (ALL). We report an adult male with B-cell ALL who developed progressive bilateral visual loss due to optic nerve infiltration and meningeal involvement, representing CNS relapse. The patient had been previously diagnosed with B-cell ALL and had discontinued therapy after induction chemotherapy. Several months later, he presented with bilateral visual loss and pain on eye movements. Ophthalmologic examination revealed bilateral optic disc edema. Magnetic resonance imaging of the brain and orbits demonstrated bilateral optic nerve thickening with postcontrast enhancement and associated leptomeningeal enhancement. Cerebrospinal fluid analysis confirmed malignant lymphoid cells, establishing CNS relapse. The patient was restarted on CNSdirected chemotherapy with partial visual improvement. This case highlights the optic nerve as a pharmacologic sanctuary site, emphasizes the importance of dedicated orbital imaging in patients with suspected CNS leukemia, and underscores the need for strict treatment compliance and long-term surveillance in ALL.

Heart failure with reduced ejection fraction (HFrEF) accounts for over half of heart failure cases and its management is directed by international clinical practice guidelines. To evaluate current recommendations, we conducted a systematic review of guidelines on the diagnosis and management of HFrEF in adults. MEDLINE and EMBASE were searched on 10 November 2024 for publications within the past decade, and websites of relevant medical societies were reviewed. Twelve guidelines were identified, of which seven met predefined AGREE II criteria for methodological 'rigour of development' and were included in the final analysis. Across the selected guidelines, there was broad consensus on the prevention of heart failure, the definition of HFrEF, and the initial diagnostic approach. Recommended investigations included coronary CT angiography, cardiac magnetic resonance imaging, and invasive coronary angiography in selected patients. There was also agreement on the principles of pharmacological management, with consistent endorsement of foundational therapies such as renin-angiotensin-aldosterone system (RAAS) inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors. However, key differences emerged regarding thresholds for serum natriuretic peptides, sequencing of RAAS inhibitors, and device-based therapies including implantable defibrillators in non-ischaemic HFrEF, cardiac resynchronization therapy, and indications for coronary revascularization. Variability was also noted in staging, particularly the identification and management of stage A (at-risk) and stage B (pre-heart failure). Only a minority of guidelines addressed common comorbidities such as iron deficiency, atrial fibrillation, obesity, sleep-disordered breathing, and frailty. Our findings underscore the need for greater harmonization to standardize and optimize HFrEF care worldwide.

Adolescence is a sensitive period for social and neural development. Empathic growth during adolescence has been linked to improved prosocial behavior in adulthood. This study examined how adolescent empathy relates to adulthood neural responses to rejection. Participants (N = 77; 42 females, 52% White) were drawn from a demographically diverse community sample and assessed annually from ages 13 to 21. Each year, participants' empathic support provision toward a close friend was evaluated during an observationally coded support task. At approximately age 24, participants completed the Cyberball social exclusion paradigm while undergoing fucntional magnetic resonance imaging (fMRI). Whole-brain exploratory analyses revealed that greater empathic support provision during adolescence was associated with reduced activation in the subgenual anterior cingulate cortex (sACC) during social exclusion in early adulthood (Cohen's d = 0.12), suggesting a contribution of empathy provision to rejection-related neural responses later in life. The effect was not driven by felt distress during social exclusion, indicating that adolescent empathic support provision is potentially associated with neural responses to social exclusion independent of subjective distress. These findings underscore the long-term links of empathy to adult social processes and may inform interventions aimed at enhancing interpersonal functioning and resilience.

In this study, we aimed to investigate the intrinsic brain activity alterations in patients with disorders of consciousness (DOC) using multidimensional resting-state functional magnetic resonance imaging (rs-fMRI) metrics at ultra-high field (7 T) MRI. We enrolled 10 patients with DOC, including those with vegetative state/unresponsive wakefulness syndrome and minimally conscious state, and 11 healthy controls (HCs). We applied various rs-fMRI metrics ranging from neuronal activity to synchronization and coordination of whole-brain activity, including amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC). Patients with DOC exhibited distinct brain activity patterns compared to HCs. The bilateral inferior temporal gyri showed enhanced activity across various metrics (right: ALFF, ReHo, DC; left: ALFF, fALFF, ReHo), while the right precuneus showed decreased activity in patients with DOC (ALFF, DC, PerAF), compared to HCs. Although an initial inverse relationship was observed between the left putamen and CRS-R total scores in DOC patients, this association did not survive multiple comparisons correction (Bonferroni-adjusted threshold: p < 0.0019). Our findings provide new insights into the neural mechanisms underlying DOC, highlighting the importance of the right precuneus and the bilateral inferior temporal gyri in consciousness level. These results can inform the development of diagnostic and therapeutic strategies for DOC.

Federally mandated breast density notifications motivate consideration of supplemental breast magnetic resonance imaging (MRI). To evaluate supplemental breast MRI strategies. Simulation of women at average to 4 times higher-than-average relative risk (RR) for breast cancer incidence undergoing screening digital breast tomosynthesis (DBT) with or without supplemental MRI. Breast Cancer Surveillance Consortium and literature. Women aged 40 years or older. Lifetime. U.S. federal payer. Screening with DBT with or without breast density-targeted MRI by starting age (40, 45, or 50 years) and interval (annual or biennial). Breast cancer deaths averted, false-positive biopsy recommendations, harm-benefit ratios, and incremental cost-effectiveness ratios (ICERs). Across all starting ages and intervals, DBT averted 7.4 to 10.5 breast cancer deaths per 1000 average-risk women screened and 23.2 to 33.6 per 1000 women with 4 times higher-than-average risk. Across all RR levels, DBT with supplemental MRI for women with extremely dense breasts (DBT+MRId) averted 0.1 to 0.8 additional breast cancer deaths and resulted in 22 to 186 additional false-positive biopsy recommendations. False-positive biopsies per breast cancer death averted for biennial DBT+MRId for women with 2 times higher-than-average risk were similar to those associated with DBT in average-risk women. For all risk groups, biennial DBT+MRId starting at age 50 years was more effective but less cost-effective than DBT starting at age 45 years. The ICERs were sensitive to cancer risk, MRI costs, and false-positive biopsy rates. Subgroups considered risk and breast density only. Supplemental MRI for women aged 40 years or older with extremely dense breasts and higher-than-average risk (RR ≥2.0) had harm-benefit ratios similar to biennial DBT alone and could be cost-effective if MRI costs and false-positive biopsy rates are reduced. National Cancer Institute.

Objectives To report a rare case of high-grade prostatic stromal sarcoma (PSS) and delineate its characteristic magnetic resonance imaging (MRI) features to facilitate early detection and accurate diagnosis. Methods A 55-year-old male presented with progressive dysuria. Preoperative multiparametric pelvic MRI was performed. The imaging findings were correlated with histopathology from a robot-assisted laparoscopic radical prostatectomy. Results MRI revealed a large, well-demarcated, encapsulated cystic-solid mass within the prostate. The solid components showed restricted diffusion. The cystic component contained multiple septations and demonstrated no diffusion restriction. An involvement nodule was identified in the right seminal vesicle. Histopathology confirmed high-grade prostatic stromal sarcoma with positive surgical margins. The patient experienced local recurrence within six months despite adjuvant chemotherapy. Conclusions Prostatic stromal sarcoma is a rare malignancy with distinct MRI features that can help differentiate it from more common prostatic neoplasms.

Knee injuries are one of the most common complaints in sports medicine. Magnetic resonance imaging is an essential adjunct to clinical evaluation for many traumatic injuries and overuse conditions. Given the heavy use of knee magnetic resonance imaging, developing faster magnetic resonance imaging acquisition methods and deployment in clinical practice would be valuable. In this article, we illustrate a spectrum of knee abnormalities from our clinical practice, utilizing a recently developed, publicly available sub-5-minute knee magnetic resonance imaging protocol with super-resolution image reconstruction based on deep learning. We review common traumatic injuries and overuse conditions of the knee and illustrate cases with this novel fast knee magnetic resonance imaging protocol.

With the introduction of andexanetalfa, a specific antidote is now available to address life-threatening bleeding associated with factor Xa inhibitors. In this study, we explore its use in an experimental model of traumatic brain injury (TBI), mimicking a closed head trauma under rivaroxaban-induced anticoagulation. Male C57BL6 mice were fed with rivaroxaban (10mg/kg body weight). Subsequently, TBI was induced by controlled cortical impact (CCI) and andexanetalfa or placebo were administered as intravenous bolus injections. Edema and hemorrhage volume was quantified by magnetic resonance imaging (MRI) 24h and 7days after CCI. Functional outcome was assessed at day 1, 3, and 7 thereafter. Andexanetalfa led to reduced hemorrhage volume 24h and 7days after CCI as compared with control group without reversal of anticoagulation (2.9 ± 1.4µl vs. 5.2 ± 3.3µl, p = 0.02; 3.4µl ± 1.5µl vs. 5.5µl ± 2.4µl, p = 0.04). Along with the smaller hematoma sizes in the MRI, edema volume was significantly lower in mice treated with andexanetalfa 24h and 7days after CCI (-6.3% of contralateral hemisphere, p = 0.0002; and -7.1% of contralateral hemisphere, p = 0.006). While functional outcomes did not differ at 24h following TBI, andexanetalfa improved neurological deficits after 7days. Our experimental data suggests that the use of andexanetalfa improves functional outcomes by reduction of factor Xa inhibitor-associated hematoma expansion in the subacute phase following TBI.

BACKGROUND The primary goal of anal fistula treatment is eradication of the fistula while preserving continence and minimizing the risk of recurrence. Although fistulotomy is effective for simple fistulas, management of complex trans-sphincteric fistulas remains challenging. Sphincter-sparing techniques show variable outcomes, with high recurrence rates and risk of incontinence. This study evaluated a hybrid technique combining core-out fistulectomy with trans-sphincteric laser ablation to improve healing while preserving sphincter function. MATERIAL AND METHODS This retrospective pilot study included 20 adult patients with magnetic resonance imaging (MRI)-confirmed trans-sphincteric fistulas ( RESULTS Twenty patients (12 males; mean age 40.5 years) underwent the procedure. The overall healing rate was 90% (18/20). Mean healing time was 6.4 weeks, with a mean follow-up of 9.9 months. Two patients experienced recurrence. No significant postoperative complications or continence disturbances were observed. The mean time to return to work was 8.9 days, and all patients resumed normal daily activities the day after surgery. CONCLUSIONS Core-out fistulectomy combined with trans-sphincteric laser ablation appears to be a safe and effective treatment for selected trans-sphincteric fistulas. Larger prospective studies with longer follow-up are needed to confirm these findings.

Bladder cancer is one of the most prevalent malignancies of the urinary system and is associated with high morbidity and mortality. With advances in medical image analysis, deep learning has shown promise for automated bladder cancer classification using magnetic resonance imaging (MRI). However, clinical deployment remains challenging due to substantial inter-center distributional discrepancies and limited feature discriminability between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). To address these challenges, we propose a Domain-Adaptive Deep Contrastive Network (DADCNet) for MRI-based bladder cancer classification. The proposed framework jointly incorporates source- and target-domain samples during feature learning to obtain domain-invariant yet discriminative representations, thereby improving cross-center generalization. In addition, a deep contrastive learning strategy is introduced to enhance inter-class separability and intra-class compactness, leading to more robust classification. Experiments conducted on a multi-center bladder cancer MRI dataset demonstrate that DADCNet consistently outperforms existing convolutional neural network- and Transformer-based methods, achieving an accuracy of 0.955, an F1-score of 0.955, and an area under the curve of 0.991.

Periosteal entrapment (PE) in displaced distal tibial Salter-Harris (S-H) II fractures is considered a risk for growth disturbances, but causality is debated. To investigate whether PE is an independent risk factor for growth disturbances in distal tibial S-H II physeal fractures and to compare the clinical efficacy of different treatment methods. Retrospective analysis of 27 patients (2015 to 2024) with distal tibial S-H II fractures and confirmed PE [magnetic resonance imaging (MRI): n=21; follow-up radiograph: n=6]. Patients received conservative treatment, closed reduction and percutaneous fixation (CR-PF), or open reduction internal fixation (ORIF). Functional outcomes were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire. Correlations (phi coefficient) and risk factors (univariable/multivariable regression) were assessed between PE and growth disturbances. Patients (19 boys and 8 girls; mean age 9.99y or younger) were followed for a mean of 22.13 months. Overall incidence of growth disturbances was 14.8%, and the difference in the proportion of growth disturbances among the 3 groups was not significant (P>0.05). No independent risk factors were identified in univariable or multivariable analysis (all P>0.05). All fractures healed, and all groups showed an excellent AOFAS score (100%) at 6 months postinjury and comparable functional recovery (all P>0.05). The only case of premature physeal closure (PPC) occurred in the ORIF group, with the bony bridge appearing at the distal tibial Kump's bump, subsequently leading to an ankle valgus deformity. PE is not independently correlated with growth disturbances following distal tibia SH II fractures, challenging the traditional mainstream view of its causal role in causing growth disturbances. In addition, the therapeutic effects of different treatment methods are comparable. Conservative treatment should be preferred when closed reduction achieves good alignment, and routine periosteal stripping may be unnecessary. Level III.

Objective.Focal therapy offers a middle ground between active surveillance and whole-gland treatment for patients with low- and intermediate-risk prostate cancer, aiming to eliminate tumor tissue while preserving surrounding structures. Among available focal therapy approaches, magnetic resonance imaging (MRI)-guided focal cryoablation offers some technical advantages, including real-time monitoring of iceball formation and intraoperative images with excellent soft-tissue contrast. Despite its minimally invasive nature, prior studies have reported postoperative urinary and sexual dysfunction, raising concerns about unintended injury to critical anatomical structures such as the external urethral sphincter (EUS) and neurovascular bundles (NVBs). However, the direct relationship between anatomical injury and postoperative symptoms remains unclear. We hypothesize that damage to the EUS or NVBs during MRI-guided focal cryoablation increases the risk of postoperative urinary or erectile dysfunction.Approach.We analyzed 402 multi-slice MRI image sets from 42 procedures. We developed an AI-assisted tool for automatic segmentation of anatomical structures and iceballs. Quantitative metrics were proposed to estimate tissue damage based on spatial overlap, exposure time, and temperature dynamics. These metrics were then statistically correlated with postoperative urinary and erectile outcomes.Main results.Significant associations were observed between injury metrics and postoperative dysfunctions, with EUS involvement predictive of urinary dysfunction in both time-based(p<0.05)and temperature-proxy models(p<0.05), and NVB involvement associated with erectile dysfunction in the time-based model(p<0.05).Significance.Our findings demonstrate that EUS and NVB injuries are quantifiable predictors of postoperative morbidity with medium-to-large effect sizes. The developed AI-assisted framework supports objective evaluation of cryo-dose and establishes a preliminary basis for a quantitative injury metric designed to minimize side effects and enhance the safety of focal cryoablation.

Duodenal diverticula are relatively common and usually asymptomatic. However, malignant transformation within these structures is exceedingly rare. The clinical presentation is often non-specific. This uncommon manifestation poses significant challenges in both diagnosis and treatment. Two cases involving patients diagnosed with duodenal diverticular carcinomas have been presented. The first case exhibited imaging characteristics consistent with an enhancing mass within a duodenal diverticular pocket, with hepatic metastasis. This case was accurately diagnosed through contrast-enhanced computed tomography (CECT). The second case involved a patient with a history of recurrent pancreatitis, who was misdiagnosed with mass-like pancreatitis based on findings from both CECT and magnetic resonance imaging (MRI). Unfortunately, both patients succumbed to their illness within two months following confirmation of the pathology. Duodenal diverticular carcinoma presents a significant diagnostic challenge due to the limited availability of medical literature. Nevertheless, early diagnosis is crucial for improving therapeutic outcomes.

Subthalamic nucleus deep brain stimulation (STN DBS) is an established treatment for advanced Parkinson's disease (PD), whereas the posterior subthalamic area (PSA) has been proposed as an alternative target for tremor-dominant cases. However, their underlying therapeutic mechanisms have not been directly compared. Leveraging the single-trajectory dual-target DBS technique, this work utilizes high-field 3.0 T resting-state functional magnetic resonance imaging data and spectral dynamic causal modeling to investigate the differential modulatory effects of PSA and STN stimulation on effective connectivity within both cortico-basal ganglia and cerebello-thalamo-cortical networks. We show that both PSA and STN stimulation suppress cortico-cerebellar connectivity and cortico-subthalamic hyperdirect connectivity, while enhancing STN self-inhibition. Compared with STN stimulation, PSA stimulation provides a greater reduction in cortico-cerebellar coupling but a greater increase in striato-STN connectivity. Moreover, changes in hyperdirect pathway coupling correlate with motor improvement in response to both PSA and STN stimulation. Furthermore, hyperdirect pathway and cerebellar connectivity were significantly associated with motor impairment and resting tremor severity, respectively, regardless of hemisphere or DBS target. Taken together, these findings suggest that PSA and STN stimulation share common network-level mechanisms but differ in their relative modulation of cortico-cerebellar pathway. The present study may offer theoretical guidance for future individualized DBS targeting in treating tremor-dominant PD.

Introduction Parkinson’s Disease (PD) is diagnosed based on motor symptoms (bradykinesia, resting tremor, rigidity); yet non-motor symptoms such as sleep abnormalities, autonomic dysfunction, and cognitive changes often precede motor signs, fulfilling the criteria for prodromal PD. How motor and non-motor symptoms emerge from dopamine depletion and whether they involve separable neural substrates remains unclear. Methods We applied correlational tractography based on multi-shell, diffusion-weighted magnetic resonance imaging in early-stage PD to assess microstructural changes throughout the brain. Eight participants with early-stage PD and 5 healthy controls underwent motor, cognitive, and mood assessments, followed by structural and multi-shell, diffusion-weighted magnetic resonance imaging. Their groupwise differences in white matter integrity associated with PD status were quantified using correlational tractography, with and without age correction. Results Correlational tractography delineated both microstructural changes that held either a significant positive or negative association with PD status, where the statistical maps of these changes linked differentially to motor and non-motor symptoms. Quantitative anisotropy (QA) extracted from positively associated fibers significantly correlated with cognitive function, while QA of negatively associated fibers correlated with motor function—independent of the effect of age. Of note, QA of positively associated fibers correlated with depressive mood only in the age-uncorrected analyses, suggesting a strong age-related effect. Conclusion In early-stage PD, motor and non-motor symptoms are mapped to anatomically distinct pathways, suggesting separable pathophysiological mechanisms. These findings further suggest that correlational tractography is appropriate to evaluate changes in structural connectivity in neurodegenerative diseases and, potentially, their therapeutic interventions.,

Obstructive rectal cancer incidentally diagnosed after a barium meal study: a case report of sequential endoscopic stenting and elective laparoscopic resection