Brain Magnetic Resonance Imaging Scans Research Articles

SynthSR: A public AI tool to turn heterogeneous clinical brain scans into high-resolution T1-weighted images for 3D morphometry.

Every year, millions of brain magnetic resonance imaging (MRI) scans are acquired in hospitals across the world. These have the potential to revolutionize our understanding of many neurological diseases, but their morphometric analysis has not yet been possible due to their anisotropic resolution. We present an artificial intelligence technique, "SynthSR," that takes clinical brain MRI scans with any MR contrast (T1, T2, etc.), orientation (axial/coronal/sagittal), and resolution and turns them into high-resolution T1 scans that are usable by virtually all existing human neuroimaging tools. We present results on segmentation, registration, and atlasing of >10,000 scans of controls and patients with brain tumors, strokes, and Alzheimer's disease. SynthSR yields morphometric results that are very highly correlated with what one would have obtained with high-resolution T1 scans. SynthSR allows sample sizes that have the potential to overcome the power limitations of prospective research studies and shed new light on the healthy and diseased human brain.

CortexODE: Learning Cortical Surface Reconstruction by Neural ODEs.

We present CortexODE, a deep learning framework for cortical surface reconstruction. CortexODE leverages neural ordinary differential equations (ODEs) to deform an input surface into a target shape by learning a diffeomorphic flow. The trajectories of the points on the surface are modeled as ODEs, where the derivatives of their coordinates are parameterized via a learnable Lipschitz-continuous deformation network. This provides theoretical guarantees for the prevention of self-intersections. CortexODE can be integrated to an automatic learning-based pipeline, which reconstructs cortical surfaces efficiently in less than 5 seconds. The pipeline utilizes a 3D U-Net to predict a white matter segmentation from brain Magnetic Resonance Imaging (MRI) scans, and further generates a signed distance function that represents an initial surface. Fast topology correction is introduced to guarantee homeomorphism to a sphere. Following the isosurface extraction step, two CortexODE models are trained to deform the initial surface to white matter and pial surfaces respectively. The proposed pipeline is evaluated on large-scale neuroimage datasets in various age groups including neonates (25-45 weeks), young adults (22-36 years) and elderly subjects (55-90 years). Our experiments demonstrate that the CortexODE-based pipeline can achieve less than 0.2mm average geometric error while being orders of magnitude faster compared to conventional processing pipelines.

Abstract TP22: Temporal Lobe Involvement In Cerebral Amyloid Angiopathy Related Inflammation Is Associated With Relapse Of Inflammation And Rapidly Progressive Cognitive Decline

Introduction: Cerebral Amyloid Angiopathy related inflammation (CAARI) is an autoimmune cause of rapidly progressive cognitive decline. Little is known about the magnetic resonance imaging (MRI) brain features associated with relapse of CAARI and the effect of treatment on relapse rates therefore we sought to study this. Methods: In this single center prospective cohort study, we analyzed MRI brain scans of 22 patients with CAARI followed at the Cleveland Clinic Cerebrovascular Center between September 2019 and July 2022. We divided patterns of edema on T2 FLAIR imaging into focal, multifocal or diffuse and assessed for temporal lobe involvement (TLI). We analyzed hemosiderin sensitive sequences for the pattern of CAA including cerebral microbleeds (CMB), macrohemorrhage (MH) and/or cortical superficial siderosis (cSS). We collected data on clinical features, treatment duration and cognition after treatment. Relapse was defined as recurrence of edema on T2 FLAIR with cognitive decline or seizure. We report percentages of each clinical feature, imaging pattern and treatment effect on relapse rates. Results: Median age was 74 (35% male, 75% White). Progressive cognitive decline (68%) and seizures (68%) were common but headaches (27.2%) occurred less frequently. Most common CAA features were asymmetric CMB (100%), followed by MH (45%) and cSS (22.7%). The most common pattern of cerebral edema was multifocal (50%), followed by focal (31.8%) and diffuse (27.2%). TLI was seen in 17 (77%) patients. 21 (95.4%) patients were treated with prednisone for median (Q1, Q3) duration of 20 (12, 24) weeks whereas 5 (22.7%) were treated with long term mycophenolate. A total of 6 (27.2%) relapses were seen during a median (Q1, Q3) follow up period of 14 (7, 21) months and occurred at a median (Q1, Q3) of 5.5 (5.12, 5.5) months after stopping steroids. Amongst those who relapsed, none were on mycophenolate, 4 (66.6%) had diffuse edema, 2 (33.4%) had focal edema and all had asymmetric CMB and TLI. No relapses were seen after initiating mycophenolate. Conclusion: Asymmetric CMBs, diffuse or focal cerebral edema with temporal lobe involvement and not being on steroid sparing therapy were associated with relapse of CAARI and rapidly progressive cognitive decline.

Longitudinal changes in global structural brain connectivity and cognitive performance in former hospitalized COVID-19 survivors: an exploratory study

BackgroundLong-term sequelae of COVID-19 can result in reduced functionality of the central nervous system and substandard quality of life. Gaining insight into the recovery trajectory of admitted COVID-19 patients on their cognitive performance and global structural brain connectivity may allow a better understanding of the diseases' relevance.ObjectivesTo assess whole-brain structural connectivity in former non-intensive-care unit (ICU)- and ICU-admitted COVID-19 survivors over 2 months following hospital discharge and correlate structural connectivity measures to cognitive performance.MethodsParticipants underwent Magnetic Resonance Imaging brain scans and a cognitive test battery after hospital discharge to evaluate structural connectivity and cognitive performance. Multilevel models were constructed for each graph measure and cognitive test, assessing the groups' influence, time since discharge, and interactions. Linear regression models estimated whether the graph measurements affected cognitive measures and whether they differed between ICU and non-ICU patients.ResultsSix former ICU and six non-ICU patients completed the study. Across the various graph measures, the characteristic path length decreased over time (β = 0.97, p = 0.006). We detected no group-level effects (β = 1.07, p = 0.442) nor interaction effects (β = 1.02, p = 0.220). Cognitive performance improved for both non-ICU and ICU COVID-19 survivors on four out of seven cognitive tests 2 months later (p < 0.05).ConclusionAdverse effects of COVID-19 on brain functioning and structure abate over time. These results should be supported by future research including larger sample sizes, matched control groups of healthy non-infected individuals, and more extended follow-up periods.

Compare of Brain Anomalies and Psychopathology of Patients in a Psychiatric Clinic: A Retrospective Study

Background: In parallel with the development of neuroimaging methods, become increasingly possible to explore the relationship between mental disorders and structural brain lesions. It is aimed to examine the relationship between the clinicalfeatures and psychopathologies of psychiatric patients and their anomalies. Methods: Two hundred-six female patients who were treated in Clinic of Psychiatry, Rize Training and Research Hospital between01/Jan/2016 and 31/Dec/2021 and had brain magnetic resonance imaging (MRI) were included in this study. Sociodemographic and clinical characteristics data form was recorded for each patient. Simultaneously, the size and location of the anomalies were recorded by scanning the brain MRI. Results: When the brain MRI scans of the patients were evaluated, 56% of 206 patients had at least one of the related anomalies. Enlarged Virchow-Robin space (VRS) in 2.4%, mega cisterna magna (MCM) in 14.6%, total empty sella (ES) in 8.3%, partial ES in 27.7%, cavum vergae (CV) in 1.9%, hippocampal remnant cyst (HRC) in 17%and 6.8% had arachnoid cyst (AC) findings. When the sociodemographic data and clinical characteristics of the patients were compared with the brain MRI findings, a significant correlation was found between the presence of MCM and the use of antidepressant medication (p=0.026). A significant correlation was found between the presenceof AC, disease duration and regular treatment history (p=0.0002). No significant correlation was found between otherdata and MRI (p&gt;0.05). Conclusions: In our study, it is noteworthy that a higher rate of anomaly was detected in brain imaging of caseswith a history of psychiatric diagnosisand treatment comparedto the general population.

Improved Prediction of Amyloid-β and Tau Burden Using Hippocampal Surface Multivariate Morphometry Statistics and Sparse Coding.

Amyloid-β (Aβ) plaques and tau protein tangles in the brain are the defining 'A' and 'T' hallmarks of Alzheimer's disease (AD), and together with structural atrophy detectable on brain magnetic resonance imaging (MRI) scans as one of the neurodegenerative ('N') biomarkers comprise the "ATN framework" of AD. Current methods to detect Aβ/tau pathology include cerebrospinal fluid (invasive), positron emission tomography (PET; costly and not widely available), and blood-based biomarkers (promising but mainly still in development). To develop a non-invasive and widely available structural MRI-based framework to quantitatively predict the amyloid and tau measurements. With MRI-based hippocampal multivariate morphometry statistics (MMS) features, we apply our Patch Analysis-based Surface Correntropy-induced Sparse coding and max-pooling (PASCS-MP) method combined with the ridge regression model to individual amyloid/tau measure prediction. We evaluate our framework on amyloid PET/MRI and tau PET/MRI datasets from the Alzheimer's Disease Neuroimaging Initiative. Each subject has one pair consisting of a PET image and MRI scan, collected at about the same time. Experimental results suggest that amyloid/tau measurements predicted with our PASCP-MP representations are closer to the real values than the measures derived from other approaches, such as hippocampal surface area, volume, and shape morphometry features based on spherical harmonics. The MMS-based PASCP-MP is an efficient tool that can bridge hippocampal atrophy with amyloid and tau pathology and thus help assess disease burden, progression, and treatment effects.

Structural and Functional Brain Changes in Acute Takotsubo Syndrome

BackgroundTakotsubo syndrome mimics an acute myocardial infarction, typically in the aftermath of mental or physical stress. ObjectivesThe mechanism by which emotional processing in the context of stress leads to significant cardiac injury is poorly understood, so a full exploration of brain structure and function in takotsubo syndrome patients merits investigation. MethodsTwenty-five acute (<5 days) takotsubo patients and 25 control subjects were recruited into this observational cross-sectional study. Surface-based morphometry was carried out on magnetic resonance imaging (MRI) brain scans to extract cortical morphology based on volume, thickness, and surface area with the use of Freesurfer. Cortical morphology general linear models were corrected for age, sex, photoperiod, and total brain volume. Resting-state functional MRI and diffusion tensor tractography images were preprocessed and analyzed with the use of the Functional Magnetic Resonance Imaging of the Brain Diffusion Toolbox and Functional Connectivity Toolbox. ResultsThere was significantly smaller total white matter and subcortical gray matter volumes in takotsubo (P < 0.001), with smaller total brain surface area but increased total cortical thickness (both P < 0.001). Individual gray matter regions (hippocampus and others) were significantly smaller in takotsubo (P < 0.001); only thalamus and insula were larger (P < 0.001). There was significant hyperfunctional and hypofunctional connectivity in multiple areas, including thalamus-amygdala-insula and basal ganglia (P < 0.05). All structural tractography connections were increased in takotsubo (P < 0.05). ConclusionsThe authors showed smaller gray and white matter volumes driven by smaller cortical surface area, but increased cortical thickness and structural tractography connections with bidirectional changes in functional connectivity linked to emotion, language, reasoning, perception, and autonomic control. These are interventional targets in takotsubo patients’ rehabilitation.

Assessment of aortic and cerebral haemodynamics and vascular brain injury with 3 and 7 T magnetic resonance imaging in patients with aortic coarctation.

Coarctation of the aorta (CoA) is characterized by a central arteriopathy resulting in increased arterial stiffness. The condition is associated with an increased risk of stroke. We aimed to assess the aortic and cerebral haemodynamics and the presence of vascular brain injury in patients with previous surgical CoA repair. Twenty-seven patients with CoA (median age 22 years, range 12-72) and 25 age- and sex-matched controls (median age 24 years, range 12-64) underwent 3 T (heart, aorta, and brain) and 7 T (brain) magnetic resonance imaging scans. Haemodynamic parameters were measured using two-dimensional phase-contrast images of the ascending and descending aorta, internal carotid artery (ICA), basilar artery (BA), middle cerebral artery (MCA), and perforating arteries. Vascular brain injury was assessed by rating white matter hyperintensities, cortical microinfarcts, lacunes, and microbleeds. Pulse wave velocities in the aortic arch and descending aorta were increased and ascending aortic distensibility was decreased in patients with CoA vs. controls. Patients with CoA showed a higher mean flow velocity in the right ICA, left ICA, and BA and a reduced distensibility in the right ICA, BA, and left MCA. Haemodynamic parameters in the perforating arteries, total cerebral blood flow, intracranial volumes, and vascular brain injury were similar between the groups. Patients with CoA show an increased flow velocity and reduced distensibility in the aorta and proximal cerebral arteries, which suggests the presence of a generalized arteriopathy that extends into the cerebral arterial tree. No substantial vascular brain injury was observed in this relatively young CoA population, although the study was inadequately powered regarding this endpoint.

Protocol for Brain Magnetic Resonance Imaging and Extraction of Imaging-Derived Phenotypes from the China Phenobank Project.

Imaging-derived phenotypes (IDPs) have been increasingly used in population-based cohort studies in recent years. As widely reported, magnetic resonance imaging (MRI) is an important imaging modality for assessing the anatomical structure and function of the brain with high resolution and excellent soft-tissue contrast. The purpose of this article was to describe the imaging protocol of the brain MRI in the China Phenobank Project (CHPP). Each participant underwent a 30-min brain MRI scan as part of a 2-h whole-body imaging protocol in CHPP. The brain imaging sequences included T1-magnetization that prepared rapid gradient echo, T2 fluid-attenuated inversion-recovery, magnetic resonance angiography, diffusion MRI, and resting-state functional MRI. The detailed descriptions of image acquisition, interpretation, and post-processing were provided in this article. The measured IDPs included volumes of brain subregions, cerebral vessel geometrical parameters, microstructural tracts, and function connectivity metrics.

Developing a PET normal brain template using diffusion tensor imaging images: A proof of concept

Background: Registered Positron emission tomography (PET) brain images to the standard normal PET brain templates can be performed to diagnosis dementia by using a vendor software, in which the brain template is based on T1-Weighted (T1W) images. However, the imperfection of an overlap between PET images and the PET-T1W based brain template could be observed. Objectives: This pilot study aimed to develop a new PET brain template and compare the accuracy of image registration between a conventional PET-T1W based brain template and our proposed PET-DTI based brain template. Materials and methods: The new PET-DTI based brain template was developed from twenty-four normal volunteers (age ranged 42-79 years old) who underwent 11C-Pittsburgh compound B PET scans and both T1W and diffusion tensor image (DTI) magnetic resonance imaging brain scans. The correction of Eddy-Current distortions and related artifact removing in DTI images were performed using the open-source FMRIB Software Library (FSL) to generate whole-brain probabilistic tractography maps (MRI-Probtract). MRI-Probtract map was then deformably registered and normalized to PET images, which were used for brain boundary guidance. The accuracy of image registration was assessed by applying the newly developed PET-DTI brain template to PET images of four mild cognitive impairment patients who underwent the same brain-scanning protocols. The accuracy of image registrations using the conventional PET-T1 and PET-DTI templates was evaluated qualitatively by three nuclear medicine physicians. Wilcoxon Signed Ranks test was used to compare registration scores of the two methods. Additionally, the dice similarly coefficient was obtained to quantitatively evaluate the accuracy of image registration. Results: The registration scores of the PET images registered with the PET-DTI template were significantly higher than the PET-T1 template at p-value &lt; 0.05. This result is consistent with the dice similarly coefficient where the value of PET-DTI template was higher. Conclusion: Result of this pilot study showed that new PET-DTI brain template provides higher registration quality, suggesting the feasibility of using PET-DTI template in a clinical PET study of the brain.

Temporal trends in the incidence of malignant and nonmalignant primary brain and central nervous system tumors by the method of diagnosis in England, 1993-2017.

Several studies report increases in the incidences of primary central nervous system (CNS) tumors. The reasons for this are unclear. Data on all 188 340 individuals diagnosed with a primary CNS tumor in England (1993-2017) were obtained from the National Cancer Registration and Analysis Service. Data on all computerized tomography (CT) head and magnetic resonance imaging (MRI) brain scans in England (2013-2017) were obtained from the National Health Service Digital. Age-sex-standardized annual incidence rates per 100 000 population (ASR) were calculated by calendar year, tumor behavior, tumor location, and method of diagnosis. Temporal trends were quantified using average annual percent change (AAPC). The ASR for all CNS tumors increased from 13.0 in 1993 to 18.6 in 2017 (AAPC: +1.5%, 95% CI: 1.3, 1.7). The ASR for malignant tumors (52% overall) remained stable (AAPC: +0.5%, 95% CI: -0.2, 1.3), while benign tumors (37% overall) increased (AAPC: +2.6%, 95% CI: 1.2, 4.0). Among the 66% of benign tumors that were microscopically confirmed, the ASR increased modestly (AAPC: +1.3%, 95% CI: 0.5, 2.1). However, among the 25% of benign tumors that were radiographically confirmed, the ASR increased substantially (AAPC: 10.2%, 95% CI: 7.9, 12.5), principally driven by large increases in those who are aged 65+ years. The rate of CT head scans in Accident & Emergency (A&E) increased during 2013-2017, with especially large increases in 65-84 and 85+-year-olds (AAPCs: +18.4% and +22.5%). Increases in CNS tumor incidence in England are largely attributable to the greater detection of benign tumors. This could be the result of the increasing use of neuroimaging, particularly CT head scans in A&E in people who are aged 65+ years.

Association between Migraine Patterns and White Matter Hyperintensities in MRI Brain: A Cross-sectional Analytical Study

Introduction: Migraine is a neurological condition characterised by recurrent episodes of headaches. The role of Magnetic Resonance Imaging (MRI) as a diagnostic tool in evaluating migraines is yet to be fully understood. Changes that occur in the blood vessels during a migraine attack lead to hypoperfusion in the brain, causing neurovascular dysfunction and cortical spreading depression. These events are manifested as White Matter Hyperintensities (WMHs) in brain MRI. Aim: To determine the association between migraine patterns and WMHs in the MRI brain scans. Materials and Methods: A cross-sectional analytical study was conducted at Department of Neurology, Mar Baselios Medical Mission Hospital, a tertiary care centre for Neurology and Movement disorders in South India, from June 2021 to June 2022. The study included 100 patients aged between 18 and 50 years who had been diagnosed with migraine. A questionnaire was prepared, which included various parameters such as the presence or absence of aura, duration, frequency, tolerability, disability, intensity of pain, nausea, and resistance to treatment. The severity of migraine in the patients was evaluated using the Migraine Intensity and Severity Evaluation (MIGSEV) scale, which considers parameters such as pain intensity, attack duration, nausea, disability, tolerability, treatment resistance, and attack frequency. Based on this assessment, patients were classified into Grade I, II, or III. After obtaining informed consent, MRI brain scans were performed on all patients. Patients exhibiting WMHs underwent Gadolinium IV contrast, and those with contrast-enhancing lesions underwent whole spine screening and CSF analysis testing. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for data analysis. The statistical tests employed included the MannWhitney test, Kruskal-Wallis test and Spearman coefficient. Results: The mean age of the participants was 28.60±7.0 years. WMHs were present in 47 out of 100 patients (47%). A significant association was observed between WMHs and aura (U=487.50) (p-value&lt;0.001). Multivariate analysis revealed that migraine severity grade, pain intensity during the attack, nausea, disability, tolerability, migraine duration, and resistance to treatment were statistically significant with a p-value of &lt;0.001. Conclusion: WMHs in MRI were more significant in patients with Grade III MIGSEV scores. There was a statistically significant association between the number of WMHs, high intensity of pain, vomiting, severe disability, and tolerability during a migraine attack. Therefore, these parameters can be considered as risk factors for developing WMHs in the brain MRI of migraine patients.

Morphometric Analysis of Lateral Ventricles of the Brain using Magnetic Resonance Imaging and Dissection Method: A Cross-sectional Study

Introduction: The lateral ventricle, which is the largest among all ventricles of the brain, can be divided into the frontal horn, body, posterior horn, and inferior horn. Various methodologies may produce different results in measuring the length of the lateral ventricle. Aim: To determine whether there are any differences in the lengths of the lateral ventricle when measured using formalin-fixed brain specimens and Magnetic Resonance Imaging (MRI) scans. Materials and Methods: This cross-sectional study was conducted from April 2014 to March 2019 in the Department of Anatomy at Silchar Medical College and Hospital, Assam, India. A total of 127 formalin-fixed cadaveric brain specimens were used to measure the lengths of different parts of the lateral ventricle using a Vernier Calliper. Additionally, MRI scans of 35 patients were used to measure the same lengths. The mean values of the lateral ventricle lengths measured in formalin-fixed brain specimens and MRI scans were compared using Student’s t-test to determine statistical significance. Furthermore, variations in the lengths of the lateral ventricle according to age and gender were also measured using MRI. Results: Among the 127 brain specimens, 78 were from male brains and 49 were from female brains. Out of the 35 MRI scans, 23 were from male cases and 12 were from female cases. The average length of the frontal horn, body, and inferior horn was found to be greater in MRI scans (34.83 mm, 54.37 mm, and 51.09 mm, respectively) compared to the dissection method in cadavers (30.64 mm, 35.49 mm, and 42.29 mm, respectively). All parts of the lateral ventricle measured in MRI scans were found to have greater lengths in males, although the difference was not statistically significant. Conclusion: A significant difference was observed when comparing the lengths of the lateral ventricle measured in MRI scans and formalin-fixed cadaveric brain specimens.

Pseudotumor cerebri in pregnant obese patient: A case report

Introduction: Pseudotumor cerebri (PTC), idiopathic intracranial hypertension, is a serious condition that is most associated with pregnancy. It is believed that symptoms are due to increased stroke volume and fluid retention ultimately increasing intracranial pressure. This increased pressure can lead to cerebral edema and dysfunction of the optic nerve fibers. The initial workup for PTC is conducting a computed tomography (CT) or magnetic resonance imaging (MRI) brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can be performed to acutely relieve the symptoms and definitively diagnose PTC; however, the definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure. Case Report: This case report discusses how a pseudotumor cerebri affected the pregnancy of a 29-year-old female who presented with headache, blurry vision with eye pain, and abdominal pain. Her pregnancy was complicated by several comorbidities. Ultrasound showed a viable intrauterine pregnancy, while an MRI without contrast of the head revealed bilateral papilledema. She was treated with acetazolamide and underwent a primary low transverse cesarean section due to fetal malpresentation and pseudotumor cerebri diagnosis. Conclusion: It is imperative that symptoms of PTC are recognized as a larger diagnosis and that imaging confirms the increased intracranial pressure. The initial workup for PTC is conducting a CT or MRI brain scan to rule out structural abnormalities that may induce a headache. A lumbar puncture can relieve the symptoms and definitively diagnose PTC. The definitive treatment is acetazolamide through the inhibition of carbonic anhydrase alleviating intracranial pressure.

Клиническое наблюдение криптококкового менингита у пациента с системной красной волчанкой

The risk of serious infectious diseases is significantly increased in individuals with systemic lupus erythematosus (SLE). The article describes a clinical case of meningoencephalitis caused by Cryptococcus neoformans, in a 33-year-old female patient with SLE. The diagnosis was based on the results of cerebrospinal fluid analysis, brain magnetic resonance imaging scans, and retrospective analysis of chest computed tomography features. The antifungal therapy comprising liposomal amphotericin B and fluconazole was used successfully. Distinctive features of this clinical case include a delayed diagnosis due to the slow development and the presence of non-specific neurological symptoms, as well as the onset of acute renal disorders amid the use of antifungal therapy. The authors discuss the issues of diagnosing infectious complications in patients with SLE, particularly fungal infections, and the up-to-date approaches to therapy of cryptococcal meningitis. The presented clinical report could help therapists and rheumatologists to improve timely recognition of cryptococcal infections in SLE patients. The authors emphasized that CSF examination plays the key role in diagnosing cryptococcal meningitis. KEYWORDS: cerebral cryptococcosis, opportunistic infection, meningoencephalitis in patients with systemic lupus erythematosus, clinical case, fungal infection, systemic lupus erythematosus. FOR CITATION: Kuzminykh D.A., Eliseev Yu.V., Matrosova M.S. et al. A clinical case of cryptococcal meningitis in patient with systemic lupus erythematosus. Russian Medical Inquiry. 2023;7(3):174–180 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-174-180.

The BrainDrugs-epilepsy study: A prospective open-label cohort precision medicine study in epilepsy

IntroductionThe BrainDrugs-Epilepsy Study is part of the established Lundbeck Foundation funded BrainDrugs research alliance (braindrugs.nru.dk). The study aims to identify biomarkers of treatment outcome as well as cognitive and psychiatric comorbidity in patients with a first epileptic seizure and epilepsy. Our goal is to provide a patient-level prediction of treatment response. MethodsIn a prospective cohort study design, we will consecutively include a total of 200 patients who have experienced their first epileptic seizure and 150 newly diagnosed patients with epilepsy (≥ 16 years old). We will systematically collect data at baseline and one, three, and five years after inclusion. Neuropsychiatric and neuropsychological assessments will be combined with electroencephalography (EEG) and neuroimaging tools such as Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) brain scans using the synaptic vesicle glycoprotein 2A-binding radioligand [11C]-UCB-J. After completing the baseline investigations, patients diagnosed with epilepsy start anti-seizure medication (ASM) treatment with either lamotrigine or levetiracetam. Patients will be monitored every three months. For daily monitoring, we will use a mobile app. Our clinical endpoints are 1) ASM treatment response, 2) development of a second seizure/epilepsy diagnosis, 3) psychiatric symptoms, 4) cognitive disturbances, and 5) quality of life. DiscussionWe hypothesize that seizures, cognitive impairment, and psychiatric symptoms share common neurobiological mechanisms that can be identified using MRI, PET, and EEG. We will assess how these biomarkers change over time and in response to treatment, providing novel insights into disease trajectories in the first years of epilepsy. Clinical trial registrationNCT05450822. Retrospectively registered July 5, 2022 (https://clinicaltrials.gov/ct2/results?term=NCT05450822&Search=Search).

Pixel’s Quantum Image Enhancement Using Quantum Calculus

The current study provides a quantum calculus-based medical image enhancement technique that dynamically chooses the spatial distribution of image pixel intensity values. The technique focuses on boosting the edges and texture of an image while leaving the smooth areas alone. The brain Magnetic Resonance Imaging (MRI) scans are used to visualize the tumors that have spread throughout the brain in order to gain a better understanding of the stage of brain cancer. Accurately detecting brain cancer is a complex challenge that the medical system faces when diagnosing the disease. To solve this issue, this research offers a quantum calculus-based MRI image enhancement as a pre-processing step for brain cancer diagnosis. The proposed image enhancement approach improves images with low gray level changes by estimating the pixel’s quantum probability. The suggested image enhancement technique is demonstrated to be robust and resistant to major quality changes on a variety of MRI scan datasets of variable quality. For MRI scans, the BRISQUE “blind/referenceless image spatial quality evaluator” and the NIQE “natural image quality evaluator” measures were 39.38 and 3.58, respectively. The proposed image enhancement model, according to the data, produces the best image quality ratings, and it may be able to aid medical experts in the diagnosis process. The experimental results were achieved using a publicly available collection of MRI scans.

Lacunes may worsen cognition but not motor function in Parkinson's disease.

As one of the imaging markers of cerebral small vessel disease, lacunes has received little attention. The objective of this study was to investigate the associations of lacunes, cognition and motor function in patients with Parkinson's disease (PD) and whether these associations are independent of other imaging markers. Patients were consecutively included from April 2019 to July 2022 in Beijing Rehabilitation Hospital. All patients underwent brain magnetic resonance imaging scans, clinical scale evaluations, and neuropsychological tests, as well as quantitative evaluation of postural control. To eliminate the possible factors contributing to cognition and motor dysfunction in patients with PD, in particular white matter hyperintensities and enlarged perivascular space in the basal ganglia, multivariate linear regression models were constructed to sort out the effect of lacunes. Ninety-four patients were included in this study, 56 without lacunes and 38 with lacunes. Patients with lacunes showed shorter disease duration, slower gait speed and spent more time on Trail-Making Test part A (TMT-A) than those without lacunes. The number of lacunes were positively correlated with the time to complete the TMT-A and negatively related to gait speed. Multivariate linear regression models showed that the presence of lacunes was associated with longer TMT-A time after adjusting for potential confounders. Lacunes were independently associated with worse visual scanning, attention, and processing speed in patients with PD. In addition, lacunes may accelerate the course of PD. Early treatment of vascular disease provides an alternate way to mitigate some motor and cognitive dysfunction in patients with PD.

CKD, Brain Atrophy, and White Matter Lesion Volume: The Japan Prospective Studies Collaboration for Aging and Dementia

Chronic kidney disease, defined by albuminuria and/or reduced estimated glomerular filtration rate (eGFR), has been reported to be associated with brain atrophy and/or higher white matter lesion volume (WMLV), but there are few large-scale population-based studies assessing this issue. This study aimed to examine the associations between the urinary albumin-creatinine ratio (UACR) and eGFR levels and brain atrophy and WMLV in a large-scale community-dwelling older population of Japanese. Population-based cross-sectional study. A total of 8,630 dementia-free community-dwelling Japanese aged greater than or equal to 65 years underwent brain magnetic resonance imaging scanning and screening examination of health status in 2016-2018. UACR and eGFR levels. The total brain volume (TBV)-to-intracranial volume (ICV) ratio (TBV/ICV), the regional brain volume-to-TBV ratio, and the WMLV-to-ICV ratio (WMLV/ICV). The associations of UACR and eGFR levels with the TBV/ICV, the regional brain volume-to-TBV ratio, and the WMLV/ICV were assessed by using an analysis of covariance. Higher UACR levels were significantly associated with lower TBV/ICV and higher geometric mean values of the WMLV/ICV (P for trend= 0.009 and <0.001, respectively). Lower eGFR levels were significantly associated with lower TBV/ICV, but not clearly associated with WMLV/ICV. In addition, higher UACR levels, but not lower eGFR, were significantly associated with lower temporal cortex volume-to-TBV ratio and lower hippocampal volume-to-TBV ratio. Cross-sectional study, misclassification of UACR or eGFR levels, generalizability to other ethnicities and younger populations, and residual confounding factors. The present study demonstrated that higher UACR was associated with brain atrophy, especially in the temporal cortex and hippocampus, and with increased WMLV. These findings suggest that chronic kidney disease is involved in the progression of morphologic brain changes associated with cognitive impairment.

The impact of cerebral small vessel disease burden and its imaging markers on gait, postural control, and cognition in Parkinson's disease.

This study aimed to investigate how cerebral small vessel disease (CSVD) burden and its imaging markers are related to alterations in different gait parameters in Parkinson's disease (PD) and whether they affect attention, information processing speed, and executive function when global mental status is relatively intact. Sixty-five PD patients were divided into the low CSVD burden group (n = 43) and the high CSVD burden group (n = 22). All patients underwent brain magnetic resonance imaging scans, clinical scale evaluations, and neuropsychological tests, as well as quantitative evaluation of gait and postural control. Multivariable linear regression models were conducted to investigate associations between CSVD burden and PD symptoms. Between-group analysis showed that the high CSVD group had worse attention, executive dysfunction, information processing speed, gait, balance, and postural control than the low CSVD group. Regression analysis revealed that greater CSVD burden was associated with poor attention, impaired executive function, and slow gait speed; white matter hyperintensity was associated with slow gait speed, decreased cadence, increased stride time, and increased stance phase time; the presence of lacune was associated only with poor attention and impaired executive function; enlarged perivascular space in the basal ganglia was associated with gait speed. CSVD burden may worsen gait, postural control, attention, and executive function in patients with PD, and different imaging markers play different roles. Early management of vascular risks and treatment of vascular diseases provide an alternate way to mitigate some motor and cognitive dysfunction in PD.